PT 5

Game Changer - The 4K score for Tests for Advanced Cancer

REFERENCES:

1)  4Kscore brochure v2 9.5.14, “The only bloos test that accurately identifies risk for aggressive prostate cancer”, 2015

First of all, a little background on myself and you’ll see why my doctor thought it was appropriate for me to get a 4Kscore done:

CAUTION: If you have prostate cancer or a high PSA, please discuss any changes with your physician first.  I am simply relating MY experience and giving you some good topics to discuss with your physician.

Basically, I was very happy with the progress I had made.  My PSA had come down and by all indications I simply had some sort of irritation and inflammation of the prostate and no prostate cancer.  By the way, I was tested for the standard bacterial prostatitis and it came back negative.

Now fast forward to last month (8/2015) when I pulled my PSA for a urological checkup:  it had crept up to 2.9.  Of course, that was quite stressful, most because I envisioned having to go off of TRT again.  My urologist also interpreted it as me having a “steadily rising PSA, because my last PSA with his office was 2.4.  Fortunately, he did not want to immediately order a biopsy, which is not a fun procedure – just trust me. Why did he not order a biopsy?  Because he now had the 4Kscore!

Basically, when your PSA rises it can be from one of five reasons:

1.  Inflammation from Unknown Causes.  (This is the most common reason.)

2.  Bacterial Prostatis.  (Quite common.

3.  BPH (enlarged prostate).

4. Low Grade Prostate Cancer.  (This is very common.  About half of middle-aged men have small prostate cancer nodules, due to the vulnerability of the prostate a Western lifestyle.

5.  Advanced (Aggressive) Prostate Cancer.

Now #1-4 should be taken seriously.  Obviously, none of these are good for your long term health.  However, none of them are likely to kill or incapacitate you immediately.  There is even evidence in my opinion that a man regress low grade prostate cancer and here is a strory that likely illustrates that: A Prostate Cancer Cure.   In fact, I would argue that #1 through 4 can usually be regressed through lifestyle changes and possibly adding a few supplements.

However, with #5 that is NOT the case, or at least we cannot assume that at this point.  Advanced prostate cancer is aggressive and can metasticize easily.  And, once it does that, you are suddenly in a life and death situation.  I have talked to several men on the forum who have had high PSA’s, and all of them have stories from their doctors of men dying within just a couple of months from this situation.

How common is #5.  Here is a fact right off 4Kscore’s patient information sheet: “Did you know that of the one million prostate biopsies performed each year only 20% are found to show life-threatening cancer?” [1] So only roughly a fifth of men with elevated PSA are in a true life and death situation.

The problem is that #5 is so difficult to diagnose.  Standard biopsies can miss the cancer.  There are other methods to look at the prostate, but none of them are perfect in detecting prostate cancer.  This is where the 4Kscore comes in. Again, this is straight from 4Kscore informational brochure:  “The test is 94% accurate in detecting aggressive cancer.” [1]

Nice!  So now if you have a rising PSA, you can check with reasonable accuracy to see if you have a very serious situation.  Your doctor can then order a saturation core biopsy – some of the more avant garde urologists no longer believe in these however – and really look for the prostate cancer.  And, if they find it, you can come up with a plan.

To my urologist’s credit, he offered for me to do a free 4Kscore and had some free samples of the same.  Remember that he makes good money off of doing biopsies and the 4Kscore can potentially eliminate between 30 and 58% of prostate biopsies. [1] Therefore, doing a 4Kscore is not really in his long term financial interest, so kudos to him for putting ethics ahead of cash.

The 4Kscore test was a pretty easy blood draw by the way.  Basically, you show up at the lab (Sonoran Quest in my case) with a frozen freezer pack and the rest of the items in the “kit” supplied by the manufacturer (OPKO Lab).  The lab then sends your blood sample off for evaluation and you get the results in about a week.

So what happened in my case?  I actually received very good news.  According to the lab report:

“The patient’s 4Kscore Test result is 2%. At a 4Kscore Test result of 2%, about 1 in 50 men biopsied would have high-grade prostate cancer.”

“Based on your 4Kscore Test result, your probablity for having an aggressive prostate cancer Gleason Score of 7 or higher is 2%. This means that if 100 men the same4Kscore Test result were to have a prostate biopsy, 2 out of the 100 have a finding of aggressive prostate cancer upon biopsy.”

So that’s about as good of news as one could expect, and my doctor wrote the following on the report: “No need to biopsy at the time.” Woo hoo!

In the meantime, I have resumed taking some anti-inflammatory supplements and consume an anti-cancer diet just to play it safe

Below is how the lab report looks for those interested.  My apologies for the lack of clarity, but this is how I received the fax:

NOTE: There is an older and less accurate test called the PCA3, which I covered here: The PCA3 Test.

HRT: Did It Raise Your Hemoglobin, Hematocrit?.

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

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:

Painkillers are the Sex Life Killers: Here are some Natural Solutions

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

10)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

REFERENCES:

Heart and Penis - Peak Testosterone

Steven Lamm, M.D., in his excellent book, The Hardness Factor,  likes to say, “The heart and the penis are one“. Is he exagerrating?  Not in the slightest and all of us males should consider that many of the leading risk factors for cardiovascular disease are also risk factors for erectile dysfunction and impotence, including hypertension (or high blood pressure), metabolic syndrome, LDL, being overweight, depression and so on.

The point is really obvious when you stop to think about it, because a lot of heart disease has to do with endothelial function – the endothelium is the delicate lining of your veins and arteries – and endothelial function is ground zero for erections.  Having a healthy, youthful endothelium is critical for our sex lives and a plaque-filled, damaged endothelium is not going to help supply blood to the arteries of your penis.

In fact, for the majority of you that made it to this site, it took you decades of putting your body through physiological hell to get where you are at.  Erectile dysfunction is generally heart-related and now you need to repair your endothelium, especially the ones in the groin area!  This page and my page on How to Repair Your Erectile Dysfunction is where I show you how.

Remember that the arteries that supply your heart are larger than the ones that supply your penis and, therefore, which is why penile arteries and veins often show symptoms first.  Erectile Dysfunction is usually a Shot Across Your Bow, a warning of impending heart disease, so you should definitely take it very seriously. Several studies have shown that, at least for diabetics and those in the early stages of heart disease, erectile dysfunction about doubles your risk of a heart attack. [39]

REFERENCES::

7) Journal of the American College of Cardiology, 2006; 48(4): 715-720

11) J Biol Chem; Apr 14, 2000; 275(15):11278-83

14) Hypertension. 2006,Nutr Rev,Aug 2007,65(8 Pt 1):361-375

18) Ann Intern Med. 2001 Jun 19;134(12):1106-14

30) Brit J of Nutr,July 2003,90(1):13-20; Brit J of Nutr,2007, 97(1):67-76

34) Amer J of Clin Nutr, 1994, 60:1023S 1028S

37) JAMA, 2008, 300(24):2859-2866p>

38) Amer J of Clin Nutr, Sep 2008, 88(3):651-659

40) Cochrane Database Syst Rev 2009, 4:CD006612, “Homocysteine lowering interventions for preventing cardiovascular events”

43) J of Lipid Res, 1997, 38:459-468, “Reducing saturated fat intake is associated with increased levels of LDL receptors on mononuclear cells in healthy men and women” associated with increased levels of LDL receptors on mononuclear cells in healthy men and women”

44) Amer J of Clin Nutr, Nov 2004, 80(5):1102-1103, “Saturated fat prevents coronary artery disease? An American paradox”

Furthermore, heart disease damages the delicate lining of your veins and arteries, which in turn whacks your best bedroom buddy: Nitric Oxide. Nitric Oxide is the stuff of erections. The way an erection works is both complex and simple at the same time: the lining of your blood vessels, called the endothelium, releases Nitric Oxide. Nitric Oxide in turn relaxes the veins and arteries allowing increased blood flow into the penis. This is the mechanism that Viagra, Cialis and Levitra use: they keep Nitric Oxide in your bloodstream longer.

So, generally, to improve your erectile dysfunction, you must get your endothelim back in shape and increase your Nitric Oxide output. Start now!  What are you waiting for?  You will be able to feel the improvements almost right away. Below are The Keys to Erectile Repair. It’s time for your sexual nightmare to end. It’s time to improve your erectile dysfunction and enjoy life again!

Well, there you have it. I have given you the most important points about how to greatly improve your erectile dysfunction and eliminate impotence. This is incredibly good news for most of us middle aged and beyond guys who assumed that we had hit the Ultimate Wall. And notice something else important: the research is showing you do not have to spend a fortune to heal your erectile dysfunction: it is almost all at the grocery store (and your gym)

Apnea and Erectile Dysfunction - Peak Testosterone

Apnea literally means “without breath”.  However, it might just as easily have been name “without sex”, because it is so deadly to your sex life and almost always leads to erectile dysfunction. Apnea does not kill instantly like a heart attack or painfully like cancer, but it kills nonetheless, and one of the first signs is usually your libido and erections.

And what would one expect?  Apnea repeatedly cuts off your air supply, a condition researchers call hypoxia, throughtout the night.  Apnea can cut off the air for as long as ten seconds before the sufferer awakes.  In the process, apnea obliterates your sleep pattern and sleep cycles. The disruption of your sleep produces symptoms that you would expect:  fatigue, headaches and concentration issues.

Behind the scenes, apnea is silently whacking your testosterone, which often leads to loss of libido and erectile dysfunction.  (Read my link Apnea Significantly Decreases Testosterone for more details.)  The problem is that testosterone is strongly associated with male libido and erectile strength, because the brain and penile muscles are packed with testosterone receptors.  Apnea leads to low testosterone and low testosterone will generally lead to erectile dyfunction.

However, it is not just hormones that apnea attacks:  it also decimates your REM cycles and it is during those REM cycles that men get those “morning erections”. [2] Erections during sleep are critical for the health and oxygenation of the penis and, without them, erectile dysfunction is almost a certainty.

Destroying your sleep cycle will also significantly affect your neurotransmitters and make you feel sleepy of course.  Anything that leads to fatigue or weariness or loss of alterness invariably affects libido and erectile function.  Many drugs, such as antidepressants are a classic example of this:  the “relaxation” that they bring also brings the same relaxation to your penis.  Apnea is no different: it relaxes your penis and leads to erectile dysfunction.

REFERENCES:

1) Journal of Sexual Medicine, 6(11):3147-3157, Published Online: 29 Jun 2009, “Sleep Apnea is an Independent Correlate of Erectile and Sexual Dysfunction”

2) By David Templeton, Pittsburgh Post-Gazette, Wednesday, July 05, 2006, “Men’s sleep apnea found alongside erectile problems”, https://www.post-gazette.com/pg/06186/703318-114.stm

3) Amer J of Respiratory and Critical Care Med, 2008, 178:644-650, “Erectile Dysfunction in a Murine Model of Sleep Apnea”

4) Sleep Medicine, July 2005, 6(4):333-339, “Erectile dysfunction, obstructive sleep apnea syndrome and nasal CPAP treatment”

5) Intl J of Impotence Res, Advance online publication 26 November 2009, “Erectile dysfunction in severe sleep apnea patients and response to CPAP”

That’s not the end of the story:  apnea also decrease NOS (Nitric Oxide Synthase). [3] Apnea robs you of the enzme that your body uses to make Nitric Oxide, that all important erection-boosting molecule. One animal study showed that tadalafil (Cialis) improved dramatically both erections and testosterone in cases of hypoxia, the state of oxygen deprivation associated with apnea.

All of these factors work together to make apnea a strong and independent risk factor for erectile dysfunction. [1]  In other words, apnea ranks right up there with age, heart disease, high blood pressure (hypertension), prostate surgery and diabetes and other male problems as a cause of erectile dysfunction. Think about what this says:  apnea is as hard on your sex life as all these other nasty conditions.  It’s right alongside major surgery and such relentless killers as diabetes and heart surgery and even old age!

One study found that the more severe the apnea, the more severe the erectile dysfunction.[2]  Again, look at what apnea attacks:

Is it any wonder that erectile dysfunction and apnea become one and the same with all of these key items under siege?

Is there any good news in all of this for apnea sufferers?  Are those with apnea doomed to a sexless, monastic existence?  The studies say otherwise and one study found that one month after initiation of CPAP treatment, 75% had been cured of their erectile dysfunction. [4] In fact, post-CPAP the researchers found no statistically significant differences in erectile function between the two study groups, one being with the most hypoxia, i.e. breathing disruption and the other with the least.  This is even more remarkable considering it was just one month after treatment began.

This is very similar to the result we saw in my link on Apnea and Testosterone, where testosterone can be dramatically raised with CPAP and weight loss.  For that reason, I would caution that weight loss should also be considered even if the CPAP machine yields good results. So, as usual, sound advice is to get a good doctor and drop those extra pounds.

I also recommend that you read my link on Natural Apnea Solutions. In the last ten years researchers have uncovered the fact that most apnea is actually lifestyle-related and not simple genetics or aging.

Do You Have Common Symptoms of Low Testosterone?

The answer to the above question is, in my opinion, just as important as your actual total testosterone lab reading. What are the signs and symptoms of low (or high) Male Testosterone Levels? For example, just what does low testosterone affect in us guys? The most accurate answer is “everything”!  Low testosterone effects almost every major system in the male body and has very serious long term health consequences, all of which I outline below.

Before I explain more, I have noticed that over half of all you reading this will have already had a testosterone lab reading taken and are wondering if your number is okay.  (Read this link on testosterone levels for more detailed information.) I mention this because some of you have had a doctor tell you that a very low number is okay.  The standard range that the labs and doctors will give you for total testosterone is 241-847 ng/dl.  But trust me – if you are in the 241-399 range, you will almost for sure be experiencing various symptoms of low testosterone.

There are some guys who do okay in the 400’s, but even in the 400’s most males will be struggling a little.  Again, it is possible for a male to have, for example, total testosterone of 450 ng/dl and feel just as good as a guy that has total testosterone of 700 ng/dl, but this is unlikely.  The same goes for high testosterone as well.

There are several things to keep in mind when analyzing the number:

1)  Your symptoms of low or high testosterone are just as important as the number itself.  Please, please read the symptoms below for signs of low testosterone and signs of high testosterone.  Science has just recently found out how all-important testosterone is for us males.

2)  Don’t trust one lab reading.  Testosterone readings can vary, but keep this in mind:  low testosterone levels can potentially be deadly long term.  You must take your testosterone levels dead serious. (NOTE:  Please read my link on How to Increase Your Testosterone Naturally for more information.)

3)  Your estradiol, the most abundant form of Estrogen, reading is just as important as your testosterone reading.  The normal range is usually 13-54 pg/ml, but what is also really critical is the ratio of testosterone to estradiol.  Young males have ratios of 30, 40, 50, etc.  You could have a healthy total testosterone reading of 500, but if your estradiol is 50, you are probably going to be struggling.  Read this link on Estrogen to understand why.

4)  Free Testosterone is just as critical as total testosterone.  Free testosterone is generally expressed as a percentage of your total testosterone and the standard range is 1.5%-2.5%.  Yes, that means only about 2% of your testosterone is really “free” to do all the things us males need testosterone to do. You want this above 2.0% for sure.  You should therefore read my page on How to Control and Manage Free Testosterone.

The symptoms of low testosterone usually creep up upon you slowly and quietly.  Because of this, many guys ignore their low testosterone symptoms for months or even years:  they literally get used to feeling lousy and functioning poorly.  But that can be a deadly mistake as I’ll show below.

The symptoms of low testosterone can also fool a guy because they are so ubiquitous.  By that I mean that testosterone affects EVERYTHING in the male. It affects our brain, our libido, our muscles, our blood – the list goes on and on. Of course, the number one thing in most guys’ mind is how it affects their sex life.  Low testosterone affects both libido and erectile strength to varying degrees and that obviously isn’t too good for the ol’ sex life.

However, common symptoms also include depression, mental fogginess/fuzziness, difficulty concentrating, anxiety, loss of muscle, increased weight gain, decreased facial hair and a general feeling of not caring about anything.  When you are low on testosterone, you often just don’t care about anything – you just “exist”.  Pleasure and desire can be greatly decreased affecting your career and your relationships.

Fortunately, verification of low testosterone levels is then rather simple: you go to the doctor and he does some blood work and three days later you get the results. The Official Level for low testosterone level is an abysmal 260 ng/dL and often doctors won’t diagnose you as low testosterone (hypogonadal) unless you are at or below this incredibly low figure.

But you need to realize that 260 is VERY low testosterone and is an outdated and arbitrary statistical figure. In all reality, if you’re below about 350, you will probably begin to experience long term health issues and many of the symptoms that I list below. I am mentioning this, because I get letters from guys all the time saying that their doctors say it is okay for them to have testosterone levels in the 200’s or low 300’s. If that is your situation, I encourage you to discuss the deadly long term health consequences of low testosterone that I list below for you.

If you get down to the 200’s, there’s a good chance that you won’t care about much of anything in your life, especially sex. This was verified in a study [1] from China where guys with low testosterone (average=268) were compared with guys with normal (average=553) levels.  Read the typical symptoms for the poor guys on the low side:  “89 percent of the subjects suffering from low testosterone reported a lack of energy; 79 percent reported erectile dysfunction; 70 percent reported a loss of pubic hair; and 66 percent reported a decrease in sexual endurance.. From this data, the researchers concluded that low levels of testosterone are directly related to both advanced age and diminished sex drive.”

Sadly enough, a lot of guys won’t do anything about low testosterone until they begin to experience signs and symptoms of impotence and erectile dysfunction.   Penile and pelvic floor muscles are packed with androgen receptors, i.e. your penis needs testosterone or the these muscles literally atrophy. And connective and nerve tissue can atrophy as well. That means you cannot trap the blood necessary for an erection leading to poor performance and the ensuing performance anxiety that follows.

This is true for both young and old by the way.  One study found that low testosterone is a factor in 20 percent of young men under 30 with erectile problems.  I find it to be an extremely common issue in the letters that I get from the younger guys.  [10]

Kegel Exercises can help you get these muscles back in shape, but you still need the testosterone for your brain and long term health. (You also need lots of Nitric Oxide and good blood flow.  See the Erection Repair Guide and the Erection Supplementation Guide for details.)

By the way, one recent Boston University School of Medicine study discovered that testosterone actually guards and protects the penile nerve fibers.  [2] In other words, at least in rats, low testosterone levels means nerve deterioration.  No wonder low testosterone is so related to erectile dysfunction!

So if the doc tells you a reading of 350 is fine, I have seen men do the reverse of what I tell you on this site:  for a few days prior to your blood test they try to decrease their testosterone:  eat horribly all the while you’re overtraining on little sleep. That ought to whack a good 30% off your score! But a better solution is to just get a new doctor. You want to work with someone who is not living in 80’s as far as medical knowledge and practice.

Why do I say that?  Because the symptoms of low testosterone are just plain dangerous. Low testosterone is associated with heart disease, depression [8], Metabolic Syndrome [4], diabetes [5], cognitive disorders and even osteoporosis. It is no exaggeration to say that low testosterone can be the Kiss of Death for all you male homo sapiens out there.  A 2007 study found that low testosterone was associated with increased risk of death from heart disease, cancer and all causes. [3]  So please, please do NOT accept your doctor’s opinion that testosterone in the 200’s or 300’s is okay. okay. Yes, some men do very well with their testosterone at low levels, but a big percentage will struggle. See my page on Testosterone and Mortality Rates for additional information.

One of the reasons that low testosterone is so deadly is that it somehow effects almost all of the major cardiovascular markers.  One recent large scale epidemiological study found that low testosterone men, < 250, were 1) fatter, 2) had lower HDL, 3) higher triglycerides, 4) higher blood pressure and 5) higher blood glucose. [7]  That is a deadly combination!  The low testosterone men were tracked over 18 years and it was found that they had a 40% higher death rate from all causes!

Low testosterone will also often put your relationships and career at jeopardy as well, because testosterone so strongly effects the male brain.  For example, supplemental testosterone can aid certain types of memory in men, including a) working memory, which allows you to manipulate information over brief periods of time, b) verbal memory, which helps you recall lists of words, and c) spatial memory, which helps you navigate a route, also benefit. [6] (By the way, I cover many ways that science has found to  re-build your brain on this site.  See this link on the Brain for more information about how to build your cognition and memory no matter what your age.

I should also mention that low testosterone is associated with an increased risk of Alzheimer’s Disease (AD) as well!  How’s that for an ugly symptom?  The well-known Baltimore Longitudinal Study showed this strong correlation to dementia.  Researchers are still trying to figure out why, but studies of rat brain cells found that the hormone limits the production of beta-amyloid peptides. These sticky protein fragments, thought to be a prime contributor to Alzheimer’s, build up into small, round deposits and clog the brains of people with the disease.

The hormone also may help ward off AD by directly preventing brain cell death. In studies, researchers manipulated human brain cells, sending them on a course to die. Adding doses of testosterone, however, limited the [brain] cell death.”

No wonder that low testosterone leads to depression, feeling like you’re “in a fog” and difficulties concentrating! Your libido will probably sag and you may find that you really don’t care about much of anything. Multiple studies show though libido increases in a dose dependent manner with testosterone. In other words, the more testosterone, the higher the libido. Low testosterone can even easily lead to anxiety and depression as well.  Remember:  these are not just symptoms – low testosterone effects your brain chemistry at its core.

On top of all that low testosterone men tend to be slightly sleep deprived because research has shown that low testosterone leads to poor quality sleep. [9] This is probably due to the extra adiposity (body fat) that comes from decreased muscle mass (or perhaps the alterated brain function mentioned above).  It helps to have decent testosterone to burn that fat off your midsection!

I should also mention, though, that one recent study found that many males with low testosterone, defined as < 300, were asymptomatic. In fact, that study found that almost 50% of males in the 50+ age range had no significant symptoms with low testosterone. [7] In other words, there is a significant percentage of you and your friends out there, generally in the 40+ age range, that are walking around with low testosterone and are actually not even exhibiting symptoms. However, it is still wise to pull your testosterone, because you could be a) low in estradiol or b) prediabetic, two conditions in part controlled by testosterone levels. We have had men on the forum, for example, who were experiencing bone loss and ended up with osteopenia without even realizing it.

The bottom line is that you need your testosterone.  It’s the heart and soul of the male physiology and psychology. Only you and your doctor can decide your ideal target levels, but the important thing is to have a plan for monitoring.  “But I thought it was dangerous to boost your testosterone you may ask?”  Well, there are certain issues to be aware of, and I cover those in my page on  The Potential Risks of Testosterone.

Again, the opposite can be argued forcefully as well, i.e. what is really dangerous is to NOT boost your testosterone.  Low testosterone symptoms are not just symptoms:  low testosterone levels can literally kill you (and before that probably make you miserable and impotent). So, please, get to the doctor and get tested if you have any doubt.  (And don’t be afraid to get tested again:  testosterone readings can sometimes be off.)

Low testosterone symptoms are not just symptoms: They are often signs of impending or manifested chronic disease. In other words, low testosterone levels can potentially be debilitating or even deadly (and before that probably make you miserable and impotent). So, please, get to the doctor and get tested if you have any doubt.

Testosterone is a natural substance that INCREDIBLY important to your male body and mind.  If your levels are low, testosterone supplementation is not abuse:  it’s simply getting your hormone levels back in line.  Remember:  your goal is not to be Barry Bonds with sky high testosterone levels so you can compete with other ten million dollar elite athletes. You are simply trying to get your tissue levels back reasonably close to the days of your youth.

So what do you do if you find you are low testosterone?  Well, it depends on your reading.  If you’re just a little low, say in the 400’s, you can try to raise your testosterone naturally.  I cover many ways on this site to boost testosterone, including Sex, High Testosterone Diet, Sleep and your Mind.  I also write about some of the common things that attack your testosterone such as Testosterone Lowerers, being Overweight, Overtraining and even Pesticides/Endocrine Disruptors.  You can put all these together and sometimes boost your testosterone 30% or more.

However, if you are in the low 300’s or 200’s consistently, then I recommend that you read my HRT (Testosterone Therapy) link.  You need to double or triple your testosterone levels and you’re probably not going to do that through lifestyle changes.  But do what you have to do.  Don’t leave yourself exposed to a lifetime of heart disease, depression, anxiety, diabetes, metabolic syndrome and other symptoms associated with low testosterone!

By the way, it is possible that some of your issues are from Excitotoxin damage.  Please read this link on Excitotoxins for more details.

More to come later…

REFERENCES:

1) Changgeng Yi Xue Za Zhi,Jun 2000,23(6):348-53

2) Intl J Impotence Research, 2007

3) Circulation,2007,116:2694-2701

4) J Endocrin Invest, Jun 2007,30(6):451-8; Journal Andrology, 2009, 30:10-22

5) Diabetes Care,Feb 2007,30(2):234-238

6) Saving Your Brain, Jeff Victoroff, p. 135

7) J of Clin Endocrin & Metab,2008,93(1):68-75

88) Arch Gen Psychiatry, 2008, 65[3]:283-289

9) J of Clin Endocrin & Metab, 2008, 93(7):2602-2609

10) J Sexual Med, 2008, 5(Suppl I):4-41

Low and High Testosterone SymptomsSTEP 3.  Do you have classic low testosterone symptoms?Low Testosterone SymptomsLow Testosterone: The Long Term Health ConsequencesLow Testosterone SolutionsHigh Testosterone Symptoms

Brain Mass - Peak Testosterone

We all know you can Build Muscle Mass through strength training, lifting weights and other forms of exercise.  What is much less well known is the fact that you can increase the mass of your brain through “brain exercises” as well.  In fact, it is not too far off to think of your brain as a muscle – yes, your wife and/or boss may quickly agree – that, if properly exercised can quite literally grow.  I am saying the brain “grow” or “get bigger” but, in fact, the brain actually becomes denser with more grey matter in the same area.  This is the equivalent of putting on mass as a bodybuilder because there are truly more neurons and synapses in the same unit space.

Neurophysiologists call this remarkable aspect of the brain to build (or rewire or rebuild in some cases) “plasticity”.  Examples abound, but here are a few interesting studies:

1.  London Taxi Drivers. London taxi drivers have a very demanding job in terms of visual spacial memory and processing requirements.  After all, London is a large and complex city to navigate and remember.  Studies have shown that taxi drivers have a signficantly larger-than-normal posterior hippocampus. [1] The hippocampus is best known for its involvement in memory storage, but the posterior section is used for spatial navigation. What is even stronger evidence is the fact that this relationship was dose dependent, i.e. the longer the time the person was a taxi driver, the bigger his posterior hippocampus.

2.  Mathematicians. Working mathmaticians, all professors, had their heads examined – sorry, I couldn’t resist – and were found to have several key areas of their parietal lobe enlargened over controls.  As with taxi drivers, it was dose dependent, i.e. the longer the time working as a mathematician, the bigger this part of their brain. [2]

3. Musicians.  Musical training, as we have already documented in How to Raise the IQ of Your Children, is an incredible brain builder.  One study found that professional musicians had, on average, a 130% bigger Heschl’s gyrus, which is involved in hearing and auditory processing, than non-musician controls. [3] Not 30% mind you – 130%!  Sure, well-developed biceps are nice, but wouldn’t it be nice to have almost one-and-a-half times the brain density you had before? The Broca area of musicians has also been found to be significantly larger as well. [4]

Is bigger better?  Well, we would certainly argue that that is the case when it comes to your brain.  By the way, this likely gives you more buffer during your senior years.  Research has shown that those who have developed their brain through education, etc. have a built-in reserve to protect them longer against the storms of dementia/Alzheimers. In other words, if you’ve built up your brain 20% and then lose 20% to Alzheimer’s, you’re still okay.

So drag yourself away from the television and get those brain waves oscillating.  Use it or lose it…

REFERENCES:

1) PNAS, April 11, 2000, 97 (8): 4398-4403, “Navigation-related structural change in the hippocampi of taxi drivers”

2) American Journal of Neuroradiology, Pulished ahead of print Oct 5, 2007, “Increased Gray Matter Density in the Parietal Cortex of Mathematicians: A Voxel-Based Morphology Study”

3) Nature Neuroscience, 2002, 5:688 – 694, “Morphology of Heschl’s gyrus reflects enhanced activation in the auditory cortex of musicians”

4) Neuroimage, 2002 Nov, 17(3):1613-22, “Voxel-based morphometry reveals increased gray matter density in Broca’s area in male symphony orchestra musicians”

Prozac (Fluoxetine): Frequent Testosterone Lowerer -

I had read about a Prozac-to-testosterone connection, but what he wrote really prompted me to study it in more depth:

“I ask because I’ve been doing some thinking on when things got bad for me back in February before I was diagnosed with low testosterone. It all started with insomnia that finally “snapped” into a chronic fatigue state, including moderate-high brain fog, memory, and concentration issues…Then after a week of this I went to my previous doc and got prescribed fluoxetine (Prozac), after which things went to s__t: insomnia got a lot worse, as did anxiety, I started having a leg twitch, ED, intense brain fog and concentration (I could barely read), feeling hot/flushed for short periods of time, and a few other things.”

Basically, he had a lot of apparent side effects from the Prozac and he asked if it could lower testosterone. Of course, I had no doubt that Prozac sometimes lowers testosterone, because anything that decreases the frequency of sexual intercourse and lowers dopamine will likely lower your T a little.  (For more information, see my page on Testosterone and Dopamine.) And, sure enough, I found that in the last five years a group of papers have come out showing that Prozac often negatively alters our “man juice” as I have heard it called.

Consider the following studies:

“Sperm motility and density were also significantly reduced in cauda epididymides and testes of the treated group. The weights of reproductive organs (testes, epididymides, ventral prostrate and seminal vesicle) were decreased considerably. The hormonal assay also showed significant decrease in testosterone levels and FSH levels. Testicular cell population dynamics also demonstrated a decrease in the number of both primary and secondary spermatocystes and spermatids in the treatment group.”

Does it get much worse than that?  Shrunken testes?  Sperm reductions?  This was definitely not good news.

2.  Early Studies Deny Change in Testosterone. A couple of studies even came out that said, in spite of the fact that Prozac can negatively alter libido and sexual function, there was no significant change in testosterone.  One of these was on animals [3] and one on humans. [4] However, the latter study admitted that a) their study was small, b) some patients did experience a loss in testosterone and c) that there were published case studies of testosterone reductions.

Therefore, the conclusion is that Prozac will likely negatively alter almost of your “male sexual parameters,” including testosterone, libido and fertility, especially if given enough time.  Now does this mean that you should not use an SSRI, especially considering the fact that they have been shown to be little better than placebo for mild to moderate depression?  Of course, that is something that you must discuss with your doctor.  Some men, especially those with more serious and severe depression, gain significant improvement from Prozac and other SSRI’s.  So “any port in a storm” as they say.

NOTE: See also my page on How Prozac Often Increases Prolactin, which can lower testosterone in and of itself potentially. More importantly, this will often impact libido.

However, I would discuss other options with your doctor.  Perhaps Wellbutrin (which can have nasty side effects) or some other medication will work just as well without the side effects.  You may also be able to gain substantial relief by going a more natural route.  See my page on  Natural Depression Cures  for more information.

CAUTION:  Few men realize just how serious depression is.  Depression can lead to actual brain and neuron damage:  it sets off a wave of inflammation, oxidation and (often) elevated cortisol that can literally shrivel key lobes between your ears including the hippocampus.  It’s also associated with heart disease and lowered testosterone.  (See my page on Depression In Men for more details.)  So do NOT just quit an SSRI without discussing it with your doctor first.  Furthermore, some experts believe that they are very dangerous during transitional phases, i.e. when you are starting up or stopping an SSRI or when you are switching from one SSRI to another.  Their research and clinical experience shows that this can lead to suicide and other extreme psychological behavior.

1) https://peaktestosterone.com/forum/index.php?topic=4264.0

2) Neuro Endocrinology Letters, 2007, 28(3):321-325, “Effects of long-term use of fluoxetine on fertility parameters in adult male rats”

3) Physiology & Behavior, Mar 1996, 59(3):479 485, “Male reproductive systems under chronic fluoxetine or trimipramine treatment”

4) Annals of Clin Psychiatry, 2006, 18(1):19-22, “Fluoxetine Treatment and Testosterone Levels”

5) Amer J of Psychiatry, 2010, “Treatment of Resistant Depression in Adolescents (TORDIA): Week 24 Outcomes”

6) Archives of General Psychiatry, 2010, “Recovery and Recurrence Following Treatment for Adolescent Major Depression”

7) J. Pharm. Biomed. Sci., 2012, 2(7):87-93, “The Effects of Fluoxetine Usage on the Concentration of Testosterone Hormone”

Ecstasy and Testosterone - Peak Testosterone

REFERENCES:

1) https://peaktestosterone.com/forum/index.php?topic=3342.msg34424#msg34424

2) Multidisciplanary Association for Psychadelic Studies, May 25 2010, “Ecstasy may damage brain cells, study finds”

3) https://www.myprimetime.com/health/fearless_aging/content/aweil/

4) https://www.erowid.org/chemicals/mda/mda_article1.shtml

And we have already had a couple of guys show up at the Peak Testosterone Forum with low testosterone and a history of Ecstasy usage. For example, look at what this young guy wrote:

“Drugs – I have taken ecstasy, some cocaine and amphetamines (about 15 times altogether) when I was 18-20. Smoked pot occasionally, but completely drug free in the last 4-5 years. I am currently looking at my testosterone readings – 12.69 nmol/l, which is about 373. Not that low, but still way below that I read is normal for 26 y.o. guy. Additionally, my test included some other hormones like FSH, where I got 1.11, which is below the reference of 1.5-12.4; and LH of 2.53 IU/l (1.7-8.6 ref. values). I mean, the general blood work is perfect…” [1]

Of course, it’s impossible to know if Ecstasy is really responsible for his low testosterone levels of 373 ng/dl.  It could also have been the cocaine or marijuana use as I document in my links on Testosterone and Marijuana and Cocaine and Erectile Dysfunction pages. However, the pattern fits well:  his LH and FSH are on the low side, indicating secondary hypogonadism and suppressed upstream testosterone signaling.

Now what is interesting is that physicians and researchers were hearing reports of lowered HPA function and decreased testosterone from Ecstasy when it first became popular. There was even an early research paper that looked at whether it was the Ecstasy lowering the testosterone or actually the simultaneous marijuana usage that usually is concomitant it. And the conclusion was that it was probably the marijuana.

However, as time went on, still other research clearly showed that Ecstasy could in and of itself lower T and that it can alter the entire HPA axis. And, as I will discuss below, a study from just a few years ago showed that it can permanently damage neurons, but first let’s start with a 2008 animal study on rats that showed that chronic (15-day) Ecstasy administration lowered the animals LH and FSH by about half and their testosterone even more significantly. [2] Furthermore, progesterone was suppressed which will likely lead to cortisol-related issues, including fatigue and achiness.

What is very interesting is that Ecstasy is really kind of a “fake orgasm.” “Ecstasy” is a good name for it.  It gives a “high” that is, from what I have read, somewhat like the feeling that you have post-orgasm.  Life is good and pain free and one is in love the world. The researchers above noted that it stimulates serotonin, dopamine, GABA, noradrenaline and acetycholine.  Likewise, an orgasm sends out a flood of neurotransmitters.

Of course, the clear difference is that an orgasm (in sexual intercourse at least) will generally increase testosterone, something I discuss in my link Why Sex is Good For You. In contrast, Ecstasy likely damages the brain and permanently lowers testosterone depending on how much and how often you have used it.  And that leads to the obvious question, “Why not just stick with sexual intercourse?”  It’s really hard to argue with Mother Nature, eh?

Two years later an even more sobering study came out that showed that Ecstasy probably damages brain cells. [2] Scientists noted that chronic Ecstasy users had lower levels of SERT, a transporter protein for serotonin, which indicates actual neuronal damage.  And what is downright frightening is that they found this damage in those only using Ecstasy twice per month. Even worse, as the damage occurs, users find they have to take greater and greater dosages, which likely inflicts an ever increasing amount of damage.  Now we have an explanation as to why so many young men that have been Ecstasy users are reporting low testosterone. (Cortisol levels also appear to be permanently damaged which just adds to the underlying issues.)

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

NOTE: Does Ecstasy have a higher use?  One interesting story, at least in my opinion, is the Dr. Andrew Weil endorsement of Ecstasy.  I almost always enjoy Dr. Weil’s articles and commentary and love his integrative approach of combining the best of alternative and Western (allopathic) medicines.  I think the two make a much potent and productive whole and could list many examples of that.  Dr Weil is one of the leading clinicians exemplifying this approach and my hats off to him for this.

However, one very curious thing about Dr. Weil is that he was a “60’s child” and, as a student at Harvard, actually broke the story of Timothy Leary and Richard Alpert’s experimentations with LSD. He also wrote a book a few year’s later called The Natural Mind: An Investigation of Drugs and the Higher Consciousness. [3] Ecstasy has also captivated his attention and he wrote an article called “The Love Drug” apparently that praised its abilities to put someone, including himself, in a rather sublime state of mind.

He even went so far as to write in this article that “In the right hands, MDA is quite safe. Out of hundreds of experiences with it htat I have observed, I have seen only three anxiety reactions. The medical potential of the drug is great and quite unexplored. I have noted repeatedly that people under the influence of MDA, when feeling high, centered, and free of desire, are in a state complete anergy – that is, they manifest no allergic reactions, even to allergens to which they have a lifelong sensitivity. Asthma disappears, hay fever disappears, cat allergies go away, and there are even no responses to mosquito bites. This effect is temporary and appears to be the analogue in the body of the mental experience of complete relaxation and lack of anxiety. It might be reproducible without the drug if we could learn to spend more time in that state.”

I don’t know what Dr. Weil’s current position on Ecstasy is, but I urge you to stay away from the stuff:  it’s just not worth the risk.  Remember that it seems to dramatically affect the HPA axis at relatively low dosages and frequencies.  Exactly where that cutoff is is not known and cannot be ethically determined, so you’re taking your health (and testosterone) into your own hands by experiementing wtih MDMA.

Is Sex Important for Women? - Peak Testosterone

Everyone deserves a great sex life, and the gift of sex should be available to everyone to enjoy. Unfortunately, low sexual desire is a very common problem affecting many marriages and relationships. When sex is happening and when it’s functional and pleasurable, it accounts for about 15 to 20 percent of marital satisfaction. However, experts also point out that, when it is absent from a marriage or when it is conflicted, it becomes disproportionately important, accounting for up to 70 percent of marital unhappiness.

Thus, low libido and sexual dysfunction can have a profound effect on not only one’s sex life but also one’s relationships. Stop and ask yourself if you have been struggling with any of these thoughts about sex:

Of course, there can be rather profound reasons for the above – past abuse, cheating, etc. – and quite often physical issues – diet, hormones, lifestyle, weight, etc. But sometimes it can be as simple as the fact that we have forgotten the advantages of sexual intercourse. It is easy to arrive at the point where you ask, “Why am I doing this anyway?” Well, one answer is that you are doing it for yourself – or should be at least. Don’t believe me? Well, check out these fantastic reasons a woman needs regular sexual activity:

NOTE: Peak Testosterone already has a page that on How Sex is Good for Men. However, I read that and felt that another motivational page was really necessary more from a woman’s standpoint.

1. Weight Loss. What burns 69 calories and is a lot more enjoyable than pilates or yoga? Researchers found that during the typical bedroom session, the women burned 69 calories and the man 101. [7] Of course, with a little more effort a women can compete with guys and get calorie levels up to 100 as well.

100 calories per day may not sound like much, but it translates to 10 pounds of fat per year. Most people gain weight by overeating about 100 calories per day. So, simply by adding some extra bedroom time to your day, you can likely maintain your weight. The same study also found that intensity levels on average were moderate as well, making it comparable to many other forms of exercise.

2. Keeping Committed Relationships. Some research shows that committed relationships tend to falter and in some cases break up due to lack of sex. Although rarely is “lack of sex” or “sexual incompatability” cited as the primary reason for divorce or separation, some experts see it as a major contributor. In fact, there is a term for this on the traditional side of the world: “sexless marriages.” What is the threshold for a “sexless marriage?” Would you believe ten times per year?!? That’s Gandhi territory if you ask me!

Whatever you want to call it, it’s tough going for most men and women. Professor Denise Donelley, who has studied sexless marriage extensively, states: “Are people in sexless marriages more likely to get divorced? In my studies, as well as others, people in sexless marriages report that they are more likely to have considered divorce, and that they are less happy in their marriages.  Some of our former respondents have kept in touch with me, and the happiest ones are actually those that have moved on to other partners. It may be that lack of sex is a signal that all intimacy in a marriage is over, and that both would be happier in other situations.” [4]

3. Depression. An orgasm floods you with a variety of neurotransmitters including dopamine, vasopressin, oxytocin, prolactin and many more. This would seem a fairly obvious way, in general, to renew the brain, boost mood and lessen depression. While it is somewhat of a chicken and egg thing, there is one study of college women that concluded that “the women with depressive symptoms reported more inhibited sexual arousal, more inhibited orgasm, more sexual pain problems, and less sexual satisfaction and pleasure than control participants. Novel to this study, the women with depressive symptoms reported greater desire for sexual activity alone (masturbation) than the nondepressed women.” [5]

4. Relationship Quality. What do most women want from a relationship? How about “Satisfaction, Intimacy, Trust, Passion and Love?” Most women would love a relationship that is all about those five foundational principles and researchers actually have a measure of this called the Perceived Relationship Quality Components (PRQC) Inventory. Satisfaction, intimacy, trust, passion and love are just different dimensions within this kind of survey and researchers found something very interesting:  only sexual intercourse improves these PRQC dimensions. [6] Other sexual behaviors such as oral sex and masturbation just do not do as well.

NOTE:  Several studies show similar results for men’s related issues as well, i.e. that sexual intercourse beats all other forms of intimacy. For example, one study showed that only sexual intercourse improves baseline testosterone levels in men.  See #1 in my link on How Sex is Good for Men for the study.

5. Skin. Many studies show the power of DHEA (dehydroepiandrosterone) in restoring women’s health, including mood, immunity and many other factors. And guess what is one of the best natural ways to increase DHEA? You guessed it – an orgasm! Dr. Eva Cwynar states that DHEA levels in women actually increases five times over baseline pre-orgasmic levels. [1] This is excellents news, because DHEA is excellent for the skin and has many other anti-aging properties.  Studies show that the skin improvements start at the genetic level, i.e. favorably turning on and off genes that will improve skin tone and aging. [2][3]

6. Migraine Relief. There are about three times as many female migraine sufferers as male. [8] Of course, when a migraine has begun, the last thing one thinks about is sex.  However, researchers found that over two thirds of migraine sufferers actually experienced moderate to total relief from making love! [9] This rivals many pharmaceutical solutions! (Be careful, because some experienced worsening of symptoms.)

GUEST AUTHOR:  Many thanks to Cristina C., certified Yoga Nidra Instructor, Hypnotherapist and Life Coach.

REFERENCES:

1)   https://www.sharecare.com/health/androgen-hormone/what-is-dhea

2) Steroid Biochem Mol Biol, 2008 Dec, 112(4-5):186-93, “Pangenomic changes induced by DHEA in the skin of postmenopausal women”

3) J Clin Endocrinol Metab, 2000 Oct, 85(10):3561-8, “Effects of dehydroepiandrosterone on collagen and collagenase gene expression by skin fibroblasts in culture”

4) https://well.blogs.nytimes.com/2009/06/03/when-sex-leaves-the-marriage/?_php=true&_type=blogs&_r=0 , “When Sex Leaves the Marriage, By TARA PARKER-POPE JUNE 3, 2009”

5) The Journal of Sex Research, 2002, 39(4), “Sexual functioning and self‐reported depressive symptoms among college women”

6) Journal of Sex & Marital Therapy, 2007, 33(4), “Women’s Relationship Quality is Associated with Specifically Penile-Vaginal Intercourse Orgasm and Frequency”

7) PLoS ONE, 8(10):e79342, “Energy Expenditure during Sexual Activity in Young Healthy Couples”

8) https://www.sciencedaily.com/releases/2007/08/070806094703.htm

9) Cephalalgia, Feb 19 2013, “The impact of sexual activity on idiopathic headaches: An observational study”

Niacin Dosage - Peak Testosterone

a) high triglcyerides

b) low HDL (but this takes awhile according to several reports on The Peak Testosterone Forum).

c) high counts of small LDL

High dose niacin will generally tremendously lower triglycerides, decrease LDL some and  and increase HDL. The effect is powerful enough that it can improve erectile dysfunction in some men with the above lipid problems, something I discuss in detail on my page on Niacin and Erections.

I will start with the dosages mentioned by two physicians who have actually been on the field reversing arterial plaque (atherosclerosis) with niacin.  I have what I think is an interesting page about two of these men that I call “The Plaque Reversers” here:  Doctors Regressing Atherosclerosis.  And we’ll also cover the dosage for Niaspan, the prescription timed release form.

1.  Dr. Davis. This best-selling author used niacin therapy as one of several supplements (including fish oil and Vitamin D) to reverse arterial plaque.  He is one of the three doctors that I call the “The Plaque Reversers”.  (You can read more about them here if you are interested:  Doctors Regressing Atherosclerosis.) Dr. Davis says that in his experience the no-flush niacin is next to worthless and provided almost no lipid changes whatsoever.  In his book Track Your Plaque he wrote that “doses at 1000-2000 mg are very effective, depending on your weight and some genetic factors.  Niacin is best prescribed by a doctor who has experience in dealing with the peculiar effects of niacin (most of them harmless), like feeling hot and itchy.” [1]

2. Dr. Gould.  Another physician that is one of what I call the “Plaque Reversers,” is Dr. K Lance Gould.  In his book Heal Your Heart, Dr. Gould writes:

3. Niaspan Directions. All the big pharmaceutical sites that I looked at recommended that you start with 500 mg daily of Niaspan for the first four weeks; 1,000 mg per day the next four weeks; 1,500 mg per day for the next four weeks; and plateau at 2,000 mg per day thereafter.  Note that Niaspan is timed release and immediate release is considered less liver toxic.  Please note that I am NOT pushing Niaspan but just using it as an example.  Notice the similarity with Dr. Gould’s strategy above, i.e. steadily increasing the dosage.

CONCLUSION:  Both doctors recommend rougly 1,000 mg per day (and in some cases up to 2,000 mg) of niacin in order to actually regress plaque.  Dr. Gould has a particularly appealing protocol in my opinion, because he is apparently able to avoid much of the rather disturbing flushing effects associated with it.

I am trying to avoid taking high dose niacin myself but have considered it.  My approach was going to be to first choose my ApoB Targets and HDL, LDL and Triglyceride Targets.  Actually, I have already done this step and am fairly close to all of these numbers simply by following a Low Fat Diet.. However, I would like to improve my numbers by about 10%. So I was simply going to increase my niacin dose until I achieved those goals.  I have a feeling that I would have to take signficantly less than 2 grams per day to achieve my goals.

1) Track Your Plaque, by William Davis, p. 94.

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

A Proven Testosterone Killer - Peak Testosterone

Apnea is one of the nastiest sleep disorders, because it is so disruptive.  After all, what could interfere with sleep more than having your airways and oxygen blocked off?  One study after another has rolled out showing how hard apnea is on the body and hormones are no exception.

One early study looked at just how severe the damage can be and found that apnea sufferers went from a low average testosterone of 391 to a much closer-to-normal 487 after corrective surgery. [1] That’s a jump of 25% in testosterone after their apnea was corrected!  However, a later study of guys in their 40’s, showed an astonishing 68% difference between controls and males with apnea. [2]  Regardless of the exact number, you get the idea:  apnea is devastating to your most precious hormone, testosterone.

However, there is actually a logical explanation for the difference in the two numbers above:  the first number comes from a comparison after apnea correction and the second before.  Researchers have found that guys who have had apnea for a significant amount of time are often overweight, even obese. [3]  Fat cells pump out more aromatase, which means more estrogen, and estrogen inhibits testosterone.  In other words, if you’ve built up a big spare tire during your sufferings with apnea, CPAP or other therapy cannot get you back to where you were before, because your own body is fighting against itself.

The researchers found that apnea subjects appeared more like aged subjects where LH (Luteinizing Hormone) cycles at night were increased, yet without a corresponding increase in testosterone as is experienced by younger males.  Young guys get a pulse of luteinizing hormone followed by one of testosterone and so on.  This cycle is dampened increasingly in males as they age and apnea appears to accelerate this process.

In other words, once you get your apnea corrected, you must take care to also lose any excess weight in order re-optimize your testosterone as much as possible.  The good news is that just getting treated for apnea will give you a nice jump in testosterone and then as you lose weight and control cortisol, you should increase it even further.  Studies have even verified this in obese men with a BMI of 32, which isn’t what I would even call obese by the way.  When they lost the weight, they regained their testosterone. [4]

MEN ON HRT: Apnea likely thickens the blood and raises hematocrit and hemoglobin. See my page Ways to Lower Hemoglobin for more information and some of the research.

REFERENCES:

1) Clin Endocrinol (Oxf), 1988 May ,28(5):461-70, “Reversible reproductive dysfunction in men with obstructive sleep apnoea”

2) The Journal of Clinical Endocrinology & Metabolism, 2002, 87(7):3394-3398, “Decreased Pituitary-Gonadal Secretion in Men with Obstructive Sleep Apnea”

3) Neuroendocrinology Letters No. 6, Dec 2003, 24:463-467  , “Pituitary-gonadal function in men with obstructive sleep apnea”

4) Intl J of Obesity, Nov 2000, 24(11)1433-1437, “Decreased androgen levels in massively obese men may be associated with impaired function of the gonadostat”

6) The Journal of Clinical Endocrinology & Metabolism, 2009, 94(11):4234-4242, “Hypothalamic-Pituitary-Adrenal Axis Activation in Obstructive Sleep Apnea: The Effect of Continuous Positive Airway Pressure Therapy

How Low Testosterone Can Destroy Relationships .

Let’s take an adult male with good testosterone of 600+ ng/dl and lower it with an anti-androgen. A big percentage of men will start to feel the drop in their testosterone when they hit the 400’s.  As they hit the 300’s, anxiety, mild depression and brain fog will probably start to set in.  They’ll notice their libido is down significantly and perhaps experience the beginnings of erectile dysfunction.  Morning erections will become less hard and more infrequent, often leading to venous leakage.  They may also suffer from anemia, fatigue and disturbed sleep.  Often their working and verbal memory will suffer and they will notice performance decreasing at wok. Some of the men will have low estradiol and their joints will hurt and have night sweats.

So, tell me how a guy is supposed to maintain his marriage with all of that going on! Sure, the wife may stay with him if she’s a Gandhi sort of woman.  But many won’t.  Furthermore, many women do not understand that it is hormonal.  They take it personally and assume the lack of interest is because of them.

This is why the typical response of endocrinologists to not treat low testosterone is so cruel. Besides the fact that low testosterone increases the risk for many nasty medical conditions such as diabetes and hardening of the arteries, the subject of my book Low Testosterone by the Numbers, low testosterone also will rip apart or at least jeopardize many committed relationships and marriages. Making matters worse are the unbelievably toxic responses that many endos tell their low T patients. In other page, I will relay some of the stories where endos told men suffering with very low testosterone to just use sex toys or go to a sex therapist or “get some counselling!”.”

And it’s not always endos:  our society has a very strong bias against testosterone, not realizing that testosterone is part of the glue that holds relationships together in men that want to be committed.  Now I admit that higher testosterone men have been shown in some studies to be less faithful.  However, my point is this:  a big percentage of men do not want that and want to make their marriages and relationships work in the long term and low testosterone can rip all of that apart.  So, yes, testosterone could be a tool to be used for the singles, multiple partner lifestyle.  But it can just as easily be used as a tool to greatly improve and maintain a committed relationship.

And one of our senior poster made some fantastic points that underscore this after being greatly helped himself by HRT:

“If this was a women’s health issue there would be a national organization fundraising for a cure and awareness campaign. I agree with this 100%! It’s sad, I think a lot of midlife crises and ruined marriages are a result of low T. I think a lot of “depression” is really low T and the pills obfuscate the problem resulting in all sorts of issues and early death. This is why I’m happy to share of my story with just about anyone that will listen – if I can help one guy recognize the signs early enough and seek help, that’s a huge win. If someone had educated me, the last 5 years of my life would have been very different…” [4]

As I have pointed out in other pages:  study after study has shown that the lower testosterone males are ones that are more aggressive and more likely to fight.  Why?  They feel more anxious and more on edge.

NOTE: Statistically you may know that marriage lowers testosterone. Of course, if your ultimate goal is to maximize testosterone, then a guy would conclude that marriage is not a desireable solution. However, most men feel that taking a slightly lower testosterone level is worth the

1.  Women Assume Erectile Dysfunction is Due to Boredom With Them. If a guy can’t get an erection, the women immediately assumes, “It’s me!”  Of course, the poor guy just needs some sympathy, but instead finds that he’s deeply hurt his wife or partner’s feelings.  It’s can create a vicious circle and is something that really requires a lot of communication.  However, many men are weak (or embarrassed) about discussing the subject, and the woman walks away thinking her man is just not interested any more.  Check out this post as an example:

“When signs of ED during relations showed up, she thought it was her, I thought it was me until I went and got bloodwork. Now with it being addressed, all is well thus.”

CAUTION:  HRT is not for everyone.  There are some patients with clotting disorders, kidney issues, hypertension and certain other medical conditions where it may not be appropriate.  Discuss with your physician.

2.  Women Take Low Libido Personally. One of our senior posters noted that that his close friends broke apart due to the man’s complete lack of interest.  Again, a guy who has a low libido due to low testosterone will very likely be apathetic, anxious, depressed and about as romantic as a rock.  How long can one’s partner handle that?

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

“Our good friends are going to split and it is my guess that the underlying cause is due to low T. The husband went to my doc and was given Axiron and has not used it. They are just so far gone that it is too late for them. The wife is miserable after many years and wants a shot at happiness. The husband seems very foggy all the time. They have not had a sex life for many years. It’s just a mess. Very unfortunate…I had a confidential conversation with him last year and found out that he has basically no sex drive. I told him about my experiences and how the pellets really turned things around for me.He did see my doc, but I didn’t want to be overly nosy, etc. He never brought it up again. His wife told my wife that things are bad and that he didn’t apply the Axiron, etc. She is just done. Think it’s too late for them.” [1]

3. Low T Impacts The Mental and Emotional. Just to drive the point home, one man wrote in who had not developed erectile dysfunction yet from the low testosterone.  However, Testosterone Really Impacts the Brain and this guy said this is what tore apart his marriage of 14 years:

“I’ve had low T for about 8-10 yrs that I know of. I guess I put my head in the sand about my condition trying only the gel treatment only for a short amount of time. So lets say I have not done anything since that but maybe take a few supplements here and there. I’m at the point in my life that my wife of 14 yrs wants to call it quits in our marriage. I have all the emotional traits that come with having this except ED. Need help.” [3]

4. Guess What? Sex Is Important To Women Too! A number of men have commented that the improved sex life has greatly helped their marriage.  There are many reasons for this, but one of the big ones is that the oxytocin released post-orgasm increases bonding.  This is very important for men and critical for women.  And women need the increases in dopamine and other post-orgasm neurotransmitters just like guys do.  Consider what this man wrote:

“As many of you who regularly read this forum know, I’m a proponent of testosterone supplemention via Testopel pellets. I have progressed over a two year period from barely being a sexual entity to now having sex as a regular/frequent mainstay in my life. My marriage has benefitted from our newly found intimacy (though not so new any more – meaning it is still great but isn’t new anymore) and things are just going well…Even though we are a bit older I got a vasectomy over a year ago as she is not through her changes yet so this combined with the Testopel has made sex unbelievable.” [2]

5) It Helps You Look Better. Only guys care about appearance, right?  Wrong!  Women are very powerfully attracted to a good physique and a poor physique will turn them off as I document in my link on The Female Libido and Looks. And respectable testosterone levels can make a significant difference with both one’s workouts and weight loss program.  For example, if you are low T, you just don’t feel like going to the gym.  You’re often tired, anxious and slow to recover.  In addition, many studies show that HRT will lead to modest weight loss.  No, it’s not a panacea, but it helps. And, yes, testosterone activates the mTOR pathway which accelerates muscle gains.  Look at what this man wrote about “letting himself go” in these categories:

“My wife of 13 years was cultivating friendships online and was planning encounters of the sexual kind including some old sex partners. When I found out it kind of jolted me. I really took a look at who I WAS. I am a great guy but I was letting myself go physically and dropping the intimacy. We were like roommates. I think she was going through some hard times also of just not feeling for sex. But those feelings of not wanting sex were just plain boredom of me and eventually she made that realization. That’s when she started with the conversations. I said to myself OK I can’t stop feelings that my woman has for someone else but I can make MYSELF the best I can be. So I started exercising and eating right and reading about Peak T after getting a low reading. She has decided she likes what she sees and does not want to throw it away. I have been doing my part in the bedroom and making it real interesting. I have lost about 45 lbs and still on my quest to lose more.” [5]

1) https://peaktestosterone.com/forum/index.php?topic=422.0

2) https://peaktestosterone.com/forum/index.php?topic=478.0

3) https://peaktestosterone.com/forum/index.php?topic=2986.0

4) https://peaktestosterone.com/forum/index.php?topic=1302.0

5) https://peaktestosterone.com/forum/index.php?topic=476.0

6) https://peaktestosterone.com/forum/index.php?topic=1871.50

VitaminD VitaminK2 to Cure Osteopenia From Low Testosterone

However, these results should strike you as very odd.  Vitamin D deficiencies have been documented in MANY studies to be related to just about every health evil under the sun – autoimmune disorders, cardiovascular disease, various cancers, etc.  So why is that giving someone Vitamin D would not improve health outcomes.  That just makes no sense.

The answer probably lies in the fact that Vitamin D needs its sister vitamin (K2) to be given at the same time.  Essentially, Vitamin K2 makes sure that calcium gets pushed into hard tissue (bone, teeth, etc.) and NOT into soft tissues – exactly what we want.  Thus the ideal situation should result from combining Vitamin D with Vitamin K2, assuming you can get the best of both worlds.

“Peak, When Dr Shippen put me on Vitamin D3 He also put me on K2 to drive the calcium into the Bones not the Soft Tissue. As I have stated before within a year my Dexa Scan showed I had improved from bones of a 70 year old to the bones of a 23 year old.”

I questioned him about some of the details and got his permission to reprint those below:

Q. When you say you had the “bones of a 70 year old” were you actually diagnosed with osteopenia? Or did Dr. Shippen basically note that your bones were older than your chronological age? (I believe you are ~ 67, right?)

Q. When you got the test showing that you had low bone mass, was this before you went on TRT or after? If after, how much after roughly? And, if before, I assume you had the low bone mass from low estradiol, right?

A. Before TRT, actually my E2 was 57 pg/ml and my SHBG was 60, Testosterone was 310.

NOTE: Estradiol of 57 is pretty good and would not normally cause bone loss. However, he may have had bone loss from his days before TRT – it’s hard to say.  Regardless, this is an important topic, because many men with low testosterone also have low estradiol and osteopenia.  We have had several men on the  with osteopenia on  Peak Testosterone Forum. Eventually, men in this situation can end up with osteoporosis which is very dangerous of course.

Q. What form of Vitamin K2 did Dr. Shippen put you on? MK4 or MK7 or both? Can I also ask the brand, as I know he was careful with what brands he used.

A. Life Extension: Super K With Advanced K2 Complex (It has all forms) and Pure Encapsulations Vitamin D3.

Q. Did Dr. Shippen (or yourself) do anything else for bone health that may have increased bone density?

A. Nothing else, I have always worked out.

Q. How long did it take roughly for your bones to go from that of a 70 year old to that of a 23 year old?

A. I had the Scan in January, saw Shippen in March, and had the next scan the following February. So 10 months after seeing Shippen.

Q. Do you take calcium just to play it safe?

A. One other thing about Vitamin D3 and K2, Shippen told me, Men do NOT need to take a Calcium supplement, but to eat lots of Greens and good meals and I would get plenty of Calcium from that.

Q. What 25-hydroxy levels did Dr. Shippen have you targeting?

A. Dr. Shippen says to keep D3 level at 50, and not over 60.

Vitamin C and Nitric Oxide - Peak Testosterone

I am always looking for ways to naturally boost my nitric oxide levels and one of the best ways is probably one the cheapest also: Vitamin C. Vitamin C is the only supplement that I megadose and the reason is that I pretty well buy into what is called “Pauling Theory”, which points out that we are one of the very few mammals that does not manufacture its own Vitamin C. To date, there are huge benefits to Vitamin C and, in my opinion, very few downsides under rather special circumstances.

But let’s go to every guy’s favorite subjects:  boosting blood flow, increasing nitric oxide, lowering blood pressure and improving erectile strength.  Vitamin C does all of these.  It can also lower cortisol and decrease inflammation, something I discuss in my link Why Take Vitamin C? On this page, though, I want to focus on Vitamin C’s NO-boosting powers and here are just a few of the studies that show, directly or indirectly, that Vitamin C can raise nitric oxide:

1. Dose Dependent NO Increases. Dose dependency is what every researcher hopes to find, because it shows that the more you give of something, the greater the effect, which shows a more clear relationship. And this is exactly the case with Vitamin C and nitric oxide. One set of researchers stated it like this: “ascorbic acid [vitamin C] has been shown to stimulate endothelial nitric oxide (NO) synthesis in a time- and concentration-dependent fashion.” [1]

This same study even found how Vitamin C works to raise nitric oxide levels:  it protects (from oxidation) a cofactor eNOS called tetrahydrobiopterin.  A cofactor is “a substance that acts with another substance to bring about certain effects – especially a coenzyme.” So, assuming you have the baseline nitric oxide in the first place, which you can likely boost with either citrulline or nitrates (in food), then Vitamin C should raise nitric oxide levels for you.

1)  The Journal of Biological Chemistry, Jan 5 2001, 276:40-47, “L-Ascorbic Acid Potentiates Endothelial Nitric Oxide Synthesis via a Chemical Stabilization of Tetrahydrobiopterin”

2) Circulation, 1999, 99:3234-3240, “Long-Term Ascorbic Acid Administration Reverses Endothelial Vasomotor Dysfunction in Patients With Coronary Artery Disease”

3) Free Radic Biol Med, 2000 May 1, 28(9):1421-9, “How does ascorbic acid prevent endothelial dysfunction?”

4) Gut, 1989, 30:436-442, “Vitamin C in the human stomach: relation to gastric pH, gastroduodenal disease, and possible sources”

5) Circulation, 1999, 99:3234-3240, “Long-Term Ascorbic Acid Administration Reverses Endothelial Vasomotor Dysfunction in Patients With Coronary Artery Disease”

6) The Journal of Biological Chemistry, Mar 19 1999, 274:8254-8260, “L-Ascorbic Acid Potentiates Nitric Oxide Synthesis in Endothelial Cells”

2. Reduction of Nitrite to Nitric Oxide.  One thing that I talk about in my Interview with Dr. Nathan Bryan is how nitrate in food is converted to nitrite by bacteria in the mouth and later to nitric oxide in the gut. Vitamin C is a similar miracle worker and converts nitrites to nitric oxide. One set of study authors noted that “”Vitamin C is an effective scavenger of nitrite, reducing it to nitric oxide and preventing nitrosamine formation in vitro and in vivo.”[4] Thus the protection of tetrahydrobiopterin is not the only way that Vitamin C can increase a man’s baseline nitric oxide levels. (There is a study out there that says, in the presence of significant fat in the stomach, nitrosamine formation is actually increased.  See my caution below.)

3. Restoration of Endothelial Function in Heart Disease Patients. Heart disease patients with arteriosclerosis are plagued with “endothelial dysfunction”, which means that the lining of their arteries cannot pump out the sorely needed nitric oxide for lowering blood pressure/increasing blood flow/getting an erection.  (The lining of the arteries is called the endothelium.)  However, Vitamin C therapy has been found to help restore endothelial dysfunction in these cases, which is remarkable considering the severity of the situation. And what is more remarkable is that this occurred at the relatively small dosage of 500 mg/day. [5] If Vitamin C can help arteries and improve blood flow in heart disease patients, it can likely do it for you too!

DOSAGE and FORM: I am currently taking 3 doses of 500 mg split throughout the day.  I take the “Ester-C” form, which is calcium ascorbate with a small amount of some other herbs and extracts thrown in to increase absorption. Ester-C is a trademark or brand name However, you can also buy calcium ascorbate from other supplement manufacturers, but it will not have the exact name Ester-C.  Of course, you can also take Vitamin C as ascorbic acid, but I have tried this and it gives me heartburn.  This is why most people take the buffered forms.

NITRIC OXIDE TESTING: What is the best way to test your baseline nitric oxide levels? That is actually a fairly involved question, but there are new nitric oxide test strips available from Neogenis that can indirectly do the trick for you in the privacy of your own home. What they actually measure is nitrite on the tongue and you can read the technical details in this link on At Home Nitric Oxide Evaluation Test Strips to find out more. Keep in mind that Dr. Bryan, the inventor of these test strips, recommends that baseline readings be taken first thing in the morning before any activity, eating, brushing of the teeth or mouthwash, etc.

CAUTION:  Vitamin C should probably be taken on an empty stomach by most people, because it can increase iron absorption.  Most men do not need increased hermatocrit/hemoglobin and/or iron stores (ferritin), due to red meat consumption and other factors.   Elevated iron levels have been implicated in heart disease and various brain conditions.  (Iron literally “rusts” the body.)  There is also a study out there that shows, if you have over 10% fat in your stomach, Vitamin C can actually increase nitrosamine formation. (This is a controversial finding however.)

REFERENCES:

A1C: How I Lowered It Below 5.0 - Peak Testosterone

Have you ever heard of the “Hold Out and Clench Your Teeth For Maximum Testosterone” theory?  Basically, this strategy is based on the idea that if you can somehow avoid ejaculation, you will experience a dramatic increase in testosterone.  And, believe it or not, there is some science behind it.  One study out of China examined 28 male volunteers and observed a clear spike in testosterone beginning on the 7th day (or darn close). [1] Furthermore, the spike was huge – 145% of baseline.

So is this a good way to overcome low testosterone and even hypogonadism?  Below I’ll outline a number of reasons that, as interesting as the research is, this is probably not a practical way to help men in their quest for more testosterone:

This was a very small study and one can’t help but wonder at the very large increase observed. Increasing T by 145% is no easy task.  For example, weight lifting, CPAP machines for apnea sufferers and other similar lifestyle changes usually only increase testosterone in the 15-30% range.

There are several other studies showing abstinence from ejaculating leading to elevated testosterone levels. One was very old [2] and one involved a three week period of “holding out” – ouch! [3]  So, yes, this is a way, for younger men anyway, to raise testosterone.  However, below I outline four reasons that I think non-ejaculation is a poor option for men:

REFERENCES:

1) J Zhejiang Univ Sci, 2003 Mar-Apr, 4(2):236-40, “A research on the relationship between ejaculation and serum testosterone level in men”

2) ARCHIVES OF SEXUAL BEHAVIOR, 1976, 5(2):125-132, “Orgasmic frequency and plasma testosterone levels in 3) WORLD JOURNAL OF UROLOGY, 2001, 19(5):377-382, “Endocrine response to masturbation-induced orgasm in healthy men following a 3-week sexual abstinence”

1. Impracticality . The authors noted that “a peak [occurred] on the 7th day of abstinence; and that the effective time of an ejaculation is 7 days minimum.” So let’s say that a man waits to ejaculate for 10 days.  According to this study, he will have his regular T levels for 7 days and then experience a dramatic increase that will continue until he ejaculates for a few day until he ejaculates on the 10th day.  This means that a) if he is in a relationship, he has avoided sexual relations for most of it and b) he only gets 3 higher T days out of 10.

2. Sex Is Good For You. Sexual intercourse is excellent for male health.  Furthermore, a couple of studies have shown increases in baseline testosterone from regular intercourse.  Sex is also very important for most health relationships. So is abstinence for 7 days really going to improve your health?  The majority of studies would seem to indicate the opposite.

3. Hypogonadism. The men who I have seem following this “7-Day Abstinence Approach” have very low testosterone or are even hypogonadal.  It is very questionable that this approach will achieve the same degree of success as it did with random volunteers.  Generally, hypogonadal men have some sort of dysfunction of either the testes, hypothalamus or pituitary. Abstinence is simply trying to “squeeze blood out of a turnip,” i.e. there is nothing there in the first place.

4. Morning Erections.  Another important point related to #4. Many men with low T have stopped experiencing regular morning erections.  This means 7 days without ejaculating will likely mean 7 days without an erection.  This is very hard on the internals of the penis as the corpus cavernosum, the spongy containers that hold the blood within the penis, need regular oxygenation to stay healthy and flexible. For more information, see my link on The Importance of Morning Erections.

How Sitting Kills Heart and Erections and How To Overcome

Have you heard of latest risk factor for death, heart disease and cancer?  It’s got to be something exotic, right?  Maybe a new form of cholesterol or a hidden retrovirus?  No, I’m afraid it’s called sitting.

Yes, sitting can be dangerous, very dangerous for your health and heart. That’s right – researchers have found that few things in your lifestyle can influence your survival as how often your butt is on a chair or couch. One study, for example, found that every hour in front of the television was associated with an increased risk of death by heart disease, cancer and all causes of 18 percent, 9 percent and 11 percent, respectively. [1] Other work has shown that for every two hours sitting per day, your risk of diabetes goes up by 7% because your body uses less blood sugar. [6]

NOTE:  Remember that anything hard on the heart is also hard – or should I say limp? – on your erections as well.

This was really sobering for someone like myself who is a computer jockey by day.  The study went on to state that for those who watch four or more hours of television per day have an 80 and 46 percent increased risk of dying from cardiovascular disease and all causes, repectively.  These are monster numbers.  The television and the computer, if you sit at them for extended periods of time, are the equivalent of a multi-pack smoking habit!

1) Circulation, Published Online Jan 11 2010, “Television Viewing Time and Mortality. The Australian Diabetes, Obesity and Lifestyle Study (AusDiab)”

2) Medicine & Science in Sports & Exercise, May 2009, 41(5):998-1005, “Sitting Time and Mortality from All Causes, Cardiovascular Disease, and Cancer”

3) Arteriosclerosis, Thrombosis and Vascular Biology, May 2009, 41(5):998-1005, “Overexpression of Human Lipoprotein Lipase Protects Diabetic Transgenic Mice From Diabetic Hypertriglyceridemia and Hypercholesterolemia”

4) American Journal of Epidemiology, Advance Access published online on July 22, 2010, “Leisure Time Spent Sitting in Relation to Total Mortality in a Prospective Cohort of US Adults”

5) https://www.medicalnewstoday.com/articles/195697.php

6) Women’s Health, Nov 2009, p. 133.

7) https://www.medscape.com/viewarticle/725341_3, “Too Much Sitting: The Population Health Science of Sedentary Behavior: Objective Assessment of Sedentary Time: New Findings”

8) Exercise & Sport Sciences Reviews, Jul 2010, 38(3):105-113, “Too Much Sitting: The Population Health Science of Sedentary Behavior”

9) https://www.sciencedaily.com/releases/2016/07/160727194405.htm

10) https://news.indiana.edu/releases/iu/2014/09/slow-walking-sitting-study.shtml

11) Med Sci Sports Exerc. 2015 Apr; 47(4):843-9, “Effect of prolonged sitting and breaks in sitting time on endothelial function”

So is this just a television thing?  We all know that television sucks the life out of your brain, so perhaps it hits the rest of the bod just as hard?  Actually, it’s not the television – it’s the act of sitting that does it.  For example, researchers divided people into groups that sit 25, 50, 75 and 100 percent of the time and then followed them for 12 years.  The results were remarkable:  a dose-dependent rise in death from all causes and cardiovascular disease. [2]  In other words, the more sitting, the more likely the participants were to die from cardiovascular disease or all causes.

Also, an interesting twist is that a recent study found that sitting, independent of activity level, was strongly correlated with total all cause mortality.  Of course, the authors emphasized that physical activity is important, but they also pointed out that even physical activity cannot overcome a lifestyle of sitting around. [4]  Men who sat more than 6 hours per day were 18 percent more likely to die (and women 37 percent). [5]

The answer to the above question  probably has many question but here are two key ones:

a) Lipase Activity. It shuts off the activity of a key enzyme called lipase.  Lipase is the enzyme that breaks down fat and, after an extended time of sitting, lipase activity plummets to as low as one tenth of its normal rate.  One study showed that if lipase levels were increased in diabetically induced mice, they completely avoided elevated low cholesterol and triglycerides. [3] In other words, lipase activity is a powerful cardiovascular protection and may explain why rural, third world lifestyles are so heart protective.

b) Endothelial Dysfunction. Researchers have found that after two hours of sitting, your arteries literally begin to “numb.”  By that I mean that they lose their ability to expand which lowers blood pressure and increases blood flow.  And I would add that endothelial dysfunction is the most common cause of erectile dysfunction.

How Much Exercise Will Compensate for Sitting?

Here are two likely solutions. Choose one and you should be able to spare yourself from the extreme negative impacts of sitting:

A. 60-75 Minutes of Moderate Exercise Daily. Does your gut tell you that the common sense solution to the negative health effects of sitting would be exercise? If so, your gut would be exactly right. The question, though, would be “how much?” This was debated and some of the early research showed that you cannot make up for extended periods of sitting time through daily exercise unless that exercise is broken up into increments throughout the day regardless of fitness or exercise levels.  In other words, if you sit almost nonstop at work, commuting and/or in front of a television/computer, then an hour of exercise at the gym cannot compensate. [7] [8]

However, a more recent review examined multiple studies and found that 60-75 minutes of moderate exercise per day could eliminate the negative health effects of sitting. This is fantastic news, because you have a relatively easy solution to a huge health issue associated with the Western lifestyle.

I do realize, however, that for some of you, 60-75 minutes may sound like a lot. However, keep in mind that “moderate exercise” includes brisk walking. You can go to the gym and walk and get something done on a treadmill. You can walk through your neighborhood – hopefully not in a pollute urban city though – and benefit. You can get an inexpensive treadmill for home use and get a little reading done. [9]

B. Five Minutes Every Hour. Previous study work indicated that the endothelial dysfunction issues could be overcome with just five minutes of walking every hour.  The study found that even in health subjects sitting for one hour lowered endothelial function by 50%! Again, this will be hard on erections as well.  However, the researchers discovered that they could completely overcome this effect by having the subjects walk five minutes of every hour.  [10][11]

REFERENCES:

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”

vitamins and supplements have not done nearly well

Do you know the best way to bathe your body in cancer-fighting, age-reducing and brain-building chemicals?  The answer is food, NOT supplements and vitamins.

Study after study has shown that, in general, vitamins and supplements have not done nearly as well as hoped for. In fact, that is actually being overly polite:  the truth is that most supplements and vitamins have not only produced lackluster study results but often can be downright dangerous!

Of course, there’s a lot of money to be made here and so rarely will your health stores, gyms or vitamin shops tell you of these dangers.  Remember:  the supplement industry is often no less corrupt than Big Pharma.

Here at Peak Testosterone we are into long term health and will lay all the facts on the table. For example, in 2009 and 2010 researchers at Kansas State University shattered the myth that “more is better” when it comes to antioxidants.  They found that large amounts of antioxidants – Vitamin C specifically in one study – decreased a supposedly dangerous oxidant called peroxide, which is critical for blood flow to muscles and arterial expansion. [9]  That’s right – megadosing on antioxidants could potentially impact both muscle growth and erections.

Again, the list goes on and on, but it’s MUCH safer to rely on exercise, diet and sleep for your health!

To give you a feeling just how precarious the supplement and vitamin industry has become, here is a list of just some of the findings on some of the once-hoped-for blockbuster vitamins and supplements:

This list could go on and on.  Contrast that with the fact that a well-rounded diet with vegetables and fruit has been associated with reduction in many cancers, autoimmune diseases and so on.  This simply cannot be said for vitamins and supplements.

So why does Peak Testosterone sometimes recommend vitamins and supplements?  Two reasons:

1. There are a few supplements and vitamins that have an impeccable safety record and rock-solid results, especially when taken at normal youthful tissue levels.

2.  Sometimes it is important and good to take supplements and vitamins short term to get past a specific problem or issue that you are facing.  You do not want to become dependent on these for life necessarily, but they can be a valuable tool to allow yourself to get back on your feet.

You will see supplements that fit #2 throughout the site.  Finally, you may to read my link on What Vitamins Everyone Should Consider Taking.  Yes, there are some vitamins and supplement that can hel almost everyone.

HYPERSUPPLEMENTATION: One writer, Ray Kurzweil, has written that he takes 250 supplements per day and has his cholesterol, LDL, HDL at very optimal levels. His cholesterol is 130 and his HDL is near 60 for example. His motivation is apparently to live long enough until science can finally extend life to near immortality through biotechnology and nanotechnology.

It will be interesting to see how he does: the human body and mind is incredibly complex and there are many subtle nuances. I cannot deny his excellent lipid profile and stats, but feel it is likely that he will run into some sort of health issue from one or more of these supplements. However, even if that is true, he will deserve credit as a pioneer.

REFERENCES:

1) Circulation, 1994,89(3):969-74

2) Immunity & Ageing, 2009, 6:9, “The immune system and the impact of zinc during aging”, Hajo Haase and Lothar Rink

3) Bone Marrow Transplantation, 2004, 33:1241 1246, Published online 19 April 2004, “Zinc in pharmacological doses suppresses allogeneic reaction without affecting the antigenic response”

4) J of Nutr, Published online ahead of print, “Prolonged Intake of Coenzyme Q10 Impairs Cognitive Functions in Mice”

5) Neurology, 2005 Dec 13, 65(11):1834-6, “Tolerance of high-dose (3,000 mg/day) coenzyme Q10 in ALS”

6) JAMA, Nov 5 2008, 300(17), “Effect of Combined Folic Acid, Vitamin B6, and Vitamin B12 on Cancer Risk in Women”

7) Amer J of Epidemiology, Received for publication July 7, 2009. Accepted for publication August 31, 2009, “Effect of Supplemental Folic Acid in Pregnancy on Childhood Asthma: A Prospective Birth Cohort Study”

8) https://www.eurekalert.org/pub_releases/2009-12/afot-plo123009.php

9) 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”

10) https://lpi.oregonstate.edu/infocenter/vitamins/vitaminB6/

Doxazosin - Erectile Drug - Peak Testosterone

Doxazosin is an alpha-1 blocker used for hypertension.  Alpha blockers work by overcoming the vasoconstricting properties of the stress neurotransmitter noradrenaline (norepinephrine). Essentially noradrenaline is the braking system to keep your erections and other “systems of relaxation” from going on forever.  Unfortunately, in some men under stress and a Western lifestyle, the brakes can be on virtually all the time and this can negatively impact sexual function.  Doxazosin is also prescribed for BPH (enlarged prostate) and works in a similar way on the prostate by relaxing smooth muscle tissue.

NOTE: Terazosin is another similar alpha-1 blocker that has a similar profile, i.e. is used to treat hypertension and BPH.  It does not, however, have any erectile dysfunction studies under its belt yet.

Many experts feel that alpha blockers are understudied and underutilized tool in the arsenal against erectile dysfunction, because they can work miraculously for so many men.  We give coverage to one other alpha blocker, which works on both the alpha-1 and alpha-2 receptors, and holds a great deal of promise for some men.  See my link on  Erectile Dysfunction and Phentolamine for more information.  However, this medication is not yet approved in most countries as we will discuss below.

CAUTION: All the alpha blockers should only be used under a doctor’s supervision, because they 1) interact very negatively with certain medications, 2) can have very serious side effects and 3) 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. immediately.

There are many reports that this blood-pressure lowering drug (an alpha-blocker) enhances the effects of PDE5i. So, though I generally have healthy blood-pressure, I persuaded my doctor, in 2008, to prescribe me daily 2mg doxazosin. (The maximum advised doxazosin dose is 16mg.) It acts as a vasodilator, and so the theoretical erection-enhancing effect is obvious.

The International Journal of Impotence Research reported in 2002 on a trial conducted by the University Hospital Genoa which investigated the efficacy and safety of sildenafil in combination with doxazosin for the treatment of non-organic erectile dysfunction in men who did not respond to sildenafil alone. 28 patients were divided in two groups: 14 were treated with doxazosin (4 mg daily) and sildenafil (100 mg before sex); the other 14 patients received sildenafil and placebo. Of the 14 patients treated with doxazosin and sildenafil, 11 showed an average increase in IIEF-EF score from 12 at baseline to 22 after 60 days. (That s much more of an increase than is generally provided by the LI-ESWT. And I don t believe it.) Only one patient in the placebo group recorded a significant increase. Blood pressure did not show significant alterations.

A Korean trial concluded in 2012 that we believe that the combination of a PDE5 inhibitor with doxazosin could be a pharmacologic strategy for simultaneously treating ED and its comorbidities and increasing response rates to PDE5 inhibitors .

Pfizer states caution is advised when PDE5 inhibitors are co-administered with alpha-blockers as the hypotensive effects of alpha-blockers and PDE5i can combine. They advise that patients already taking PDE5i, should initiate alpha-blocker therapy at the lowest dose ; and if already on alpha-blockers initiate Viagra at the lowest dose. The Levitra package leaflet offers the same advice. The Cialis package leaflet advises that you tell your doctor if you take alpha blockers.

I have checked my blood pressure when first on this combination of drugs, and it was around its usual 120/80.

Doxazosin initially, in 2008, made me feel a bit odd, slightly dizzy, but this effect disappeared after a few weeks. My doctor, without referring to PDE5i, suggested I start on half a tablet, to avoid the worst of these side effects, before taking the whole 2mg. I did that, and I thought did detect a positive effect on erections. After a couple of years I reduced the dose to 1mg a day, and then stopped altogether. Between June 2012 and January 2013 I had no doxazosin. I can t recall why I stopped doxazosin, I think I started to take the benefit for granted, and I then I just forgot about it. (And my blood pressure rose slightly around 125/85.)

Reflecting on doxazosin in early January 2013 I recalled the reliability of my erections reduced with the reduced doxazosin intake, so I restarted daily 2mg doxazosin on 20th January 2013. After a few months of noticing no improvement I reduced the dose to 1mg a day.

A private prescription allows you to buy a month s supply of 2mg Doxazosin for 1; much less than the 7.65 NHS charge.

NOTE: The most common side effect is probably dizzines. Other hypoglycemic-like symptoms can occur as well.

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:

My Personal HRT Story - Peak Testosterone

I’ve had a number of men on the Peak Testosterone Forum (and in emails) ask why I started this site.  And they’ve asked what has worked for me and what hasn’t.  And they’ve asked how I boosted my testosterone.  Those are all fair questions of course.

When asked a question like this, I scarcely know where to start.  It has been a very long road and I’ve been through about five distinct stages. I’m not trying to bore anyone into a coma, but I think most of the men coming to the site are very much going to relate to one of these and so I am going to do a thumbnail sketch of each:

NEWS FLASH: I was pretty excited to have an interview with Men’s Health Magazine, which was published in a recent 2015 issue, regarding TRT. You can read about it here: My Men’s Health Magazine Interview.

Well, it all started for me in about 2007.  This is when I really hit “the Wall”.  As I’ve described elsewhere, I was absolutely miserable.  Here were some of my symptoms:

Basically, I was just barely able to function at work and in my personal life. Survival was just about my only goal. Work, relationships – everything was a chore.

Of course, I searched for answers.  I began reading on the internet and tried to find what would cause my symptoms.  To my surprise, I found many syndromes that could supposedly cause these symptoms.  This included adrenal fatigue, yeast overgrowth/candididas, celiac’s disease, Lyme Disease, Epstein-Barr, fibromyalgia, Chronic Fatigue Syndrome and several others.  The doctors ran all the standard tests and found nothing.  I even had my colon checked for celiac disease and nothing turned up.  Everything was a dead end.

My doctor at the time was an excellent diagnostician if you had the flu or a stomach ulcer or a rash or broken leg.  But he absolutely did not know what to do with me. When I explained to him that I was beginning to experience a little erectile dysfunction, his solution was simple:  20 mg Cialis horse tabs.  And wow did those bad boys work!  It was like being back in high school!

I should also mention that during this time I tried everything I could think of to try to boost my testosterone naturally.  But nothing worked.  Changes in diet, sleep, etc. just gave me no significant increase in testosterone that I could see what so very.  And so my testosterone story seemed to have deadended.

Fortunately, we did another testosterone blood draw and it dipped into the 280’s.  Suddenly, my doctor was willing to designate me as hypogonadal!  I could not wait to start testosterone therapy but, at the time, knew absolutely nothing about it.  My physician’s solution – and I think this was the only HRT method he knew anything about whatsoever – was to give me Androgel.

Androgel, for those who do not know, is the blockbuster bioidentical testosterone that really brought HRT into the mainstream.  Suddenly, PCPs everywhere had a Big Pharma-backed method of giving a man testosterone that was easy and convenient.  This made testosterone therapy less “steroid like” and more palatable to those in primary care.

Androgel came in bottles with a pump on the top and applying was similar to lotion.  You just rub on the upper body and – voila! – the testosterone absorbs through the skin and you’re cured.

If it was only that easy!  I found out the hard way that Androgel is often poorly absorbed and some men get no boost in testosterone whatsoever.  (See my link on Testosterone and Androgel for more information.) I was one of “those men” and my next reading showed no significant increase in testosterone.  I I knew that I did not feel any better – that was for sure.  My doctor then – reluctantly! – allowed me to increase the number of pumps on my Androgel.  Soon I found I was slathering Androgel all over my upper body.  It was getting ridiculous as my upper body was just covered with the stuff in thick goopy layers.

I thought, “This ought to take care of the problem!” Well, it didn’t.  Strangely, I found that no matter how much Androgel I put on myself, my testosterone did not increase.  Androgel never got me out of the lower 300’s and with all that gel all over my upper body, I was worried about transferrence to my wife and kids.  (On the Forum, this is by far the most common complaint that we get about HRT, i.e. what one might call Androgel Failure.)

This was very disappointing as I felt I may have finally found the root cause of many of my problems. I assumed that HRT was just not going to work for me.  I did not know that there were actually many different forms of HRT that were much more effective than Androgel and just assumed that I was out of luck.  I did, however, ask my doctor if he knew of another physician that dealt with this kind of thing, i.e. “men’s issues”.  I think he couldn’t wait to get rid of me and so he referred me to a urologist that he had heard knew something about testosterone.  I made an appointment as fast as I could!

My urologist read my case and, fortunately, recognized that Androgel just was not going to work with me.  He did not know a lot about HRT, actually, but did know of a good compounding pharmacy.  He said that a compounded testosterone was cheaper and could be made with a stronger strength and absorption than Androgel.

And this turned out to be true.  The compounded testosterone did what I thought could never happen:  it brought up testosterone levels up into the 400’s.  I even had a reading around 550 one time.  But, in general, my testosterone readings during this period were less than 500.  My urologist was very comfortable with me at this level, because he had undoubtedly seen many men struggle and in many cases die from prostate cancer.  I told him how I had read a number of studies showing prostate cancer risk was not increased by giving men HRT.  His response, “Sure until they come up with a study that shows the opposite.”  This just showed his caution and who can blame him?

What I found was that I felt better but certainly not great. However, it was during this time that I had another big breakthrough:  I tried a Low Fat diet.  I had picked up a copy of Dean Ornish’s book and, being experimental, I tried it.  I was shocked at the results.  Within just a few days, it had greatly improved my fatigue and erectile dysfunction. This, coupled with the slight increase in testosterone, finally gave me hope:  I was actually feeling better for the first time in years!

NOTE: I actually follow mostly closely a Low Fat Diet build on the guidelines of another researcher named Neal Bernard, at least to a large part. Dr. Bernard shows how to reverse disabetes and slow down or even reduce your arterial plaque, something I cover in this link on Low Fat Diets and Diabetes and The Best Health Books. I also avoid the heavily GMO’d grains (wheat, corn, soy).

Inside I was anxious to try to raise my testosterone more and was convinced that this would help me considerably.  I had been reading much more about testosterone and realized at this point that the 400’s was still quite low compare to normal youthful levels.  However, my urologist was clearly uncomfortable with the idea and I was very thankful to have found him in the first place, since finally I was at least moving in the right direction.

After being on the compounded testosterone for a couple of years, my doctor actually came to me and asked if I wanted to try pellets.  He had a change of heart and told me that he could probably get me into the mid 600’s with pellets if I was willing to try it.

Of course, I was all over that and, after making sure that my insurance covered it, I scheduled the procedure.  For those who don’t know how pellets work, it’s an interesting procedure where little mini-tubes are inserted into your hip tissue quite close to the surface.  These tubes have the pellets and basically the tube is withdrawn leaving the pellets under your skin.  You can actually feel the pellets after the procedure as a small bump.

The procedure wasn’t too bad.  Sure, you’re partially naked with the nurse and doc staring at your hemorrohoids for about 20 minutes while you lay on your side, but I would have done just about anything to get my testosterone levels up.  Of course, you have a good amount of anasthesia and cannot really feel anything except the pressure of your urologist wiggling the mini-tube (trocar) to get into place.

Now I had read somewhere that getting pellets was no more painful “than drawing blood.”  And that is true if you are just talking about the procedure itself.  However, afterward, I found it to be quite painful.  Basically, I could not exercise or lift weights for about five days afterward, which for me was a fate worse than death, and the area felt semi-infected.  (It was not actually infected – it was just painful and felt inflamed.)

However, after I recoved from the procedure itself, I was one happy guy.  We never measured my testosterone at the peak, but I would guess I went up to close to upper 600’s and so, finally, I had doubled my testosterone levels! The biggest change was “in my head”.  I FELT fantastic.  Testosterone has a big effect on a man’s brain and I definitely felt it right between the ears.  What I noticed in particular was that the anxiety and sense of melancholy that I had experienced for years and years subsided.  Testosterone was simply a fantastic “brain tonic” if you will.

I also noticed that I started to get some morning erections and my erectile strength became even more consistent.  I was sold on the power of testosterone!  Of course, anything to do with erections is always front and center for a guy, but I was particularly struck with the mental aspect.  I noticed feelings – and I don’t know quite how to describe this – that I had not felt since I was much, much younger.  I was always into music growing up and I found that music once again profoundly affected me the way it used to. And there were feelings of elation and joy in the everyday things of life that I just had not experienced for a very, very long time.

I can remember thinking:  “you’re just not really alive if you are low testosterone.”

One other thing I noticed was that my gains in the gym seemed to acclerate.  I had been able to put on muscle even when I was in the 300’s, but it was slow going.  However, during this relatively short time period, I picked up some nice increases in strength and leg and arm size.

But there was a gnawing thought in the back of my head:  could I go through that procedure again?  I’m a very thin guy – a card-carrying Skinny Bastard by any standards – and I had precious little fat tissue as buffer against those trocars.  Plus, my doc wanted me to take antibiotics for a few days before the procedure to insure that I did not get an infection.  This went against my tightly held health beliefs that antibiotics very often attack your all-important good gut flora.  So the whole thing seemed a messy, painful business.  And yet, I had to admit, it was literally a fountain of youth for me.

Another problem that arose was that after a couple of months my testosterone levels began to fall somewhat.  That’s the way the pellets work.  Everyman is a little different, but, depending on the number of pellets and other factors, your testosterone levels will gradually begin to fall and then you need another procedure.  I also found that my urologist seemed to be trying to spread out the time between procedures quite a bit and so I was concerned about having a month+ of lowish testosterone where I felt about like I did with the compounding.

All of my hesitation about pellets finally came to a head one day at work and I did a quick search for HRT clinics.  I noticed one just a couple of miles from my house and went in for an appointment.  By this time, I had become quite knowledge on HRT matters and had been wanting to get on HRT.  This particular clinic was great because 1) they were national and thus should be fairly stable/reliable, 2) they worked with my insurance companies and 3) they used cypionate with Arimidex, which was my preferred delivery system based on the research that I had seen.

NOTE: Injections must be well-managed to avoid most side effects and to be effective. I discuss that here in my link on Testosterone Cypionate .

I was really looking forward to my first shot as my libido was really slipping from being so long on the pellets. I believe that by the time I got into the clinic, it had been almost four months since my pellet procedure.

When I got my injection, the reaction I got was spectacular.  No, I didn’t start getting spontaneous erections like I was 14 again.  What I did get that evening was, as best I can describe it, “fireworks in my brain“.  I felt a little Jim Carrey in The Mask:  the feeling was really powerful between the ears. Not painful.  Not scary.  But I definitely had the sesnsation that there was some “rewiring” going on.

Jumping ahead a little, the injections did something huge for me:  they completely vaporized my dysthymia. I had had mild depression pretty much all of my adult life.  A Low Fat Diet got rid of some of it and exercise still another part of it.  But I could never really defeat it completely. What I noticed a couple of weeks after my injection was that I had absolutely no sense of melancholy about me.

Also, I have always been high anxiety.  I will sometimes call myself Captain Anxiety in front of my family and they always laugh, because they know it is true.  The injections greatly helped with this issue.  It was strikingly noticeable to my boss and he has commented several times to me about just this.  This goes along with a lot of research that shows that, counterintuitively to some, low testosterone animals are actually the ones most likely to fight.

And then I got the best gift of all. In fact, it was like Christmas:  I got my morning erections back.  I got occasional morning erections with a Low Fat Diet and compounding and even a few more with pellets.  But there was no comparison with the injections:  morning erections occurred almost every night.

The return of the morning erections also was a “Aha!” moment for me.  I suddely realized the obvious:  I had not had morning erections probably my entire adult life.  This coupled with the lifelong dysthymia makes me wonder if I was low testosterone my entire adult life.  (I have had zero dysthymia, a.k.a. mild depression, since going on testosterone cypionate.)

When I started cypioante at the HRT clinic, my protocol was the following:

–Testosterone Cypionate (130 mg weekly intramuscular)

–Arimidex (1/2 mg 2 X per week)

It took abou 9-12 months, but I was finally able to get completely off of Arimidex by doing the following:

1.  Dropping my dosage to 100 mg per week.

2.  Doing my cypionate injections subQ (subcutaneous) two times per week.  (50 mg each injection)

3.  Losing weight and getting down to about 12-13%% bodyfat.  (The more bodyfat, the more estradiol is produced.)

And I also faced another realization:  I probably had pretty bad venous leakage and my newfound testosterone levels finally helped me overcome that.  My HRT clinic has me at a trough of about 670 ng/dl and a peak of about 850 ng/dl.  And, because my last estradiol read was 21 pg/ml, I backed off my dosage of Armidex to the 1/4 mg.  One of my goals is to take as few pharmaceutical as possible.

So you can see why I am such a huge fan of HRT:  it literally gave me back the youth back that I never had.  I feel fanstic and have put on some extra muscle by the way.  I am now significantly stronger than I was in college and my physique is better too.

That said, I want to point out that not everyone has such a rosy experience with testosterone therapy and, like everything, there are certain risks and rewards.  I highly encourage every man interested in TRT to read my link on Weird Testosterone Risks for more information:  it has all the things that my doctor should have told me before I went on testosterone.

In the meantime, I am very much enjoying feeling about half of my age!  I seriously feel MUCH better than I did in my 20’s or 30’s and I feel that I owe it all to a Low Fat Diet, exercise, my HRT program and a good woman.

At the end of the year in 2013 I had to go off of HRT briefly due to a high PSA reading and even had a prostate biopsy. However, they found that there was no cancer (or even precancer) but did find inflammation. I was able to resume HRT. For details of my whole experience, see this page: My Prostate Scare (High PSA but No Cancer).

I got a PSA at my clinic about a month afterwards and already my PSA had dropped from a peak of 6.3 to 3.9.   This is a very good sign that my new “prostate program” was working, because the urologist said my prostate would be inflamed for several months afterward.  (They take 12 chunks out of the prostate when they do the biopsy.)

One interesting comment is that I implemented a bunch of natural anti-inflammatories (turmeric, quercetin, bromelain and IP6) and flaxseed along with a vegan diet in order to protect my prostate.  To be honest, as much as I love whole grains, vegetables and fruits, I don’t really want to be vegan but am doing it to make sure my IGF-1 levels stay in line.  And it seemed to work:  over about 6 to 9 monts my PSA dropped down to a low of 1.9, which is close to my early HRT levels.

In mid 2015 my PSA bumped jumped back up a bit to 2.9.  My urologist suggested that I try the new 4kScore test, which is able to tell with solid accuracy whether or not you have the aggressive form of prostate cancer.  I took this test and it found that I have a very low probability of having the aggressive form of prostate cancer, something I cover in more detail here:  My 4kScore to Test for Aggressive Prostate Cancer

Stage I.  Pain and Suffering

There was one problem though:  Cialis gave me tremendous heartburn.  I knew that this was not going to be a good long term solution.  At the time I did not understand that Cialis and the other PDE5 inhibitors have issues with other similar enzymes in the ear, eyes and stomach and can cause very severe side effects.  I would occasionally get mild ringing in my ears as well and cut back on the dose. Plus, I found that Cialis was somewhat ingermittent (The PDE5 Inhbititors are notorious for decreasing in efficacy, something I discuss in this link on Viagra Failure.)

Stage II.  Diagnosis and Non-Treatment (Androgel)

I can’t remember for sure, but I am almost positive that I asked my doctor for a testosterone test.  I had run across an article that stated low testosterone symptoms and I had a lot of them.  Nothing else had worked, so maybe, just maybe it could be hormonal.  My testosterone reading came back in the low 300’s – I don’t remember the exact number – and my doctor told me I was fine.

In those days all the labs had the lower range at about 260 or maybe 280 ng/dl.  And I was around 320, so my doctor concluded I was okay.  Well, I’m a numbers guy and I was thinking things to myself like, “That’s only a little over 10% above this magic threshold.  So maybe I’ve got about 90% of the symptomology and not 100%, but that’s still bad!”

My reasoning was not bad if you think about it.  No man hits a magic number and then all of his low testosterone symptoms appear, right?  Obviously, as his testosterone lowers more and more symptoms appear at a greater and greater degree.  However, I really didn’t know any better and so I just let it lie, although I did bug him for another test or two and they were always in the 300-350 ng/dl range.  Unfortunately, he would not budge and I probably suffered for a year like this, going back and forth with him.

Stage III.  A Change in Diet and an Almost Effective Treatment (Compounding)Stage IV.  Painful But Effective Treatment (Testopel Pellets)Stage V.  Finally!  Testosterone Injections and ArimidexElevated PSA

Heart Scan Versus: The Best Way To Measure Arterial Plaque

One point that I to often bring up on the Peak Testosterone Forum is that most erectile dysfunction is a result of heart disease and most heart disease is a result of arterial plaque (atherosclerosis). I won’t go into all the scientific evidence for that, but you can read some about it here if you are interested:  Scary Heart Attack Risk If You Have Erectile Dysfunction and Erectile Dysfunction and Arterial Plaque. In the meantime, you’ll have to trust me that it is critical to your sex life that you measure and monitor your arterial plaque levels. (And it will probably help you to avoid a heart attack!)

There are two basic ways that physicians typically measure arterial plaque levels – at least among the doctors that care about it:

a) IMT (CIMT). This is an ultrasound of the carotid (neck) artery and measures intima media thickness, which is the “donut” part of your artery that includes plaque and is correlated to your atherosclerosis.

b) Heart Scan (Calcium Score). This is a sophisticated 64-slice (usually) count CT scan of the cardiac artery and measure the calcium in your artery, i.e. the calcified part of your plaque.

There are other techniques – more on that below – but, again, these are the ones that are accessible under normal circumstances. Each of these methods (IMT and Heart Scan) has its pros and cons and below is a quick summary. Keep in mind that it is much better if you work with a knowledgeable doctor when it comes to plaque of course. My purpose here is to give you some ground level information so that you can quickly get up to speed and “talk shop” with him or her.

What about working with a cardiologist?  I hate to say it but most cardiologists do not want to spend the time helping you to regress your plaque:  it’s much more lucrative to tell you that you need a stint or a bypass or an angioplasty in a few years, right?  However, there are some excellent cardiologists that love this stuff out there, so you have to really ask around.

NOTE:  I was fortunate enough to have a zero Calcium Score a couple of years ago, something I talk about here:   Heart Scan Results. I attribute it to a low fat and largely plant-based diet.  I can never “rest on my laurels” though and continually work on lifestyle and measure my lipids, glucose/insulin and other parameters.

PROS OF AN IMT: An IMT involves no radiation and is ultrasound only. An IMT also monitors both hard and soft plaque. There is a company that I have heard and have no affiliation with (Lifeline) that offers IMT’s without a direct doctor’s orders for $70 the last time I checked.

CONS OF AN IMT: I have read that IMT’s do not have the kind of accuracy to let you monitor changes within a year very well. It is best something done maybe once a year and the trend monitored according to that school of thought. Other doctors feel that an IMT is sufficiently accurate.

NOTE2: The ultimate technique is probably the PET-CT, which combines the CT of a Heart Scan with PET (Positron Emission Tomography) which shows function of the arteries as well.  Dr. K. Lance Gould, who is one of the two main  Doctors Reversing Arterial Plaque in my opinion, uses this technique.  See this page for more information:  Heal Your Heart by K. Lance Gould, a book on how to regress your arterial plaque.

PROS OF A HEART SCAN: In his bestselling book Track Your Plaque, Dr. William Davis argues forecfully that a Heart Scan is the best method for measuring plaque in those with heart disease, because it is plaque in the cardiac artery that most often kills us men. It also provides an accurate number that can be tracked easily on an ongoing basis, and there is extensive research dealing with risk levels by age range and so on.

CONS OF A HEART SCAN: A Heart Scan does involve some radiation unfortunately. The device is very sophisticated and times the scan of a “slice” of your heart artery with the beating of your heart to minimize exposure time. I have had trouble finding the exact radiation exposure from this procedure, so discuss with your provider.  Most states will allow you to get a Heart Scan without a doctor’s orders and the cost is typically right around $100, so you will have to do some research regarding the radiation.

Brain and Stress - Peak Testosterone

REFERENCES:

Niacin: Improving Erectile Dysfunction - Peak Testosterone

1. Increased Blood Flow in Men with Lower Niacin Levels. Of course, there is a lot to an erection, but I think just about everyone would agree that the #1 goal is to increase something called endothelial function.  The endothelium is the delicate lining of the arteries that pumps out nitric oxide and relaxes the arteries.  And, of course, a relaxed, i.e. more open artery is one that allows more blood to flow into your arm, your leg or your brain.  And I’m sure I don’t need to explain why increased blood flow into your penile arteries is critical for erectile strength.

This is where a recent (2014) study of 127 healthy adults aged 48 to 77 shed some important light on vitamin B3 (niacin).  This study calculated and compared dietary niacin intake for the participants and then looked at FMD (flow-mediated dilation), which is a clinical measure of blood flow.

In all subjects, brachial (upper arm) arterial FMD was positively correlated to dietary niacin intake, and dietary niacin intake remained a significant independent predictor of FMD. In subjects with above-average dietary niacin intake, FMD was 25% higher compared with the below-average dietary niacin group.

2. Less Oxidized LDL. In the above study niacin was also inversely related to levels of oxidized LDL. [1] Of course, oxidized LDL is the kind that really does the damage to your arteries and can build up plaque.  Improving oxidized LDL is one of the goals of controlling arterial plaque as well.

3. Men With Bad Lipid Readings. One study examined men with both erectile dysfunction and “dyslipidemia.”  Dyslipidemia is medical speak for bad HDL, LDL, triglyceride or some combination of the three.  They gave these men 1.5 grams of niacin, which is a megadosed amount, and is a favorite of Dr. Davis.  (See my  Review of Track Your Plaque for Dr. Davis’ approach to plaque regression.) Besides the above listed benefits, niacin will also a) lower triglycerides, b) boost HDL, c) increase particle size and d) decrease LDL particle counts.  All of these are very anti-atherosclerosis and great for your arteries.

The researchers noted that “when patients were stratified according to the baseline severity of ED, the patients with moderate and severe ED who received niacin showed a significant improvement in IIEF-Q3 scores (0.56 0.96 [P = 0.037] and 1.03 1.20 [P < 0.001], respectively) and IIEF-Q4 scores (0.56 1.03 [P = 0.048] and 0.84 1.05 [P < 0.001], respectively] compared with baseline values, but not for the placebo group…For patients not receiving statins treatment, there was a significant improvement in IIEF-Q3 scores (0.47 1.16 [P = 0.004]) for the niacin group, but not for the placebo group. Niacin alone can improve the erectile function in patients suffering from moderate to severe ED and dyslipidemia.” [3]

These results are remarkable, because it appears that not only can niacin improve short term erectile function in many men, but also can likely help to reverse arterial plaque if a comprehensive program is undertaken.  Of course, neither I nor anyone else knows how safe megadosed niacin is long term, but many experts consider it safe when used under the care of a knowledgeable physician.  You’ll have to do your own due diligence.

Who Can Likely Boost Erectile Strength from Taking Niacin?

a) Some Vegetarians and Vegans. It should be pointed out that certain animal-based foods are known for being the highest providers of niacin. So does this mean that animal-emphasized diets will result in increased blood flow over vegetarians?  My experience on the Peak Testosterone Forum has been the opposite and this is the subject of my book The Peak Erectile Strength Diet. Basically, a great many plant foods directly stimulate nitric oxide and will increase blood flow while lowering blood pressure. In fact, some plant foods can lower blood pressure as much as modern hypertension medications. See my page on Flaxseed and Blood Pressure for an example of that. High nitrate foods, such as spinach, arugula and beets, are yet another example.

In contrast, even moderate amounts of saturated fat in animal foods will lower nitric oxide and actually “stun” arteries.  Researchers have searched for ways to overcome these artery-numbing effects of saturated fat and only exercise and certain nuts, such as walnuts, are powerful enough to overcome this clinical effect.

Futhermore, I have seen many times on the Forum where men have dropped their blood pressure dramatically going on a whole foods, mostly plant-based diet.  One man with essential hypertension, which is nastiest kind, actually dropped his blood pressure by over 20 points switching to plant-based diet! [2]

That said, I think that guys like myself who eat a ton of plant foods have to be consider the fact that they may not always be getting all the niacin they could.  Men with lower niacin status can probably give their erectile strength and cardiovascular health a nice boost by consuming more niacin-rich plant foods.  There are many plant foods, such as broccoli and mushrooms that are quite high in niacin.  I actually consume nutritional yeast and BPA-free sardines daily and get a nice amount of niacin this way on top of my regular diet.  Therefore, I feel that I am likely maximizing my erectile strength by combining the best of both worlds, i.e. some NO-boosting plant foods and high niacin foods as well.  (Both  sardines and nutritional yeast also have a decent amount of protein as well, which is important to me since I enjoy lifting weights.)

b) Men With Digestive Disorders. There are many, many GI disorders that plague modern, urban dwellers:  atrophic gastritis, Crohn’s, diverticulitis, enzyme deficiencies, IBS, ulcerative colities and on and on.  All of these can lower vitamin and mineral absoprtion.  Men struggling with these issues may very well benefit from increased amounts of niacin in the diet or possibly with supplementation.

By the way, even though animal foods have higher levels of niacin, this can backfire:  our intestines are narrow, convoluted and almost identical to that of an herbivore.  We simply were never meant to digest a slow moving, low fiber, high fat animal carcas and many studies on gut flora and intestinal disorders are bearing this out.

c) Men with Poor Libid Readings Who Megadose. According to the above study, megadosing with niacin can be a big help for men with low HDL, high triglcyerides and/or high LDL.  Keep in mind that this must be accompanied by lifestyle changes that focus on diet and exercise to really make it work.

1) J of Applied Physciology, Jan 15 2014, 116(2):156, “Vascular endothelial function and oxidative stress are related to dietary niacin intake among healthy middle-aged and older adults”

2) https://www.peaktestosterone.com/forum/index.php?topic=7236.0

3) J Sex Med 2011 Oct, 8(10):2883-93, “Effect of niacin on erectile function in men suffering erectile dysfunction and dyslipidemia”

Female Libido and Exercise - Peak Testosterone

You’re going to have to trust me on this one:  if you can get your wife or girlfriend to start exercising, if she’s not of course, you will have a lioness in the bedroom.  Not only will her libido light up, but her strength and endurance as well.  In other words, you better be ready – you might get hurt, Big Boy!

Now why do I say that you’ll have to trust me on this one?  Because I cannot find a study to support that statement, but I do know it works. And I’ve read it on many sites as well:  exercise improves libido, decreases PMS and many other wondeful things for the fairer sex.  It also does all the same wonders that it does for guys that I have already documented in my Exercise link. Again, females are different that males – oo la la! – but the foundations of their libido is similar.  Almost always, what boosts your libido will also boost hers.

NOTE:  One of the not-so-well-known reasons that exercise may boost libido for women is that it affects their body self-image so significantly. It’s undoubtedly is the same with guys:  if you don’t feel good about yourself, your libido and bedroom performance can fade quickly.  For example, the womens magazine, Self, recently found that 71% of women who were happy with their looks worked out at least three times per week. [1] By the way, body self-image may also be tied into happiness:  61% of happy women say their body is ‘just right’ as well. [1]

So the question of a lot of guys, who already know the Power of Exercise, are asking is:

“How do I get my spouse exercising?”

That can be a tough question, admittedly, because many women were never in sports or their families didn’t take care of themselves or they feel overwhelmed with work and kids or they’re the “ultra-feminine” type or any number of other things. Never fear, though, because you can lure almost all females into some basic exercising through one of the following exercise methodologies that I list below.

An important point is that hopefully you’ve been modelling the fantastic things that exercise does for you.  With your spouse or girlfriend, or anyone you are close to for that matter, nothing speaks quite as loud as pure example.  People admire someone who is disciplined and who gets results and, if you haven’t already, use your own life to lay the foundation.

Some females don’t want to exercise, but they do want to lose weight and realize how it is all but impossible to lose weight without moving one’s booty at the same time.  Again, in your sweet and gentle way, you can occasionally bring up the advantages of Exercise and good, clean livin’.

Remember, guys:  this will be well worth your effort.  Of course, the important thing is that she’ll be healthier.  Hopefully, you guys are in it for the long haul and, of course, exercise is probably the #1 thing you can do to improve her health.  However, also keep in mind that exercise will likely decrease her PMS symptoms, improve her general mood, and boost her self-image as she loses weight and gains muscle. (We all know self-image is an all-important bedroom concept for both males and females.) And, yes, you will find that her libido will skyrocket as well.

Here are some great ideas that should get her moving if she’s not already:

1.  Yoga Classes. Many ignorant guys have said, “Yoga?  That ain’t exercise!”  Then the dull fellow tried one of the simpler moves and cried like a little girl.  Just one standard Yoga move will leave most guys quivering in pain and begging for mercy.  Seriously, most yoga instructors are lean, muscular and emphasize a healthy lifestyle, all of which will benefits your wife’s libido.  CAUTION:  Some yoga instructors lead students down a path of “overstretching” and injury.  Watch out for those “down dogs”!

2.  Pole Dancing. No, I’m not asking you to send your wife or girlfriend down a new career path.  I’m talking about her learning to pole dance either in an exercise class or in the privacy of your own home.  This ain’t for every girl, but a lot of females find this a fine form of exercise that is a complete strength and aerobic workout. You’ll have to check locally, but in a decent-sized city, there are usually pole dance classes that are both legitimate and popular. Alternatively, you can install a pole at home either permanently or non-fixed.  Of course, with the non-fixed variety, your woman can’t do those Cirque du Soleil moves that you were hoping for. Finally, if the female in your life does let you watch her pole dance, be sure to put your tongue back in your mouth!

2.  Gym Classes. You may enjoy weights and the treadmill, but have you noticed there’s more guys out on the floor than females.  The reason is simple:  most of the women are in taking classes.  These classes often emphasize things like dance and group participation that us muscle-bound hunks avoid like the swine flu.  When I play basketball, I barely notice that I am working and sweating like a pig because I’m having so much fun.  Well, these classes are the same thing for a good percentage of females out there. And, again, don’t give me a “that ain’t no exercise” excuse:  most of these classes are brutal and will leave you whimpering. Break out the card and sign her up!

3.  Dance.  If you enjoy dancing – I’ve seen pictures of people who do – sign the two of you up for dance classes.  Most dance is darn good exercise and will achieve the goal of blood flow and circulation.  Plus, a huge block of women out there enjoy dancing (assuming you don’t remove a toe nail off of her as I once did).  Remember:  not only will the exercise boost her libido, but you may find that you score a few additional points as well!

4.  Walking. Assuming a walk in your neighborhood doesn’t require packing heat or a Marine escort, there is no better way to burn calories.  Walking is steady and enjoyable.  In fact, why don’t you guys walk together sometimes.  A romantic walk coupled with your witty humor and thought-provoking insights could very well score even more points than #3.

5.  Exercise Videos.  Many women love this form of exercise.  They can buy a video of kickboxing, aerobics, dance, yoga or whatever they want and sweat and breathe heavy in the privacy of their own bedroom (where that sort of thing ought to be done).

6. Boot Camps. Boot camps are becoming increasingly popular, where women enroll in a gym or fitness program’s one or two hour program several days per week. Turning fat to muscle and burning lots of calories are usually the big goals.  Because these are done in a group and with good intensity, results can be very good.

7. Zumba.  Zumba is becoming very popular.  It is often taught in gyms and other fitness locations.  This is quite popular with some females as it is high energy and dance oriented.  Calories for many women are burned off without even noticing. It emphasized latin dancing and is designed to be relatively easy to learn and follow. A Google search can pull up a mountain of information including classes in your area.

8. The Dailey Method. The Dailey Method recently went national.and is quite popular as it combines ballet movements with core conditioning and stretching.

9. Trainer. For some people, a personal trainer is a huge asset, supplying a much needed dose of accountability and expertise. This is especially true for females with definite weight loss and other goals but limited time to research the best way to do it. Plus, just having to show up every few days and explain to someone what you have and haven’t done is a big motivator.

10. Cardio Tennis.  This is a natural for both women and men.  Tennis is one of those pleasurable sports where you don’t even notice you are getting a fantastic workout because it is so enjoyable. Even if you haven’t played, get yourself a few lessons and start playing.  Most decent-sized cities (in the U.S. at least) have organized Cardio Tennis.  You can expect a good dose of fat-burning, growth-hormone-producing intensity along with the standard workout paces.  See the Cardio Tennis Site for locations and details.

11. Weight Training. Many women really enjoy weight training once they learn that muscle burns fat. Women also greatly other women with “toned arms and shoulders” and want the same.  Females also have several advantages over us testosterone-laden males, including a shorter recovery time.  Sroll down to this link on  for some interesting details.  And this can be a nice way for you and her to do something mutually beneficial together, eh Pierre?

Again, if you can just get her started, everything will take care of itself.  She’ll start to get that endorphin high from the workouts.  She’ll look better, feel better, lose weight and many other things that will be highly appealing to women.  In fact, after she drops a dress size, she’ll be hooked.

Some of these can involve time and money.  Yes, you may have to watch the kids for her while she heads out to burn some calories and, yes, you may need to forego that compressor for a month or two so she can get a gym membership. It’s well worth it, though, and will pay off in almost every aspect of both her life and yours – yes, even in the sheets.

REFERENCES:

1) Self, 2/2010, p. 102.

What is low testosterone level and how it is treated by physicians.

From the book:

It always struck me as very arbitrary how testosterone deficiency was defined by most practicing physicians.  For years most physicians decided to treat or not to treat based on the bottom value of their lab’s total testosterone range.  So, for example, consider what this man posted: [1]

“I got a hold of the lab results from my first testosterone test.

Total Testosterone 194 —— reference range ——-> 241-827ng/dL”

Now this man will have no trouble getting treatment simply because his total testosterone reading of 194 is well below the bottom range value of 241.  Basically, the physician trusts the labs definition of what low testosterone is and treats accordingly.  However, if the man had a value of 242, most physicians would not treat him, which is unfair in my opinion as some of the labs are using incredibly low levels for hypogonadism.

The labs and physicians are simply not using common sense in my opinion.  Why do I say that?  Testosterone in the 200’s is below that of the average 80 year old man!  Stop and think about it.  Why would we definite clinically low testosterone based on the levels of sickly seniors of a very advanced age?!?   You can check the numbers out for yourself in my page on Average Male Testosterone Levels by Age.

Evidence as to just how “old school” this is can be shown by the fact that there is one forward thinking lab, LabCorp, that has raised their reference ranges anyway.  And LabCorp is the biggest lab in the nation, so, hopefully, others will follow some day.  Look at what this poster on the Peak Testosterone Forum wrote:

“It may just be placebo although I doubt it but since having taken the thyroid medication for this little bit it seems I am seeing far less hair on my pillows and noticeably less in my hands after washing my hair. Metabolism seems to have picked up some as well.

Testosterone serum 343 L labCorp range= gold standard (348-1197 ng/dl)

LabCorp changed their entry level range for what is regarded as hypogonadal serum T levels from 240 ng/dl to 348 ng/dl in October 2011. This has helped many men get a more serious consideration from their otherwise unsympathetic GP’s. This new standard has been long overdue for many many years, but finally something has been done about it and LabCorp should be commended. Had this change been made 7 months earlier to when I first had a lab taken at 294 ng/dl in March 2011 my experience regarding testosterone deficiency and the effect it has had on my quality of life may have been very different from what it has been for the past two years.”

I think that one can make a good case that 348 is even a bit low, but at least it is a starting point.  And, on a practical level, I can tell you that almost all men writing into the Forum with classic low testosterone symptoms are below this level.  We do get quite a few young guys with levels even higher than this struggling however.

Again, it is important to note that there is no guarantee that raising testosterone will correct the underlying issues.  However, the point is that it may and, furthermore, many studies show that correcting hypogonadism in the 350-400 ng/dl range will often help alleviate symptoms.  And this begs the question:  if you can fix a man’s symptoms at 350 ng/dl, then why isn’t 350 ng/dl the threshold for hypogonadism?

Unfortunately, many doctors are not aware of this.  They still believe that testosterone is just something you give to the patient to make him feel better about himself but really does very little.  Hopefully, the studies below will shatter that myth, and I encourage you to show some of them (in a polite way) to him or her:

1) Arterial Stiffness. Low testosterone greatly increases cardiovascular risk, which can, of course, manifest in many different forms. High blood pressure, low vasoreactivity (arterial responsiveness), arteriosclerosis (arterial plaque) and endothelial dysfunction are some of the primary culprits. As we’ll show below, low testosterone is associated with almost all of these.

Another very dangerous cardiovascular risk factor is arterial stiffness, or hardening of the arteries, and low testosterone has been shown in several studies to be correlated with this condition. [17][18] For example, one study of dialysis patients found that men with total testosterone below 235 ng/dl (8 nmol/l) had increased arterial stiffness. Although this study was on a unique subset of the population, it was controlled for a number of important cardiovascular risk factors including BMI (a measure of body fat) and C-Reactive protein (a measure of systemic inflammation). Another example comes from prostate cancer patients, who are often pharmaceutically driven into a hypogonadal treatment state. These men, who are already undergoing cancer treatment, also experience increased arterial stiffness due to the anti-testosterone therapies.

Why is hardening of the arteries so dangerous? The root causes of arterial stiffness are generally loss of flexible connective tissues, decreased vascular muscle tone and plaque buildup.  Of course, the latter is famous for also narrowing arteries and raising the potential for higher blood pressure, blockages and stroke. And low testosterone definitely accelerates plaque buildup in the arteries.

Hardened arteries are also dangerous, because they can result in some unexpected phenomenon, such as creating a greater blood pressure spike that can do damage over time. Even worse, stiffened tissues are less able to absorb this pressure spike and thus allow more injury to surrounding tissues, especially in the brain and kidneys.

Does supplemental testosterone help improve arterial stiffness in men with low T? One study tried to answer this question by examining two groups of men, a hypogonadal group with average arterial stiffness of 8.9 and a control group with a lower reading of 6.78. Within 48 hours of testosterone therapy, the low T men were improved to an average arterial stiffness of 8.24 (measured as PWV).[21] The units actually are not important: the point is that testosterone therapy overcame in two days about a third of the arterial stiffness on average that these men had accumulated from years of basement level hormones.

2) Depression. Most men will will not talk about it, but depression is a huge and common issue with men. Again, I see it all the time on the Peak Testosterone Forum. And many guys with low testosterone have experienced firsthand the fact that testosterone profoundly affects the brain. Several studies have verified this and shown that low testosterone can lead to mood issues and depression. The threshold at which this becomes statistically significant appears to be around 350 ng/dl (10.2 nmol/l). [22] Researchers have also found that testosterone does not just affect how you feel but also how you think. One study observed that low testosterone men experienced memory issues in a manner very similar to that experienced by Alzheimer and dementia patients. [23]

Free testosterone levels may play even more of a role in this case. One group of scientists rediscovered the 300 ng/dl (10.2 nmol/l) threshold for depression but found that the free testosterone level was 10 ng/dl. This is a little above what is normally considered hypogonadal, about 5 ng/dl, in some of the studies. The odds of depression were found to be between 1.5 and 3.0 times more for the lower quintile guys, depending on whether one used total or free testosterone numbers. The bottom line is that if either free or total testosterone is low enough, get ready for a bumpy emotional and mental ride. [24]

NOTE: It is extremely critical to get depression under control. Not only does it tend to lower testosterone, it is also a physical stressor than can literally destroy neurons and raise your risk of cardiovascular disease due to elevated cortisol levels.

As anticipated, testosterone therapy benefits men with low testosterone and depression. One study looked at depressed men with testosterone below 350 ng/dl (11.9 ng/dl) and found that when these men were given testosterone therapy (gel), there was substantial improvement. [25] Of even more weight is the fact that a recent meta-analysis examined seven different studies and found that not only did testosterone therapy improve depression in hypogonadal men, but in men with a broad range of testosterone levels. [26] One can’t help but wonder how many men out there are struggling with depression who do not realize that low testosterone is playing a role.

In addition, testosterone has been found in several studies to be related to mood. [29][30] “Mood” may seem a somewhat subjective word, but, as expected, researchers have studied the subject in considerable psychological detail. For example, one study found that testosterone replacement improved “energy, well/good feelings, and friendliness and decreased negative mood parameters including anger, nervousness, and irritability”. [27] Furthermore, when studying the use of Androgel, scientists found that “mood parameters improved rapidly and were maintained throughout T treatment.” [18]

3) Metabolic Syndrome. Prediabetes, when one begins to lose insulin sensitivity, is an absolute epidemic in the U.S. and other modern cultures right now.  The current prevalence is about a fourth of the population. Common symptoms, such as visceral (belly) fat, low HDL, high triglycerides and blood pressure, often accompany it in a suite of symptoms called Metabolic Syndrome (Met-S).  My guess is that around a half of the guys that show up to my site over the age of 40 probably have Met-S.  Researchers have found that Met-S has been tied to an increased risk of developing cardiovascular death and all-cause mortality. [64][65] It also increases the risk of erectile dysfunction, since it ages the arteries and accelerates plaque build up.

What does Metabolic Syndrome have to do with low testosterone? As discussed, low testosterone raises insulin levels very significantly and thus directly worsens or initiates 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 more 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). [66] 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.

4) Muscle and Fat. A number of studies have shown that testosterone will add muscle and subtract fat.  For example, one study on senior men (over age 65) found that fat mass decreased and lean mass increased in the testosterone treated men. [4] This is truly remarkable considering that the men were put on no special diet or exercise program:  their body composition just magically improved for the better with the additional testosterone.  It should be noted that these were not large improvements in body composition:  it will always boil down to diet and exercise in the end, but testosterone can clearly be a help.

5) Memory. Doubling – actually a little more than doubling – senior males’ testosterone levels led to significant improvements in visual and spacial memory.  I can tell you on a practical level that I very often get comments from men on testosterone therapy of the incredible effect that testosterone has on the brain.  In fact, some executives now are going on testosterone just to improve their careers!  I’m not advising that, of course, but the phenomenon is interesting and you can read about it in this Forum Post.

6) Diabetes. Great improvements in type II (adult onset) diabetes can often be achieved with testosterone therapy in middle-aged and senior men via HRT.  Again, I relate the story of one HRT clinic who told me that ALL of their diabetic patients had completely eliminated their need for insulin after testosterone therapy.  A couple still had to take Metformin, but, nevertheless, this is a dramatic improvement.  Of course, the reason is that increased testosterone led to decreased insulin levels and improved insulin sensitivity in general.  Nice!

7) Erectile Dysfunction and Libido. Many studies have shown the positive effect of additional testosterone for men with low T in the area of sexual health.  For example, one study on hypogonadal men found that morning erections, total erections and libido were all improved after increased T levels. [6] The authors wrote: “all had a rapid and dramatic recovery from major depression following testosterone augmentation.” Wow!  How many psychological disorders have a 100% success rate?!?

CAUTION:  Do not stop any medications or treatments without first talking to your doctor.

8) Venous Leakage. This is an ugly condition that afflicts men, young and old.  It very often has a root cause of low testosterone levels.  The reason is simple:  low testosterone leads to a decay of the internal structures of the penis.  This decay does not allow the veins to be closed off during an erection and thus the outflow from the penis is as great as the inflow and erections are either quickly lost or, in the worst case, impossible to even achieve. For more information, see my link on Venous Leakage.  And several studies have shown the benefit of testosterone levels to men with venous leakage.  One study showed that well over half of men were either partially or fully cured of their venous leakage from testosterone therapy. [8]

This list could be greatly extended.  The point is that eliminating a testosterone deficiency and restoring more youthful levels can significantly or even completely reverse many key symptoms. Should this not be the definition of a true deficiency?  And is this something to discuss with your physician?

Get Your Testosterone Lab Test Done Cheaply

Estrogen: The (All-Important) T-to-E Ratio - Peak Testosterone

Remember those chem lab days?  Well, if you do, you may remember that sometimes the concentration of a solvent or chemical is more important than the absolute amount of the same.  What I remember even more is getting kicked solidly in the right buttock by my 8th grade chem teacher for goofing around with chemicals in the laboratory, but that’s another story.

Again, though, the concentration is often critical and this hold true in the hormonal world as well.  For example, researchers recently found that it is the ratio of testosterone to estrogen that determines prostate cancer health more than total testosterone.

So what is a good T/E ratio?  A solid number for a 20 year old male is 30-40 with some guys shooting near 50.  Of course, some would argue that a T/E ratio that high makes it to where most guys can’t think straight.  Regardless, youthful testosterone-to-estradiol ratios are quite high and are certainly ideal in terms of maintaining male health.

NOTE: Estradiol is the most powerful estrogen in us guys and is termed E2.  Most testosterone-to-estrogen ratios are actually testosterone-to-estradiol ratio in the literature from what I have read, and I use them interchangeably below.

Of course, the problem is that guys, as they age, find this all-important testosterone to estrogen ratio steadily decreasing to sometimes even the single digits. The situation seems hopeless because all males find their testosterone simultaneously decreasing and their estrogen increasing.  This is assaulting our T/E fraction in both numerator and denominator:  you’ve got the numerator decreasing while the denominator is increasing.  Quite the “double whammy”, eh?

NEWS FLASH: A recent study showed that lower testosterone-to-estradiol ratios were actually tied to higher PSA’s. [6] In fact, this study showed that testosterone may actually be protective and estradiol the prime culprit in fueling cancer.  See my page on High Estradiol’s Links to BPH and Prostate Cancer.

What causes these rapid changes on both top and bottom in the negative direction.  Well, some of it is aging.  Males just naturally lose a little testosterone as they age due to mitochondrial dysfunction, DNA and oxidative damage and so on.  However, one of the greatest culprits is the extra pounds around our middle. Extra fat pumps out more aromatase which in turn pumps out more estrogen into our system.

That creates a viscious cycle because the extra estrogen will “crowd out” testosterone and lower the body’s testosterone output.  Then, as testosterone is lowered, muscle is lost and as muscle is lost, fatty tissue is increased and so on.

Is there any good news in all of this?  Yes, the same “double whammy” that lowers our T/E ratio can also raise it. Below we cover three excellent ways to dramatically improve your testosterone-to-estrogen ratio:

1.  Body Fat. Of course, it’s not secret that body fat and male estrogen levels go hand-in-hand.  Many studies show this, but let’s look at one study of guys with fertility problems.  These were relatively young guys within a decade on either side of the average age of 39.  They split them up into two groups: those with a BMI > 25 and those with a BMI less than 25.  The difference in testosterone-to-estrogen ratios was signficantly different:  12 versus 17.  That is a 42% difference!

Does this make sense that body fat would make such a significant difference in the T/E ratio?  Remember that the more fat, the more aromatase and the more aromatase the more estrogen and the more estrogen, the less testosterone.  Excess body weight is correlated with both lowered testosterone and increased estrogen.  In other words, being overweight will hit both sides of the fraction negatively.

By the way, this may explain why weight lifting has been associated with increased long term testosterone levels.  Weight will increase muscle mass and “muscle burns fat”.  Adding muscle, however you do it, will actually change your metabolism for the better so that the same calories go farther.

And I should add that some men, generally obese, can experience MONSTROUS increases in testosterone by losing lots of weight (once the restore their calories).  The reason is that obesity can lead to a type of secondary hypogonadism where the signaling from the hypothalamus-pituitary-testes axis gets dramatically reduced.

2.  Low Fat Diet.  Most men believe that a Low Fat Diet is very negative for your endocrine profile and, in particular, will devastate testosterone.  However, preliminary evidence shows just the opposite.  One small study found that estradiol (the “bad” estrogen or E2) fell from 47.2 to 23.8 pg/ml on average, which is obviously a big change.  This is a reduction of over 50% and cut their estrogen levels in half! [3] And the remarkable thing is that their testosterone stayed steady before and after at 510 ng/dl.

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. For additional information, see my link on Low Fat Diets and Testosterone.

Increasing your T/E Ratio by a factor of 2+ should grab every man’s attention, especially considering it was done simply by diet.  Check out The Incredible Benefits of a Low Fat Diet.

3.  Sexual Intercourse (via Cialis). As an example, let’s look at an eye-opening Cialis study.  Of course, Cialis is the 36-hour PDE5 inhibitor that has put so many middle-aged and beyond guys back in the game.  And getting back into the game has a profound effect for most much guys:  it boosts  their testosterone to estrogen ratio by 24% on average according to one study. [1]

The reason?  Cialis gives guys who are struggling confidence and that all-important Nitric Oxide boost that leads to more sex.  And more sex boosts testosterone and a host of other changes.  What is interesting is that in the above study, testosterone only increased 5.5% on average but estrogen lowered by about 15%.  And the net boost in the T/E ratio exceed the sum of those two by a few percentage points as well.

Now this is a remarkable change if you think about it.  The “concentration” of testosterone and estrogen – estradiol is what really counts – changed by 24% from just one lifestyle change.  Imagine what could happen as you pile on some of the other Testosterone Increasing Techniques and Estrogen Lowering Strategies that I have mentioned on the web site.  There is no reason that you cannot dramatically improve your ratio of testosterone to estradiol (unless you happen to be training for the Olympics with a professional trainer).

4.  Arimidex. Arimidex (anastrolozole) is an aromatase inhibitor that, not too surprisingly, can do wonders your T/E ratio.  It works by actually binding to the aromatase enzyme that converts testosterone to estrogen. And if you want to best your testosterone-to-estradiol ratio, it’s hard to beat.  For example, one study showed that in hypogonadal senior men, the T/E ratio was increased on average by 115%!  It produced a 62% in testosterone and a 24% decrease in estradiol. [4]  Of course, it is a pharmaceutical and thus has side effects and unknown long term safety.  But it’s hard to argue against its great hormonal properties.  NOTE:  Other AI’s (aromatase inhibitors) can produce similarly spectaculr changes in the testosterone to estrogen ratio as well.  For example, one study showed Teslac (testolactone) also produced an improvement of over 100%. [5]

The point is that, at least using #1-#2, you can use some very natural strategies that will very likely make a very substantial change to your testosterone/estrogen ratio and, as a consequence, feel much better and lower your risk for many diseases and conditions.

CAUTION:  Most guys probably do not know that caffeine increases both cortisol AND testosterone.  Unfortunately, it does not raise testosterone enough proportionately thus lowering the overall testosterone-to-estrogen ratio. [3]

REFERENCES:

1) The Journal of Sexual Medicine, Jul 2006, 3(4):716-722, “Testosterone:Estradiol Ratio Changes Associated with Long-Term Tadalafil Administration: A Pilot Study”

2) Systems Biology in Reproductive Medicine, 2006, 52(2):97-102, “EFFECT OF BODY WEIGHT ON TESTOSTERONE/ESTRADIOL RATIO IN OLIGOZOOSPERMIC PATIENTS”3) Int J Sport Nutr Exerc Metab, 2008 Apr, 18(2):131-41, “Dose effect of caffeine on testosterone and cortisol responses to resistance exercise”

3) 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”

4) Clin Endocrinology, 2009, vol. 70(1)”116-123, “Effects of aromatase inhibition in hypogonadal older men : a randomized, double-blind, placebo-controlled trial”

5) The Journal of Urology, Feb 2002, 167(1):624-629, “AROMATASE INHIBITORS FOR MALE INFERTILITY”

6) Indian J Clin Biochem, 2015 Jan, 30(1):59-65, “Serum Testosterone, 17β-Estradiol and PSA Levels in Subjects with Prostate Disorders”

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

Natural TNF Alpha Inhibitors - Peaktestosterone

What would you want to inhibit TNF (TNF-alpha or Tumor Necrosis Factor)? Simple – it is the Root of All Evi! Think I’m exagerrating? As I covered in my link on Erectile Dysfunction and Inflammation, TNF-alpha is a major contributor to erectile dysfuntion, heart disease, autoimmune disease and cancer. That’s why controlling TNF should be one of your major priorities as a male and this page is one of the most important on my site.

So what is TNF?  TNF is just one of the body’s “inflammatory cytokines” used to handle infections and inflammation.  Like estrogen, a little is essential and good.  However, also like estrogen, most guys don’t have trouble with too little, they have trouble with too much. Our modern lifestyle raises TNF to unhealthy levels and, eventually, these increased levels kill us.  It’s easy to make the case that too much TNF-alpha is the biggest killer of males in modern societies.

TNF is so potent that they now have anti-TNF drugs used to treat conditions such as rheumatoid arthritis.  Of course, drastic disease sometimes require drastic action, but consider this:  below I document many natural ways to lower this potentially toxic cytokine.  Of course, the answer is ‘yes’ and below you’ll see many of the same players known for

5. Turmeric / Curcumin.  Many studies have shown that this spice, present in yellow mustard and curry, inhibits TNF production. [4]

6. Green Tea / EGCG. EGCG is one of the most potent of all plant phytochemicals and has a host of miraculous properties. Multiple studies show that EGCG limits TNF-alpha production. [5]

7. Vitamin E / Alpha Tocopherol. This vitamin not only limits TNF release in arteries but also prevents oxidation of LDL and many other processes that lead to arteriosclerosis. [6] Although scientists have studies alpha tocopherol, it is probably prudent to only take mixed tocopherol Vitamin E because the alpha form can lower levels of the others (gamma, etc.).

8.  Ashwagandha.  This traditional ayurvedic herb has been shown to reduce TNF-alpha output. [7] It has many other uses, including a Natural Sleep Aid (see no. 18) as well.

9. Magnesium. There is strong evidence that low magnesium levels can negatively affect TNF levels. [8] Of course, one can easily get enough magnesium from a well-rounded, plant-based diet, but still many in modern societies do not. [8] See my link on The Boron and Testosterone for more information.

10. Tart Cherry Juice. This cherry juice is, well, tart, but is well worth the effort as it tightly clamps down on rising TNF alpha levels.  It is so powerful at controlling inflammation that is can reduce post-exercise muscle soreness and is used by many athletes already.  See my link on Inflammation and Juicing for more information.

11. Progressive Muscle Relaxation (PMR). One of the most powerful ways to control TNF alpha levels is actually not a food, juice or supplement but rather a time-proven relaxation technique. PMR was developed originally as psychological tool but has since proven itself to help with many health-related issues. I discuss these at length in my link The Many Health Benefits of Progressive Muscle Relaxation for Men.

NOTE:  TNF alpha is not the only cytokine that needs to be controlled.  For other natural ways to lower inflammation, see my link on Inflammation. In addition, many foods and a number of supplements favorably alter the upstream TNF inflammatory signaling.. Alpha lipoic acid and an extract of Korean Ginseng are examples of this. [10][11] [12] It should be noted, though, that other extract of Ginseng have actually stimulated TNF-alpha itself. [13]  Quercetin, the miracle phytochemical in apples and onions, is also in this category.

CAUTION:  The only potentially negative affect of cocoa that I know is that it does seem to stimulate TNF-alpha. [9]  The same thing has been found in certain Korean Ginseng extracts as well. [12]

REFERENCES:

1) Am J Clin Nutr, Jan 1996, 63:116-122, “The effect on human tumor necrosis factor alpha and interleukin 1 beta production of diets enriched in n-3 fatty acids from vegetable oil or fish oil”

2) BioFactors, 2008, 32(1-4):179-183, “Functions of coenzyme Q_{10} in inflammation and gene expression”

3) Eur J Nutr, 2005, 44:348–354, “A Mediterranean dietary style influences TNF-alpha and VCAM-1 coronary blood levels in unstable angina patients”

4) Phytomedicine, 2005 Jun, 12(6-7):445-52, “The effect of turmeric extracts on inflammatory mediator production”

5) Cancer Detect Prev, 2000, 24(1):91-9, “A new concept of tumor promotion by tumor necrosis factor-alpha, and cancer preventive agents (-)-epigallocatechin gallate and green tea–a review”

6) Current Opinion in Lipidology, Feb 1998, 9(1):11-15, “The effects of alpha-tocopherol on critical cells in atherogenesis”

7) https://hot24.weebly.com/uploads/5/2/3/8/5238782/ alternative_treatment_for_cancer_new.pdf#page=276

8) Magnes Res, 2004 Sep, 17(3):189-96, “Elevated concentrations of TNF-alpha are related to low serum magnesium levels in obese subjects”

9) Dev Immunol, 2002 Sep, 9(3):135-41, “Modulation of TNF-alpha secretion in peripheral blood mononuclear cells by cocoa flavanols and procyanidins”

10) International Immunopharmacology, Feb 2008, 8(2):362-370, “Alpha-lipoic acid inhibits TNF-? induced NF-?B activation through blocking of MEKK1–MKK4–IKK signaling cascades”

11) FASEB Journal, 2001, 15:2423-2432, “?-Lipoic acid inhibits TNF-?-induced NF-?B activation and adhesion molecule expression in human aortic endothelial cells”

12) International Immunopharmacology, October 2007, 7(10):1286-1291, “Anti-arthritic effect of ginsenoside Rb1 on collagen induced arthritis in mice”

13) Phytomedicine, 2002 Jul, 9(5):398-404, “Extractable polysaccharides of Panax quinquefolius L. (North American ginseng) root stimulate TNFalpha production by alveolar macrophages”

1. Fish Oil.  It’s no secret that omega-3’s are one of your most potent inflammation fighters and studies have shown this to be true in the case of tnf as well. In one study of healthy volunteers, tnf-alpha synthesis was dramatically reduced by 74% as fish oil dosage was increased to about 9 grams per day.  [1]  NOTE:  This is a hefty dose and higher than what is normally recommended for typical fish oil supplementation. Going with a smaller dosage should result in significant reductions according to this study.

2. Exercise. Moderate exercise can powerfully lower exercise and decrease baseline levels of TNF alpha and IL-6, your body’s two most powerful inflammatory chemicals. See this page for information: Exercise and Inflammation for more information.

3. CoQ10.  A number of studies have shown that this antioxidant molecule reduces tnf levels. [2] This is yet another example as to the Danger of Statins.

Â4. Mediterranean Diet. One study the degree of adherence to a Mediterranean Diet was inversely related to TNF-alpha levels. [3] In other words, the more the Mediterranean Diet, the less the tnf. For more information about how to improve mortality, heart disease and erectile strength, read this link on The Power of the Mediterranean Diet.

Progesterone in Men: Some Risks and Rewards.

Progesterone is known as a “female hormone,” since it plays a significant role in ovulation, pregnancy and fertility in women.  What most men don’t realize is that plasma levels of progesterone are surprisingly high in men and appear to play a significant role in male health.  Surprisingly, it can also help some men in the bedroom and many alternative and anti-aging physicians are actually using progesterone to help cure erectile dysfunction and other male-related health issues, something I will discuss below.

Although progesterone therapy has certainly not gone mainstream in men, it certainly has many impressive benefits, which are outlined below.  Again, here are some reasons progesterone is growing in popularity for middle-aged and beyond men:

CAUTION: Progesterone should only be administered under the care of a knowledgeable physician.  Not everyone feels good on progesterone.  One man wrote that “I tried using a very small amount of progesterone cream but even the recommended small amount for men made me feel lousy the following morningm so I stopped using it after only a few days.” [9] In addition, please read my page on The Potential Dangers of Progesterone for additional important information.

1. 5-Alpha-Reductase Inhibition. This enzyme is responsible for converting testosterone into DHT.  DHT is a powerful hormone in males and is responsible in part for libido, muscle growth and many other male functions.  However, too much DHT can be hard on the prostate and lead to hair loss.  Progesterone, which decreases with aging, is a significant inhibitor of 5-alpha reductase. [2]

2. Erectile Dysfunction Treatment. There are some anecdotal reports, admittedly from non-peer reviewed sources, that indicate that progesterone can be a near miraculous cure for some men with erectile dysfunction, especially when combined with HRT (testosterone therapy).  I cover this in my page on Progesterone and Erectile Dysfunction.

3. Noradrenaline Control and Reduction.  It looks progesterone can help control and even reduce noradrenaline. [5] This stress hormone is known for being the “anti-erection” hormone in the sense that it actually provides necessary feedback from men getting spontaneous erections.  However, too much noradrenaline puts the brakes on one’s hardness factor.

1)   Psychoneuroendocrinology, Apr 2004, 29(3):339 354, “Administration of progesterone produces mild sedative-like effects in men and women”

2) The Journal of Clinical Endocrinology & Metabolism, Jan 1 1974, 38(1):142-147, “Inhibition of Testosterone Conversion to Dihydrotestosterone in Men Treated Percutaneously by Progesterone”

3) Clin Endocrinol (Oxf), 1980 Nov, 13(5):409-12, “Leydig cell tumour of the testis with gynaecomastia and elevated oestrogen, progesterone and prolactin levels: case report”

4) Plast Reconstr Surg, 2000 Oct, 106(5):1011-3, “Estrogen and progesterone receptors in gynecomastia”

5) Gynecol Obstet Invest, 1993, 36:234 238, “Progesterone Reduces Sympathetic Tone without Changing Blood Pressure or Fluid Balance in Men”

6) Br Med J (Clin Res Ed), 1985 Jan 5, 290(6461):13 14.”Natural progesterone and antihypertensive action”

7) The Aging Male, 2004, Vol. 7(3):236-257, “Progesterone: the forgotten hormone in men?”

8) https://peaktestosterone.com/forum/index.php?topic=2111.5;wap2

9) https://peaktestosterone.com/forum/index.php?topic=2270.5;wap2

10) https://peaktestosterone.com/forum/index.php?topic=244.0

11) J Endocrinol. 1981 Jul;90(1):97-102, “Effects of testosterone, pregnenolone, progesterone and cortisol on pituitary and testicular function in male golden hamsters with gonadal atrophy induced by short photoperiods”

12) Fertility and Sterility, 1992, 58(6):1191-1198, “Direct effects of progesterone and antiprogesterone on human sperm hyperactivated motility and acrosome reaction”

NOTE:  Are you high or low in progesterone?  You can find out yourself through one of these Testosterone and Hormone Labs.

4. High Blood Pressure. Progesterone, likely from the effects of #2, can improve blood pressure a little in men and, of course, hypertension is one of the leading risk factors for erectile dysfunction. [5][6] For more information, see this link on High Blood Pressure and Erectile Dysfunction.

5. Sleep Improvement. Progesterone plays an important role in sleep and sleep quality. [7] Some commentators believe this is progesterone’s primary role, because Sleep is So Critical to Male Health.

7. Fertility. Sperm hyperactivation may not sound like a good thing, but it’s actually important in order for the egg to be fertilized.  Progresterone is actually one of the major factors responsible for this. [12] You can get your levels checked at one of these Man Friendly Labs.

NOTE:  One of the Peak Testosterone Forum members reported  that progesterone restroed the size of his testes: [8] “As a side note, (just thought about this ), I do have a fair amount of testicular atrophy going on because I was so low testosterone for so many years. I found that using progesterone cream stopped the atrophy. You can find more about this by googleing men and progesterone.” However, the above does not make sense to me and was contradicted by an animal study. [11]

DOSAGES:  The dose that physicians seem to be using is based on a couple of reports that I have received on the Peak Testosterone Forum and are in the 10-50 mg/day range when it comes to the creams.  Again, I do not know about long term safety and nor does anyone else, but here is what these men reported:

“I use Source Naturals natural progesterone cream, which has 500 mg progesterone per ounce, or 22 mg per 1/4 teaspoon. I use about 1/4 teaspoon twice a day. Don’t go by the instructions on the package, as these are for perimenopausal women. I use it every day without a break.”  [9]

“I have been discussing a progesterone/Testosterone compound with my physician. He states that he has many of his patients on a compounded cream of prog/test (10mg/50mg daily) from a pharmacy in town. He said that the progesterone will help block some of the estrogen, therefore blocking some estrogen side effects.” [10]

REFERENCES:

Semen Volume: Causes of Low Semen Volume - Peak Testosterone

Some men with low testosterone and/or erectile dysfunction notice that their semen volume greatly decreases, sometimes, it would seem, to almost nothing.  Any decrease in function is a little scary for us men and we can’t help but wonder what is going on.  Look at what this poster wrote:

“One of the things I noticed that occurred along with me ED is that i stopped “shooting” ejaculate. Now it just drips out. Additionally, the volume of ejaculation is much less (about 50-75% less). Did anyone else experience the same thing along with weak erections?” [1]

Of course, the answer to his question is ‘yes’ as it is quite common for men to notice this.  One of the things you have to evaluate is how much of a decrease in semen volume has occurred for reasons we will discuss below:

2. Aging. One study found that semen volume decreases by about half just from normal aging from age 35 to about age 55. The researchers found that “a peak semen volume of 3.51 +/- 1.76 ml(-1) was observed at age >or=30 to <35 years and a lowest volume of 2.21 +/- 1.23 ml(-1) was observed at age >or=55 years (P<0.05).” In other words, (P<0.05).” In other words, (P<0.05).” In other words, a man can expect a drop of about 38% at least from his early 30’s to his early senior years.

2. Retrograde Ejaculation. If a man notices a more pronounced loss of volume, it may be due to a condition called retrograde ejaculation. Basically, the sperm comes up from the testes into the prostate where it is mixed with the semen. It should then, during “the Big O”, get pushed through the urethra and out the opening of the penis. However, this requires that muscles on the neck of the bladder to close off tightly in order to keep the semen and sperm mixture from being shunted into the bladder.

In many men this “closing off” process does not happen, usually due to improper nerve function or even damage. (This is somewhat similar to a condition where a man loses his erection quickly called Venous Leakage.) This difficulty in sealing the bladder off is not usually a big issue for a man unless he is concerned about fertility. If you have retrograde ejaculation and you want to have kids, then you need to talk to your urologist or fertility specialist as a few treatments have been explored and some have reasonable success rates, which I discuss below.:

3. Diabetes. One of the primary symptoms of diabetes is neuropathy, or nerve damage. And one of the less well-known consequences of this type of nerve damage can be retrograde ejacaulation.  The reason is that the nerves on the neck of bladder that are involved in retrograde ejaculation can be affected.

4. ;Medications. Certain medications, especially SSRI’s and blood pressure medications can lead to retrograde ejaculation as well. Be sure to talk with your physician if this is an issue.

Solutions: Low Semen Volume

So are their any natural ways to increase semen volume? Certainly! I list these below:

1. Increase by Natural Methods. It is possible in many cases to increase your semen volume through lifestyle changes and/or supplements. For details, see my link on Natural Ways to Increase Semen Volume.

2) HCG. HCG has become a mainstay for men receiving testosterone therapy in many HRT and fertility clinics. It also reportedly increases semen volume as well in many men.

However, if you have retrograde ejaculation, these solutions are unlikely to help much. What good does it to increase semen volumen if almost all of it gets shunted down into the bladder? Those with retrograde ejaculation have to look at other options.

I do have to say, though, that semen volume is probably not terribly important unless you are interesting in having children. Retrograde ejaculation can negatively impact fertility and so, if this is your case, discuss possible solutions and aid with a urologist or fertility physician that specializes in these areas.

Some of the studies and research summaries out there show some very novel solutions: [2][3]

3) Imimaprine

4) Pseudoephedreine

5) a and b combined (61% success rate with diabetic patients)

6) Improving Nerve Function. Anything that aids or cures neuropathy will like help a significant percentage of men.  For ideas, see my page on Natural Neuropathy Remedies.

Anything that helps with neuropathy is likely to help as well and I discuss some of the more natural solutions in my link on Neuropathy Remedies for those interested in more information.

REFERENCES:

1)  https://peaktestosterone.com/forum/index.php?topic=2518.0

2) Asian J Androl, 2012 Jan, 14(1):61-8, “Male sexual dysfunction and infertility associated with neurological disorders”

3) J Sex Med, 2008 Jan, 5(1):194-8, “Medical treatment of retrograde ejaculation in diabetic patients: a hope for spontaneous pregnancy”

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:

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:

The New PCA3 Test and Varicocele Tie to Cancer? - Peak Testosterone

I’m one of the few that on the Peak Testosterone Forum that still believe there is considerable value in the PSA test. Even so, I will freely admit that there is a lot to be desired with the PSA.  One of the issues is that it picks up on other conditions, such as the prostate growing in volume, increased inflammation, prostatis, etc.  So wouldn’t it be a great idea if they came up with a test that specifically targeted just prostate cancer? Well, that is exactly what the new PCA3 test does.  The test is not perfect, but it does give good additional information that I believe can help in the diagnosis and treatment of prostate issues.  (I have read that it is about 70% accurate.)

NEWS FLASH: There is now a significantly more accurate test out of the market called the 4Kscore.  I recently took this test and here is my story with it:  My 4kScore to Test for Aggressive Prostate Cancer. I urge you to read that page first.

I am particularly interested in this topic, because I myself had a high PSA and was kicked off of HRT. “Never again” is my motto now.  Urologists have not begun using this test, but a few naturopaths that specialize in men’s health issues have and below is my interview with one of them, Dr. Eric Yarnell.  You will be fascinated with the Doctor Horror Story that drove him to become a naturopath and a discussion as to how he has healed a few men of their low testosterone.  He also discusses a fascinating (and scary of course) research link between varicoceles and prostate cancer.  Most of the interview below, though, is a discussion of the PCA3 test and how he uses it in his practice.

CAUTION: Please do not alter your treatment plan or medications based on anything in this article without discussing it first the urological physician, naturopathic or allopathic, first.

Q. I think it’s great that you’re a naturopathic doctor. Can you let us know what drove you to take this route with your career?

A. My displeasure with the conventional medical system combined with my general interest in healthy eating (I became vegetarian as a teenager, though ultimately found that diet wasn’t the best for me) and helping people. I’ll give an example: I developed otitis media in college. I went to the emergency room as I was very dizzy and disoriented. I sat naked except for a hospital gown in a freezing cold room (to this day I have no idea why they wanted all my clothes off for an ear problem) for over 2 hours before I was seen by an intern who was super rushed and fairly disoriented himself. He did look in my ear and pronounced that I had an “ear infection.” When I expressed skepticism about his plan to give me antibiotics, he eventually brought in the senior doctor who seconded his opinion without looking in my ears. I was prescribed the antibiotics and sent on my way. I did not fill the prescription; I found a naturopathic doctor in Colorado Springs who instead gave me some herbs to take, explained that usually otitis media was due to allergies, and had me do hot compresses over my ear and to rest. She took her time, really listened to me, didn’t have me sit and freeze naked and exposed for 2 hours, and was just generally very pleasant. In a day I was feeling much better without drugs and really feeling encouraged that there were options.

Q. One thing that I know some men will be interested in: do you handle HRT in your current practice? If you want to say a bit about that, I know some men are always looking for good practitioners.

I have chosen not to prescribe testosterone in my practice. I am working hard to figure out why testosterone levels fall in some men and correct the underlying causes. In some cases where testosterone has been clearly indicated I have referred to colleagues who do prescribe it. I am concerned that we are headed down a similar path as what happened with estrogen in women: an uncritical treatment of the lab numbers instead of the person, a failure to ask why the process was happening, and a failure to then do something about the underlying causes. And we have the added difficulty that the “normal range” for testosterone is extremely wide and no one can really explain why or how one man with a serum total T of 300 feels completely fine when another with a serum total T of 400 feels awful with classic hypogonadism symptoms. And I’ve seen both situations!

Anyway, it seems clear to me we are in a new era of understanding men have hormonal changes, but they are complicated and I don’t believe they just happen out of nowhere. I believe obesity, sedentariness, poor diet, stress, environmental toxins, and probably many other factors play a role in causing this (based on my observation that very often I can get patients feeling better and their levels will go up if they are able to make major changes in their lifestyles).

Q. The PCA-3 test is a topic of great interest to me. As you know, I had a high PSA read (6.3) and I am still above my old baseline values of about 1.4. I had a biopsy and they found no cancer or precancer (PIN) and found inflammation. So, supposedly, I have no PC, but the bioposies are not perfect. Would I be a good candidate for the PCA-3 test and, if so, why?

A. In my opinion you would be a good candidate, though having more information about your case would be necessary to say for certain (including results of past prostate exams, urinalyses if any, and any other symptoms you might have in the area). One of the main problems with biopsy is sampling error: at some level the needles are stuck in randomly (ultrasound does try to identify the most likely areas of problem to target, but often doesn’t see any). PCA-3 is much better at overcoming this (but not perfect) as it is dealing with cells shedding from throughout the prostate. Anyhow, the test is also relevant because it is very safe (no needles, just a digital rectal exam/brief massage of the prostate required) and either of its results could really change the course of your case. If it were positive, I would strongly consider imaging the prostate with color Doppler ultrasound or endorectal MRI. If it were negative, I would be thinking much more about chronic prostatitis.

Q. Where you do you stand on the subject of testosterone and prostate cancer? Do you feel that well-managed HRT can fuel prostate cancer, etc.?

A. I am following closely the publications by Gat and Goren out of Israel and their studies on local vs. systemic testosterone and prostate cancer. This is my current working model (which is subject to change and isn’t perfect I’m sure, but does a better job than existing models of explaining what we see clinically):

Q. How accurate do you feel the test is both on the false positive and false negative side of the equation?

A. Very good on false negatives front, moderately good on the false positives front.

False negatives: so far I haven’t seen any of these and the test numbers look pretty good. We’ll need a lot more data to be really sure. But I suspect due to sampling error problems we will see false negatives. We may also see some due to mutational differences between prostate cancer strains that the test can’t identify (yet).

False positives: I have not seen this be thrown off by prostatitis or BPH which is a big step up over PSA. However, I have seen several positive tests where biopsy showed low-grade, minimal cancer (Gleason 3+3 in 1-2 cores only) or imaging (if the patient refused biopsy) showed only what seem to be very mild problems.

So like practically every test we have for prostate cancer, this test is still limited by its inability to distinguish aggressive from non-aggressive prostate cancer. This is huge because most prostate cancer is non-aggressive and doesn’t need to be treated with surgery, radiation, or drugs (the major exception would be for those patients who are so very anxious they can’t stand living with even this low-grade cancer in their body). All patients with prostate cancer have to be monitored lest they have early aggressive forms and we can catch them as they start to look more aggressive as early as possible.

Q. Is the PCA-3 test FDA-approved yet? If not, do you think it ever will be?

A. It is approved (well at least one testing kit for it by Gen-Probe is approved): https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm294907.htm

Q. What are the rough costs for the test itself? And are you seeing other naturopaths and/or traditional urologists making it a part of their regular practice?

A. I have seen some pretty crazy differences in prices between labs. I talked the current lab down to $432 (used to be several hundred dollars more). The lab they bought out used to charge $250.

I am not seeing urologists use it much at all. They seem to feel that it is biopsy or nothing. But I see it occasionally. And more naturopaths are definitely starting to use it, though I still get a lot of referrals. Part of the problem is, it doesn’t warrant keeping the kits around if you don’t do a lot of them, so most NDs are just not seeing enough patients with this problem to warrant it. I do, so it makes a lot of sense for me.

I also tend to see those patients who refuse a prostate biopsy no matter what, and conventional urologists get frustrated and angry and can’t work with these patients. Rather than writing them off as “kooks” or whatever, I have come up with other ways to help them the best I can. PCA-3 and imaging are part of this, as they avoid the needles but can still help us know pretty well (nothing is perfect) whether they have aggressive cancer that really needs conventional and natural medicine combined, or if they have low-grade cancer which just natural medicine can help, or no cancer at all.

Q. Do you think the PCA-3 should be used in conjunction with the PSA or in place of it or neither?

In conjunction, with careful education and preparation of the patient to understand what the tests can and cannot do, and how to interpret them. I also emphasize that if they are positive it means more testing is going to be necessary.

Q. Do you feel that the PCA-3 is as accurate as the standard 12-point biopsy? And, if so, could it ever replace the biopsy?

A. In terms of detecting prostate cancer in general, it gives the biopsy a run for its money. In terms of differentiating aggressive from non-aggressive cancer, biopsy is way, way better. So it is not really an issue of replacement, and I don’t think it ever will be. PCA-3 should be a tool to decide whether a patient should undergo a biopsy or more intensive imaging; if it is negative, then we can just wait and retest in a year or two.

Q. One of the things we really need to know is if one has aggressive prostate cancer. Does the PCA-3 test help with that at all?

A. Nope. See discussion above.

Q. Finally, can you tell us a little bit your practice and give men some contact information if they have further questions for you?

A. DrYarnell.com has all the information. I do a lot of things so I only practice one or two days a week depending on my teaching and writing schedules.

Cheers,

Eric Yarnell, ND

Sugar : Testosterone Killer Extraordinaire - Peak Testosterone

REFERENCES:

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

2) Diabetes Res Clin Pract, 2003, 62:139-48

3) Diabetes Metab, 2004 Feb,30(1):29-34

4) Endocrine Abstracts, 2007, 13:P286, “Effect of Glycaemic index of the diet on salivary cortisol and testosterone levels in females”

Just this week (6/22/2009) one of the most important testosterone-related discoveries was uncovered, although it was one of those things many of us were saying, “I always wondered!” It was found that glucose lowered testosterone. As you may know, a glucose drink is often given before a fasting blood sugar test and researchers, commissioned by the Endocrine Society, administered the standard 75 gram glucose test and monitored testosterone after ingestion of the drink  The results surprised everyone:  testosterone was whacked for hours after the glucose drink.

The extent of the hormonal effect was shocking. First of all, testosterone was diminished by up to 25% regardless of whether the men were diabetic, prediabetic or healthy.  In other words, glucose greatly decreased testosterone in everyone.  Secondly, 98.6% of the study participants had significantly lower testosterone two hours after taking the glucose!  Finally, 15% of the subjects were actually driven into the hypogonadal range, i.e. their testosterone would have been flagged as clinically low.

Many bodybuilders drink a high glycemic drink with protein after a weight lifting workout in order to produce an insulin spike to push amino acids into their cells for muscle building.  In light of the above, this may not be such an enlightened practice.

NOTE:  There’s another reason that you may not want to drink that sugary drink:  Fructose Sabotages Weight Loss. Another interesting fact is that this same effect probably holds true with females as well.  Scientists put a group of females on low and high glycemic load diets with a washout period in between.  What they found was that females produced on average 22% less testosterone on the high glycemic diet versus the low. [4]

Okay, so testosterone is diminished significantly by glucose – but what about the table sugar and corn syrup that are in almost everything that we eat?  The answer is that these will almost for sure affect testosterone in a similar way because table sugar is one half glucose, one half fructose.  Corn syrup is similarly proportioned.

This is also supported by the fact that scientists have already established that elevated insulin levels are correlated with lower testosterone. However, the researchers in the above study found that testosterone seemed to fall independently of insulin levels suggesting that it was blood sugar, i.e. glucose levels that actually depressed testosterone.  For example, blood sugar levels are best measured by what is called the hemoglobin A1c test.  This A1c test has shown that the worse the blood sugar, i.e. blood glucose (in diabetics) the lower the testosterone. [3] Therefore, it is very likely that any sugar or high glycemic meal will lower testosterone to varying degrees for hours afterwards.  Therefore, the best advice we have at this point is to play it safe and avoid all sugars and simple carbs if you value your testosterone.

For additional protection, there are a couple of other things that you can do:

1) Vinegar.  As I document in this link on How Vinegar Can Help Weight Loss, vinegar has a profoundly positive affect on blood sugar metabolism and decidedly dampens the body’s glucose and insulin responses after a meal with significant carbs.  Just have a tablespoon or two with any carb meal and you will lower your blood glucose and insulin rises post-meal, which should help to protect your precious testosterone.

Anti-Viagra: Glucose (and therefore sugar) now has been shown to take down your testosterone.  You should keep in mind that sugar assaults your sex life in many other ways as well.  I intend to do a page or two on this sometime but haven’t had a chance, but I will summarize by saying that sugar also does a full frontal attack on your erections.  Remember:  sugar is half glucose AND half fructose and the fructose component directly lowers Nitric Oxide. That’s right:  fructose directly affects the liver and hits your erections right where they count.  They really should call sugar and corn-syrup Anti-Viagra!

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.

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

Quite a few guys would be reluctant to admit it but have a strong sweet tooth, not realizing what a profound effect this can have on their sex life.  Remember that sugar, almost immediately upon hitting the taste buds and saliva, creates an endorphin rush.  What I’m trying to say that sugar can make you no brighter than Pavlov’s dogs if you’re not careful.  For a few minutes blast of endorphins, you can basically castrate yourself.

I freely admit this is one of my biggest areas of weakness.  It is easier for me not to eat than to eat without at least some sweetness in my meal.  It tooks weeks of work to break this addiction but it is well worth the effort!

By the way, I just want to point out that, once again, Jack LaLanne was way ahead of his time.  As usual, he foresaw about 75 years ahead of his time these research results for how horrendous sugar is for the body. He has for decades preached against sugar and has never consumed a gram of it since he gave it up in his teens.  Undoutedly, this is yet another key to his good health and fitness.

2) Cinnamon.  Cinnamon’s glucose lowering action seem to be based on methylhydroxychalcone polymer, or MHCP.  MHCP is actually a mock insulin and ushers glucose into the cells in much the same that insulin does.  One study gave diabetic patients 1, 3 or 6 gram daily doses of cinnamon.  Even at the 1 gram dose, the results were particularly impressive:  particpants after six weeks of use had glucose levels reduced by 16%. [1] By the way, it should be mentioned that cinnamon also seems to improve insulin sensitivity [2], which is one of the hallmark symptoms of a long-term testosterone killer:  Metabolic Syndrome.  Again, this has not been proven by any study, but cinnamon should help protect your precious testosterone post-carbs just as Vinegar does. CAUTION: There is a certain type of “mock” cinnamon (Cassia) commonly sold in stores that has significant couramin, which is known to cause liver and kidney problems. You only want to buy true cinnamon, which is Ceylon Cinnamon.

Diabetes and Testosterone - Peak Testosterone

What if I told you that I knew of a cure for adult onset diabetes (in men)?  Or what if I told you that there was a simple injection that would completely reverse the diabetes of many middle-aged and senior patients?  Well, it’s true and very few doctors know about it.

How did I find out about it?  Well, I was told by one (pretty large) HRT clinic that every one of their type II diabetic patients was able to completely get off of insulin. Now a couple of them still had to take Metformin, but still it is incredible that all of these men were able to completely get off of insulin.  This should be front page medical press news, but, unfortunately, no one is interested.

How does this HRT clinic do it?  They simply take their men to fairly high testosterone levels – about an average of 1000 ng/dl via weekly injections and then make sure that estradiol is managed biweekly doses of Arimidex (if needed).  So the typical man in this clinic is hypogonadal with testosterone less than 400 ng/dl and then gets boosted to the level of a 20 year old.  Here is the key:  in general, as testosterone rises, insulin levels fall.  And, as insulin levels fall, insulin resistance is decreased and blood sugar levels fall.  This is why increasing testosterone so significantly completely eliminates their need for insulin.

CAUTION:  Can all low testosterone men be cured of their type II diabetes through HRT?  Probably not.  Nor am I saying that everyone should go on HRT.  But I mention the above story, because it is definitely something to discuss with a knowledgeable physician if you are having insulin-related issues.  Even if it halves your need for insulin, that would be an impressive accomplishment, right? Men with Metabolic Syndrome (prediabetes) should take note that testosterone therapy has actually been part of a very successful treatment protocol that completely reversed the condition in the great majority of men. See this link on Testosterone and Metabolic Syndrome for more information.

CAUTION #2: Some men with diabetes have weakened renal function. It turns out that testosterone can potentially be hard on kidneys, in men with existing kidney disease. Discuss with your doctor if you are diabetic and considering going on HRT.

NOTE:  Diabetes is known to accelerate overall aging and it can have a profound affect on one’s sex life.  See this link on Diabetes and Erectile Dysfunction for more details.

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

2) Diabetes Care, Jan 2002, 25(1):55-60, “Endogenous Sex Hormones and the Development of Type 2 Diabetes in Older Men and Women: the Rancho Bernardo Study”

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) 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) Diabetes Care, Apr 2007, 30(4):911-917, “Clinical and Biochemical Assessment of Hypogonadism in Men With Type 2 Diabetes Correlations with bioavailable testosterone and visceral adiposity”

6) Diabetes Care, July 2005, 28(7):1636-1642, “Relationship Between Testosterone Levels, Insulin Sensitivity, and Mitochondrial Function in Men”

7) The Aging Male, 2003, 6(1):1-7, “Testosterone supplementation in men with type 2 diabetes, visceral obesity and partial androgen deficiency”

8) Acta Physiologica Scandinavica, Dec 1992, 146(4):505 510, “The effects of testosterone on insulin sensitivity in male rats”

So is the story above supported by the studies?  Indirectly, yes, although studying the effects on diabetics of going to these higher testosterone levels has not been looked at as far as I know.  But look below at the many ways that testosterone is tied into and can reverse or prevent adult onset diabetes:

1.  Hypogonadism and Diabetes Risk.  The studies show clearly that low testosterone increases the risk for diabetes.  At what T level will the risk of diabetes increase significantly? A couple of studies give us some interesting insights. The first looked at several hundred community-dwelling seniors and found that men in the lowest quartile of low testosterone had a dramatically increased risk (2.7 times) of developing diabetes. The lowest quartile in this case was found to be total testosterone less than 256 ng/ml (8.6 nmol/l). [2] Other studies have found similar numbers, around 294 ng/dl (10 nmol/l) for example. [1]

The answer to that was clearly shown in some animal studies, where rats were castrated and the authors found that insulin resistance followed along with a decreased ability to utilize glucose.  Over the years resarchers clearly concluded that even in humans “low testosterone levels and impaired mitochondrial function promote insulin resistance in men.” [6] And , as further proof, researchers  put low T men on Hormone Replacement Therapy and watched their insulin levels fall.. See my link on Testosterone and Insulin for more details, but a perfect example was a study that gave testosterone to hypogonadal men with type II diabetes.  What happened?  Every standard diabetes measure improved – that’s what happened!  And, yes, both fasting insulin and insulin sensitivity improved markedly. [3]

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

3. Blood Glucose Levels. Now, if testosterone really improves insulin sensitivity, wouldn’t you expect testosterone therapy to generally result in lower blood glucose levels, at least in low T men?  Of course, this has been verified both in studies and clinically, such as the story I told above.  In fact, the same study mentioned in #2 also showed substantial reduction in blood glucose levels. [3] Both glycated hemoglobin (A1C) and fasting blood glucose levels went down. Glycated hemoglobin, for the unitiated, is essentially a way to measure a rolling (approximately) 90 day average of blood glucose levels. It is not a perfect measurement but, in this case, shows that average glucose levels were substantially reduced through testosterone therapy.

4.  Eliminated Risk of Dying. Let’s start with a profound study of type II (adult onset) diabetics that grouped men according to testosterone levels. They found that the hypogonadal men, defined as less than 306 ng/dl (10.4 nmol/l), had double the chance of dying. This is very large increase in mortality – usually studies are looking 20%, 30%, etc Yet in this case, a man has twice the risk of dying with both low testosterone and diabetes.

What was the solution? When the researchers gave the diabetic men with low T testosterone therapy, the results were impressive: a mortality rate equal to that of the diabetic men with normal T. [25] In other words, the researchers found that if you put them on HRT, it eliminated ALL the additional risk of dying, leaving them at the same risk on average as other diabetic men. This is good news, because it suggests that the ravages of low testosterone are largely reversible in men with glycemic issues such diabetes and possibly Metabolic Syndrome, a large cross section of any modern, industrialized society.

5.  Visceral Fat.  Belly fat and insulin resistance go hand in hand – something I disucss in my link on Visceral Fat. A lot of belly fat on a man (or woman for that matter) is a sure sign that they have lost or are losing their insulin sensitivity. Testosterone, or the lack thereof, can definitely play a strong role. A couple of studies have found, for example, that low testosterone is correlated with higher visceral fat levels. [4][5]

One of these studies found that “obesity is associated with low testosterone levels in diabetic men.”  Now we know that obesity can actually cause low testosterone by actually shutting off the signaling from the hypothalamus / pituitary.  So is this all that is going on?  Low T correlates with belly fat simply because obesity causes low T?

It turns out that that is not the whole story as evidenced by the fact that giving hypogonadal (diabetic) men testosterone lowers belly fat without doing anything else. [3][7] So, if you want to get rid of that belly fat, improving your testosterone levels will very likely help. Of course, it’s not a miracle cure:  diet and exercise are kings.

REFERENCES:

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):

Vegetarianism, Longevity and Mortality - Peak Testosterone

REFERENCES:

1)  Bratisl Lek Listy, 2008, 109(10):463-6, “Vegetarian diets, chronic diseases and longevity”

2) Am J Clin Nutr, 1999 Sep, 70(3 Suppl):516S-524S, “Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies”

3) Am J Clin Nutr, 1999 Sep, 70(3 Suppl):532S-538S, “Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists”

4) Ann Nutr Metab, 2012, 60:233-240, “Cardiovascular Disease Mortality and Cancer Incidence in Vegetarians: A Meta-Analysis and Systematic Review”

Right now Paleo and Low Carb diets are BY FAR the most popular here in the U.S. among men from all that I have seen. They simply dominate the health and fitness landscape and vegetarianism is now associated with weakness and ill health. This is the ultimate irony, however:  vegetarians actually enjoy superior longevity and significantly increased mortality rates.

Now why would the health and fitness community not promote the dietary regimen that produces the greatest longevity?  Well, I don’t know either, but I want to start by pointing out a common theme:  vegetarians have improved longevity almost entirely due to reduced cardiovascular mortality rates. In other words, vegetarians generally live longer simply because heart disease is the number one killer and vegetarianism greatly reduces the risk of dying from heart disease.  There are many reasons for this, but here is something that I want to point out immediately:  anything that improves your cardiovascular system is VERY likely to improve your sexual health and erectile strength.

The reason is that the cardiovascular and penile/erectile systems are joined at the hip so to speak.  Erections are very dependent on blood flow and clean arteries and so is heart health as well.  This is one of the reasons I am largely vegetarian:  it’s G-O-O-D for the bedroom.

Anyway, here are just some of the studies that show improved mortality and longevity rates from a vegetarian lifestyle:

1.  Meta-Analysis. One journal article pooled five studies and found that vegetarians had significantly reduced cardiovascular mortality rates, i.e. the risk of dying from heart-related issues. [2] Those who ate fish but not meat or were lactoovovegetarians enjoyed a particularly large benefit and decreased their death rates by a little over a third.

The abstract shows has one and only one sentence in it: “Vegetarians have a lower risk of dying from ischaemic heart disease than non-vegetarians.”

NOTE: I consider myself a “Plant-Based Eater”.  In my mind, this has a less dogmatic connotation that avoids a lot of the unnecessary rhetoric that sometimes goes along with being a vegetarian. For example, I do eat occasionally eat meat and consume eggs almost daily.  I also am willing to admit some of the advantages that eating meat confers. But, overall, in my mind vegetarianism is the clear winner overall.

2. Large Adventist Health Study.  This very large study of over 34,000 Seventh Day Adventists (SDAs) shows very similar results to #1:  vegetarian men enjoy improved cardiovascular mortality rates by about one third or even a little over. [3] (fyi:  They also found that vegetaarian Adventists had lower risks of diabetes, arthritis and high blood pressure than meat-eating Adventists.

3. The Other China Study.  This study from China made a mishmash of the research by including some semi-vegetarian groups in it.  Due to not making careful distinctions between vegetarians and non-vegetarians, conclusions were hard to come by.  Still the researchers will willing to state clearly: “The mortality from ischemic heart disease was significantly lower in vegetarians than in nonvegetarians (RR = 0.71; 95% CI, 0.56 0.87).” [4]

4.  European Vegetarians. [1] This research summary out of Slovakia was clearly vege-skeptic. For example, the authors noted that vegetarianism conferred little benefit in the cancer arena, but admitted that “in vegetarians, a decrease of ischemic heart disease mortality was observed probably due to lower total serum cholesterol levels, lower prevalence of obesity and higher consumption of antioxidants. Very probably, an ample consumption of fruits and vegetables and not the exclusion of meat make vegetarians healthful.” This is the ultimate irony:  the researchers try to defend meat eating and yet admit that fruits and vegetables and high antioxidants (obviously from plants) are keys to cardiovascular improvements that beat meat out every time. So what’s not to like??

The summary of all this research data can be summarized as follows:

1.  Several studies show big benefits in longevity to vegetarians.  These mortality benefits are largely cardiovascular.

2.  No studies (that I know of) show any significant advantage to eating meat in terms of extending life span or reducing death rates.

3.  A couple of studies show relatively neutral benefits in terms of all cause mortality and cancer.

4.  All studies show vegetarians experience an improvement in ischemic heart disease mortality rates.  We will discuss this more below.

Now a quick side comment:  in light of this data, the evidence points to vegetarianism as being the likely winner.  Admittedly, the data is not as consistent as one would like.  But meat never wins and has often lost.

In light of this, one cannot help but ask, “Why do herbivores (meat-eaters) so aggressive attack vegetarian diets?” It simply does not make sense based on the data. Again, just go to the Paleo and Low Carb sites and you will constant charges that a) vegetarian diets will increase heart disease (in spite of the evidence), b) are packed with “anti-nutrients” and c) will hammer your testosterone.  Yet the evidence actually shows that Vegetarians Are Equal or Better in Testosterone Than Meat Eaters.

But now let’s go back to what is probably the most important point about vegetarian diets and longevity:  the improvement in ischemic heart disease. This is should be of interest to men everywhere, because ischemic means a “lack of blood supply” or “insufficient supply of blood” to a tissue or organ.  In other words, vegetarianism improves blood flow. (Yes, that is what my book, The Peak Erectile Strength Diet is all about.)  And, if you’re interested in sex, it’s all about blood flow.  So, again, a vegetarian diet is one of the keys, in my opinion, of becoming a true Orgasmatarian and this is shown clearly in virtually all of these mortality studies.

In addition, I have to point out that I think it is remarkable, actually, that vegetarian diets do so well considering there are so many vegetarains that eat a lot of wheat and other refined carbs. I am particularly afraid of wheat, because it is heavily GMO’d, has a high glycemic index and produces an immune response in many people, a fact that I cover in my link on A Review of Wheat Belly.

It is quite easy to supercharge a vegetarian diet, by limiting things like wheat and refined carbs, and make it even much more healthy and likely to produce superior longevity.  This is shown by the fact that the most elite cultures on planet earth with no heart disease, hypertension, cancer, etc. are all almost entirely vegetarian.  For more information, see my link on A Review of Healthy at 100.

Muscle: What should be Pre Workout Drink or Meal

Ready to look about twenty years younger?  Then put on about twenty pounds of muscle.  Seriously, every pound of muscle will take a year off of your bodily appearance and make you significantly more attractive.  I have warned you that Females Value Your Appearance and so, very likely, the better you look, the more strongly she will be attracted to you.

Building muscle is one of the key aspects to this and it doesn’t have to be complicated.  Most of it is common sense:  do a hard workout without overtraining; get plent of sleep and rest; get enough protein and so on.  You don’t have to spend hours and hours in the gym, nor do you have to push yourself so hard you can’t move for the next week because you’re so sore.  Quite the opposite.

Here at Peak Testosterone we encourage, whenever possible, to work smarter and not harder.  And your pre-workout diet is an excellent example of this rule:  taking five to ten minutes to eat or drink appropriately before your workout can make a significant difference in your muscle gains.

CAUTION:  Before I go on, though, almost all store wheys that I have seen are loaded with dangerous excitotoxins and I document that here in my link called No Whey!  However, there is an alternative, undenatured or biologically active whey, which I document in my link called Yes Whey! if you want more information.

But the reason that pre-workout drinks do their wonders is simple:  leucine.  As you know, when you eat protein your body breaks down the protein into a number of different amino acids, but it is primarily one protein, leucine, that triggers your body’s absorption of these amino acids into your muscle tissue. [1]  Some of you have read online or in bodybuilding mags the importance of protein to bodybuilding.  Well, it really all boils down to this one key amino:  leucine.  And, for all you middle aged and beyond guys, one animal study shows that adding leucine to the diet actually reversed the age-related decline in protein synthesis! [2]

Numerous other studies have shown similarly remarkable results.  There are many common ways guys ingest leucine, such as through direct amino acid supplementation, protein powder, egg whites and so on.  More often than not, they are not even aware that their primary goal is leucine, but that is precisely how they are receiving their muscle-building benefits.

One of the most intriguing ways to your leucine is through whey.  Whey is a dairy product and so one has to be careful regarding food allergies and not getting too much calcium is a risk factor for prostate cancer.  However, one serving per day with no food allergies has some distinct advantages according to the studies.  Many studies have shown that whey is a potent immune system builder and also dampens post-meal glucose and insulin response. [3]  We also document, in our thread on Easy Weight Loss, how whey can help you lose weight as well.  In other words, whey appears to have many health benefits besides building muscle.

But the real key isn’t so much what protein you eat but rather as to when you eat it.  It turns out that it is critical that you consume protein in a pre-workout meal about an hour before your weight or strength training.  One study examined protein uptake into muscle when protein was consumed pre-workout versus post-workout. [4] Their interesting discovery was that amino uptake into muscle was stronger with a pre-workout meal, probably because the aminos were already digested and in the blood stream during the workout.

Personally, I eat egg whites since I believe that I am a little lactose intolerant and have a mild dairy allergy.  The key, though, is to get that protein in before lifting and then consume some protein as well afterwards.  For more tips, see my link on Muscle Building 101.

NOTE: As a side note, there is one study that shows fasting can actually stimulate an anabolic state. [5]  I don’t recommend that – just an interesting footnote.  In addition, one should be very cautious about a Low Carb Diet as at least one study has shown greatly reduced muscle protein synthesis and recovery parameters on this type of diet. [6]

REFERENCES:

1) The Journal of Physiology, Jul 1 2007, 582:813-823. “Nutrient signalling in the regulation of human muscle protein synthesis”

2) The Journal of Physiology, Dec 1 2005, 569:489-499, “A leucine-supplemented diet restores the defective postprandial inhibition of proteasome-dependent proteolysis in aged rat skeletal muscle”

3) FASEB Journal, “The Effect of Whey Protein on Post-Meal Blood Glucose and Insulin”

4) Am J Physiol Endocrinol Metab, Aug2001, 281(2):E197-E206, August 2001, “Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exercise”

5) European Journal of Applied Physiology, Mar 2010, 108(4):791-800, “Increased p70s6k phosphorylation during intake of a protein carbohydrate drink following resistance exercise in the fasted state”

6) Journal of Exercise Physiology, 2009, 12(6): 33-39, “Dietary Carbohydrate and Protein Manipulation and Exercise Recovery in Novice Weight-Lifters”

Salt Caused My Prehypertension - Peak Testosterone

Yes, you read the above right:  I had struggled with prehypertension off and on for a couple of years.  I simply could not figure out what was going on!

–My A1C looked good and my post-meal blood sugar levels, i.e. I did not appear to be prediabetic.

–A year and a half ago, I had a Heart Scan and they found NO plaque. (You can read my story here if you are interested: My Heart Scan (Calcium Score) Results.

Yet, more often that not, my blood pressure showed up at roughly 133/78 give or take a few points.  I found that if I ate a boatload of high-nitrate foods, I could pull it down to 120/80.  But the nagging question was why I had to go to such extremes just to have normal blood pressure.  It was starting to get very frustrating, because I really make the effort to keep up my health – tons of whole foods, few industrial foods, plenty of exercise, etc.

Well, you can guess from the title that I made a great discovery.  What happened is that I was using a lot of salsas, salad dressings, etc. to flavor my food.  I’m not much of a chef (to put it politely), and so I was relying on those for flavor.  However, as anyone who has read a few labels know, the amount of salt in packaged food is ungodly.  So one day I was thinking, “How can I flavor my food without salt?”  I happened to be in Trader Joe’s and bought a couple of jars of no salt spaghetti sauce and used that for the next two days.

Both lowering blood pressure and pulse are big gains by the way from the anti-aging standpoint.  There is a school of thought that believes that elevated blood pressure creates stress at certain key junctures and bends of your arterial system making them vulnerable to the buildup of plaque.  And there is even some research that shows you may only get so many Heart Beats in a Lifetime, so controlling pulse may be a big winner for survival.

Regardless, I mention the above to hopefully illustrate how you sometimes have to keep digging and keep searching to find out root causes. I had gone many different rabbit trails in my search:  I thought it might be damage from weight lifting, because some research shows weights can raise blood pressure post-workout and stiffen arteries in some men according.  I thought it might have been stress.  I thought it might have been fructose.  What a relief to figure it out finally!  The bottom line is that foregoing added salt dropped my blood pressure about 15 mm and 9 mm systolic and diastolic, respectively!

Yes, I realize that guys that are going a lot of endurance sports and sweating heavily need extra sodium.  However, that was not my case:  My intense exercise comes from weight lifting, but there is simply no comparison between myself and a man who goes out and runs or bikes for a couple of hours.

And all I can say is this:  I hope I don’t get tired of that no salt Marinara Sauce…

The results were nothing short of miraculous for me:  I have not had a blood pressure reading over 120/80 since.  I used to think that coffee might be causing my issues.  Well, yesterday morning I drank the equivalent of about four cups of coffee and took my blood pressure and it showed up as 117/78 mm!

And my pulse was 57.  It was almost always right around 70.

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”

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 .

Metabolic Syndrome: Erection Killer - Peak Testosterone

Metabolic Syndrome is a plague of modern society and would better be named Erectile Dysfunction Syndrome or Castration Syndrome.  I cover Metabolic Syndrome several times on this site because it is so critical to the health of your heart and your penis.  Metabolic Syndrome, or Erectile Dysfunction Syndrome as I like to call it, is a set of symptoms that includes

Many researchers would also include increased Inflammation and blood clotting as well.  Some of you well-read health fanatics may even remember when this syndrome was called Syndrome X or Insulin Resistance Syndrome.  Whatever the name, it leads to nasty stuff for us males!

If you have two or more of the above symptoms, then you need to consider yourself as having Erectile Dysfunction Syndrome and you need to take action immediately for the sake of your sex life (and health).  Metabolic Syndrome is a full frontal assault on your penis.  First of all, it is associated with lower levels of testosterone and increased levels of erectile dysfunction. [1]

This relationship was clearly established in a study that showed strong correlations between one of the hallmarks of Metabolic Syndrome, insulin resistance, and testosterone levels. [9]  In these senior men the greater the insulin resistance, the lower the testosterone. Other researchers have concluded that “while it is clear that disease, and in the context of this contribution, in particular the metabolic syndrome can suppress circulating testosterone levels, it has also been documented that low testosterone levels induce the metabolic syndrome “. [5]

NOTE:  Interested in the hormonal link?  See my page on Testosterone, Insulin and Insulin Resistance for more information.

To put it more clearly, Metabolic Syndrome likely causes low testosterone and low testosterone likely causes Metabolic Syndrome. [28] Again, it’s the Kiss of Death to your sexual life and all you hold dear as a male.

Just as bad, this Erectile Dysfunction Syndrome has another little known symptom:  it increases levels of ADMA, an amino acid that mimics Nitric Oxide!  In other words, your body pushes that most precious of all chemicals, Nitric Oxide, out of the way. That means the Little Guy stays little. (For more details, read here.)

REFERENCES

1) Jour Urol, 2007 Feb,177(2):651-4; Jour Clin Endocrin Metab 1990 Oct,71(4):929-31

2) Hypertension,1998;31:780-786

3) Obesity Reviews,Jul 2008,9(4)340-354(15)

4) Am J Clin Nutr,2003 Nov,78(5):965-71

5) J of Mens Health, Sep 2008, 5(1):S40-S45

6) Med Sci Sports Exerc, Oct 2003, 35(10):1703-9

7) Tex Heart Inst J, 2005, 32(3): 387 389

8) Am J Cardiol, 2008 Feb 15,101(4):497-501

9) Diabetes Care, 2005, 28:1636-1642

10) Kobe J Med Sciences, 2007, 53:99-106

11) Diabetes, 2005, 54:1926-1933

12) J Clin Invest, 2007, 117(712) J Clin Invest, 2007, 117(7): 1995-2003

13) Yale University (2004, February 23). Young People Prone To Type 2 Diabetes Exhibit Alterations In Mitochondrial Activity

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

15) Circulation, 2005, 111(11):1448-1454; Lupus, 2005, 14(9):760-764

17) Henriksen EJ, et al. Chronic thioctic acid treatment increases insulin stimulated glucose transport activity in skeletal muscle of obese zucker rats. Diabetes (Suppl.) (1994) 1:122A

18) Diabetes Res Clin Pract, 2003, 62:139-48

19) Physiologica Scandinavica, 1992, 146:505 510

20) Science, 1987, 237(4817):885-888

21) J. Nutr, Nov 2005, 135:2634-2638

22) European Heart Journal, Advance Access published online on January 23, 2008, “Work stress and coronary heart disease: what are the mechanisms?”, Received 1 August 2007; revised 14 November 2007; accepted 22 November 2007.

23) “Alpha-Glucosidase Inhibitors for Type 2 Diabetes.” Chen, H., Journal of Food Science, published online June 30, 2009.

24) Obesity Reviews,Jul 2008,9(4)340-354(15)

25) J of Clin Endocrin & Metab, Nedeltcheva, A.V. , published online ahead of print, June 30, 2009

26) 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”

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

28) J Endocrin Invest, Jun 2007,30(6):451-8; Journal Andrology, 2009, 30:10-22

While Erectile Dysfunction Syndrome is annhilating your testosterone and decreasing your Nitric Oxide levels, it also is taking out your cardiovascular system.  That means that it is clogging up your veins and arteries, including the all important ones that supply blood to your penis!  This, in turn, leads to high blood pressure, which is also strongly associated with Erectile Dysfunction.

Consider also what researchers found when they did an analysis of the Third National Health and Nutrition Examination Survey (NHANES III), a large national survey of the U.S. population ages 20 to 89 taken between 1988 and 1994.  They found that each of the aspects of Metabolic Syndrome raises your chances of a heart attack by the following percentages:

This metabolic disorder doesn’t stop with decreased erectile and cardiovascular function:  it is also associated with “brain damage“. 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”. [2]  None of this is surprising considering that Erectile Dysfunction Syndrome and insulin resistance are associated with systemic Inflammation. [15] Inflammation ravages both the body and mind as informed Peak Testosterone readers already know.

Recent research shows that insulin resitance may be the deadliest aspect of this syndrome and, adding to the problem, is the fact that insulin resistance can be tricky to diagnose.  One warning sign, regardless of your weight, is if you have higher triglycerides and lower HDL scores. [7] That ratio can be a warning sign even for someone who is relatively thin.

NOTE:  The Triglyceride to HDL-C ratio is certainly not a perfect measure of insulin resistance and has been found to be only a little better than the Total Cholesterol to HDL ratio for predicting cardiovascular outcomes. [8] Again, keep in mind that total cholesterol less than 150, and not having resulted from disease or medical condition of course, is probably the best insurance against heart disease. I cover this in the following link on a Low Fat Diet, which is the easiest way to get your cholesterol at or near the 150 mark. Interesting enought, a Low Fat Diet can actually raise Triglycerides and lower HDL and yet it still provides excellent heart protection assuming one’s cholesterol is near 150.

Researchers have also discovered that where fat is located is all-important when it comes to insulin resistance for example.  One study pointed out that there are no sumo wrestlers or NFL players who are insulin resistant even though many are significantly overweight.  However, when they retire they almost always become insulin resistant because “their fat moves from the subcutaneous compartment to the visceral compartment”. [7]  Visceral fat is considered to be an actual organ and effects many part of our metabolism.  A good measure is basically the ratio of a measurement around your belly button to that of your waist.

What is visceral fat?  You may have read about “apples” versus “pears”, referring to the general shape of a person’s body.  Basically, this is referring to whether or not any excess weight on your body tends to go to your belly button area or to your butt.  If it goes to your belly button area, you are more quickly building up “organ fat”, which is linked to type 2 diabetes, Erectile Dysfunction Syndrome and cardiovascular disease.  So even if you are a Skinny Bastard, like myself, you can have a relatively high level of visceral fat and its ensuing negative health consequences.

Another factor that may lead to insulin resistance is a High Fat Diet. Researchers found that, at least in animals, a High Fat Diet led to mitochondrial function genes being down-regulated which mimics what is seen in insulin resistance. [11] This has been verified in multiple animal studies and scientists have just discovered in the last few years the pathway by which this occurs. [12]  Originally, it was thought that free fatty acids might compete with glucose-like substances for use in the cell, but research is pointing in a different direction now.  The important thing to remember is this:  the more fat, the less the mitochondrial function, the more likely you are to be insulin resitant and receive all of the nasty symptoms that come with it.

Keeping and raising mitochondrial function is also related to its sister disorder:  type II diabetes.  The lead of one recent study [13] on the subject wrote “There is a strong relationship between lipid [fat] content in the muscle and insulin resistance in skeletal muscle”.  He then stated something ultra-critical:  “Insulin resistance is the best predictor for whether someone will eventually develop type 2 diabetes”. In other words, type II diabetes is really not the sister of Erectile Dysfunction Syndrome, it is the offspring!pring!

Another important aspect of Metabolic Syndrome to remember is that it generally leads to weight gain, due to the insulin resistance as Japanese scientists have just discovered that high insulin levels keep your body from breaking down fat. An insulin resitant individual will have high insulin levels and high glucose concentrations, a toxic combination that causes damage in different ways.  The high insulin levels are deadly because the block the breakdown of fats by adrenaline and lipase. [10]

So is there hope in the battle against Erectile Dysfunction Syndrome or is it simply an inevitable part of aging? As always, science has uncovered many practical solutions, which I have compiled in my link How to Defeat Metabolic Syndrome.

NOTE ON APNEA:  Of course, the easy weight gain that comes from insulin resistance is deadly in many ways.  I document the many Dangers of Being Overweight. But one I would like to highlight is that weight gain is associated with apnea. [3] Apnea is a sleep disorder where the airway is temporarily restricted leading to extremely restless and interrupted sleep and it whacks testosterone, makes Erectile Dysfunction Syndrome even worse and can lead to a host of nasty distorders.

Prolactin: How to Lower It Naturally - Peak Testosterone

Elevated prolactin can lower libido and testosterone and affect your bedroom prowess.  As I discuss in my link on The Male Refractory Period, elevated prolactin can also lengthen the recovery time post-intercourse. In fact, men with a high enough prolactin level can actually end up anorgasmic.  Remember that right after the Big O, a surge of prolactin is released and this is meant by Mother Nature to counteract the effects of elevated dopamine. [1]

Elevated prolactin also tends to lower dopamine, your feel-good neurotransmitter, which can affect mood (negatively).  Conversely, dopamine is a prolactin inhibitor. [2] In addition, high prolactin can decrease your fertility as well.  So the picture can turn ugly quickly to say the least.

CAUTION:  If you have elevated prolactin, discuss immediately with your physician.  It can be the result of a prolactinoma, a pituitary tumor, that needs medical evaluation.

Of course, there are several well-known medications that powerfully lower prolactin.  Cabergoline (Dostinex) and bromocriptene are the two well-known pharmaceuticals that have helped many men with clinically high prolactin.  There is one big problem with these two drugs:  they are rife with side effects.  Cabergoline does a little better, but many men struggle with nasty issues such as nausea, constipation, dry mouth, fluid retention, heart palpitations and so on.  Furthermore, the percentage of men who struggle with some kind of significant side effect is quite high, although that is dependent on dosage.

Are their decent natural alternatives?  Well, yes and no.  Nothing has the power of one of these medications, but, nevertheless, there are a few ways to lower your prolactin that could potentially help a man with mildly elevated prolactin.  (Always discuss with your doctor first!)

1. Macuna Pruriens. Researchers in India found that an extract (5 grams of a certain product) from the legume called Velvet Bean not only gave a nice boost in testosterone from 449 to 572 ng/dl, but also dropped prolactin levels from 10.76 to 7.28 ng/ml, at least in men struggling with fertility. [3] For those without mathematical superpowers, that’s a 27% increase in testosterone and a 33% drop in prolactin.  Keep in mind that a specific subpopulation was studied in this case.

CAUTION:  Macuna pruriens seem to have caused heart palpiations in a couple of Peak Testosterone Forum members. Of course, most men do not experience arrhythmias from macuna, but apparently the increase dopamine may affect some men. I would recommend discussing with your doctor first.

2. Zinc. Zinc may help some men according to one study of male hemodialysis patients. Giving these men 50 mg of zinc per day lowered their prolactin levels from 29 to 11 ng/ml! CAUTION: Don’t go too high with zinc as some experts believe it is neurotoxic above a certain threshold. See my page on The Potential Dangers of Zinc for many other issues with zinc supplementation.

CAUTION: Believe it or not, low prolactin is a fairly common issue with many men and can be linked to a variety of medical conditions.  See my link on A Guide to Low Prolactin for details.

3. Decrease Estradiol. Increasing estradiol, the “bad” estrogen, is said to increase prolactin by a number of experts.  (Actually, you need some estradiol, or E2, as I document in my link on Do Men Need Estrogen?) However, I see no research evidence that lowering estradiol, through Arimidex (anastrozole), etc., actually lowers prolactin.  In fact, a couple of studies in women show no significant change. [4] However, there is a chance that in some men lowering estradiol may help, which means things like weight loss may improve prolactin levels.

4. Sleep. Sleep disorders or lack of sleep will lower your dopamine levels, which can increase prolactin, as I document in my link on Sleep and Dopamine. One study of men with sleep apnea found that they had a significant decrease in prolactin levels from treatment with CPAP devices. [5] I’m not sure why, but they monitored this after about 1-3 years in these men, but, at least it shows that the positive changes look permanent.

5. Ashwagandha (Withania Somnifera). This popular ayurvedic herb lowered prolactin in a couple of subpopulations according to one study. [8] It should be noted that the effects were small – 10 to 15% depending on the subpopulation looked at.  The dosage was 5 grams/day of the root powder.

6. Magnesium Deficiency. A magnesium deficiency is reported to lead to lower levels of dopamine.  Often dopamine is antagonistic with dopamine and so it is possible that a magnesium deficiency could lead to elevated levels of prolactin, although I was not able to verify this.  But it is easy to test this out.

7. Primary Hypothyroidism. This lowering of thyroid function is usually caused by Hashimoto’s or an iodine deficiency.  It leads to an increase in TRH and can increase prolactin levels, something I cover in my page on Hypothyroidism and High Prolactin.

8. CAUTION: Vitamin B6. Megadosing B6 can lower prolactin. I do not mention this as a solution, because megadosing with B6 can lead permanent nerve damage if done incorrectly. (I am cautious about megadosing vitamins in general.) The form of Vitamin B6 may matter as well. [9] Regardless, it would probably be prudent to make sure you are not deficient in one of these vitamins.

9. CAUTION: Chasteberry (Vitex agnus castus). Chasteberry has been shown in several in vitro studies to bind to dopamine receptors in pituitary cells. [6] It also has a history of being used in women for hyperprolactinemia. [7] Unfortunately, there appear to be no studies on men and, at least in women, it has some unusual affects such as increasing progesterone and LH (leutinizing hormone) while decreasing FSH (follicle stimulating hormone).  In my opinion, this seems like an unpredictable mix of effects for long term usage.

REFERENCES:

1)  Biol Psychol, 2006 Mar, 71(3):312-5. Epub 2005 Aug 10, “The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety”

2) Endocr Rev, 2001 Dec;22(6):724-63, “Dopamine as a prolactin (PRL) inhibitor”

3) https://www.ergo-log.com/mucunatest.html

4) Tumori, 1998 Jan-Feb;84(1):45-7, “Clinical efficacy of the aromatase inhibitor anastrozole in relation to prolactin secretion in heavily pretreated metastatic breast cancer”

5) Sleep and Breathing, Sep 2010, 14(3):253-257, “Infertility and obstructive sleep apnea: the effect of continuous positive airway pressure therapy on serum prolactin levels”

6) https://longwoodherbal.org/vitex/vitex.pdf, Clinicial Nutrition Insights, Black Cohosh and Chasteberry: Herbs Valued by Women for Centuries, BY JOSEPH L. MAYO, MD, FACOG

7) Drug Saf, 2005, 28(4):319-32, “Vitex agnus castus: a systematic review of adverse events”

8) Evidence-Based Complementary and Alternative Medicine, 2011, “Withania somnifera Improves Semen Quality in Stress-Related Male Fertility”

9) J Pharm Sci, 1979 Sep, 68(9):1179-81, “Effects of pyridoxine hydrochloride (vitamin B6) on chlorpromazine-induced serum prolactin rise in male rats”

Vasectomy - Peak Testosterone

Vasectomies – some guys just can’t wait for the day their wives say to “cut the ties” and other guys are very concerned. So who’s right?  Well, the bottom line is that so far there has been no convincing evidence that vasectomies put males, in general, at risk. However, there are some studies that will make you think.

But before we discuss those studies, I want to mention one thing:  anything that gets you to have more sex will in general be healthy.  See my pages Sex is Good for Your Testosterone and Sex is Good for Erectile Strength for some of the research showing this.  And my point is that a vasectomy, for some couples anyway, can increase the chances of having sexual intercourse.

For males the reasons are probably 1) loss of concern about pregnancy and 2) being able to orgasm inside of the woman without a condom (assuming you have no concern about STD’s), which is heaven on earth indeed.  The most prominent reasons for females are undoubtedly 1) less need to use a condom so intercourse feels better and 2) less worry for the woman (or male) about pregnancy.

But, all of that said, I think a Vasectomy 101 might be in order here.  Your doctor will probably not tell you any of this and it’s good to be fully informed.  (He or she often knows more about health insurance reimbursement than about the multitude of studies regarding vasectomies.)

First of all, one of the concerns about vasectomies was that they might somehow negatively affect male hormone levels.  Most of us think, if you cut anything near my gonads, it’s bound to negatively impact my testosterone.  Interestingly enough, there are quite a few studies showing the opposite:  a slight increase in testosterone.  These post-vasectomy testosterone increases have shown up in various healthy populations. [4][5] And these slight increases in testosterone have even shown up in long term studies as well.  [1][6] Of course, one could never advise getting a vasectomy to boost T, especially since some studies have shown no significant increase.[7]  (You may also be interested in my page on How to Increase Your Testosterone Naturally and Common Causes of Low Testosterone for more information.)

Another big concern has been vasectomies and prostate cancer, especially since some of the initial studies showed an increase in T.  The National Cancer Institute has a valuable study [3] that every male should read before deciding on a vasectomy.  This issue has been studied by teams of scientists with largely inconclusive results.  For example, in March 1993, the National Institute of Child Health and Human Development (NICHD) held a conference and examined this issue.  They found mixed study results and, furthermore, “could not find any convincing biological explanation for a link between vasectomy and an increased risk of prostate cancer”.  Similar large scale studies in 1997 and 1998 have found similar results.  But be aware:  there are a couple of studies that show a slight increase in prostate cancer risk [4]

Finally, there is the “dementia connection”.  There is a certain rather obscure form of dementia called Primary Progressive Aphasia (PPA), that ends up with the individuals having trouble remembering and understanding words.  One researcher, Sandra Weintraub, first posited this potential connection.  However, the contrasting argument is simply this:  millions of vasectomies have been done through the world, especially in China, and there is simply not an army of men walking around with PPA.  Again, though, it may be something to research if you are concerned.

One other side effect that doctors frequently do not inform their patients about is what’s called congestive epididymitis. Basically, after a vasectomy, the sperm is trapped in the epididymitis where it is reabsorbed into the body.  If sperm becomes “backed up”, especially in (very lucky) men who have a lot of sex or produce a lot of sperm, scientists call this “congestive epididymitis” and it can cause some pain and discomfort to be sure.  In fact, it can even rupture in some cases.

Here’s my final shocker:  some guys actually regrow the tube back together – yes, like a lizard’s tail – and start pushing out sperm again.  It is very unlikely, but is almost impossible to detect since it could happen in six months or in twenty years.  Urologists call this “recanalization” or “spontaneous connection of the vasa defentia”, which is medical name for the thing that your doctor took a big slice out of.

However, if those concerns all seem low risk and minor to you, especially compared to the benefits, you may want to go ahead.  The procedure itself is relatively simple.  Probably the most painful thing is the initial anasthetic, which is like a bee sting into the testicle area and usually repeated in the middle of the procedure.  The post-operative pain is relatively minor, assuming you don’t have to drive yourself home or have one of the kids welcome you home with a diving hug.

What might seem the worst part of it all for some guys is to go without sex for seven to ten days.  However, that’s just about the time that you feel like having sex, so that works out perfectly.  (This is to avoid the “congestive epididymitis”  mentioned above.)  Most guys can even return to work after two to three days.

The decision is yours.

REFERENCES:

1) J of Urology, Dec 1995, 154(6):2065-2069

2) Intl J Andrology, 1987, 10:471-479

3) https://www.cancer.gov/cancertopics/factsheet/risk/vasectomy

4) Br J Cancer, 1988 March, 57(3): 326 331, “Vasectomy, cigarette smoking, and age at first sexual intercourse as risk factors for prostate cancer in middle-aged men”

5) Fertil Steril, 1988 Feb, 49(2):309-15, “Annual variation in semen characteristics and plasma hormone levels in men undergoing vasectomy”

6) Fertil Steril, 1976 Feb, 27(2):144-51, “An investigation of plasma hormone levels before and after vasectomy”

7) Fertil Steril, 1975 Apr, 26(4):329-30, “Plasma testosterone, luteinizing hormone, and follicle-stimulating hormone after vasectomy”

Dr. Davis's Method for Plaque Reversal - Peak Testosterone

Both Heal Your Heart and Track Your Plaque by Dr. William Davis should be on your nightstand you should read a few pages of them every night for motivation in my opinion.  Why am I being so dramatic?  Because if you lose your testosterone, HRT can usually rescue you.  But, if clog up your arteries, nothing on heaven or earth can help you.

NOTE: Track Your Plaque has been a huge influence on me and I actually had a Heart Scan done after being on a low fat diet for several years to check my progress.  To my pleasant surprise, they found I had 0 plaque – none whatsoever – something I discuss in my page  Heart Scan Results (Lee Myer).

a) Both doctors want you to limit saturated fat and have spartan LDL levels.

b) Both doctors have rigorous requirements for HDL, LDL and triglycerides.

c) Both doctors want carbs to be limited and low glycemic.

d) Both doctors believe that many other lipid and inflammation parameters must be monitored.

e) Both doctors believe that you can eat some meat and reverse plaque.

f) Both doctors believe that you diet alone often cannot control plaque in some men and that additional help in the forum of supplements (or pharmaceuticals in the case of Gould) are required.

g) Both men are cautious about classic low fat diets.

h) Both men believe that you should monitor your plaque and carefully watch your progress.

Now let me go through the above points and highlight some of the differences in their approaches:

a) Dr. Davis really dislikes classic low fat diets and rails against them quite often.  And he has good reason to, because men so often eat a bunch of wheat, white rice and other low fat “foods” and call that low fat.  I have seen this many times myself in talking to guys who did not feel good on what they called a “low fat diet.”  Many men get the idea that he embraces saturated fat because of it, but nothing could be further from the truth.  Let me quote from his book:

“All foods you eat should be low in saturated fat.  Saturated fats serve no purpose whatsoever and are entirely unnecessary for health.  Do away with saturated fat completely and you’ll be better off.  Your goal should be as close to zero grams of saturated fat per day as possible.” [p. 112.]

I get beat up all the time on my own forum, The Peak Testosterone Forum, because guys want to hear that saturated fat and high cholesterol levels are just fine. Well, Drs. Davis and Gould would beg to differ.   I do want to mention that Dr. Davis emphasizes consumption of the omega-3’s and believe that some monounsaturated fat has it’s place in order to displace calories normally consumed from carbs.

b) Dr. Davis has even more spartan numbers than Dr. Gould.  See my page HDL, LDL and Triglycerides Levels as a Starting Point for Plaque Reversal for more information.  I do want to point out that HDL, LDL and triglycerides are certainly NOT the only numbers that need to monitored and Dr. Davis has what I consider to be the best discussion of the markers necessary to reverse heart disease.

d) Again, Dr. Davis has an extensive discussion of these markers.  The book is well worth it just from this aspect alone.

e) Dr. Davis wants low fat cuts of meat and wants you to cut the excess fat off.

f) Track Your Plaque emphasizes the use of (what I would consider megadosed) fish oil, megadosed niacin and Vitamin D at a minimum to ensure plaque reversal.  The niacin is the most controversial of these solutions in my opinion as no one knows if this is a good long term solution as far as I know.  In addition, niacin can have side effects and possible liver issues in some men.  (Dr. Gould has an excellent discussion about the different forms of niacin and common issues men face with them.)

g) Dr. Davis does NOT advocate a low fat diet.  I believe an implementation of his dietary guidelines would land a man more squarely with Mediterranean fat levels, both in composition and quantity.

h) Track Your Plaque, as the title implies, has popularized the concept of Heart Scans, or Calcium Scores as they are sometime known.  A Heart Scan is basically a very sophisticated CAT scan of your heart that is timed to the beating of your heart to literally photograph, if you will, the calcium in your cardiac arteries.  Dr. Davis prefers this method and makes a case for it.  The one disadvantage to this method is that requires some exposure to radiation.  I am uncertain as to the exact level, so please check with your provider.

An alternative method is to get an IMT done.  Lifeline offers one – in states that allow it! – for $70 as of this writing.  An IMT has the advantage of being a simple ultrasound of your neck artery.  It is not a perfect test, as Dr. Davis points out, because it has only a 60-80% correlation with your important cardiac arteries that so often lead to heart attacks.  Again, the Heart Scan directly look into the cardiac arteries.

NOTE:  You may recognize Dr. Davis from one of his other bestsellers, which I examined in my page A Review of Wheat Belly. In this book Dr. Davis pushes for the elimination of wheat form one’s diet as a means of weight and blood sugar control primarily.

PT-141:Future Dopamine-Related Erectile Dysfunction Cure For Some Men.

PT-141 should never be used without a doctor. It is a melanocortin and melanocortins are involved in anhedonic depression. One of our members experienced anhedonia after a one time use of PT-141.

One of the posters on the Peak Testosterone Forum that I admire most is Inigo. If you’ve followed this site at all, you will have noticed that he has tried everything under the sun to cure his erectile dysfunction. He has tried many of the rather “exotic” treatments and guest authored his experiences in the section of my site called Alternative Erectile Dysfunction Strategies. And I will send men there who have tried all the traditional treatments, such as the natural cures on my site and, if necessary, HRT and/or PDE5 Inhibitors. When nothing else works, one of Inigo’s articles may inspire them and provide a solution where nothing would. I am sure he has helped countless men in rather desperate situations.

Unfortunately, though, he has not been able to help himself – that is until PT-141 as you’ll see below.  My theory is that Inigo has been helped through PT-141’s dopamine agonist properties. Look at this excerpt from an abstract regarding PT-141:

“Previous studies have shown that melanocortin peptides have facilitatory effects on dopaminergic neurotransmission…D(1)-like receptor binding was increased in the nucleus accumbens and the caudate putamen, but reduced in the substantia nigra (reticular part), whereas D(2)-like receptor binding was reduced in the caudate putamen, but increased in the periaqueductal grey, substantia nigra (compact part) and the ventral tegmental area. These data…support the hypothesis that melanocortin peptides may regulate the activity of central dopamine neurons.” [1]

Inigo’s experience is a perfect example as to how an erection involves so many different systems in the body and brain – hormonal, arterial/cardiovascular and the neuronal as well.  While he has not completely cured his erectile dysfunction with PT-141, it has improved his morning erection tremendously and he believes that now intercourse would be possible with the help of a PDE5 inhibitor.  His experimentation with PT-141 is documented below:

CAUTION: You do always have to be careful about priapism, which is an erection over a couple of hours.  This can destroy the inside of the penis and be the end of your sex life.  Also, as far as I know, PT-141 is not approved yet in any country.  As much as I admire Inigo, I would definitely wait until for your country’s approval and for a more in depth safety track record.  On the forum, we had a very interesting PT-141 Thread where some side effects were reported. Dosage is also ill-defined and unknown at this point.

GUEST AUTHOR:  Inigo

Bremelanotide (PT-141) has been developed from Melanotan II , which was initially developed as a sunless tanning agent, but which was found to induce spontaneous erections. It is a synthetic melanocortin agonist, and acts within the brain, and not directly on blood vessels. Its full method of action isn t fully understood, but is in part a dopamine agonist.

Clinical Trials. A trial published by Rosen et al in 2004 reported on inhaled PT-141. See this thread. It was administered in doses between 4mg and 20mg. Mean plasma concentrations were highest after thirty minutes, and had reduced to low levels after eight hours. Good safety was reported even at 20mg doses. The effects of PT-141 became apparent in as little is 30 minutes.

A second report by Rosen et all, in 2004, on 4mg and 6mg doses of injected PT-141 in dysfunctional patients, concluded that

“The erectile response induced by PT-141 was statistically significant at both doses. PT-141 was safe and well tolerated in both studies. The erectogenic potential of PT-141, its tolerability profile and its ability to cause significant erections in patients who do not have an adequate response to a PDE5 inhibitor suggest that PT-141 may provide an alternative treatment for ED with a potentially broad patient base.”

10mg PT-141 was injected into the non-dysfunctional patients. Only injected doses over 1mg were thought to give a significant improvement. 50% of dysfunctional men in the trials were restored to normal levels of sexual function and, as you might expect, PT-141 worked better in combination with PDE-5 inhibitors. Hypertension was observed in two patients with a history of hypertension (but not the others). 4mg of sc PT-141 was thought to possibly equate to 20mg of inhaled PT-141.

In 2008 another report, on rats, by Dr Shadiack, opined that the frequency of erections increased in a dose-dependent manner. In addition, with repeat doses of bremelanotide, spontaneous erections continue to be produced without evidence of tachyphylaxis. Repeat dosing also results in a reduction in the time to first erection. (Dr Shadiack once worked for, and owns shares in Palatin.)

Despite these promising reports, work on the PT-141, either injected or inhaled, ceased in 2008 due to concerns over hypertension.

However, in March 2012, Palatin Technologies restarted Phase IIb trials using a subcutaneous delivery system that has even less effect on blood pressure. A positive report into the trials was released on 8th November, but this treatment is now for female sexual dysfunction. The effect the drug would have on men isn t mentioned. In December 2014 Palatin Technologies announced an intent to begin phase 3 trials .

Purchasing and Using PT-141. There are a number of sites offering PT-141. I ve used [edited] who delivered the day after ordering. With a 20 vial of PT-141 containing perhaps eight or ten doses it s an inexpensive medication, – compared to, say, Vitaros.

The PT-141 is generally available in 10mg vials of freeze-dried powder, to which you add 1ml of sterile water. This is best done using a syringe to squirt the water into the vial. The powder quickly dissolves and you then fill syringes with the liquid, or fill nasal sprayer with the liquid, and keep them in a fridge. (Some reports suggest storing in a freezer is better, but if you re only storing them for a couple of weeks it s probably unimportant.)

Online Reports. Looking at online personal experiences, recommended doses seem to vary between 0.5mg and 2mg for injections into stomach fat. This is a lot less than was used in the Rosen trial. Reports also claim an injection takes around 4 6 hours to kick in, and lasts for somewhere between 24 and 72 hours. But the effect is a bit unpredictable.

Reports suggest headaches and nausea are common side effects. (Affecting about 1 in 3 patients according to Rosen.) Back pain, vomiting, facial flushing and diaphoresis (sweating) were also reported. It seems that side effects lessen with repeated use. It also seems that used too regularly and the pro-sexual effects often lessen too. Looking at personal experiences of online bloggers there are a few reports of bad reactions, and many reports that PT-141 works reasonably well. Some folk report a short term down the day or two after using PT-141

My Experiences. I tried PT-141 on 9th January 2015. I injected about 0.8mg. No obvious side effects, though five hours later I felt a little cold and my back ached for a while, but I wondered if this was a coincidence. Two self-tests , one after three hours and the other after ten, suggested increased erectile function. That night I had pretty continuous npt, and still had an erection whilst putting my trousers on the next morning. (A first for a couple of decades.) But a naked romp with new woman 36 after injection (and no Viagra) showed no advantages. (But she was 59 unexciting, we just had a heavy meal, and I hardly knew her.)

By the fourth injection (with doses of 0.8mg to 1.5mg) I had experienced a couple of incidents of light and transient flushing, and a continued slightly cold achy and unwell feeling between about three and twelve hours after the injections. Hopefully these side-effects will lessen in time. Repeated blood pressure checks revealed no change from my usual level of 120/80 or less.

My fifth injection, of 1.3mg, was in the afternoon of 23rd January. This time I inserted the needle at a more acute angle and shallower depth. Only 10 or 15 minutes later I felt more obvious facial flushing than before. By 2:30 I was feeling a little cold; and felt slightly tired/unwell for rest of the day. I retired at 10:30, and five minutes later a spontaneous erection occurred, lasting 2 hours till, worrying about priapism, I got up for a decaffeinated Scotch-coffee. I had felt increased libido too, and the two and a half hour experience of high libido and a continuous solid erection was quite cheering. Shame I was alone. However when I decided to go for coffee my erection vanished before my first foot hit the carpet. The following day I perhaps felt a slightly decreased libido (as reported by some online bloggers).

No proper out-of-bed spontaneous erections yet.

REFERENCES:

1)   Pharmacol Res, 2002 Feb, 45(2):119-24, “Chronic infusion of a melanocortin receptor agonist modulates dopamine receptor binding in the rat brain”

My Experience with Bremelanotide (PT-141)

How to Increase HDL - Peak Testosterone

How does HDL do it? HDL has the well-documented role of ushering cholesterol away from the lining of the arterteries into the liver where is can be re-used or ferried out of the body. But recent research has shown that HDL does much more than just this simple function. For example, researchers have found that it predicts cardiovascular disease completely independently of LDL. [9] In other words, the fact that HDL can pull away LDL from arterial walls is a relatively minor consideration. Furthermore, HDL was found as an important risk factor in males who developed arteriosclerosis at a relatively early age. [10]

HDL increases Nitric Oxide through several pathways, but the primary appears to be by directly raising eNOS levels, the enzyme responsible for creating Nitric Oxide. [11] This, in turn, has been shown in studies to increase vasodilation, meaning more blood flow into the penis area, and improved endothelial function, mean more blood flow into the penis area. Yes, this is good for your sex life!

How does HDL do it?  HDL has the well-documented role of ushering cholesterol away from the lining of the arterteries into the liver where is can be re-used or ferried out of the body.  But recent studies have shown that increasing HDL does much more for both heart and penis:  it protects both by raising Nitric Oxide, the stuff of erections and arterial health.  In fact, Dr. Philip Shaul, an HDL researcher has stated that “HDL is the most potent stimulator of nitric-oxide production that we have found in the past decade [and] what we’re realizing is that, not only is it a taxi, but that it hits the arterial walls, and it causes a dramatic response by the arterial walls to produce nitric oxide”.

CAUTION:  Now I do have one important caution:  if you go on a Low Fat Diet, you will probably find that your HDL will actually fall somewhat.  But LDL and total cholesterol fall as well as many other risk factors. In fact, those with cholesterol around 150 from a Low Fat Diet have almost no heart disease.  Furthermore, you will find that all the plant foods that are part of a Low Fat Diet will dramatically help your Nitric Oxide output.  So, in reality, raising HDL is really only critical if you are not willing to go on a Low Fat Diet.

How to Increase HDL

So, yes, HDL should be one of your dearest friends, especially those of us in middle age and fighting andropause or erectile dysfunction, and all of us guys should have the goal to increase our HDL.  So how can you  increase and raise HDL?

1) Aerobic Exercise.  Aerobic exercise provides a significant increase in HDL levels.  And it should be pointed out that even moderate exercise provided these significant benefits. [3]  (Moderate exercise also lowered lowered the bad kind of LDL cholesterol that damages arteries.)

2) Intense Exercise. Intense exercise, the kind that makes you sweat and lose your breath, leads to steadily increasing HDL levels even in men in their late 50’s according to one study, which concluded that “plasma high density lipoprotein (HDL)-cholesterol concentration increased from 38 +/- 3 to 45 +/- 4 mg X dl-1 at 12 months and rose further to 53 +/- 5 mg X dl-1 at 6 years of follow-up (p less than 0.05)”.   In other words, these men went from an average of 38 to an average of 45 after one year.  And, even more amazing, their HDL continued to increase even six years to an average level of 53. [4]

NEWS FLASH:  A recent Norwegian study found (at least in patients with Metabolic Syndrome) that exercising using a high-intensity technique called Interval Training led to increases in HDL in a sixteen week period, whereas regular aerobic exercise did not.  The participants did four cyles of 4-minute high intensity exercise at 90 percent of maximal heart rate (220 minus age) followed by a 3 minutes of rest. What is very remarkable is that these people only exercised 3 times per week to achive the increases in HDL. [17][18]

3) Cranberry Juice. One study found that (in obese men) moderate Cranberry Juice consumption significantly increased (almost 10%) HDL levels by drinking only 8 oz. daily. And don’t forget about Cranberry’s Many Anticancer Properties. [8]

4)  Smoking. Smoking, being overweight and trans-fatty acids are all associated with a lowering of HDL (and a hundred other nasty disorders and diseases). Most of us these things are bad for us and now you know they are bad for your HDL as well. Of course, do the opposite to increase your HDL.5) Moderate Drinking. Drinking of one (or at most two) drinks/day has been shown to increase HDL. [6]  Do not drink more than one to two drinks per day.&  NOTE:  Do NOT drink more than that as Alcoholt as Alcohol can lead to a build up of estrogen, arguably enemy #1 for the adult male, and body fat which, in turn, leads to even greater estrogen levels.

6) Soluble Fiber. Soluble fiber, at least 2 servings per day, increases HDL levels.  By the way, soluble fiber is what is found in oats and various fruits and vegetables.

7) Monunsaturated Fats.  Monounsatured fats, such as those found in olive oil olive and the Mediterranean Diet, increase HDL. However, one should read my Olive Oil Cautions.

8) Hazelnuts.  Turkish researchers found that hazelnuts (although any nut such as almonds, pecans, etc. should work almost as well) increased HDL levels (by about 8%) in a 2002 study published online. [5]

9) Walnuts. In 2004 researchers found that walnuts increased HDL, alt least in men with type 2 diabetics. [12]  (Walnuts have also been found to lower LDL and protect you somewhat from the effects of a high fat meal.)

10) Cortisol Reduction.  Increases in cortisol will lower your HDL. [14] In other words, as cortisol goes up, your HDL goes down.  See this link on How to Reduce Cortisol and Stress for more details.

11) Laughter. Laughter does a good a good job of reducing stress hormones and so it’s no wonder that it also has a study under its belt showing that it can raise HDL (at least in diabetic patients). [15] HDL rose very significantly, 26%, in the “laughter cohort”.

12) Sugar Reduction. Watch out for sugar, especially fructose.  Several studies have shown a as consumption of sugar goes up, HDL goes down. [7]

13) Tran Fat Reduction. These bad boys do a lot of nasty things to you body and one of them is lowering HDL. So forget the chips, the fries, the donuts – they’ll never change the oil fast enough to keep the trans fats out of their products!

14) Berries.  A 2008 study showed that moderate berry consumption resulted in increased HDL (and decreased blood pressure) in a group of middle subjects. [16]

15) Curcumin. This component of turmeric (and part of curry and yellow mustard) increased HDL by 29% in one human study using 500 mg/day. [19] It also lowered cholesterol.  Curcumin also has anti-inflammatory powers and probably protects against prostate cancer.

16) Tomato.  One recent study looked at men and women with normal triglycerides but lowish HDL and gave them two uncooked roma tomatoes.  That’s not much tomato, but the researchers found that it significantly boosted HDL by about 14%. [20] Not a bad boost for one simple change.  And tomatoes are good for the prostate as well!

CAUTION: Diabetics beware: increased HDL has actually been found to be damaging to diabetics in one study.  HDL, in the diabetic alone, binds to myristic acid which actually decreases Nitric Oxide.  And, of course, we don’t want decreased Nitric Oxide, now do we?  So, diabetics, proceed carefully and talk to your doctor.

1) Am J Epidemiol 1994,(140)930-7

2) Zhonghua Nan Ke Xue. 2005 Feb;11(2):112-5

3) Jour Appl Physio, 2007, 203:432-442; Experimental Biol and Med,2003,228:434-440;Archives Intern Med,2007,167:999-1008

4) J Am Coll Cardiol,1987,10:321-326

5) European Journal of Clinical Nutrition, Feb 2007, 61:212-220, “THE EFFECTS OF DIET HIGH IN MONOUNSATURATED FAT FROM HAZELNUTS ON PLASMA CHOLESTEROL AND LIPOPROTEINS”

6) Diabetologia, Oct 2004,(47)10:1760-1767(8)

7) The Sugar Fix, Ricard J. Johnson, M.D., 2008,  p. 49-50

8) Brit J of Nutr, 2006, 96:357-364

9) Circulation, 2000, 102:III90-III94

10) Arteriosclerosis, 1988, 8:737-741 11) Nat Med, 2001, 7:853-857;J Biol Chem, 2002, 277:11058-11063

11) Nat Med, 2001, 7:853-857;J Biol Chem, 2002, 277:11058-11063

12) Am J Clin Nutr, 2001,74:72-79, Almario RU, et. al, “Effects of walnut consumption on plasma fatty acids and lipoproteins in combined hyperlipidemia”

13)  Men’s Health, Sep. 2009, p. 42.

14) Intl J of Obesity, 2004, 28:1168–1173, Published online 22 June 2004, “Central adiposity and cortisol responses to waking in middle-aged men and women”

15) 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.

16) 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”

17) https://agelessbrain.com/2010/04/the-best-exercise-type-to-fight-metabolic-syndrome/

18) https://www.aahf.info/sec_news/section/hi-intensity-exercise-improves-HDL_012507.htm, International Symposium on Atherosclerosis, June 21, 2006, Rome, Italy, Poster 369, “Reversing the metabolic syndrome with high-intensity training”

19) Indian Journal of Physiology and Pharmacology, 1992, 36(4):273-275, “Effect of oral curcumin administration on serum peroxides and cholesterol levels in human volunteers”

20) Diabetes Metab Syndr Obes, 2013 Jul 26, 6:263-73, “Effect of tomato consumption on high-density lipoprotein cholesterol level: a randomized, single-blinded, controlled clinical trial”

The G Spot, A Suprising History - Peak Testosterone

The history of the G Spot is an interesting read:  it’s the story of a whole bunch of male researchers who, after years of study, realized they didn’t understand female anatomy. It’s also a story of otherwise staid and phlegmatic white coat Ph.D.’s getting rather ugly and jumping into the cage for a little laboratorial face thumping. The whole story even includes a dozen cadavers along the way.

And that’s good, because reading about female anatomy in the research can be a little “dry” shall we say?  Consider this ground-breaking, mouth-watering description of the clitoris:  “The clitoris is a multiplanar structure with a broad attachment to the pubic arch and via extensive supporting tissue to the mons pubis and labia. Centrally it is attached to the urethra and vagina. Its components include the erectile bodies (paired bulbs and paired corpora, which are continuous with the crura) and the glans clitoris. The glans is a midline, densely neural, nonerectile structure that is the only external manifestation of the clitoris”. [1]  I’ve included the reference in case you want to do a little reading.

Actually, this journal article is trying to point out that the clitoris is actually a much more complex structure than was initially realized.  Us guys – we’re simple.  We’re easy.  But females are just as complex physically as they are in every other way!

The G Spot is no different. Researchers in 2001 stated that the G Spot was a complete fabrication because it could not be located. [3] Another researcher actually wrote a paper entitled “The G-spot: a modern gynecologic myth“. [2] One team even noted that vaginal stimulation caused blood to rush to the clitoris and thus a vaginal orgasm was really a clitoral orgasm.

Case closed, right?  Well, the next year a researcher examined fourteen cadavers and found that 9/14 had Skene’s glands and 12/14 had erectile tissues in the general vaginal G Spot area.  (The Skene’s glands are responsible for female ejaculation and are the female version of the prostate.) [4]  In other words, most females examined had analagous structures to us males within the vagina itself.  (The 2001 researchers were strangely silent thereafter.)

Several years later researchers examined the G Spot areas of women who said that they had vaginal orgasms.  All of the women had a thickened G Spot area or “urethrovaginal space”.  The researcher did further investigation and found that only women that had this thickened area were able to achieve vaginal orgasms. [5]

This researcher, Emmanuele Jannini, is the king of the G Spot and also found that PDE5 was mostly clustered around the G Spot, especially in women that had an thickened G Spot area by the way.  The significance of this is that PDE5 is the same enzyme that Viagra works on in males.  (PDE5 actually depletes Nitric Oxide.)  In other words, most women have erectile tissue right in the area of the G Spot confirming what many enthusiastic males have been saying for years:  this area can become engorged.

So what does all this mean?  Well, there are a couple of important points.  The first is that us males can actually learn something about females after years of intense and painful effort. The second is that it appears that some women, although no one has a hard – no pun intended of course – number, will have great difficulty achieving a vaginal orgasm because they do not have a thickened G Spot area and/or low PDE5.

Perhaps the G Spot Shot (or G Spot Augmentation) can help these women?  I don’t think anyone knows the answer to that question fully, but if you’ve been trying like a mad dog to stimulate the G Spot and nothing much is happening, there may be an anatomical reason for it.  Remember that about one third of women report not being able to achieve a vaginal orgasm and perhaps this explains a lot of that phenomenon.

However, the opposite point can also be made:  most women have actual erectile tissues in their vagina, Skene’s glands, PDE5 and a whole lot of other fun stuff. So guys get busy if you haven’t already and you can add a whole new dimension to your woman’s sexuality. Most importantly, I can only encourage you to do a little “verification” of the research yourself…

NEWS FLASH:  One large study of 1,800 female identical twins (Jan 2010) asked each twin if they had a G-spot.  The researchers argued that if one twin had a G-Spot, the other should as well and, therefore, the answers of one twin should match the other. They actually did not find that to be the case and concluded that the G-Spot “doesn’t appear to exist”. [6] Back and forth go the arguments, eh? In my opinion, it is a flawed approach to rely on a subjective answer from a woman on this topic:  many women struggle to even have an orgasm or know its location for a variety of reasons.

REFERENCES:

1) Journal of Urology, 174(4):1189-1195, H. O’CONNELL, K. SANJEEVAN, J. HUTSON, “ANATOMY OF THE CLITORIS”

2) American J of Obstetrics and Gynecology, Jan 9 2001, 185(2):359-62, “The G-spot: a modern gynecologic myth”

3) Am J Obstet Gynecol, 2001, 185:359-362

4) Urology, 2002, 60(2):1077-1082

5) J Sexual Med, published online Mar 4, 2008, Jannini, “Measurement of the Thickness of the Urethrovaginal Space in Women with or without Vaginal Orgasm.”

6) http://news.bbc.co.uk/2/hi/health/8439000.stm

Cialis and Viagra: Basic Information and Side Effects - Peak Testosterone

Viagra / Cialis / Levitra. These big three blockbuster drugs are only available by prescription and therefore are not supplements. But I wanted to cover them, because they’re as close to a “miracle pill” for anyone struggling with testosterone, libido or erectile difficulties. Viagra is good for four hours and Levitra for six. Cialis, on the other hand, in this category is king: it’s potency lasts for 36 hours. This makes it ideal as it really gets the penis back in shape by increasing early morning erection count, confidence and sexual activity for extended periods of time.

So do you want the good news or the bad news first?  I’ll start with the good news.  Viagra has been found, for example, to help with treatment of high blood pressure in the lungs, cardiovascular performance at high altitudes and may also prevent blood clots, a major cause of heart attacks and strokes. [1]  And Viagra’s long-lasting brother, Cialis, has been found to help men with BPH (Enlarged Prostate). [2]

Need to boost your Nitric Oxide naturally through food, drink and supplements? Check out Lee Myer’s book here: The Peak Erectile Strength Diet

Or do you need the most comprehensive testosterone book in Amazon? Here it is: Natural Versus Testosterone Therapy

So there is actually a lot of good medical news coming out about these drugs and the reason is probably simply the fact that you need Nitric Oxide and all of these drugs help Nitric Oxide to stay in your system longer.  Nitric Oxide does many things to help your body fight heart diseasse (and cancer) and so it should not be overly surprising that in aging males, a little more Nitric Oxide may actually be helpful in the same way that Testosterone Supplementation (HRT) actually helps restore youth to many older guys.

However, I would still recommend caution with these three drugs, becuase of their side effect profile – see below – and because, in general, it is better to solve the root of your erectile difficulties, which is almost always poor heart and endothelial function. Erectile dysfunction can also be related to low testosterone, another condition that you should see a doctor for.

NOTE:  Please read my link on Recreational Use of Viagra and Other PDE5 Inhibitors for additional information.

I recommend that these drugs be used primarily as a bridge to help you get your penile tissue back in shape after months of few morning erections. Furthermore, keep in mind that there are Supplements that are very effective as well for short term solutions.

There’s another reason that I emphasize using these short term if at all possible:  you want to coax your body to actually produce more Nitric Oxide on its own because this is a sign of endothelial health.  The endothelium is the thin lining of your veins and arteries and one of the signs of an injured, out-of-shape endothelium is decreased Nitric Oxide production.  Please, please, please read this link How To Fix Erectile Dysfunction Long Term to find out how to get your endothelium to start pumping out more Nitric Oxide naturally.

By the way, it is also possible that some of the men afflicated were taking too large of a dose. Some men overtake testosterone derivatives, i.e. steroids, quite frequently.  Would it be surprising that some men take too much Viagra during “desperate” situations?  But arguing against that is the fact that all three of these drugs had patients experiencing oxotocity, hearing problems during clinical trials while they were presumably testing dosing and other aspects of bringing this public. Again, talk to your doctor and do your homework.

Also, back in 2000, it looked as if there would be a promising new class of drugs coming out both more potent and with fewer side effects. So far these have not been tested on humans, but the animal studies are looking very good. I have not been able to find if the clinical trial process is making good progress on these drugs or not.

One interesting side note is that researchers have found that Viagra is about 80 X more potent at inhibiting PDE5, the enzyme that indirectly affects Nitric Oxide production, than the primary ingredient in Horny Goat Weed Icariin. However, there are many less side effects with Icariin and Horny Goat Weed, making it an excellent alternative to Viagra depending on the severity of one’s erectile dysfunction.  Researchers are currently taking Icariin and modifying it slightly to see if they can come up with a “new Viagra” with decreased side effects.  Read below for a discussion of the many side effects associated with these drugs:

NOTE: One recent study showed an increase in testosterone post-exercise in healthy male subjects taking Cialis. [7] So are these PDE5 inhibitors a good idea before exercise?  Unfortunately, the study also showed that Cialis increased cortisol more than normal and, of course, cortisol is definitely not something we want to boost under normal circumstances.  In addition, below I list a number of side effects from Cialis (and Viagra and Levitra as well) that would make using Cialis as a testosterone booster even more questionable.

CAUTIONS AND SIDE EFFECTS:

Now for the bad news or, better worded, cautions:  it is important to note that the FDA is now requiring a warning label on all three of these drugs because there have been 29 cases (at the date of writing this) of sudden hearing loss.  The problem is that there are related PDE5 receptors involved in hearing that these drugs activate. (Viagra has also been implicated in making sleep apnea worse.)  However, the number of men affected by this is small considering the very large number, about 30 million, using these drugs. In fact, Lilly spokeswoman Keri McGrath said a recent Lilly review found about 1.1 incidents of sudden hearing loss per million Cialis patients, which she said was lower than the incident rate in the general population. Nearly 12 million men have been prescribed the drug, the company said. Note: I have also read that Cialis has less of this crossover effect than Viagra. But, again, discuss all this with your doctor if you feel you need to go this route.

The underlying problem with these drugs is that they affect other phosphodiesterases in the body, including the ones that effect hearing, sight and heart function.  For example, Viagra can inhibit the PDE6 inhibitor, affecting the rod and cone photoreceptors in your eyes to a certain extent. One study came out and said there could even be potential damage to the optic nerve. [4] But subsequent studies found no such association. [5]

Another major issue with these drugs are dangerous arrythmias and palpitations.  The problem is that they increase, for reasons not fully understood, the sympathetic nervous system.  One study showed that noradrenaline was significantly increased after taking Viagra, for example, in healthy young men. [6] These fight-or-flight chemicals can be dangerous to the heart as they increase the likelihood of irregular heartbeat (and potentially stroke).

No, the doctor won’t tell you that when he gives you a prescription!  These drugs can cause problems with heart issues and medications so you’ve got to discuss that with your doctor if that is your situation.  Remember:  there are a number of possible side effects from drug combinations with Viagra for example.  You can also potentially get facial flushing, stomach upset and/or heartburn and headaches.

And the most potentially dangerous side effect involves nitroglycerin.  Nitroglycerin, a drug prescribed for heart pain, can result in shock if taken at the same time as Viagra. And, because drugs such as Viagra are worked on by the same liver enzyme, it could raise or lower levels of many other drugs such as ketoconazole and entacapone.

There has been concern that these PDE5 inhibitors should not be prescribed to patients with heart disease or that they could possibly lead to heart attacks.  However, several studies have shown Viagra to be safe in both cases [3], but of course you should also discuss this with your doctor.

REFERENCES:

1) Proceedings Nat Acad of Sciences USA, 1008, 105:13650-13655

2) J of Urology, 2008, 180:1030-1033

3) BMJ, 2001, 322(7287): 651–652; Archives of Int Med, 2004, 164(5): 514–520

4) Br J Ophthalmol, 2006, 90:154-57, “Non-arteritic anterior ischaemic optic neuropathy and the treatment of erectile dysfunction”

5) J of Sexual Med, 3(1):12-27, Published Online 5 Jan 2006, “Ocular Safety in Patients Using Sildenafil Citrate Therapy for Erectile Dysfunction”

6) https://seniorhealth.about.com/library/weekly/aa010701a.htm

7) The Journal of Clinical Endocrinology & Metabolism, 2008, 93(9):3510-3514, “The Type 5 Phosphodiesterase Inhibitor Tadalafil Influences Salivary Cortisol, Testosterone, and Dehydroepiandrosterone Sulphate Responses to Maximal Exercise in Healthy Men”

Hypothyroidism Correction and Potential Doubling of Testosterone

STEP 3. Many men start yawning almost immediately when you bring up anything to do with the thyroid, but that really should not be the case. The thyroid is somewhat like the floor pedals (accelerator/brake) on your car, since the thyroid either slows down or speeds up hormones and metabolism. For example, low thyroid function (hypothyroidism) is associated with lower testosterone and elevated thyrooid function (hyperthyroidism) with increased testosterone.

Now on this page I am going to concentrate on hypothyroidism for the simple reason that the symptoms are so common on the Peak Testosterone Forum. A very high percentage of men coming to the forum have the classic symptoms of low thyroid function such as fatigue, poor libido, depression and erectile dysfunction. (For more information on the latter, see my link on Erectile Dysfunction and the Thyroid.) From my perspective, it is almost an epidemic and I want to cover some of the basics below.

However, let’s start by looking at the evidence that hypothyroidism actually lowers testosterone:

1.  Decreased LH (Leutinizing Hormone). Researchers have found that hypothyroid men have a “subnormal response of luteinizing hormone (LH) to gonadotropin-releasing hormone (GnRH) administration.” [1] Of course, GnRH is produced by the hypothalamus, which then triggers LH.  LH, in turn, stimulates the testes to produce testosterone.  This means that hypothyrodism sabotages the first step in the testosterone production assembly line.

2. Decreased Free Testosterone Levels.  The same study and others have noted that hypothyroid men tend to have lower free testosterone concentrations. [1][2]

3.  Treating Hypothyroidism Often Increases Testosterone. A further sign of hypothyroidism’s causal effect on low testosterone is the fact that treating men with thyroid medications can actually boost their testosterone back to normal. [1][2] One study found that giving hypothryroid hypogonadal men thyroxine (T4) almost doubled their free testosterone levels! [3]

4.  More Than Doubling Total Testosterone. Normally one will not get a huge boost in testosterone from fixing his hypothyroidism.  However, huge gains are possible as evidence by a case study of one man with both severe hypothyroidism and hypogonadism. [4] This individual was able to increase his total testosterone by 150% just my standard thyroid treatment.  His testosterone was still pretty low – in the low 400’s – but it was an impressive gain nonetheless.

It is no different with hypothyroidism.  Again, from what I have seen, endocrinologists are very reluctant to treat men (and women) for hypothyroidism as well.  Not all endocrinologists (and PCPs) are like this, but certainly a significant percentage.  What has emerged from the discontent over this are alternative health protocols based on treating subclinical hypothyroidism.

What is subclinical hypothyroidism? Basically, it refers to low thyroid function that responds to treatment even though it is technically not clinical hypothyroidsim by the “old school” definition.  Many practitioners – “new school” endocrinologists, naturopaths, anti-aging doctors, etc. – have broadened their protocols for hypothyroidism and we will discuss how they do some of this monitoring and testing below.

  Let’s look at some of the ways that are currently being used to find low thyroid function that are “out of the box”:

1.  TSH Between 3 and 5. TSH is the signaling hormone released from the pituitary that signals the thyroid to start producing more thyroid hormones.  In some kinds of hypothyroidism (and in a manner analagous to rising LH in primary hypogonadism), TSH begins to rise.  The old school definition was a TSH > 5.0 to define hypothyroidism.  However, a recent study showed that this should be revised down to 3.0.  (From what I have read, the “ideal” TSH is roughly between 1 and 2.)  On a practical level, this means that many patients with a TSH between 3 and 5 would receive treatment from a different physician who was using the more recent, updated number.  For a more detailed explanation, see this article.

2.  Thyroid Antibodies. What many men do not know is that the most common form of hypothyroidism actually is autoimmune in nature and is called Hashimoto’s Thyroiditis. Basically, the body’s own immune system attacks the thyroid and slowly destroys it over the years. This can usually be identified by a couple of simple thyroid antibody tests. The two most critical tests are Thyroid Peroxidase Antibodies (TPOAb) Thyroglobulin Antibodies (TgAb). For thresholds see this Medscape article.

3.  Elevated rT3 (Reverse T3). Most men know that the two primary thyroid hormones are T4 and T3. TSH actually triggers the production of these in the thyroid at a ratio of 17::1, i.e. 17 T4 molecules for every one T3 molecule. A significant amount of T4, however, is converted into T3 in various body tissues. And, to further complicate matters, the liver converts about 20% of your T4 into something called Reverse T3 (rT3).  rT3 is part of the body’s feedback mechanism, but in some people it becomes elevated.  And, as its name implies, rT3 reverses normal thyroid function, i.e. can make you hypothyroid.  Again, someone with fairly normal TSH numbers but high rT3 can experience hypothyroid symptoms. Fortunately, you can test rT3 and see if this a problem for you.

4.  Free T3 and Free T4. The thyroid hormones are similar to testosterone and estradiol in the sense that they have a bound and unbound form.  If you have low or lowish free T3 and/or free T4 values, this can indicate hypothyroidism. And it makes sense as it is showing a low output of hormones from the thyroid.

There are other tests as well, but these have been quite common on The Peak Testosterone Forum and seem to be in wide use. In my opinion, this is a good thing and I am sure many men have been helped by it.

Just as in the case with low testosterone, there are a number of approaches that have been used to overcome hypothyroid issues. Here are a few of them:

1. Go Natural. Instead of just running off and taking thyroid medication, you may want to consider the fact that in some cases low thyroid issues can be reversed by relatively simple lifestyle changes alone. This may be part of these reason that “going natural” can sometimes increase testosterone levels and improve erectile function. Here are a few examples:

–Lower Stress.  Excess cortisol actually inhibits the conversion of T4 to T3, and result in smaller amounts of T3 and larger amounts of rT3. In other words, stress and the elevated cortisol levels that often accompany it can literally turn you hypothryoid. Instead of going on thyroid hormones, why not eliminate the stress? I have many suggestions that I discuss in my Summary Page on Stress and Cortisol.

–Dieting. If you cut your calores too much, you can make yourself hypothyroid. Your body compensates for the loss of calories by dropping T3 output, something I discuss in my link on Why Crash Dieting Just Does Not Work. So, if you’re cutting calories and are hypothyroid, it may be that you will normalize after you restore baseline calorie levels. Discuss with your physician.

–The Two I’s: Inflammation and Infection.  As mentioned, Hashimoto’s is definitely an autoimmune disease which is usually a result of elevated inflammation levels. And, as discussed in this article, inflammation can also induce hypothyroidism in other key ways as well. The bottom line is that I think it would be prudent to check your CRP (C-Reactive Protein) levels and make sure they are less than 1.0 along with any other key markers. For more information on the subject, see my link on Natural Ways to Lower Inflammation. Keep in mind that latent infections can raise inflammation, including things like gum disease and Super Bugs. So get a thorough checkup and keep digging.

2. T4 Only or T3 Only or Both. One thing that will you notice with thyroid medications is that “it is more art than science.” Basically, some patients do well on T4 only. Some do well on T3 only. And some do well on both. It sometimes takes some experimentation.

3. Dessicated Thyroid. Some patients do much beter with “dessicated thyroid” products which are basically dried pork and beef thyroids. These will have a combination of T3, T4 and rT3 along with a couple of other thyroid hormones. This wide range of hormones is considered by some to be more “natura” and probably accounts for the reason that dessicated thyroid works well in some patients and poorly in still others.

REFERENCES:

1) Thyroid, 2004, 14 Suppl 1:S17-25, “The interrelationships between thyroid dysfunction and hypogonadism in men and boys”

2) Horm Res, 1990, 34:215 218, “Reproductive Endocrine Functions in Men with Primary Hypothyroidism: Effect of Thyroxine Replacement”

3) Clinical Endocrinology, Feb 2000, 52(2):197 201, “Testicular dysfunction in men with primary hypothyroidism; reversal of hypogonadotrophic hypogonadism with replacement thyroxine”

4) Cleveland Clinic Journal of Medicine October 2012 vol. 79 10 717-725, “Male hypogonadism: More than just a low testosterone”

STEP 2:  TESTOSTERONE and HYPOTHYROIDISM

a) Assess Your Symptoms.  Start by taking a quick look at these symptoms.  Do any of them apply to you?

Of course, these symptoms can have many other root causes.  However, when you see that you have several of them, it could point to hypothyroidism.  Also, notice that there are some symptoms that overlap with hypogonadism (low testosterone) and this can undoubtedly be partially explained by the fact that hypothyroidism can cause low testosterone as mentioned above.

So how do you determine if you have low thyroid function?  Well, this is where it gets interesting.  At least here in the U.S., endocrinologists are more often than not extraordinarily conservative.  As an example, they are the most reluctant to treat men for low testosterone.  They do this by creating a very rigid definition of what constitues hypogonadism based on a very low testosterone threshold.

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

Testing for Subclinical HypothyroidismHypothyroid Solutions

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]

Female Libido: Pain - Peak Testosterone

Have you noticed your woman disinterested from any or all advances to make love? Assuming you’ve ruled out BO, halitosis and various psychoses, then maybe you need to dig a little deeper for the cause. You may not be a bad lover or a loser after all. In fact, there could be another reason: pain  (Remember:  Sex is Incredibly Physically Important for Males.)

That’s right – it is VERY common – and we’ll cover some of the common issues below – for women to experience pain during intercourse.  “But she would tell me if there was a problem like that!”  Not necessarily, Casanova. First of all, it may not be bothering her all the time and, secondly, she knows this is an emotional topic for us guys.  Let’s face it:  if she told you, you would probably think she was really saying, “Not tonight, dear, I’ve got a headache”, right?

Regardless, there are probably a hundred reasons – women are pretty complex if you haven’t noticed – that she might not tell you and pain is suprisingly common, so you should be aware.  Remember that probably not even a horn dog like you would want to have sex if it felt like you were getting catheterized, so be patient with her.

So what causes pain for females?  Unfortunately, many things.  For us guys, about the only thing that causes us pain during intercouse is if we fall off the chair or the overhead mirrors land on our forehead.  And you’d be unlikely to complain anyway unless you had a spear through your thigh, eh?

That said, it pays to be aware of some of the common things that can cause pain for females:

1. Yeast Infection.  A full-blown yeast infection will make intercourse about as pleasurable as 120 grit sand paper on your scrotum.  Sometimes women have a less pervasive infection that causes them discomfort.  Over the counter medications can generally help with this.

2.  Dryness.  This one can be caused by many factors from hormones to lack of foreplay on your part, you Eager Beaver.  One important thing to keep in mind is that a number of common medications can increase or cause vaginal dryness, a topic that I cover in my links on Vaginal Dryness and Drugs and the Best and Most Nutural Lubricants for Intercourse.

3. UTI’s.  Urinary tract infections make everything hurt “down under” for her.  Of course, the solution is a antibiotic, although cranberry juice should also help.

4.  STD’s.  Herpes is a prime example and can cause considerable discomfort during outbreaks.  Look for the “pimples” and get her to go to the doc if necessary.  Chlamydia can trigger Pelvic Inflammatory Disease (PID) which will take the fun out all sex until she gets proper medication.

5.  Vulvodynia.  This is very common and basically refers to “pain of the vulva”, the vulva being that worshipped little mound above a woman’s vagina.  This is generally handled by docs who specialize and have experience with this condition.

6. Cervix Issues.  A lot of women have a uterus that can get in harm’s way during intercourse.  How would you feel if every thrust thumped your bladder or kidney, big fella?  There’s no pill for this as it is generally caused by the genetic positioning of the uterus in her abdomen.  The only solution is to try different positions, you lucky dog!

7.  Endometriosis.  Does your woman have very painful periods and frequent pelvic pain?  It could be endometriosis, a common condition where uterine tissues actually disperse into neighboring parts of her body.  One side effect can be painful sex.

It is important that you deal with the pain as soon as possible for many reasons.  Of course, you want to find the underlying medical issue and, in addition, it is possible that she can develop a very common condition called vaginismus.  Vaginismus occurs when a woman experiences an involuntary tightening of the PC muscles, the ones engaged during Kegel Exercises, making intercourse painfully difficult or even impossible.  Researchers have noted that this condition can occur seemingly without cause (idiopathic), but can occur after rape, anxiety and painful sexual encounters.

There are many, many other things that can cause under-the-sheet discomfort for females, but this is a good starting overview.  Again, this is another difference between guys and gals:  we have few such problems that take us out of commission. So we need to be sympathetic, ask questions and get her to a good doctor if there is a problem.  Once you remove the pain, you should get your old tigress back…

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”

BPH (Enlarged Prostate) and Diet - Peak Testosterone

Okay, we covered in painful detail Why You Want to Avoid BPH (Benign Prostate Enlargement) Like the Black Plague. Again, unless you somehow enjoy urinating every hour on the hour day and night, BPH (Benign Prostate Enlargement) is not for you. But can you really do anything about it.  Can you avoid BPH (Benign Prostate Enlargement), or is it a Mack Truck with your name written on the grill?  As usual, the answer is that the research you can avoid it through proper diet and other natural solutions.

NOTE:  Be sure to discuss any change with your doctor.

1) Low Fat.  Once again all directions point to the Ornish Diet. One of the leading researchers in the area of prostate cancer and BPH (Benign Prostate Enlargement) is Dr. Alan Kristal.  His research found that “a high-fat diet increased the risk of BPH by 31 percent, and that daily consumption of red meat increased the risk by 38 percent.” [1]

2) Vegetables.  Dr. Kristal found that “eating four or more servings of vegetables daily was associated with a 32 percent reduction in risk“. [1]  Vegetable and plant consumption, again, is a hallmark of the Low Fat (or Ornish Diet) and really the Mediterranean Diet as well.

3) Alcohol. This is counterintuitive, because many believe that estrogen is kind of “anti-prostate” as alcohol give estrogen a longer shelf life in the body. But moderate drinking (of 1-2 drinks per day and no more) led to a 38 percent reduction.  For a more in-depth discussion of alcohol, read here.

4) Onions and Garlic.  Recent studies have shown that onions and garlic very significantly lower the chances of BPH (Benign Prostate Enlargement). [2] Onions were found to be the most protective but garlic was also a powerful BPH Protector.  Men who ate onions four or more times per week had a 59% lower BPH risk than men who never ate onions. Garlic was also found to be protective: men who ate the most garlic had a 28% lower risk than men who never did.

5) Testosterone Therapy. One prominent study showed that testosterone therapy (Hormone Replacement Therapy) actually decreased the typical enlarged prostate symptoms that guys often experience.  Participants experienced less nighttime urinations, less leaking and dribbling and less urgency. [3]

6) Red (or Yellow) Maca. One study on rats showed major prostate shrinkage in rats using red maca and some shrinkage using yellow maca. [4]  Researchers are not totally sure why but note that maca is actually a cruciferous vegetables just as broccoli, cabbage and cauliflower are and thus it is very high in phytochemicals called glucosinolates.  These glucosinolates are converted downstream to I3C and other important prostate shrinking and protecting chemicals.  You can also read about Maca and Testosterone, Libido and Fertility.

7) Exercise. Many researchers have noted that BPH risk often go hand-in-hand with cardiovascular risk factors and exercise is no exception.  For example noted that “physical activity reduces the risk of BPH”. [5]

8) Insulin Resistance. Several studies have noted a connection between BPCH and insulin resistance.  IR seems to change molecular signaling within the prostate and actually trigger the growth that we associate with Benign Prostatic Hyperplasia. [6] Of course, there are many things that can reduce insulin resistance and I cover these in my link on Metabolic Syndrome.

REFERENCES:

1) https://www.newswise.com/articles/view/540125/

2) Urology, 2007 Oct;70(4):672-6

3) Intl J Andrology, 2002 Apr, 25(2):119-25

4) Reproductive Bilology and Endocrinology, 2005, 3:5, “Red maca (Lepidium meyenii) reduced prostate size in rats”

5) European Urology, 2008, 53:1228-1235, “Physical Activity, Benign Prostatic Hyperplasia, and Lower Urinary Tract Symptoms”

6) European Journal of Pharmacology, Sep 2010, 641(2-3):75-81, “Insulin-resistance and benign prostatic hyperplasia: The connection”

HDL, LDL & Triglycerides: Clear Penile Artery to Boost Erections

But, practically speaking, how do you that?  What strategy can you use with a reasonable assurance of success?  Well, as you might have guessed, a couple of the major clinicians actually reversing plaque in the field give us a good starting point:  targets for HDL, LDL and triglycerides. Their message is simple:  get all three of these in line if you want good odds in reversing atherosclerosis (or maintaing clean arteries if you are of the lucky few with no plaque).

What this means is that when you get your lipid panel from your doctor, he is going to say, “Yeah, yeah, that’s great – it all looks good.”  Docs generally do not want to mess with cholesterol and lipid numbers – it’s very time consuming and many patients are “religous” in their view and, to be frank, most non-cardiologists have little expertise anyway.  The bottom line is that you are probably going to have to be the one to manage the long term care of your precious arteries and below we show you the stance of a couple of the experts with practical field experience:

NOTE:  Keep in mind that there are several different alternative pathways to boost NO and I cover those in my link on How to Increase Your Nitric Oxide Naturally.

NOTE: See my link on Does a Low Fat Diet Have to Increase Triclycerides? The answer is no and I show that simply by eating low glycemic carbs, you can keep your triglycerides more than likely below 100 and have stellar LDL numbers, i.e. give yourself a good chance to reverse that nasty arterial plaque that has been lowering your nitric oxide levels!

In any event, he has very rigorous requirements for those with existing heart disease and/or significant familial risk factors.  Check out his goals for HDL, LDL and triglycerides:

So how are you going to achieve numbers like this?  Well, to be honest, it wouldn’t be easy.  I have come close to these numbers with a low fat diet but my LDL was a little higher and my HDL a little lower as well.  How did I come close at least?  Here is what I did:

c) You can measure your plaque now with inexpensive testing that (in most states) does not even require a doctor’s orders. You should be able to get a Heart Scan or Calcium Score for between $50 and $100.  Alternatively, a company called Lifeline now offers CIMT’s, which basically measures the arterial plaque via ultrasound in your carotid artery for (the last time I checked) $70.  So before you assume you do not have plaque, test it!

CAUTION: Dr. Davis recommends Heart Scans, because IMT’s only predict with 60-80% accuracy the plaque within cardiac arteries and cardiac arterial plaque is the most dangerous.  However, a Heart Scan does expose you to some radiation.  This is the tradeoff.

There are a few “lucky dogs” who seem to have good genetics and just don’t develop plaque.  But the great majority of us do not fall in this category and that is why as you enter your 50’s, 60’s and 70’s, you’ll see your friends dropping like flies.  So I would recommend managing your HDL, LDL and triclycerides right away.

2. Dr. Davis’ Rule of 60.  For God’s sake, don’t fall for the arteriosclerosis-doesn’t-matter argument. This is very common in Paleo and low carb circles.  Dr. William Davis just tears this silly thinking apart in his classic book on plaque reversal called Track Your Plaque.  He shows how rapidly atherosclerosis typically progresses and his excellent stats will definitely scare you straight.  This is more material to keep by your bedside.

Dr. Davis is so convinced of the importance of plaque reversal to that he developed his Rule of 60 where – at least according to one video I saw – he stated that 90-95% of men could reverse plaque if they achieved the following:

These numbers, of course, are even more strict that Dr. Gould’s and he typically achieves them from what I understand through some adjustments in the diet coupled with niacin, Vitamin D, fish oil and a few other supplements.  And the clear message of these two men is that

a) Men on low fat diets (like myself) cannot ignore their triglycerides and HDL readings.

b) Men on low carb and classic Paleo diets cannot ignore their LDL numbers.

None of us can be smug and patronizing.  We all have work to do.

CAUTION: If you follow these guidelines for HDL, LDL and triglycerides, are you guaranteed to reverse your plaque?  The clear answer from both Drs. Gould and Davis is that these are just the starting point. They give you good odds, but there are other cardiovascular that need to checked as well.  For the details, I urge you to read the page with Gould’s Guidelines above as well as their two books.  It’s really an involved subject and I urge you to learn about it as much as you can.

INFLAMMATION ONLY?  I cannot tell you the number of times on The Peak Testosterone Forum that someone has proposed the idea that plaque is “all inflammation.” In other word, lipid number, such as HDL, LDL and cholesterol, do not matter as long as your inflammation is under control. This is very risky thinking, in spite of the fact that inflammation does play a major role in atherosclerosis. And the reason is that no one has any targets for CRP, TNF alpha or any other inflammatory markers that I know of to reverse plaque.

As far as I know, no one is doing what Drs. Gould and Davis are doing by ignoring lipids and just focusing on inflammation. How are you going to know if your inflammation is low enough?  Besides, I think it is very unlikely that you can have triglycerides or LDL and expect your arteries to do well. To me this is naive and wishful thinking.  A much safer method is to stick to a time tested method and that means lasering in on lipids.

Is low testosterone causing you bone loss? - Peak Testosterone

What does testosterone have to do with your bones? Surprisingly, testosterone plays an indirect but very significant role in bone health for males. In fact, one common and potentially dangerous symptom of hypogonadism is osteopenia and osteoporosis. Yes, men can suffer from osteoporosis with the associated hip fractures and spinal problems just like their wives and girlfriends.

One of our oldest members (Starry) on The Peak Testosterone Forum had osteopenia and wrote:

“I was pretty shocked when he did my bone density last month….”osteopenia in the spinal column” it read. I’m not in my 20’s but I’m not old either! work out hard, exercise, eat right, etc, and here i am with essentially pre-osteoporosis. Yikes. Just another reminder of the insidious things low T (my counts in lower 200s) can do. He made sure to tell me to immediately start on at least 500 milligrams of calcium a day. Really anticipating my T level and estrogen/estradiol results next week after 5 months on Clomid.” [7]

Like Starry, most men do not realize is that the root cause of their low estradiol is actually low testosterone. Remember that estradiol in men comes from testosterone through a conversion process centering around the aromatase enzyme. While it s true that too much estrogen can be a problem for some males, it is equally possible for a man s testosterone to fall so low that estradiol in turn plummets to dangerously levels because there is just isn’t enough baseline T to convert to E2. This is when net bone loss can begin to occur and, as the years go by, osteoporosis and all of its medical complications can set in.

Just how serious is this issue? Researchers studied a group of men over 60 and controlled for all the standard osteoporosis risk factors. They 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. [1] Obviously, when your bones begin fracturing, this becomes both painful and debilitating.

Is low testosterone (and the ensuing low estradiol) causing you bone loss? osteopenia? osteoporosis?

At what testosterone level did this become a problem? The researchers broke the study participants into quartiles and found that the lowest quartile, which was total testosterone less than 291 ng/dl (9.9 nmol/l), had the highest fracture rates. (NOTE: The lowest quartile of estradiol (E2) was less than 13.9 pg/ml.) Men who suffer from osteoporosis can also find themselves with other debilitating conditions, such as joint issues and compressed spines.

Just how serious is this issue? Researchers studied a group of men over 60 and controlled for all the standard osteoporosis risk factors. They found that low total testosterone was strongly correlated to bone loss and associated with an 88% and 28% increased risk of hip and non-spinal fractures, respectively. [1] Obviously, when your bones begin fracturing, this becomes both painful and debilitating.

What about osteopenia?  Many low testosterone men are now diagnosed with osteopenia instead of osteoporosis. Osteopenia is basically bone density that is analogous to prehypertension.  It is indicating bone loss but not as severe yet as traditional osteoporosis.  Should you take it seriously?  Yes!  One of https://www.peaktestosterone.com/forum/index.php?topic=222.msg1744#msg1744 wrote “Because I am on steroids for the next month or so and was diagnosed with osteopenia some years ago, possibly from steroid use or from colitis.”

As expected, testosterone therapy helps significantly. One study looked at senior men (about 65 years old and not necessarily with osteoporosis) and found that if they started with total testosterone levels of about 200 ng/dl (6.8 nmol/l), testosterone therapy significantly increased their bone mass. The study encompassed three years and the men s average peak testosterone went from 367 to 625 ng/dl.

Just how common is osteoporosis in men with low testosterone?  Well, in men with testosterone < 200 ng/dl, which is VERY low T, 12.3% of men were found to be osteoporotic. [4] That’s roughly one in eight and thus is a significant percentage.  Furthermore, the studies, as far as I know, have not looked at the prevalence of osteopenia among hypogonadal men and this would undoubtedly be a substantially higher percentage.

I should mention that not all the research has shown this relationship.  In fact, one interesting study showed that testosterone levels were not really associated with osteoporosis and that it was SHBG that was the true correlate instead. [5] Yet another study showed that it was really estradiol that was critical and not testosterone, which is not too big of a shock. For a good summary of the studies, see https://onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2265.1999.00730.x for more information.  However, since our estradiol comes from testosterone, it is somewhat of a moot point. Obviously, this is yet another reason that low testosterone can be an indirect root cause of osteoporosis in men and should be taken very seriously

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NOTE: Low estradiol should be taken seriously for many other reasons as well, including negative effects on sexual, cardiovascular and brain health. See my link on Why Men Need Adequate Estrogen for more information.

Of course, ramping up your testosterone is key if that is the root cause for your bone loss. Other critical factors to regaining your bone density are ample calcium, Vitamin D, magnesium and exercise.  Do not go overboard with calcium without discussing with your physician, as it has been linked to several kinds of cancer.  Also, I highly recommend you get your Vitamin D check if you have not already as it can lead to low testosterone.  See my links on Prostate Cancer Prevention and Vitamin D for more details.

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) J Clin Endocrinol Metab, 1999 Jun, 84(6):1966-72, “Effect of testosterone treatment on bone mineral density in men over 65 years of age”

3) https://www.peaktestosterone.com/forum/index.php?topic=222.msg1744#msg1744

4) The Journal of Clinical Endocrinology & Metabolism, Oct 1 2006, 91(10):3908-3915, “Association of Testosterone and Estradiol Deficiency with Osteoporosis and Rapid Bone Loss in Older Men”

5) Bone, 2001 Jul, 29(1):90-5, “Osteoporosis in men: a potential role for the sex hormone binding globulin”

6) Clinical Endocrinology, Apr 1999, 50(4):411-414, “The effects of testosterone on osteoporosis in men”

7) https://www.peaktestosterone.com/forum/index.php?topic=221.0

Testosterone and Arimidex - Peak Testosterone

STEP 8:  If you are high estradiol, consider pharmaceutical solutions to high estradiol (with your physician of course):

What if I told you there was a relatively inexpensive pill that any low testosterone man could take that would likely double his bioavailable testosterone and increase his total testosterone by around two thirds?  One study looked at men over 60 years old found an increase in testosterone of 62% and a decrease in estradiol, the “bad estrogen”, of 24% for a net improvement in the testosterone-to-estradiol ratio of 115%. [3] It took their total testosterone levels up from an average of 330 to 535 ng/dl.

Another study on infertile men with a T/E ratio less than 10 and total testosterone under 200 ng/dl found even more impressive results:  total testosterone was increased by an average of 95%. [4] (Another similar drug (Femara or letrozole) produced spectacular results and other studies have shown that Teslac (testolactone) also does very well) [5]

Personally, I don’t think this kind of Arimidex Monotherapy is a good idea for several reasons:

1. Less Sexual Improvements. Some study work indicates that Arimidex Monotherapy does not improve libido and sexual function significantly, even though testosterone and estradiol levels are improved.  [8]

2. The Current State of Testing. One quandary that physicians and their patients are facing right now is coming up with a target range for estradiol levels.  The big labs are now emphasizing LC-MS/MS estradiol tests for men, which makes sense, because LC-MS/MS is the best practical technology to read the low levels of estradiol that a male has.  However, the results for the LC-MS/MS appear to be a little lower than the old assays, due to decreased cross reactivity with other molecules, making the old target ranges from previous study work probably invalid.

3. Risk of Osteopenia / Osteoporosis.  Some physicians do not properly monitor or use the wrong estradiol test.  This could lead to a man ending up with bone loss.

4. Possible Risk of Clotting.  Some experts believe that Arimidex, even low dose, could increase of clotting in some men.

Now what is curious is that Arimidex (anastazole) actually works by binding to the infamous aromatase enzyme that converts your testosterone into estrogen.  Thus it effectively inhibits or blocks this conversion.  So one might expect estrdiol (E2) to be affected more proportionately than testosterone, but notice that it was T that was affected more than E in the above study.  (For other ways to affect your proportion of T to E, see my Natural Ways to Improve Your Testosterone-to-Estrogen Ratio link.

REFERENCES:

1) https://www.peaktestosterone.com/forum/index.php?topic=295.msg2616#msg2616

2) https://www.peaktestosterone.com/forum/index.php?topic=433.msg4718#msg4718

3) Clin Endocrinology, 2009, vol. 70(1)”116-123, “Effects of aromatase inhibition in hypogonadal older men : a randomized, double-blind, placebo-controlled trial”

4) https://hrt-rx.com/2012/06/05/ arimidex-vs-femara-for-increasing-testosterone-in-men-hrt/

5) Fertility and Sterility, Jul 2012, 98(1):48-51, “Changes in hormonal profile and seminal parameters with use of aromatase inhibitors in management of infertile men with low testosterone to estradiol ratios”

6) Molecular and Cellular Endocrinology, 16 May 2006, 250(1-2):2-7, “Hormonal approaches to male contraception: Approaching reality”

7) The Journal of Urology, Feb 2002, 167(1):624-629, “AROMATASE INHIBITORS FOR MALE INFERTILITY”

8) J Sex Med, 2012 Jun, 9(6):1681-96, “Estrogens in Men: Clinical Implications for Sexual Function and the Treatment of Testosterone Deficiency”

9) J Urol, 2013 Feb, 189(2):647-50, “Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy”

Some of the more forward thinking doctors are now prescribing Arimidex in conjunction with HCG.  HCG, of course, stimulates the testes to produce testosterone and is used primarily to avoid testicular shrinkage, but it can also cause estradiol problems downstream.  One of the more famous “internet hormone doctors” is Dr. Eugene Shippen and one of our Peak Testosterone posters went to him.  Dr. Shippen’s overall protocol for this man, whose testosterone was 296 ng/dl, was as follows:

“He sent back a letter and a prescription for Clomid. (for 7 day stimulation test) My results showed I had Secondary Hypogonadism. My T had risen to 541, My E2=47, and DHEA was below the bottom of normal and D3 was low. On May 30th I went to Pa. to meet with him, he spent over 2 hours going over all my test results and did a physical that included a prostate check. He order[ed] the following meds: HGC, Arimidex, and 25mg DHEA oral supplement. I must have a followup blood test in 3 weeks for T, E2, and DHEA-S. Then in 6 weeks a full blood workup for Endocrine testing. He wants me to take D3 4000mg daily and drink Pomergranate juice plus Vit. C 1000mg.” [1]

Of course, in this case Arimidex was used in conjunction with HCG, but it is also often used by itself. Look at what one of the men on the Peak Testosterone Forum experienced:

“Having said that, Arimidex has done wonders for me in the 2 months i’ve been taking it, and my E2 was only 48 after a few months on hcg. the doc prescribed me 0.5mg ED, which is higher than what most people I read about on msg boards take. I tried that at first, felt nothing for about 10 days, then all of a sudden I started waking up with the biggest erections I had experienced in many years. and libido came back and now I think about sex all the time. just the hcg alone wasnt doing it for me even though it did raise my T levels. i have now cut back to 0.5mg EOD, which is still higher than most people seem to take, but it seems to be working for me. I read a comment on another more steroid oriented forum where a guy was saying to calibrate the Arimidex dosage based on morning wood, because if it gets too low you wont have it, but if it’s just right it will be huge and powerful.” [2]

NOTE:  Arimidex is not the only way to clinically lower estradiol.  There are other aromatase inhibitors, such as letrozole (Femara), for example.  There are also irreversible aromatase inhibitors.  See my page Suicide Inhibitors for some background information.

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Arimidex also has a big advantage for younger men wanting to possibly have kids: it does a much job at preserving fertility than traditional testosterone therapy.  Classic HRT (Hormone Replacement Therapy) will generally significantly decrease fertility, making childbearing difficult to impossible.  In fact, the new 6-week testosterone therapy injectable, Nebido, is actually being used as a quasi-contraceptive by some men.  And there is considerable research going on to find the best way to use HRT to achive a reliable male contraceptive. One research summary even wrote that “current hormonal combinations completely suppress spermatogenesis without severe side-effects in 80 90% of men, with significant suppression in the remainder of individuals. Recent trials with newer, long-acting forms of testosterone combined with progestogens have yielded promising results and may soon result in the marketing of a safe, reversible and effective hormonal contraceptive for men..” [6]

The aromatase inhibitors (AI’s) can sometimes bypass that concern.  (Confirm with your doctor, of course.)  In fact, Arimidex will actually improve some fertility parameters.  One recent study looked at Arimidex and found that, besides delivering a nice boost in testosterone, FSH was largely unchanged and sperm density was increased by 78%. [4][5] For these reasons, fertility doctors will sometimes use Arimidex to treat male fertility issues.  For example, you might be started on Clomid for a few months and, if your testosterone is too high, Arimidex (anastrozole) may be prescribed in combination.  Or some men are started with both immediately and then monitored.  Again, I’m not a big fan of Arimidex due to the above four concerns, but some physicians do make use of it.

These types of fertility treatments for men are much more common than generally realized:  male fertility is probably impacting up to a fourth of all troubled pregnancies. Fertility doctors also tend to be much more cutting edge when it comes to boosting testosterone than many traditional doctors, such as urologists, endocrinologists and primary care physicians. Why? Fertility specialists have been treating men for over a decade with alternative treatments and are interested in preserving libido, which requires good testosterone levels, along with boosting sperm parameters. Thus, they have on average built up a lot more experience than most other specialities.

However, I should point out that some physicians are now using low dose HCG in conjunction with testosterone therapy in order to maintain fertility.  For those interested, see a fertility specialist familiar with Dr. Lipschultz’s work.  [9]

Arimidex and Testosterone Therapy

Arimidex (anastrozole) is also quite commonly used in men who are on testosterone therapy (HRT or TRT).  The reason is that 80% of a man’s estradiol comes from the conversion of testosterone into estradiol in the fat tissue through the aromatase enzyme.  The more weight that a man has gained, the higher the estradiol levels that he will have on average.  Furthermore, some TRT providers push men to very beefy levels of testosterone, say 1000-1200 ng/dl, which may be above the man’s natural set points.

When I first started cypionate injections at an HRT clinic, they put me on low Arimidex just a couple of months later. This really surprised me, because I really did not want to have to “medicate my TRT.”  The argued that the dose was very low compared to, say, a cancer patient, and it has no real side effects when done properly, i.e. estradiol is not sent overly low.

So for a few months I took .5 mg twice a week.  I then pushed them to let me lower it to .25 mg twice per week.  Both of these doses are pretty common for men on testosterone, and I see it quite often on the Peak Testosterone Forum. But I did everything in my power to get off of Arimidex and used a threefold approach to actually accomplish the task:

This allowed me to get off of Arimidex completely.  My testosterone levels are still very solid and in the 700-800 ng/dl range.  And in my opinion almost every guy on TRT should endeavor to do the same, because this will generally be more physiological, or natural.  Plus, the cautions and risks cited above for Arimidex Monotherapy also apply here as well.

Of course, Arimidex is often used by steroid users to decrease over-aromatization from driving their testosterone into supraphysiological zones, i.e. way above normal, which in turn leads to elevated estradiol.  They aslo use it post-cycle period when they are desperately trying to get their testosterone jumpstarted – sometimes unsucccessfully I might add. As strange and annoying as this is, steroid users and fertility doctors were some of the early pioneers of Armidex usage.

CAUTIONS: However, Arimidex is not something that should be used unless it is under a doctor’s supervision, primarily because estradiol, the E2 estrogen, needs to be monitored.  One of the problem’s with Arimidex is that one can easily push estrogen levels too low.  In the short term this can lead to joint pain.  Scientists are not sure why, but, when estrogen gets too low on Armidex, the joints can begin to be very painful.

Even more dangerous, though, would be long term damage fromm overly low estrogen levels.  Low E2 will eventually lead to bone mass loss, i.e. osteopenia and ultimately osteoporosis.  See my link on Why Men Need Estrogen for more details.

Arimidex can also negatively effect libido.  The thinking is that if estradiol gets driven too low that sex drive goes with it.  Again, estrogen in males has a fairly tight therapeutic range with too much or little decreasing sexual desire. (It can also send libido thorugh the roof!)

Creatine Dangers (Raising DHT) - Peak Testosterone

I had a little surprise during my 2012 physical:  I had a low GFR, which indicates poor kidney function.  In addition, I had had a few aberrant readings in the docs office over the lost year of my blood pressure in the prehypertension phase.  All of this pointed to my kidneys being under stress and perhaps even injured.

My doc quizzed me and was horrified to find I was taking creatine.  Now I had read dozens of articles on creatine and all of them insist that it is incredibly safe and well-tolerated and does not affect kidney function, so I thought she was just operating on “old school” information.  And perhaps she was, but I did find in my research that these articles, most of whom are on sites selling creatine, leave out several important facts about this supplement. And weight lifters like myself don’t want to hear anything negative about creatine, because it is one of our star performers.

For those unaware, creatine has many incredible properties, which I document in my link on The Advantages of Creatine for Vegetarians, such as building satellite cells – one of the Holy Grails of bodybuilding – and boosting workout performance, etc.  Unfortunately, to get those kind of benefits, you have to megadose.  5 grams is the typical maintenance dose and this is this is the amoung of creatine in a little over a pound of salmon!  Unless you’re working on an Alaskan fishing boat, you’re not going to get anywhere near that on a daily basis.  During the “loading phase” many men take creatine of 20-25 grams for a week or two as well.  Some muscleheads like myself take 5 grams before and after a workout.

So let’s look at just what risks creatine potentially poses in some men:

Does this mean that creatine usage could cause hair loss?  Many men are low or lowish in DHT and so it is doubtful that they would be impacted.  However, for men with more robust DHT levels, raising in another 40% is definitely not going to help matters. You can get your DHT measured – a doctor is unlikely to do it for you – at any one of these Testosterone Self-Testing Labs.

Does this mean that creatine is universally danger-free?  That is a big assumption.  First of all, creatine increases the amount of urine by about 25%. [3] This just will create an additional burden on the kidneys.  Obvioiusly, for healthy individual this does not appear to be a big problem however.

Long term users of creatine, though, should keep in mind that several cases of inflamed kidneys have been reported [3] and that studies on creatine usage have always been on the young and healthy.  Long term usage by middle and senior-aged men may not fare so well.  Furthermore, what about in men with type II diabetes, whose kidneys have often “been through the war?”  Again, there are many large population groups who do not need and may not do well with this extra burden on one of their vital organs.

This reminds me a bit of salt in the diet, which will pull extra water into the arteries.  This, of course, requires the heart to work a little harder, but is a burden that is handled fairly well by most people.  However, in some sensitive people, it can create high blood pressure and other problems.

The bottom line is this:  if you are going to use creatine, it would be wise to regularly check your kidney function in my opinion. Better safe than sorry, eh?

3.  Creatine + HRT.  As I have documented in my link on Testosterone and the Kidneys, HRT could cause issues in men with kidney problems. Some research shows that testosterone can cause cell death in the kidneys in certain cases, explaining why men have a much higher rate of kidney failure than women. [5] However, the good news is that giving men testosterone therapy is not noted for increasing kidney issues.

But I could not help but ask myself the question:  did my GFR fall below range because I was on both testosterone AND creatine at the same time?  Perhaps the two of these together created issues for me.  (I was on testosterone cypionate at the time and my testosterone was peaking at about 1200 ng/dl at the time.)  One further evidence of this is the fact that, after I gave up the creatine, my GFR rose again back within acceptable lab range levels.

1)  Clin J Sport Med, 2009 Sep, 19(5):399-404, “Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players”

2) Med Sci Sports Exerc, 1999 Aug, 31(8):1108-10, “Long-term oral creatine supplementation does not impair renal function in healthy athletes”

Garlic and Vitamin C: Erectile Dysfunction Cure For Some

We have a few heavyweight nutraceutical erectile dysfunction cures that are growing in popularity on the Peak Testosterone Forum. One of them is garlic with Vitamin C. Researchers have long known that Vitamin C has a postive effect on endothelial function and artery health in general – something I document in my link on Vitamin C and Erectile Dysfunction – and garlic has been known for the same. However, to be honest, neither produces particularly spectacular results on its own.

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

2) https://www.peaktestosterone.com/forum/index.php?topic=3610.0

3) https://www.peaktestosterone.com/forum/index.php?topic=3980.0

Someone, though, got the bright idea to combine the two and see what would happen. The results were nothing short of spectacular and actually met or exceeded any single drug hypertension pharmaceutical out there. [1] It turns out that, somehow, Vitamin C and garlic provide synergistic effects that even exceeded the power of the two summed. Look at some of the spectacular results that this study achieved on marginally hypertensive patients:

1.  Increased endothelial nitric oxide by about three times baseline!

2.  Dropped systolic blood pressure from an average of about 142 mm to about 115 mm at the one week point!

3.  Lowered diastolic blood pressure from an average of about 92 mm to about 77 mm at the one week point!

Of course, this is going to ramp up blood flow to an incredible degree and so men with erectile dysfunction have been trying it.  I know that, at least on Peak Testosterone Forum, some men have been very pleasantly surprised, especially when you consider that neither of these are expensive – quite the opposite.  Look at what a couple of posterswrote:

“Hello. I’m 38 an healthy. I smoke weed and cigs. I have had problems with erections since I was 35. Some days good some days bad. Tried just about everything to help my erection. Nothing really helped. I till now I am a new man! Like I’m in my 20s! I started taking vitamin c about 2,000 to 4,000 milligrams a day. Saw a huge difference in erection! That was great! But I just found a breakthrough! Vitamin c works really well for erection, but take vitamin c with garlic an omg hard one like your 20. Rock hard. I was researching vitamin c when I stumbled upon an article. About researchers giving men in there 50s vitamin c with garlic. An it boosts nitric oxide by 300%!!! So I tried it an this us it. This is the combo that will fix you. It fixed me. I started taking both about a week ago. An I haven’t been this happy for long time. It works so well that I don’t think I could get this hard when I was 16!!” [2]

Now, if you read between the lines here, this guy likely damaged his endothelium with tobacoo and marijuana. (Inhaling the smoke from burning leaves is always hard on the lining of the arteries!)  He did so much damage that he actually developed early onset erectile dysfunction at age 35.  The garlic and Vitamin C actually “cured him” and brought him back to his youth.

Now does this mean it’s okay to smoke?  Of course not!  Eventually, nothing will work for him if he continues with the smoking: it’s really just a matter of time.  The real point is that this nutraceutical solution is so powerful that it can often overcome, at least temporarily, the effects of a negative lifestyle.

Yet another example was one of our senior posters who has a science background.  He is forever experimenting with different supplements and nutritional strategies and found that a combo of Pycnogenol, which indirectly boosts nitric oxide, and garlic dropped his prehypertensive systolic blood pressure by about 10 points from 125 to 113-116! [3] Again, this shows the synergies that can be achieved.  ( For more information, see my link on Pycnogenol and Erectile Dysfunction.

It should be added that both Vitamin C and garlic have health superpowers in many other key areas besides simply improving erectile dysfunction.  The available research shows that garlic is a potent cancer and arteriosclerosis fighter.  Vitamin C is no slouch either and helps with immunity, cortisol, skin aging and inflammation just for starters.  For more information, see my link on https://www.peaktestosterone.com/why_take_vitamin_c.

DOSAGE:  How much should you take?  Well, in the above study, participants took the following:

a)  2 grams/day of Vitamin C (2 1-gram tablets of an “ester-C.”)

b)  4 tablets of garlic, where each tablet contained 6 mg of allicin and 13.2 mg of alliin.

The article does not really specify how many times per day those in the study took the tabs as far as I can tell.  However, generally it is better to spread out one’s supplements to achieve more stable and steady plasma levels.

CAUTION:  Dr. Blaylock recommends taking Vitamin C on an empty stomach, because Vitamin C can increase iron absorption.  (Too much iron, which is a very common problem, is a neurotoxin and contributes to heart disease.) In addition, one study shows that Vitamin C increases nitrosamine output if there is fat in your stomach, i.e. what you ate has fat in it.

REFERENCES:

Depression Symptoms - Peak Testosterone

This will sound strange, but a lot of people don t even realize that they are depressed, especially if they have a mild to moderate case. But any kind of long term depression is something to be concerned about as it can negatively impact your hormones, sleep, sex life and brain function. Depression is extremely hard on the body and mind and many people unwittingly let it go on and on and on. Depression, among other things, can literally shrink the brain and destroy neurons due to elevated cortisol levels.

So how do you recognize if you have depression? Well, some of the symptoms are quite well-know and are almost synonymous with depression: lethargy, indifference, sadness, thoughts of suicide and oversleeping for example. However, some symptoms are much more subtle:

1. Whole Body Pain. True depression usually hurts it is much, much more than just feeling a little blue. Talk to someone with clinical depression and they will tell you it is hell and they mean physically. Often joints, muscles in fact everything! hurts.

2. Chronic Fatigue. Many depressed individuals feel tired all the time. I am not implying the depression and Chronic Fatigue Syndrome are in any way synonymous. But a large percentage of depressed people have almost no energy.

3. Decreased Appetite. During depression many people lose desire for just about everything, including the will to eat.

4. Headaches. For reasons that are not really understood, depression is often associated with headaches, including migraine.

5. Chest, Back and Stomach Pain. Depression can make you feel like you have angina, an ulcer or a herniated disk. In other words, sometimes you have the chronic, whole body pain and sometimes it is much more acute and localized. Again, depression hurts!

There are other symptoms that are also very common including lapses of crying, crankiness, low libido, inability to sleep and difficulty concentrating. If you know someone that is depressed, then I encourage you to gently start to encourage them to get hold. Again, there can be many organic reasons for Depression as well, including a all-too-common deficiency of folic acid or a low functioning thyoid. So please read this link on How to Significantly Help Depression and discuss with your doctor if this is an issue for you or a loved one.

Vitamin C - The Incredible Benefits - Peak Testosterone

Hopefully, you have read about Some Potential Risks of Vitamin C. If so, you know that Vitamin C has definitely not turned out to be the rock star that so many promised.  In spite of that, Vitamin C, in some cases at megadose levels, does merit very strong consideration.

Here are some of the nice benefits from Vitamin C, including some potentially significant help in the bedroom:

1) Intercourse Frequency. Yes, you read that right. One study of healthy young volunteers found that 3 grams/day significantly increased their frequency of sexual intercourse.  Not a bad day’s work for a cheap supplement, eh? [3]  The authors of the study noted that vitamin C improves “catecholaminergic activity, decreases stress reactivity, approach anxiety and prolactin release, improves vascular function, and increases oxytocin release”.  Of course, all of these can improve your bedroom performance, desire and enjoyment.

2) Your Brain. So is there anywhere where megadoses of Vitamin C seem justified?  One good example is in the brain.  As I frequently point out, the brain is a huge energy and nutrient hog and Vitamin C is no exception. Several studies have shown Vitamin C intake correlated with improved cognitive function [4] and neuroprotection. [5]  But it should be noted that there are other studies that show no correlation between Vitamin C intake and cognitive function.  Researchers examining the Rotterdam Study, for example, concluded that “there was no association between cognitive function and intake of vitamins C and E”. [6]  Again, though, the majority of studies show some advantage to Vitamin C supplementation.

3) Blood Flow, Nitric Oxide and Erections. There is good evidence that in men struggling with endothelial and erectile dysfunction that Vitamin C can significantly help their situation.  I show all the latest evidence for this in my link on Vitamin C and Erectile Dysfunction.

4) Weight Loss. Researchers found that “Vitamin C status is inversely related to body mass. Individuals with adequate vitamin C status oxidize 30% more fat during a moderate exercise bout than individuals with low vitamin C status; thus, vitamin C-depleted individuals may be more resistant to fat mass loss”. [9] But remember this is only for Vitamin C deficient individuals and does not justify megadosing.  You can get plenty of Vitamin C from food to overcome these kind of deficits.

1) J Am Col Nutr, 1999, 18:166-70, “The effect of ascorbic acid supplementation on the blood lead levels of smokers”

2) EurJ Cancer Prev, 1998 Dec, 7(6):449-54, “Effects of high dose vitamin C treatment on Helicobacter pylori infection and total vitamin C concentration in gastric juice”

3) Biological Psychiatry, 15 August 2002, 52(4)371-374, “High-dose ascorbic acid increases intercourse frequency and improves mood: a randomized controlled clinical trial”

4) Eur J of Clin Nutr, 2003, 57(Suppl1):S54 S57

5) J. Amer Geriatr Soc, 2000, 48:1285 1291

6) Am J Epidemiol, 1996, 144:275 80

10) Int J Sports Med, 2001 Oct, 22(7):537-43, Peters EM, Anderson R, Nieman DC, Fickl H, Jogessar V., “Vitamin C supplementation attenuates the increases in circulating cortisol, adrenaline and anti-inflammatory polypeptides following ultramarathon running.”

11) Psychopharmacology (Berl),Jan 2002,159(3):319-24

12) J Strength and Conditioning Res,1998,12(3):179-184

13) https://www.sciencedaily.com/releases/1999/08/990823072615.htm

14) Free Radic Biol Med, 2009 Jan 1, 46(1):70-7, “Vitamin C treatment reduces elevated C-reactive protein”

15) Free Radical Biology and Medicine, April 2003, 34(7):881-891, “Vitamin C protects low-density lipoprotein from homocysteine-mediated oxidation”

5) Cortisol and Stress Reduction. Vitamin C has been shown in a number studies to reduce cortisol during times of stress.  For example, one study of ultramarathoners [10] showed decreases in cortisol from those given megadoses of Vitamin C.  Another (almost humorous) study induced stress by forcing subjects into public speaking and mathematical test-taking situations and found that 3000 mg reduced cortisol levels significantly.  [11]  More recent research found that 1,000 mg of Vitamin C reduced cortisol levels in weight lifters for 24 hours after lifting. [12]  Animal studies have shown the same thing on animals under stress. [13]

6) Skin. Vitamin C protects your collagen, a key component to any anti-aging regimen for your Skin and Appearance. Now I know of no study that shows that oral Vitamin C supplementation reduces wrinkling and sagging.  However, it is very likely that Vitamin C does reduce or at least protect your skin from wrinkling on a small scale. In fact, researchers just found that Vitamin C protects skin cell DNA through fibroblast stimulation [14] and think it may help to actually heal the skin. NOTE:  Vitamin C definitely can reduce wrinkling if applied topically.  See this link on Skin and Topical Vitamin C for more details.

7) Immunity. Vitamin C has many immune-boosting properties but hasn’t done quite as well in the studies as one might hope.  However, one thing that most experts agree upon, as I document in my link on Immunity, is that Vitamin C often lowers the effects of colds and flus.  The worst thing about colds and flus is that they last for a week or two and make you miserable with drainage, runny nose and similar symptoms. Vitamin C seems to help significantly with these type of symptoms, thus putting it somewhat in the “pain reliever” category, i.e. making your cold or flu more tolerable while you give your body’s own immune system time to recover.

8) Mood.  The above study, and others as well, have found that Vitamin C often improves mood and reduces depression. [3]

10) Lead. Megadoses of Vitamin C have substantially reduced baseline lead levels in several studies.  For example, one study on smokers showed that a gram daily of vitamin C reduced lead levels by a whopping 80%. [1]

11) Libido. One reader reported to me – this is anecdotal of course – that Vitamin C helps significantly with his ADHD and libido.  I explain why this may be the case for some men in this link on Vitamin C and Libido.

12) Inflammation. There is gathering evidence that Vitamin C may improve inflammation, particularly in at risk men.  One prominent example was a 2009 study showed that CRP (C-Reactive Protein) can be reduced by 25% in men (and women) with levels  > 1.0 mg/L. [14] What is remarkable is that this was achieved with a mere gram per day, which is a fairly low intake by “Linus Pauling” standards.

13) Homocysteine Protection.  Hopefully, you have read my Erectile Dysfunction and Homocysteine page. Basically, that article warns men that even mid normal homocysteine levels can lower nitric oxide and increase the risk of erectile dysfunction (and heart disease).   Vitamin C may actually be a huge help in this battle because it protects against oxidized LDL, which is what can increase atherosclerotic plaque. [15]

Vitamin C – My Current Dosage and Strategy

My strategy is to take 3 500 mg doses of Ester-C or one of the equivalent supplements. And I will take more if I feel as if I might be getting sick. And I always take Vitamin C with no fat in my stomach.  Of course, this is no problem for me as I almost always consume a Low Fat Diet anyway.

NOTE: Regular Vitamin C is acidic and can be hard on the stomach:  you may want to consider the Ester-C (500 mg) , which is neutralized, if you do decide to take it.

REFERENCES:

Natural Aromatase Inhibitors / Estrogen Blockers.

Assuming my estradiol is high, how can I lower it naturally?

One of the questions that frequently comes up on The Peak Testosterone Forum is the subject of natural estrogen blockers or, usually more correctly, aromatase inhibitors. The reasons are generally due to concerns such as:

So the patient wants to take matters into his own hands.  Now, before one considers this option, let me mention that I have written a couple of pages that discuss the best natural ways to lower estradiol and, in my opinion, these should be your first line of defense:  Estradiol and Weight Loss and Lowering Estradiol by Adjusting Dosage and Frequency.  CAUTION:  Any pharmaceutical or supplemental method of lowering estradiol is potentially dangerous, because, if you happen to lower your estradiol too low, you could end up with bone loss (osteoporosis).  Best to work with a (knowledgeable) doctor on this.

If you look at my page on “Normal” or Youthful Estradiol levels, you’ll see that most men are in the 20-35 pg/ml range throughout their life. And, from what I have seen, most docs (who care) try to keep their male patients in the 20 to 35 pg/ml range and the reason is that going either too high or too low can lead to cardiovascular, erectile, mood and other general health issues if it continues for long enough.  See my pages on High Estradiol and the Link with Prostate Cancer / Enlarged Prostate and High Estradiol Increases Arterial Plaque.  (High estradiol also likely puts some men at risk for clotting issues.)

But remember that around two thirds of men in the U.S. are either overweight or obese.  The extra aromatase in fatty tissue will generally raise baseline estradiol – the “bad” estrogen – levels and lower baseline testosterone levels (if you are not on TRT).  And many men can dramatically lower their estradiol levels simply by losing weight. In other words, looking for any kind of an estrogen blocker can in some cases just be masking the fact that a man has too much body fat.  It’s always better to treat the root cause, eh?

So, that said, is there a legitimate use for natural ways to lower estradiol?  Yes, I believe so, assuming, of course, one is monitored by a physician, and that is simply for this simple reason:  virtually all men in modern societies are inundated with estrogen.  Bisphenol-A is on receipts and in plastics.  Phthalates are in many plastics.  Pesticides and many household chemicals as well as food additives can all increase a man’s estrogen load.  Unfortunately, rarely are men exposed to things that increase their T levels to balance things out. And this is undoubtedly one of the big reasons that we see fertility and testosterone levels falling worldwide.

However, as you will see below, the natural estradiol blockers used by HRT clinics and sold by supplement companies have some major issues associated with them in my opinion. If you are considering of the standard methods, I highly recommend what you read below.  men on HRT are particularly concerned with this, because their estradiol levels climb with the boost in testosterone.  Clinics and doctors will sometimes suggest dubious solutions, such as DIM, zinc, zinc/copper and chrysin, that may put their guys at risk long term.  I got my estradiol in line by getting my body fat down to 12% and by going to subQ cypionate injections and lowering my dose a little.  I believe most men can control their estradiol much  more safely by using that strategy as opposed to the supplements below.

1. Calcium D-Glucarate.  This has become the most widely used estradiol-lowerer on the Peak Testosterone Forum. And for good reason: it has a good side effect profile – nothing is perfect of course – and also can help the body detoxify and lower cholesterol / LDL-C. I actually covered this popular supplement on a separate page: Calcium D-Glucarate Lowers Estradiol.

2.  CAUTION: DIM. DIM (diindolylmethane) is a well-known estrogen controller and a phytochemical in a number of plant foods including cruciferous vegetables and kale.  Of course, researchers noticed these properties and a number of studies have shown promising results. DIM is known for switching the estrogen profile from the “bad” metabolites to the “good” metabolites.

However, DIM aficionados have gone one step beyond the studies and swear by Indolplex DIM, a DIM that is supposedly better absorbed than regular DIM and actually lowers estradiol levels.. I believe both iHerb and the parent company sell it.

WARNING and NEWS FLASH:  I recommend staying away from DIM and I3C.  One researcher has found a link between DIM / I3C and liver cancer in animal studies and wrote that “we performed a tumor study in trout to examine the effects of DIM on cancer development compared to 17β-estradiol. Feeding the trout either DIM (24 mg/kg/day) or estradiol in the diet long-term following acute exposure to a liver carcinogen resulted in more tumors compared to control animals. Concentrations of DIM lower than 24 mg/kg/day did not significantly increase the number of tumors. We confirmed that DIM was promoting cancer by acting like an estrogen by comparing gene expression in the liver samples over the course of cancer development.” [5]

For the record I have no affiliation with this product.  However, it has a good reputation in the steroid community for lowering estradiol levels and so I am just passing along information.  However, there are two things to be aware of:  a) although Indolplex DIM is fairly widely used in the alternative and steroid communities, there are no studies that I know of and, therefore, very little data on side effects and b) it is fairly expensive costing around $31 as of this writing for 60 capsules.

And how do you determine dosage?  Well, you’re forced to go by word of mouth.  One of our posters on this thread of the Peak Testosterone Forum, basically got into a hypogonadism user group and found a word of mouth dosage and stuck with that. This is a big disadvantage in my mind as Arimidex dosing is fairly well known.  An experienced doctor can fairly well look at your estradiol levels along with a couple of other factors and determine a reasonable starting dosage for Arimidex.  Indoplex DIM seems much more art than science.

Sure DIM is in food, but once you megadose, is it really “natural” any more?  I’ll leave it up to you and your doctor to determine if this is a more natural solution.

CAUTION:  This one is powerful enough that you should be under a physicians guidance and have your estradiol monitored regularly for the reason mentioned above. Again, you can hurt yourself if you drive your estrogen levels too low for too long. We had one user on the forum who claimed that his estradiol levels never recovered after months of taking too high of dosage on Arimidex for example and potentially the same thing could occur with DIM. [1]

HRT USERS: Some men on HRT may find that they only need to control estradiol with a supplement or medication for six to twelve months, because often the body’s testosterone and estrogen levels are stabilizing.  You may be able to get away with lowering estradiol for six months while your a) estradiol levels stabilize or b) you lose weight.

3. Zinc. Although the studies have been somewhat mixed, many experts feel that zinc supplementation will likely raise testosterone in zinc deficient men. And zinc deficiency is probably not too unusual. As you can see in My Page on Sleep Aids, a combination of zinc, magnesium and melatonin greatly improves insomnia and some users on the forum have reported that just simple ZMA greatly helps with sleep. (Anything that helps with sleep will likely give a little boost to testosterone.)

Zinc is also known for its ability to limit the activity of aromatase.  I don’t think anyone has any doubt that it works to a certain extent and probably most powerfully if you are zinc deficient.  However, I don’t know of any studies that actually show zinc being used to clinically lower male estrogen/estradiol levels.  (If you know of one, please post it on The Forum!)  Furthermore, I do not read of the steroid guys reporting zinc as a silver bullet in this area.

WARNING: I suspect the reason is that, to get a significant E2-lowering effect, one would have to consume a lot of zinc and this is probably risky based on the opinion of many experts.  I cover this in my issue article on Zinc Dangers where I discuss how zinc supplementation could easily lead to increased risk for prediabetes, prostate cancer, dementia and other chronic diseases.  Too little zinc and too much are both potentially huge issues.

So the bottom line is that taking a reasonable dosage (1-3 RDA’s) of supplemental zinc, especially vegetarians and plant-based eaters, is not a bad idea.  You may get a little bump downward in estradiol levels and many other benefits from taking zinc.  However, but don’t expect it to solve elevated estradiol levels.

CAUTION: My HRT clinic, in guys whose estradiol is not too high, will use a combination of zinc (15-30 mg) and copper (2-4 mg) per day to pull down E2 (estradiol) levels a little.  Zinc and copper compete and so many experts worry that giving supplemental could lead to copper depletion and inflammation.  However, I have some concerns with this, because copper has been implicated in a number of neurological diseases and excesses are hard on neurons. These same experts believe that we are slowly poisoning ourselves in many cases with copper pipes. You’ll have to do your own research and decide where you stand on the issue.

4. Chrysin. This is an old and well-known aromatase inhibitor. It has a spotty reputation for a number of reasons, including poor absorption.  However, a few years ago, Life Extension release a turbo-charged version that basically included piperine.  Piperine increases the absorption rates of many herbals and supplements and it seems to work well with chrysin.  For example, two of the anti-aging physicians, Drs. Smith and Whitcomb, that have answered the Peak Testosterone Questionnaires have mentioned (unprompted) chrysin as a regularly-used estrogen controller. And the fact that Life Extension, which is a well-respected supplement company, backs it is also a sign of its efficacy.

WARNING: Are there concerns with chrysin?  One side effect that has been reported is the slowing down of thyroid function.  Obviously, you don’t want to solve your estradiol problems just to create a new thyroid issue.  See my link on Controlling Estrogen for a study that shows this as well.  That said, I do see a number of alternative and even mainstream physicians on the Peak Testosterone Forum utilitizing it with their patients.  Perhaps taking a before and after snapshot of the thyroid would be a good idea?  You can see most of the standard tests for hypothyroidism in my page on Testosterone and the Thyroid.

5.  Grape Seed Extract. Many studies have shown Grape Seed Extract to be an aromatase inhibitor [3].  It also, in vitro at least, gives Vitamin C a longer shelf life. However, Grape Seed Extract has a couple of cautions that need to go along with it:  1) in combination with Vitamin C it apparently raises blood pressure [2] and 2) it may slightly decrease free testosterone because it can raise SHBG, the protein that binds to testosterone.  It also is known for improving venous insufficiency. That said, Grape Seed Extract has many properties that will very likely help with erectile dysfunction and perhaps serve as a cheap substitute for Pynogenol. For more information, read about it on my page covering Grape Seed Extract and Erectile Dysfunction.

However, there is one problem in using Grape Seed Extract as an aromatase inhibitor:  you would simply have to take too much.  For this reason, I have read of very few men actually using it for this purpose.

6.  I3C (Indole-3-Carbinol) + Calcium-D-Glucarate. One of our members, who had his estradiol slammed down too low by Arimidex, used these two supplements to successfully manage his estradiol.  He said these brought him into the lower 20’s and was very stable, i.e. he did not have any significant swings in estradiol. His dosage was:  “Source Naturals 500mg. Morning and Evening, and Indole-3-Carbinol 200mg. with lunch..” [4] Again, you’ll have to do your own research and find out if you think that these supplements are more safe than low dose Arimidex (anastrazole).  Long term effects are poorly understood in both.  WARNING:  The researcher above that tied increased liver cancer to DIM also tied it to I3C.

7. White Button Mushrooms.  I make the case in my page on Mushrooms: A Natural Aromatase Inhibitor, that some research suggests that white button mushrooms, eaten in sufficient quantity, may actually lower estradiol levels a bit.  And one of our senior posters found that his estradiol jumped from 25 pg/ml to 79 pg/ml when he stopped eating white button mushrooms. [6] Now, admittedly, he ate a lot of them, but this is a pretty big effect as well.  Again, read the page above to see the evidence that he may have been spot on.

REFERENCES:

1) https://peaktestosterone.com/forum/index.php?topic=894.0

2) J Hypertensm 2005 Feb, 23(2):427-34

3) Cancer Res. 2006 Jun 1;66(11):5960-7

4) https://peaktestosterone.com/forum/index.php?topic=3145.msg27519#msg27519

5) https://lpi.oregonstate.edu/ss06/indole.html

6) https://www.peaktestosterone.com/forum/index.php?topic=7661.0

Testosterone and Weight Loss - Peaktestosterone

There are a lot of questions surrounding weight loss and testosterone.  On this page we are going to cover a lot of very important ground, so be ready!  Here are the basic topics that we are going to deal with below:

I. Hypogonadal testosterone levels caused by being very overweight or being obese

II. How weight loss can double testosterone levels

III. How rapid weight loss and intense exercise can destroy – yes, destroy – your testosterone levels

IV. How TRT (Testosterone Replacement Therapy) can help with weight loss

Of course, if you are only interested in one of these topics, skip ahead to the pertinent section.

I. Testosterone Therapy and Weight Loss

One study on severely obese men found that their average testosterone was 223 ng/dl. [3] That hurts just to think about it!  This is VERY low testosterone and will often lead to many of the classic low testosterone symptoms:  low libido, erectile dysfunction, loss of morning erections, fatigue, depression, osteoporosis, anemia, hardening of the arteries, etc.  They then compared these men to age-matched controls, whose average testosterone was 599 ng/dl, and found that the difference was 268%!  What happens is that profound weight gain halts testosterone signaling from the hypothalamus. Basically, your hypothalamus gets fooled into thinking that you have a lot of testosterone – due to the fact that your estradiol is so high – and GnRH drops like a rock.  So, ironically, your testes are ready to go and able to pump out testosterone, but there’s nothing there to flip on the switch!

How does your hypothalamus get fooled?  The reason is that as you gain weight, your aromatase levels increase dramatically and this extra aromatase converts your testosterone into estradiol, the “bad estrogen.”  This leads to ever-increasing levels of free estradiol to free testosterone and, when this ratio goes high enough, it shuts down the hypothalamus output as mentioned above. [4][5] And, again, as we’ll show below, the low testosterone levels will also make it MUCH more difficult to maintain one’s weight, creating a vicious circle of testosterone loss and weight gain.

It should be noted that this does not just apply to the morbidly obese.  One study of men with significant visceral fat showed that dropping about 35 pounds led to a 15 percent increase in free testosterone. [1] Other research showed that losing between 57 and 283 pounds produced even more significant changes in testosterone:  average total testosterone levels went 240 to 377 ng/dl, a sizeable 58% rise on average. Free testosterone also increased by 41%. [2] Again, the men who lost the most amount of weight probably doubled their testosterone levels.

This is why on the Peak Testosterone Forum I always try to ask men with low testosterone how overweight they are.  I am not trying to get personal, but feel that it is important to let them know that weight loss can very significantly boost their T in most cases.  And it will also lower estradiol which will very favorably alter their all-important testosterone-to-estradiol ratio.  I discuss this and other strategies in my page on How to Improve Your Testosterone-to-Estrogen (Estradiol) Ratio.

Have I seen this in real life?  One of our longest term posters reported:

“I have a friend who weighed 238 pounds, his testosterone fluctuated between 439-500 Ng/dl. Once he spent a few years reducing his weight to 170, changing his diet, exercising, getting hydrated, his testosterone went back up to the 750-800 ng/dl range.” [9]

If being overweight can make you hypogonadal and weight loss can double or more your testosterone (in some cases), then obviously you want to lose weight as rapidly as possible, right?  And you probably want to add in some intense exercise to accelerate the process even more, correct?  Wrong! That might seem logical, but nothing could be further from the truth  unless perhaps you are a man not on TRT (testosterone replacement therapy).

This was shown powerfully in a study that I documented in my page on A Protocol to Lose Weight Rapidly and Maintain Muscle. The participants in this study did something remarkable: they combined a wide variety of intense exercises with a 40% reduction in calories and lost 11 pounds and either maintained or even gained some muscle. This is not an easy thing to do and so I did a page on that.

However, one of the guys on the Peak Testosterone Forum read the fine print and noticed that the testosterone levels of the men in the study dropped from 507 to 126 ng/dl! That is an ugly fall in testosterone and left those men severely hypogonadal.

IV. Testosterone Therapy and Weight Loss

Okay, so we know that gaining weight can lower testosterone.  What about going the “other direction?”  If you add (external or exogenous) testosterone, will you lower body fat? It turns out that many studies say ‘yes’, especially if you are hypogonadal. Let’s check out a few examples:

1. Hypogonadal Males.  One study found that giving hypogonadal males testosterone enanthate, which is very similar to the cypionate that is used in the U.S., resulted in a loss of 13% subcutaneous fat. [6] Remember:  participants were not put on any type of an exercise program but rather just lost weight – somewhat miraculously – from the HRT itself.  Yes, that’s the Power of T!

2.  Middle-aged Obese Males. Giving HRT to middle-aged, obese males lowered visceral fat but not subcutaneous fat in study. [7] Visceral fat is “belly (or stomach) fat” and is deadly.  It is commonly associated with insulin resistance and MetS (Metabolic Syndrome).  Of course, obese males will very likely be low or lowish in testosterone and may even be hypogonadal.

Another study showed that weight loss (with testosterone undecanoate) may be more pronounced on the obese and found that “More than half of the men (53%) lost at least 33 lbs., and almost a third lost 44 lbs. or more weight. Similarly, 86% of the men had a least a 2-inch reduction in waist circumference and 46% dropped 6 inches or more.”  These are impressive numbers and what was really remarkable is that the men kept losing weight generally all the way through the five year point.  This is the opposite of what usually happens with dieting where the typical guys’ weight yo yo’s back and forth. [11]

3.  Prostate Cancer Patients. As you may know, prostate cancer patients are often given anti-androgen pharmaceuticals and in one study this lowered patient testosterone levels by almost 80%.  As might be expected, weight increased by 1.8% after 12 months and the percent fat mass increased by 11% after about 12 months.

4.  Steroid Users.  One study noted that lean body mass increased in a somewhat dose dependent manner with men on HRT gaining a little Lean Body Mass and those on steroids gaining still more.  As you know, steroid users go “supraphysiological,” i.e. beyond the typical max values experienced by a young male (~1200 ng/dl).  Thus, researchers could look at values even well beyond 1200 and see that HRT made a difference.  (Steroids can also shut off your testosterone completely if done incorrectly.)

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

If you look at the cases above, particularly #1 and #2, you see that testosterone works very well for the special cases where men are likely deficient in testosterone.  But what about in normal, health males?  Well, one study looked at this and found that, even though total testosterone was only increased by 30%, visceral fat accumulation was fought off in healthy senior males. [10] So testosterone therapy will likely improve outcomes for almost any man.

Now I do want to issue a caution here:  I have heard that some of the HRT clinics are putting out ridiculous ads where they claim that testosterone will melt the pounds off of you like lipo.  This is simply not the case.  The studies (overall) show that testosterone therapy results in mild weight loss and is an aid in management of the same.  The big guns are always diet and exercise and, I would argue, sleep.

What about your erectile strength?  Can weight loss improve that as well?  Of course, anything that boosts your testosterone and testosterone-to-estradiol ratio is likely to help improve your bedroom performance.  But weight loss goes way beyond just improving your hormones.  For every pound lost, you drop a point in cholesterol for example.

A similar drop in C-Reactive protein – a standard measure whole body inflammation – occurs with each pound lost as well.  This drop in inflammation is very important, because “circulating CRP levels were significantly higher in obese men with erectile dysfunction as compared with obese men without erectile dysfunction.” [8] Arterial inflammation can lead to endothelial dysfunction and arteriosclerosis, both of which can lead to erection problems in the short and long term, respectively.  For more information see my page on Weight Loss and Erectile Dysfunction.

REFERENCES:

1) Total testosterone was improved as well.) [Diabetes, Obesity and Metabolism, May 2004, 6(3):208 215, “Changes in sex hormone-binding globulin and testosterone during weight loss and weight maintenance in abdominally obese men with the metabolic syndrome”

2) The Journal of Clinical Endocrinology & Metabolism, May 1 1988, 66(5):1019-1023, “Effect of Massive Weight Loss on Hypothalamic Pituitary-Gonadal Function in Obese Men”

3) The Journal of Clinical Endocrinology & Metabolism, Dec 1 1977, 45(6):1211-1219, “Low Serum Testosterone and Sex-Hormone-Binding-Globulin in Massively Obese Men”

4) Medical Hypotheses, April 1998, 50(4):331-333, “The role of estradiol in the maintenance of secondary hypogonadism in males in erectile dysfunction”][International Journal of Impotence Research, 2003, 15:38 43, “Oestrogen-mediated hormonal imbalance precipitates erectile dysfunction”

5) Med Hypotheses, 1998 Apr, 50(4):331-3, “The role of estradiol in the maintenance of secondary hypogonadism in males in erectile dysfunction”

6) Journal of Clirncal Endocrinology and Metabolism, 81(12), “Increase in Bone Density and Lean Body Mass during Testosterone Administration in Men with Acquired Hypogonadism”

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

8) Journal of Endocrinological Investigation, 2004, 27(7):665-669, “Erectile dysfunction associates with endothelial dysfunction and raised proinflammatory cytokine levels in obese men”

9) https://peaktestosterone.com/forum/index.php?topic=401.30

10) The Journal of Clinical Endocrinology & Metabolism January 1, 2008 vol. 93 no. 1 139-146, “Testosterone Therapy Prevents Gain in Visceral Adipose Tissue and Loss of Skeletal Muscle in Nonobese Aging M”

11) https://www.worldhealth.net/news/testosterone-therapy-helps-trim-mens-waistlines/

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:

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.

How Do You Reverse Diabetes & Pre-diabetes - Peak Testosterone

One of the things that gets me excited about running a site and forum like this is that the body can so often heal itself. If we just get off the hell-bound train that the Western lifestyle has boarded us on, we can very often completely reverse the medical issues that have slowly gained a stranglehold on our lives. One of the examples of this is type II or adult onset diabetes. This is the diabetes caused by insulin resistance and post-meal glucose surges, as opposed to type I, which results froman autoimmune attack on the body’s pancreatic Beta cells.

Type I diabetes cannot be reversed, because the beta cells have actually been destroyed.  Only stem cell therapy, which is being investigated in animals as I write this, can reverse this kind of damage.  Type II, however, is a completely different issue and the root cause is liver cells stuffed with extra “fat” – lipids from your meals – to where they become insulin resistant.  All you need to do is put those liver cells on a “diet” and get rid of the extra fat inside of them.  If you catch it early enough, you can actually completely reverse your diabetes.  And, even if you can’t totally reverse it, you can almost for sure partially reverse it and end up lowering your medication levels.

By the way, it probably goes without saying that if you can reverse type II diabetes with any of these methods then you can also do the same with Metabolic Syndrome (Met-S  / prediabetes) as well.  Some of you have been diagnosed with Met-S and it also a defeatable foe.

STEP 3:  The goal of most of these techniques and the final study of any program to Reverse Prediabetes (and Sometime Diabetes) is to drop your A1C (glycated hemoglobin or HbA1C) by about 1 point.  Glycated hemoglobin is a molecule that does something astonishing:  it (rather miraculously) lets your doctor measure your average blood glucose levels for the last ~ 3 months.  That’s incredible if you stop to think about it:  it’s the equivalent of doing a finger stick glucose test every half hour for 3 months and then computing a rolling average. While A1C (HbA1C) is not a perfect measure, it is a good one overall and in my opinion definitely a marker to pay attention to.

NOTE: You can now get an at home A1C test ridiculously cheap at Walmart or through Amazon via the Reli-On brand:  ReliOn A1C Test Kit . Another way to do it inexpensively yourself – you don’t need a prescription or a doctor’s order – is through one of these Cheap Testosterone Labs.

UNDERSTANDING A1C: So the way it works is this:  an A1C of 5.7 to 6.4 is considered prediabetic and 6.5 and above diabetic.  Most guys that show up on my site are not diabetic yet, and I believe that is generally due to the fact that they are highly managed (in the medical sense).  However, many guys reading this will have A1C’s between about 5.7 and 6.4 and be prediabetic.  And some may even be a little below 5.7 but have some of the warning signs of impending idabetes that I will discuss below.

Hopefully, now you see the purpose in trying to drop your A1C by 1 point.  Let’s say you are an early diabetic with an A1C of 6.6.  If you can drop your A1C by 1.0, you will then be sitting at 5.6 and below even the prediabetes level! .  And, if you are prediabetic at, say, 5.8 and can drop your A1C by 0.6, you are suddenly sitting at 5.2 – a very respectable number.  (Dropping your A1C down to 5.0 is no small task.  In fact, this is Life Extension Foundation’s recommended anti-aging level. [1])

Again, the goal, assuming your diabetic or prediabetic, is to drop your high A1C by at about a point using a research-backed methodology. Of course, this can be done generally with pharmaceuticals. Metformin, for example, will typically lower a diabetic’s A1C by about 1.0 – sometimes even a bit more. [2] However, it can have liver and GI issues associated with it, so I personally would rather seek out a more natural approach.  Below I have listed below Five Research-Backed (Pretty Natural) Ways to Reverse Adult Onset Diabetes:

1.  HRT + Exercise + Weight Loss For Low Testosterone Men. Most diabetics are low in testosterone, and my guess is that a solid percentage of those with Metabolic Syndrome (prediabetes) are also low or lowish in testosterone.  One study took advantage of this fact and put the participants on this regimen:

)

The purpose of this study was basically to evaluate if adding HRT (TRT) with Testogel improved outcomes significant over the standard lifestyle changes of weight loss, diet and exercise. The results are very interesting and summarized by the authors in this way:

“All D&E [Diet and Exercise] plus testosterone patients reached the HbA1c goal of less than 7.0%; 87.5% of them reached an HbA1c of less than 6.5%. Based on Adult Treatment Panel III guidelines, 81.3% of the patients randomized to D&E plus testosterone no longer matched the criteria of the MetS, whereas 31.3% of the D&E alone participants did. ” [3]

This means that dieting, as in weight loss, coupled with exercise will drop A1C by 1.0 in the solid majority of lower testosterone men.  However, many men will still retain some of the characteristics of the Metabolic Syndrome (Met-S), which is a whole suite of symptoms including high triglycerides and blood pressure.  These men can even reverse these additional Metabolic Syndrome symptoms using supplemental testosterone (assuming they are hypogonadal).   Of coure, this makes scientific sense, since increasing testosterone levels can improve Met-S by improving insulin sensitivity.  A lot of research backs this up, something I discuss in my pages on Testosterone and Diabetes and Testosterone and Insulin.

NOTE:  If you are 50+ pounds overweight, you may just need to lose a lot of weight.  Losing over 50 pounds can double (or more) your testosterone  – see my page on Testosterone and Weight Loss for the supporting studies – and make a nice dent in your A1C as well.

CAUTION: Always check with your physician if you have diabetes or are on any medications before you make any changes. (You want to avoid drug interactions, dangerous drops in blood pressure or blood sugar, etc.)  In addition, diabetics need to be particularly careful with walking and running as neuropathy can mask some exercise-induced damage.

2. Straight HRT for Men with Low Testosterone? The above study indicated that diet and exercise were the heavy hitters and HRT played a supportive role when it comes to reversing diabetes and Met-S.  However, the clinic where I was first put on cypionate insisted that all their diabetic men were able to completely get off of insulin. I asked several staff there, and they insisted that it was 100% of the diabetic men.  They added that they could not always get off Metformin and other anti-diabetes medications, but insulin needs were always reduced to zero.

So why did the study in #1 not find HRT (TRT) quite this powerful?  My guess is that it’s a difference in average testosterone levels.  At this clinic – based on my experience anyway – the peak testosterone levels were always very close to 1200 ng/dl and I would guess average testosterone was 900-950 ng/dl.  These are pretty beefy levels as HRT goes and so this may have improved insulin sensitivity over the study mentioned above.  And this clinic would often use Arimidex (anastrozole) to control estradiol levels as well, which is important considering that most diabetic men are overweight. (Again, discuss any changes with your doctor first if you are diabetic.)

NOTE: I have many more pages on how to tell if you are insulin resistant, normal post-meal glucose levels and how it relates to testosterone here: Summary Page on Diabetes and Prediabetes (Met-S).

3.  Dr. Barnard’s Methodology. I have found in the last few years that many men are now interested in plant-based diets.  They usually want to eat some meat but want mostly whole plant foods for the huge boosts in nitric oxide and blood flow and drop in blood pressure. In addition, most guys coming to my site are pretty serious exercisers and need good, clean carbs and, obviously, good clean carbs have to come from plant foods.

This is where Dr. Barnard’s research comes in.  He put men on a low glycemic, low fat diet and the men in the study saw their A1C drop like a rock – 1.0 on average. “What?? A low fat diet??”  This is completely counterintuitive for many of you out there.  The reason Dr. Barnard’s strategy works so well is that the underlying cause of insulin resistance:  intramyocellular lipids.  That’s the medical word for muscle and liver cells that are just STUFFED with fat.  They are so stuffed with fat that they cannot process insulin correctly any more.

Most of us have the idea that carbs cause diabetes and insulin resistance, but that is actually not the case.  The root cause is overloading of lipids – and this is generally from overly high fat levels in the diet.  However, it can also result from refined carbs (which produce high triglycerides levels).

So a low glycemic low fat diet gets rid of, or I should say greatly reduces both of these main sources of intramyocellular lipids. This kind of low fat diet lowers both fat levels AND refined carbs in the diet.  Yes, it’s the perfect 1-2 punch against diabetes!  (You cannot consume a bunch of wheat and white and basmati rice and corn chips and expect this to work!)  Also, Dr. Barnard’s methodology can be combined nicely with Dr. Gould’s – another low fat guru that few men heard about – to reverse arterial plaque.  See my page called A Review of Heal Your Heart by Dr. K. Lance Gould for more information. (Dr. Gould’s diet includes a little meat and dairy. Dr. Barnard’s does not.)

NOTE: Interestingly enough, vegans and vegetarians have equal or higher testosterone levels when compared to meat eaters according to one well-done study, which I discussed in my page on Testosterone Levels and Vegetarianism.

4.  Dr. Whitaker’s Methodology. One of the first books to come out with a strategy to reverse diabetes was done by Dr. Julian Whitaker, which I review in my page on his book Reversing Diabetes. It is a very practical book and many men will find doable in my opinion.

Berberine – The New Metformin? As a side note, Dr. Whitaker is greatly interested of late in the perhaps-better-than-Metformin supplement called berberine.  Berberine is a powerful supplement against Metabolic Syndrome and diabetes and, apparently, Dr. Whitaker has been using it with great success.  It is relatively new, so I don’t think anyone knows about long term safety.  That said, we do have some data:  one study examined men taking berberine, red yeast extract and a couple of other supplemets and found, even after one year, no safety issues. [4] Again, long term safety is largely unknown as far as I know.

Also, I should mention that one of the men on our forum who had low SHBG completely reversed his condition using berberine, exercise, diet and weight loss.  He had zero side effects from the berberine and he is one of the few – very few actually – that reversed low SHBG, ,which is a sign of impending diabetes and liver dysfunction.  I docmented his story in my page on How To Cure Low SHBG. I just chatted with him and he used the berberine for 9 months and then stopped and believes he is doing good now.

5.  Weight Loss Alone. If you are obese and you catch it early enough, you may be able to completely reverse your condition by losing a lot of weight.  Look at what these researchers wrote:

“Marked weight loss (30% of body weight) following gastric bypass surgery can normalize glycemic control in more than two-thirds of extremely obese patients with type 2 diabetes (30 33).” [5]

Now, granted, losing 30% of one’s body weight is a lot.  But the point is that the changes are semi-linear, and you can completely reverse things potentially.  And, of course, I encourage everyone to do lots of moderate exercise and some strength training.

REFERENCES:

1) https://www.lef.org/protocols/appendix/blood-testing/Page-04

2) https://www.jwatch.org/jw201204030000003/2012/04/03/how-much-does-metformin-lower-hba1c-level

3) Journal of Andrology, Nov-Dec 2009, 30(6):726 733, “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”

4) Adv Ther, 2011 Dec, 28(12):1105-13, “Long-term effects of nutraceuticals (berberine, red yeast rice, policosanol) in elderly hypercholesterolemic patients”

5) Diabetes Care, Aug 2004, 27(8):2067-2073, “Weight Management Through Lifestyle Modification for the Prevention and Management of Type 2 Diabetes: Rationale and Strategies: A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition”

Research-Backed Ways to Reverse Diabetes

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”

Safe Levels of Apolipoprotein B (apoB) - 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.

“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.

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.”

Pulse Rate - Peak Testosterone

In fact, scientists have made an interesting observation:  virtually all mammals get about a billion heartbeats. [5] (We humans actually get 3 billion.) Yes, there is another clock ticking:  the faster the mammal’s pulse rate, the shorter the life expectancy.  So, as an overall principle, it’s clearly in your best interest to slow down the ol’ ticker.  Scientists have even extended the lifespan of mice given drugs to slow down their heart rate. [3]

Researchers have found another interesting aspect of pulse rate: pulse rate “issues”, in particular a high pulse rate, are a sign of heart disease.  One study found that men with a pulse rate over 80 had a survival rate of seven years less! [1] Seven years is a huge amount for just one risk factor.  Yet another study verified the same thing – higher pulse rate is associated with increased mortality – and added another twist:  higher mortality was observed in those whose heart beat five times per minute faster in the morning. [2]  A heart rate of 75 or 80 has shown up particular bad in the research:  you definitely want to keep your pulse rate below 70 for sure to play it safe.  This was verified in yet another study where “”every extra 10 beats per minute higher than a normal resting pulse was associated with a 16 percent increased risk of death from cardiovascular disease and a 25 percent greater risk of all-cause death””. [6] [7] To put numbers on that, a pulse rate of 84 was linked to a 55 percent increased cardiovascular mortality and a 79 percent risk of dying from all causes.

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

Furthermore, your heart rate recovery is another important indicator of mortality.  This is the ability of our heart, after exercise, to recover to a lower pulse rate.  Those with the beginnings of heart problems have a heart that cannot return easily to baseline.

The reasons that pulse rate is so linked to cardiovascular issues is many fold.  One surprising one appears to be the fact that a slower pulse rate actually lessens arteriosclerosis according to one recent study with mice. [4]  A low pulse rate is also correlated with good autonomic and parasympathetic nervous system function, which in turn is associated with good heart health.

So what does this have to do with erectile dysfunction?  Heart health is penis health:  the two go together. As I like to say:  a happy heart is a happy penis. And the beauty of pulse rate is that you can measure it yourself.  It’s an easy way to get a gauge as to your heart health, especially if it’s a little on the high side.

Remember:  you’ve got about a few billion beats one way or the other.  So exercise and clean out those arteries using the Low Fat (or Ornish) Diet and get that pulse rate down while you still can.  The clock is ticking…

NOTE:  Pulse rate can be rated to thyroid issues.  A slow pulse rate in particular can be a sign of hypothyroidism.

REFERENCES:

1) Kardiologiia, 2005, 45(10):45-50

2) Amer J of Hypertension, Nov 2004, 17(11):1005-1010

3) John Hopkins Med J, 1971, 128:169-191

4) Circulation, 2008, 117:2377-2387

Depression and the Brain - Peak Testosterone

In my link on Testosterone and Depression, I discuss how testosterone can lower depression and depression can lower testosterone. In fact, the latter scenario recently showed up in a study where researchers found that depression was very predictive of low testosterone. In fact, they found that there were three things that forecasted and thus probably causative of low T and that was a) obesity, b) smoking and c) depression:

“On average, testosterone levels did not decline significantly over five years; rather, they decreased less than 1 percent each year, the authors reported. However, when the investigators analyzed the data by subgroups, they found that certain factors were linked to lower testosterone levels at five years than at the beginning of the study. “Men who had declines in testosterone were more likely to be those who became obese, had stopped smoking or were depressed…” [1]

Basically, what this study did was look at men who were depressed at the start of the study and then followed them five years later.  At five years they found that depression was a major risk factor for low T.  Now why would depression (likely) cause low testosterone?

2. Platelet Nitric Oxide. Another study found that platelet nitric oxide levels were higher in depressed patients who were untreated when compared to controls. [3]

Isn’t more nitric oxide always better?  Again, not when created in excess and the body does do this sometimes. Remember that nitric oxide is a free radical.  Sure, it is a very important free radical that dilates your arteries, creates erections and acts as a brain neurotransmitter among other things.  But too much of it has been implicated as a root cause in the following brain disorders:

And, sticking to the subject at hand, elevated nitric oxide has been implicated in depression as well. [8] And it is no wonder:  researchers have found that “nitric oxide modulates norepinephrine, serotonin, dopamine, glutamate, the major neurotransmitters involved in the neurobiology of major depression.” [7]  Furthermore, oxidative stress has been coupled with depression as well in a number of studies and reviews.  So it is not just nitric oxide that is getting increased but other free radicals in general as well. [12][13]

Of course, oxidative load and inflammation are intimately linked and one of the most important studies showed that untreated depressed patients were higher in oxidative stress and IL-6, one of the “killer” inflammatory cytokines that is associated with many chronic diseases and conditions. [11] And, most importantly, treatment for depression brought IL-6 and oxidative stress back into line. Of course, the moral of the story is that it is actually dangerous to leave depression untreated for an extended period of time, since it can leave a man exposed to chronic inflammation and oxidation, both of which destroy tissues, trigger nasty metabolic reactions and possibly permanently damage his testosterone.

Now I have some natural solutions that have been shown to help with many types of depression in my page on Depression Cures. But depression should always be taken seriously and, as I hope you see from the above, is every bit as much a medical condition as a psychological one. In other words, depression appears to be a huge stressor that raises inflammation and oxidative stress that can negatively impact the brain and body permanently.  I believe that scientists will soon discover that depression can, if allowed to go on long enough, even lead to lowered testosterone as the initial study I mentioned showed.

REFERENCES:

1)  https://www.sciencedaily.com/releases/2012/06/120623144944.htm

2) Journal of Affective Disorders, Mar 2001, 63(1-3):221 224, “Elevated plasma nitrate levels in depressive states”

3) Psychiatry Research, Oct 2013, 209(3):447-452, “Increase in nitric oxide levels and mitochondrial membrane potential in platelets of untreated patients with major depression”

4) Progress in Neuro-Psychopharmacology and Biological Psychiatry, Aug 2006, 30(6):1091-1096, “Increased plasma nitric oxide level associated with suicide attempt in depressive patients”

5) https://www.schizophrenia.com/sznews/archives/005764.html#

6) Neurotox Res, 2012 Nov, 22(4):251-64, “Nitric oxide-mediated oxidative damage and the progressive demise of motor neurons in ALS”

7) Nitric Oxide, Apr 30 2011, 24(3):125 131, “Nitric oxide and major depression”

8) Journal of Affective Disorders, Mar 2001, 63(1-3):221-224, “Brief report Elevated plasma nitrate levels in depressive states”

9) Neuropsychobiology, 2002,45:57 61, ” Possible Role of Nitric Oxide and Adrenomedullin in Bipolar Affective Disorder”

10) Nature Medicine, 1999, 5:1403 – 1409, “Inducible nitric oxide synthase stimulates dopaminergic neurodegeneration in the MPTP model of Parkinson disease”

11) Brain Behav Immun, 2013 Jul, 31:143-52, “Dysregulated relationship of inflammation and oxidative stress in major depression”

12) Psychiatry Res, 2013 Apr 30, 206(2-3):213-6, “Increased oxidative stress in patients with depression and its relationship to treatment”

13) Curr Pharm Des, 2012, 18(36):5890-9, “The role of oxidative stress in depressive disorders”

The answer lies is just what depression does to the brain.  It turns out that depression greatly increases:

Any one of these can do damage, but if you put all three together, it is definitely a dangerous scenario.  (Yes, nitric oxide in moderation is a good thing, but, in excess, can destroy as we will discuss below.)  And this undoubtedly explains why depression hammers the brain and unwires neurons.  Depression has been found in a couple of studies to actually, over time, shrink the hippocampus.  In my page on Testosterone and Depression, I discuss how depression is basically a stressor and stressors generally result in a, b and c above.

Does depression really increase nitric oxide?  Several studies indicate that that is indeed the case:

1. Plasma Nitric Oxide. One (admittedly small) study found that plasma (blood) nitric oxide levels were significantly higher in depressed patients than in controls. [2]

Growth Hormone - Peak Testosterone

Many people consider Growth Hormone the Holy Grail of Health and Youthful Living.  That’s a highly debatable sentiment in my opinion, but I can’t argue with the fact that Growth Hormone burns fat and contributes slightly to muscle growth as well.  As we age, our Growth Hormone output decreases significantly and this is yet another reason we put on weight so much more easily. In fact, at 40 your body puts out only about half as much Growth Hormone as you did at age 40!  At age 80 you’ll be down near 5% – ouch! – making it one of most severe hormonal reductions that us guys get to go through during the aging process.

How does Growth Hormone do its magic? As it turns out, it is your double-barreled trusty friend that both spares amino acids (the building blocks of muscle) from being burned as energy and at the same time promotes fat to be used for energy. Sound like a fantasy?

CAUTION: Recent research has cast considerable doubt on Growth Hormone’s supposed anti-aging properties.  For example, one 2010 study on mice found that using a drug that inhibits growth hormone improved longevity, telomerase, cognition and cancer.  In other words, inhibiting Growth Hormone looks to be the true fountain of youth! [6][7]

Also, keep in mind that Growth Hormone is still very expensive.  And it is relatively easy to increase your Growth Hormone output naturally.  Here is how you do it:

1) Sleep.  Hopefully, you have read my link on Sleep and, if so, you already know that sleep boost testosterone, neurotransmitters, memory and Growth Hormone.  This is one reason that experienced bodybuilders often say that muscle is built more at night on the pillow not during the day at the gym.

2) Intense Exercise. Intense Exercise is the kind of exercise that leaves you sweating and breathing heavily. As it turns out, you can dramatically increase your Growth Hormone output for several hours after exercise if you do it the right way.  What is the “right way”?  Read this link on Interval Training to find out one way.

3) Creatine. Researchers discovered that Creatine, the well-known and well-studied bodybuilding supplement, increased Growth Hormone output post-consumption even in those who did no exercise. [1]  However, there are a few things to keep in mind about this study:  it was extemely small with only 6 young men involved.  Three of the men experienced a very significant rise in Growth Hormone but the other three much less so.  So this many depend on individual physiology and other factors.  Nevertheless, it an intriguing finding.

4) L-Arginine. Large doses, say > 7-9 g/day, of L-Arginine increase Growth Hormone output substantially.  However, I recommend extreme caution for large doses (> 3g/day) as discussed in this link on Arginine. Dosages of about 2 g/day should be safe.

5) Glutamine. Studies have shown that ingested glutamine at levels even as low as 2 g/day can increase Growth Hormone output. [3]CAUTION:  It is possible that increased ingestion of glutamine could raise body levels of glutamate, which is a neuron-killing Excitoxin. Furthermore, glutamine is used by cancer cells for fuel and so theoretically – and this is strictly  theoretical – glutamine could be slightly mutagenic.

6) Insulin.  Watch your insulin:  insulin is negatively correlated with Growth Hormone. [2] In other words, the more insulin floating around your system, the less Growth Hormone that you are likely to have. The insulin resistant state, where insulin levels stay perpetually high, of the Metabolic Syndrome is a Growth Hormone squasher as are high glycemic meals. Eating a lot of sugars and starchy carbs that cause your blood sugar and insulin to spike is anti-Growth Hormone. For this reason, be careful to not to eat a high carb meal right before bed because nighttime is primetime for Growth Hormone release. And, please, I urge everyone over the age of about 30 to read this link on the Metabolic Syndrome and find out to defeat insulin resistance.

7) Laughter. It appears Growth Hormone may be very sensitive to humor.  In a study dating back to the 80’s, subjects had an average 87% increase in Growth Hormone just from anticipating a humorous show. [4]  A little laughter goes a long ways as they say.

8) Visceral Fat.   Visceral fat and fasting insulin levels are also associated with decreased growth hormone. [8]

NEWS FLASH:  A study in late 2009 showed that a gherlin-like drug called MK-677 increases Growth Hormone significantly to levels of a “healthy young adult”. [5] The health media is calling it a Fountain of Youth – time will tell. Side effects seem relatively mild.

REFERENCES:

1) J of Sports Med and Phys Fitness, Dec 2000, 40:336-342

2) J Biol Chem, 1999 May 7,274(19):13434-13442

3) Am J Clin Nutr, May 1995, 61(5):1058-61

4) Am J Med Sci, 1989 Dec, 298(6):390-6, “Neuroendocrine and stress hormone changes during mirthful laughter”

5) Annals of Int Med, Nov 4 2008, 149(9):601-611, “Effects of an Oral Ghrelin Mimetic on Body Composition and Clin

6) Saint Louis University (2010, December 23). ‘Un-growth hormone’ increases longevity, researchers find. ScienceDaily. Retrieved December 23, 2010, from https://www.sciencedaily.com /releases/2010/12/101223091746.htm

7) Proceedings of the National Academy of Sciences, 2010, 107(51), “Effects of a growth hormone-releasing hormone antagonist on telomerase activity, oxidative stress, longevity, and aging in mice”

8) 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”

Pulse Rate - Peak Testosterone

In fact, scientists have made an interesting observation:  virtually all mammals get about a billion heartbeats. [5] (We humans actually get 3 billion.) Yes, there is another clock ticking:  the faster the mammal’s pulse rate, the shorter the life expectancy.  So, as an overall principle, it’s clearly in your best interest to slow down the ol’ ticker.  Scientists have even extended the lifespan of mice given drugs to slow down their heart rate. [3]

Researchers have found another interesting aspect of pulse rate: pulse rate “issues”, in particular a high pulse rate, are a sign of heart disease.  One study found that men with a pulse rate over 80 had a survival rate of seven years less! [1] Seven years is a huge amount for just one risk factor.  Yet another study verified the same thing – higher pulse rate is associated with increased mortality – and added another twist:  higher mortality was observed in those whose heart beat five times per minute faster in the morning. [2]  A heart rate of 75 or 80 has shown up particular bad in the research:  you definitely want to keep your pulse rate below 70 for sure to play it safe.  This was verified in yet another study where “”every extra 10 beats per minute higher than a normal resting pulse was associated with a 16 percent increased risk of death from cardiovascular disease and a 25 percent greater risk of all-cause death””. [6] [7] To put numbers on that, a pulse rate of 84 was linked to a 55 percent increased cardiovascular mortality and a 79 percent risk of dying from all causes.

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

Furthermore, your heart rate recovery is another important indicator of mortality.  This is the ability of our heart, after exercise, to recover to a lower pulse rate.  Those with the beginnings of heart problems have a heart that cannot return easily to baseline.

The reasons that pulse rate is so linked to cardiovascular issues is many fold.  One surprising one appears to be the fact that a slower pulse rate actually lessens arteriosclerosis according to one recent study with mice. [4]  A low pulse rate is also correlated with good autonomic and parasympathetic nervous system function, which in turn is associated with good heart health.

So what does this have to do with erectile dysfunction?  Heart health is penis health:  the two go together. As I like to say:  a happy heart is a happy penis. And the beauty of pulse rate is that you can measure it yourself.  It’s an easy way to get a gauge as to your heart health, especially if it’s a little on the high side.

Remember:  you’ve got about a few billion beats one way or the other.  So exercise and clean out those arteries using the Low Fat (or Ornish) Diet and get that pulse rate down while you still can.  The clock is ticking…

NOTE:  Pulse rate can be rated to thyroid issues.  A slow pulse rate in particular can be a sign of hypothyroidism.

REFERENCES:

1) Kardiologiia, 2005, 45(10):45-50

2) Amer J of Hypertension, Nov 2004, 17(11):1005-1010

3) John Hopkins Med J, 1971, 128:169-191

4) Circulation, 2008, 117:2377-2387

Andropause, The Root Causes - 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 Low Testosterone by the Numbers 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 How to Avoid Andropause 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”

Beetroot Juice - Peak Testosterone

One of the best ways to boost nitric oxide actually has to do with your tongue. That’s right – bacteria in your tongue can convert the nitrates in food to nitrites and then that is converted to the precious nitric oxide that you need in your gut. Dr. Nathan Bryan – and you can read My Interview With Dr. Bryan – has noted that this is the most effective and efficient way for the typical man over 40 to boost his nitric oxide and yet has been largely ignored by the medical community.

Of course, the issue is this:  how do you consume those nitrates?  There are foods that are high in nitrates, and I discuss some of them in My book The Peak Erectile Strength Diet. But there is another way as well: food extracts.  One of the foods very high in nitrates is beetroot juice and one study after another of late has verified its superpowers:

WARNING: Mouthwash can sabotage the above nitrate conversion process that occurs on the tongue.  See my link on Mouthwash and Your Sex Life for more information.  It is like that toothpaste does the same thing, although to a lesser extent.  Read this link on The Dangers of Toothpaste to understand more.

1)  Hypertension, 2010, 56: 274-281, “Inorganic Nitrate Supplementation Lowers Blood Pressure in Humans”

2) Nitric Oxide, 2011, 24(1):34-42, “Acute effect of a high nitrate diet on brain perfusion in older adults”

3) Neuropsychology, Jul 1995, 9(3):313-320, “Executive function deficits in mild Alzheimer’s disease”

4) Ann Oncol, 2004, 15(2):346-349, “Processed meat and the risk of selected digestive tract and laryngeal neoplasms in Switzerland”

5) JAMA, 2005, 293(2):172-182, “Meat Consumption and Risk of Colorectal Cancer”

6) CANC6) CANCER CAUSES AND CONTROL, 1994, 5(2):195-202, “Processed meats and risk of childhood leukemia”

7) Nutrition and Cancer, 2008, 60(2), “Processed Meat and Colorectal Cancer: A Review of Epidemiologic and Experimental Evidence”

8) Carcinogenesis (2007) 28 (6): 1210-1216, “Processed meat intake, CYP2A6 activity and risk of colorectal adenoma”

9) https://news.bbc.co.uk/2/hi/health/8186947.stm

10) Journal of Applied Physiology, Mar 1 2011, 110(3):591-600, “Dietary nitrate supplementation reduces the O2 cost of walking and running: a placebo-controlled study”

11) Diabetologia, 2003, 46:1465-1473, “Processed meat intake and incidence of Type 2 diabetes in younger and middle-aged women”

1. Blood Pressure. One recent (2010) study found that 250 ml of beetroot juice, particularly in men, decreased blood pressure in dose-dependent manner. [1] This means that the more beetroot juice consumed, the more that blood pressure lowered.

DOSAGE:  If you are going to just drink beetroot juice itself, the 250 ml used in the above study is equivalent to about 8 oz. or 1 cup (for those in non-metric countries). Of course, the 500 ml study is 2 cups, which would allow you to take two doses morning and evening. If your going to use powder or extract, you will need to go by the manufacturer’s specifications. Beetroot juice is not terribly sweet either or high in fructose, so there is little concern there.

3. Erections and Erectile Dysfunction.  Can beetroot juice help a man who has erectile dysfunction? There is no study yet verifying this, but it is very likely.  Anything that increases blood flow and cGMP and nitric oxide significantly is going to improve erectile strength.

4. Brain Blood Flow. Okay, so we know beetroot juice increases blood flow throughout the body.  But what about the brain?  Would it benefit as well?  Scientists found that beetroot juice’s benefits crossed right through the tricky blood-brain barrier and increased blood flow in key areas of the brain relating to executive function.  This study was in seniors, but there is little doubt that blood flow will be increased for many decades downward as well.

What is executive function?  It is the idea that there is a region of the brain that manages the others.  Executive function involves many creative and multitasking processes, for example.  Poor executive function leads to poor career and social performance and interaction for many people.  Beet root juice may be a critical help for people as they age. And many studies have shown that the early stages of Alzheimer’s show a loss of executive function. [3]

5.  Exercise Endurance. Scientist aren’t quite sure how it works, but 500 ml (2 cups) of beetroot juice each day boosted how long they could ride their bike by 16%. [10] This may not seem like much, but the authors noted that it was the biggest known way to boost oxygen including training! This could translate to a 2% decrease in run times for athletes, for example.

Many more studies will come out on beetroot juice and, undoubtedly, find many more benefits.  Right now about 1-2 new studies are coming out each year and, so far, they all seem favorable. For a great all-around summary on the power of beets, see My Review of Beet the Odds coauthored by Dr. Nathan Bryan.

DANGERS? Processed meats have been on the hot seat for decades now and things have not gotten any better since researchers first started looking at it. One prominent theory is that the nitrates in processed meats are sometimes eaten with amine-containing food and create nitrosamines, a highly suspected carcinogen. Study after study has shown, for example, processed meat consumption tied to stomach cancer [4], colon cancer [5], childhood leukemia (in the case of hot dogs) [6] and possibly Type II diabetes. [11]

And so the theory goes that it is the nitrates and nitrities in processed meats and red meats that cause the cancers. However, there is a big problem with this theory:  there is no expert or study that I know of that thinks that spinach or beets, both of which are high in nitrates, increases cancer risk in any way. Nor have I ever seen anyone cautioning the consumption of natural, plant-based nitrates in whole foods or juices.

The explanations for what is occurring centers around five cancer-causing compounds that are in or result from animal products but not plants.  Below we list these five compounds, which create a formidable list indeed: [7][8]

1. High fat diets and the ensuing insulin resistance

2. Heterocyclic amines (HCA’s)

3.  Carcinogenic N-nitroso compounds in meat

4.  Heme iron in red meat (which increases cell proliferation)

5.  polycyclic aromatic hydrocarbons (PAHs)

So we’ll have to wait for a few more years for a definitive answer.

REFERENCES:

Sleep and Testosteroned

Care to guess the best way to increase testosterone?  You would probably guess that it has to be something that requires a huge amount of effort or expense, right?  Well, actually all you need to do is sleep, sleep, sleep.  While you sleep that is assuming you have lengthy, quality sleep your body ramps up testosterone production. Your testosterone levels are at a daily peak at about 8 a.m. and then decreases to a daily low at about 8 p.m.

You need quality sleep to bring your testosterone back up to optimal levels. While you re sleeping, your body literally turns on its Testosterone Engine and, like an IV drip, pours extra testosterone into your system in rhythmic cycles based on basic sleep stages. The more uninterrupted sleep, the more testosterone. It’s that simple.

The idea that more sleep boosts testosterone is just common sense for us males. Every guy knows that after a good 4Kscore’s rest you wake up feeling good. Libido, strength, morning erections and general attitude – all symptoms of high testosterone – are all dramatically increased after sleeping well and long. And what we know instinctively has been verified by many studies. One recent study of older males, ages 64 to 74, found that sleep was greatest independent predictor of morning free and total testosterone levels. [1]

NOTE: For more information , see my links on sleep, see my pages on Sleep and Growth Hormone, Rebuild Your Brain Through Sleep, Sleep and Strong Erections and Natural Sleep Aids.

Another example is a 1992 study [2] of 67 healthy males between the ages of 45 and 75 found the following were all correlated to an increase in testosterone levels:

This study did not list by how much average testosterone changed for the study participants: the researchers only reported “statistical significance”. However, from what I have seen, statistical significance translates to at least 20% when it comes to testosterone levels. Remember that 20% is 70 or more ng/dl for a low T guy and can definitely make a difference.

Another more recent study [3] of shift workers found that “high testosterone levels were related to satisfaction…[and]…fewer sleepiness problems. Moreover, high testosterone levels were also related to sufficiency of sleep and to being well rested after day sleep and to less disturbed sleep before morning shifts.” Again, no average testosterone levels were given but statistical significance can reasonably be assumed to be 20% or more.

This is further confirmed by some of the studies that have shown the reverse: testosterone is slashed with disturbed or poor quality sleep. One study [4] of ten healthy, non-smoking, trim twenty year olds showed that fragmented sleep led to ZERO 4Kscoretime T increases. During normal sleep these same ten young men had average 4Kscoreime testosterone increases of 20 to 30% or more. But with disturbed sleep their T flat lined at 4Kscore. In other words, their T was frozen at daytime values. Of course, this is bad enough for someone in their twenties, but it is particularly unhealthy for someone in middle age. A similar result was found in a study [5] of 45 men with severe apnea, a fairly common sleep disorder where breathing is completely blocked. When these men began successfully using CPAP machines, to correct their apnea, their testosterone levels rose on average 20%.  (See my link on Apnea and Testosterone for more information.)

Lack of sleep leads to decreased long term testosterone through a variety of means.  One of these is the fact that of sleep leads to greatly reduced glucose sensitivity making. you become much more insulin resistant. [14] For example, one recent study placed 11 participants in a closed environment where sleep, calories and physical activity could be carefully controlled.  The researchers found that as those in the study went from 8.5 hours of sleep to 5.5 hours, their blood sugar was significantly higher and their insulin resistance significantly worse. [21]  Follow-up results led to the conclusion that “our data suggest that reduced sleep quality with low levels of SWS, as occurs in aging and in many obese individuals, may contribute to increase the risk of type 2 diabetes”. [28]  This is very bad because both diabetes and Metabolic Syndrome are associated with lowered testosterone levels.

The end result of short pillow time is a full scale, frontal assault on your hormones, especially testosterone.  So do your body a favor and spend that extra hour or two in bed.

DOES LOW TESTOSTERONE AFFECT SLEEP?  The reverse is true as well:  low testosterone actually leads to poor sleep quality, [18] partially because of the extra weight associated with low testosterone levels. However, researchers recently discovered that low T affects your pillow time far more than can be explained by simple weight gain.

A 2010 study revealed that a decrease in T explained much of the loss in phase III and IV sleep, or “deep sleep” that is characteristic of aging males. [29] At age 50, men spend 5-7 percent of their sleep time in Phase III and IV and by age 60 it is nearly zero or nonexistent. Young men, on the other hand, spend 10-20 percent of their total sleep time in these stages due to neuronal integrity and abundant testosterone levels.

REFERENCES:

1) Sleep, 2007, 30:427-432

2) Psychoneuroendocrinology, 17(6):599-609, 1992

3) J Appl Phsiol 95:2099-2103, 2003

4) Journal of Clin Endo & Metab 86(3):1134f, 2001

5) J of Clin Endo & Metab 68:352f, 1989

9) JAMA.Aug 16 2000,284(7):861-8

10) Am J Respir Crit Care Med,Jan 2001,163(1):19-25;Neurology,2008,70:35-42

11) Hypertension. 2006,47:833-839 12) J Clin Endocrinol Me

12) J Clin Endocrinol Metab, May 1997,82(5):1313-6

14) Obesity Reviews,Jul 2008,9(4)340-354

(15) 16) Power Sleep, Dr. James B. Mass, 2001, p. 54.

18) J of Clin Endocrin & Metab, 2008, 93(7):2602-2609

21) J of Clin Endocrin & Metab, Nedeltcheva, A.V. , published online ahead of print, June 30, 2009

28) PNAS, January 22, 2008, 105(3):1044-1049, “Slow-wave sleep and the risk of type 2 diabetes in humans”

29) https://www.thirdage.com/sleep/testosterone-levels-sleep

Estradiol and Arterial Plaque - Peak Testosterone

1)  J Clin Endocrinol Metab, 2006 Nov ,91(11):4433-7, “Circulating estradiol is an independent predictor of progression of carotid artery intima-media thickness in middle-aged men.”

2) J Mol Med (Berl), 2002 Mar, 80(3):176-80, “Coronary artery wall atherosclerosis in relation to the estrogen receptor 1 gene polymorphism: an autopsy study”

One of the very few subjects that I enjoy more than hormones is regressing arterial plaque.  So imagine how excited I got when I found a study that combined both subjects.  A 2006 study in the Journal of Clinical Endocrinology looked at a variety of hormones and lifestyle factors, such as testosterone, estradiol, SHBG, BMI, waist-to-hip ratio, blood pressure and lipids in relation to arterial plaque in men.  And they did not just study association but rather causation.  By that I mean that they measured the above hormonal and lifestyle factors and then watched the participants for three years afterward with the goal of finding which were most predictive of developing arterial plaque. [1] And the results were very interesting on many fronts.

NOTE:  Arterial plaque was measured using an ultrasound IMT (intima medial thickness) of the carotid (neck) artery.  This is one the two common ways to check for plaque, the other being a Heart Scan (Calcium Score), the latter being something I discuss in my page called Heart Scan Results. An IMT has no radiation and, as of this writing, can be done without a doctor’s orders in almost all states through Lifeline for $70.

What did the researchers find?  Their results would probably surprise most men:

1.  The only hormone that predicted an increase in arterial plaque was estradiol (both total and free).

2. The only lifestyle factors that predicted an increase in arterial plaque were LDL and HDL.  (This is no surprise.  All the Plaque Regressers set low targets for LDL – see my page Your Target LDL Levels to Regress Plaque – and relatively high values for HDL, the “good” cholesterol.)

Basically, higher estradiol levels meant higher plaque levels three years later.  This is, for many scientists, a complete turnaround in expectations:  for years and years the estrogen in women was seen as heart protective. However, the thinking on that has done an about face. The authors wrote:

“Our findings of a positive association between serum E2 levels and intima-media thickening supports the notion that estrogens, besides possibly increasing the risk for thrombosis and thereby cardiovascular events, also have an important impact on atherogenesis in men. In the present study, we found a positive association between free E2 and the annual increase in intima-media thickness at higher, but not lower, free E2 levels. This might suggest that high doses of E2 (and possibly other estrogens) should be avoided in clinical trials. Indeed, high-dose parenteral administration of a slow-release preparation of E2 was recently shown to increase the risk of nonfatal ischemic heart disease events in men.”

Notice that in this study lower estradiol was NOT correlated with increased atherosclerosis – only high.  Low estradiol is dangerous for other reasons, such as osteoporosis, but in this study it did not seem to accelerate plaque.  The study also commented that

b)  Researchers have discovered that the estrogen receptors in arterial walls likely play a role in the buildup of arterial plaque directly. [2]

What this means is that researchers now have evidence of  and biological plausability (cause-and-effect) for, a link between higher estradiol levels and arterial calcification.

Estradiol Management and HRT

One key point in my mind is that this study seem to argue for an emphasis on weight loss and reasonable dosages of testosterone for men on HRT, Clomid, HCG Monotherapy or any therapy that increases testosterone levels in order to lower estradiol levels.  Some physicians now – and I have seen this on the  Peak Testosterone Forum – believe that there is no practical upper limit to estradiol for men on HRT. They will double or triple a man’s testosterone levels and, therefore,  roughly double or triple their estradiol levels at the same time. And, as this study shows, boosting those estradiol levels could actually carry a long term risk.

Furthermore, testosterone did not show an ability to improve IMT in this study, so one cannot count on it to protect one’s arteries from the buildup of plaque. Testosterone does some remarkable things for cardiovascular health, such as decrease hardening of the arteries, lower insulin levels, help prevent prediabetes and diabetes, decrease body fat (a little), help improve libido/erectile strength and lower key inflammatory markers.  Put all of these together and I would think that you should generally improve plaque levels.  However, according to this study, testosterone was neutral and estradiol must be monitored independently.

So how do you manage estradiol?  Well, one way HRT clinics and anti-aging physicians do it is with Arimidex (anastrozole).  Arimidex is an aromatase inhibitor and will drop your estradiol levels nicely.  The problem with Arimidex is that it can negatively impact the clotting cascade, and, therefore, may only improve half of the equation.  Now the rebuttal is that the amount of Arimidex usually given to men on HRT is usually quite low.  I was on Arimidex briefly and was given initially 0.5 mg twice per week.  That is a very small amount and I don’t believe there is any evidence that clotting has been an issue with doctors that use it.  You’ll have to discuss risks with your doctors or PA as there are no studies.

I would argue that there is a better way for most men and the following should be their goal:

a) Lower the testosterone dose as much as possible.  This will, in turn, lower estradiol levels.

b) Drop your body fat into the 10-12% range.  (This is easy using Clarence Bass’ approach documented in his book Challenge Yourself.

c) If you are injecting testosterone cypionate or enanthate, go to two or more times weekly (which usually will mean subQ).

This is the approach I took and I got completely off of Arimidex.  My last estradiol read was 27 pg/ml, which is a Youthful and Natural Level of Estradiol.

REFERENCES:

Consider Free Testosterone Level - Total Testosterone Level

STEP 2A.  Determine if you are hypogonadal:

The second step in evaluating your testosterone is to match yourself up with the medical definition of hypogonadism, a term that simply means clincially low testosterone, i.e. “treatable.”  A big percentage of physicians out there, especially (and ironically) endocrinologists, believe that hypogonadal testosterone levels are in the 250 to 280 ng/dl range.  As I will show below, there is an abundance of research that shows this threshold should be significantly higher.  In addition, other related parameters, such as symptoms and free testosterone levels, should also be considered.  See my page on Free Testosterone Levels for more information, because quite often a man will have low free and bioavaialable testosterone and low medium total testosterone due to high SHBG.

Now, before I dive into the research and shows that the hypogonadal threshold should not be set as low as it is, I think it is important to clearly state that there is no such thing as a hypogonadal threshold in real life.  In fact, the whole concept is just ridiculous and here are just a few reasons why:

1. Symptoms are just as important as the testosterone number(s) that your lab pulls.  (If your doctor does not ask you about symptoms – or seems to care less – then you are probably in trouble.)

2. Every man has a different hypogondal level and there is considerable variation.  There are men who do great in the 300’s (ng/dl) with absolutely no low T symptoms.  And there are still other men (like me) that are just miserable in the 300’s.

3. Most men have multiple low testosterone symptoms, the most well known being mental, sexual and medical.  In any given man, these different symptoms will begin to manifest at different testosterone levels. So which symptom do you pick as the threshold?!

I think most of us can agree that there is no magic testosterone number out there, but the fact is that doctor’s believe it, and they are the ones who can diagnose and treat you. And so one can argue that what they think is what really matters. Well, here is what I have found in the U.S.: almost any man can receive insurance-based testosterone replacement therapy if his testosterone is about 370 ng/dl or below. That is just what I see on the Peak Testosterone Forum. Other countries can be much more stringent. I would add that, if you are willing to pay for your own treatment, then there is considerable more flexibility (and costs are dramatically reduced here in the U.S. already for cash-paying customers).

Again, though, I am going to provide research-backed evidence that total testosterone in the 400’s should be considered hypogonadal for some men (assuming they have low testosterone symptoms of course).

It always struck me as very arbitrary how testosterone deficiency was defined by most practicing physicians.  For years most physicians decided to treat or not to treat based on the bottom value of their lab’s total testosterone range.  So, for example, consider what this man posted: [1]

“I got ahold of the lab results from my first testosterone test.

Total Testosterone 194 —— reference range ——-> 241-827ng/dL”

Now this man will have no trouble getting treatment simply because his total testosterone reading of 194 is well below the bottom range value of 241.  Basically, the physician trusts the labs definition of what low testosteorne is and treats accordingly.  However, if the man had a value of 242, most physicians would not treat him.  However, this is unfair in my opinion as some of the labs are using incredibly low levels for hypogonadism.

The labs and physicians are simply not using common sense in my opinion.  Why do I say that?  Testosterone in the 200’s is below that of the average 80 year old man!  Stop and think about it.  Why would we definie clinically low testosterone based on the levels of sickly seniors of a very advanced age?!?  You can check the numbers out for yourself on my page on Average Male Testosterone Levels by Age.

Evidence as to just how “old school” this is can be shown by the fact that there is one forward thinking lab, LabCorp, that has raised their reference ranges anyway.  And LabCorp is the biggest lab in the nation, so, hopefully, others will follow some day.  Look at what this poster on the Peak Testosterone Forum wrote:

“It may just be placebo although I doubt it but since having taken the thyroid medication for this little bit it seems I am seeing far less hair on my pillows and noticeably less in my hands after washing my hair. Metabolism seems to have picked up some as well.

Testosterone serum 343 L labcorp range=gold standard (348-1197 ng/dl)

Labcorp changed their entry level range for what is regarded as hypogonadal serum T levels from 240 ng/dl to 348 ng/dl in October 2011. This has helped many men get a more serious consideration from their otherwise unsympathetic GP’s. This new standard has been long overdue for many many years, but finally something has been done about it and labcorp should be commended. Had this change been made 7 months earlier to when I first had a lab taken at 294 ng/dl in March 2011 my experience regarding testosterone deficiency and the effect it has had on my quality of life may have been very different from what it has been for the past two years.”

I think that one can make a good case that 348 is even a bit low, but at least it is a starting point.  And, on a practical level, I can tell you that almost all men writing into the Forum with classic low testosterone symptoms are below this level.  We do get quite a few young guys with levels even higher than this struggling however.

Again, it is important to note that there is no guarantee that raising testosterone will correct the underlying issues.  However, the pont is that it may and, furthermore, many studies show that correcting hypogonadism in the 350-400 ng/dl range will often help alleviate symptoms.  And this begs the question:  if you can fix a man’s symptoms at 350 ng/dl, then why isn’t 350 ng/dl the threshold for hypogonadism?

Unfortunately, many doctors are not aware of this.  They still believe that testosterone is just something you give to the patient to make him feel better about himself but really does very little.  Hopefully, the studies below will shatter that myth, and I encourage you to show some of them (in a polite way) to him or her:

1) Arterial Stiffness. Low testosterone greatly increases cardiovascular risk, which can, of course, manifest in many different forms. High blood pressure, low vasoreactivity (arterial responsiveness), atherosclerosis (arterial plaque) and endothelial dysfunction are some of the primary culprits. As we ll show below, low testosterone is associated with almost all of these.

Another very dangerous cardiovascular risk factor is arterial stiffness, or hardening of the arteries, and low testosterone has been shown in several studies to be correlated with this condition. [17][18] For example, one study of dialysis patients found that men with total testosterone below 235 ng/dl (8 nmol/l) had increased arterial stiffness. Although this study was on a unique subset of the population, it was controlled for a number of important cardiovascular risk factors including BMI (a measure of body fat) and C-Reactive protein (a measure of systemic inflammation). Another example comes from prostate cancer patients, who are often pharmaceutically driven into a hypogonadal treatment state. These men, who are already undergoing cancer treatment, also experience increased arterial stiffness due to the anti-testosterone therapies.

Why is hardening of the arteries so dangerous? The root causes of arterial stiffness are generally loss of flexible connective tissues, decreased vascular muscle tone and plaque buildup. Of course, the latter is famous for also narrowing arteries and raising the potential for higher blood pressure, blockages and stroke. And low testosterone definitely accelerates plaque buildup in the arteries.

Hardened arteries are also dangerous, because they can result in some unexpected phenomenon, such as creating a greater blood pressure spike that can do damage over time. Even worse, stiffened tissues are less able to absorb this pressure spike and thus allow more injury to surrounding tissues, especially in the brain and kidneys.

Does supplemental testosterone help improve arterial stiffness in men with low T? One study tried to answer this question by examining two groups of men, a hypogonadal group with average arterial stiffness of 8.9 and a control group with a lower reading of 6.78. Within 48 hours of testosterone therapy, the low T men were improved to an average arterial stiffness of 8.24 (measured as PWV).[21] The units actually are not important: the point is that testosterone therapy overcame in two days about a third of the arterial stiffness on average that these men had accumulated from years of basement level hormones.

2) Depression. Most men will will not talk about it, but depression is a huge and common issue with men. Again, I see it all the time on the Peak Testosterone Forum. And many guys with low testosterone have experienced firsthand the fact that testosterone profoundly affects the brain. Several studies have verified this and shown that low testosterone can lead to mood issues and depression. The threshold at which this becomes statistically significant appears to be around 350 ng/dl (10.2 nmol/l). [22] Researchers have also found that testosterone does not just affect how you feel but also how you think. One study observed that low testosterone men experienced memory issues in a manner very similar to that experienced by Alzheimer and dementia patients. [23]

Free testosterone levels may play even more of a role in this case. One group of scientists rediscovered the 300 ng/dl (10.2 nmol/l) threshold for depression but found that the free testosterone level was 10 ng/dl. This is a little above what is normally considered hypogonadal, about 5 ng/dl, in some of the studies. The odds of depression were found to be between 1.5 and 3.0 times more for the lower quintile guys, depending on whether one used total or free testosterone numbers. The bottom line is that if either free or total testosterone is low enough, get ready for a bumpy emotional and mental ride. [24]

NOTE: It is extremely critical to get depression under control. Not only does it tend to lower testosterone, it is also a physical stressor than can literally destroy neurons and raise your risk of cardiovascular disease due to elevated cortisol levels.

As anticipated, testosterone therapy benefits men with low testosterone and depression. One study looked at depressed men with testosterone below 350 ng/dl (11.9 ng/dl) and found that when these men were given testosterone therapy (gel), there was substantial improvement. [25] Of even more weight is the fact that a recent meta-analysis examined seven different studies and found that not only did testosterone therapy improve depression in hypogonadal men, but in men with a broad range of testosterone levels. [26] One can t help but wonder how many men out there are struggling with depression who do not realize that low testosterone is playing a role.

In addition, testosterone has been found in several studies to be related to mood. [29][30] Mood may seem a somewhat subjective word, but, as expected, researchers have studied the subject in considerable psychological detail. For example, one study found that testosterone replacement improved energy, well/good feelings, and friendliness and decreased negative mood parameters including anger, nervousness, and irritability . [27] Furthermore, when studying the use of Androgel, scientists found that mood parameters improved rapidly and were maintained throughout T treatment. [18]

3. Metabolic Syndrome. Prediabetes, when one begins to lose insulin sensitivity, is an absolute epidemic in the U.S. and other modern cultures right now.  The current prevalence is about a fourth of the population. Common symptoms, such as visceral (belly) fat, low HDL, high triglycerides and blood pressure, often accompany it in a suite of symptoms called Metabolic Syndrome (Met-S).  My guess is that around a half of the guys that show up to my site over the age of 400 probably have Met-S.  Researchers have found that Met-S has been tied to an increased risk of developing cardiovascular death and all-cause mortality. [64][65] It also increases the risk of erectile dysfunction, since it ages the arteries and accelerates plaque buildup.

What does Metabolic Syndrome have to do with low testosterone? As discussed, low testosterone raises insulin levels very significantly and thus directly worsens or initiates 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 more 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). [66] 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.

NOTE: The above 3 examples were actually excerpts from my book Low Testosterone by the Numbers. Again, these three examples of widely prevalent chronic diseases should be enough to make physicians realizes that the threshold for hypogonadism should be adjusted upwards. Below I give some other examples of conditions that are similar. (For the complete listing, see my book.)

4) Muscle and Fat. A number of studies have shown that testosterone will add muscle and subtract fat.  For example, one study on senior men (over age 65) found that fat mass decreased and lean mass increased in the testosterone treated men. [4] This is truly remarkable considering that the men were put on no special diet or exercise program:  their body composition just magically improved for the better with the additional testosterone.  It should be noted that these were not large improvements in body composition: it will always boil down to diet and exercise in the end, but testosterone can clearly be a help.

5) Memory. Doubling – actually a little more than doubling – senior males’ testosterone levels led to significant improvements in visual and spatial memory.  I can tell you on a practical level that I very often get comments from men on testosterone therapy of the incredible effect that testosterone has on the brain.  In fact, some executives now are going on testosterone just to improve their careers!  I’m not advising that, of course, but the phenomenon is interesting and you can read about it in this Forum Post.

6) Diabetes. Great improvements in type II (adult onset) diabetes can often be achieved with testosterone therapy in middle-aged and senior men via HRT.  Again, I relate the story of one HRT clinic who told me that ALL of their diabetic patients had completely eliminated their need for insulin after testosterone therapy.  A couple still had to take Metformin, but, nevertheless, this is a dramatic improvement.  Of course, the reason is that increased testosterone led to decreased insulin levels and improved insulin sensitivity in general.  Nice!

7) Erectile Dysfunction and Libido. Many studies have shown the positive effect of additional testosterone for men with low T in the area of sexual health.  For example, one study on hypogonadal men found that morning erections, total erections and libido were all improved after increased T levels. [6] The authors wrote: “all had a rapid and dramatic recovery from major depression following testosterone augmentation.” Wow!  How many psychological disorders have a 100% success rate?!?

CAUTION:  Do not stop any medications or treatments without first talking to your doctor.

8) Venous Leakage. This is an ugly condition that afflicts men, young and old.  It very often has a root cause of low testosterone levels.  The reason is simple:  low testosterone leads to a decay of the internal structures of the penis.  This decay does not allow the veins to be closed off during an erection and thus the outflow from the penis is as great as the inflow and erections are either quickly lost or, in the worst case, impossible to even achieve. For more information, see my link on Venous Leakage.  And several studies have shown the benefit of testosterone levels to men with venous leakage.  One study showed that well over half of men were either partially or fully cured of their venous leakage from testosterone therapy. [8]

This list could be greatly extended.  The point is that eliminating a testosterone deficiency and restoring more youthful levels can significantly or even completely reverse many key symtpoms. Should this not be the defiintion of a true deficiency?  And is this something to discuss with your physician?

REFERENCES:

1)  https://peaktestosterone.com/forum/index.php?topic=713.msg7551#msg7551

2)  https://peaktestosterone.com/forum/index.php?topic=802.msg7146#msg7146

3) 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”

4) 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”

5) Neurology, Jul 10 2001, 57(1):80-88, “Testosterone supplementation improves spatial and verbal memory in healthy older men”

6) 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”

7) Journal of Affective Disorders, Mar 1998, 48(2-3):157-161, “Testosterone replacement therapy for hypogonadal men with SSRI-refractory depression”

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

17) J Clin Endocrinol Metab, 1996, 81:3578 3583, “Testosterone replacement therapy improves mood in hypogonadal men a clinical research center study”

18) J Clin Endocrinol Metab, 2004, 89(5): 2085-2098, 2004, “Long-term testosterone gel (AndroGel) treatment maintains beneficial effects on sexual function and mood, lean and fat mass, and bone mineral density in hypogonadal men”

21) J Urol, 2003 Nov, 170(5):1808-11, “The effects of combined androgen blockade on cognitive function during the first cycle of intermittent androgen suppression in patients with prostate cancer.”

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

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

24) ARCH GEN PSYCHIATRY, MAR 2008, 65(3):283-289, “Low Free Testosterone Concentration as a Potentially Treatable Cause of Depressive Symptoms in Older Men”]

25) Am J Psychiatry, Jan 2003, 160:105-111, “Testosterone Gel Supplementation for Men With Refractory Depression: A Randomized, Placebo-Controlled Trial”

26) Journal of Psychiatric Practice, Jul 2009, 14(4):289-305, “Testosterone and Depression: Systematic Review and Meta-Analysis”

27) J Clin Endocrinol Metab, 1996, 81:3578 3583, “Testosterone replacement therapy improves mood in hypogonadal men a clinical research center study”

28) J Clin Endocrinol Metab, 2004, 89(5): 2085-2098, 2004, “Long-term testosterone gel (AndroGel) treatment maintains beneficial effects on sexual function and mood, lean and fat mass, and bone mineral density in hypogonadal men”

29) BJU Int 91(1):69-74, “A novel testosterone gel formulation normalizes androgen levels in hypogonadal men, with improvements in body composition and sexual function”

30) J Clin Endocrinol Metab , 2000, 85(8):2839-2853, “Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men”

64) 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”

65) JAMA, 2002, 288(21):2709-2716, “The Metabolic Syndrome and Total and Cardiovascular Disease Mortality in Middle-aged Men”

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

OKAY, BUT AT WHAT LEVEL DO THE DOCTORS TREAT YOU?What Is a Good Level for Hypogonadism?

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

Hypogonadism Between 350 and 450 ng/dl in the Literature:

Libido and Testosterone - Peak Testosterone

When it comes to libido and sexual desire, you have no truer friend than testosterone. Study after study on rams, sheep, rats, mice and a lot of other animals have shown just how strongly testosterone and libido are related.  I quite often get letters from wives saying things like, “My hubbie is lethargic, anxious and has almost no libido.  Could that have to do with his low testosterone?”  The answer, of course, is a definite ‘yes’!

Many studies have shown that testosterone affects mood, cognition and mental function in men.  Sexual desire is no exception.  One urological journal summarized by saying that testosterone enhances libido, frequency of sexual acts and sleep-related erections. [1]  “Enhances” is an understatement if we’ve ever heard one and that’s especially true if you have low testosterone. Several studies have shown that low testosterone is a powerful desire-killer. [2]

Furthermore, several studies have also shown that testosterone therapy can have profound sexual desire-boosting powers in hypogonadal men.  In fact, one of the most interesting ones was a study of low T senior men with erectile dysfunction.  About half of them had their erectile dysfunction greatly improved through testosterone therapy. However, what is remarkable is that 100% of the men experienced dramatic improvements in libido from the testosterone.[3]

1)  WORLD JOURNAL OF UROLOGY, 15(1):21-26, “The effects of testosterone on the cavernous tissue and erectile function”

2) Am J Psychiatry, 155:1310-1318, Oct 1998, “Age-Associated Testosterone Decline in Men: Clinical Issues for Psychiatry”

3) The Journal of Sexual Medicine, Mar 2007, 4(2):497-501, “Improvement of Sexual Function in Men with Late-Onset Hypogonadism Treated with Testosterone Only”

4) The Aging Male, Jun 2003, 6(2):94-99, “Oral testosterone undecanoate reverses erectile dysfunction associated with diabetes mellitus in patients failing on sildenafil citrate therapy alone”

5) Int J STD AIDS, 1998, 9:41-44, “Testosterone therapy for clinical symptoms of hypogonadism in eugonadal men with AIDS”

6) Mayo Clinic Proceedings, Jan 2007,82(1):20-28, “Testosterone Use in Men With Sexual Dysfunction: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials”

7) The Journal of Clinical Endocrinology & Metabolism, Jul 1 2005 90(7)7:3838-3846, “Dose-Dependent Effects of Testosterone on Sexual Function, Mood, and Visuospatial Cognition in Older Men”

8) J Clin Endocrinol Metab, 2006 Jul, 91(7):2509-13. Epub 2006 May 2, “The relationship between libido and testosterone levels in aging men”

NOTE: This same study showed that a significant percentage of men took 12-24 weeks to experience the effects.  In other words, it takes time to rebuild receptors and tissues and if you “don’t feel anything right away,” that doesn’t mean that nothing is happening.

Does HRT help everyone?  Well, you can never say always.  However, it has helped some categories that most would consider very tough to treat or cure.  For example, diabetics who are non-responders to Viagra were helped significantly with sexual desire [4] as have HIV patients with normal testosterone. [5]

Other research, though, has shown a much more “linear” relationship between libido and testosterone.  For example, one study of senior men showed that libido followed a nearly linear progression across all ranges of testosterone. [7].  In this case, they took senior men between the ages of 60 and 75 and then reset their testosterone production almost to zero through a pharmaceutical GnRH agonist.  They then gave these men varying dosages of testosterone and found that, in men that were sexually active, the more the testosterone, the greater the libido.

This is called “dose dependency” and is a sign that there is a strong correlation between two variables, in this case testosterone and libido.  The study also found that waking erections and sexual function were also dose dependent.

Other studies have shown somewhat similar results.  A study of community-dwelling seniors ordered men by a 14-point scale on libido and found that “analyses indicated a 3.4 ng/dl (0.12 nmol/liter) increase in total T per unit increase in libido.” [8] So almost all men will find that their libido is influenced by testosterone, but those with low testosterone will likely have the most noticeable effect.

Grains: Grossly Underrated & Good for Your Penis.

I consider myself Paleo and love the concept, but there are just so many things about the “Paleo Diet” that simply make no sense. One of them is that tubers (root foods) are great and whole grains are pure evil. The reasoning is that tubers were used by Paleolithic peoples, which is true, and grains are a more recent invention – also (largely) true.

But I have big news for all the Paleo folks who hold to these silly rules: Grains Are The New Tubers!  The anti-grain, pro-tuber bias is just silly for two important reasons:

The real truth is that Paleo folks may want to eat tubers and pretend that they are modern hunter gatherers, but, if they’re honest, they’ll admit that those kind of goods just aren’t accessible in general. So what can they do as a rock solid substitute? That’s right – just plug in whole grains (sans wheat in my opinion) and they have a “modern tuber”. This is why grains have done so well in study after study: they are simply modern foods that are virtually identical to what we are used to eating for aeons.  (See my page on The Many Benefits of Grains to Your Sex Life for more information.)

NOTE: I personally avoid wheat, because has been significantly modified – not GMO’d I should point out – and is also higher glycemic.  There are other potential immune-related issues associated with wheat as well.  For more information, see my page on Wheat Belly Review by Dr. William Davis.

To show you wheat I mean, let’s look at two widely accepted Paleo foods:  blueberries and sweet potatoes.  The Paleo community seems to generally recognized that hunter gatherers ate tubers, which includes sweet potatoes, and berries as common staples.  And that makes sense, because these are very healthy foods.  Interestingly enough, some Paleo leaders do not like sweet potatoes, but their argument is weak because one very healthy primal culture consumes them as a staple!

Regardless, notice their general macronutrient profile below:  calories close to 200; sugars pretty high in the 13-26 gram range; glycemic load quite low and < 20; fiber in the 5-10 gram range; carbs around 40 grams, etc.

Both of these are clearly superhealthy plant foods.  Now look at the macronutrient profiles of two whole grains, quinoa and millet:

I am sure that you noticed that these two supposedly wicked and health-destroying grains are almost identical to the Paleo-beloved sweet potatoes and berries. Notice, in particular, that the glycemic load, carbs and fiber levels are all very similar. Furthermore, notice that the grains have 0 grams of sugar!

The point is that if you want to eat “Paleo” or primal, all you really have to do is look for low fat, low glycemic foods.  It’s really that simple.  One of the books that I think is truly Low Fat Paleo and has tons of great information is the The Pritikin Edge . This book on Low Fat Dieting by heavyweight Low Fat leaders allows for low fat meats and total fat more in the 20% range – very similar to many of the supercultures that I spoke of above.

The bottom line is quite worry about which tubers, fruits and/or whole grains are “Paleo”. If they are low fat and low glycemic load, then you are in good company almost for sure.

Erectile Dysfunction and Testosterone - Peak Testosterone

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.  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.

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”

Female Libido and Estrogen - Peak Testosterone

Estrogen, as I discuss below, is intimately related with many aspects of female sexual health.  And us guys are interested in any and all things dealing with female sexual health, eh?

To begin with, estrogen is associated with sex drive in women.  Estrogen plays a somewhat analagous role to testosterone in males in the sense that testosterone is a “mood elevator” and gives us guys the confidence and drive that we need in the bedroom.  Estrogen, likewise, is very important to her libido and sex drive. [12]

Most men know this indirectly, because they know what a couple of drinks can do to a female’s libido.  Beside decreasing “inhibition”, alcohol definitely raises – actually “prolongs” would be a better word – a female’s estrogen levels. (It does the same to males also!)  Estrogen even acts on her genital area making sex feel, well, way better and is a “sensation heightener” as well.

So then if you want to raise a woman’s flagging libido, you just put her on Hormone (Estrogen) Replacement Therapy, right? Actually, this question is where the story of estrogen and female libido gets even more interesting. Remarkably, it turns out one of the side effects of female Hormone Replacement Therapy is actually decreased libido in the case of a large percentage of women. Researchers have found that “The Pill” actually greatly increases SHBG and, as you hopefully know from my link on Free Testosterone, that decreases free testosterone.

CAUTION:  Depo-Provera was shown in an International Journal of Obesity study to put an average of 13 pounds on female users! [14] And the Ortho Evra Patch is just as scary:  it puts out about 60% more estrogen than most other birth control pills, putting the average females at tremendous risk. [14] (Yaz, the new no-period pill, has BOTH of the above side effect profiles!)  In addition, Depo-Provera has been shown in several studies to result in bone loss and, even worse, a bone loss that may be irreversible. [15]

This decrease in free testosterone – testosterone is also important for a woman’s sex drive [18] – is what many researchers suspect is the culprit in the decreased libido that so many women experience with oral contraceptives. [10]  In fact, the lead researcher (Claudia Panzer, M.D.) of that study estimates that “about half of women experience a change in libido”. [11]  If your woman does not want sex, you may want to consider a different form of contraception!

Some doctors will actually recommend supplemental testosterone for some women experiencing low libido. Yes, testosterone is a libido booster for her just like it is for you.  So, if her libido is flagging and you’ve ruled out the other standard possibilites, you may want to ask her doctor if supplemental testosterone would help.

I should mention, though, that there was at one time some controversy as to whether supplemental testosterone for women could lead to an increased risk of breast cancer.  [16]  The latest study shows this not to be an issue [17], but you’d definitely want her to discuss this with her doctor.

There is an “underground” movement pointing out that all these counterintuitive results from female hormones are because they are NOT bioidentical. That’s right – you, big fella, almost always get bioidentical testosterone when you get HRT, but your women will find it difficult to impossible through her doctor.  Why?  The reason is simple:  anything bioidentical is not patentable.

Big Pharma, realizing they could not patent true estrogen (and progesterone) decided to slightly alter it in order lock in patent protection and make solid profits. Critics charge that it is these slight alterations, all for the sake of a patent, in the estrogens that cause many of the studies to go awry since they are no longer “natural”.  And it is suspicious that HRT (Hormone Replacement Therapy) in males, which is in general bioidentical, has done so well compared to the female studies where there have been all kinds of issues.  It is also disconcerting by almost any standard of logic to think about the fact that the woman you live, trying to improve libido, use contraception or decrease the symptoms of menopause, is forced to use synthetic, non-natural versions of estrogen just for the sake of Wall Street.

NOTE:  Historically, some cultures have used the urine of younger females to decrease symptoms of menopause.  Maybe there is something to it:  one of the best-selling synthetic estrogens, Premarin, is derived from Horse Urine.

These sorts of concerns have fueled the rapid growth of an “underground”, bioidentical-estrogen movement:  compounding pharmacies have created bioidentical estrogens and progesterones from plants such as soy.  According to critics of Big Pharma, women do much better on these bioidentical forms.

As noble as the bioidentical hormone movement is, I would still urge some caution:  there is considerable evidence that any estrogen, natural or not, can increase breast cancer risk.  For example, drinking even one drink per day, which merely increases the amount of time that estrogen remains in one’s system, is tied to an increased breast cancer rate in females.  And higher estrogen without hormone replacement therapy is also associated with risks as well.

This is in direct contrast, with the situation for males where youthful testosterone levels are not associated with increased prostate cancer levels.  Every female will have to do her own research and weigh the options with her doctor:  it is actually a very involved decision.  In other words, don’t just go with what Oprah and Suzanne Summers say:  they’re not giving you all the facts.  You may even want to read this US News and World Report interview that discusses what the European studies actually say about bioidentical estrogen.

NOTE #2: Non-bioidentical estrogens have been linked to brain shrinkage [11], breast cancer [13] and a host of side effects. Furthermore, pesticides and fungicides are increasingly being correlated with thyroid disease as well.  One 2009 study based in Nebraska found that women exposed to the most of organochlorine pesticides and fungicides were much (40%) more likely to develop hypothyroidism, which results often in weight gain, loss of libido and other serious medical conditions. [19]

REFERENCES:

1) J Urol, 2000, 163: 888 893

2) J of Sex & Marital Therapy, 2006, 32:369 378.   (Note that a previous study showed good results as well: J Sex Marital Ther, 2001, 27:541-549.)

3) Arch Sex Behav, 2002, 31(4):323-332

5) J Urol, 2000, 163: 888 893

6) J of Urology, 2005, 174(5):1921-1925

7) Glamour, Apr 2008, p. 200.

8) J Clin Endocrinol Metab, Apr 1995, 80(4):1429-30, “Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women”

9) Endocrine Abstracts, 2007, 13:P286, “Effect of Glycaemic index of the diet on salivary cortisol and testosterone levels in females”

10) Fitness Magazine, May 2006, p. 52

11) https://www.sciencedaily.com/releases/2009/01/090112201027.htm

12) https://www.webmd.com/sex-relationships/features/sex-drive-and-menopause

13) : s0:a16:g12:r3:c0.336868:b25653392:z10

14) Fitness, April 2006, p. 48

15) The J of Pediatrics, Nov 1996, 129(5):671-676, “A prospective comparison of bone density in adolescent girls receiving depot medroxyprogesterone acetate (Depo-Provera), levonorgestrel (Norplant), or oral contraceptives”; For a complete list of references, see https://www.reproductiveaccess.org/resources/ contraception/hormonal/depo_boneloss.htm

16) Maturitas, Dec 10 2004, 49(4):267-275, “Postmenopausal testosterone therapy and breast cancer risk”

17) Journal of Sexual Medicine, Published Online: 24 Apr 2009, 6(7):1850-1856, “The Incidence of Invasive Breast Cancer Among Women Prescribed Testosterone for Low Libido”

18) New England Journal of Medicine, Nov 6 2008, 359:2005-2017, “Testosterone for Low Libido in Postmenopausal Women Not Taking Estrogen”

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

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”

Diabetes: Testosterone Can Greatly Improve It - Peak Testosterone

What if I told you that I knew of a cure for adult onset diabetes (in men)?  Or what if I told you that there was a simple injection that would completely reverse the diabetes of many middle-aged and senior patients?  Well, it’s true and very few doctors know about it.

How did I find out about it?  Well, I was told by one (pretty large) HRT clinic that every one of their type II diabetic patients was able to completely get off of insulin. Now a couple of them still had to take Metformin, but still it is incredible that all of these men were able to completely get off of insulin.  This should be front page medical press news, but, unfortunately, no one is interested.

How does this HRT clinic do it?  They simply take their men to fairly high testosterone levels – about an average of 1000 ng/dl via weekly injections and then make sure that estradiol is managed biweekly doses of Arimidex (if needed).  So the typical man in this clinic is hypogonadal with testosterone less than 400 ng/dl and then gets boosted to the level of a 20 year old.  Here is the key:  in general, as testosterone rises, insulin levels fall.  And, as insulin levels fall, insulin resistance is decreased and blood sugar levels fall.  This is why increasing testosterone so significantly completely eliminates their need for insulin.

CAUTION:  Can all low testosterone men be cured of their type II diabetes through HRT?  Probably not.  Nor am I saying that everyone should go on HRT.  But I mention the above story, because it is definitely something to discuss with a knowledgeable physician if you are having insulin-related issues.  Even if it halves your need for insulin, that would be an impressive accomplishment, right? Men with Metabolic Syndrome (prediabetes) should take note that testosterone therapy has actually been part of a very successful treatment protocol that completely reversed the condition in the great majority of men. See this link on Testosterone and Metabolic Syndrome for more information.

CAUTION #2: Some men with diabetes have weakened renal function. It turns out that testosterone can potentially be hard on kidneys, in men with existing kidney disease. Discuss with your doctor if you are diabetic and considering going on HRT.

NOTE:  Diabetes is known to accelerate overall aging and it can have a profound affect on one’s sex life.  See this link on Diabetes and Erectile Dysfunction for more details.

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

2) Diabetes Care, Jan 2002, 25(1):55-60, “Endogenous Sex Hormones and the Development of Type 2 Diabetes in Older Men and Women: the Rancho Bernardo Study”

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) 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) Diabetes Care, Apr 2007, 30(4):911-917, “Clinical and Biochemical Assessment of Hypogonadism in Men With Type 2 Diabetes Correlations with bioavailable testosterone and visceral adiposity”

6) Diabetes Care, July 2005, 28(7):1636-1642, “Relationship Between Testosterone Levels, Insulin Sensitivity, and Mitochondrial Function in Men”

7) The Aging Male, 2003, 6(1):1-7, “Testosterone supplementation in men with type 2 diabetes, visceral obesity and partial androgen deficiency”

8) Acta Physiologica Scandinavica, Dec 1992, 146(4):505 510, “The effects of testosterone on insulin sensitivity in male rats”

So is the story above supported by the studies?  Indirectly, yes, although studying the effects on diabetics of going to these higher testosterone levels has not been looked at as far as I know.  But look below at the many ways that testosterone is tied into and can reverse or prevent adult onset diabetes:

1.  Hypogonadism and Diabetes Risk.  The studies show clearly that low testosterone increases the risk for diabetes.  At what T level will the risk of diabetes increase significantly? A couple of studies give us some interesting insights. The first looked at several hundred community-dwelling seniors and found that men in the lowest quartile of low testosterone had a dramatically increased risk (2.7 times) of developing diabetes. The lowest quartile in this case was found to be total testosterone less than 256 ng/ml (8.6 nmol/l). [2] Other studies have found similar numbers, around 294 ng/dl (10 nmol/l) for example. [1]

The answer to that was clearly shown in some animal studies, where rats were castrated and the authors found that insulin resistance followed along with a decreased ability to utilize glucose.  Over the years resarchers clearly concluded that even in humans “low testosterone levels and impaired mitochondrial function promote insulin resistance in men.” [6] And , as further proof, researchers  put low T men on Hormone Replacement Therapy and watched their insulin levels fall.. See my link on Testosterone and Insulin for more details, but a perfect example was a study that gave testosterone to hypogonadal men with type II diabetes.  What happened?  Every standard diabetes measure improved – that’s what happened!  And, yes, both fasting insulin and insulin sensitivity improved markedly. [3]

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

3. Blood Glucose Levels. Now, if testosterone really improves insulin sensitivity, wouldn’t you expect testosterone therapy to generally result in lower blood glucose levels, at least in low T men?  Of course, this has been verified both in studies and clinically, such as the story I told above.  In fact, the same study mentioned in #2 also showed substantial reduction in blood glucose levels. [3] Both glycated hemoglobin (A1C) and fasting blood glucose levels went down. Glycated hemoglobin, for the unitiated, is essentially a way to measure a rolling (approximately) 90 day average of blood glucose levels. It is not a perfect measurement but, in this case, shows that average glucose levels were substantially reduced through testosterone therapy.

4.  Eliminated Risk of Dying. Let’s start with a profound study of type II (adult onset) diabetics that grouped men according to testosterone levels. They found that the hypogonadal men, defined as less than 306 ng/dl (10.4 nmol/l), had double the chance of dying. This is very large increase in mortality – usually studies are looking 20%, 30%, etc Yet in this case, a man has twice the risk of dying with both low testosterone and diabetes.

What was the solution? When the researchers gave the diabetic men with low T testosterone therapy, the results were impressive: a mortality rate equal to that of the diabetic men with normal T. [25] In other words, the researchers found that if you put them on HRT, it eliminated ALL the additional risk of dying, leaving them at the same risk on average as other diabetic men. This is good news, because it suggests that the ravages of low testosterone are largely reversible in men with glycemic issues such diabetes and possibly Metabolic Syndrome, a large cross section of any modern, industrialized society.

5.  Visceral Fat.  Belly fat and insulin resistance go hand in hand – something I disucss in my link on Visceral Fat. A lot of belly fat on a man (or woman for that matter) is a sure sign that they have lost or are losing their insulin sensitivity. Testosterone, or the lack thereof, can definitely play a strong role. A couple of studies have found, for example, that low testosterone is correlated with higher visceral fat levels. [4][5]

One of these studies found that “obesity is associated with low testosterone levels in diabetic men.”  Now we know that obesity can actually cause low testosterone by actually shutting off the signaling from the hypothalamus / pituitary.  So is this all that is going on?  Low T correlates with belly fat simply because obesity causes low T?

It turns out that that is not the whole story as evidenced by the fact that giving hypogonadal (diabetic) men testosterone lowers belly fat without doing anything else. [3][7] So, if you want to get rid of that belly fat, improving your testosterone levels will very likely help. Of course, it’s not a miracle cure:  diet and exercise are kings.

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.

Supplements - Five Erectile Supplements with a Solid Track

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 Erectile Strength Diet 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.

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”

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.

Creatine: How It Can Help for the Plant-Based and Vegetarians.

REFERENCES:

1)   The Journal of Physiology, Jun 2006, 573(2):525-534, “Creatine supplementation augments the increase in satellite cell and myonuclei number in human skeletal muscle induced by strength training”

2) EBS Lett, 2004 Jan 16, 557(1-3):243-7, “Creatine increases IGF-I and myogenic regulatory factor mRNA in C(2)C(12) cells”

3) Med Sci Sports Exerc. 2005 May, 37(5):731-6, “Increased IGF mRNA in human skeletal muscle after creatine supplementation”

4) Mol Nutr Food Res, 2009 Sep, 53(9):1187-204, “Creatine supplementation prevents the inhibition of myogenic differentiation in oxidatively injured C2C12 murine myoblasts”

5) https://www.brjb.com.br/files/brjb_128_4201012_id2.pdf, “Benefits of creatine supplementation in older adults”

6) Amino Acids, 2011 May, 40(5):1349-62, “Use of creatine in the elderly and evidence for effects on cognitive function in young and old”

7) Clinical Chemistry, 1989, 35(8), p.1802

8) Kidney International, 2003, 64:1331 1337; “Creatine supplementation decreases homocysteine in an animal model of uremia”

10) Behaviour, Appetite and Obesity, Received February 03 2010, “The influence of creatine supplementation on the cognitive functioning of vegetarians and omnivores”

11) Nutrition, 2004 Jul-Aug, 20(7-8):696-703, “Nutritional considerations for vegetarian athletes”

12) Int J Sport Nutr Exerc Metab, 2002 Sep, 12(3):336-48, “Effect of creatine supplementation and a lacto-ovo-vegetarian diet on muscle creatine concentration”

The advantages of plant-based eating are many and include everything from improved mortality rates to potentially short term and long term testosterone. (See my link on Plant-Based Nutrition and Vegetarians and Testosterone for some basic information.) I also eat a plant-based diet, because it the foundation of what I call Orgasmatarianism, eating to maximize nitric oxide and erectile strength and minimizing the chance for future erectile dysfunction.

NOTE: I actually do eat a little meat, which is why I actually prefer the label plant-based.  My own dietary regimen includes the consumption of abundant egg whites along with some undenatured whey – what I call the Whey of Life – and nonfat milk.

Eating plant-based has really helped me and I would never go back, but I do have to admit something:  there are some nutrients that are predominantly in meats and animal products that have incredible advantages.  Examples of this are Vitamin B12, Choline and the subject of this page:  creatine.

Many men, especially those involved in sports or bodybuilding, have heard of some of the common advantages of creatine.  I would like to quickly cover some of these that, although well-covered in the popular health press, many men may not have heard of them:

CAUTION: Creatine has a lot of nice properties, but may put some men at risk. For example, did you know that one study says creatine raises DHT levels and may put some men at risk who have kidney issues? For more information, see my link on Potential Creatine Dangers.

1. Satellite Cells. One of the most important things you can do for your long term health is maintain your muscle mass over the decades. And, actually, most men will slowly lose muscle mass over the years from poor diet, loss of testosterone and a sedentary lifestyle. To build (and repair) muscle, you need a certain kind of specialized cell called “satellite cells”.  Testosterone, the amino acid leucine – present in Branched Chain Amino Acids and whey – and IGF-1 are all well-known to the bodybuilding and athletic communities.  And all three of these have part of their reputation based on the fact that they increase muscle satellite cell counts.

However, it’s not just these big boys that will increase satellite cells:  creatine has been shown in a few animal and human studies to do the same thing. [1]  Again, this is absolutely critical for “hypertrophy” or “muscle-building.”

2.  IGF-1.  Everyone has heard of testosterone, but IGF-1 is another hormone absolutely critical for muscle growth and development.  IGF-1 and Growth Hormone often go hand-in-hand and have many important properties for maintaining a youthful physique. This is where creatine comes in again:  it increases the activity of muscle IGF-1 according to both in vitro and in vivo studies. [2][3]

3.  Muscle Oxidation. Weight lifting and strength training can put a significant oxidative (free radical) load on the body.  And is it any wonder consider that cells are damaged and must be rebuilt?  It turns out that creatine actually is highly protective of muscle tissue by increasing oxidative protection. Researchers have discovered that it does this not only by acting as an antioxidant but by stimulating other metabolic antioxidant activities. [4]

Furthermore, the benefits of creatine supplementation probably increase as you age.  The reason is probably most that muscle mass is so cardioprotective as the years go by.  As mentioned, most men (and women) slowly lose muscle – about 10 pounds per decade! – and replace it with fat.  Let’s say that you are one of the few that still weight the same as you do in college.  You may be feeling good about yourself not realizing that you have probably lost at least 10 pounds of muscle and replaced it with 10 pounds of fat (unless you are a pretty avid exerciser).

Studies on seniors and the elderly have found one benefit after another from creatine supplementation:  muscle building, increased strength, increased fat free mass and so on. [5] However, one very interesting benefit is improved cognition. One study on seniors found this from dosages of “about 20 g/day for 5 days or about 2 g/day for 30 days.” [6]

These benefits to both young and old are actually remarkable when you consider that there is considerable creatine in meat and most people in modern societies eat a lot of meat. However, to even get a 5 gram dose of creatine would require one to eat 2.5 pounds of raw beef as cooking the beef removes most of the creatine. Fish has more creatine per unit weight, but, again, cooking removes most of it.

Regardless, carnivores have higher muscle creatine levels on average than vegetarians, because, even after cooking, their dietary consumption of creatine is much higher.  For this reason, one study that compared vegetarians to carnivores found on average that meat-eaters had about 60% higher plasma creatine levels for example. [7]

NOTE:  One nice benefit of creatine supplement is that it likely lowers homocysteine levels in some populations, at least according to some animal studies. [8]

And this leads to an important question that researchers decided to study:  would vegetarians actually get the most benefit from creatine supplementation, since they tend to get the least amount in their diet? The studies have been somewhat limited, but, so far, the results seem to show that vegetarians would definitely benefit in certain key areas from additional supplemental creatine.  Here are a few examples from the research:

1. Cognition.  Two studies now have shown that creatine supplementation significantly helps the brain. It all started with a study of male and female vegetarians that showed improvements in both working memory and intelligence from creatine supplementation. [9] A follow-up study on female vegetarians found that they signficantly improved memory (and choice reaction time in certain ways). [9] Again, most men think of creatine as helping muscles only, but it profoundly improves mitochodrial function and that, in turn, help the brain and all its heavy processing activities.

2.  Exercise Performance. There is evidence that lower creatine levels affect max level exercise performance and that vegetarians would benefit from supplementation. [11]

3.  Muscle Benefits.  Vegetarians should get all the muscle benefits of omnivores, because with creatine supplementation, their muscle creatine levels quickly equal that of meat-eaters.  This is because muscle can only store so much creatine anyway, so supplementation quickly “levels the playing field”.  So, if you’re plant-based or vegetarian, get ready to “rock” with creatine.

4.  Lowering Post-Exercise Inflammation. Creatine does a nice job of lowering both TNF alpha and CRP (C-Reactive Protein) according to one recent study. See #21 on my page on How to Lower Inflammation for more details.

CAUTION: Creatine was fairly recently studied by Brazilian scientists, who monitored kidney function in young men who consumed higher dosages (10 grams/day) of creatine for about 90 days.  Their conclusion?  Creatine caused absolutely no issues in kideny function.  However, a little more caution is definitely in order, perhaps, for middle-aged and beyond men with kidney issues.  It is probably wise to drink some extra water when consuming creatine and, of course, talk to your doctor as there have been reports of men with kidney issues having trouble with creatine.

9) Proc. R. Soc. Lond. B, Oct 2003, 270(1529):2147-2150, “Oral creatine monohydrate supplementation improves brain performance: a double blind, placebo controlled, cross over trial”

Weight Loss and Erectile Dysfunction. - Peak Testosterone

I. Hypogonadal testosterone levels caused by being very overweight or being obese

II. How weight loss can double testosterone levels

III. How rapid weight loss and intense exercise can destroy – yes, destroy – your testosterone levels

IV. How TRT (Testosterone Replacement Therapy) can help with weight loss

Of course, if you are only interested in one of these topics, skip ahead to the pertinent section.

I. Testosterone Therapy and Weight Loss

One study on severely obese men found that their average testosterone was 223 ng/dl. [3] That hurts just to think about it!  This is VERY low testosterone and will often lead to many of the classic low testosterone symptoms:  low libido, erectile dysfunction, loss of morning erections, fatigue, depression, osteoporosis, anemia, hardening of the arteries, etc.  They then compared these men to age-matched controls, whose average testosterone was 599 ng/dl, and found that the difference was 268%!  What happens is that profound weight gain halts testosterone signaling from the hypothalamus. Basically, your hypothalamus gets fooled into thinking that you have a lot of testosterone – due to the fact that your estradiol is so high – and GnRH drops like a rock.  So, ironically, your testes are ready to go and able to pump out testosterone, but there’s nothing there to flip on the switch!

How does your hypothalamus get fooled?  The reason is that as you gain weight, your aromatase levels increase dramatically and this extra aromatase converts your testosterone into estradiol, the “bad estrogen.”  This leads to ever-increasing levels of free estradiol to free testosterone and, when this ratio goes high enough, it shuts down the hypothalamus output as mentioned above. [4][5] And, again, as we’ll show below, the low testosterone levels will also make it MUCH more difficult to maintain one’s weight, creating a vicious circle of testosterone loss and weight gain.

It should be noted that this does not just apply to the morbidly obese.  One study of men with significant visceral fat showed that dropping about 35 pounds led to a 15 percent increase in free testosterone. [1] Other research showed that losing between 57 and 283 pounds produced even more significant changes in testosterone:  average total testosterone levels went 240 to 377 ng/dl, a sizeable 58% rise on average. Free testosterone also increased by 41%. [2] Again, the men who lost the most amount of weight probably doubled their testosterone levels.

This is why on the Peak Testosterone Forum I always try to ask men with low testosterone how overweight they are.  I am not trying to get personal, but feel that it is important to let them know that weight loss can very significantly boost their T in most cases.  And it will also lower estradiol which will very favorably alter their all-important testosterone-to-estradiol ratio.  I discuss this and other strategies in my page on How to Improve Your Testosterone-to-Estrogen (Estradiol) Ratio.

Have I seen this in real life?  One of our longest term posters reported:

“I have a friend who weighed 238 pounds, his testosterone fluctuated between 439-500 Ng/dl. Once he spent a few years reducing his weight to 170, changing his diet, exercising, getting hydrated, his testosterone went back up to the 750-800 ng/dl range.” [9]

If being overweight can make you hypogonadal and weight loss can double or more your testosterone (in some cases), then obviously you want to lose weight as rapidly as possible, right?  And you probably want to add in some intense exercise to accelerate the process even more, correct?  Wrong! That might seem logical, but nothing could be further from the truth  unless perhaps you are a man not on TRT (testosterone replacement therapy).

This was shown powerfully in a study that I documented in my page on A Protocol to Lose Weight Rapidly and Maintain Muscle. The participants in this study did something remarkable: they combined a wide variety of intense exercises with a 40% reduction in calories and lost 11 pounds and either maintained or even gained some muscle. This is not an easy thing to do and so I did a page on that.

However, one of the guys on the Peak Testosterone Forum read the fine print and noticed that the testosterone levels of the men in the study dropped from 507 to 126 ng/dl! That is an ugly fall in testosterone and left those men severely hypogonadal.

IV. Testosterone Therapy and Weight Loss

Okay, so we know that gaining weight can lower testosterone.  What about going the “other direction?”  If you add (external or exogenous) testosterone, will you lower body fat? It turns out that many studies say ‘yes’, especially if you are hypogonadal. Let’s check out a few examples:

1. Hypogonadal Males.  One study found that giving hypogonadal males testosterone enanthate, which is very similar to the cypionate that is used in the U.S., resulted in a loss of 13% subcutaneous fat. [6] Remember:  participants were not put on any type of an exercise program but rather just lost weight – somewhat miraculously – from the HRT itself.  Yes, that’s the Power of T!

2.  Middle-aged Obese Males. Giving HRT to middle-aged, obese males lowered visceral fat but not subcutaneous fat in study. [7] Visceral fat is “belly (or stomach) fat” and is deadly.  It is commonly associated with insulin resistance and MetS (Metabolic Syndrome).  Of course, obese males will very likely be low or lowish in testosterone and may even be hypogonadal.

Another study showed that weight loss (with testosterone undecanoate) may be more pronounced on the obese and found that “More than half of the men (53%) lost at least 33 lbs., and almost a third lost 44 lbs. or more weight. Similarly, 86% of the men had a least a 2-inch reduction in waist circumference and 46% dropped 6 inches or more.”  These are impressive numbers and what was really remarkable is that the men kept losing weight generally all the way through the five year point.  This is the opposite of what usually happens with dieting where the typical guys’ weight yo yo’s back and forth. [11]

3.  Prostate Cancer Patients. As you may know, prostate cancer patients are often given anti-androgen pharmaceuticals and in one study this lowered patient testosterone levels by almost 80%.  As might be expected, weight increased by 1.8% after 12 months and the percent fat mass increased by 11% after about 12 months.

4.  Steroid Users.  One study noted that lean body mass increased in a somewhat dose dependent manner with men on HRT gaining a little Lean Body Mass and those on steroids gaining still more.  As you know, steroid users go “supraphysiological,” i.e. beyond the typical max values experienced by a young male (~1200 ng/dl).  Thus, researchers could look at values even well beyond 1200 and see that HRT made a difference.  (Steroids can also shut off your testosterone completely if done incorrectly.)

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

If you look at the cases above, particularly #1 and #2, you see that testosterone works very well for the special cases where men are likely deficient in testosterone.  But what about in normal, health males?  Well, one study looked at this and found that, even though total testosterone was only increased by 30%, visceral fat accumulation was fought off in healthy senior males. [10] So testosterone therapy will likely improve outcomes for almost any man.

Now I do want to issue a caution here:  I have heard that some of the HRT clinics are putting out ridiculous ads where they claim that testosterone will melt the pounds off of you like lipo.  This is simply not the case.  The studies (overall) show that testosterone therapy results in mild weight loss and is an aid in management of the same.  The big guns are always diet and exercise and, I would argue, sleep.

What about your erectile strength?  Can weight loss improve that as well?  Of course, anything that boosts your testosterone and testosterone-to-estradiol ratio is likely to help improve your bedroom performance.  But weight loss goes way beyond just improving your hormones.  For every pound lost, you drop a point in cholesterol for example.

A similar drop in C-Reactive protein – a standard measure whole body inflammation – occurs with each pound lost as well.  This drop in inflammation is very important, because “circulating CRP levels were significantly higher in obese men with erectile dysfunction as compared with obese men without erectile dysfunction.” [8] Arterial inflammation can lead to endothelial dysfunction and arteriosclerosis, both of which can lead to erection problems in the short and long term, respectively.  For more information see my page on Weight Loss and Erectile Dysfunction.

REFERENCES:

1) Total testosterone was improved as well.) [Diabetes, Obesity and Metabolism, May 2004, 6(3):208 215, “Changes in sex hormone-binding globulin and testosterone during weight loss and weight maintenance in abdominally obese men with the metabolic syndrome”

2) The Journal of Clinical Endocrinology & Metabolism, May 1 1988, 66(5):1019-1023, “Effect of Massive Weight Loss on Hypothalamic Pituitary-Gonadal Function in Obese Men”

3) The Journal of Clinical Endocrinology & Metabolism, Dec 1 1977, 45(6):1211-1219, “Low Serum Testosterone and Sex-Hormone-Binding-Globulin in Massively Obese Men”

4) Medical Hypotheses, April 1998, 50(4):331-333, “The role of estradiol in the maintenance of secondary hypogonadism in males in erectile dysfunction”][International Journal of Impotence Research, 2003, 15:38 43, “Oestrogen-mediated hormonal imbalance precipitates erectile dysfunction”

5) Med Hypotheses, 1998 Apr, 50(4):331-3, “The role of estradiol in the maintenance of secondary hypogonadism in males in erectile dysfunction”

6) Journal of Clirncal Endocrinology and Metabolism, 81(12), “Increase in Bone Density and Lean Body Mass during Testosterone Administration in Men with Acquired Hypogonadism”

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

8) Journal of Endocrinological Investigation, 2004, 27(7):665-669, “Erectile dysfunction associates with endothelial dysfunction and raised proinflammatory cytokine levels in obese men”

9) https://www.peaktestosterone.com/forum/index.php?topic=401.30

10) The Journal of Clinical Endocrinology & Metabolism January 1, 2008 vol. 93 no. 1 139-146, “Testosterone Therapy Prevents Gain in Visceral Adipose Tissue and Loss of Skeletal Muscle in Nonobese Aging M”

11) https://www.worldhealth.net/news/testosterone-therapy-helps-trim-mens-waistlines/

Salt and Erectile Dysfunction - Peak Testosterone

Can salt cause erectile dysfunction?  Today there is no study that has actually looked at this.  However, such a study is likely to come out soon and below I give you reason after reason that salt is going to be hard on erections, both in the short term and in the long.  Salt raises many of the key risk factors for erectile dysfunction and so it’s just a matter a time before the researchers find that sodium actually plays dirty and punches below the belt.

Salt is abundant in almost all packaged and processed foods, making it very difficult to avoid.  Most of us have grown up addicted to heavy sodium content in our diet and food seems dull and uninteresting without it.  Most of us have become salt addicts and, as I’ll show below, that will likely prove to be deadly to your sex life.

1)  Am J Hypertens, 2001 Feb, 14(2):155-63, “Effect of salt loading on nitric oxide synthase expression in normotensive rats”

2) American J of Physiology: Heart and Circulatory Physiology, Published online before print March 2002, “High-salt diet depresses acetylcholine reactivity proximal to NOS activation in cerebral arteries”

3) Neuroscience, 2001, 103(2):351-63, “Dahl salt-sensitive and salt-resistant rats: examination of learning and memory performance, blood pressure, and the expression of central nicotinic acetylcholine receptors”

1.  Nitric Oxide.  Salt is yet another of what I call an “anti-Viagra.”  By that I mean a food or substance that does the opposite of Viagra and lowers endothelial nitric oxide.  Salt is just such a player and is the last thing you want to allow into your bedroom.

Many men believe that salt raises blood pressure by pulling water into the vessels and arteries.  This is a partial explanation at best. The truth is that, according to several animal studies, if you have enough salt, it actually makes NOS (nitric oxide synthase) “less active”. [1] NOS is the very enzyme that Viagra works on to allow nitric oxide to persist in your blood stream longer, which in turn relaxes your arteries and allow more blood to flow into your penis.

Significant salt will do the opposite, constrict your arteries and can lead to hypertension.  This is why, as I cover in my link on Erections and High Blood Pressure, that hypertension is a risk for erectile dysfunction.

NOTE: Acetylcholine is known as the “memory neurotransmitter.”  Anything that hammers acetylcholine is likely to be hard on mental performance. This may be why several studies link salt to decreased cognitive function. [3]

3. Inflammation and Hardening of the Arteries.  I covered this in my link on Deadly Salt: salt boosts both arterial inflammation and arterial stiffness.  Neither of these are going to help you in the bedroom and will, over time, lead to loss of erectile strength. Think of this way:  inflammation leads to damge on the delicate inside of the arteries where nitric oxide is produced.  And hardening of arteries damages the entire artery!

ONE FINAL NOTE:  watch out when you eat out.  One of the quick and dirty ways to make any food taste better is to add a lot of salt and most restaurants do it without conscience.  In fact, this is absolutely necessary to keep a salt-addicted public happy and paying customers returning to the tables.  If you eat out, you’ll almost for sure end up with too much salt in your diet and that could set you up for long term erectile dysfunction.

REFERENCES:

The Sane Way to Put on Muscle - Peak Testosterone

REFERENCES:

1) https://www.benbest.com/calories/Meth.html

2) https://www.bbc.com/news/health-19112549

3) Bioscience Horizons, 2010, 3(2):197-212, “A scientific review of the reported effects of vegan nutrition on the occurrence and prevalence of cancer and cardiovascular disease”

4) https://www.vegan-nutritionista.com/tony-gonzalez-vegan.html

5) https://www.veganhealth.org/articles/cancer

6) Cancer Epidemiol Biomarkers Prev, 2013 Feb, 22(2):286-94, “Vegetarian diets and the incidence of cancer in a low-risk population”

7) Eur J Endocrinol, 2011 Feb, 164(2):223-9, “Prediction of incident diabetes mellitus by baseline IGF1 levels”

Animal proteins have certain advantages, especially for the younger men out there.  And supplement manufacturers and bodybuilding magazines push egg, whey and casein proteins very heavily for reasons that are well-known and well-understood by most men interested in athletics and/or bodybuilding.  In this article I want to go into the reasons that a man might want to actually to back off of animal protein and instead lean more heavily on plant based proteins.

Below are  Five Reasons to Consume Plant Based Proteins:

1.  Potential Anti-Aging. Animal proteins are stimulatory and the primary reason is that they are heavy in the sulfur-based amino acid methionine. Methionine basically triggers an extra release of IGF-1, which stands for Insulin-Like Growth Factor.  It ain’t called “growth factor” for nothing and basically prods the body into cell turnover and production.  When you are young, you want lots of growth factors in order to maximize one’s size and development.  Past the age of about 35, this is no longer needed and IGF-1 can cause growth in things like cancer nodules and tumors. Plus, as its name implies, IGF-1 also mimics insulin – and can even bind to insulin receptors.  Because of this, elevated IGF-1 levels are associated with an increased risk of developing adult onset diabetes. [7]

As you can see, much of the chronic disease has its roots in an increased production and overstimulation of IGF-1.  Verifying this is a significant body of research evidence that shows that lowering IGF-1 is one of the more significant anti-aging strategies. (You don’t want to go too low with IGF-1 though!)  Trying to summarize all the research in this area would be a huge task, but let me give you some teaser facts on the subject:

a) Caloric Restriction is the only legitimate life-extending strategy to date.  Researchers have estimated that approximately half of its benefit comes from lowered IGF-1 levels. [1]

b) Lower IGF-1 levels are associated with decreased risk for developing prediabetes, diabetes and many types of cancer as mentioned above.  Look at what one study author wrote about the cancer connection for example:

“While this may appear disadvantageous to vegans, a correlation is hypothesized between protein quality, insulin-like growth factor 1 (IGF-1) and increased incidence in prostate and breast cancer. IGF-1 (a somatomedin hormone) has a well-documented role in stimulation of prolific neoplastic cell growth. One study reviewing correlations between varying cancers and IGF-1 found consistently high RR [Relative Risk] ascribed to colorectal cancer, premenopausal breast cancer and late stage colorectal cancer.” [3]

c) Lower IGF-1 levels actually switch on repair genes that are responsible for powerful life-preserving and extending effects.  This appears to be one of the keys to Intermittent Fasting, which many of you have undoubtedly read about. [2]

2. Cancer Protection. If plant proteins and plant-based eating in general really protects against cancer, then one would expect vegans to have the best cancer rates.  The reason I say that is that vegetarians generally eat a lot of plants but they also consume a lot of animal protein as well in the form of dairy and/or eggs.  Both eggs and dairy can stimulate IGF-1 particularly well.  Only vegans uniquely consume both a lot of plants and exclusively plant proteins.  Is there any evidence that veganism actually protects against cancer?

a)  A vegan diet, due to its generally lower methionine content, has been shown, as expected, to lower IGF-1 levels. [3]

b) There are only 3 studies that I know of that have look veganism and compared them to meat eaters, vegetarians or the general population.  The results seem compelling in my opinion:

–Vegans had a 19% lower overall cancer rate than the general population in the EPIC Oxford Study and significantly lower than vegetarians as well. [5]

–Vegans had a 15% lower overall cancer rate than the general population in both Adventist Health Studies and significantly lower than vegetarians as well. [5][6]

Now if you eat too much of any protein, it will likely raise IGF-1, so keep that in mind.  I take some supplemental plant protein for muscle building and so this likely raises my IGF-1 a little, but not nearly as much as if I was consuming exclusively animal protein.

3. Unstoppable Gains. Many guys coming to this site are interested in gaining muscle for health, athletic and/or bedroom purposes. What’s the only thing that can stop them from gaining muscle, assuming they have a decent diet, workout plan and hormone levels?  Things like cancer – Metabolic Syndrome – diabetes.  That’s right – these chronic diseases are what will take them out of the gym and into the doc’s office or emergency room.  Of course, plant proteins and a plant-based diet in general can give you the best odds possible in my opinion to keep you exercising and building muscle year after year and decade after decade.

NOTE: You may also need to reverse arterial plaque.  Well, the following two Plaque Reversers as I call them, are either entirely or largely plant-based.  See my reviews of Heal Your Heart by Dr. Gould and Prevent and Reverse Heart Disease by Dr. Esselstyn for examples.

If you stop and think about it, it you put on just 1 pound of muscle for a decade, that’s 120 pounds of muscle!  Well, that’s not too likely to happen obviously, but my point is that the steady accumulation of muscle can lead to a massive  physique over the years and you don’t have to risk life and limb.

I am 54, working lots of extra hours per week with 3 kids and a day job – you know the story since yours is probably similar – and  I have put on muscle steadily since going to plant based proteins.  (I do consume a BPA-free can of sardines almost every day, so I’m not completely vegan.)

The way that I do it is that I take four supplemental proteins every day:  a) BPA-free sardines, b) excitotoxin-free rice protein, c) excitotoxin-free hemp protein and d) nutritional yeast. I get about 25 grams of protein from each, so that is about 100 grams of protein every day.  In addition, I get about 40 grams of protein from other plant-based sources, bringing my total up to about 140 grams/day.  (About 82% of my protein is plant and 18% animal.)

Now I currently weigh 75 kg (165 lb), so that is 1.87 g/kg.  Some of you fellow gym rats may be thinking that a) I am not consuming enough protein, i.e. a gram per pound and b) I am being foolish because my protein quality is low.  Let me address each of those:

a) The 1 gram per pound is a complete myth.  The actual NASM guidlelines are 1.2-1.7 g/kg for strength and weigh training.  Clearly I am well above that.

b) While it is true that my protein quality is singificantly lower, it is probably only about 25% lower.  If we multiply .75*1.87 g/kg, we would still get 1.40 g/kg which is right in the middle of the above range.  Again, I have found this to be plenty of protein for muscle gains and I realized that I had been consuming WAY too much protein over the years.

4. HRT Protection. I had a high PSA read and the HRT clinic I was going at the time immediately dropped me took me off of testosterone.  You can read my story on my page High PSA But No Cancer. Of course,  the concern was the possibility of prostate cancer. It turns out that almost for sure I did not have prostate cancer, but it was a sobering experience for me. I realized just how fragile my HRT really was and that I had to focus on cancer as well. Being a family man, I knew what I had to do and went on plant proteins immediately as I described above. (I have seen added the BPA-free sardines for the extra omega-3’s.)

5. Incresaed Energy, Endurance and Alertness. This is one benefit of plant-based eating and plant-based proteins that I cannot prove but have personally experienced.  Anecdotally, many people on vegan diets – or those who are darn close like myself – love the increased energy that they experince.  Look at whatTony Gonzalez, the NFL player who went vegan for awhile, wrote:

“Now he talks about how much faster he recovers from game day, and how his energy has sky-rocketed. “It’s unbelievable how good I feel,” Gonzalez said. “Seriously, my recovery is so much better than it’s ever been, and my endurance is tremendous. The best part is that during games I really don’t get tired. I have more focus, too. I’m even staying awake in meetings.” [4]

He did eventually go off of veganism, because he wanted maximum muscle growth. Since I am not in the NFL, I love it and enjoy putting on muscle AND a nice boost in energy.

Fish Safely and Avoid Methylmercury - Peak Testosterone

We all know that fish is one of the superfoods, packed with protein for muscle building and those all-important omega-3’s that help with mood, inflammation, heart disease, the brain and potentially free testosterone.  However, it is rare to find an expert who advocates eating fish on a consistent basis.  In fact, the great majority would caution against fish consumption more than once or twice per week. (Read my link on Fish and Fish Oil for more details.)

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.

The reluctance to recommend even moderate food consumption is with good reason:  methylmercury.  For example, one famous actress, Daphne Zuniga, ate sushi four time per week and found herself with mercury poisoning and the ensuing “weak memory, headaches, crying spells, skin rashes and low grade depression”. [3]  Furthermore, the New York Times recently ran a piece that explained how badly contaminated Manhattin sushi was.  Their findings were that “at most of [the restaurants], a regular diet of six pieces a week would exceed the levels considered acceptable by the Environmental Protection Agency. Sushi from 5 of the 20 places had mercury levels so high that the Food and Drug Administration could take legal action to remove the fish from the market”. [5]

CAUTION:  Kids can get dangerous levels of mercury from eating the wrong kind of mercury. Canned (albacore) tuna is a large fish that accumulates about three times the level of mercury as the canned light variety. [4]   The brains of children are particularly vulnerable to mercury and experts believe that even relatively small amounts of mercury can

Rest assured, it’s not just sushi that has high levels of mercury:  many varieties of fish have been affected.  Freshwater fish in the U.S., for example, have been found to be loaded with mercury and PCB’s and dioxin as well. Ocean going fish are often no better, especially shark, swordfish and king mackeral. [1]

The problem is unlikely to go away anytime soon as the methylmercury comes from the emissions of coal fired plants throughout the globe.  Fortunately, most of us can detoxify mercury in about a month or a little more, but what is frightening is that a significant block of us carry a gene that retains mercury for about six months, making its impact much more profound and long lasting.

One Discover reporter had his mercury levels measure at 4 ug/l, a little below the level, 5.8 ug/l, considered the safe threshhold by most experts.  However, when he ate fish, his blood mercury levels spiked to 12 and 13 ug/l, a very dangerous level. [6] As expected, he found that he had the negative gene that affected glutathione activity, glutathione being the body’s natural antioxidant that detoxes mercury and many other dangerous chemicals and

By the way, some would argue that the risk of fish consumption is grossly overstated.  After all, a huge percentage of people in Japan eat a boatload of fish and have very high tissue mercury levels and yet have shown no ill effects. [2]  Again, though, I would argue better safe than sorry as there is no compelling reason to consume fish more than once per week, considering that there are excellent brands of fish oil out there.

Another option is to eat the five varieties of fish recommended by the EPA as relatively low in mercury:  canned light tuna, salmon, pollock and catfish. [7] However, caution should be exercised in the case of farm raised catfish as they have significant levels of inflammatory agents according to Chilton’s book Inflammation Nation.

REFERENCES:

1) https://calorielab.com/news/2005/10/20/fish-health-benefits-outweigh-minor-mercury-risk/

2) https://calorielab.com/news/2005/08/19/is-mercury-in-fish-really-a-problem/

3) https://en.wikipedia.org/wiki/Daphne_Zuniga

4) https://www.edf.org/article.cfm?contentID=7682

5) https://www.nytimes.com/2008/01/23/dining/23sushi.html?_r=1

6) https://discovermagazine.com/2009/apr/19-how-to-tell-if-you.re-poisoning-yourself-with-fish

7) https://www.epa.gov/fishadvisories/advice/

Hypothyroidism Correction and Potential Doubling of Testosterone

STEP 3. Many men start yawning almost immediately when you bring up anything to do with the thyroid, but that really should not be the case. The thyroid is somewhat like the floor pedals (accelerator/brake) on your car, since the thyroid either slows down or speeds up hormones and metabolism. For example, low thyroid function (hypothyroidism) is associated with lower testosterone and elevated thyrooid function (hyperthyroidism) with increased testosterone.

Now on this page I am going to concentrate on hypothyroidism for the simple reason that the symptoms are so common on the Peak Testosterone Forum. A very high percentage of men coming to the forum have the classic symptoms of low thyroid function such as fatigue, poor libido, depression and erectile dysfunction. (For more information on the latter, see my link on Erectile Dysfunction and the Thyroid.) From my perspective, it is almost an epidemic and I want to cover some of the basics below.

However, let’s start by looking at the evidence that hypothyroidism actually lowers testosterone:

1.  Decreased LH (Leutinizing Hormone). Researchers have found that hypothyroid men have a “subnormal response of luteinizing hormone (LH) to gonadotropin-releasing hormone (GnRH) administration.” [1] Of course, GnRH is produced by the hypothalamus, which then triggers LH.  LH, in turn, stimulates the testes to produce testosterone.  This means that hypothyrodism sabotages the first step in the testosterone production assembly line.

2. Decreased Free Testosterone Levels.  The same study and others have noted that hypothyroid men tend to have lower free testosterone concentrations. [1][2]

3.  Treating Hypothyroidism Often Increases Testosterone. A further sign of hypothyroidism’s causal effect on low testosterone is the fact that treating men with thyroid medications can actually boost their testosterone back to normal. [1][2] One study found that giving hypothryroid hypogonadal men thyroxine (T4) almost doubled their free testosterone levels! [3]

4.  More Than Doubling Total Testosterone. Normally one will not get a huge boost in testosterone from fixing his hypothyroidism.  However, huge gains are possible as evidence by a case study of one man with both severe hypothyroidism and hypogonadism. [4] This individual was able to increase his total testosterone by 150% just my standard thyroid treatment.  His testosterone was still pretty low – in the low 400’s – but it was an impressive gain nonetheless.

It is no different with hypothyroidism.  Again, from what I have seen, endocrinologists are very reluctant to treat men (and women) for hypothyroidism as well.  Not all endocrinologists (and PCPs) are like this, but certainly a significant percentage.  What has emerged from the discontent over this are alternative health protocols based on treating subclinical hypothyroidism.

What is subclinical hypothyroidism? Basically, it refers to low thyroid function that responds to treatment even though it is technically not clinical hypothyroidsim by the “old school” definition.  Many practitioners – “new school” endocrinologists, naturopaths, anti-aging doctors, etc. – have broadened their protocols for hypothyroidism and we will discuss how they do some of this monitoring and testing below.

  Let’s look at some of the ways that are currently being used to find low thyroid function that are “out of the box”:

1.  TSH Between 3 and 5. TSH is the signaling hormone released from the pituitary that signals the thyroid to start producing more thyroid hormones.  In some kinds of hypothyroidism (and in a manner analagous to rising LH in primary hypogonadism), TSH begins to rise.  The old school definition was a TSH > 5.0 to define hypothyroidism.  However, a recent study showed that this should be revised down to 3.0.  (From what I have read, the “ideal” TSH is roughly between 1 and 2.)  On a practical level, this means that many patients with a TSH between 3 and 5 would receive treatment from a different physician who was using the more recent, updated number.  For a more detailed explanation, see this article.

2.  Thyroid Antibodies. What many men do not know is that the most common form of hypothyroidism actually is autoimmune in nature and is called Hashimoto’s Thyroiditis. Basically, the body’s own immune system attacks the thyroid and slowly destroys it over the years. This can usually be identified by a couple of simple thyroid antibody tests. The two most critical tests are Thyroid Peroxidase Antibodies (TPOAb) Thyroglobulin Antibodies (TgAb). For thresholds see this Medscape article.

3.  Elevated rT3 (Reverse T3). Most men know that the two primary thyroid hormones are T4 and T3. TSH actually triggers the production of these in the thyroid at a ratio of 17::1, i.e. 17 T4 molecules for every one T3 molecule. A significant amount of T4, however, is converted into T3 in various body tissues. And, to further complicate matters, the liver converts about 20% of your T4 into something called Reverse T3 (rT3).  rT3 is part of the body’s feedback mechanism, but in some people it becomes elevated.  And, as its name implies, rT3 reverses normal thyroid function, i.e. can make you hypothyroid.  Again, someone with fairly normal TSH numbers but high rT3 can experience hypothyroid symptoms. Fortunately, you can test rT3 and see if this a problem for you.

4.  Free T3 and Free T4. The thyroid hormones are similar to testosterone and estradiol in the sense that they have a bound and unbound form.  If you have low or lowish free T3 and/or free T4 values, this can indicate hypothyroidism. And it makes sense as it is showing a low output of hormones from the thyroid.

There are other tests as well, but these have been quite common on The Peak Testosterone Forum and seem to be in wide use. In my opinion, this is a good thing and I am sure many men have been helped by it.

Just as in the case with low testosterone, there are a number of approaches that have been used to overcome hypothyroid issues. Here are a few of them:

1. Go Natural. Instead of just running off and taking thyroid medication, you may want to consider the fact that in some cases low thyroid issues can be reversed by relatively simple lifestyle changes alone. This may be part of these reason that “going natural” can sometimes increase testosterone levels and improve erectile function. Here are a few examples:

–Lower Stress.  Excess cortisol actually inhibits the conversion of T4 to T3, and result in smaller amounts of T3 and larger amounts of rT3. In other words, stress and the elevated cortisol levels that often accompany it can literally turn you hypothryoid. Instead of going on thyroid hormones, why not eliminate the stress? I have many suggestions that I discuss in my Summary Page on Stress and Cortisol.

–Dieting. If you cut your calores too much, you can make yourself hypothyroid. Your body compensates for the loss of calories by dropping T3 output, something I discuss in my link on Why Crash Dieting Just Does Not Work. So, if you’re cutting calories and are hypothyroid, it may be that you will normalize after you restore baseline calorie levels. Discuss with your physician.

–The Two I’s: Inflammation and Infection.  As mentioned, Hashimoto’s is definitely an autoimmune disease which is usually a result of elevated inflammation levels. And, as discussed in this article, inflammation can also induce hypothyroidism in other key ways as well. The bottom line is that I think it would be prudent to check your CRP (C-Reactive Protein) levels and make sure they are less than 1.0 along with any other key markers. For more information on the subject, see my link on Natural Ways to Lower Inflammation. Keep in mind that latent infections can raise inflammation, including things like gum disease and Super Bugs. So get a thorough checkup and keep digging.

2. T4 Only or T3 Only or Both. One thing that will you notice with thyroid medications is that “it is more art than science.” Basically, some patients do well on T4 only. Some do well on T3 only. And some do well on both. It sometimes takes some experimentation.

3. Dessicated Thyroid. Some patients do much beter with “dessicated thyroid” products which are basically dried pork and beef thyroids. These will have a combination of T3, T4 and rT3 along with a couple of other thyroid hormones. This wide range of hormones is considered by some to be more “natura” and probably accounts for the reason that dessicated thyroid works well in some patients and poorly in still others.

REFERENCES:

1) Thyroid, 2004, 14 Suppl 1:S17-25, “The interrelationships between thyroid dysfunction and hypogonadism in men and boys”

2) Horm Res, 1990, 34:215 218, “Reproductive Endocrine Functions in Men with Primary Hypothyroidism: Effect of Thyroxine Replacement”

3) Clinical Endocrinology, Feb 2000, 52(2):197 201, “Testicular dysfunction in men with primary hypothyroidism; reversal of hypogonadotrophic hypogonadism with replacement thyroxine”

4) Cleveland Clinic Journal of Medicine October 2012 vol. 79 10 717-725, “Male hypogonadism: More than just a low testosterone”

STEP 2:  TESTOSTERONE and HYPOTHYROIDISM

a) Assess Your Symptoms.  Start by taking a quick look at these symptoms.  Do any of them apply to you?

Of course, these symptoms can have many other root causes.  However, when you see that you have several of them, it could point to hypothyroidism.  Also, notice that there are some symptoms that overlap with hypogonadism (low testosterone) and this can undoubtedly be partially explained by the fact that hypothyroidism can cause low testosterone as mentioned above.

So how do you determine if you have low thyroid function?  Well, this is where it gets interesting.  At least here in the U.S., endocrinologists are more often than not extraordinarily conservative.  As an example, they are the most reluctant to treat men for low testosterone.  They do this by creating a very rigid definition of what constitues hypogonadism based on a very low testosterone threshold.

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

Testing for Subclinical HypothyroidismHypothyroid Solutions

Triglycerides: How to decrease Them Naturally.

Ready to control and/or reverse arterial plaque? I hope that is the case, because doing so will greatly improve your cardiovascular health and erectile strength.  As those arteries, arterioloes and capillaries begin to fill up with plaque and the entire body and brain calicifes, it gets ugly very fast.  Some of the lesser known issues showing up in the research related to atherosclerosis are Alzheimer’s and Parkinson’s, which appear to be partially related to the calcification of the brain.

Research by Dr. Gould has shown us that there are two primary factors leading to the buildup of arterial plaque:  [1]

a) Fasting cholesterol levels. These are the lipid numbers that you typically pull when get them pulled first thing in the morning after fasting for 12 hours.

b) The Post-Meal Lipid Surge.  This is basically the sudden increase in triglycerides and cholesterol that occur after you eat.

Now I have already covered ways to naturally lower your fasting cholesterol in my page on How to Lower LDL Naturally (Without Statins), so you can read that if you are interested. On this page I will discuss ways to clean up the other side of the house, i.e. quenching baseline and  post-meal triglycerides.  Realize that triglycerides are most related to refined carbs.  Wheat, white rice and many processed foods are notorious for increasing triglycerides.

Researchers found the most natural way to lower the triglyceride portion of the lipid wave that occurs after eating (besides avoiding refined carbs of course) is post-meal low intensity exercise.  A recent study found that if you simply walked for a short period of time after a meal – details are below – that triglycerides dropped from 172 to 131 mg/dl!  That’s a huge 24% drop just by doing a very simple activity. [3]  And this solution is rather obvious if you stop and think about it:   the typical day of those in our ancestral past included lots of low intensity exericse, the majority of which was walking.  This is the foundation that our physiologies were built on.  In fact, I would make the argument that the supplements that we use to pull down triglycerides are simply crutches to hide our unnaturally sedentary lifestyles.

Now keep in mind that these participants were put on a high fat diet to skew their lipid results, so if you have lower triglyceride levels, you will probably not get that big of a drop.  However, even if your triglyceride levels are significantly lower, you still need to shave off that surging wave of lipids coursing through your arteries after you eat.

How to Decrease the Post-Meal Triclyceride Surge

a) Exercise was 1 hour after the meal.

b) Walk at low intensity, which is definied as brisk walking.  Low intensity does not mean slow walking by the way:  you need to keep up a decent pace to meet this requirement.

c) Walk for 2 km = 1.24 miles, which is about 16-19 minutes for most of us

What is more simple than walking or doing about 15 minutes of exercise 2 or 3 times per day, ideally about an hour after eating?  Furthermore, I am sure that you do not have to go walking.  You can run into a room and do a treadmill / stationary bike, or work out with some dumbells or resistance bands.  The point is that you just need to fire up your metabolism and utilitize your muscles for a short period of time.<

The rewards for doing this are huge:  arteries that are clean and clear of plaque.  (You also need a proper diet of course!) And you get another huge benefit:  restored endothelial function.  Endothelial function is a scientific way of saying that your blood vessels and arteries can relax and increase blood flow.  This is absolutely critical for erectile function and heart health.

Here is what this study on endothelial actually found:

Again, you’ve got to get up and move!  It doesn’t matter than much how or why – just that you do it.

How to Decrease BaselineTriclycerides via Diet and Exercise

Another way to indirectly help the post-meal triglyceride is via lowering your baseline triglyceride levels.  In other words, if you have a post-meal surge, at least you are starting from a lower point. Here are some natural ways to pull that off:

1. Lose Weight.  Weight loss resutls in a reduction of baseline triglyceride levels, as well as a lowering baseline cholesterol levels.  The rule on the latter is about a point reduction for each pound of weight lost. [5]

2. Exercise (60 min).  One study showed ~20% reductions in baseline triglycerides for those doing a kind of cross training (weight + endurance exercse) or just endurance alone. [6] The participants in this study were sedentary adults, so, obviously, a more healthy individual will probably not experience as large of a reduction.  But the point is that you can very significantly reduce triglycerides using longer term exercise:  the endurance portion was 60 minutes at a low medium intensity.  However, participants only did this three times per week.  (I would recommend an hour per day of moderate exercise however.)

Also, this study seemed to indicate that it was endurance training that was responsible for most of the decrease in triglycerides.  However, another study on sedentary adults showed similar drops in those who were only using weight training. [7] Again, the point is to exercise for probably somewhere around an hour at least three times per week (with overtraining)

3. Drop the High Glycemic Carbs.  Many men think that all carbs raise triglycerides.  As metnioned above, the truth is that it is only refined carbs, such as wheat, white rice, etc., that significantly raise triglyceride levels.  Low glycemic carbohdrates, such as beans, lentils, vegetables, etc., have a marginal impact.  Therefore, there is no reason not to eat good carbs, but every reason to be cautious about processed foods.

4. Flaxseed.  Reportedly flaxseed can produce a nice drop in triglycerides.  Animal studies certainly back this up. [9]

.

Other Ways to Decrease Triclycerides with Supplements levels.

i) Niacin. A common methodology – and one of the pillars’s of Dr. Davis’ methodology – is megadosed Niacin.  This is best done under a physicians supervision as liver function shoud be tested and side effects evaluated.  It results are impressive:  a solid lowering of triglycerides and increase in HDL. Long term effects are unknown.

ii) Pantethine (Downstream of Vitamin B5).  900 mg is usually taken and this supplement has the remarkable ability to raise HDL, lower triglcyerides and lower LDL:  it does everything one could hope for.  However, this also appears to be using non-physiological dosages.  The adult male RDA for pantothenic acid, which is the standard form of Vitamin B5, is just 5 mg and pantethine is downstream of it.  Although pantethine is composed of two molecules of pantothenic aicd and a cysteamine molecule, i.e. is a heavier molecule, and thus 900 mg is still undoubtedly a non-physiological dose. However, it has been used in Japan and Europe as a choesterol-lowering medication actually and so it does have some history of safety. [2].  From what I understand, side effects are virtually non-existent.  However, long term effects are unknown.

iii) Fish Oil.  Fish oil can lower triglycerides by up to 30% in diabetics and by a significant amount in prediabetics, which includes a high percentage of men reading this. [8]

CAUTION:  If you have any medical conditions or are on any medications, discuss with your physician first.

REFERENCES:

1)  Heal Your Heart, Dr. K. Lance Gould, p. 59.

2) https://lpi.oregonstate.edu/mic/vitamins/pantothenic-acid#ref14

3) Med Sci Sports Exerc, 2013 Feb, 45(2):245-52, “Combined light exercise after meal intake suppresses postprandial serum triglyceride.

4) https://news.indiana.edu/releases/iu/2014/09/slow-walking-sitting-study.shtml

5) Metabolism, Feb 1997, 46(2):217 223, “Effect of prolonged exercise training without weight loss on high-density lipoprotein metabolism in overweight men”

6) Medicine & Science in Sports & Exercise, Sep 1997, 29(9):1170-1175, “Effects of cross-training on markers of insulin resistance/hyperinsulinemia”

7) JAMA, 1984, 252:504-506, “Changes in Lipid and Lipoprotein Levels After Weight Training”

8) Diabetes Care, Apr 98, 21, “Fish Oil and Glycemic Control in Diabetes: A meta-analysis”

9) The Journal of Nutritional Biochemistry, Nov 2002, 13(11):684 689, “Differential effects of dietary flaxseed protein and soy protein on plasma triglyceride and uric acid levels in animal models”

HDL, LDL and Triglycerides: Clean Plaque to Boost Nitric Oxide

Want more nitric oxide?  Well, what guy doesn’t!?!  And one of the most noble ways to do that for most guys over about the age of 30 is to reverse arterial plaque. If Mother Nature and Father Time could tell you one hot tip for the bedroom, I don’t doubt that it would be, “Get your arteries back!”  Clogged arteries restrict blood flow for many reasons: they narrow the passageway within the arteries and they quench the release of nitric oxide from the endothlium, the delicate lining of the arteries.

There are a few “lucky dogs” who seem to have good genetics and just don’t develop plaque.  But the great majority of us do not fall in this category and that is why as you enter your 50’s, 60’s and 70’s, you’ll see your friends dropping like flies.  So I would recommend managing your HDL, LDL and triclycerides right away.

2. Dr. Davis’ Rule of 60.  For God’s sake, don’t fall for the arteriosclerosis-doesn’t-matter argument. This is very common in Paleo and low carb circles.  Dr. William Davis just tears this silly thinking apart in his classic book on plaque reversal called Track Your Plaque.  He shows how rapidly atherosclerosis typically progresses and his excellent stats will definitely scare you straight.  This is more material to keep by your bedside.

Dr. Davis is so convinced of the importance of plaque reversal to that he developed his Rule of 60 where – at least according to one video I saw – he stated that 90-95% of men could reverse plaque if they achieved the following:

These numbers, of course, are even more strict that Dr. Gould’s and he typically achieves them from what I understand through some adjustments in the diet coupled with niacin, Vitamin D, fish oil and a few other supplements.  And the clear message of these two men is that

a) Men on low fat diets (like myself) cannot ignore their triglycerides and HDL readings.

b) Men on low carb and classic Paleo diets cannot ignore their LDL numbers.

None of us can be smug and patronizing.  We all have work to do.

CAUTION: If you follow these guidelines for HDL, LDL and triglycerides, are you guaranteed to reverse your plaque?  The clear answer from both Drs. Gould and Davis is that these are just the starting point. They give you good odds, but there are other cardiovascular that need to checked as well.  For the details, I urge you to read the page with Gould’s Guidelines above as well as their two books.  It’s really an involved subject and I urge you to learn about it as much as you can.

INFLAMMATION ONLY?  I cannot tell you the number of times on The Peak Testosterone Forum that someone has proposed the idea that plaque is “all inflammation.” In other word, lipid number, such as HDL, LDL and cholesterol, do not matter as long as your inflammation is under control. This is very risky thinking, in spite of the fact that inflammation does play a major role in atherosclerosis. And the reason is that no one has any targets for CRP, TNF alpha or any other inflammatory markers that I know of to reverse plaque.

As far as I know, no one is doing what Drs. Gould and Davis are doing by ignoring lipids and just focusing on inflammation. How are you going to know if your inflammation is low enough?  Besides, I think it is very unlikely that you can have triglycerides or LDL and expect your arteries to do well. To me this is naive and wishful thinking.  A much safer method is to stick to a time tested method and that means lasering in on lipids.

But, practically speaking, how do you that?  What strategy can you use with a reasonable assurance of success?  Well, as you might have guessed, a couple of the major clinicians actually reversing plaque in the field give us a good starting point:  targets for HDL, LDL and triglycerides. Their message is simple:  get all three of these in line if you want good odds in reversing atherosclerosis (or maintaing clean arteries if you are of the lucky few with no plaque).

What this means is that when you get your lipid panel from your doctor, he is going to say, “Yeah, yeah, that’s great – it all looks good.”  Docs generally do not want to mess with cholesterol and lipid numbers – it’s very time consuming and many patients are “religous” in their view and, to be frank, most non-cardiologists have little expertise anyway.  The bottom line is that you are probably going to have to be the one to manage the long term care of your precious arteries and below we show you the stance of a couple of the experts with practical field experience:

NOTE:  Keep in mind that there are several different alternative pathways to boost NO and I cover those in my link on How to Increase Your Nitric Oxide Naturally.

NOTE: See my link on Does a Low Fat Diet Have to Increase Triclycerides? The answer is no and I show that simply by eating low glycemic carbs, you can keep your triglycerides more than likely below 100 and have stellar LDL numbers, i.e. give yourself a good chance to reverse that nasty arterial plaque that has been lowering your nitric oxide levels!

1. Gould’s Guidelines.  Dr. Lance Gould is one of the foremost researchers reversing plaque on the planet.  He is still doing this in his Texas clinic and has written an excellent book called Heal Your Heart: How You Can Prevent or Reverse Heart Disease.  In addition, he has generously put on a white paper on reversing plaque for professionals and lay people serious about atherosclerosis.  Both of these are must reads and should be like a bible on your nightstand:  cardiovascular disease is the #1 killer of men and it leads to most erectile dysfunction as well.  This paper can help you to turn that around.  He goes into great detail as to what tests should be run, how you should eat and why he recommends what he recommends, so it’s a must read.

In any event, he has very rigorous requirements for those with existing heart disease and/or significant familial risk factors.  Check out his goals for HDL, LDL and triglycerides:

So how are you going to achieve numbers like this?  Well, to be honest, it wouldn’t be easy.  I have come close to these numbers with a low fat diet but my LDL was a little higher and my HDL a little lower as well.  How did I come close at least?  Here is what I did:

b) Many studies – and Dr. Gould lists these in his book by the way – show that men in their 20’s and 30’s already have substantial plaque in their arteries.  This is often why young guys start to notice those spontaneous erections disappearing.and some even having the start of E.D.

c) You can measure your plaque now with inexpensive testing that (in most states) does not even require a doctor’s orders. You should be able to get a Heart Scan or Calcium Score for between $50 and $100.  Alternatively, a company called Lifeline now offers CIMT’s, which basically measures the arterial plaque via ultrasound in your carotid artery for (the last time I checked) $70.  So before you assume you do not have plaque, test it!

CAUTION:  Dr. Davis recommends Heart Scans, because IMT’s only predict with 60-80% accuracy the plaque within cardiac arteries and cardiac arterial plaque is the most dangerous.  However, a Heart Scan does expose you to some radiation.  This is the tradeoff.

STUDY: Loss of Morning Erections Likely Due to Arterial Plaque.

One of the things that I constantly point out is that erections have everything to do with arterial plaque (atherosclerosis).  There are many lines of evidence for this, something I discuss in my page on Erectile Dysfunction and Arterial Plaque. Further evidence of this was shown in a study I just came across that used Cialis (tadalafil) to show some remarkable things about daytime erections, morning erections, nitric oxide and the role of atherosclerosis in each. The study involved was from 2005 and they took middle-aged and senior men with erectile dysfunction and compared them to younger men with psychogenic (psychological) erectile dysfunction for comparison purposes.

Why did they use men psychogenic erectile dysfunction as the control group?  The reason is that this group had nothing physically, if you will, with their ability to get an erection.  In other words, the plumbing was just fine at least, and one sign of this is the fact that men with psychogenic erectile dysfunction usually still have reasonable morning erections.  This is not necessarily the case generally with middle-aged and older men, who generally have a cardiovascular / arterial origin for their E.D.  The study authors decided to study a different aspect of this phenomenon and hypothesized that the loss of nighttime erections was primarily due to arterial plaque.

All men in the study were given 20 mg of Cialis, which is a huge dose, every other day.  Let’s look at some of the significant findings of this study and the conclusions that one might come to based on the results: [1]

1. No Arterial Plaque = Restoration of Morning Erections. The authors actually used a penile “cuff” if you will to monitor morning erections as the patients were sleeping.  What they found was that Cialis restored morning erections only in the men with no arterial plaque. Of course, the reason for this is that you “can’t squeeze blood out of a turnip.”  Basically, nitric oxide triggers (downstream) cGMP which relaxes the artery, including those feeding the penis and within the penis.  Cialis protects the degradation of this process and thus preserves this relaxing effect.  However, if there is not enough nitric oxide to go around, then there is nothing to preserve:  Cialis cannot do its job.  (I cover this in my page on Viagra Failure.)

2. No Arterial Plaque = Improvement in Daytime Erections.  The authors also gave a standard quesitonnaire to monitor improvement in erectile dysfunction, which of course has to do with the ability to have an erection during the waking hours. You can read about it on this page if you are interested:  IIEF Scores and Erectile Dysfunction.  What they found was that only the men with no arterial plaque had a significant improvement in their IIEF scores.

1)  European Urology, Aug 2005, 48(2):326 332, “Resumption of Spontaneous Erections in Selected Patients Affected by Erectile Dysfunction and Various Degrees of Carotid Wall Alteration: Role of Tadalafil”

3. Morning Erections Were Correlated with the Amount of Arterial Plaque. The authors stated that “NPTRM [nocturnal erectile strength] and P-CDU [doppler score] parameters were inversely related to different degrees of carotid wall alteration .” In other words, the more the plaque, the worse the nighttime erections.  Yes, plaque lowers your ability to produce nitric oxide, even with huge doses of Cialis!

CONCLUSION:  Why is arterial plaque so hard on the arteries and your ability to get an erection?  Caldwell Esselstyn, one of the Doctors Reversing Arterial Plaque, illustrates this nicely.  He points out that young, healthy men have 6-8 tennis courts of endothelial cells lining their arteries pumping out nitric oxide.  However, the typical senior man, due to the Western lifestyle, will have 1-2 tennis courts of endothelial cells.  This occurs because the Western lifestyle is so hard on the lining of the arteries that it literally destroys the endothelial tissue.  Of course, part of this process is the buildup of atherosclerotic plaques that are a root cause in  heart attacks, angina and stroke.

Step 2 is to beging regressing any plaque if you have any.  I have many pages discussing some of the important information surrounding this here:  Summary Page of Arterial Plaque Regression. You may want to start out with my page on How to Clear Your Arteries.

REFERENCES:

Morning Erections: Critical for the Erectile Strength

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

And that leads to this important question:

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

Below we give you few ideas:

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

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

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

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

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

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

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

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

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

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

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

REFERENCES:

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:

Endothelial Dysfunction - How to Get Your Nitric Oxide Back -

Blood flow. That’s what it’s all about for us guys. We need it for optimal brain function.  We need it for cardiovascular health and athletics.  And, most importantly some of us might argue, we need to for maximum bedroom performance. But it’s all dependent on our endothelium, that delicate lining of our arteries that pumps out nitric oxide.  Unfortunately, the endothelium is under attack by a Western lifestyle. Damage begins accumulating from a very young age due to inflammation, oxidation, skewed lipid profiles and toxins (especially smoking).

Most of us think of our arteries, including the ones in our penis, as a hose.  However, this is actually a poor analogy, because our arteries can expand (dilate) and contract (constrict).  When duilated, the arteries literally become wider and blood flow is increased.  This also drops blood pressure, because there is more space (or volume actually) for your heart to pump the blood.

So what controls endothelial function?  This is actually an involved subject, but there are three primary chemicals that can dilate/constrict your arteries:

1.  Nitric Oxide. Just about every male knows about this heavy hitter. Nitric oxide is what is increased (through action on an enzyme called NOS) by PDE5 Inhibitors such as Viagra and Cialis.

2.  Acetylcholine.  This is a less powerful, but nonetheless significant vasodilator. Interestingly enough, it is used in research labs to measure endothelial function.

3.  Noradrenaline (norepeniphrine).  This stress hormone will put the brakes on artery expansion and your erections. Some noradrenaline is actually a good thing and keeps you from destroying your penile tissues due to priapism, an erection that persists for hours.

These three are natural acclerators/decelerators of blood flow and endothelial function.  So what don’t they work in your middle-aged and senior years?  Why do so many 35+ men struggle with endothelial issues?

The problem lies with a modern  lifestyle that literally attacks the endothleium. This a very involved subject, but the Cliff Notes version is the following:

As you can imagine, every step in this process is hard on the delicate lining of the arteres, especially the inflammation, oxidation and plaque-raising stages.  All of these will tend to lower nitric oxide over time and decrease the flexibility of arteries to dilate.

Accelerating the process is the increased blood pressure that results from a decrease in nitric oxide and narrowing arteries due to arteriosclerosis.  See my link on 30+ Natural Ways to Lower High Blood Pressure for some additional information.

Measuring Endothelial Dysfunction

Can you measure endothelial function?  There are some excellent ways that are done in sophisticated research settings.  Unfortunately, for the Everyman like you and me, these are simply too expensive and, therefore, there is no perfect replacement methodology.  You can get a pretty idea, however, by using some of the less expensive, more available techniques listed below:

1) FMD (Flow Mediated Dilation). This is most common method used by doctors, but does have some potential inaccuracies associated with it and is expensive unless covered by insurance.

2) Nitric Oxide Test Strips.  Neogenis recently developed test strips that can quite accurately estimate your endothelial nitric oxide levels. The test strips seem to work quite well, but they do not give an actual numerical reading.  Instead, it is kind of “litmus” test where you have four color regions on a test strip that give you an idea of your NO. Of course, the big advantage is that they are relatively inexpensive and can be done in the privacy of your own home. For more information, see my link on Nitric Oxide Test Strips.

3) Blood Pressure. Blood pressure is not actually a direct measure of endothelial dysfunction. However, the two are definitely related. You can measure this at home with an inexpensive blood pressure monitor.  From what I have heard, it is important to get one that uses an arm band and not a wrist strap.  You also cannot trust the ones in big stores that are for public use with the unadjustable cuff. Again, arteries with endothelial dysfunction resulting from heavy plaque buildup and low nitric oxide levels will tend to have elevated blood pressure.  You want 120/80 or below.

4) IMT (Intima Media Thickness). This is actually a measure of arteriosclerosis. However, arterial plaque buildup and endothelial are definitely related. Arteriosclerosis is somewhat like A1C (glycated hemoglobin) in the sense that it is usually going to show the cumulative damage that has built up over the years. Lots of arterial plaque indicates lots of damage and hardened, stiffened arteries.

Natural Solutions for Endothelial Dysfunction

When you first realize you have endothelial dysfunction, it can be a “little bit scary” as my five year old would say.  What is very sobering is that you suddenly realize that you have years or even decades of heavy damage to your arteries. Suddenly, the whole picture seems hopeless.  The good news is that the body can remarkably recover and even heal itself as we will cover below.

CAUTION:  Talk to your doctor if you are on any heart or blood pressure medications before doing any of these. Some of these can alter absorption rates of certain medications for example.

Here are 10+ Ways to Get Back Your Endothelial Function:

1.  Nitrates. Foods that contain nitrates can boost your baseline nitric oxide. Beetroot juice, spinach, lettuce and any green leafy vegetable has ample nitrates to get your arteries moving again.

5.  Nitric Oxide Boosting Supplements. Most of the supplements that have studies behind them will boost nitric oxide through one pathway or another. There are lots of ideas here in my link on Erectile Supplements. (Always talk to your doctor first.)

3. Low Fat Diet. When it comes to beating endothelial dysfunction, it is hard to beat a Low Fat Diet. This diet, popularized by men such as Pritikin, Ornish and Esselstyn, has actually been shown to arrest and, according to some studies, even reverse arterial plaque buildup. It also boosts blood flow and lowers

4. William Davis Track Your Plaque. This cardiologist has a strategy to reduce plaque.  I don’t have personal experience with his approach, but he is well-known at this point and can be followed on the site “Track Your Plaque”.  You can also read my review of his book Wheat Belly here.

5.  Nitric Oxide Boosting Foods. I cover these in my book called The Peak Erectile Strength Diet.

6.  Exercise. There is a simple solution to boost your nitric oxide and improve blood flow and endthelial function avaialbe to virtually every man: walk, move and exercise throughout the day. Instead of a 30 minute, once per day workout, just walk every few hours. This is how our bodies were designed and how every superculture on planet earth lives. These walking or exercise sessions boost your nitric oxide for several hours afterward just like Mother Nature intended it.

7.  Pomegranate Juice. I cannot say enough good things about Pomegranate Juice. It can boost nitric oxide, lower blood pressure and one study even shows it clearing out arterial plaque. For more information, read my link on Pomegranate Juice.

8. Testosterone. Yes, testosterone builds muscle and raises libido, but it also does three things that can directly improve your endothelial function: a) boosts nitric oxide levels by acting on NOS, b) lowers inflammation and c) protects your arteries from arteriosclerosis. So, if you are low or lowish testosterone and boost your baseline T enough through either Testosterone Therapy or natural methods, it can definitely help the lining of your arteries in multiple ways. For more information, see my links on Testosterone and Inflammation and Natural Solutions for Hardening of the Arteries.

9. Mediterranean Diet. The Mediterrean Diet is protestosterone diet, based on fruit, vegetables, grains, wine and olive oil.  It has a nice benefit of being likely pro-testosterone in nature due to the 30-35% total fat levels and emphasis on monounsaturated fats. It has been shown in a number of studies – on men with elevated cholesterol or obese for example [1][2] – to improve flow mediated dilation.

10. Drop the Vices.  #1 through #9 are not going to work if you are significantly overweight, smoking, using (most) recreational drugs, drinking immoderately or prescribed to certain medications. (Do not go off of a medication without talking to your physician.) All of these are incredibly hard on the endothelium.

So get out of the cycle now and get your endothelium back. Remember: “Never Say Die!”

REFERENCES:

1) Am J Clin Nutr August 2009, 90(2):263-268, “Close adherence to a Mediterranean diet improves endothelial function in subjects with abdominal obesity”

2) Annals of Internal Medicine, 2001, 134(12):1115-1119, “Mediterranean and low-fat diets improve endothelial function in hypercholesterolemic men”

Cholesterol: Testosterone Therapy Lowers Both Cholesterol & LDL

UPDATE:  I also highly recommend that one read these important 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.

I am not going to get into the debate on cardiovascular risk on this page.  However, here I do want to show yet another risk factor for heart disease that testosterone alters positively in almost all of the studies that I have seen:  total cholesterol and LDL.  As I will show, most of the research shows HRT pushing both of these bad boys down.  Now I know that some of you are convinced that high cholesterol and LDL are actually good for you.  To that I can only point out that all the Plaque Reversers Require Low Levels of LDL and Total Cholesterol.

Here are the Key Lines of Evidence that Testosterone is Critical for Cholesterol Management:

1. Testosterone Undecanoate. One study looked at testosterone undecanoate, which is the injectible testosterone ester in Nebido and Aveed, and concluded that “there were parallel declines in plasma total cholesterol, LDL, and triglycerides, whereas plasma HDL showed a parallel rise. The magnitude of these changes was greater with TU than with T gel.” [1] Basically, it was everything a cardiologist could hope or dream for!  Notice that both the topical testosterone and the testosterone undecanoate exhibited these properties, but undecanoate was the winner.  Why is that?  The authors also point out that the testosterone undecanoate gave them higher testosterone levels, so one could argue that more testosterone resulted in greater cholesterol control.  Below we will show you another study that indicates this.

2. 2005 Research Review. One study looked over all the past studies and did its best to statistically aggregate the results.  The researchers found that, in general, testosterone therapy reduced total serum cholesterol, although they also concluded that it did not statistically change LDL. [3]  There are studies that have found no change in cholesterol. [4] However, these researchers tried to pool results and did not look at just one isolated study.  Now the fact that the above research review found no net decrease in LDL may sound rather damning.  However, check out the study in #3 before you come to any conclusions!

  Here is the Mescape summary as to what happened:

“They also examined whether testosterone affects the components of the metabolic syndrome. Testosterone treatment resulted in a gradual and consistent decline in total-cholesterol levels, which was significant as early as 12 months of therapy and reached a plateau at 24 months. At baseline, the mean total cholesterol was 7.3 mmol/L (282 mg/dL), and this was reduced to about 4.9 mmol/L (188 mg/dL) by 24 months of therapy, remaining low throughout the remaining period of therapy. Similarly, there were marked and significant gradual and consistent decreases in LDL-cholesterol levels, from 4.2 mmol/L (164 mg/dL) to 2.8 mmol/L (110 mg/dL), significant within the first year of treatment and at 24 months and stable thereafter over the course of the 5-year period.” [5]

These are huge drops in cholesterol and LDL if you’ll notice!  Furthermore, the researchers pointed out that the results just kept getting better and better. Even if we keep in mind that these men started with very high average cholesterol and pretty nasty lipid profiles, the results are impressive and point out that testosterone can do some very impressive health-promoting things if you give it time and, of course, provide the patient with a decent protocol.

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

CAUTION: High estradiol from overly aggressive TRT could potentially increase a proclivity toward clotting for men with an actual clotting disorder, something I discuss in my page on Some Potential Dangers with TRT Injections.  Some studies also show that TRT can lower the “good” cholesterol: see Testosterone and HDL for more information.  Hopefully, more study work will follow.

4.  Low Testosterone Leads to High Cholesterol! A literature review found that “Testosterone therapy has beneficial and deleterious effects on cardiovascular risk factors. It improves insulin sensitivity, central obesity, and lowers total cholesterol and LDL.” [2]  The authors went on to point out that “hypogonadism is associated with central obesity; insulin resistance; low levels of high-density lipoprotein (HDL); high cholesterol levels; and high levels of low-density lipoprotein (LDL), triglycerides, fibrinogen, and plasminogen activator 1.” [2] So this is another case where low testosterone does not look so good for the heart!

5. Testosterone Suppression Raises Cholesterol. One study pharmaceutically suppressed the testosterone of eight men to nearly castrate levels and – you got it – cholesterol rose from an average of 177 to 208, a 17.5% increase. [6] NOTE:  HDL, the “good cholesterol” also increased.

CAUTION #2:  You do not want to go too high in testosterone, something I discuss quite often in the Peak Testosterone Forum. First of all, steroid men often have greatly skewed lipids and high cholesterol. However, there was also a study done where researchers gave healthy men 200 mg of testosterone enanthate per week. Enanthate is quite similar to the cypionate ester and 200 mg per week is a beefy dose. So these men did not really need probably HRT and they gave them a large dose. And, even though the men were not taking steroid levels, they experienced no beneficial changes in cholesterol and a significant decrease in HDL.  Again, the body is a highly tuned machine and it is very difficult to push physiological ranges successfully.

1)   A Dose-Response Study of Testosterone on Sexual Dysfunction and Journal of Andrology, Jan-Feb 2008, 29(1):102 105, January-February 2008″Features of the Metabolic Syndrome Using Testosterone Gel and Parenteral Testosterone Undecanoate”

2) The American Journal of Cardiology, Dec 2005, 96(12 Supp2):67 72, “Cardiovascular Issues in Hypogonadism and Testosterone Therapy”

3) Clinical Endocrinology, Sep 2005, 63(3):280 293, “Effects of testosterone on body composition, bone metabolism and serum lipid profile in middle-aged men: a meta-analysis”

4) JCEM, Published Online: Jul 01 2013, “Pharmacokinetics of Transdermal Testosterone Gel in Hypogonadal Men: Application of Gel at One Site Versus Four Sites: A General Clinical Research Center Study”

5) Medscape Medical News, “Five Years of Testosterone Ameliorates Metabolic Syndrome in Hypogonadal Men”, Lisa Nainggolan, October 28, 2013

6) JCEM, Published Online: Jul 01 2013, “Suppression of Plasma Testosterone Leads to an Increase in Serum Total and High Density Lipoprotein Cholesterol and Apoproteins A-I and B”

Cost Testosterone Replacement Therapy TRT With Defy Medical

Costs of TRT (Testosterone Replacement Therapy) With Defy Medical

Word spreads quickly on the Peak Testosterone Forum and already Defy Medical has an excellent reputation and many forum members going there.  Because they are cash only and do not do insurance processing, one very commmon question that I get is the cost of treatment.  (Many patients do submit lab claims to their insurance for reimbursement on the back end however.)

To get some ballpark figure, I queried Dr. Saya as to their current charges (as of August of 2016).  He wrote me back the following responses – see below.  Please keep in mind that these are rough estimates based on the typical patient and can change at any time.  You must, of course, actually call  Defy Medical to get the numbers for you own medical situation.

—LAB COSTS: “The general HRT/TRT lab panel is $249. If “other” labs are added (IGF-1, further thyroid testing, etc) then the cost can be a little higher. Then again, if a FULL panel isn’t needed on follow-up (i.e. Once dialed in for some lab draws we can check a limited panel) then lab cost can be lower. ”

—LAB FREQUENCY:  “We check labs generally at initial, 90 days, then between q3-6 months depending on how well balanced/stable a patient is (6 months if stable). I also sometimes give a “longer leash” to patients such as yourself with a lot of experience with TRT and those who do their own monitoring/testing. ”

—CONSULTATION PRICES:  “The INITIAL consult price is $250, but follow-ups are cheaper at a cost of $50-$120 depending on if with MD or with mid-level practitioner.”

—COST OF TESTOSTERONE:  “Testosterone cypionate 200mg/ml cost typically ~$120 for 10ml vial (generally ~3 month supply depending on dosing).”

–“COST OF HCG and ARIMIDEX (ANASTROZOLE):  “HCG 11,000 IU vial ~$70-$75 (generally 3 month supply) or 5,000iu vial ~$40-45; Anastrozole (if needed).”

—OTHER HORMONES: “DHEA/pregnenolone, thyroid, etc are on a “per cap” or “per tablet” price and are not very expensive. Ancillary medications and supplements are available at a discounted cost. We make EVERY effort to keep our services as affordable as possible while trying to deliver the best of care.”

Estimated Yearly Costs of TRT (Testosterone Replacement Therapy) With Defy Medical

TOTAL ESTIMATED YEARLY COSTS: The upper end range for our patients in the first year if on a TRT protocol T cyp 200mg/ml – 0.35ml BIW, HCG 400iu BIW, and anastrozole 0.15mg/DIM 200mg cap BIW would be right around $2041. The lower range would be roughly $1300.

NOTE: Your cost will be less on an ongoing basis after the first year, because you will no longer have the initial one hour consultation fee.

We also provide a 10% discount to all military and first responders, run specials on various medications throughout the year, and provide patients with a $25 credit on their birthdays. This doesn’t take into account if the patient is ordering injectable nutrients or other supplements from us, or if they are having other issues treated (Thyroid or ED for example). Anytime someone calls in, though, we are very clear about all the costs, and provide clear costs of all medications. The largest variable is the lab work, but I know in the past that form some patients on a budget Dr. Saya has been able to adjust his required follow up labs to something more affordable.

Fee and Cost Breakdown For TRT (Testosterone Replacement Therapy) With Defy Medical

Initial TRT/HRT Consult: $250

After your initial evaluation, the Defy Medical staff requires at least two follow up appointments per year for men on Testosterone therapy (about every 6 months) at the discretion of your physician. You can choose to have your follow up with the Doctor or with a mid-level practitioner.  The follow up costs are as follows:

** The Intake Department may be contacted for more information on our Fee Schedule and other procedures/treatments offered. Please go to their web site for contact information: Defy Medical.

NOTE:  Defy Medical is currently a site sponsor.  Dr. Saya is also my personal HRT / TRT physician.

Vitamin C: Are Peroxide Levels a Concern? - Peak Testosterone

Hopefully, you have read my page on the Evidence That Vitamin C Can Cure (Partially or Totally) Most the World’s Nastiest Viruses: I consider to be one of the most important pages on my site. Or perhaps you have read one of Dr. Thomas Levy’s groundbreaking books, such as Curing the Incurable: Vitamin C, Infectious Diseases and Toxins, about its superpowers against Dengue, Epstein Barr, Acute Hepatitis, Rheumatic Fever, West Nile Virus and many more. If you have, then you probably know that one of the key mechanisms by which Vitamin C kills these kind of deadly viruses is through peroxide. Taking megadoses – and this is via liposomal or IV Vitamin C and not standard supplements – releases elevated peroxide levels which are devastating to viruses (and many cancerous tumors and nasty bacteria as well).

The importance of this cannot be overstated as modern medicine and pharmaceuticals have a lackluster – deplorable is probably a better word – track record against virtually all of these viruses.  Vitamin C should clearly be a tool in every doctor’s toolbelt, but it does not get the coverage it deserves, since it is a non-pharmaceutical that cannot be patented.  If a patient is very sick and suffering with one of these viruses, I think it is inexcusable that Vitamin C therapies are not considered.  In my mind it’s a no brainer, since it is cheap, easy to implement and has a stellar side effect profile.

That said, I have had only one nagging question about megadosed Vitamin C, and I asked this of Dr. Thomas Levy, the modern day apostle of Vitamin C Therapy that I mentioned above. The summary of my concern is that peroxide is a potent free radical and so, even though Vitamin C therapy causes virtually no side effects, I wanted to double check that there were no long term issues.  Dr. Levy graciously answered me with the information below:

Q. Is high dose IV or liposomal Vitamin C only safely used a few times in your life? Can liposomal or IV Vitamin C be used regularly as part of a maintenance treatment protocol for patients with Epstein-Barr or various STD-related viruses such as herpes? Finally, do we have anecdotal or case study evidence of patients using maintenance doses of liposomal or IV Vitamin C over the years with no ill or side effects?”

A. Hello Lee,

All chronic degenerative diseases are characterized, and facilitated by, increased oxidative stress inside the diseased cells. It is truly a final common denominator. Furthermore, it is increased intracellular concentrations of iron, copper, and/or calcium that will always cause and propagate this state in the diseased cell. One of the most common mediators of this increased oxidative stress is via upregulation of the Fenton reaction, breaking down peroxide into the most oxidative free radical known, the hydroxyl radical.

Catalase normally keeps peroxide levels inside cells to negligible levels. However, when it is largely absent, as in most cancer cells and probably many chronically diseased cells, antioxidants such as vitamin C can donate an electron to Fe3+, forming Fe2+, which then donates the electron to peroxide and forms the hydroxyl radical. This is a primary way in which VC can kill a cancer cell when acutely given in very high doses.

So, regarding the following quote, “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.”

Peroxide certainly worsens any chronic degenerative disease when it is present in excess inside a cell. However, the chronic dosing of VC and other powerful antioxidants by multiple mechanisms works to decrease the already increased oxidative stress inside such cells, such as by helping to purge such cells of the accumulated toxins that promoted the increased oxidative stress in the first place.

So, take as much vitamin C and antioxidants as possible. It’s only long-term side effect will be increased longevity and less symptomatic diseases.

Best regards,

Dr. Levy, M.D. and Founder of Peak Energy

Female Libido, Drugs - Peak Testosterone

We all know that Us Guys Need Sex for our health and well-being.  Females do too by the way.  However, often the woman in our life just isn’t interested:  her libido has gone right out the window. Of course, there can be a hundred different reasons for decreased libido in females, but one of the most common is actually prescription medications.

This is not a rare occurrence by any means, because, as you’ll see below, many of these medications are blockbuster drugs that have become household names.  Furthermore, few people, be ye female or male, stop to consider that their libido or sexual function may actually be affected by some little pill they take every morning and/or evening.

Let’s take a look at some of the prescriptions that can take the wind right out of your woman’s sails and leave her libido flagging and sagging:

1.  Estrogen, the Pill and Contraceptives.  Many of these drugs, which are all synthetic estrogens and pregesterones for women, decrease testosterone.  Testosterone is responsible for libido in females and so child prevention can easily lead to sex prevention as well.  Please see this link on Female Libido and Estrogen for more details.

2. Antihistamines. These can have a mild relaxing effect on the body and mind.  The old-line antihistamines such as Benadryl are particular potent in this category, because they cross the blood-brain barrier. However, even the newer antihistamines can cross to a certain extent the blood-brain barrier and effect libido and sex drive.

3.  NSAIDs. This highly popular class of drugs, which includes Motrin, Advil, ibuprofen, etc., is taken by many females – and men too of course – like candy, not realizing that they may be sabotaging their lubrication and libido in the process.  Not all women are affected in this way by NSAIDs, but decreased libido is a very common side effect.  By the way, NSAIDs are notorious for causing GI issues, including ulcerations.  If you know anyone taking these regularly, they are asking for trouble.  They also make one sensitive to the sun:  remind your woman if all else fails that these can only make her skin look worse.

4.  Antidepressants.  Women produce significantly less seratonin than males and thus are more susceptible to depression.  A very common solution is to pop a daily SSRI, a class of antidepressant, which boosts seratonin. Seratonin is the feel-good, at-peace-with-the-world neurotransmitter and can make males or females too relaxed to even achieve orgasm.  Some experts estimate that about half of women on SSRI’s experience lowered libido.  NOTE:  It is very important to take care of depression:  the elevated cortisol levels are extremely hard on the body and brain.

5. Panic and Anxiety Drugs.  Medications, such as Xanax and Valium, are also notorious for decreasing female libido and arousal.

The list could go on and on and include other classes of drugs such as those for blood pressure, but you get the idea:  if your woman has a low libido, it may not be because you’re insensitive and ugly:  Big Pharma may have anhilated her sex life.

Reverse Diabetes Using Dr. Whitaker's Method - Peak Testosterone

I thank God every day for antibiotics, polio vaccines and eye glasses.  But let’s be honest:  the standard protocols of Western medicine sometimes just look downright silly and diabetes is a case in point.  Julian Whitaker, in his must-read book Reversing Diabetes, confronts common medical wisdom with a bold statement on p. 54: “90% of diabetics should be treated with diet, exercise, weight control and targeted nutritional supplements.”

Dr. Whitaker backs up his claims and in his practice he almost always “gets his man”.  He finds that he can dramatically reduce the medications of almost all of his diabetic patients who undergo his all-natural program. This is incredibly important because of the many complications of insulin therapy incluing hypoglycemia and weight gain.  (Insulin promotes fat storage!)  Plus, many of the oral medications are rife with even nastier side effects.

The bottom line is that those fairly recently diagnosed with diabetes can much more often than not completely reverse their condition.  And even veteran diabetics get dramatic symptom relief and medication reduction through these common lifestyle principles.

Notice that the title of this book, Reversing Diabetes, espouses another principle that I emphasize often on this site:  the body can almost always do a significant amount of self-healing through the lifestyle changes of diet and exercise.  If you throw in sleep, sex (healthy of course), supplements and a few other powerful principles such as mediation and laughter – well, there’s usually not much that can stop you from becoming a completely new person altogether.  (You can also check out his web site Dr. Whitaker for lots of interesting articles.)

One of the best aspects of the book is an extensive list and analysis of glucose-aiding and weight loss-assisting supplements packed with studies and references.  This is a must read for almost modern, urban dweller as, even those of us who are not yet diabetic, are likely dealing with some insulin resistance and pre-diabetic conditions.

This is a must-read in my opinion for health professionals and anyone with a family member who is diabetic.  There are almost 30 million diabetics in the U.S. alone and imagine if 25 million of them could dramatically improve their life just by reading and practicing the contents one book alone.

Dr. Whitaker’s program, which of course he outlines in this book, is entirely reasonable and includes such common sense strategies as ample fiber, lots of plant foods, emphasis on a low glycemic index along with relatively low total  and almost no saturated fat.  Some lean protein and low fat dairy are allowed and so many Westerners would be relatively comfortable with the diet.

The book has many miraculous stories, including a patient scheduled for leg amputation, which is quite common among diabetics, who avoided that completely once normal glucose levels were restored. Another patient had bleeding of the eyes – retinal problems are also common amoung diabetics – that was completely eliminated upon entrance into his program. Some on insulin therapy are able to completely quit.

Is There a Safe Dose of MSG? - Peak Testosterone

One of the questions I get asked from time to time is:

First of all, this is an involved question and experts are split over the issue.  I am going to go into the pros and cons of the various positions and leave the decision for yourself.  First, some background info for this not familiar with the underlying issues:

Glutamic acid is in all proteins.  If you buy whey or rice protein, you can usually see on the label the L-Glutamic Acid content.  The debate centers around the free from of glutamic acid, which is handled by the body completely differently than the “bound form” normally in protein.  The idea is that the free form can spike blood glutamate levels much more quickly and lead to “excitotoxicity”, because glutamate is an actual neurotransmitter.  Increasing glutamate levels can lead to overexcitement of neurons and lead to actual neuronal death.  High glutamate levels open calcium channels into neuron cells and can literally “overinflate” them to the point that they will die off shortly after.  Of course, the question is at what dose this occurs.

c) The human/mice ratio for glutamate is about 5 and injury to the hypothalamus occurs at 60-100 nmole/l.  Therefore, the plasma levels should easily achieve the hypothalamic injury level.

So, if you subscribe to this theory, you would probably want to consume less than 200 mg/kg of body weight as a bare minimum of protection.

3. MSG May Not Destroy Neurons But is Toxic Nonetheless. Some would take a middle position and point to some of the studies that are more recent that have shown toxic effects from excitotoxins such as MSG and aspartame and yet don’t necessarily point to any kind of permanent neuronal damage. In other words, increasing plasma glutamate levels (or one of the other byproducts in diet drinks) may have an unforeseen or poorly understood but negative effect.

An example of this is the study showing women having “Excitotoxin Syndrome, a suite of symptoms similar to fibromyalgia.  Now admittedly, this was a very small study.  However, the women repeated withdrawal and reintroduction and found that MSG increased symptoms.  For more information, see my link on Excitotoxin Syndrome.

Yet another example is an animal study that showed increased cancers in animals and still another a human study that shows kidney decline in diet drinkers. See my link on Monosodium Glutamate and Excitotoxins for more information.

NOTE: My position is that I get no benefit from excitotoxins and cannot think of any reason to consume them.  Another way to look at this is that modern wheys, autolyzed yeast extracts and hydrolyzed proteins are all very unnatural substances where food manufacturers and processors have boiled the living crap ouf certain proteins for no good reason whatsoever.  So I am protesting adding empty, non-nutritive additives to my food that may actually hurt me and my family.  In addition, I believe that #3 is certainly possible as well and more study work is needed.

For more information, see my links on Testosterone and MSG, Wheys and Excitotoxins, and Undenatured Proteins.

REFERENCES:

1)  Experimental and Molecular Pathology, Oct 1975, 23(2):203 213, “Electron microscopic observations of hypothalami in neonatal rhesus monkeys (Macaca mulatta) after administration of monosodium-L-glutamate”

2) J Toxicol Environ Health, 1976 Nov, 2(2):471-80, “Hypothalamic morphology following ingestion of aspartame or MSG in the neonatal rodent and primate: a preliminary report”

3)  Excitotoxins:  The Taste That Kills, by Russell Blaylock, p. 37

4)  Blaylock, p. 85.

1. MSG is Safe At Any Reasonable Dose Even for Very Young Children. This position is based on the idea that advanced animals, such as ourselves and monkeys, are largely unaffected by excitotoxins.  The argument for this is based on a couple of studies on monkeys that show no hypothalmic injury even when fairly large dosages were given. [1] One of these studies gave a range of big doses to mice and found that the very young mice had lesions at a dose level of 0.5 g/kg of body weight for MSG and 1.0 g/kg for aspartame.  In contrast, they gave 1-4 g/mg to infant monkeys and found no lesions.[2] Their conclusion was that primates process glutamates differently than mice and thus there is likely no concern for humans either.

2.  MSG is Unsafe for Young Children and Possibly Adults.  Those in this camp are skeptical of the above experiements and point to several important facts:

a) MSG will spike plasma glutamate levels about fives time higher than those found in mice. [3]

b) A child having some soup, which is high in free glutamine, and a diet drink, which is high in free aspartic acid will see his or her plasma levels increase to 400-500 nmole/dl.  This is achieved with a excitotoxin-loaded meal at about 200 mg/kg of body weight. Again, it is only the free glutamine form that counts.

Inorgasmic Women, Solutions - Peak Testosterone

What if you could not experience an orgasm?  Wouldn’t that put a bit of a damper on your sex life?  Well, this is a surprisingly common scenario for many couples as many females are “nonorgasmic” or “inorgasmic.” Estimates are in the 10% range. [1]  Of course, this can put a strain on a relationship both for a fella and his honey.

Apparently, the lack of nookie can make everyone involved a little crabby:  researchers have noted that a healthy sexual life contributes about 15-20% to the relationship’s viability and satisfaction but an unhealthy sex life does the opposite at a rate of about 60-70%. [5]  In other words, lack of sex and quality sex strongly and readily contributes to failed relationships.

So we’re going to look at some interesting studies using the Way Back Machine.  Back in the 70’s, while society was wrestling with free love and, more importantly, the breakup of the Beatles, researchers were frantically looking for solutions to the issues of nonorgasism – is that a word? – and found a few things worth noting.  Now nonorgasm can be due to medical conditions, medications and childhood abuse. [2]  However, as it turns out, there can physical reasons as well which will be discussed below.

For example, one study put 8 nonorgasmic women into a fairly involved program with the ambitious goal of getting them to the point where they could orgasm, especially with their spouse and thus achieve a more satisfactory sex life for all. They actually achieved their goal – all 8 women become orgasmic – and presumably lived happily ever after.  (Follow up work six months later actually showed that all women stayed orgasmic.)  However, if you read the details of the study, the experiences of two of the women is particularly important.  These two women had to spend 45 minutes daily masturbating with a virbrator for three weeks before they could achieve an orgasm and had to practice Kegels while they were at it as well!

NOTE: Kegels are excellent for women for many reasons, but subsequent research has not verified their usefulness in overcoming the ability to achieve an orgasm.

For these two women, orgasm was something had to be developed and was a process requiring considerable patience and effort. By all accounts, it appeared that these women did not have a psychological issue, but rather that a physiological one:  their vascular, capillary and nervous system simply could not support an orgasm.  The researchers speculated that these women had to develop these physiological systems through weeks of stimulation and pointed out that other studies indicated that a lack of  “sufficient vascularity” could be the underlying issue.  This is verified by the fact that females can become nonorgasmic after the ravages on veins and arteries of diabetes. [4]  Yes, diabetes can produce similar problems in males.

A similar study was done a few years later on 3 nonorgasmic women and documented that it took 3, 4 and 6 weeks of regular masturbation for these women to achieve an orgasm. [6] The old adage “if at first you don’t succeed…” really applies here, eh?

Is this possible? Well, certainly, and there is an analagous situation in men.  Men, generally in middle and senior age, may experience a lack of morning erections and/or sexual activity. This leads to atrophy of receptors, musculature and “vascularity” in a sense as well.  These men find that they need to literally practice ejaculating for a time and “get back into shape”.

The good news is that subsequent research has verified that, generally, nonorgasmic women can become orgasmic through proper strategies.  Masters and Johnson, for example, found an 83% and 60% success rate just a few years later. [3]

REFERENCES:

1. https://www.nytimes.com/2005/05/17/science/17orga.html?_r=1&pagewanted=2

2)  Archives of Sexual Behavior, 1972, 2(2), “The Role of Masturbation in the Treatment of Sexual Dysfunction”

3) Archives of Sexual Behavior, 1976, 5(3), “Group Therapy for Nonorgasmic Women: Two Age Levels”

4) SEXUALITY AND DISABILITY, 6(2):83-92, “Diabetes mellitus and female sexuality”

5) Handbook of Clinical Family Therapy, Chap. 18, “Couple Sex Therapy: Assessment, Treatment and Relapse Prevention”, p. 464.

6) Archives of Sexual Behavior, 1974, 3(4), “Directed Masturbation and the Treatment of Primary Sexual Dysfunction”

Low Carb Diet (Potential) Dangers - 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. 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.

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.

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

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”

How One Man Quit Cialis Cold Turkey - Peak Testosterone

Cialis has a lot of side effects, due to the fact that it affects other similar PDE enzymes in the body. Common side effects include headaches, tinnitus, visual disturbances, heartburn and stuffy nose where these PDE enzymes are located.  It can even cause permanent visual or hearing loss, and we had one such man on The Peak Testosterone Forum.

The good news is that I recently corresponded with a man that actually successfully quit Cialis cold turkey successfully, and I relay his story below.  He relayed how he had been plaqued by various symptoms of Cialis, in particular “super bad GERD – doc said it looked like I’d smoked all my life – of course, I don’t smoke.”

I asked him his secret of course, because I have been unable to quit Cialis completely as of this writing but have shaved the dose down to 3 mg/day.  His strategy was a little more simple – just quit!  Actually, there was a bit more to it and here is how he described his experience:

I asked him if he had completely recovered and he said:

“Yeah, I’d say I’m around 80%. Was closer to 90+, but work stressors have definitely had an impact lately. Penile sensitivity is probably the largest lingering issue – can’t climax maybe 30% of the time.  Some days work out better for me than others in that regard (probably 80% sustained liftoff rate), but still better than the sides (GERD, stuffy nose, stomach issues.) Still have some stuffiness due to a few good broken noses, but the GERD and stomach issues have pretty much gone away since I stopped.”

Now the one thing that I have wondered is if you could possibly taper back.  Maybe go from 5 mg/day to 4 to 3 to 2 to 1 mg to zippo.  But maybe that just prolongs the agony?  Regardless, the point is that many men can undoubtedly just quit Cialis and get back to normal.  He did mention that initially he would sometimes use Viagra a couple of times per week. However, now he does not use any PDE5 inhibitors and has achieved victory in that sense.

CAUTION: I would not quit Cialis if you have high blood pressure, any CVD issue or BPH (enlarged prostate) without talking to your doctor first.

“Not much to it really – had a talk with the girlfriend about it, and wanting to quit. With her support, I worked up the confidence to go for it and, about three weeks after coming off, found that I was able to function relatively normally for the first time since going on Cialis about five years prior. Still not like it ‘used to be’, but certainly not too shabby. Honestly, without the girlfriend’s A-OK I probably never would have tried.”

Notice that he had been on Cialis for five years and it took him about 3 weeks to largely recover. PDE5 inhibitors work by inhibiting an enzyme and it is quite common for it to take about three weeks for enzymes to normalize.  From what I have seen, stopping Arimidex, for example, will bring back a man’s estradiol in about 2-3 weeks in men that have accidently crashed it.

His story made a lot of sense to me.  I see very few men successfully quitting Cialis, and the reason is likely that they can’t or won’t put their sex life on hold for a few weeks.  All it took, though, was a little communication with his girlfriend.

I admire him for doing it, because I have occasionally taken a couple of days break from Cialis and I always feel “hung over.”  That’s the best way I can explain it – there is some definite mental fog and lack of energy.  And erections almost completely vanish after a couple of days – fear sets in – and so I’m back on the Cialis in short order.  It sounds like the key, though, might be to muscle it out for a longer period of time.

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:

Vitamin C - The Potential Dangers - 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:

Cortisol: Man Killer - Peak Testosterone

Elevated cortisol is a huge problem for many men and will destroy everything you hold dear as a male.  In fact, it is actually astonishing how much damage one hormone can do.  Testosterone can boost your career, relationships and sex life.  Cortisol will undo the same and tear you apart head to toe.

Don’t believe me?  Check out these 10 research-backed reasons that (elevated) cortisol and manliness just do not go together well:

1. Visceral Fat. It is no secret that visceral (stomach or belly) fat kills. It is associated with Metabolic Syndrome and many other nasty diseases that can lead you and your sex life. What many men do not realize is that cortisol actually helps push fat to the abdomen [8][11], because, among other things, visceral fat has four times the number of cortisol receptors. [3]

5.  Memory Loss and Brain Shrinkage.. A number of studies have shown that higher-than-normal, long term cortisol levels can damage the hippocampus, the seat of memory for all humans. [12] Furthermore, several structures of the brain, especially the hippocampus, have been shown to actually shrink with long term cortisol exposure. [12]

NOTE:  If you feel you have likely damaged and/or shrunk your brain matter due to excess stress/cortisol, don’t panic.  Researchers have found good evidence that the brain shrinkage is actually reversible (to one degree or another) for a number of high-cortisol conditions, including depression [15] and Cushing’s [13][14]. The reversibility (significant but partial) of Cushing’s Syndrome brain matter loss is particularly significant considering the severity of the disease.

In addition, you can likely rebuild and increase your brain through mindfulness meditation [17] or the vispanna meditation. [18]  Progressive Muscle Relaxation will certainly protect your hippocampus from damage and may help to rebuild it as well.

CAUTION: Some psychiatric illnesses (PTSD, i.e. Post-traumatic Stress Syndrome are actually characterized by low serus cortisol levels.  This is probably due to overexcitation of cortisol for many years.

6.  Blood Pressure. It is no secret that stress raises blood pressure and can be a significant factor in hypertension. So it should be no shock that the primary stress hormone, cortisol, has been found in multiple studies to raise blood pressure. [5][11] Of course, hypertension is a leading cause as I document in my link on High Blood Pressure and Erectile Dysfunction.

7. Arteriosclerosis. One study verified 5 and 6 but also found that, not too surprisingly, that higher morning cortisol levels were associated with accelerated arteriosclerosis, i.e. arterial plaque. [6]

8. Neuroticism and Depression. Higher morning cortisol levels have been associated with your odds of being neurotic [18][19] and may also play a role in developing depression. [20]

9.  Metabolic Syndrome. Thanks to #1, many researchers believe that elevated cortisol may be the primary cause of the Metabolic Syndrome. [7][10][11] Visceral fat and insulin resistance go hand-in-hand, so this is no wonder. Several studies have shown that stress and Metabolic Syndrome are related giving still more evidence to this relationship. [9]

10. Diabetes. With the decreases in insulin sensitivity and the increases in blood glucose very often comes Type II diabetes according to the latest research as well.

11. Cholesterol. Ever feel like you’re fighting a losing battle with your cholesterol levels.  Well, the primary reason is likely Saturated Fat – see my page Why Saturated Fat Can Be Bad For Men According to the Latest Research – but cortisol can play a role as well and studies have shown that elevated cortisol can in turn elevate cholesterol levels as well. [5]

12. Erectile Dysfunction. Stress has been tied into erectile dysfucntion and itis no wonder considering that it almost always raises cortisol, which in turn raises so many cardiovascular risk factors. [21]

So how do you get cortisol under control.  See my links on Stress Management and Progressive Muscle Relaxation for practical and natural answers.

REFERENCES:

1)  Obes Res, 1999 Jan, 7(1):9-15, “Stress-induced cortisol, mood, and fat distribution in men”

2) CELLULAR AND MOLECULAR LIFE SCIENCES, 1981, 37(12):1296-1297, “The relationship between high and low trait psychological stress, serum testosterone, and serum cortisol”

3) Psychosomatic Medicine 62:623-632, 2000, “Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat”

4) Neuropsychopharmacology. 2005 Oct;30(10):1906-12, “Testosterone suppression of CRH-stimulated cortisol in men”

5) Hypertension, 1999, 33: 1364-1368, “Cortisol Effects on Body Mass, Blood Pressure, and Cholesterol in the General Population”

6) Atherosclerosis, Feb 1977, 26(2):151 162, “The association of elevated plasma cortisol and early atherosclerosis as demonstrated by coronary angiography”

7) The Journal of Clinical Endocrinology & Metabolism, Aug 1 2009, 94(8):2692-2701, “The Pathogenetic Role of Cortisol in the Metabolic Syndrome: A Hypothesis”

8) Science, 7 Dec 2001, 294(5549):2166-2170, “A Transgenic Model of Visceral Obesity and the Metabolic Syndrome”

9) BMJ 2006, “Chronic stress at work and the metabolic syndrome: prospective study”

10) British Journal of Nutrition, Jun 2000 , (83 Suppl)S49-S57, “The metabolic syndrome a neuroendocrine disorder?”

11) Issue Clinical Endocrinology, Apr 2003, 58(4):500 505, “Cortisol and the metabolic syndrome in South Asians”

12) Nature Neuroscience, 1998, 1:69 – 73, “Cortisol levels during human aging predict hippocampal atrophy and memory deficits”

13) Psychoneuroendocrinology, Jun 2005, 30(5):505-515, “Plasma cortisol levels, brain volumes and cognition in healthy elderly men”

14) The Journal of Clinical Endocrinology & Metabolism, May 1 2002 87(5):947-1948, “Cortisol, Cushing s Syndrome, and a Shrinking Brain: New Evidence for Reversibility”

15) Psychiatry Research, Mar 1983, 8(3):191-197, “Relationship of cortisol hypersecretion to brain CT scan alterations in depressed patients”

16) NeuroImage, 15 April 2009, 45(3):672-678, “The underlying anatomical correlates of long-term meditation: Larger hippocampal and frontal volumes of gray matter”

17) The Journal of Alternative and Complementary Medicine, Jan 27 2010, 16(1), “Vipassana Meditation: Systematic Review of Current Evidence”

18) he American Journal of Psychiatry, Apr 01 2005, 162(4), 162(4), “Enhanced Early Morning Salivary Cortisol in Neuroticism”

19) Biological Psychiatry, Mar 2001, 49(5):410-415, “High and low neuroticism predict different cortisol responses to the combined dexamethasone CRH test”

20) The American Journal of Psychiatry, Apr 01, 2007, 164(4), “Increased Waking Salivary Cortisol Levels in Young People at Familial Risk of Depression”

21) Psychiatry Research, March 1983, 8(3):191-197, “Relationship of cortisol hypersecretion to brain CT scan alterations in depressed patients European Urology, January 2005, 47(1):80-86,”Prevalence and Risk Factors for ErectileDysfunction in 2869 Men Using a Validated Questionnaire”

So why do men tend toward abdominal obesity?  Yep – the have great “cortisol reactivity”, i.e. when under stress, they have higher cortisol levels than women. [1] Well, and they just tend to have higher cortisol levels. [5] This, on average, makes them much more susceptible to inflating that “spare tire”.  You can read more about it in my link on Visceral Fat and Abdominal Obesity.

2. Testosterone. Several studies have found that elevated cortisol leads to lowered testosterone levels. [2] How does cortisol attack your testosterone? It actually does this through an enzyme that affects testosterone in the Leydig cells of the testes. See my link on Stress and Testosterone for more information.

3.  Secondary Hypogonadism. Researchers have reported that in some extreme cases stress can cause secondary hypogonadism, which means clinically low testosterone resulting from failure in the signaling to the testes and not the testes themselves. This can happen from being overweight, for example, because excess body fat can turn off proper signaling from the hypothalamus.

Well, it turns out that excess cortisol can do something similar, i.e. lower GnRH output from the hypothalamus. [4] Of course, GnRH is what signals the pituitary from.

4.  Insulin Resistance and Blood Glucose.  Higher cortisol levels are associated with increased insulin resistance and elevated blood glucose levels. [11]

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

Depression and Cortisol - Peak Testosterone

When depression comes to mind, most guys think serotonin and dopamine.  And the reason is that antidepressants target one or both of these neurotransmitters and so most men and physicians assume this is the end of the story.  However, there is significant evidence that these pharmaceutical solutions are not hitting the source or root cause of depression and are missing the mark, because they are acting too far downstream of the real problems:  cortisol, inflammation and oxidation. Basically, stress often sets results from a tidal wave of nasty metabolic processes in the brain that sabotage its ability to rest, recuperate and recover, leading to neurotransmitter deficits.  (It also creates similar metabolic avalanches, creates a vicious circle that can be difficult to escape from.)

As proof of the above, research has shown that stress and cortisol actually lowers 5-HT (serotonin) directly in some people. Supposedly, this is only is susceptible individuals. [1] One set of researchers stated that “more recent formulations have suggested that elevated cortisol levels, probably caused by stressful life events, may themselves lower brain 5-HT function and this in turn leads to the manifestation of the depressive state. This elegant proposal neatly ties abnormalities of cortisol secretion and 5-HT function into a causal chain in which cortisol is the key biological mediator through which life stress lowers brain 5-HT function, thereby causing depression in vulnerable individuals.” [2]

This should not surprise anyone:  cortisol is known for literally destroying neurons and high levels have been linked with shrinkage of several parts of the brain, including the all-important hippocampus.  If cortisol can literally kill brain cells, is it any wonder that it can lower serotonin?

CAUTION: Nutritional deficits (and lack of exercise) have often been linked with depression and other psychological issues.  The brain is a giant nutrient hog and requires a constant supply of base raw materials along with anti-inflammatories and antioxidants in order to properly function.  There is also evidence that an overabundance of certain minerals (copper, zinc and iron) and toxins (pesticides, mercury, lead, etc.) can wreak havoc with neurons.  For more information, see my links on Depression Cures and Brain Health Links.

I find that many men on the Peak Testosterone Forum have been put on a variety of SSRI’s and antidepressants by their doctor. Rarely are any cortisol-lowering strategies included and this simply makes no sense.  Think of this:  Cushing’s Disease, which results in clinically elevated levels of cortisol, has depression as an extremely common side effect.  In fact, one study stated that “major depression is the most common comorbid disorder. Other psychopathological aspects of Cushing’s syndrome in adults include mania, anxiety disorders and cognitive dysfunction.”  I cannot tell you the number of guys on the Forum – and I’ve been there myself – that have significant depression and anxiety and yet it has never crossed their mind – or their doctor’s! – to check cortisol levels.

Yes, there are a number of medical issues that can result in increased depression and anxiety.  But why not check to see if elevated cortisol is one of them??  Plus, consider the fact that many cortisol and stress-lowering strategies have excellent records in improving depression.  Here are just a few examples:

1. (Soy or Plant-Based) Phosphatidylserine . Phosphatidylserine (S-PS) is very commonly prescribed by alternative practitioners to lower the elevated cortisol levels see in cases of adrenal fatigue and other HPA dysfunctions.  And, not too surprisingly, it has been found in the research to help depression in seniors. [3] It also helped with a number of cognitive parameters as well!

2.  Mindfulness Meditation. The most recent meta-analysis shows convincingly that mindfulnesss meditation does indeed help with depression, mood and anxiety. [4] This is particularly impressive because a meta-analysis will study many studies.

3. Progressive Muscle Relaxation (PMR). This is one of my favorite forms of lowering cortisol and relaxation, because it is so simple and easy to do, especially for someone with a “racing mind” like myself.  PMR has many studies showing that it helps with depression. [5][6]

4.  Yoga.  A recent research review found five studies that showed that yoga helped with depression. [7]

5.  Autogenic Training. This relaxation technique is not as well-known as meditation and yoga here in the U.S., but has been shown in a number of studies to help with depression. [8][9]

This list could undoubtedly go on, but I think you get the idea:  if you lower stress and cortisol, you are very likely to help with depression. So think of the irony for most guys with depression: stress boosts their cortisol and then cortisol lowers their serotonin. Physicians, not knowing any better usually, give their patients SSRI’s to boost their serotonin, even though the underlying cortisol issue still remains. No wonder studies of SSRI efficacy have shown them to be little better than placebo for most depressed individuals. It is like putting two guys in a boat and telling one of them to row forward and the other backwards. Who knows which guy is going to win?

JAMA, the heavy weight journal of the AMA, did a meta-analysis and was willing to clearly state that “the magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms.”  You know it’s gotta be bad when the AMA is willing to state that a medication is not helping the great majority of patients.

CAUTION #1: Do NOT stop any medication without talking to your doctor first. The above study was also clear in saying that patients with severe depression experienced significant benefit from SSRI’s.  Depression is very serious and you need to battle it with every tool in your arsenal. [10] Going off of SSRI’s or even switching SSRI’s, in particular, is something to be done under a physician’s supervision.

CAUTION #2: Remember that low testosterone makes a man susceptible to depression.  Furthermore, HRT can often significantly improve depression. (It did with me:  I had decades of mild depresion, or dysthmia as it is called prior to going on testosterone cypionate.)  See my links on Testosterone and Depression and Testosteorne and the Brain for more information.

Finally, one last thing that shows the important of cortisol management with depression are the studies that show it is raised at different times of the day:

1. At Bedtime.  A study of depressed adolescents showed that the elevated kids had elevated cortisol levels at sleep onset. [11]

2. Upon Waking. Another study of severely depressed patients found that their cortisol levels were elevated when they woke up first thing in the morning. [12]

3. Throughout the Day. Several studies have noted that depressed patients have higher urinary free cortisol levels and one study commented that a little less than half of the depressed patients have cortisol levels as high as Cushing’s patients! [13]

So it’s probably hard to predict exactly at what time of day the cortisol will be elevated  and so a three or four-point cortisol exam would probably be prudent.  See my link on Adrenal Fatigue Testing for some discussion of this common technique.

The bottom line is that it is very often going to be foolish to ignore cortisol when dealing with depression. For additional information, please see my summary pages on Stress Management and Cortisol and Depression and Anxiety.

REFERENCES:

1)  The British Journal of Psychiatry, 1994, 164:365-371, “Glucocorticoids and the genesis of depressive illness. A psychobiological model.”

2) The British Journal of Psychiatry, 2002, 180:99-100, “Cortisol, serotonin and depression: all stressed out?”

3) https://pop.lipogen.us/articles/CTMEM01.pdf , “EFFECT OF SOY LECITHIN PHOSPHATIDYLSERINE (PS) COMPLEX ON MEMORY IMPAIRMENT AND MOOD IN THE FUNCTIONING ELDERLY”

4) Journal of Consulting and Clinical Psychology, Apr 2010, 78(2):169-183, “The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review”

5) JCO June 1991 vol. 9 no. 6 1004-1011, “A randomized clinical trial of alprazolam versus progressive muscle relaxation in cancer patients with anxiety and depressive symptoms”

6) 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”

7) Journal of Affective Disorders, Dec 2005, 89(1-3):13 24, “Yoga for depression: The research evidence”

8) Applied Psychophysiology and Biofeedback, Mar 2002, 27(1):45-98, “Autogenic Training: A Meta-Analysis of Clinical Outcome Studies”

9) Eur Psychologist, 1999, 4(1), “Long-Term Evaluation of the Effectiveness of Additional Autogenic Training in the Psychotherapy of Depressive Disorders”

10) JAMA. 2010;303(1):47-53, “Antidepressant Drug Effects and Depression Severity A Patient-Level Meta-analysis”

11) Biological Psychiatry, July 1991, 30(1):25-36, “24-Hour cortisol measures in adolescents with major depression: A controlled study”

12) Psychopharmacology, Oct 2005, 182(1):54-57, “Increased salivary cortisol after waking in depression”

13) Psychological Medicine, Feb 1976, 6(1):43-50, “Urinary free Cortisol excretion in depression”

LDL-P: Values for Plaque Control and Reversal .

I also want to mention that LDL-P is merciless and the reason is that it is a gradient-driven chemical process. This is why it is so important to pay attention to this number.  If you had high school chemistry, you may remember what I am talking about here.  A gradient refers to the situation where the concentration of a molecule, in this case an LDL particle, is higher than on the other side of the membrane.  If the membrane is porous, there will be a “force” or “pressure” to try to equalize both sides of the membrane.  What this means is that LDL, when the Particle Count is too high, is driven into your arterial walls by simple chemical processes, where they can do little except cause inflammation and plaque.

So how do we keep those LDL particles floating along in our blood instead of imbedding themselves in our endothelium?  Basically you have to somehow lower your LDL-P enough to keep that from happening.  Unfortunately, as far as I know, no one has studied an exact level of LDL-P to target for plaque reversal.  Does this make LDL-P useless?  For example, I have a page on my site where I discuss HDL, LDL and Triglyceride Levels for plaque reversal according to the men that I call The Plaque Reversers. However, there are no such guidelines (with one exception) for LDL-P.

1. Dr. Davis’ Target (700 nmol/l).  I recommend every man read this book on plaque about ten times.  You can read my praise and appraisal of it here:  A Review of Track Your Plaque. It has the best coverage of cardiovascular markers for the layman that I have read and is just great info. And one of the sections in the book covers Dr. Davis’ recommended LDL-P for plaque reversal which is 700. Now my one comment is that Dr. Davis tends to have very aggressive thresholds compared to either Dr. Gould or Dr. Esselstyn.  I think the reason for that is that Dr. Davis wants to make sure that virtually every man and woman that tries for plaque reversal actually achieves it and thus sets aggressive targets.

The bottom line is that, if you want to play it very safe, then you should probably shoot for his target.  However, as an example, 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. Basically, Dr. Davis wants to save as many lives as possible and that is certainly admirable!

2.  Aim For the 2nd or the 5th Percentile. In a person who is diabetic or prediabetic, using LDL-C (the traditional LDL value) is risky. The reason for this is that those individuals often have a high LDL-P even though the LDL-C is much more reasonable.  Studies show that having high LDL-P even with low LDL-C places you at high risk for heart disease. And odds are that a high percentage of men who make it to my site are probably prediabetic or diabetic, since those go hand-in-hand with erectile dysfunction and low testosterone so often.

Nevertheless, pretend just for a minute that LDL-C is always valid.  The Plaque Reversers do this in their patients by insisting that they have low triglycerides and reasonably high HDL, something that is uncommon in those with insulin resistance. Thus, if you properly control these other two lipid markers (HDL and triglycerides), LDL-C is usually going to be a decent target value for you and the Plaque Reversers want your LDL-C between 60 mg/dl and 85 mg/dl.

Now what is the corresponding LDL-P number?  The same Framington Offspring Data showed the 5th percentile of LDL-P to be 850 nmol/l. [2] Therefore, I suspect that 850 is a very good starting number to shoot for for many men, but, again, there is no data to prove or disprove this.

Therefore, to play it safe you may want to target the 2nd percentile. The 2nd percentile of LDL-C was 70 mg/dl.  70 is an excellent LDL number and when accompanied with low triglycerides (less than about 90) and would give you a high probability of plaque reversal.  What LDL-P does this correspond to?  It turns out that the 2nd percentile of LDL-P is 720 nmol/l, which is almost exactly Dr. Davis’ target value. Obviously, being in the top 2% of Americans or any modern culture is a much, much safer place to be, considering the rampant heart disease (and complications such as erectile dysfunction) that dominate the general population.

CONCLUSION:  700-850 nmol/l is probably a good range to target for LDL-P, depending on your existing plaque levels and cardiovascular risk.  Using a knowedeable cardiologist to assess risk is the way to go, but there are few that are knowledgeable in plaque reversal according to what I have seen.

Get an IMT or Heart Scan – generally speaking you will not need a doctor’s order and can get this done yourself – and see how much plaque you have.  (A Heart Scan does involve some radiation, so you have to research that.)  If you have a significant amount of plaque, then you want to probably get as close to that 700 number as possible, since the only recommendation that I know of for arterial plaque reversal is Dr. Davis’ 700 number.

Again, it is always better to find a cardiologist or physician that knows about plaque reversal and can help you out.  (Most doctors are uninterested in this subject yet and will just hand you a statin and some Cialis and send you on your way.)

I also recommend that you read pages on How to Clear Your Arteries and The Importance of LDL-P For Plaque Reversal.. LDL-P is the best number to use. In the case of the latter, I make the case that LDL-P is a much better number to use than LDL-C, because so many men in modern cultures are prediabetic. If you do not have access to testing for LDL-P, which is common in other countries and in certain (Gestapo-like) states in the U.S., then you can use the a combination of LDL-C, triglycerides and HDL like the Plaque Regressers to approximate LDL-P. See my page on HDL, LDL and Triglyceride Levels.

1)  J Clin Lipidol,m 2011 Mar-Apr, 5(2):105-13, “Clinical implications of discordance between low-density lipoprotein cholesterol and particle number”

2) American Assoc of Clinical Chemistry, 2009, 55:3, “Apolipoprotein B and Cardiovascular Disease Risk: Position Statement from the AACC Lipoproteins and Vascular Diseases Division Working Group on Best Practices”

Depression in Men and Natural Methods for Healing - Peak Testosterone

Many of you know my story: I was low testosterone (almost for sure) since puberty and struggled with dysthmia (mild depression) until age 52 when I got my first testosterone cypionate shot. Bam! I remember thinking, “Wow! I finally know what it feels like to be a normal person.” Of course, not everyone experiences that kind of effect from HRT, but it happens quite often as testosterone has a HUGE impact on us guys right between the ears. (You can read more about the subject in my link on Testosterone and the Male Brain.)

More importantly, I have notice a big percentage of men on The Peak Testosterone Forum are struggling with depression but are getting no useful information – often quite the opposite – from their front line doctors. (Not all physicains are like this, but many are and so I think it is important to highlight this.)  There are a lot of reasons for that, which I will discuss below, but let’s look at some of the comments straight off the the forum that are just downright scary in my opinion:

“Been to all sorts of doctors and all kind of tests, no help from any of them… and thing are bad. taking vitamins and ALC and hope my nerves get better somehow. Stress and depression are killing me. So everyone be gentle with yourself. It’s one of the worst things that can happen to a man. I feel like theres no point to live anymore, I cant concentrate on my work nor sleep. losing my friends because I feel like I’m uncapable to communicate like I did before the stupid accident. I’m screwed. I had perfect body and mind. Now there’s nothing left of me.” [1]

“I’ve been fighting a periodic stress induced problem for about 7 years now starting in 2005. I’ve had 4 “episodes” now. They always start in periods of high stress and last from 1 month to 6 months depending on how long it takes me to get on top of the stress. I get depression, anxiety, and I have a very specific form of insomnia where I wake up many times a night with bladder pain like I need to urinate but little or nothing is actually voided. These episodes are really hard on me, my family and my job.” [2]

“I wanted to see if anyone had any ideas on how to get a more agressive doctor to address my symptoms…I also told him of shortness of breath, elevated pulse rate, and borderline hypertension… I also have depression/anxiety/chronic fatigue.  I don’t know if I should go to a immunologist, neurologist, endo, or that guy from “House” (the old tv show)?” [3]

“The first endocrinologist didn’t offer any help because my testosterone was in the “normal” range and because I “look like an athlete” (I was +20% bodyfat and bloated). He told me to “be confident” regarding my anxiety and depression/mood swings.” [4]

These are just a few quotes, but you get the idea.  Obviously, these men are struggling. Because I see this so often, I am including the subject of depression as Step 10 in my “Peak Testosterone Program”, which deals with the typical symptoms that we see over and over again: fatigue, anxiety, mental fog, low testosterone, erectile dysfunction and so on. Yes, depression can cause all of these and so I want to cover some of The Natural Ways to Overcome Depression that your doctor will probably never discuss with you:

CAUTION: Do not quit any medication without discussing it first with your physician.  Likewise, do not add any supplement without first discsussing it with your doctor if you have an underlying medical condition or any current medicaitons.

1. Testosterone. A few savvy practitioners out there are now screening depressed men for low testosterone levels. Why? Because depression has been shown in numerous studies to be linked to low T and, furthermore, giving a man HRT (testosterone therapy) can often improve his depression.  I am living proof of that one!  To see some of the research, check out my link on Testosterone and Depression. Again, the reason that testosterone is so helpful in this area is that testosterone stimulates many neurotransmitters, including dopamine, and is just good for male brain health as you can see in my link on Testosterone and the Brain.

2. Nutrition, Supplements and Exercise. There are actually many nutrients that, when low, can create or worsen depression. Your brain is a huge energy hog and requires massive amounts of vitamins, minerals, fatty acids, amino acids, antioxidants, anti-inflammatories, etc. in order to run effectively. It is too much to cover here, but I discus all of this in my link Natural Depression Cures. Put these small things together and they can make a huge difference.

3. Meditation and PMR. There is a strong and underemphasized cortisol/stress/anxiety component to depression.  This aspect of depression responds very well to stress management techniques.  These take just a few minutes out of the day and are also just good for general health.  See my links on Secular (Non-Religious) Meditation, Mindfulness Meditation and Progressive Muscle Relaxation for the basics.

4. Thyroid. Hypothyroidism can cause or worsen depression. Unfortunately, most doctors do not do an extensive evaluation and so I urge you to read this link on The Many Causes and Ways to Diagnose Hypothyroidism for some good starter information.

Of course, sometimes depression is severe and incapaciting enough that it requires some kind of medical or psychological intervention.  Don’t put off treatment if you need it:  depression is very hard on the body.  It elevates inflammation levels, cortisol, free radicals and is so hard on the brain that it can damage the hippocampus and possibly other neurological regions as well.  It also may lead to hypgonadism in some cases and can lead to difficulties in the bedroom as I document in my link on Depression and Erectile Dysfunction. Obviously, that is only going to make a bad situation worse.

So, if you are struggling with depression, it’s important to face it and defeat it.  Again, stop by The Peak Testosterone Forum if you have any questions or comments.

REFERENCES:

1) https://www.peaktestosterone.com/forum/index.php?topic=2217.msg23764#msg23764

2) https://www.peaktestosterone.com/forum/index.php?topic=785.msg7007#msg7007

3) https://www.peaktestosterone.com/forum/index.php?topic=1310.msg12503#msg12503

4) https://www.peaktestosterone.com/forum/index.php?topic=2342.msg22942#msg22942

STEP 8: Treat Your Depression – Hopefully Naturally

The Hypothalamus and Your Hormones - Peak Testosterone

What is the most important gland in the body?  The testes, right?  No way!  Not even the all-important testes can hold a candle to the hypothalamus.  The testes get the glory, but the hypothalamus sits back in the shadows as the real master of all we hold dear as a male.  As we’ll show below, the hypothalamus governs just about everything that is worth governing.

Most men think of the hypothalmus as a structure that lies deep within the brain behind the blood-brain barrier.  Well, that simply is not true.  It is true that it is “tucked away” with the brain, but it is mostly in front of the blood brain barrier and has considerable exposure to chemicals and toxins.  The most infamous of the toxins that can damage the hypothalamus are the so-called excitotoxins, MSG and aspartame for example.  Excitotoxins are abundant, and more often that not hidden in most modern wheys and processed foods.  Have you seen autolyzed yeast extract or hydrolyzed protein in an ingredient list?  You can bet it’s packed with excitotoxins.

Many health-conscious men expose their hypothalamus to multigram dosages of free glutamine simply out of ignorance.  As I document in my link on Excitotoxins and Testosterone , this is a really BAD idea.  These dosages are likely slowly damaging hypothalmic tissues and it’s no wonder that probably 95% of low T men on the Peak Testosterone Forum have secondary hypogonadism:  they have been unknowingly hammering their hypothalamus for years with small but significan dosages of these toxins.<

So I am hoping in this thread to encourage men to take care of this all-important gland and also point out some very interesting research that shows that the hypothalamus’ importance actually extends far beyond just it’s hormone-boosting properties: it appears to be a literal fountain of youth. Consider these functions of the hypothalamus:

Furthermore, most hypogonadal men are secondary, meaning that men with hypogonadism have an issue with either the pituitary or the hypothalamus. I base that on the fact that the great majority of low testosterone men on the Peak Testosterone Forum are secondary and have an issue with either the pituitary or the hypothalamus. The fact that they are secondary is shown by the fact that Clomid works on so many of them and that their LH (leutinizing hormone) levels are low or lowish.  When a man has primary hypogonadism, usually his LH is on the high side, because it is “working overtime” to try to stimulate the testes into a more normal testosterone output.

The primary points are this:  the hypothalamus is ground zero for production of your testosterone and other steroid hormones (DHT and the estrogens) and there is evidence that the hypothalamus is often the problem area for most low testosterone men.

2. Thyroid Function.  Many, many men are hypothyroid.  Hypothyroidism affects general health, sexual function, energy levels and can lower testosterone.  And, very analagous to the situation with testosterone, the hypothalamus is starting point for thyroid hormone production.  It secretes thyrotropin-releasing hormone (TRH) which is turn triggers the more well-known TSH that is released by the pituitary and monitored by many doctors.  Thus, hypothalmic dysfunction can affect thyroid function in a very similar way to how it can downgrade testicular function.  (For some research showing this, see #22 on my link How to Increase Testosterone Naturally.)

3.  Insulin Sensitivity. What does a huge percentage of heart disease and erectile dysfunction have in common?  Insulin resistance.  Prediabetes and diabetes are rempant here in the U.S. and probably affect about half of adults over the age of 40.  And how these conditions take a toll on our sex life.  (See these Links on Diabetes and Metabolic Syndrome for more information.)  Most men know that the pancreas houses the beta cells that manufacture insulin and that diet and exericse play a major role in controlling blood glucose and insulin levels.  However, what few men realize is that the hypothalamus plays just as pivotal of a role in insulin regulation.

Further evidence is shown by the fact that excitotoxins, which damage the hypothalamus, make animals fat in a number of research studies.. Excitotoxins accelerate weight gain in other ways as well by the way:  they have been shown in several studies to stimulate the pancreas.  Plus, diet drinks, most of which are packed with excitotoxins, also have been shown in study after study to lead to weight gain. [2] (The reasons for this are a little different, however, than hypothalmuc damage.)

4.  Aging.  Where is the Holy Grail of human aging?  Scientists recently found that it lies in the hypothalamus.  Already in animals they have increased longevity by 20% simply by controlling NF-kB within the hypothalamus. [3] It turns out that FN-kB is literally a dial that controls aging and it is all due to the fact that it acts on the hypothalamus.

Some experts think that life span can be extended somewhat in humans through this as well.  And, althought it hasn’t been tested in primates yet, I don’t think anyone doubts that the hypothalamus is ground zero to human aging.  And no wonder:  it controls blood sugar/insulin control and our key hormones.  It’s hard to find anything more important than that, eh?

So there are four very good reasons to protect your hypothalamus.  Keep in mind that science may even develop a reasonable anti-aging strategy that involves control of the hypothalamus in the next few decades.  Do you want to be left out of the party because your hypothalmic tissue is lesioned and unresponsive??

1)   https://www.sciencedaily.com/releases/2008/07/080710180013.htm

2) https://www.uthscsa.edu/hscnews/singleformat2.asp?newID=1539

3) https://www.sciencedaily.com/releases/2013/05/130501131845.htm

Few Common Tests That Men Pull - Peak Testosterone

Testosterone Tests

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 https://www.peaktestosterone.com/hypogonadism_testosterone.

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 https://www.peaktestosterone.com/. (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:

[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.

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..

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

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.

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.

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

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 https://www.peaktestosterone.com/forum/index.php?topic=346.0 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 https://www.peaktestosterone.com/forum/index.php?topic=221.0 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.

REFERENCES:

1)  Quest Diagnostics, Table 1, Testosterone Reference Ranges in Adults, https://appointment.questdiagnostics.com/patient/confirmation

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

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

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

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

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

7) https://www.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://www.peaktestosterone.com/forum/index.php?topic=346.0

10) https://www.peaktestosterone.com/forum/index.php?topic=221.0

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

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.

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

Whey & Testosterone

Undenatured whey should be considered a superfood in my opinion. Anything that simultaneously increases glutathione and immunity while lowering insulin resistance and weight is impressive by any standards. One might expect that anything that good for you would also increase testosterone levels.  However, this is not the case and, as I will discuss below, it probably lowers baseline testosterone levels in one critical area.

That said, I do not know of any study that has looked at whether or not whey increases or decreases baseline testosterone levels.  I have a fear that if a man consumes too much of the standard excitotoxin-loaded wheys, he could potentially damage his hypothalamus – something I document in my page Whey and Free Glutamine – which could lead to a drop in testosterone, since is controlled by the same.  However, forgetting about that concern, there is no real evidence that whey has a significant impact on resting testosterone levels.  Actually, there is one study on rats that shows that whey delays puberty, but this is just one isolated animal study. [1]

What there is evidence for is a testosterone-lowering effect post-exercise. As many of you may know, testosterone generally spikes after exercise and so researchers have looked at whey’s effect on this phenomenon.  One recent study found that whey lowered the cortisol spike that occurs after heavy squatting with weights. [2] Of course, this should help keep a man from going catabolic – into a muscle-wasting state – because, in general, anything that lowers cortisol will raise testosterone.

However, other research shows that, in some cases at least, whey may actually lower testosterone after a workout (with weights).  The first hint of this actually came in 2005 when researchers gave men – again doing heavy resistance training – a mixture of whey and caseinate.  They found that both post-exercise growth hormone and testosterone levels were higher in men consuming a placebo than men consuming this protein mixture that included whey. [3] Of course, one wants those testosterone increases and so this was undoubtedly a bit concerning.

The obvious problem with the above study is that one does not know whether or not the whey or the casein blunted testosterone in this situation.  Fortunately, a follow-up study was done in 2008 that looked at whey alone without casein.  Again, the post-exercise rise in testosterone was found to be blunted, indicating that whey was the culprit. [4]

“In conclusion, the protein ingestion hinders RE-induced increase in serum testosterone in older men but may not significantly affect muscle AR, MGF or IGF-IEa gene expression,” where AR = “Androgen Receptor” and MGF /  IGF-IEa = “Insulin Like Growth Factor.” [4]

In other words, whey may lose a little out of the gate but seems to more than make up for it down the stretch when it comes to muscle gains.  And countless bodybuilders over the decades have used whey successfully for massive gains, so this cannot be too much of an issue, eh?

NOTE:  There are now many undenatured wheys out there and I discuss one of them in my page on Undenaturated Whey Protein.

REFERENCES:

1)  International Journal of Toxicology, May 2001, 20(3):165-174, “Developmental Effects and Health Aspects of Soy Protein Isolate, Casein, and Whey in Male and Female Rats”

2) Journal of the American College of Nutrition, 2013, 32(1), “The Effects of Soy and Whey Protein Supplementation on Acute Hormonal Responses to Resistance Exercise in Men”

3) Medicine and Science in Sports and Exercise, 2005, 37(11):1990-1997, “Protein ingestion prior to strength exercise affects blood hormones and metabolism”

4) J Steroid Biochem Mol Biol, 2008 May, 110(1-2):130-7, “Androgen receptors and testosterone in men–effects of protein ingestion, resistance exercise and fiber type”

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”

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

Why would any of us guys want to boost our DHT?  After all, DHT (dihydrotestosterone) in us males is created from testosterone via the 5-alpha reductase enzyme and, therefore, most men with decent testosterone also have decent  DHT levels.  Furthermore, if you ask almost all physicians (that even care) how to boost your DHT, they will tell you that you should do it via HRT, which will raise both testosterone and DHT simultaneously.  In spite of these points, I have seen on The Peak Testosterone Forum some legitimate reasons for wanting to raise HRT. Quite often men that are interested have the following situation:

–Average or midrange testosterone levels

–Below range or near below range DHT levels

–Low libido

The reason that these men are so concerned is because DHT plays a major role in libido, something I discuss in my link on Testosterone and DHT. So it is reasonable to assume that below average DHT could be playing a role. And DHT can also serve to limit estradiol, so some men are concerned that low DHT could lead estradiol-related symptoms.  For example, there is some evidence that low DHT can lead to certain kinds of gynocomastia.  In addition, some men also simply do not like the idea of standard HRT for a variety of reasons and feel that DHT is a safer and less instrusive way to go

CAUTION: In my opinion, you only want to consider DHT under a doctor’s supervision and with adequate monitoring.  And the primary reason is that too much DHT could lead to accelerated hair loss.  What if Mother Nature already gave you a buzz cut?  Well, too much DHT could also lead to acne and hair growth.  Some say that it could enlarge the prostate as well.  This is questionable, though, because DHT actually blocks estradiol and it is the latter that is most associated with prostate enlargement according to many experts.

Here are some Ways to Increase DHT Naturally:

1.  Scrotal Testosterone. Okay, I said I would avoid HRT in this discussion. However, scrotal testosterone is a bit different. Basically, there is a (admittedly small) study out there that shows that rubbing testosterone on the scrotum leads to a higher conversion rate to DHT than normal. [3] The authors noted that applying testosterone to the scrotum lead to

“The serum testosterone and estradiol levels did not rise above the normal adult male range at any time during therapy. However, elevated serum dihydrotestosterone (DHT) concentrations occurred during treatment; the pretreatment DHT concentration was 95 +/- 3 ng/dL (3.3 +/- 0.1 nmol/L), and it increased to 228 +/- 40 ng/dL (7.8 +/- 1.4 nmol/L) after 4 weeks of treatment and remained elevated thereafter.”

This is a large boost in DHT and, therefore, great care should be taken for reasons mentioned above.  (Of course, talk to your physician first.)

NOTE: There are also oral DHT’s out there.  For example, Winstrol, stanololzol, Proviron and other medications are oral, synthetic DHT’s.  You can also buy DHT in gels – Andractim for example – but this is only available in certain countries.

2. Topical Testosterone. Dr. Crisler has stated several times that he prefers topical or transdermal testosterone preparations, because they boost DHT a little more proportionately.  So, if you’re a man on standard testosterone therapy (TRT or HRT), then this might be another route to go.  You do have to be very careful around women and children if you use this option.

3. Creatine.  One study shows creatine to be a solid DHT booster.  Furthermore, this was shown to be true on young, male rugby players who should have beefy DHT levels to start with.  The study showed that DHT levels increased to 56% above their starting point and settled in at 40% above baseline at the two week point. [1] How creatine does this is not known, but it is apparently NOT by increasing testosterone.  This same study showed no significant increase in testosterone but found that the T-to-DHT ratio increased by 22% after two weeks.  If you are wondering about dosage, the study gave these young men the standard “gym dosage” of 5 grams daily.

Creatine has many other benefits including increasing workout output and satellite cells (for muscle building).  Be careful if you have any existing kidney disease and be sure to consume some extra water throughout the day.

CAUTION: 21 grams daily of creatine led to huge (450%) increases in urinary formaldehyde. [5] Normal daily dosages are 5 grams but even modest increses in formaldehyde are potentially dangerous, because formaldehyde is a likely carcinogen. [6]

4. Protein/Carb Ratio. There is also a study out there that shows that you can alter the conversion of testosterone to DHT with just diet alone.  Here are the macronutrient levels in this particular study:

“The volunteers were fed a high protein diet for 2 weeks and then a high carbohydrate diet for a second 2-week period; there was an interval of 3 weeks between the study periods during which they consumed their usual home diets. The high protein diet consisted of 44% of calories as protein, 35% as carbohydrate and 21% as fat; the high carbohydrate diet consisted of 10% of total calories as protein, 70% as carbohydrate, and 20% as fat.” [2]

So notice that both of the diets had, at least for the typical American, fairly low levels of fat and essentially the researchers were playing with the protein/carb ratio.  So diet #1 was with a protein-to-carbohydrate ratio of about 1.25 and diet #2 had a protein-to-carb ratio of 0.14. Of course, as a guy who lifts weights and eats a lot of protein, I would like to believe that the higher protein diet was superior.  However, that was not the case and, in fact, the higher protein diet actually lowered DHT and it did so by lowering the activity of the 5-alpha reductase enzyme that converts testosterone to DHT.  The authors noted that “the isocaloric substitution of protein for carbohydrate in the diet decreased the delta4-5alpha-reduction of testosterone while concurrently increasing the oxidative metabolism of estradiol and also of antipyrine in man.”

Again, I consume a lot of protein, but I do this with “eyes wide open.”  I discuss some of the potential issues in my page on Dangers of Protein for those interested.

5. Zinc. If you are zinc deficient, the evidence shows that it can be a root cause for low DHT.  Furthermore, if this is your underlying issue, you can significantly raise your DHT just by taking this inexpensive supplement.  Try to avoid the zinc oxide form, since it is so poorly absorbed.  For some of the studies, see my link on Zinc and DHT. (A zinc deficiency can also lead to very low testosterone levels as well.)  I do have some cautions though about taking too much zinc and I urge anyone taking supplemental zinc to scan through this page:  The Potential Dangers of Zinc.

5. Oral DHEA.  There is For details on this study, see my link on What Hormones Does DHEA Change Anyway? page.

6. Exercise. If you are fairly inactive, exercising my increase your DHT significantly.  One study followed a 100 sedentary men after putting them on a one hour per day (6 days per week) exercise program.  Their DHT increased from their baseline by 14.3% at the 3 months point and 8.6% at 12 months. [4] Not bad for something that will boost you nitric oxide and help you lose weight, eh?

7. MEN ON TRT: Once a Week Transdermal. Some men on testosterone cypionate (or enanthate) injections may have DHT levels a little too low and their libido may not be where it should be.  On this page I discuss a clever solutions that one of our senior posters mentioned that Dr. Shippen is using:  Low DHT While on Testosterone Injections.

NOTE:  If your doctor does not do enough monitoring due to insurance and cost considerations, see my page on Inexpensive Testosterone Labs. I have no affiliation with any of these, so, of course, do your own due diligence.

REFERENCES:

1) Clin J Sport Med. 2009 Sep;19(5):399-404, “Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players”

2) PNAS, Dec 1983; 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”

3) J Clin Endocrinol Metab, 1988 Mar, 66(3):546-51, “Transdermal Testosterone Therapy in the Treatment of Male Hypogonadism”

4) 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”

5) Med Sci Sports Exerc, 2005 Oct, 37(10):1717-20, “Effect of oral creatine supplementation on urinary methylamine, formaldehyde, and formate”

6) https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/formaldehyde/formaldehyde-fact-sheet

Creatine: Can It Help for the Plant-Based Vegetarians - Peak Testosterone

I had a little surprise during my 2012 physical:  I had a low GFR, which indicates poor kidney function.  In addition, I had had a few aberrant readings in the docs office over the lost year of my blood pressure in the prehypertension phase.  All of this pointed to my kidneys being under stress and perhaps even injured.

My doc quizzed me and was horrified to find I was taking creatine.  Now I had read dozens of articles on creatine and all of them insist that it is incredibly safe and well-tolerated and does not affect kidney function, so I thought she was just operating on “old school” information.  And perhaps she was, but I did find in my research that these articles, most of whom are on sites selling creatine, leave out several important facts about this supplement. And weight lifters like myself don’t want to hear anything negative about creatine, because it is one of our star performers.

For those unaware, creatine has many incredible properties, which I document in my link on The Advantages of Creatine for Vegetarians, such as building satellite cells – one of the Holy Grails of bodybuilding – and boosting workout performance, etc.  Unfortunately, to get those kind of benefits, you have to megadose.  5 grams is the typical maintenance dose and this is this is the amoung of creatine in a little over a pound of salmon!  Unless you’re working on an Alaskan fishing boat, you’re not going to get anywhere near that on a daily basis.  During the “loading phase” many men take creatine of 20-25 grams for a week or two as well.  Some muscleheads like myself take 5 grams before and after a workout.

So let’s look at just what risks creatine potentially poses in some men:

1. Raising DHT.  DHT (dihydrotestosterone) is a steroid hormone almost as important as testosterone itself.  It has a significant impact on libido, but is infamous for its role in male pattern baldness and BPH (enlarged prostate).  All DHT comes from the conversion of testosterone via the 5-alpha reductase enzyme.  This is why HRT almost always causes the prostate to grow:  the body converts some of the newfound testosterone into DHT and the size of the prostate increases accordingly.  It usually does not cause issues however.

Creatine supplementation was recently studied in healthy young rugby-playing males and found to increase by 56% during the 25 gram loading phase and 40% during the 5 gram maintenance phase. [1] In addition, the testosterone-to-DHT ratio increased by 22%, which indicates that there was increased 5-alpha reductase activity.

Does this mean that creatine usage could cause hair loss?  Many men are low or lowish in DHT and so it is doubtful that they would be impacted.  However, for men with more robust DHT levels, raising in another 40% is definitely not going to help matters. You can get your DHT measured – a doctor is unlikely to do it for you – at any one of these Testosterone Self-Testing Labs.

Does this mean that creatine is universally danger-free?  That is a big assumption.  First of all, creatine increases the amount of urine by about 25%. [3] This just will create an additional burden on the kidneys.  Obvioiusly, for healthy individual this does not appear to be a big problem however.

Long term users of creatine, though, should keep in mind that several cases of inflamed kidneys have been reported [3] and that studies on creatine usage have always been on the young and healthy.  Long term usage by middle and senior-aged men may not fare so well.  Furthermore, what about in men with type II diabetes, whose kidneys have often “been through the war?”  Again, there are many large population groups who do not need and may not do well with this extra burden on one of their vital organs.

This reminds me a bit of salt in the diet, which will pull extra water into the arteries.  This, of course, requires the heart to work a little harder, but is a burden that is handled fairly well by most people.  However, in some sensitive people, it can create high blood pressure and other problems.

The bottom line is this:  if you are going to use creatine, it would be wise to regularly check your kidney function in my opinion. Better safe than sorry, eh?

3.  Creatine + HRT.  As I have documented in my link on Testosterone and the Kidneys, HRT could cause issues in men with kidney problems. Some research shows that testosterone can cause cell death in the kidneys in certain cases, explaining why men have a much higher rate of kidney failure than women. [5] However, the good news is that giving men testosterone therapy is not noted for increasing kidney issues.

But I could not help but ask myself the question:  did my GFR fall below range because I was on both testosterone AND creatine at the same time?  Perhaps the two of these together created issues for me.  (I was on testosterone cypionate at the time and my testosterone was peaking at about 1200 ng/dl at the time.)  One further evidence of this is the fact that, after I gave up the creatine, my GFR rose again back within acceptable lab range levels.

1)  Clin J Sport Med, 2009 Sep, 19(5):399-404, “Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players”

2) Med Sci Sports Exerc, 1999 Aug, 31(8):1108-10, “Long-term oral creatine supplementation does not impair renal function in healthy athletes”

4) https://www.racquetballcentral.com/pdf/creat150.pdf

5) Kidney Int, 2004 Apr, 65(4):1252-61, “Testosterone promotes apoptotic damage in human renal tubular cells”

Sleep Disorders and Erectile Dysfunction - Peak Testosterone

We have already covered how Sleep Apnea Leads to Erectile Dysfunction. However, sleep apnea is a very severe sleep disorder where the patient is often woken hundreds of times during the night.  So what happens when a guy has a more mild sleep disorder?  Can those affect erections and possibly lead to impotence as well?

Study after study has showed that is exactly the case. Almost every sleep issue that you can think of will put the brakes on your sex life in one way or the other.

Most guys think that it’s only what they do or do not do while they are awake that affects their bedroom prowess.  Below we document that pillow time is every bit as important:

1) Sleep, 2010 Jan 1, 33(1):75 79,”Restless Legs Syndrome and Erectile Dysfunction”

2) The Journal of Sexual Medicine, Apr 2008, 5(4):898-908, “Snoring as a Risk Factor for Sexual Dysfunction in Community Men”

3) Sleep, 1986, 9(1 Pt 2):227-31, “Erectile dysfunction in narcoleptic patients”

4) The Journal of Sexual Medicine, Jul 2005, 2(4):543-550, “Association between Erectile Dysfunction and Sleep Disorders Measured by Self-Assessment Questionnaires in Adult Men”

1.  Restless Leg Syndrome. A study of over 23,000 senior men with RLS showed that those with symptoms 5-14 times per month and 15+ times per month were 16% and 78% more likely to experience erectile dysfunction, respectively. [1]

2.  Snoring. Yes, just snoring, particularly heavy snoring, was associated with sexual dissatisfaction according to one study of 800+ senior men. [2] It is also doesn’t do a lot for your partner sexual desire either…

4.  All Sleep Disorders. One study of younger men found looked at any and all sleep disorders.  They found that virtually any and all were associated with erectile issues. [4]

The bottom line is that anything that decreases sleep will likely negatively testosterone, neurotransmitters and energy levels the next day.  Plus, good evidence shows loss of sleep leads to insulin resistance, arterial plaque and other long term risk factors for impotence as well.

REFERENCES:

Whey That Won't Fry Any Neurons - Peak Testosterone

However, I was in for the shock of my life when I began to research the amino acid profile on the label. I was shocked to see glutamic acid and aspartic acid! In fact, the label almost proudly displayed to four significant digits the glutamic acid as 3,146 mg and aspartic acid as 1,961 mg per serving.

Are all of those mg excitotoxins?  No.  But a significant percentage were, because almost all modern whey are processed at high temperatures that leads to high levels of free glutamine.  And it is the free glutamine which is the true excitotoxin. (Natural glutamates are actually good for you and can lower blood pressure.)

So with each and every scoop I was inadvertenly flooding my system with excitotoxins. That’s right – glutamic acid and aspartic acid are just the downstream versions of monosodium glutamate and aspartame.  If you don’t know what these bad boys do to your neurons, read more here about Excitotoxins, Testosterone and Your Brain.

Of course, I called Body Fortress and asked their nutritional representative essentially, “How could you poison my neurons with megadoses of excitotoxins?” His answer? “What’s an excitotoxin?”  I quickly realized this conversation was going nowhere, so I did a little research and found that the excitotoxins glutamic acid and aspartic acid are created in the hydrolyzation process that creates whey protein isolates and concentrates.  And virtually all bodybuilding whey powders are composed of these isolates and concentrates.

Once again, it just goes to show that you do not want to touch processed foods, because corporations, for the most part, have little to no regard for your health.  These whey powders are created and manufactured by supplement companies that should know better and, in many cases, probably do know better but still put out a dangerous product to squeeze out extra profits.

YET ANOTHER CAUTION:  The above whey powder also had L-Taurine of energy drink fame, L-glutamine and creatine added.  I asked the rep how much of the first two were added and he said that it was “proprietary”.  Translated that means, “We are going to throw a bunch of chemicals in your whey and you just have to trust us”.  They also put in sucralose, an Artificial Sweetener that likely attacks intestinal flora.

How To Lose Weight The Easy and Healthy Way - Peaktestosterone

Most of the men who write me wanting to improve their erectile dysfunction or low testosterone are significantly overweight. The truth is that they don’t need to be told that their spare tire is an issue – they’re experiencing the symptoms first hand!

Many of them have struggled all their lives with weight issues and many of you reading this are in the same situation.  Rest assured, though, that losing weight does not have to be the laborious, painful experience that so many make it to be.  The key is to understand your body, your hormones and a few tips and tricks that the research has uncovered.  For example, did you know that one study showed that if you lose weight by diet along you will lose muscle? [25] However, if you add exercise to your diet, you will lose primarily fat and maintain your muscle. Again, many people, even in the health community, are unaware of this fact.

Now, before I move on and discuss the best way to lose weight, I want to mention that more than anything else it is perhaps most critical that you not lose weight too rapidly.  You will have trainers, your conscience and maybe a few friends and family pushing you to drop those pounds quickly.  Well, don’t listen!  Losing weight rapidly destroys your testosterone (and leutinizing hormone) like nothing else.  A recent Finnish study found that wrestlers who dropped weight very quickly decreased testosterone levels by over 60%! [14] Ouch! (See the bottom for more details.)

So my advice is relax and lose weight slowly, steadily and peacefully with dignity and grace.  No need for television theatrics.  No need for family and friends or even yourself to suffer immeasurably.  Losing weight is not a monumental decision – it’s just a part of life for all of us.

If you need motivation, read here about the Many Dangers of Being Overweight.  And here’s some scientific findings that will really help:

1)  Muscle. If you have lost a lot of muscle over the years, you will find it easy to put on weight.  Remember that “Muscle Burns Fat”.  If you can trade five pounds of fat for five pounds of muscle, you will burn 200 more calories per day!  This translates to at least 21 pounds per year.  A lot of people wonder why they gain weight so easily and it’s because they’ve let their muscle mass slowly decline, which leads to a nasty metabolic downward spiral.

2)  Fructose.  Watch the fructose!  Read here about How Fructose Sabotages Weight Loss.

3) Green Tea Extract. One supplement will help you lose weight is Green Tea Extract.  Animal experiments have shown that mice (with an obesity gene) experienced less weight gain with Green Tea Extract and had lower cholesterol and triglyceride levels as well. [7]  Another 2008 study showed that rats had less weight gain while on Green Tea Extract. [8] Previous studies had shown that Green Tea does this through thermogenesis [9], basically increasing one’s metabolism and fat burning, but these animal studies showed additional mechanisms.  But additional research has shown that Green Tea inhibits fat-digesting enzymes [10] and helps you eliminate (poop) a higher percentage of fat after ingesting a high fat meal. [11]

4) Exercise. I don’t need to tell you that exercise burns calories. [1] I have known a number of people who could not lose weight until they started exercising and exercise makes you less insulin resistant.  Regardless of the reason, you may need to couple exercise with your weight loss program.

5) Insulin Resistance.  Read my link on Metabolic Syndrome.  One of the hallmarks of Metabolic Syndrome is insulin resistance and scientists have just discovered that high insulin levels keep your body from breaking down fat.  An insulin resitant individual will have high insulin levels and high glucose concentrations, a toxic combination that causes damage in different ways.  The high insulin levels are deadly because the block the breakdown of fats by adrenaline and lipase. [15] In other words, insulin resistance makes it MUCH easier for to retain fat, so it is critical that you put in your gym or road time.

6) Low Glycemic Index. One recent 12-week study found that eating a low glycemic diet produced greater weight loss than those on a high glycemic diet. [16] Low glycemic foods are those that do not spike your blood sugar as much, such as whole grains and most fruits and vegetables.  NOTE:  It should be noted, though, that not all studies have found these results.  Glycemic Load is, by the way, a much more important concept actually than the Glycemic Index.

7) Exercise to Increase Basal Metabolism. As we age our metabolism slows down, largely due to the loss of lean muscle mass.  “Muscle burns fat” is a saying that is largely true.  Exercise is one of the best ways to ramp up your metabolism and burn off calories.  Plus, most forms of exercise will also build some muscle for you as well.  The book, The GI Mediterranean Diet – an excellent read by the way – talks about how if you exercise in the morning for even 20 minutes, you increase your metabolism for the next 10-12 hours! [18] Yet another study found that weight training (8 exercises, 8 sets, and 6 repetitions) increased baseline energy expenditure for at least 72 hours afterward! [20]  If you exercise in the evening, you only get this boost in metabolism for four or five hours until you go to bed.  Of course, the best thing to do is exercise for a half hour in the morning and then a half hour in the evening and you’ll be burning calories every waking hour.

8) Squats.  Do strength and weight training on your large muscle groups, especially the quads (thighs) and gluts (butt). Researchers at Syracuse University found that the body takes more energy afterwards to repair and rebuild and so more calories are burned off. [19]

9) Avoid Late Night Snacks. You still here “calories in, calories out” is all that matters in weight gain and weight loss.  That belief is slowly getting shattered of lateResearchers recently found that late night snacks affect metabolism negatively and lead to greater weight gain. [21]  Mice fed late at night gained over twice as much weight as mice fed during regular feeding hours.

10) Sitting and Lipase. Scientists have found that sitting does something particularly nasty: it shuts off the activity of an all-important weight loss enzyme called lipase. It does this by severely limiting the circulation of lipase and lipase is critical because it allows the body to process fat and cholesterol.  Just the simple act of standing allows for a much, much better dispersion of lipase throughout your tissues.  If you are sedentary and haven’t been able to lose weight, now you know one of the reasons why.  It’s not just that you have been burning enough calories, it’s that you have been limiting your body’s natural chemical processing factories.  So, the old expression “Get off your a#$%!” might actually save one’s life!

11) High-Intensity Training.  If you can take the pain, High-Intensity Training, a close relative of Interval Training, has also been shown to help you lose weight the fastest. Intensity is a technical term that basically refers to the amount of effort in a certain amount of time or the amount of “sweat and burn” the exercise induces.  High-Intensity Training actually boosts your metabolism so that you “burn fat” for more hours than other training methods. [22] Researchers put (female) participants on a repeated cyle of “sprinting” on a stationary bike for 12 seconds and then pedaling much more slowly for 12 seconds and so on for twenty minutes three times per week. [23]  This very minimal amount of exercise significantly reduced body fat and controlled blood sugar metabolism.

12) GoWear/Sensewear/Bodybugg. This is the device used on Biggest Loser and with good reason:  many guys may benefit from the use of this armband which uses a complex set of readings on acceleration, skin temperature/response and heat to determine how many calories you have burned. It is supposedly much more accurate than standard heart monitors and considering that a lot of us are motivated by numbers, myself included, this offers a considerable level of detail.  You get numbers and charts galore as it is used in conjunction with a web site that lets you analyze your progress.

13) Sleep.  Sleep is a key to keeping off the pounds.  It is so important that I have created a separate link How Lack of Sleep Sabotages Weight Loss.

14) Low Fat Diet.  The beauty of a Low Fat (or Ornish) Diet is that it solves your hunger problem during dieting, because you can eat as much as you want.  Think how much you can eat if you are eating nothing but (whole) grains, beans, legumes, vegetables, fruit and egg whites?  You can fill your stomach up many times per day and still lose weight because there is no high-calorie fat in your gut.  Fat is 9 calories per gram, whereas carbohydrates and protein are only 4 calories per gram.  The typical American eats a diet around 35-40% fat and so the typical American end up eating too many calories.

In fact, the astonishing thing is that you will get full before you actually get all the calories.  In other words, you’ll actually lose weight on a Low Fat (or Ornish) Diet.  Dr. Ornish performed a study and found that people who followed his diet lost an average of 22 pounds in their first year. [5] Imagine almost effortlessly losing weight while you walk around full and satisfied.  In other words, forget dieting -just eat the right way!

15) Vinegar: Vinegar has just been found in an extremely promising animal study to lower visceral fat.  Visceral fat is that annoying and dangerous fat that most guys get around their abdomen, i.e. a paunch/spare tire/gut.  Lab animals who consumed vinegar had 10% lower fat. Please about How Vinegar Can Help You Maintain (or Lower) Your Weight.

16) Appetite. One of keys to weight control is controlling your appetite. Packaged and processed food, in particular, is packed with sugar, salt and fat and compel you to eat more than you need.  On the other side, there are actually many healthy foods that are particularly satisfying.  Read this link about Foods that Help Control Appetite.

17) Stress. Watch your stress levels.  Researchers recently found that on average chronic stress led to weight gain, due to “eating in the absence of hunger”. [26]

18) Whey.  Research, some of it quite recent, has shown that whey will very likely help you lose weight.  Whey, a common bodybuilding protein supplement, does this through satiety of the appetite [27], control of glucose and insulin post-meal [28] and muscle building (and muscle burns more calories).  Even more interesting is the fact that whey appears to actually raise the body’s Resting Energy Expenditure, thus making your system a fat-burning inferno. [29]  In other words, whey seems to help you burn off those calories in almost every way possible. CAUTION:  Almost all store bought wheys that I have seen are loaded with dangerous excitotoxins and I document that here in my link called No Whey!.  However, there is an alternative, undenatured or biologically active whey, which I document in my link called Yes Whey if you want more information.

NOTE 1: Chromium, in spite of what your health food store may have told you, has been shown to be ineffective for weight loss.  However, it does seem to help your body manage blood sugar.  So there is some justification for taking chromium but not as miracle weight loss supplement.

NOTE 2:  For those of you who are Mediterranean Diet aficionados, you’ll be glad to know that a recent meta-analysis found that most studies showed a decreased risk for becoming obese for those who followed a Mediterranean Diet. [6] Again, the Mediterranean Diet is relatively high fat (~30%), making it easier to put on weight. However, it does convey a low glycemic load, which may contribute to its ability to keep off weight gain.  And one could also speculate that perhaps because it is fulfilling and satisfying, it leaves its practioners eating somewhat less.

NOTE 3:  You can’t trust the calorie labelling on food items. [17] The problem is that our bodies digest food and don’t burn it, which is where the whole calorie calculations are based on.  This is important because protein and fiber actually take significant energy to digest whereas cheap carbs do not.  So if one consumes a meal with a lot of protein and fiber, the amount of calories actually stored by the body may be as much as 25% less than that with sugars and other less healthy foods.  Yes, this is yet another reason to avoid the bad stuff.

REFERENCES:

1) Metabolism, 2001, 50(7):795 – 800

3) Amer J of Clin Nutrition,Jun 1984,39(6):930-6

6) Obesity Reviews, Nov 2008, 9(6):582-593

7) Amer Soc for Nutrition J Nutr, Feb 2008, 138:323-331

8) Amer Soc for Nutrition J. Nutr, Nov 2008, 138:2156-2163

9) Int J Obes Relat Metab Disord, 2000 Feb, 24(2):252-8; J Med Food, 2006, 9(4):451-8

10) J Nutr Biochem, 2000 Jan, 11(1):45-51

11) Eur J Clin Nutr, Nov 2006, 60(11):1330-1336

12) Nutr J, 2008, submitted

13) West Afr J Med, Apr-Jun 1990, 9(2):108-115

14) Karila, TA., et al. Rapid Weight Loss Decreases Serum Testosterone. (2008) Int. Journal of Sports Medicine. May 30

16) Eur J of Clin Nutr, 2008, 62:145-149

17) Brit J of Nutr, 2001, 85:271-287, A perspective on food energy standards for nutrition labelling, Geoffrey Livesey

18) The GI Mediterranean Diet, Dr. Fedon Alexander Lindberg, p. 89-90.

19) Men’s Health, Sep 2009, p. 38.

20) J of Strength and Conditioning Res, Sep 2008, 22(5):1602-1609, “Resting Energy Expenditure and Delayed-Onset Muscle Soreness After Full-Body Resistance Training With an Eccentric Concentration”, Hackney, Kyle J

21) Obesity, “Circadian Timing of Food Intake Contributes to Weight Gain”, Arble, et. al.

22) Intl J of Obesity, 2008, 32:684-691, “The effects of high-intensity intermittent exercise training on fat loss and fasting insulin levels of young women”

23) International Journal of Obesity, 2001, 25:332-339, “Impact of high-intensity exercise on energy expenditure, lipid oxidation and body fatness”

25) The Amer J of Med, 95(2):131-140, “Effect of an energy-restrictive diet, with or without exercise, on lean tissue mass, resting metabolic rate, cardiovascular risk factors, and bone in overweight postmenopausal women”

26) Obesity, 2008, 17(1):72 77, “Acute Stress-related Changes in Eating in the Absence of Hunger”

27) British Journal of Nutrition, 2003 Feb, 89(2):239-48, “Casein and whey exert different effects on plasma amino acid profiles, gastrointestinal hormone secretion and appetite”

28) FASEB Journal, “The Effect of Whey Protein on Post-Meal Blood Glucose and Insulin”

29) Med Sci Sports Exercise, 2009 Dec 4, [Epub ahead of print], “Timing Protein Intake Increases Energy Expenditure 24 Hours Post-Resistance Training”

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/

Diet and Skin - Peak Testosterone

We know that diet affects your erectile strength, your arteries, your testosterone, but what about your appearance?  Can you prevent or accelerate wrinkling based on how you eat?  The answer is a definitive “yes” based on many studies.  The results of this research, somtimes referred to as the Monash Study, are basically this simple:  anything in the Mediterranean Diet is good for the skin and anything outside of the Mediterranean Diet is bad for the skin.[2] The only items a little on the fringes of the Mediterranean Diet were eggs, and, as I mention below, researchers have since found that the Lutein and Zeaxantin (found in eggs and spinach) are extremely skin protective.

I was shocked at how much of a difference eating right made on my skin.  In my case, I literally saw years melt off of my appearance and cannot encourage you enought to give it a try.  In fact, what was remarkable to me is that did not just slow aging, but it actually healed my skin and I saw a decrease in wrinkles.  Of course, that doesn’t last forever:  I’m not saying you’re going to look like you just went through puberty.  But try it:  you’ll be shocked at the results.

Below I give you some of the major foods to eat and/or avoid in order to do the same and we’ll look at a few supplements as well:

REFERENCES:

1) “Clinical Evidence for Lutein and Zeaxanthin in Skin Health, Part 1: Comparison of Placebo, Oral, Topical and Combined Oral/Topical Xanthophyll Treatments,” was conducted in Italy on female subjects, ages 25 to 50, over a 12-week period. The test product utilized in the study contained FloraGLO Lutein, manufactured by Kemin Health, L.C. It was administered daily at 10 mg (oral supplementation) and 50 ppm (topical formulation) to subjects in the study’s different test groups.

2) J of Amer College of Nutr, Feb 2001,20(1):71-80, “Skin Wrinkling: Can Food Make a Difference?”

3) The Sugar Fix, Richard J. Johnson, M.D., 1998.  p. 97.

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

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

9) Brit J of Dermatology, Apr 2008, 158(4):885-886, “Lycopene protects against biomarkers of photodamage in human skin”: O17.

10) https://esciencenews.com/articles/2009/09/09/ study.reveals.new.role.vitamin.c.skin.protection

12) Self, Aug 2009, p. 82.

13) 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”

14) FASEB Journal, “Ellagic acid prevents ultraviolet radiation-induced chronic skin damage of skin cells and in the hairless mice”

15) 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”

The GMO Studies observe Cancer/ Liver/Kidney/GI Tract Issue.

Are GMO foods really all that bad?  Is the concern all just a bunch of environmental paranoia?

First of all, I used to be pretty neutral to GMO, but, after reading about it what it really entails, I have no hesitation in labelling it both nasty and toxic.  So, yes, GMO is bad – really bad.  I would never serve it to my kids and I avoid it like the plaque myself now and below I’ll give you many studies showing you just why I am so emphatic about the subject.   And for the record:  in my opinion, what has been done with GMO products shows the very worst in American corporate ethics and philosophy and it shames me to think that I have done so little to oppose it.

But before we even go into how toxic and deceptive GMO foods appear to be, I want you to step back and think of something very important:  good, quality food is our #1 arsenal against chronic disease at this point. That’s right:  I think that proper diet and nutrition can heal the majority of our health problems and I know many of you do as well. So, if you believe that food is our last bastion of health, why would we let a bunch of mad scientists go in there and alter the genome of all our most precious crops?!?  Well, we shouldn’t as I’ll show you below.

Again, check out these 12 Studies that (Likely) Show GMO is Deceptive and Dangerous:

1. GMO Gate, Part I (The Pustazi Study).  What happens to a researcher who finds issueswith GMO crops? Simple: he is fired immediately. This is exactly what happened to Dr. Pusztai after the explained on public television that his study on GMO potatoes resulted in intestinal damage to lab rats. Basically, the lining of their stomach and intestines thickened from the stuff.  He even went on to say that he would never feel it to his kids.

REFERENCES:

1) Lancet, 1999 Oct 16, 354(9187):1353-4, “Effect of diets containing genetically modified potatoes expressing Galanthus nivalis lectin on rat small intestine”

2) Environmental Sciences Europe, 2014, 26:14, “Republished study: long-term toxicity of a Roundup herbicide and a Roundup-tolerant genetically modified maize”

3) https://www.agbioworld.org/biotech-info/articles/biotech-art/pusztai-potatoes.html, “Pusztai’s Potatoes – Is ‘Genetic Modification’ the Culprit?”, By Dr. Nina V. Fedoroff, Willaman Professor of Life Sciences and Evan Pugh Professor

4) https://www.gefree.org.nz/assets/pdf/joecummins.pdf

5) Cell Biol, 2008 Nov, 130(5):967-77, “A long-term study on female mice fed on a genetically modified soybean: effects on liver ageing”

6) Int J Biol Sci, 2009; 5(7):706-726, “”A Comparison of the Effects of Three GM Corn Varieties on Mammalian Health”

7) Nat Toxins, 1998, 6(6):219-33, “Fine structural changes in the ileum of mice fed on delta-endotoxin-treated potatoes and transgenic potatoes”

8) https://biointegrity.org/FDAdocs/17/view1.html

Well, good for him! But instead of receiving praise for protecting the public welfare, he was fired from his post at the Rowett Institute and was censored by the government. Yes, the GMO players, which include some of the largest corporations in the world (Monstanto, Dupont, etc.) are powerful! Fortunately, the following year the prestigious journal Lancet was willing to publish some commentary – kind of an open discussion about his research at least. [1]

The scientific community was appalled by this censorship and it was noted that:

“Their memorandum stated (the following is largely verbatim from the WSWS website): “Those of us who have known Dr. Pusztai’s work or have collaborated with him, were shocked by the harshness of his treatment by the Rowett and even more by the impenetrable secrecy surrounding these events. It is an unacceptable code of practice by the Rowett and its Director, Professor James, to set themselves up as arbiters or judges of the validity of the data which could have such a profound importance not only for scientists, but also for the public and its health.” The memorandum concludes, “There is no doubt in our minds that the reviews will remove the stigma of alleged fraud and will restore Dr. Pusztai’s scientific credibility.” One of the scientists who reviewed Pustzai’s work, Dr. Vyvyan Howard, foetal and infant toxico-pathologist at the University of Liverpool, told the World Socialist Web Site, “I am working on some features of lectin toxicity and that is how I came to know Arpad Pusztai, who is certainly one of the world’s experts in this field.”” [3]

NOTE:  I urge you to visit his personal site here and check out his commentary.

2.  GMO Gate, Part II. (The Seralini Affair). One “trick” that company-paid researchers do is to keep animal studies nice and short.  My understanding is that Monsanto and other GMOers always stop the study at 90 days as a protection.  Well, one research did what should be done in every case and ran a rat study out to two years.  What he and his colleagues found was horrific:

“Biochemical analyses confirmed very significant chronic kidney deficiencies, for all treatments and both sexes; 76% of the altered parameters were kidney-related. In treated males, liver congestions and necrosis were 2.5 to 5.5 times higher. Marked and severe nephropathies were also generally 1.3 to 2.3 times greater. In females, all treatment groups showed a two- to threefold increase in mortality, and deaths were earlier. This difference was also evident in three male groups fed with GM maize. All results were hormone- and sex-dependent, and the pathological profiles were comparable. Females developed large mammary tumors more frequently and before controls; the pituitary was the second most disabled organ; the sex hormonal balance was modified by consumption of GM maize and Roundup treatments. Males presented up to four times more large palpable tumors starting 600 days earlier than in the control group, in which only one tumor was noted. These results may be explained by not only the non-linear endocrine-disrupting effects of Roundup but also by the overexpression of the EPSPS transgene or other mutational effects in the GM maize and their metabolic consequences.” [2]

Notice that the males were attacked the most fiercely by this product!  Now what do you think happened when this study was published?  Yes, all hell broke loose – pardon the expression but that’s the best term – and the journal finally retracted the paper under pressure.  You can actually see the restracted paper here!

Fortunately, we can actually read the paper for ourselves and you’ll see that the paper was very careful and just stated that more study work needed to be done. It was very fair and balanced and did not make inflammatory comments. In spite of that, the paper was forced out and, fortunately, there was a huge backlash from scientists around the globe objecting to the censorship of this fine paper. If you have doubts that Monsanto, Dupont and other GMO players are weak and without power, guess again!

3. Bt Toxin Corn is Allergenic. For those who do not know, researchers (at Monsanto) genetically altered a corn to produce an insecticide called “Bt toxin.” Those ingesting the corn ingest this Bt toxin. The concept is that this toxin attacks the skeleteons of insects, thus acting as a pesticide, and yet does not affect humans. Of course, I think this vast majority of people would think that it was ethically deplorable to engineer a plant that we consume to produce a pesticide of any sort. Yet this is exactly what was done and with very little testing.

As one might expect, problems have abounded.  How often have we been told that a pesticide is safe only to find out ten years later that it was damaging us and our children?  (See my link on Testosterone and Pesticides for some examples. Academics have pointed out that GMO corn is associated with increased allergic reactions.  Professor Joe Collins has done a fantastic job of summarizing research that shows that this kind of corn is [4]

“We present for the first time a comparative analysis of blood and organ system data from trials with rats fed three main commercialized genetically modified (GM) maize (NK 603, MON 810, MON 863), which are present in food and feed in the world. NK 603 has been modified to be tolerant to the broad spectrum herbicide Roundup and thus contains residues of this formulation. MON 810 and MON 863 are engineered to synthesize two different Bt toxins used as insecticides…Our analysis clearly reveals for the 3 GMOs new side effects linked with GM maize consumption, which were sex- and often dose-dependent. Effects were mostly associated with the kidney and liver, the dietary detoxifying organs, although different between the 3 GMOs. Other effects were also noticed in the heart, adrenal glands, spleen and haematopoietic system. We conclude that these data highlight signs of hepatorenal toxicity, possibly due to the new pesticides specific to each GM corn.”

Can a technology get any uglier than that?  I mean let’s just throw a bunch of uranium and plutonim in our kids’ breakfast cereal while we’re at it, right?

5. Interestinal Cancer? A study of GMO potatoes showed “hyperplastic cell growth” in the intestines of mice.  This is basically the early warning signs of potential cancer, i.e. abnormal cell growth in the intestinal walls.  Researchers wrote:

“Although mild changes are reported in the structural configuration of the ileum of mice fed on transgenic potatoes, nevertheless, thorough tests of these new types of genetically engineered crops must be made to avoid the risks before marketing.” [7]

C’mon, guys!  You man enough to eat those?

6. Stomach Lesions. Many of you will have heard of the famed FlavrSavr tomato.  Well, did you know that some research showed a shocking amount of stomach lesions in mice?  [8]

CONCLUSION:  There are actually many more studies and expert testimony that show issues with GM foods.  The bottom line is that these foods likely can cause many, many health issues, especially in the liver, kidney and GI tract.  This is NOT something that has been adequately tested and there is ample evidence that they are dangerous.

And, seriously, it makes sense.  If you go into the forest, can you just start munching on any plant out there? Of course not!  Only a few plants are safe for long term consumption and logic dictates that you cannot take one of the few plants that work as foods and crops and start chaning it willy nilly or you will corrupt it into a dangerous, inedible plant.

Grains: Grossly Underrated & Good for Your Penis.

I consider myself Paleo and love the concept, but there are just so many things about the “Paleo Diet” that simply make no sense. One of them is that tubers (root foods) are great and whole grains are pure evil. The reasoning is that tubers were used by Paleolithic peoples, which is true, and grains are a more recent invention – also (largely) true.

But I have big news for all the Paleo folks who hold to these silly rules: Grains Are The New Tubers!  The anti-grain, pro-tuber bias is just silly for two important reasons:

The real truth is that Paleo folks may want to eat tubers and pretend that they are modern hunter gatherers, but, if they’re honest, they’ll admit that those kind of goods just aren’t accessible in general. So what can they do as a rock solid substitute? That’s right – just plug in whole grains (sans wheat in my opinion) and they have a “modern tuber”. This is why grains have done so well in study after study: they are simply modern foods that are virtually identical to what we are used to eating for aeons.  (See my page on The Many Benefits of Grains to Your Sex Life for more information.)

NOTE: I personally avoid wheat, because has been significantly modified – not GMO’d I should point out – and is also higher glycemic.  There are other potential immune-related issues associated with wheat as well.  For more information, see my page on Wheat Belly Review by Dr. William Davis.

To show you wheat I mean, let’s look at two widely accepted Paleo foods:  blueberries and sweet potatoes.  The Paleo community seems to generally recognized that hunter gatherers ate tubers, which includes sweet potatoes, and berries as common staples.  And that makes sense, because these are very healthy foods.  Interestingly enough, some Paleo leaders do not like sweet potatoes, but their argument is weak because one very healthy primal culture consumes them as a staple!

Regardless, notice their general macronutrient profile below:  calories close to 200; sugars pretty high in the 13-26 gram range; glycemic load quite low and < 20; fiber in the 5-10 gram range; carbs around 40 grams, etc.

Both of these are clearly superhealthy plant foods.  Now look at the macronutrient profiles of two whole grains, quinoa and millet:

I am sure that you noticed that these two supposedly wicked and health-destroying grains are almost identical to the Paleo-beloved sweet potatoes and berries. Notice, in particular, that the glycemic load, carbs and fiber levels are all very similar. Furthermore, notice that the grains have 0 grams of sugar!

The point is that if you want to eat “Paleo” or primal, all you really have to do is look for low fat, low glycemic foods.  It’s really that simple.  One of the books that I think is truly Low Fat Paleo and has tons of great information is the The Pritikin Edge . This book on Low Fat Dieting by heavyweight Low Fat leaders allows for low fat meats and total fat more in the 20% range – very similar to many of the supercultures that I spoke of above.

The bottom line is quite worry about which tubers, fruits and/or whole grains are “Paleo”. If they are low fat and low glycemic load, then you are in good company almost for sure.

Brain and Mindfulness Meditation - Peak Testosterone

This site emphasizes natural health practices that can supercharge a man’s life (and sex life). Of course, exercise and a clean, whole foods diet are probably the top two items that come to mind. But right behind those should be Secular Meditation in its various forms. (I would also throw Progressive Muscle Relaxation into the mix as well due to its profound benefits.) Meditation may not seem manly, but, when you look at the benefits, it is hard to beat and I will prove that below when we examine Mindfulness Meditation specifically.

One of the myths that we have is that you always have to work harder to get ahead as a guy. Mindfulness Meditation shows how just untrue that assertion is:  it shows that by just sitting quiety for 1 or 2 10-15 minutes periods during your day you can rebuild your body, brain, personal psychology and hormones.  Again, “work smarter, not harder” applies perfectly here.

Here are a few of the stunning benefits for men of Mindfulness Meditation:

1. Brain Building for Career and Relationships. Several studies have noted Mindfulness Meditation’s ability to rebuild many parts of the human brain.  For example, one study found that it took just a few months to see increased “left anterior” brain activation. [1] This echoed a previous study on particpants with SAD (Social Anxiety Disorder), who were not only helped with their people-related issues but also saw increased activity in areas of the brain used for focus and attention. [2] And in those with mild cognitive impairment, Mindfulness Meditation increased both the density of the hippocampus (memory) and the “inferior frontal gyrus”. [4] However, it should be noted that one study showed improvement in the hippocampus in normal, healthy individuals. [5]

There are many reasons that cortisol will rip your health and sex life apart, but the primary ones are probably a) accelerated visceral fat, which is associated with cardiovascular disease and endothelial, a.k.a erectile dysfunction, b) brain shrinkage and c) testosterone reduction.  And overexcitation of the HPA Axis in general can lead to or accelerate many psychiatric disorders as well.

So anything that lowers cortisol and/or keeps it in check is a potent tool in your arsenal.  And Mindfulness Meditation has lowered cortisol in a number of studies with a wide variety of patients.

3.  Executive Function. There are few things more important to your career and relationships than executive function.  Wiki definites executive function as “cognitive processes that regulate, control, and manage other cognitive processes.” [10] It involves multitasking, reasoning, working memory and many, many other critical things that separate us from the rest of the animal kingdom.  And poor executive executive function is associated with “attention deficit hyperactivity disorder, depression, drug abuse, and antisocial behavior.” [11]

Mindfulness Meditation has been shown in several studies to be excellent at improving executive function in many key ways, including “increasing awareness of one’s thoughts, emotions, and actions have been shown to improve specific aspects of EF, including attention, cognitive control, and emotion regulation.” [11] Who can improve their executive function?  Studlies look promising for just about everyone and include groups as diverse as  and 2nd and 3rd graders. [12]

NOTE: Some of these studies are based on MBSR (Mindfulness Based Stress Reduction) which is mindfulness meditation plus some other things such as class instruction and yoga.  Nevertheless, the core of all these programs is just pure Mindfulness Meditation.

4.  High Blood Pressure (Hypertension). One of the biggest risk factors for erectile dysfunction and sexual dysfunction is high blood pressure.  High blood pressure has many apsects to it. Everyone knows that narrowing of the arteries from arteriosclerosis can lead to high blood pressure and on this site we often discuss how endothelial damage from a Western lifestyle can lead to decreased nitric oxide and hypertension.  However, for many men the primary component of their high blood pressure is stress-related Western lifestyle.  This is where Mindfulness Meditation can really make a difference and lower blood pressure. Many studies have shown just this, including cancer pateints [9] and junior high students. [13]

5. Social Life. This is odd, but sitting quietly doing Mindfulness Meditation can improve your social life.  As mentioned above, researchers found that people with Social Anxiety Disorder were greatly helped because their “stress reactivity” to social situations. [2] In other words, this type of meditation helps to keep you from overreacting and, again, this was also evidenced by decreased activity in the amygdala, the part of the brain involved in fear reactions.

6.  Depression.  The Peak Testosterone Forum is packed with men who are struggling or have recently struggled with depression.  Many are on depression medications such as SSRI’s.  MBSR has been thoroughly studied as a treatment for depression and has done very well in the studies overall, showing benefits for a variety of patients including some of the tougher treatment groups such as cancer patients. [9]

Admittedly, not all studies have shown improvement from MBSR.  However, another mindfulness approach called Mindfulness Based Cognitive Therapy (MBCT) has even been used very successfully even with patients who have experienced recurring bouts of major depression. One meta-analysis concluded that it prevented relapse into major depression at a very high rate. [20] The authors also noted that “in two studies, MBCT was at least as effective as maintenance antidepressant medication.”

7.  Amygdala (the Brain’s Stress Region) Reduction. There are some areas of the brain that you don’t want to build up.  In fact, researchers have noted that a decrease in one area of the brain, the amygdala that is responsible for panic and fair, is actually a good thing.  And, sure enough, Mindfulness Meditation shrinks this critical part of the brain, showing just how forcefully it reduces stress. [2] Another study noted the same shrinkage of the amygdala on “stressed but otherwise healthy” individuals, which covers just about everyone in modern, urban societies! [3]

8. Immunity. The same study that noted increased brain activity from meditation also found that meditators had a much better immune response against the influenza vaccine, thus likely providing very real protection against flus and other viruses. [1]

REFERENCES:

1) Psychosomatic Medicine, Jul/Aug 2003 vol. 65 no. 4 564-570, “Alterations in Brain and Immune Function Produced by Mindfulness Meditation”

2) Emotion, Feb 2010, 10(1):83-91, “Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder”

3) Soc Cogn Affect Neurosci (2010) 5 (1): 11-17, “Stress reduction correlates with structural changes in the amygdala”

4) BMC Complement Altern Med, 2012, 12(Suppl 1):P202, “Mindfulness based stress reduction in adults with mild cognitive impairment: a pilot study using fMRI”

5) Psychiatry Research: Neuroimaging, Jan 2011, 191(1):36-43, Mindfulness practice leads to increases in regional brain gray matter density”

6) Neuropsychobiology, 65(3), “Influence of Mindfulness Practice on Cortisol and Sleep in Long-Term and Short-Term Meditators”

7) Behaviour Research and Therapy, Nov 2012, 50(11):651 660, “Improving sleep with mindfulness and acceptance: A metacognitive model of insomnia”

8)

9) Brain, Behavior and Immunity, 2007, “One year pre post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients”

10) https://en.wikipedia.org/wiki/Executive_functions

11) Child Development Perspectives, Article first published online: 21 JUN 2012, “Improving Executive Function and Its Neurobiological Mechanisms Through a Mindfulness-Based Intervention: Advances Within the Field of Developmental Neuroscience”

12) Journal of Applied School Psychology, 2010, 26:70 95, “Effects of Mindful Awareness Practices on Executive Functions in Elementary School Children”

13) Psychosomatic Medicine, Nov 1 2004, 66(6):909-914, “Impact of Meditation on Resting and Ambulatory Blood Pressure and Heart Rate in Youth”

14) Clinical Psychology Review, Aug 2011, 31(6):1032 1040, “The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: A systematic review and meta-analysis”

Now, just in case the importance of this escaped anyone, let me translate what this means:

The typical man in a modern, industrialized environment is stressed out with career, relationships, finances, commuting and the overstimulation of television, media and the internet. This type of man, though, is the ideal candidate to be helped from Mindfulness Meditation, since rebuilding one’s brain is clearly going to be of great benefit for both career and relationships. Seriously, how can increasing the density of neuroconnections in your brain not be good for almost everything you do in life as a male?

Also, many men have lived lives of depression, post traumatic stress disorder and other major cortisol-increasing stressors that can actually shrink the brain.  Now, thru this simple meditational technique, these men  have been give the chance to rebuild their brains and recover much of those lost years. Again, though, it is not just the stressed that will benefit according to some of the evidence, but healthy, “normal” individuals as well.

NOTE: Interested in giving it a try? Consider reading my link on How to Do Secular Meditation, which gets rid of all the religious verbiage associated with meditation and distils it down to just the most simple steps.

2.  Cortisol Reduction. Did you know that one study showed that cortisol levels did not change from the beginning of an Mindfulness session to the end. [6] Does this mean that it has no effect on cortisol? Actually, the same study showed that the longer one meditates, the lower the cortisol levels. And as you hopefully know from My Links on Cortisol, it is one of our most potent enemies.

Testosterone & HRT Effects on Hypertrophy - (Muscle Gains)

Low testosterone ages a man.  There are many reason for this – one of them is the Low Testosterone-Induced Rise in Insulin Levels – including increased inflammation.  As men we think of testosterone as mostly the “muscle” or “sex” hormone, but it is much, much more than that.  If you begin to lose your testosterone, you pay the price in many more ways that just simply losing your muscle mass and libido.

As it turns out, one of the key ways that testosterone protects us men is by “modulating inflammation”, i.e. keeping inflammation in check. Runaway inflammation is the curse of modern living (from poor diet and excess calories and body fat primarily) and is a root cause for heart disease, cancer and autoimmune diseases.  So low testosterone is a big deal as inflammation ages and damages tissues in many ways as the decades roll by and we will show examples of this below.

In addition, it should be noted that excessive inflammation can also affect Leydig cell function and reduce testosterone. One study states that “There is evidence from many experimental studies that IL-6, TNF-alpha and IL-1beta inhibit T secretion by their influence on the central (hypothalamic-pituitary) and peripheral (testicular) components of the gonadal axis.”  IL-6, TNF-alpha and IL-1 are molecules called cytokines that control inflammation levels in your body and they are all-important.

Can this inflammation cause the hypogonadism and early andropause epidemic that we see in Western societies?  I don’t know of any proof of that, but it certainly is in the realm of possibility.  On this page, though, I want to cover what we do know much more clearly:  that low testosterone is correlated with high inflammation and that testosterone therapy can lower inflammation levels.  Below are some of the major inflammatory markers affected in this way:

1)   Eur J Endocrinol, 2007 May, 156(5):595-602, “The effect of testosterone replacement therapy on adipocytokines and C-reactive protein in hypogonadal men with type 2 diabetes”

2) Obes Rev, 2005 Feb, 6(1):13-21, “Adiponectin: action, regulation and association to insulin sensitivity”

3) Journal of Andrology, January/February 2005, 26(1), “Testosterone Administration Suppresses Adiponectin Levels in Men”

4) https://www.fasebj.org/content/early/2011/06/20/fj.11-182758.full.pdf

5) Clinical and Experimental Rheumatology, 1993, 11(2):157-162, “Effect of gonadal steroids on the production of IL-1 and IL-6 by blood mononuclear cells in vitro”

6) Endocrinology September 1, 1991 vol. 129 no. 3 1305-1311, “Interleukin-1 Inhibits Cholesterol Side-Chain Cleavage Cytochrome P450 Expression in Primary Cultures of Leydig Cells*”

7) Journal of Endocrinological Investigation, 2005, 28(11 Suppl Proceedings):116-119, “The relationship between testosterone and molecular markers of inflammation in older men”

8) Journal of Andrology, Jan/Feb 2009, 30(1), “The Dark Side of Testosterone Deficiency: II. Type 2 Diabetes and Insulin Resistance”

9) Cellular Physiology and Biochemistry, 2007, 20:847-852, “Effects of Testosterone on Cytokines and Left Ventricular Remodeling Following Heart Failure”

10) Nature Reviews Endocrinology 5, December 2009, “Testosterone deficiency, insulin resistance and the metabolic syndrome”

1. Adiponectin. Adiponectin is not an inflammatory cytokine like all the other markers I will discuss on this page.  However, I put it first, because it affects inflammation and is SO important, although the relationship is complex. But here is the key takeaway:  as a man loses insulin sensitivity (usually through weight gain and other aspects of a modern lifestyle), adiponectin levels will begin to drop and testosterone administration raises adiponectin levels. [2][3]

2.  Phospholipase D.  In 2011, scientists discovered one of the major reasons that testosterone may keep inflammation at bay.  It turns out that your T actually slows down the activity of an enzyme related to inflammation called Phospholipase D. [4]

4. TNF Alpha.  The most infamous of the inflammatory cytokines is undoubtedly TNF alpha as it has been singled out to be the root cause for so many nasty medical conditions including cardiovascular disease. See my page on Natural TNF Alpha Inhibitors for some additional information. And testosterone therapy has been found to lower TNF alpha levels in an animal study on rats following heart failure. [9]

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

5. IL-6. Although this is not uniform, some studies show that testosterone administration will actually decrease IL-6. [7] IL-6 is associated with many conditions, including diabetes, certain cancers, Alzheimer’s and arterial plaque, etc.

6.  CRP (C-Reactive Protein). Most middle-aged and senior men reading this page will have prediabetes, Metabolic Syndrome or full-fledge type II diabetes.  For men suffering from these maladies relating to loss of insulin and blood sugar control, low testosterone had been found to correlate with higher CRP levels. [1] If testosterone actually causes this state of affairs, this is very bad indeed.  C-Reactive protein is now a common test given by doctors to measure systemic inflammation and it is very correlated to the risk for heart disease, Alzheimer’s, and many other medical conditions.

NOTE: The above study found that testosterone therapy did not actually lower CRP values, so low testosterone may not cause low CRP. When you see all the other ways below that testosterone negatively impacta inflammation, one cannot help but be skeptical however.

Now the short term data, which I outlined above, clearly shows that low testosterone affects some of the pro-inflammatory molecules in the body negatively and that testosterone therapy can help significantly.  However, keep in mind that the long term picture is much more negative.  The reason?  Low testosterone promotes several medical conditions that are known to be pro-inflammatory.

For example, one research summary wrote:

“We suggest that androgen deficiency is associated with IR [insulin resistance], T2D [type II diabetes], Met-S [Metabolic Syndrome], and with increased deposition of visceral fat, which serves as an endocrine organ, producing inflammatory cytokines and thus promoting endothelial dysfunction and vascular disease.” [8] Basically, low testosterone generally ages a man and puts his body in a pro-inflammatory state that is very difficult to escape from.[9]

Other researchers have made the same observation, nothing that testosterone seems to have a protective effect on your Beta cells (that make insulin) through controlling these inflammatory messengers. [10]

REFERENCES:

Flaxseed's Benefits: Lowering Blood ,Cancer and Inflammation.

One of the guys on The Peak Testosterone Forum essentially asked the question, “Why would any man take flaxseed?”  I would actually ask it the other way around:  why would any man NOT consume flaxseed?  Flaxseed is that good and arguably the most powerful superfood on the planet right now.  (One could make a great case for spinach, broccoli and berries however.)  I simply do not know any food that can do as much for men as flaxseed. As you’ll see below, it does literally everything a guy could possibly want a food to do, including clear benefits for the bedroom.

Tragically, it is currently in vogue to attack plant foods (at least here in the U.S.).  Flaxseed comes under fire from those who have not bothered to read the research, because it has a fairly high phytoestrogen content. In fact, it is obvious that the above poster had read material from these blogs:

“Okay guys, Cronos, Peak T, anyone… sort me out with a quick answer, you’re all well informed on here. Remind me again…why should we be taking flaxseed oil or flaxseed in general, when we know it to be a ‘gazillion’ times more estrogenic to the male body than (processed) soy? Thank you…” [5]

1. Protecting Against and Possibly Clearing Out Penile Arterial Plaque.  I know of only one other food – Pomegranate Juice – that has research showing that it can single-handedly help with arterial plaque.  However, we have another recent addition to the family:  flaxseed.  (See my page on  Pomegranate Juice: Your Best Bedroom Buddy for more details on this powerhouse.)  For example, an animal study showed greatly decreased plaque progession in flaxseed fed animals versus controls:

“Dietary flax-supplementation resulted in a significant ≈40% reduction in plaque formation (P = 0.033). Both Group II and III animals displayed improved contraction and endothelial-dependent vessel relaxation. Dietary flaxseed is a valuable strategy to accelerate the regression of atherosclerotic plaques; however, the flaxseed intervention did not demonstrate a clear beneficial effect on vessel contractile response and endothelial-dependent vasorelaxation.” [1]

Will it actually help you regress the plaque you already have?  My guess is ‘yes’ – and you’ll see later why I say this – but suffice it to say that flaxseed has many CVD marker and atheroclerotic studies under its belt. And keep in mind that almost every man growing up with a Western lifestyle has signficant plaque if they are over the age of about 30 – sometimes younger! – and so flaxseed is clearly a fantastic tool in their arsenal.  Also remember that it only takes a little bit of plaque in your penile arteries to really make a difference in erectile strength.

2.  Powerfully Lowering Blood Pressure.  Many men have hypertension and the added pressure on arterial walls is a risk factor for erectile dysfunction and atherosclerosis (and stroke, etc.).  Many men do not realize that a recent study showed that flaxseed lowered blood pressure in a study on men and women with hypertension by an average of 15 points (mm) systolic and 7 points (mm) diastolic. [2] This is a huge drop and rivals that of most of the phamaceutical solutions out there!  Now the study in #1 did not show a signficant increase in endothelial function.  However, this will undoubtedly occur in most of those with high blood pressure per the above

3.  Protecting You From Prostate Cancer.  I point out everwhere I can that research shows that about half of all men by middle age have small prostate cancer nodules growing within their prostate. Now this is no reason to panic, because prostate cancer typically grows slowly.  But, given the right environment, those nodules can grow and raise your PSA value.  Then the ugly stuff starts to happen:

a) Your urologist may want to biopsy you.  This means a painkilling shot into where the sun don’t shine and ejaculating blood for a few weeks while your prostate heals from the samples they clipped out of it.

b) If you are on HRT, you will probably be pulled off of HRT while you are evaluated with a biopsy.  See my story High PSA But No Cancer for a very personal example of this.

c) Unfortunately, these nodules can metastisize.  Once this happens, it is very hard to treat and, well, you know the story.

And, by the way, try to have an active sex life after you’ve had a biopsy and your wife or girlfriend is worried over your rising PSA and if you’re gonna be there next Christmas…

4.  Decreases in LDL, Triglycerides and Lp(a)l.  Many studies have shown flaxseed’s incredible ability to lower cardiovascular disease markers. Again, flaxseed potency in this arena is similar to Pomegranate Juice in terms of it’s sweeping potency and long term arterial protective powers.  I plan on doing a more detailed page on the subject, but let’s just look at the conclusions of one study here (on men and women with high cholesterol):

“Flaxseed supplementation was associated with significant reductions in TC (-17.2%), LDL-C (-3.9%), TG (-36.3%) and TC/HDL-C ratio (-33.5%). There were no significant differences in absolute change in BMI nor in percentage change in TC, HDL-C, LDL-C, TC/HDL-C ratio between flaxseed and statin groups. Dietary flaxseed significantly improves lipid profile in hyperlipidemic patients and may favorably modify cardiovascular risk factors.”  [3]

First of all, notice that the authors compared its powers to the pharmaceutical statins.  And notice that it powerfully dropped triglycerides and total cholesterol (and its modest reduction LDL).  If you’ve read my page on  How to Clear Your Arteries of Plaque or my page on HDL, LDL and Triglycerides, then you’ve got some starter info as to how these markers can reasonably reliably help you actually regress plaque (or maintain zero plaque if you are one of the “lucky” individuals). Another study (on women) shows that flaxseed can reduce Lp(a). [4] This is another risk factor for arterial plaque and it can bite people with good lipid numbers otherwise.

5.  Improving Your Omega-3/Omega-6 Ratio.  Many of you know that some of our standard plant-based oils, such as sunflower, are high in omega-6’s and can lead to inflammation.  Flaxseed is completely different, however, as it is packed with alpha-linolenic acid, which your body converts into the all-important omega-3’s DHA and EPA.  Many guys feel noticably better when consuming flaxseed and this is probably the reason why.  Our bodies were meant to consume a very low omega-6 to omega-3 ratio – Dr. Greger says 4:1 is probably the safe maximum – and flaxseed can help you greatly improve this ratio.

Vegetarians and vegans – and I am 95% plus vegan – interestingly enough, get themselves quite frequently into trouble with their omega-6 to omega-3 ratio.  The reason?  It is probably because in the U.S. there are now so many packaged and processed plant-based foods.  Cooking and food preparation is a lot of work and even the health-conscious can be foiled by food manufacturers who, quite frankly, are thinking of convenience, price and shelf-life before the health of their customers.

REFERENCES:

1)   Am J Physiol Heart Circ Physiol (April 12, 2013), “The Effects of Dietary Flaxseed on Atherosclerotic Plaque”

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

3) Revista Medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi, 2005, 109(3):502-506, “Flaxseed supplementation in hyperlipidemic patients”

4) Nutrition Research, Jul 1998, 18(7):1203–1214, “Whole flaxseed consumption lowers serum LDL-cholesterol and lipoprotein(a) concentrations in postmenopausal women”

5) https://www.peaktestosterone.com/forum/index.php?topic=5969.0

Metabolic Syndrome: Erection Killer - Peak Testosterone

Metabolic Syndrome is a plague of modern society and would better be named Erectile Dysfunction Syndrome or Castration Syndrome.  I cover Metabolic Syndrome several times on this site because it is so critical to the health of your heart and your penis.  Metabolic Syndrome, or Erectile Dysfunction Syndrome as I like to call it, is a set of symptoms that includes

Many researchers would also include increased Inflammation and blood clotting as well.  Some of you well-read health fanatics may even remember when this syndrome was called Syndrome X or Insulin Resistance Syndrome.  Whatever the name, it leads to nasty stuff for us males!

If you have two or more of the above symptoms, then you need to consider yourself as having Erectile Dysfunction Syndrome and you need to take action immediately for the sake of your sex life (and health).  Metabolic Syndrome is a full frontal assault on your penis.  First of all, it is associated with lower levels of testosterone and increased levels of erectile dysfunction. [1]

This relationship was clearly established in a study that showed strong correlations between one of the hallmarks of Metabolic Syndrome, insulin resistance, and testosterone levels. [9]  In these senior men the greater the insulin resistance, the lower the testosterone. Other researchers have concluded that “while it is clear that disease, and in the context of this contribution, in particular the metabolic syndrome can suppress circulating testosterone levels, it has also been documented that low testosterone levels induce the metabolic syndrome “. [5]

NOTE:  Interested in the hormonal link?  See my page on Testosterone, Insulin and Insulin Resistance for more information.

To put it more clearly, Metabolic Syndrome likely causes low testosterone and low testosterone likely causes Metabolic Syndrome. [28] Again, it’s the Kiss of Death to your sexual life and all you hold dear as a male.

Just as bad, this Erectile Dysfunction Syndrome has another little known symptom:  it increases levels of ADMA, an amino acid that mimics Nitric Oxide!  In other words, your body pushes that most precious of all chemicals, Nitric Oxide, out of the way. That means the Little Guy stays little. (For more details, read here.)

REFERENCES

1) Jour Urol, 2007 Feb,177(2):651-4; Jour Clin Endocrin Metab 1990 Oct,71(4):929-31

2) Hypertension,1998;31:780-786

3) Obesity Reviews,Jul 2008,9(4)340-354(15)

4) Am J Clin Nutr,2003 Nov,78(5):965-71

5) J of Mens Health, Sep 2008, 5(1):S40-S45

6) Med Sci Sports Exerc, Oct 2003, 35(10):1703-9

7) Tex Heart Inst J, 2005, 32(3): 387 389

8) Am J Cardiol, 2008 Feb 15,101(4):497-501

9) Diabetes Care, 2005, 28:1636-1642

10) Kobe J Med Sciences, 2007, 53:99-106

11) Diabetes, 2005, 54:1926-1933

12) J Clin Invest, 2007, 117(712) J Clin Invest, 2007, 117(7): 1995-2003

13) Yale University (2004, February 23). Young People Prone To Type 2 Diabetes Exhibit Alterations In Mitochondrial Activity

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

15) Circulation, 2005, 111(11):1448-1454; Lupus, 2005, 14(9):760-764

17) Henriksen EJ, et al. Chronic thioctic acid treatment increases insulin stimulated glucose transport activity in skeletal muscle of obese zucker rats. Diabetes (Suppl.) (1994) 1:122A

18) Diabetes Res Clin Pract, 2003, 62:139-48

19) Physiologica Scandinavica, 1992, 146:505 510

20) Science, 1987, 237(4817):885-888

21) J. Nutr, Nov 2005, 135:2634-2638

22) European Heart Journal, Advance Access published online on January 23, 2008, “Work stress and coronary heart disease: what are the mechanisms?”, Received 1 August 2007; revised 14 November 2007; accepted 22 November 2007.

23) “Alpha-Glucosidase Inhibitors for Type 2 Diabetes.” Chen, H., Journal of Food Science, published online June 30, 2009.

24) Obesity Reviews,Jul 2008,9(4)340-354(15)

25) J of Clin Endocrin & Metab, Nedeltcheva, A.V. , published online ahead of print, June 30, 2009

26) 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”

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

28) J Endocrin Invest, Jun 2007,30(6):451-8; Journal Andrology, 2009, 30:10-22

While Erectile Dysfunction Syndrome is annhilating your testosterone and decreasing your Nitric Oxide levels, it also is taking out your cardiovascular system.  That means that it is clogging up your veins and arteries, including the all important ones that supply blood to your penis!  This, in turn, leads to high blood pressure, which is also strongly associated with Erectile Dysfunction.

Consider also what researchers found when they did an analysis of the Third National Health and Nutrition Examination Survey (NHANES III), a large national survey of the U.S. population ages 20 to 89 taken between 1988 and 1994.  They found that each of the aspects of Metabolic Syndrome raises your chances of a heart attack by the following percentages:

This metabolic disorder doesn’t stop with decreased erectile and cardiovascular function:  it is also associated with “brain damage“. 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”. [2]  None of this is surprising considering that Erectile Dysfunction Syndrome and insulin resistance are associated with systemic Inflammation. [15] Inflammation ravages both the body and mind as informed Peak Testosterone readers already know.

Recent research shows that insulin resitance may be the deadliest aspect of this syndrome and, adding to the problem, is the fact that insulin resistance can be tricky to diagnose.  One warning sign, regardless of your weight, is if you have higher triglycerides and lower HDL scores. [7] That ratio can be a warning sign even for someone who is relatively thin.

NOTE:  The Triglyceride to HDL-C ratio is certainly not a perfect measure of insulin resistance and has been found to be only a little better than the Total Cholesterol to HDL ratio for predicting cardiovascular outcomes. [8] Again, keep in mind that total cholesterol less than 150, and not having resulted from disease or medical condition of course, is probably the best insurance against heart disease. I cover this in the following link on a Low Fat Diet, which is the easiest way to get your cholesterol at or near the 150 mark. Interesting enought, a Low Fat Diet can actually raise Triglycerides and lower HDL and yet it still provides excellent heart protection assuming one’s cholesterol is near 150.

Researchers have also discovered that where fat is located is all-important when it comes to insulin resistance for example.  One study pointed out that there are no sumo wrestlers or NFL players who are insulin resistant even though many are significantly overweight.  However, when they retire they almost always become insulin resistant because “their fat moves from the subcutaneous compartment to the visceral compartment”. [7]  Visceral fat is considered to be an actual organ and effects many part of our metabolism.  A good measure is basically the ratio of a measurement around your belly button to that of your waist.

What is visceral fat?  You may have read about “apples” versus “pears”, referring to the general shape of a person’s body.  Basically, this is referring to whether or not any excess weight on your body tends to go to your belly button area or to your butt.  If it goes to your belly button area, you are more quickly building up “organ fat”, which is linked to type 2 diabetes, Erectile Dysfunction Syndrome and cardiovascular disease.  So even if you are a Skinny Bastard, like myself, you can have a relatively high level of visceral fat and its ensuing negative health consequences.

Another factor that may lead to insulin resistance is a High Fat Diet. Researchers found that, at least in animals, a High Fat Diet led to mitochondrial function genes being down-regulated which mimics what is seen in insulin resistance. [11] This has been verified in multiple animal studies and scientists have just discovered in the last few years the pathway by which this occurs. [12]  Originally, it was thought that free fatty acids might compete with glucose-like substances for use in the cell, but research is pointing in a different direction now.  The important thing to remember is this:  the more fat, the less the mitochondrial function, the more likely you are to be insulin resitant and receive all of the nasty symptoms that come with it.

Keeping and raising mitochondrial function is also related to its sister disorder:  type II diabetes.  The lead of one recent study [13] on the subject wrote “There is a strong relationship between lipid [fat] content in the muscle and insulin resistance in skeletal muscle”.  He then stated something ultra-critical:  “Insulin resistance is the best predictor for whether someone will eventually develop type 2 diabetes”. In other words, type II diabetes is really not the sister of Erectile Dysfunction Syndrome, it is the offspring!pring!

Another important aspect of Metabolic Syndrome to remember is that it generally leads to weight gain, due to the insulin resistance as Japanese scientists have just discovered that high insulin levels keep your body from breaking down fat. An insulin resitant individual will have high insulin levels and high glucose concentrations, a toxic combination that causes damage in different ways.  The high insulin levels are deadly because the block the breakdown of fats by adrenaline and lipase. [10]

So is there hope in the battle against Erectile Dysfunction Syndrome or is it simply an inevitable part of aging? As always, science has uncovered many practical solutions, which I have compiled in my link How to Defeat Metabolic Syndrome.

NOTE ON APNEA:  Of course, the easy weight gain that comes from insulin resistance is deadly in many ways.  I document the many Dangers of Being Overweight. But one I would like to highlight is that weight gain is associated with apnea. [3] Apnea is a sleep disorder where the airway is temporarily restricted leading to extremely restless and interrupted sleep and it whacks testosterone, makes Erectile Dysfunction Syndrome even worse and can lead to a host of nasty distorders.

Testosterone & HRT Effects on Hypertrophy

Just about every man on planet earth knows that testosterone is a one of the most important factors for gaining muscle, i.e. hypertrophy.  And so few men would be surprised to read that studies have shown that this is very likely one of the key ways that Testosterone Therapy (HRT) improves general health for hypogonadal men: it increases fat free muscle mass, which is basically muscle. If you take a man with low testosterone and give him testosterone, it does many near miraculous things, but one of them is put on muscle.

How does testosterone work its magic?  Testosterone induces muscle gains in several key ways.  However, probably the most powerful way is through the stimulation of “satellite cells”.  These are specialized cells that are located near the end of muscle fibers and, after a workout, they fuse together, supply nuclei, multiply and do many other things to build additional muscle fiber.  Of course, this leads to a greater cross sectional area of muscle and the muscle growth that so many of us covet.

One study on senior men verified just this and found that increases in supplemental testosterone led to a dose dependent increase in both satellite calls and muscle cross sectional area. [1] For all your seniors out there:  testosterone can help you put on muscle at ANY age. Of course, studies on healthy young men have found the same thing: the more the T, the more the muscle growth, both through increased cross secional area and increased fiber counts. [2][3]

And it’s no secret that steroid guys enjoy the dose dependent aspect of testosterone, because in this case more T usually does lead to more muscle. It also leads to more estradiol and a host of problems when go into “supraphysiological” territory, i.e. above normal, but that’s another story. The point is that testosterone has been verified in many ways to lead to muscle growth if increased enough.

If you are hypogonadal, i.e. you have clinically low testosterone, testosterone therapy at any reasonable level can REALLY help you put on muscle. Many studies have shown that testosterone therapy increases fat free mass in hypogonadal men without them doing much of anything else, i.e. limited or no workouts. This study showed, interestingly, that muscle was increased with fat levels staying the same roughly. [4] Of course, even with no fat loss, this will be good for long term health. The list of studies showing all of this could go on and on, but it is well-established that the more the testosterone, the more the muscle.

NOTE: Interestingly enough, as a low testosterone guy for several years (with a total testosterone level in the 280-370 ng/dl range), I was still able to put on some pretty decent muscle.  However, I was very disciplined and diligent and worked out hard and watch my diet/protein levels much more than most guys. So you don’t have to have high testosterone levels for hypertrophy.  Verifying this is the fact that I have had a number of younger men write in with low testosterone who were shocked because they were still able to lift phenomenal amounts of weight. My main point is this: you can get all the hypertrophy with lower levels of testosterone. However, it requires greater discipline and longer recovery times.

Common questions I get are:

“Does it matter how I raise my testosterone?  Which method of HRT (testosterone therapy) will give me maximum muscle growth?”

First of all, most of the standard methods of HRT (pellets, patches topicals such as Andogel and Testim, etc.) use all bioidentical testosterone, i.e. these are not synthetic in any sense.  Now the injectibles are a little more complicated and injections are quite common in HRT now for many reasons.

Injectibles are “dang near” bioidentical.  Have you seen labels such as testosterone cypionate, enanthate,  propionate, etc.?  This is the name of an ester molecule that is tied to a bioidentical testosterone.  These esters render the testosterone inactive, where it is ushered into the muscle and lays dormant until one of the body’s enzymes breaks the ester off leaving you with a bioidentical free testosterone that is ready to put you into a hypertrophic state, increase libido, pump up your brain and do all the other magic of your body’s own endogenous testosterone. The half life of the esterified testosterone is essentially related to its fat solubility, which times how fast it is released.

These esters are currently considered harmless and I have not ready of any downside.  However, talk to your doc and do your own research as I always say.

5) The Journal of Clinical Endocrinology & Metabolism, Jul 1 2000, 85(7):2370-2377, “Estrogen Suppression in Males: Metabolic Effects”

I had someone write into the forum who was receiving injections yet only had testosterone of 310 ng/dl five days later, i.e. the dosage was clearly very low.  Now normally injections are excellent for muscle gains if done right and, as I mentioned, most steroid guys go this route.  But, if one’s dosage is too low, someone with a good prescription for patches or pellets will be superior.

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

This means that one key is to make sure that you are monitored.  Get your testosterone tested after going on any particular delivery system.  And, if you do go on the standard injectives such as enanthate which have a short half life, realize that two weeks is quite long between injections and you will likely be low testosterone during the last half week of that two weeks.  Good docs check your testosterone at about the midpoint of your whatever injections cycle you are on, hopefully weekly but some docs still do biweekly.

NOTE:  For more information on how just how much testosterone can boost hypertrophy, see this link on Testosterone and Muscle. We even include an intriguing new study that claims testosterone has nothing to do with muscle growth.

Testosterone levels also taper off with pellets.  If your doctor gives you too few pellets, say 10 instead of 12, and lets you go on too long between procedures, you can end up with low testosterone for several weeks.  Again, this requires careful monitoring.  For more information, see my links on https://www.peaktestosterone.com/ and an Interview with a Man That Loves Pellets.

Again, get tested and find out what your average testosterone levels are.  Also, do not advise the “more is better” philosophy when it comes to testosterone.  If you get too high, you will begin to overaromatize – just go on the steroid forums to see what this does! – and your estradiol levels will get too high, leading to potential prostate, libido and other issues.  So far, the available data is showing that testosterone therapy works well as long as you stay within normal physiological ranges (unlike the steroid guys!).

What about alternative therapies for raising T, such as Arimidex and Clomid?  These will definitely boost testosterone for most low testosterone men, but will they lead to significant hypertrophy?  First of all, there are few direct studies on this subject with these pharmaceuticals as far as I know.

Furthermore, no steroid guy is going to take Clomid for muscle gains since the testosterones have such a proven track record and are very androgenic so we don’t have a lot of information from this crowd either.  Clomid, for example, is taken by them for very specific purposes, such as reinitiating post-cycle testosterone productions or during the cycle to try to minimize testes shutdown.  And Arimidex is the same:  it is generally taken for to limit the overaromatization of testosterone to estrogen from the ultrahigh testosterone levels of steroid usage.

That said, there is one study on young men given Arimidex therapy that shows it did not lead to any significant change in fat free mass. [5] Estrogen was decreased by about half and T increased by about the same.  This may sound good, but really isn’t that much of an increase in testosterone relatively speaking and so it may be that the study just did not pick up on it.  Or it may be that Arimidex limits hypertrophy in ways we do not understand yet.

There is little data on Clomid and so it probably is similar to Arimidex.  (For more information, see my links on Arimidex for Hypogonadal Men and Clomid and the Low T Guy.) I suspect that both Clomid and Arimidex should lead to substantial muscle gains if you are low testosterone and either of these raise your T enough.  Hopefully, studies will come out that lead to more information about hypertrophy with these type of medications.

REFERENCES:

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:

DHEA: The Benefits and "Testosterone-Like" Properties - Peak Testosterone

DHEA levels plummet with aging.  In fact, DHEA declines even more rapidly (on average) than either total or free testosterone, averaging 3% per year. [10] Furthermore, there is abundant evidence that low DHEA is associated with many medical conditions.  But the acid test for any hormone is this:  if you replace this hormone in those who are low or deficient, are significant benefits gained?  For example, many studies show restoring youthful testosterone levels in low T men results in improved cardiovascular, psychological and insulin/diabetes parameters.  But what about DHEA?  Does DHEA Replacement Therapy yield comparable benefits?

As I will show below, I believe that DHEA packs close to the same hormonal punch in men and, when done properly, DHEA Replacement Therapy yields excellent results.  (Consult your physicain or naturopath for your individual medical evaluation.).  As I will show below, if a man is low in the first place, restoring more youthful levels of DHEA can do many of the same things that testosterone does.  And many men feel that DHEA replacement is much more natural that testosterone therapies anyway, because DHEA is near the top of the hormone cascade.

Here are the Top Testosterone-Like Benefits of DHEA Replacement Therpay:

2. Increased Free Testosterone. Before I go into the medical benefits of DHEA, it is worth pointing out that DHEA will actually raise free testosterone in some men.  Some hypogonadal men just do not like the idea of TRT. I was so miserable when I was low T that I never hesitated, but many men feel that it is unnatural, because it shuts down the body’s own production.  And some men are concerned about side effects on HRT. DHEA may offer some of these men a reasonably effective alternative. This was shown in a study where DHEA was combined with HIIT. HIIT is basically what we used to call “interval training,” where you do a few rounds of max intensity for a minute or so followed by very low intensity for a few minutes. One study at least found that a combination of HIIT with 50 mg of DHEA twice daily produced significant increases in free testosterone with no real change in total testosterone. [1]

However, Ergo-log points out that the study found that the interval training actually contributed little or nothing to the rise in free testosterone and further points out that DHEA increased free testosterone in both the younger men in the 20’s and the older guys in their late 40’s. [2] Admittedly, the younger guys didn’t get as much of a boost proportionately, but they did get an increase.  Now the older men approximately doubled their free testosterone on average and the effect lasted at least 24 hours. The authors of the study point out that free testosterone tends to fall faster than total testosterone and so the 40+ crowd seems ripe for a readjustment.

CAUTIONS:  100 mg per day is a large dose and furthermore is usually non-physiological. One should not take DHEA unless DHEA-S is low and one should not raise DHEA-S levels too high either.  In other monitoring DHEA-S levels before and after is critical.  I cover these here:  Some Potential Dangers of DHEA.  See my page on Inexpensive Hormone Testing Labs for testing.

LOW SHBG MEN: Some men are low SHBG due to, probably, liver dysfunction and insulin resistance.  DHEA tends to lower SHBG and, if it did so in a low SHBG male, could cause issues. [3]

2. Insulin Sensitivity. One study looked at 28 men (and 28 women) seniors aged 65-78, all of which were verified to have age-related decreases in DHEA.  In other words, they chose the perfect cohort to test DHEA supplementation.  Furthermore, they gave the participants a fairly reasonable dose of 50 mg/day.  The results were very impressive:  the total area under the curve for insulin was significantly reduced, indicating a significant improvement in insulin sensitivity. [8]

This is reminiscent of testosterone, which lowers insulin levels and improves insulin sensitivity. This is one of the reasons that low testosterone is associated with increased risk for metabolic syndrome (prediabetes) and adult onset diabetes. See my pages  Testosterone and Diabetes and Testosterone and Insulin for just how powerful this effect is.

It turns out that DHEA is also likely strongly protective against both prediabetes and adult onset diabetes as well according to some recent research.  A number of animal studies have shown this, but let’s look first at a study on senior men and women with high cholesterol.  In this study the researchers noted that DHEA significantly lowered insulin levels and increased insulin sensitivity. [8] However, they found that the area-under-curve for blood glucose was not changed.  However, yet another study on senior men found the opposite:  blood glucose levels were significantly lowered but insulin was not. [11] In spite of the contradiction, there seems to be growing body of research that DHEA can help some men with blood glucose and insulin control.  NOTE:  Not all studies show with DHEA show improvement in blood glucose and insulin control.

3. Youthful Mental Outlook. A 2009 study looked at a similar situation:  middle and senior aged men and women and the researchers restored youthful levels.  What they found was a greatly improved mental state:

This was associated with a remarkable increase in perceived physical and psychological well-being for both men (67%) and women (84%) ” [9]

4.  Endothelial Function. This is a biggee for most men, since it can improve bedroom performance.  Endothelial function refers to the ability of the inner lining of your arteries to relax via the release of nitric oxide.  DHEA supplementation of 25 mg/day was shown to improve this in early senior men with high cholesterol.  There is added weight to the validity of this study, because it was randomized, double-blind study.  By the way, this study also validated #3 above and found improved insulin sensitivity.

Other studies have verifed the same and one at dosage of 25 mg/day as well. [13] How does it work this magic?  It works on the same enzyme that Viagra and Cialis do and one set of researchers noted that “DHEA administration to human endothelial cells triggers nitric oxide synthesis, due to enhanced expression and stabilization of endothelial nitric oxide synthase (eNOS).” [14] Interestingly enough, standard HRT can also improve things in this way, since testosterone also activates eNOS. [4]

Now this is not going to be a massive effect, but every little bit of blood flow helps, eh?

5. Visceral (Stomach / Belly) Fat. The above study on seniors showed that visceral fat decreased significantly in seniors that took DHEA.  And lowering visceral fat is a sign that insulin control is improving generally.  Again, this is similar to HRT, which also has several studies showing it can often decrease visceral fat when give to hypogonadal men as well.  See my page on Testosterone and Visceral Fat for more information.  Testosterone can also lower subcutaneous fat according to some studies and DHEA did likewise in the same study. [8]

OTHER BENEFITS?  There may be other benefits as well, and I have listed these below:

6.  Anxiety. DHEA decreases anxiety for me significantly.  It doesn’t do this for everyone, but I remember thinking a couple days after starting it, “So this is how normal people feel?”

7.  Depression. Many men come to the Peak Testosterone Forum on SSRI’s, SNRI’s and other antidepressants. Of course, depression is very serious and, if you have to be on medications, then you just do.  But keep in mind that one of the root causes for depression can be low brain hormone levels.  Many men, inclduing myself, have seen depression vanish after getting on a good HRT protocol.  Of course, it doesn’t always work that way, but some of us “get lucky.”

And it looks like low levels of DHEA could possibly be a root cause at times as well.  For example, there are now several studies that show that DHEA supplementation can help with depression – even major depression.  Check out these comments from journal articles for example:

“Depression ratings, as well as aspects of memory performance significantly improved. One treatment-resistant patient received extended treatment with DHEA for 6 months; her depression ratings improved 48 72% and her semantic memory performance improved 63%. These measures returned to baseline after treatment ended. In both studies, improvements in depression ratings and memory performance were directly related to increases in plasma levels of DHEA and DHEA-S and to increases in their ratios with plasma cortisol levels. These preliminary data suggest DHEA may have antidepressant and promemory effects and should encourage double-blind trials in depressed patients.” [5]

“These results suggest that DHEA treatment may have significant antidepressant effects in some patients with major depression. Further, larger-scale trials are warranted.” [6]

8. Morning Erections. As far as I know, there are no studies showing that DHEA improved nocturnal/morning erections.  However, we have had a couple of reports on the Peak Testosterone Forum.  Here is an example:

“Before that i was experimenting with 50mgs of DHEA, after a week or 2 I noticed morning erections, that were rock hard, the last time i had this was when I was a teenager. I also noticed I was able to concentrate better and seemed to have more energy, when playing darts, and was able to score better and felt more enhusiastic. I am a FPS gamer and i seemed to improve no end when gaming also. I had to stop taking it doctors orders for a few weeks to get my T levels done. I have been off it about 3 weeks and up until a few days ago I was still getting morning wood.” [12]

9. Inexpensive. You can buy a six month supply of DHEA for around $14.00 (at 50 mg per day) on Amazon. And some experts argue for even lower dosages between 5 and 25 mg and, in that case, you’ve got a year’s supply at that cost! Even the cheapest of HRT clinics will cost you several hundred dollars per month for testing, injections and so on.

CAUTION:  Do not quit any medication, especially an antidepressant, without discussing it with your physician first.

CONCLUSION: Is DHEA as good as HRT (TRT)? My impression on the forum is that, generally speaking, it lacks the power that testosterone has for the typical hypogonadal male. Nevertheless, DHEA seems to work very well for some guys and so, considering it’s low cost, may be worth a try.

REFERENCES:

1)   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.

2) https://www.ergo-log.com/dhea-supplementation-boosts-post-interval-training-anabolism.html

3) Clin Endocrinol (Oxf), 1998 Oct, 49(4):421-32, “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”

4) Endocrinology, 151(4), Published Online Jul 1 2013, “Androgen Receptor-Dependent Activation of Endothelial Nitric Oxide Synthase in Vascular Endothelial Cells: Role of Phosphatidylinositol 3-Kinase/Akt Pathway”

5) Biological Psychiatry, Feb 1997, 41(3):311 318, “Dehydroepiandrosterone (DHEA) treatment of depression”

6) Psychiatry Online, Apr 1999, 156(4):646-649 Next Article”Double-Blind Treatment of Major Depression With Dehydroepiandrosterone”

7) JAMA, Nov 10 2004, 292(18), “Effect of DHEA on Abdominal Fat and Insulin Action in Elderly Women and Men: A Randomized Controlled Trial”

8) JAMA, Nov 10 2004, 292(18), “Effect of DHEA on Abdominal Fat and Insulin Action in Elderly Women and Men: A Randomized Controlled Trial”

9) JCEM, First Published Online: January 14, 2009, 78(6), “Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age”

9) International Journal of Obesity, 1990, 14(5):457-463, “Lack of effect of dehydroepiandrosterone in obese men”

10) Systems Biology in Reproductive Medicine, 1998, 40(2):87-93, “Andropause and the Aging Male”

11) JAMA, 2004 Nov 10,292(18):2243-8, “Effect of DHEA on abdominal fat and insulin action in elderly women and men: a randomized controlled trial”

12) https://www.peaktestosterone.com/forum/index.php?topic=6099.0

13) JCEM, Published Online: Jul 02 2013, “Dehydroepiandrosterone Supplementation Improves Endothelial Function and Insulin Sensitivity in Men”

14) Endocrinology, 144(8), Published Online: July 01, 2013, “Dehydroepiandrosterone Modulates Endothelial Nitric Oxide Synthesis Via Direct Genomic and Nongenomic Mechanisms”

15) JCEM, 88(7), First Published Online: April 26, 2011, “Dehydroepiandrosterone Supplementation Improves Endothelial Function and Insulin Sensitivity in Men”

Alpha Lipoic Acid: Improving Erectile Strength for 40+ Year Olds

Alpha lipoic acid is one of our most powerful antioxidants and is known for its ability to protect at the cellular level in both water and lipid mediums. We can actually make lipoic acid, but we lose that ability with aging.  Therefore, we can replace some of that from food, but the amount is quite small relatively speaking. As you’ll see below, the sweet spot for alpha lipoic acid is probably for diabetic, prediabetic and 40+ year old men.  And what also stands out is that this supplement can likely help some of these men with their erectile strength and general bedroom performance.  Here are 5 Ways That Alpha Lipoic Acid Can Help with Erectile Dysfunction:

1. Increase Nitric Oxide Through Decreased Phosphorylation (Due to Aging). There are many natural processes of aging working against men as they hit middle age and one of them is in a completely different pathway than is benetitted by the standard PDE5 inhibitors, such as Cialis and Viagra.  Basically, what happens is that, as your body ages, your levels of one of its master antioxidants, glutathione, declines.  And the decrease in glutathione causes an increase in ceramide and this, in turn, causes a loss of phosphorylation – the addition of a phosphate group – to eNOS.  That’s a lot of chemistry I realize, but it has the net effect of basically stunting the relaxation of your arteries, including penile. [5] Of course, this means less blood flow and worse erections.

Researchers decided to show just how important this is by giving young and old rats acetylcholine.  Basically, acetylcholine works by stimulating the phosphorylation mentioned above and, in young rats, this worked as expected and vasodilation (relaxing of the arteries) occurred.  However, in older animals, there was very little vasodilation that resulted from acetylcholine, supporting the theory that ceramide accumulation leads to arterial unresponsiveness. [2]

I have noticed this on the Peak Testosterone Forum before. Some young guys have sworn that whole eggs improve their erections. And the reason is likely the high dose of choline that is present in egg yolks. However, it is only the younger men who seem to benefit from this.

1)  Brit J of Pharmacology, online 29 Jan 2009, 153(8), “Lipoic acid supplementation and endothelial function”

2) Biochemical Society Transactions, 2003, 31(6), “Vascular endothelial dysfunction in aging: loss of Akt-dependent endothelial nitric oxide synthase phosphorylation and partial restoration by R-alpha-lipoic acid”

3) Diabetes Care, 2006 Nov, 29(11):2365-70, “Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial”

4) Biochem Pharmacol, 1995 Jun 29, 50(1):123-6, “Thioctic (lipoic) acid: a therapeutic metal-chelating antioxidant?“

5) British Journal of Pharmacology, 2008, 153:1615 1622, “Lipoic acid significantly restores, in rats, the age-related decline in vasomotion”

6) Free Radical Biology and Medicine, Jul 2001, 31(1):53-61, “Beneficial effects of a-lipoic acid and ascorbic acid on endothelium-dependent, nitric oxide-mediated vasodilation in diabetic patients: relation to parameters of oxidative stress”

7) J Diet Suppl, 2012 Jun, 9(2):116-27, “Evidence for using alpha-lipoic acid in reducing lipoprotein and inflammatory related atherosclerotic risk.”

8)  https://lpi.oregonstate.edu/book/export/html/373

9) https://umm.edu/health/medical/altmed/supplement/alphalipoic-acid

10) Circulation, 2005 Jan 25; 111(3):343-8, .”Irbesartan and lipoic acid improve endothelial function and reduce markers of inflammation in the metabolic syndrome: results of the Irbesartan and Lipoic Acid in Endothelial Dysfunction (ISLAND) study”

By the way, the results of these studies and a few others that we will mention below caused one set of authors to create a “rallying cry” for using ALA more in the prevention and treatment of cardiovascular disease. They stated, for example, that “in summary, the favourable antioxidant, anti-inflammatory, metabolic and endothelial effects of lipoic acid in rodents warrant further assessment of its potential role for prevention and treatment of cardiovascular diseases.” [1] And, if it improves heart disease, it likely improves erectile function.

NOTE:  See also my page on How to Raise Your Glutatione Levels Naturally.

2. Increase Nitric Oxide Due to Diabetes and Prediabetes / Metabolic Syndrome. All of the above studies on nitric oxide, phosphorylation and aging were done on animals.  Have there been any studies on nitric oxide and alpha lipoic acid on humans?  Yes, there have been such studies and they involved diabetic patients.  Basically, researchers found that alpha lipoic acid increases NO in diabetic patients but not in controls. [6]

More importantly, ALA greatly increases vasodilation – the relaxing of arteries – in prediabetics.  Typical symptoms of prediabetes:  an A1C > 5.7 but not diabetic; prehypertension or hypertension; high triglycerides; low SHBG; a “pattern B” lipid profile from a VAP or NMR. And I would guess that about half the men reading this would qualify for prediabetes and their NO levels and blood flow are impaired because of it.  ALA can help these men greatly as well according to multiple studies.  In fact, one study found that “oral supplementation with 300 mg/day of LA for four weeks improved flow-mediated vasodilation by 44% compared to placebo” in prediabetics [8][10]

Therefore, alpha lipoic acid is not necessarily going to improve endothelial function or vasodilation in everyone that takes it.  However, if you are middle-aged, senior, prediabetic or diabetic, then it will probably have a significant effect.  (Always talk with your doctor first of course.)

CAUTION:  Generally speaking, supplements should be considered a short term solution and ALA is no exception.  Personally, I am going to cycle ALA as a method of regularly detoxing.  However, ALA can a) lower thyroid hormone levels [9] and b) there is some concern that, in the long term, it could lower nutrient status, since it is so good at binding to things.  Now there is no evidence of the latter that I know, but no one has been taking it for decades.

3. Arterial Plaque (Atherosclerosis). There is mounting evidence that alpha lipoic acid may be able to help maintain or reduce atherosclerosis (arterial plaque).  First of all, it tends to improve lipid profiles by lowering LDL and triglycerides and raising HDL. [7] However, it also inhibits vascular adhesion molecules, which are ground zero for plaque formation.  Interestingly, an article in the Linus Pauling Institute showed that alpha lipoic acid did this not by raising glutatione but rather somehow with its chelating abiilites – more on that later – as described here:

“We found that alpha-lipoic acid significantly inhibits both the formation of adhesion molecules and the adherence of monocytes to endothelial cells in culture. However, to our surprise these processes were not influenced by vitamin C or glutathione, suggesting that general oxidative stress does not play a significant role in the activation of human endothelial cells to produce adhesion molecules. Because alpha-lipoic acid also is a good metal chelator, we hypothesized that metals may be involved in the production of adhesion molecules. To test this hypothesis, we added compounds to the cell culture that specifically chelate iron or copper. Our results showed that treatment with metal chelators also inhibits the production of adhesion molecules and monocyte adherence to cultured endothelial cells, thus supporting our hypothesis that the metal-chelating activity of alpha-lipoic acid may be responsible for its salubrious effects on endothelial cell function.” [8]

Clearing out plaque can greatly help men improve their blood flow and also avoid more severe erectile dysfunction and heart disease.  See my page on How to Clear Your Arteries of Plaque for other key strategies as well.

4. Neuropathy. One of the big complaints that I get from many men is that of “penile insensitivity.”  Guys say that they almost feel dead down there.  Of course, there can be many reasons for this, but one of them at times is probably that they have developed the beginnings of neuropathy.  As prediabetes and insulin resistance set in, nerve function can be mildly impaired.  One example of this is retrograde ejaculation, somethng I discuss in my page on Semen Volume. Alpha lipoic acid has some solid research behind it showing that it can heal or help neuropathy in diabetics.  And it can undoubtedly help men with prediabetes as well.  Look at what the authors of this study stated:

“Oral treatment with ALA for 5 weeks improved neuropathic symptoms and deficits in patients with DSP. An oral dose of 600 mg once daily appears to provide the optimum risk-to-benefit ratio.”

5. Detoxification of Heavy Metals. One thing that probably is an issue more often than we realize is the buildup of heavy metals in certain tissues.  Of course, lead and mercury and copper have all been implicated in various neurological, vascular and other chronic diseases and disorders.  Because of this, a fair amount of alternative practitioners will now use alpha lipoic acid as a metal chelator.  Chelation refers to any protocol that removes toxic substances from the body.  I have seen some alternative doctors suggesting that ALA be cycled, for example, i.e. detoxifying the body every so often with a “cleanse.”

Is there any research support for this view?  First of all, alpha lipoic is known for it’s ability to bind with many metals.  For example, there is a study out there that discusses its ability to bind with the neurotoxin copper.  (We tend to get overly high doses of copper and it has been implicated in Parkinson’s.)  The authors stated that “we found that TA had a profound dose-dependent inhibitory effect upon Cu(2+)-catalysed ascorbic acid oxidation (monitored by O2 uptake and spectrophotometrically at 265 nm) and also increased the partition of Cu2+ into n-octanol from an aqueous solution suggesting that TA forms a lipophilic complex with Cu2+.” [4]

REFERENCES:

Andropause - Is T a Function of Your Age? The Research

“Total testosterone levels fall at an average of 1.6% per year whilst free and bioavailable levels fall by 2% 3% per year.” [2]

I guess the word “inevitable” comes to mind when I read descriptions like that.  Losing your testosterone just seems like “part of life.”  However, the Australian study mentioned above throws that way of thinking out the window.  The particpants were 40+ year old men, and, again, the researchers noted that if a man reported very good or excellent health, then he simply had no decline in testosterone.

So what could explain this?  Well, if you no me, I would like for their to be a natural, lifestyle-related answer to that question.  And there is some evidence for it at least:

The Okinawans. Now I believe that sometimes this can be related to lifestyle.  One of the most well-know of the long-lived cultures was the Okinawans.  In another page, I document how the Okinawans had the highest senior age testosterone levels on record:  How to Avoid Andropause. By the way, the Okinawans did not consume the typical “high testosterone diet” that most of the men’s health blogs push, i.e. abundant saturated fats.  They were also not bodybuilders or into weights either, something I mention because so many of the blogs here in the U.S. push weights as a way to increase testosterone.  Yes, there is likely a small effect there, something I document in my page on Testosterone and Weight Lifting.  And, while weight lifting weights is my favorite form of exercise, the evidence just isn’t there that it is a big T booster.

NOTE:  Toxins, such as pesticides and heavy metals, along with head injuries and concussion, are likely causes of an acclerated drop in testosterone.  Obviously, avoiding these type of injuries, along with well done chelation, may be critical for many men as well.

Research-Backed Causes of Andropause.  In my page on The Causes of Andropause I discuss how inflammation and mitochondrial damage are some of the suspected culprits. This seems reasonable, because there inflammation and mitochondrial dysfunction are so powerfully associated with aging in the research. This leaves the intriguing possibility that a well done anti-aging strategy could actually preserve one’s testosterone (along with DHT and estradiol) if begun early enough.

This leaves the very intriguing possibility that men, who are diligent from a somewhat early age, could actually keep their testosterone levels through a carefully designed anti-aging program.  For example, we now have realistic strategies to boost the body’s key mitochondrial antioxidants, such as SOD, glutathione and CoQ10, to youthful levels as one ages.  We even have strategies that can help create new mitochondria.  And decreasing inflammation can be done nutraceutically with many supplements from turmeric extract, red tart cherry extract, quercetin, etc.  Could this stop the decline?

Or Is It Just the Womb? However, I suspect that if you study the men with perfect testosterone, you will find that they are not living that much healthier of a lifestyle than their andropause-laden peers.  This is what we find with centennarians.  They are generally not health fanatics in any sense of the word, and I doubt any of their friends or family could have predicted their longevity.  The same phenomenon may be true regarding testosterone and the secret may lie in the womb.  Check out this research:

“A study has revealed how men s testosterone levels may be determined before they are born…Researchers have shown that the cells responsible for producing testosterone in adults – known as Leydig cells – are derived from a specific population of stem cells found in the testes…Leydig cells do not develop until puberty but the team showed that their function is impaired if their stem cell forefathers are exposed to reduced levels of testosterone in the womb.” [3]

Now this does not exactly show that testosterone must decline with age via an andropause like effect.  However, it does illustrate how things outside of our control (including genetics and epigenetics) may play more of a role than we think.

CONCLUSION:  We simply do not know yet if preservation of testosterone levels comes from variables within our control, such as lifestyle and anti-aging, or if it may be the result of events outside of our control, such as womb T levels.  In the meantime, what we can reasonably conjecture (in my opinion) is the fact that we can at least slow down the rate of andropause through lifestyle and possibly nutraceutical methods.  Hopefully, more studies will follow.

1) Clin Endocrinol, 2012; 77(5):755-763, (See Medscape), “Serum Testosterone, Dihydrotestosterone and Estradiol Concentrations in Older Men Self-reporting Very Good Health: The Healthy Man Study”

2) Clin Interv Aging, 2008 Mar, 3(1): 25 44, “Testosterone for the aging male; current evidence and recommended practice”

3) https://www.ed.ac.uk/news/2014/testosterone-230414

Tamoxifen and Prolactin - Peak Testosterone

Tamoxifen (Nolvadex) is a drug that is not widely used for men’s issues based on what I have seen in the Peak Testosterone Forum. I was getting a slight amount of gyno when I first started my weekly testosterone cypionate injections and was offered tamoxifen. (Letrozole is used more by the steroid guys from what I have read, but this is what my clinic offered.) I solved the problems, actually, by losing a little weight and dropping my cypionate dosage. I also had an interesting case on the Peak Testosterone Forum where one man was using it in place of Clomid to raise his testosterone, because he was concerned about Clomid’s potential vision issues. [1] (See my link on Potential Risks of Clomid for more information.) And it reportedly raised his testosterone from 371 to 533 ng/dl, a modest increase at least, which is what any self-respecting SERM would do.

This forum poster also had mildly elevated prolactin and was concerned about a prolactinoma.  Of course, prolactinomas actually secrete extra prolactin by definition and can elevate a man’s prolactin levels substantially.  When this occurs, it is very bad for the bedroom since the extra prolactin can lower testosterone and libido.  And, of course, a large prolactinoma can cause other health issues, such as headaches if it grows too large.  And this poster was, indeed, experiencing may of the standard symptoms that accompany elevated prolactin and low testosterone: “erectile dysfuction, fatigue, low motivation, difficulty concentrating, grumpy, barely any morning wood, bad sleep.”

So was the tamoxifen he was taking raising or lowering his testosterone?  Well, there is no great study on men, but what research we do have all seems to indicate the same thing:  tamoxifen, in general, lowers prolactin:

1. Rats with Prolactinomas.  One study implanted prolactin-secreting tumors into rats and found that tamoxifen actually decreased tumor size and lowered prolactin levels. [2] In fact, it did it better than the frontline drug bromocriptine. This is a remarkable result, but, as far as I know, tamoxifen is not used in the battle against prolactinomas by physicians here in the U.S. Cabergoline, bromocriptine and surgery seem to be the standard medical treatments and you can read more the subject in my link on Testosterone and Prolactin.

2. Male Rats with Elevated Prolactin. Another study looked at rats who had their prolactin levels artificially increased with estradiol, which also enlarged the pituitary itself. [3] Remarkably, tamoxifen blocked both of these, i.e. normalized pituitary weight and lowered prolactin levels and, once again, outperformed bromocriptine!  As always, the problem is that this would be an off label use of tamoxifen and most physicians are unwilling to experiment with non-FDA approved usages of a medication.

3. Female Rats without Ovaries.  More verification came from a study of female rats where researchers studied the increase in the uterus and prolactin levels from injected estradiol.  The authors stated that “the results of the present paper showed that tamoxifen reduced estrogen-stimulated prolactin levels in some, but not in other hormonal conditions and that these effects were not mediated by an inhibition of lactotroph cell growth.”  In the female rats, bromocriptine was actually more powerful. Nevertheless, the tamoxifen did have a significant effect.

Of course, one should never self-treat when it comes to elevated prolactin levels or a prolactinoma.  Both can be potentially crippling and, of course, affect one’s sex life and marriage.  So always work with your doctor.

Nevertheless, tamoxifen’s effect on prolactin and related tumors is interesting, because in many men it would have a much better side effect profile. Both cabergoline and bromocriptine are notorious for rather harsh side effects.  Tamoxifen would also have the nice advantage of often raising testosterone levels a little as well as it did for the man above.

CAUTION:  Side effects are very high on higher dosage of tamoxifen used for cancer patients.  See this study for an example. [5] In addition, long term effects are poorly understood.  Discuss with your physician.

REFERENCES:

1) https://peaktestosterone.com/forum/index.php?topic=4303.0

2) J Endocrinol, 1980 Jul, 86(1):109-16, “Tamoxifen suppresses both the growth of prolactin-secreting pituitary tumours and normal prolactin synthesis in the rat”

3) Cancer, 1984 Apr 1, 53(7):1473-7, “Comparative effects of tamoxifen and bromocriptine on prolactin and pituitary weight in estradiol-treated male rats”

4) Horm Metab Res. 1996 Apr, 28(4):171-6, “Effects of tamoxifen on serum prolactin levels, pituitary immunoreactive prolactin cells and uterine growth in estradiol-treated ovariectomized rats”

5) Annals of Oncology, “Retrospective review of male breast cancer patients: analysis of tamoxifen-related side-effects”

Herbs That Can Boost Testosterone - Peak Testosterone

Actually, the opposite is actually the case:  there are many studies using herbs that show an increase in testosterone under certain circumstances and I have listed them below.  Now it is true that the FDA tends to shut anything that boost testosterone in the 50-100% range.

However, below I outline some of the herbs that likely work (to a lesser extent) under certain circumstances.

CAUTION: If you think you have low testosterone, get checked out by a (good) doc.  Low testosterone is a serious medical condition that has long term consequences, including risks for diabetes, heart disease and erectile dyfunction. Also, if you are on any medications or have an existing medical condition, talk to your physician before making any change

1.  Fenugreek. One study on 30 young males found that 500 mg of Fenugreek increased total and free testosterone by 7% and 12%, respectively. [10] Now this isn’t a big increase, but it also seems to proportionately inhibit the normal conversion to estrogen and DHT. Furthermore, Fenugreek is dirt cheap – see for example Fenugreek Seed 610 mg 90 Caps – and so it may be worth a try. Fenugreek has many other excellent properties, including blood sugar/insulin control and libido and growth hormone augmentation.

NOTE: The brand that has gotten the best comments on the Peak Testosterone Forum is Testofen. I cover both the pros and cons in my page on The Benefits of Fenugreek.

Is Fenugreek safe?  Well, it should be as it is eaten as a common food and spice in many eastern cultures.  Now there is a fenugreek extract, Testofen, out there that is very effective in improving libido and has its own following. However, the extracts may boost prolactin, not something a guy necessarily wants to do. Here is an example of the extract on Amazon: Testofen Fenugreek Extract (300 mg 60 Caps).You can read more about here in my link on The Benefits of Fenugreek.

NOTE: One very small study of college age men showed that testosterone (and growth hormone) levels were not significantly raised by Ginseng. [5] My guess is that Ginseng produces a small boost in testosteorne for some men.  It has the added benefit, for men with erectile dysfunction, of generally increasing nitric oxide and hardness factor. For more information, see this link on How Ginseng Can Boost Erectile Dysfunction.

Some Ginseng manufacturers have been caught with lead in the their products. To get around this, one should probably play it safe and go with a brand that has been tested by an impartial testing company such as Consumer Lab. This brand, for example, was found to be lead free and to deliver the active ginsenocides specified on the label: Solgar – Korean Ginseng Root Extract, 60 veggie caps .

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DOSAGE: In one of the studies where the men experienced significant improvement in erectile dysfunction [13][14], the men took 900 mg of Korean Ginseng three times daily. Smaller amounts can be taken effectively by many men of course and several studies have used 600 mg 3 times daily.

3) Horny Goat Weed. Horny Goat Weed has a PDE5 inhibitor, a la Viagra and Cialis, called Icariin. Most Horny Goat Weed supplements on the market have an extract of Icariin to boost its power and efficacy. This may be good for testosterone in some circumstances as one study showed that Icariin increased testosterone levels in animals with damaged reproductive systems. [6]

Icariin has the added benefit of generally improving erectile function in men with erectile issues. For more information, see this link on The Benefits of Icariin and Horny Goat Weed. Also, 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 .

4) Tribulis Terristris.  This herb is somewhat controversial because, although initial evidence showed that it did increase testosterone, one one recent and study showed the opposite. [12] What gives?  Well, one important thing to note is that the study showing that Tribulis did not significantly increase testosterone was on younger, healthy men.  These men already, generally, have abundant testosterone, so do we really expect Tribulis to help in this category?

Tribulis may very well affect men with low testosterone or with certain types of hypogonadism, which may explain the many anecdotal reports of it helping significantly.  Furthermore, Tribulis has some excellent properties, such as raising libido, that make it a very likely bedroom booster even in cases where it only marginally helps testosterone. For example, other studies show that it increases both libido and nitric oxide.  Some of these other qualities I have covered in some detail elsewhere in my links on Super Sexual Herbs, Aphrodisiacs (Male Libido Supplements) and the How to Increase Testosterone Naturally Guide.

Tribulis is typically packaged in very expensive formulations in health food and bodybuilding stores.  However, the herb itself is not expensive: Ultimate Bulgarian Tribulus (750 mg, 90-Count) or NOW’s brand NOW Tribulus (1000mg, 45% Extract, 180 Tablets)

DOSAGE: The dosage in the above study was 10-20 mg/kg daily.  For a 180 lb man, this works out to be between about 800-1600 mg daily. Many men take smaller amounts, more in the 400-800 mg per day range.

5) Tongkat Ali (Eurycoma Longfolia). One study on rats using Tongkat Ali showed a significant increase in testosterone. [1] This has not been verified in humans however.  One set of researchers in Brazil noted that Tonkat Ali’s true powers seem to lie in its ability to halt the “inhibitory effects of estrogen on testosterone production.”  [2] They further noted something very important for many guys: “where there is an excess of estrogen or deficiency in testosterone, EL may be able to act as a remedy for the condition.”  Of course, a low testosterone, high estrogen state is what a large percentage of males struggle with in modern, industrialized societies and so Tongkat Ali may be a significant help in these situations. NOTE:  Tongkat Ali is generally sold as an extract and probably the most reliable form is LJ100 as it is, at least, backed by certain agreed-upon concentration levels.  I am a little cautious about this product, though, because some of its components have shown toxicity. [11] However, the counterargument is that men have been using Tongkat Ali for years seemingly without issue.

6) Zinc (ZMA).  There is one supplement, ZMA, a form of zinc that has one study that shows a boost in testosterone.  Although, a follow-up study showed no significant benefit, it seems like that zinc deficient men may get some benefit in testosterone levels, if nothing else from improved sleep. For more information, see my link on Zinc and ZMA. ZMA also has an absorbable form of magnesium, which is worth its weight in gold.

CAUTIONS: Another supplement, high potency resveratrol, has also been shown to raise testosterone. [7]  However, it has also been reported as an estrogen agonist, i.e. estrogenic. [8] Forskolin is another supplement that has a study showing a modest increase in testosterone. [9] Unfortunately, little is known about its medium, or even short term effects.

REFERENCES:

1) Fundam Clin Pharmacol, 2002 Dec, 16(6):479-83, “Effect of Eurycoma longifolia Jack on orientation activities in middle-aged male rats”

2) Clinics (Sao Paulo). 2010 January; 65(1): 93 98, “The Effect of Eurycoma Longifolia Jack on Spermatogenesis in Estrogen-Treated Rats”

3)  Panminerva Med, 1996 Dec, 38(4):249-54, “Effects of Panax Ginseng C.A. Meyer saponins on male fertility”

4) 8)  Systems Biology in Reproductive Medicine, 1982, 8(4):261-263, “Effect of Panax Ginseng on Testosterone Level and Prostate in Male Rats”

5) 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”

6) Asian J Androl, 2006 Sep, 8(5):601-5, Epub 2006 Jun 5, “The testosterone mimetic properties of icariin”

7) Arch Pharm Res, 2008 Jan;31(1):83-7, “trans-Resveratrol relaxes the corpus cavernosum ex vivo and enhances testosterone levels and sperm quality in vivo”

8) Proc Natl Acad Sci U S A, 1997 Dec 9, 94(25):14138 14143, “Resveratrol, a polyphenolic compound found in grapes and wine, is an agonist for the estrogenreceptor”

9) Obesity Research, 2005, 13:1335 1343; “Body Composition and Hormonal Adaptations Associated with Forskolin Consumption in Overweight and Obese Men”

10) https://robthoburn.wordpress.com/2011/02/05/fenugreek-increases-testosterone-and-it-smells/

11) Planta Med, 2002 Jul, 68(7):662-4, “The toxicity of some quassinoids from Eurycoma longifolia”

12) J Ethnopharmacol, 2005 Oct 3, 101(1-3):319-23, “The aphrodisiac herb Tribulus terrestris does not influence the androgen production in young men”

13) The Journal of Urology, Nov 2002, 168(5):2070 2073, “A Double-Blind Crossover Study Evaluating the Efficacy of Korean Red Ginseng in Patients With Erectile Dysfunction: A Preliminary Report”

14) British Journal of Clinical Pharmacology, Oct 2008, 66(4):444-450, “Red ginseng for treating erectile dysfunction: a systematic review”

Cortisol and Psychopaths - Peak Testosterone

Ever known a psychopath?  You probably have but just didn’t know it.  Most psychopaths, about 500,000 in the U.S., end up in jail.  However, experts estimate that there are another 250,000 that live in society as best they can. [1]  Researchers call these “successful psychopaths.”

One of the most disturbing aspects of my adult life was knowing a psychopath quite well, although I didn’t know the correct label at the time.  I was never worried for my own safety but noticed that this human being was completely self-centered and had virtually no sympathy for other human beings, including his own family.

And these are some of the hallmarks of a true psychopath:  they have very low empathy and emotions.  They simply do not “feel” the suffering of other human beings as a normal human being would.  In fact, they have low levels of all emotions.  They also are responsive to typical risk and reward scenarios and are known for fearlessness and impulsiveness.

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This combination of lack of fear, lack of empathy and low emotion is what turns so many of them into killing machines. They can kill, rape and even torture, without remorse and without regret.  The person that I knew was not a killer but had multiple wives in multiple states simultaneously and had little to no remorse for the incredible damage that he left behind.

Now I mention all of this, not to let you know that I am vying for a screenwriting job on Criminal Minds, but because an examination of psychopathology shows the incredible importance of guarding our gray and white matter.  As I will show below, psychopathology is an extreme, but straightforward lesson in how we should treat the most important organ in our body:  the brain.

What neurobiologists have found, through neuroimaging and other recent techniques, is that the brain of the typical psychopath has been partially destroyed.  There is an inner donut, if you will, of cerebral subsytems called the paralimbic system, that governs “decision making, high-level reasoning and impulse control.” [2] The paralimbic system includes the anterior cingulate, orbitofrontal cortex, amygdala, poserior cingulate, insula, etc.  In psychopaths, these all-critical regions have actually been “shrunk” or reduced in volume. [3]  Or they may have never fully developed due to a traumatic childhood or genetic factors.

Furthermore, there is another part of the brain that is probably also tied into psychopathology:  the prefrontal cortex.  The prefrontal cortex is the part of the frontal cortex that is involved in things like suppressing urges, deciding between conflicting thoughts and so on.  Damage to the prefrontal cortex from aging and other factors is what makes being around older men so scary at times:  they just blurt out whatever they are thinking.

The prefrontal cortex is supposed to act as the filter, if you will, for what we say and do.  However, in some older men this filter has been effectively removed due to literal brain damage and so you get to hear their every thought.

It may be not suprise that prefrontal atrophy or damage like this has been tied to criminal psychopaths.  Those psychopaths that end up incarcerated have been found to have 21% less volume in this key area of their brain [4] and, of course, it shows in their actions.

Now here is what should make us all pause and reflect societally and otherwise.  Consider some of the factors that can damage the prefrontal cortex according to the research:

1.  Physical Trauma. A blow to the head, especially during childhood. [5]

2. Cortisol. It is well-know that elevated cortisol levels, such as those in patients with PTSD and/or depression, can literally unhook neurons and shrink the hippocampus. However, one groundbreaking 2010 study found evidence that elevated cortisol was also associated with atrophy of prefrontal tissues as well. [6]

3.  Alzheimer’s. If you’ve been on a typical Western Diet for very long, then the typical plaques and tangles of Alzheimer’s have been accumulating in your brain due to elevated inflammation and other factors.  As the decades roll by, the damage begins to manifest itself in the typical signs of dementia that we associated with Alzheimer’s. But it’s important to note that you can have substantial plaques and tangles before you really start to reach “critical mass” and exhibit symptoms.  One 2010 study showed a correlation between the damage of Alzheimer’s and “prefrontal volume.” [7]  This means that Alzheimers leads to a shrinkage of the prefrontal cortex.

So, yes, every morning you should wake up and ask yourself, “What am I doing to my poor brain?”  Do you want to be one of those grumpy, old guys that no one wants to be around and that embarasses himself much of the time?

Furthermore, there is a sobering study out there that shows that healthy people can potentially be shifted toward psychopathology through frontal lobe damage. [8] Of course, I am not saying that damaging your frontal/prefrontal regions is going to automatically turn anyone into a serial killer.  But let’s be honest:  damage to the brain has consequences.  It has consequences to our behaviors, our relationships and our careers.  Again, this is yet another reason to carefully guard and protect your gray matter.

Another question should be asked as well: “Why is it that so many psychopaths come from unspeakably awful family backgrounds?”  Well, the jury is still out, but one possible explanation is that extreme childhood stress, and its ensuing elevated cortisol levels, leads to a permanently damaged and defective brain in the prefrontal and paralimbic regions.  There are undoubtedly genetic, hormonal – there are many fewer females psychopaths and females do not move to psychopathology as easily – and neurological factors as well of course.

Are you in a toxic, highly stressful or abusive relationship?  If so, you need to find a way to reduce your physiological stress reaction.  Are you depressed?  Are you suffering from sleep deprivation or apnea?  Again, do what you have to do:  you’ve only got so much gray and white matter and there is no uglier example than that of a psychopath to remind us of that fact.

REFERENCES:

1) Scientific American Mind, “Inside the Mind of a Psychopath”, Sep/Oct 2010, p. 28.

2) ) Scientific American Mind,  “Inside the Mind of a Psychopath”, Sep/Oct 2010, p. 27.

3) Biological Psychiatry, Nov 1 2001, 50(9):677-684, “Limbic abnormalities in affective processing by criminal psychopaths as revealed by functional magnetic resonance imaging”

4) Biological Psychiatry, May 15 2005, 57(10):1103-1108, “Volume Reduction in Prefrontal Gray Matter in Unsuccessful Criminal Psychopaths”

5) https://www.fi.edu/learn/brain/head.html

6) Neuroimage, 2010 Nov 15, 53(3):1093-102, Epub 2010 Feb 13, “Salivary cortisol and prefrontal cortical thickness in middle-aged men: A twin study”

7) Neurobiology of Aging, Nov 1999, 20(6):591-596, “Sex differences in prefrontal volume with aging and Alzheimer’s disease”

8) Cognitive and Behavioral Neurology, July 2000, 13(3)”The Relation Between Tendency for Psychopathology and Reduced Frontal Brain Volume in Healthy People”

Exercise - Erectile Dysfunction - Peak Testosterone

I don’t know of anything that can improve erectile dysfunction as much as exercise with the exception of Eating the Right Foods. Exercise turns back the clock:  some of you will find it’s literally a fountain of youth, especially for your sex life.

First of all, let’s start with an intuitive concept:  exercise improves blood flow. Let me say that again in case you didn t catch the significance of it:  exercise improves blood flow. And if you’re male, blood flow is what it’s all about when it comes to erectile dysfunction.

In fact, I would go so far as to write a simple formula: Exercise=Viagra. Yes, exercise has been shown to so signficiantly improve erectile dysfunction so that it has been compared to that blockbuster impotence drug.  Sound like an exaggeration? Fitness Rx reported that “German scientists, in a paper presented at the European Association of Uruology Annual Meeting, found that putting men with erection problems on an exercise program was just as effective for improving erection capacity as taking Viagra.” [1] And recently Hong Kong researchers reviewed seven previously published studies and verified that “moderate and high physical activities were associated with a lower risk of ED [Erectile Dysfunction]”. [2]

Think of the significance of this. Viagra, Cialis and Levitra have been hailed as miracle cures for middle and senior aged men, when, in fact, the underlying root cause of their erectile dysfunction is often lack of exercise. Why is exercise so critical to sexual health?  The reason is that your blood vessels are lined with delicate circulatory tisse called the endothelium. And guess what appendage of yours is all about having a healthy endothelium? That s right good erections depend on a good endothelium and a good endothelium depends on good exercise and diet of course.

“Why?” you ask. Well, there are many reasons.  But #1 is probably that exercise increases Nitric Oxide [3], the all-important chemical which relaxes blood vessels throughout your body including the penis.  (Nitric Oxide is very heart-protective as well.) Viagra/Cialis/Levitra work on Nitric Oxide for this reason – actually the enzyme (nitric oxide synthase) that breaks down nitric oxide – and relax the  blood vessels that allow blood flow into the penis.

1) Fitness Rx 7/05, p.192.

2) Intl Jour Impot Res (2007) 19, 245 252

3) J Appl Physiol,1997,82:760 64

4) Jour Appl Physio, 2007, 203:432-442;Experimental Biol and Med,2003,228:434-440;Archives Intern Med,2007,167:999-1008

5) J Am Coll Cardiol,1987,10:321-326

6) J Am Coll Cardiol, 2004, 43:1405-1411, “Heart disease risk factors predict erectile dysfunction 25 years later”

7) Circulation, 1999, 100:1194-1202, “Regular Aerobic Exercise Augments Endothelium-Dependent Vascular Relaxation in Normotensive As Well As Hypertensive Subjects”

8) Circulation, 2000, 101:2896-2901, “Physical Activity Prevents Age-Related Impairment in Nitric Oxide Availability in Elderly Athletes”

9) J Sex Med, 2008 Mar, 5(3):552 561, “Low-Fat Diet and Exercise Preserve eNOS Regulation and Endothelial Function in the Penis of Early Atherosclerotic Pigs: A Molecular Analysis”

10) JAMA, 2004, 291(24):2978-2984, “Effect of Lifestyle Changes on Erectile Dysfunction in Obese Men A Randomized Controlled Trial”

25) Circulation, 1995, 92:197-204

Exercise seems to raise nitric oxide levels primarily by increasing the bioavailability of eNOS. [7] Yes, that is the same enzyme that Viagra works on!  Again, this is why Exercise=Viagra, except without all the nasty, toxic side effects.  And the beauty of exercise is that it works in men with normal or high blood pressure, old and young – everyone!  [7][8]

And it does something that Viagra and Cialis can never do:  vascular remodeling. This term refers to the fact that exercise.literally rebuilds small veins and capillaries throughout your body. Vascular tissues are literally rebuilt throughout your body when you get active.

Does this include the penis?  You bet it does! Exercise increases the “number and diameter of blood vessels” throughout the body and that is going to be good news below the belt. [9]

And exercise isn’t going to just help your erections in the short term – it will help long term as well.  One study examined combining a Low Fat Diet with exercise.  The results were dramatic.  Besides increased blood flow, which is always great for erections, the participants also experienced an average 16% drop in blood pressure, a 17% drop in cholesterol, a 19% drop in LDL and a 20% drop in triglycerides. [25] These represent large drops in some of the most important risk factors for cardiovascular disease.  That means that, on top of all the new Nitric Oxide your body is pumping out, the exercise and low fat diet were protecting the delicate veins and arteries supplying the penis.

This study points out something else important:  exercise protects you from and improves any existing erectile dysfunction both in the short term, through improved blood flow and increased nitric oxide, and in the long term by protecting your entire cardiovascular system. Many studies have shown that exercise drops triglycerides and blood pressure and both of these are key risk factors for erectile dysfunction. (The drop in total cholesterol and LDL was likely due to the Low Fat Diet for the most part.)

One study found that exercise improved erectile dysfunction in obese men, one of the hardest-to-treat groups. [10] (For more information as to how and how much exercise increases nitric oxide leves, see my link on Exercise and Nitric Oxide.

Exercise also raises HDL, the good cholesterol. [4][5] HDL is, generally speaking, known for its remarkable ability to “clean up” your arteries and protect them from artery-damaging plaque.  You want plaque-free arteries for maximum endothelial performance and minimal erectile dysfunction.  HDL also is a strong booster of nitric oxide and so it helps both short and long term with erectile dysfunction as well.

Is erectile dysfunction always related to poor blood flow and the endothelium?  Not always actually – low testosterone can play a vital role as well.  Healthy testosterone levels are critical to the penile muscles that trap blood for maintaining erections.  As you might have guessed, one form of exercise, weight lifting, has been found to raise testosterone in several studies.  Read this link on How Weight Lifting Can Increase Testosterone for more details.

Again, generally erectile dysfunction in middle age and beyond is nitric oxide and blood flow related, but low testosterone can definitely be a root cause as well.  One thing that can help those penile mucles and improve erectile dysfunction directly are Kegels, which are essentially exercise for the penile mucles that need to powerfully contract for erection. It may sound strange to exercise muscles in the groin area, but it is an effective and research-backed way to improve erectile dysfunction.

The bottom line is that exercise will greatly improve and likely cure your erectile dysfunction, especially if coupled with proper diet as well.  (Always talk to your doc of course.)

REFERENCES:

Depression and Testosterone (Low T Causes Depression)

Low Testosterone and depression.  Unfortunately, the two seem to be married at the hip.  The reason is simple:  depression lowers testosterone and low testosterone leads to depression.

Many men simply do not realize that testosterone dramatically affects the male brain.  Sure, testosterone is the “sex hormone” and the “muscle hormone”.  But I would argue that even more impressive is its ability to affect mood and cognition.  As testosterone decreases, anxiety, mental fog and depression increase until, eventually, it becomes hard to function in marriages and careers.  And that isn’t good for anyone.

I have to admit that I was surprised often the subject of depression came up when I started the Peak Testosterone Forum. Perhaps I shouldn’t have been, but it was simply stunning how many of the posters complained of depression either currently or recently and the usage of various antidepressants.

“I was wondering if anyone knew anything about 5-HTP? Is it a good thing to take? I was thinking of taking it for depression. I have slumped into a depressive state after my last job placement came to an end. I feel quite hopeless, a failure” [1]

“I suffer from many of the publicised symptoms along with a long spell of depression and feel that I need to address this testosterone level issue to address this and the other symptoms. ” [2]

1) https://www.peaktestosterone.com/forum/index.php?topic=62

2) https://peaktestosterone.com/forum/index.php?topic=406

3) https://peaktestosterone.com/forum/index.php?topic=395

4) https://peaktestosterone.com/forum/index.php?topic=186

5) Am J Psychiatry, Jan 2003, 160:105-111, “Testosterone Gel Supplementation for Men With Refractory Depression: A Randomized, Placebo-Controlled Trial”

6) Journal of Psychiatric Practice, Jul 2009, 14(4):289-305, “Testosterone and Depression: Systematic Review and Meta-Analysis”

7) J Clin Endocrinol Metab, 1996, 81:3578 3583, “Testosterone replacement therapy improves mood in hypogonadal men a clinical research center study”

8) BJU Int 91(1):69-74, “A novel testosterone gel formulation normalizes androgen levels in hypogonadal men, with improvements in body composition and sexual function”

9) J Clin Endocrinol Metab , 2000, 85(8):2839-2853, “Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men”

10) Maturitas, 15 April 2002,, 41(Supplement 1):25-46, “The impact of testosterone imbalance on depression and women’s health”

11) Menopause, Sep 2003, 10(5):390-398, “Transdermal testosterone therapy improves well-being, mood, and sexual function in premenopausal women”

12) The Journal of Clinical Endocrinology & Metabolism, Feb 1 1999, 84(2):573-577, “Bioavailable Testosterone and Depressed Mood in Older Men: The Rancho Bernardo Study”

13) The Journal of Clinical Endocrinology & Metabolism, Jan 1 2000, 85(1):60-65, “Effects of Hypogonadism and Testosterone Administration on Depression Indices in HIV-Infected Men”

14) Biological Psychiatry, Feb 1985, 20(2):222-225, “Plasma testosterone levels, depression, sexuality, and age”

15) Journal of Clinical Psychiatry, Dec 2002, 63(12):1096-1101, “Testosterone therapy in late-life major depression in males”

“Hi there all.i am new here.been on androgel since 2/16/12..was hypogonadal.  The psychological part started when I thought that was it for me…it was then of course I started feeling down and not knowing anything about depression and anxiety and what it was actually doing to my body at the time ( T levels etc ) then just getting steadily worse further down the line” [4]

“People were noticing at work that I wasn’t cracking the stupid jokes I used to dish out. I started to go into >a slowly ,accelerating depression until the age of 30-31 when it became full blown major depression with crying fits that would make a grandmother look like Chuck Norris in comparison to myself.” [5]

“I have talked with the Dr. about the depression but I cannot take anti-depressants ( am in the military they do not like people taking them).” [7]

These posts could go on and on and are tragic to say the least and I have not even included the many discussions about Wellbutrin, Paxil, SSRI’s and so on.  You may want to read this Thread:  Roll Call on Depression for some interesting reads as well.

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As you can see, usually the men believe that over time lower and lower testosterone levels lead to an increased state of depression.  Generally, though not always, they do not attribute their depression as actually causing the low testosterone.  So that leads to a “chicken and egg” question:  which usually comes first?

Of course, showing “causality” as it is called is tricky business.  However, we can tease out some interesting conclusions from this simple fact:  HRT (testosterone therapy) has many studies showing that it dramatically improves depression and mood.  Just look at some of the studies that show just this:

NOTE:  Although I am focusing on the opposite, studies definitely show that depression can lower testosterone.  This is no surprise since depression raises cortisol and cortisol fight testosterone. For example, one study found that daytime and nightime testosterone levels were lower in men with depression and the trigger molecule to the testes, leutinizing hormone, was decreased as well. [15] And, as one would expect, one study found that the greater the depression, the lower the testosterone levels independent of age.  (See my link on Natural Depression Cures for possible helps.)

1.  Refractory Depression. Refractory depression is depression that does not respond to standard treatments.  Interestingly enough, one small study found that “testosterone gel may produce antidepressant effects in the large and probably underrecognized population of depressed men with low testosterone levels.” [8]  Of course, this implies that in many hard-to-treat men low testosterone is actually a root cause.  Tragically, many doctors never even think to do a blood draw.

2.  Standard Depression. One meta-analysis using 7 studies found the same thing:  testosterone therapy exerted a significant anti-depressant effect on patients with existing depression. [9]

3.  Hypogonadal Men.  One would not necessarily expect testosterone supplementation to help men with normal testosterone, healthy testosterone levels.  However, one would expect that if men had low testosterone, Hormone Replacement Therapy might give them a nice boost in mood parameters.  This is exactly what one study found. [10] One study with Testim found that only was mood improved but also body composition, i.e. more muscle and less fat. [11] This common with testosterone therapy and will help your depression, undoubtedly, due to improved self-image as well.

4. HIV Infected Men One study showed that men with AIDs may experience a significant boost in depression from testosterone therapy. [17}

5. Seniors. Certain groups of senior men may benefit from HRT as well. [18] This is not too suprising since testosterone decreases with aging.  See my links on The Causes of Andropause and Hormone Replacement Therapy for more information.

So there are clearly man subpopulations of men where testosterone can significantly help with depression. This is, of course, something to discuss with your physician if it applies.

How long does it take for the improvements in depression to hit?  One study found that the maximum improvement in mood occurred at about 30 days and then no significant further improvements occurred. [12] However, this may or not be the case for you.  Some men feel the difference almost immediately and others can take several months.

NOTE: Testosterone may actually help the women in your life with depression in some cases as well and several studies have shown just that. Of course, women have lower seratonin levels and, therefore, tend to struggle more with depression than men. However, even though their testosterone levels are about a tenth of ours, it looks like they may benefit in some cases as well.[13][14]

REFERENCES:

Acne - How Do Eliminate It Post-HRT? - 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]

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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”

Cialis and Viagra: Basic Information and Side Effects - Peak Testosterone

Viagra / Cialis / Levitra. These big three blockbuster drugs are only available by prescription and therefore are not supplements. But I wanted to cover them, because they’re as close to a “miracle pill” for anyone struggling with testosterone, libido or erectile difficulties. Viagra is good for four hours and Levitra for six. Cialis, on the other hand, in this category is king: it’s potency lasts for 36 hours. This makes it ideal as it really gets the penis back in shape by increasing early morning erection count, confidence and sexual activity for extended periods of time.

So do you want the good news or the bad news first?  I’ll start with the good news.  Viagra has been found, for example, to help with treatment of high blood pressure in the lungs, cardiovascular performance at high altitudes and may also prevent blood clots, a major cause of heart attacks and strokes. [1]  And Viagra’s long-lasting brother, Cialis, has been found to help men with BPH (Enlarged Prostate). [2]

Need to boost your Nitric Oxide naturally through food, drink and supplements? Check out Lee Myer’s book here: The Peak Erectile Strength Diet

Or do you need the most comprehensive testosterone book in Amazon? Here it is: Natural Versus Testosterone Therapy

So there is actually a lot of good medical news coming out about these drugs and the reason is probably simply the fact that you need Nitric Oxide and all of these drugs help Nitric Oxide to stay in your system longer.  Nitric Oxide does many things to help your body fight heart diseasse (and cancer) and so it should not be overly surprising that in aging males, a little more Nitric Oxide may actually be helpful in the same way that Testosterone Supplementation (HRT) actually helps restore youth to many older guys.

However, I would still recommend caution with these three drugs, becuase of their side effect profile – see below – and because, in general, it is better to solve the root of your erectile difficulties, which is almost always poor heart and endothelial function. Erectile dysfunction can also be related to low testosterone, another condition that you should see a doctor for.

NOTE:  Please read my link on Recreational Use of Viagra and Other PDE5 Inhibitors for additional information.

I recommend that these drugs be used primarily as a bridge to help you get your penile tissue back in shape after months of few morning erections. Furthermore, keep in mind that there are Supplements that are very effective as well for short term solutions.

There’s another reason that I emphasize using these short term if at all possible:  you want to coax your body to actually produce more Nitric Oxide on its own because this is a sign of endothelial health.  The endothelium is the thin lining of your veins and arteries and one of the signs of an injured, out-of-shape endothelium is decreased Nitric Oxide production.  Please, please, please read this link How To Fix Erectile Dysfunction Long Term to find out how to get your endothelium to start pumping out more Nitric Oxide naturally.

By the way, it is also possible that some of the men afflicated were taking too large of a dose. Some men overtake testosterone derivatives, i.e. steroids, quite frequently.  Would it be surprising that some men take too much Viagra during “desperate” situations?  But arguing against that is the fact that all three of these drugs had patients experiencing oxotocity, hearing problems during clinical trials while they were presumably testing dosing and other aspects of bringing this public. Again, talk to your doctor and do your homework.

Also, back in 2000, it looked as if there would be a promising new class of drugs coming out both more potent and with fewer side effects. So far these have not been tested on humans, but the animal studies are looking very good. I have not been able to find if the clinical trial process is making good progress on these drugs or not.

One interesting side note is that researchers have found that Viagra is about 80 X more potent at inhibiting PDE5, the enzyme that indirectly affects Nitric Oxide production, than the primary ingredient in Horny Goat Weed Icariin. However, there are many less side effects with Icariin and Horny Goat Weed, making it an excellent alternative to Viagra depending on the severity of one’s erectile dysfunction.  Researchers are currently taking Icariin and modifying it slightly to see if they can come up with a “new Viagra” with decreased side effects.  Read below for a discussion of the many side effects associated with these drugs:

NOTE: One recent study showed an increase in testosterone post-exercise in healthy male subjects taking Cialis. [7] So are these PDE5 inhibitors a good idea before exercise?  Unfortunately, the study also showed that Cialis increased cortisol more than normal and, of course, cortisol is definitely not something we want to boost under normal circumstances.  In addition, below I list a number of side effects from Cialis (and Viagra and Levitra as well) that would make using Cialis as a testosterone booster even more questionable.

CAUTIONS AND SIDE EFFECTS:

Now for the bad news or, better worded, cautions:  it is important to note that the FDA is now requiring a warning label on all three of these drugs because there have been 29 cases (at the date of writing this) of sudden hearing loss.  The problem is that there are related PDE5 receptors involved in hearing that these drugs activate. (Viagra has also been implicated in making sleep apnea worse.)  However, the number of men affected by this is small considering the very large number, about 30 million, using these drugs. In fact, Lilly spokeswoman Keri McGrath said a recent Lilly review found about 1.1 incidents of sudden hearing loss per million Cialis patients, which she said was lower than the incident rate in the general population. Nearly 12 million men have been prescribed the drug, the company said. Note: I have also read that Cialis has less of this crossover effect than Viagra. But, again, discuss all this with your doctor if you feel you need to go this route.

The underlying problem with these drugs is that they affect other phosphodiesterases in the body, including the ones that effect hearing, sight and heart function.  For example, Viagra can inhibit the PDE6 inhibitor, affecting the rod and cone photoreceptors in your eyes to a certain extent. One study came out and said there could even be potential damage to the optic nerve. [4] But subsequent studies found no such association. [5]

Another major issue with these drugs are dangerous arrythmias and palpitations.  The problem is that they increase, for reasons not fully understood, the sympathetic nervous system.  One study showed that noradrenaline was significantly increased after taking Viagra, for example, in healthy young men. [6] These fight-or-flight chemicals can be dangerous to the heart as they increase the likelihood of irregular heartbeat (and potentially stroke).

No, the doctor won’t tell you that when he gives you a prescription!  These drugs can cause problems with heart issues and medications so you’ve got to discuss that with your doctor if that is your situation.  Remember:  there are a number of possible side effects from drug combinations with Viagra for example.  You can also potentially get facial flushing, stomach upset and/or heartburn and headaches.

And the most potentially dangerous side effect involves nitroglycerin.  Nitroglycerin, a drug prescribed for heart pain, can result in shock if taken at the same time as Viagra. And, because drugs such as Viagra are worked on by the same liver enzyme, it could raise or lower levels of many other drugs such as ketoconazole and entacapone.

There has been concern that these PDE5 inhibitors should not be prescribed to patients with heart disease or that they could possibly lead to heart attacks.  However, several studies have shown Viagra to be safe in both cases [3], but of course you should also discuss this with your doctor.

REFERENCES:

1) Proceedings Nat Acad of Sciences USA, 1008, 105:13650-13655

2) J of Urology, 2008, 180:1030-1033

3) BMJ, 2001, 322(7287): 651–652; Archives of Int Med, 2004, 164(5): 514–520

4) Br J Ophthalmol, 2006, 90:154-57, “Non-arteritic anterior ischaemic optic neuropathy and the treatment of erectile dysfunction”

5) J of Sexual Med, 3(1):12-27, Published Online 5 Jan 2006, “Ocular Safety in Patients Using Sildenafil Citrate Therapy for Erectile Dysfunction”

6) https://seniorhealth.about.com/library/weekly/aa010701a.htm

7) The Journal of Clinical Endocrinology & Metabolism, 2008, 93(9):3510-3514, “The Type 5 Phosphodiesterase Inhibitor Tadalafil Influences Salivary Cortisol, Testosterone, and Dehydroepiandrosterone Sulphate Responses to Maximal Exercise in Healthy Men”

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:

vitamins and supplements have not done nearly well

Do you know the best way to bathe your body in cancer-fighting, age-reducing and brain-building chemicals?  The answer is food, NOT supplements and vitamins.

Study after study has shown that, in general, vitamins and supplements have not done nearly as well as hoped for. In fact, that is actually being overly polite:  the truth is that most supplements and vitamins have not only produced lackluster study results but often can be downright dangerous!

Of course, there’s a lot of money to be made here and so rarely will your health stores, gyms or vitamin shops tell you of these dangers.  Remember:  the supplement industry is often no less corrupt than Big Pharma.

Here at Peak Testosterone we are into long term health and will lay all the facts on the table. For example, in 2009 and 2010 researchers at Kansas State University shattered the myth that “more is better” when it comes to antioxidants.  They found that large amounts of antioxidants – Vitamin C specifically in one study – decreased a supposedly dangerous oxidant called peroxide, which is critical for blood flow to muscles and arterial expansion. [9]  That’s right – megadosing on antioxidants could potentially impact both muscle growth and erections.

Again, the list goes on and on, but it’s MUCH safer to rely on exercise, diet and sleep for your health!

To give you a feeling just how precarious the supplement and vitamin industry has become, here is a list of just some of the findings on some of the once-hoped-for blockbuster vitamins and supplements:

This list could go on and on.  Contrast that with the fact that a well-rounded diet with vegetables and fruit has been associated with reduction in many cancers, autoimmune diseases and so on.  This simply cannot be said for vitamins and supplements.

So why does Peak Testosterone sometimes recommend vitamins and supplements?  Two reasons:

1. There are a few supplements and vitamins that have an impeccable safety record and rock-solid results, especially when taken at normal youthful tissue levels.

2.  Sometimes it is important and good to take supplements and vitamins short term to get past a specific problem or issue that you are facing.  You do not want to become dependent on these for life necessarily, but they can be a valuable tool to allow yourself to get back on your feet.

You will see supplements that fit #2 throughout the site.  Finally, you may to read my link on What Vitamins Everyone Should Consider Taking.  Yes, there are some vitamins and supplement that can hel almost everyone.

HYPERSUPPLEMENTATION: One writer, Ray Kurzweil, has written that he takes 250 supplements per day and has his cholesterol, LDL, HDL at very optimal levels. His cholesterol is 130 and his HDL is near 60 for example. His motivation is apparently to live long enough until science can finally extend life to near immortality through biotechnology and nanotechnology.

It will be interesting to see how he does: the human body and mind is incredibly complex and there are many subtle nuances. I cannot deny his excellent lipid profile and stats, but feel it is likely that he will run into some sort of health issue from one or more of these supplements. However, even if that is true, he will deserve credit as a pioneer.

REFERENCES:

1) Circulation, 1994,89(3):969-74

2) Immunity & Ageing, 2009, 6:9, “The immune system and the impact of zinc during aging”, Hajo Haase and Lothar Rink

3) Bone Marrow Transplantation, 2004, 33:1241 1246, Published online 19 April 2004, “Zinc in pharmacological doses suppresses allogeneic reaction without affecting the antigenic response”

4) J of Nutr, Published online ahead of print, “Prolonged Intake of Coenzyme Q10 Impairs Cognitive Functions in Mice”

5) Neurology, 2005 Dec 13, 65(11):1834-6, “Tolerance of high-dose (3,000 mg/day) coenzyme Q10 in ALS”

6) JAMA, Nov 5 2008, 300(17), “Effect of Combined Folic Acid, Vitamin B6, and Vitamin B12 on Cancer Risk in Women”

7) Amer J of Epidemiology, Received for publication July 7, 2009. Accepted for publication August 31, 2009, “Effect of Supplemental Folic Acid in Pregnancy on Childhood Asthma: A Prospective Birth Cohort Study”

8) https://www.eurekalert.org/pub_releases/2009-12/afot-plo123009.php

9) 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”

10) https://lpi.oregonstate.edu/infocenter/vitamins/vitaminB6/

Smoking: The Great Penis Killer - Peak Testosterone

Smoking is the best way I know of to put your sex life up in smoke – no pun intended.  Yes, indeed, smoking and erectile dysfunction are married at the hip.  In fact, I would go so far as to say that smoking is another example of an Anti-Viagra.  It lowers Nitric Oxide, erection buddy #1, and constricts blood vessels. [1] I don’t think I have to tell you that this is bad news for one’s sex life and can lead to erectile dysfunction.

Smoking is also associated with heart disease and arteriosclerosis, so, rest assumed, it’s not just taking out erections in the short term – those cigarrettes have a long term commitment as well.  Yes, each and every light is helping to clog the arteries that supply blood to the penis as well. [3]  One of the primary causes for this is that smoking increases insulin resistance and the likelihood of full-blown Metabolic Disorder. [4] Smoking also raises blood pressure, a leading risk factor for heart disease. [9]  Studies also show that it also raises bad cholesterol, lowers good cholesterol [10] and leads to more arterial plaques. Pulse rates are also elevated in smokers.  Smoking is just plain nasty on your arteries and Peak Testosterone readers know that anything that effects your arteries will eventually lead to erectile dysfunction of one degree or another.

1) Amer Journal of Epidemiology, Received March 15, 2005, Accepted July 7, 2005, “Endothelial Nitric Oxide Synthase (NOS3) Genetic Variants, Maternal Smoking, Vitamin Use, and Risk of Human Orofacial Clefts”

2)  Journal of Investigative Dermatology, 2003, 120:548 554, “Effect of Smoking and Sun on the Aging Skin”

3) Amer Journal of Epidemiology, 1972, 95(1):17-25, “CIGARETTE SMOKING AND ARTERIOSCLEROSIS OBLITERANS: AN EPIDEMIOLOGIC APPROACH”

4) Atherosclerosis, 181(2):381-388, “Association between cigarette smoking, metabolic syndrome, and carotid arteriosclerosis in Japanese individuals”

5) Amer Journal of Epidemiology, 2005, 161(4):346-351, “Association between Smoking and Erectile Dysfunction: A Population-based Study”

6) https://www.webmd.com/heartburn-gerd/guide/heartburn-foods-to-avoid

7) European Urol, Aug 2007, 52(2):416 422, “Association between Smoking, Passive Smoking, and Erectile Dysfunction: Results from the Boston Area Community Health (BACH) Survey”

8) Archives of Gerontology and Geriatrics, May 2008, 46(3):307-316, “Factors associated with self-reported halitosis (SRH) and perceived taste disturbance (PTD) in elderly”

9) Cardiology, 1992, 81(4-5):233-237, “Cardiovascular Effects of Cigarette Smoking”

10) European Journal Clin Invest, Oct 1993, 23(10): 630-40, “Smoking and plasma lipoproteins in man: effects on low density lipoprotein cholesterol levels and high density lipoprotein subfraction distribution”

11) NEJM, Jun 10 1999, 340(23):1773-1780, “Effect of Cigar Smoking on the Risk of Cardiovascular Disease, Chronic Obstructive Pulmonary Disease, and Cancer in Men”

12) Intl Journal of Andrology, Nov 29 2006, 30(3):137-143, “Endogenous testosterone levels and smoking in men. The fifth Troms study”

13) Nature Reviews Urology, January 2005,”Smoking cessation improves erectile dysfunction”

14) PLoS, Jun 2005, 2(6):e160, “Smoking Cessation and Cardiovascular Disease Risk Factors: Results from the Third National Health and Nutrition Examination Survey”

15) Tob Control, 2010, 19:50-57, “The effects of smoking and smoking cessation on mortality from cardiovascular disease among Japanese: pooled analysis of three large-scale cohort studies in Japan”

16) Journal American College Cardiology, 2009, 54:2382-2387, “Smoking Status and Long-Term Survival After First Acute Myocardial Infarction”

All of these cardiovascular and endothelial issues add up to a big bedroom train wreck waiting to happen and is undoubtedly why smoking has in a number of studies been associated with erectile dysfunction. [5] In fact, smoking is so nasty that there is even some evidence that long term exposure to second hand smoke can lead to erectile dysfunction! [6] Of course, this means that male smokers may not only be giving themselves erectile dysfunction but propogating among their close friends and family.

If you are smoker, you should also realize that the damage is cumulative and gradual.  Some smokers think, “Well, I have smoked for ten years so there is no point in stopping now.  My fate is sealed.”  One large scale study, cited above, found that “an association between smoking and ED and supports a dose-response relationship between cumulative pack-years of smoking and risk of ED”. [7] This study actually calculated pack-years for the participants, i.e. the number of years times the number of packs per day, in order to gauge if more smoking led to more problems.  What they found is that the longer one smokes a longer amount, the more likely the risk of erectile dysfunction.

Smoking also ages the skin and face, so not only are you likely to perform worse in the bedroom, but you’ll look older and less attractive while you’re doing it. For example, one study found that smoking significantly aged skin through loss of elasticity. [2] Only ego maniacs can help but be effected by changes in appearance and loss of self-confidence can contribute to erectile dysfunction.

By the way, you may have heard that smoking raises both free and total testosterone. [12]  While this is likely true in the short term, what good does a little boost in testosterone do when you have to live a life of cardiovascular disease and erectile dysfunction?  Notice that increased testosterone should help with erectile dysfunction and yet smoking is so bad for one’s erections that it completely overcomes this “positive”.

Smoking and Erectile Dysfunction – Solutions

Is there any good news in all of this?  Definitely!  I mentioned above that smoking is dose dependent, which means the sooner you quit the less damage you do.  Furthermore, there is considerable evidence that smoking cessation actually partially reverses, or perhaps allows the body to self-heal, erectile dysfunction. [13]  And example of this is that nflammation levels, a risk factor for erectile dysfunction, were found to return to normal about five years after quitting smoking. [14]  Furthermore, the evidence shows that smoking cessation leads to decreased cardiovascular mortality on an ongoing basis [15] and after one’s first heart attack as well. [16]

Again, the obvious lesson is that, if you are a smoker, you should quit and quit now.  You can avoid, at least, future damage.  And if you are a long term smoker, you can likely overcome most of the damage  you have done to yourself with Exercise, Proper Diet and some initial Supplementation coupled with body’s own natural restorative processes.  Erectile dysfunction and impotence does NOT have to be your destiny.

So, if you smoke and won’t quit because it may kill you from cancer or a heart attack, at least do it for the Little Guy…

NOTE: Cigar smokers should not think that they are immune to all of this:  cigar smoking is associated with cardiovascular disease, cancer and COPD.  [11]

NOTE:  Smoking is also a risk factor for heartburn and GERD as well. [6]

REFERENCES:

Hemoglobin A1C (HbA1C) evaluates long-term sugar control

I was utterly stunned the other day:  I got an A1C (hbA1C) read and it was less than 5.0!  This is stellar actually and the odd thing is that I consume a high carb, pretty doggone low fat diet.  I would guess that my average fat levels for the last two months were around 20%.  So how did I do it?

Before I answer that question, let me just explain to anyone unfamiliar with A1C that it means “glycated hemoglobin” and is essentially a rolling average of your blood glucose levels for about the last 3 months.  It’s a incredible useful measurement that Mother Nature provided us and should be regularly monitored in my opinion at 3-4 times per year, since blood glucose levels are one of the primary aging mechanisms.

I had long wanted to get my A1C down to 5.0 for anti-aging purposes.  Life Extension Foundations recommendations are just that in fact:

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

“Hemoglobin A1C (HbA1C) evaluates long-term blood sugar control and is one of the leading theories of aging. Serum glucose reacts with important proteins in the body rendering them nonfunctional in a process called glycation. Hemoglobin A1C is a reflection of this detrimental reaction…Life Extension® believes an ideal HbA1C level to be <5.0.” [1]

This destruction of proteins in the body, unchecked, can lead to long term damage.  Note that prediabetes begins at 5.7 and diabetes at 6.5, and so I wanted to be well below these.  And check out what the lab report said:

Notice that the lab report estimated my average blood glucose to be 94.  This is pretty impressive when you consider that many men have fasting levels well above that in the U.S.  And keep in mind that I am 55 with a history of adult onset diabetes on one side of my family.

Let me explain what was really strange about that 5.0 read:  I had had a 5.6 read several months prior on 11/5/2015.  This was a wake up call for me, because it was fairly close to the prediabetic range.  My previous A1C was 5.3, and so it was quite disturbing that it had gone up.  At 55 a rising A1C is not something you want to see, but I had been doing a lot of sitting – I have two jobs that require a ton of staring at a computer screen – and was under quite a bit of stress and lack of sleep.  All of these are hard on insulin sensitivity, and so I knew I needed to change things.

MY PROTOCOL TO LOWER A1C:  So here is what I did:

a) 15,000 Steps. Started aiming for 15,000 steps per day.  I like this goal as it keeps me moving all day.  I don’t hit 15,000 every day but probably averaged 12-13,000.

b) Took Berberine. Actualy, I took goldenseal root from Vitamin Shoppe, which does not even have a guaranteed amount of berberine on it’s label.  However, I believe this worked due to the fact that my A1C dropped so significantly.  CAUTION:  Many experts recommend that you stop taking berberine after 8 weeks due to the fact it has mild antibiotic properties.  In fact, this is how it seems to work – by somehow favorably altering gut bacteria.  Part of metformin’s superpowers can also be attributed to its mildly antibiotic properties. But the concern is that taking berberine indefinitely could lead to antibiotic resistant bacteria – always a scary proposition.  So I stopped after 8 weeks.

c) Low Fat Diet. I followed a low fat diet more strictly. Yes, I know that low fat diets are much maligned here in the U.S.  However, and contrary to the conventional wisdom out there, the latest thinking on insulin resistance is that the root cause is when the liver and muscle cells get literally stuffed with intramycellular lipids. This mostly comes from fat in the diet and researchers use high fat diets to induce insulin resistance all the time.  It can also results from refined carbs as well.  I had been cheating a little, and so I stuck to low glycemic low fat carbs almost exclusively.  This undoubtedly cleared out the intramyocellular lipids and helped lower A1C.  CAUTION:  Most people who eat low fat diets consume a lot of wheat, white rice and other refined carbs.  Success with a low fat diet requires one to consume low glycemic whole foods.  See my pages on My Low Fat Paleo Diet.

CONCLUSION: Using natural and nutraceutical methods, I lowered my A1C from 5.6 to 4.9.  Low fat diets, when done with low glycemic load foods, can be used effectively to lower A1C.  Because this is the lowest A1C that I have had, berberine likely played a major role.  And, finally, avoid the three S’s:  Sitting, Sleeplessness and Stress

REFERENCES::

1) https://www.lifeextension.com/vitamins-supplements/ItemLC001453/Hemoglobin-A1C-HbA1C-Blood-Test

Low Fat Diet: Erections? - Peak Testosterone

There are basically two reasons to eat a Low Fat (or Ornish) Diet: 1) your penis and 2) your penis. You can probably guess the third reason as well.

The reason I say this is that a typical  High Fat Diet/Low Carb Diet has negative short term AND long term effects on your blood flow.  First, let’s talk about the short term reasons.  Researchers compared for six weeks a Low Carb (or High Fat) Diet versus a Low Fat (or Ornish) Diet.  The study clearly showed less Nitric Oxide and decreased blood flow for the Low Carb (or High Fat) Diet. [4] The lead researcher of this study warned that “the reduced production from the endothelium of nitric oxide, a specific chemical, puts the vessel at higher risk of abnormal thickening, greater clotting potential, and cholesterol deposition, all part of the atherosclerosis process”.  That’s a scienfically polite way of saying that a Atkins Diet will clog your arteries, slow blood flow and make your arteries less elastic, i.e. temporarily hardened.  This, of course, is the antithesis of what you need for a good sex life.  (Read my Why Satured Fat Can Be Bad for Men link for even more details.)

Now this is very bad:  you want lots of Nitric Oxide and lots of blood flow between your legs if you know what I mean!  The typical Low Carb (or High Fat) Diet will not do this for you.  He also warned that the Low Carb (or High Fat) Diet had much less folic acid, which could easily lead to increased homocyteine levels.  (Homocysteine is a leading risk factor for heart disease.)

Besides these short term blood flow and nitric oxide issues are long term issues that will definitely effect your sex life.  First of all, cholesterol levels are directly and almost linearly associated with Erectile Dysfunction. And guess what study after study has shown raises cholesterol?  You got it – saturated fat. And saturated fat is normally the fat associated with most High Fat Diets.

And here is my point:  cholesterol levels are directly and almost linearly associated with Erectile Dysfunction. For example, researchers found that for about every 35-40 points of increase in total cholesterol, there was a 0.38 times increase in erectile dysfunction risk! [1] That makes sense, because many studies have reavealed that men with cholesterol at or below 150 have virtually no heart disease. That this should translate to better erectile function was shown in a study where researchers studied a group of men with erectile dysfunction whose only risk factor was high cholesterol.  These men were given a statin drug and erectile function improved significantly. [2] Furthermore, one study showed that exercise coupled with a low fat diet led to great improved blood flow and that that will do nothing but improve your erections. [3]

Many of you will find drastic improvements in your erectile dysfunction if you’ll just adopt a Low Fat Diet.  For more information, read my links on the The Many Benefits of a Low Fat Diet and https://www.peaktestosterone.com/. Some of you will get almost immediate relief by simply breaking the High Protein and High Saturated Fat habit.

High Protein and High Saturated Fat usually go hand in hand due to meat and dairy consumption. High Protein diets have now been implicated as well, decreasing blood flow in a recent study.Furthermore, the authors pointed out that “fibrinogen, Lp (a), and C-RP increased by an average of 14%, 106%, and 61% respectively”. [5] This is a one way ticket to heart and penis problems – avoid it like the plague. Also, remember that saturated fat raises your cholesterol and literally hardens your arteries temporarily.  I know that high saturated fat diets are the rage right now, but for most guys, this is nuthin’ but trouble for their sex life.  We know many guys who after a week on a plant-based diet cured their erection problems. If you just gotta have fat, use olive oil or have a few almonds and walnuts.

NOTE: Don’t believe the bad press that is floating around the web: read about How Incredibly Healthy Grains Are for you.

REFERENCES:

1) Am J Epidemiol 1994;140:930 7

2) J of Urology,2004,172(1)255-258

33) Circulation, 1995, 92:197-204

4) Hypertension 2008; 51: 376-82

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

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

Why would any of us guys want to boost our DHT?  After all, DHT (dihydrotestosterone) in us males is created from testosterone via the 5-alpha reductase enzyme and, therefore, most men with decent testosterone also have decent  DHT levels.  Furthermore, if you ask almost all physicians (that even care) how to boost your DHT, they will tell you that you should do it via HRT, which will raise both testosterone and DHT simultaneously.  In spite of these points, I have seen on The Peak Testosterone Forum some legitimate reasons for wanting to raise HRT. Quite often men that are interested have the following situation:

–Average or midrange testosterone levels

–Below range or near below range DHT levels

–Low libido

The reason that these men are so concerned is because DHT plays a major role in libido, something I discuss in my link on Testosterone and DHT. So it is reasonable to assume that below average DHT could be playing a role. And DHT can also serve to limit estradiol, so some men are concerned that low DHT could lead estradiol-related symptoms.  For example, there is some evidence that low DHT can lead to certain kinds of gynocomastia.  In addition, some men also simply do not like the idea of standard HRT for a variety of reasons and feel that DHT is a safer and less instrusive way to go

CAUTION: In my opinion, you only want to consider DHT under a doctor’s supervision and with adequate monitoring.  And the primary reason is that too much DHT could lead to accelerated hair loss.  What if Mother Nature already gave you a buzz cut?  Well, too much DHT could also lead to acne and hair growth.  Some say that it could enlarge the prostate as well.  This is questionable, though, because DHT actually blocks estradiol and it is the latter that is most associated with prostate enlargement according to many experts.

Here are some Ways to Increase DHT Naturally:

1.  Scrotal Testosterone. Okay, I said I would avoid HRT in this discussion. However, scrotal testosterone is a bit different. Basically, there is a (admittedly small) study out there that shows that rubbing testosterone on the scrotum leads to a higher conversion rate to DHT than normal. [3] The authors noted that applying testosterone to the scrotum lead to

“The serum testosterone and estradiol levels did not rise above the normal adult male range at any time during therapy. However, elevated serum dihydrotestosterone (DHT) concentrations occurred during treatment; the pretreatment DHT concentration was 95 +/- 3 ng/dL (3.3 +/- 0.1 nmol/L), and it increased to 228 +/- 40 ng/dL (7.8 +/- 1.4 nmol/L) after 4 weeks of treatment and remained elevated thereafter.”

This is a large boost in DHT and, therefore, great care should be taken for reasons mentioned above.  (Of course, talk to your physician first.)

NOTE: There are also oral DHT’s out there.  For example, Winstrol, stanololzol, Proviron and other medications are oral, synthetic DHT’s.  You can also buy DHT in gels – Andractim for example – but this is only available in certain countries.

2. Topical Testosterone. Dr. Crisler has stated several times that he prefers topical or transdermal testosterone preparations, because they boost DHT a little more proportionately.  So, if you’re a man on standard testosterone therapy (TRT or HRT), then this might be another route to go.  You do have to be very careful around women and children if you use this option.

3. Creatine.  One study shows creatine to be a solid DHT booster.  Furthermore, this was shown to be true on young, male rugby players who should have beefy DHT levels to start with.  The study showed that DHT levels increased to 56% above their starting point and settled in at 40% above baseline at the two week point. [1] How creatine does this is not known, but it is apparently NOT by increasing testosterone.  This same study showed no significant increase in testosterone but found that the T-to-DHT ratio increased by 22% after two weeks.  If you are wondering about dosage, the study gave these young men the standard “gym dosage” of 5 grams daily.

Creatine has many other benefits including increasing workout output and satellite cells (for muscle building).  Be careful if you have any existing kidney disease and be sure to consume some extra water throughout the day.

CAUTION: 21 grams daily of creatine led to huge (450%) increases in urinary formaldehyde. [5] Normal daily dosages are 5 grams but even modest increses in formaldehyde are potentially dangerous, because formaldehyde is a likely carcinogen. [6]

4. Protein/Carb Ratio. There is also a study out there that shows that you can alter the conversion of testosterone to DHT with just diet alone.  Here are the macronutrient levels in this particular study:

“The volunteers were fed a high protein diet for 2 weeks and then a high carbohydrate diet for a second 2-week period; there was an interval of 3 weeks between the study periods during which they consumed their usual home diets. The high protein diet consisted of 44% of calories as protein, 35% as carbohydrate and 21% as fat; the high carbohydrate diet consisted of 10% of total calories as protein, 70% as carbohydrate, and 20% as fat.” [2]

So notice that both of the diets had, at least for the typical American, fairly low levels of fat and essentially the researchers were playing with the protein/carb ratio.  So diet #1 was with a protein-to-carbohydrate ratio of about 1.25 and diet #2 had a protein-to-carb ratio of 0.14. Of course, as a guy who lifts weights and eats a lot of protein, I would like to believe that the higher protein diet was superior.  However, that was not the case and, in fact, the higher protein diet actually lowered DHT and it did so by lowering the activity of the 5-alpha reductase enzyme that converts testosterone to DHT.  The authors noted that “the isocaloric substitution of protein for carbohydrate in the diet decreased the delta4-5alpha-reduction of testosterone while concurrently increasing the oxidative metabolism of estradiol and also of antipyrine in man.”

Again, I consume a lot of protein, but I do this with “eyes wide open.”  I discuss some of the potential issues in my page on Dangers of Protein for those interested.

5. Zinc. If you are zinc deficient, the evidence shows that it can be a root cause for low DHT.  Furthermore, if this is your underlying issue, you can significantly raise your DHT just by taking this inexpensive supplement.  Try to avoid the zinc oxide form, since it is so poorly absorbed.  For some of the studies, see my link on Zinc and DHT. (A zinc deficiency can also lead to very low testosterone levels as well.)  I do have some cautions though about taking too much zinc and I urge anyone taking supplemental zinc to scan through this page:  The Potential Dangers of Zinc.

5. Oral DHEA.  There is For details on this study, see my link on What Hormones Does DHEA Change Anyway? page.

6. Exercise. If you are fairly inactive, exercising my increase your DHT significantly.  One study followed a 100 sedentary men after putting them on a one hour per day (6 days per week) exercise program.  Their DHT increased from their baseline by 14.3% at the 3 months point and 8.6% at 12 months. [4] Not bad for something that will boost you nitric oxide and help you lose weight, eh?

7. MEN ON TRT: Once a Week Transdermal. Some men on testosterone cypionate (or enanthate) injections may have DHT levels a little too low and their libido may not be where it should be.  On this page I discuss a clever solutions that one of our senior posters mentioned that Dr. Shippen is using:  Low DHT While on Testosterone Injections.

NOTE:  If your doctor does not do enough monitoring due to insurance and cost considerations, see my page on Inexpensive Testosterone Labs. I have no affiliation with any of these, so, of course, do your own due diligence.

REFERENCES:

1) Clin J Sport Med. 2009 Sep;19(5):399-404, “Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players”

2) PNAS, Dec 1983; 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”

3) J Clin Endocrinol Metab, 1988 Mar, 66(3):546-51, “Transdermal Testosterone Therapy in the Treatment of Male Hypogonadism”

4) 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”

5) Med Sci Sports Exerc, 2005 Oct, 37(10):1717-20, “Effect of oral creatine supplementation on urinary methylamine, formaldehyde, and formate”

6) https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/formaldehyde/formaldehyde-fact-sheet

Erection Repair - Peak Testosterone

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

2) Amer Jour Med 128:151-157,2007

3) Eastern Med Hea J,May 2001,7(3):510-518

8) JAMA. 2007 Jul 4;298(1):49-60

9) Amer J Clin Nutr, Vol. 81, No. 3, 611-614, March 2005

10) Amer J Clin Nutr,Mar 2005,81(3):611-4

12) Obesity Reviews,2002 Aug,3(3):167-172

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

16) JAMA,Sep 13 2006,296(10):1255-65

17) J Biol Chem,Nov 5 2004,279(45):46637-43 [Epub 2004 Aug 27]; J Nutr,2003;133(10):3293S-3297S;Circulation,2001,104(2):151-156;Clin Sci (Lond),2002,102(2):195-201;Am J Clin Nutr,2005,81(1 Suppl):292S-297S;Am J Clin Nutr.2005;81(1 Suppl):292S-297S;Circ J,2006,70(8):1052-1057; Am Coll Nutr,2007,26(2):95-102

19) J of Urol,2001,166:1624-32;British J of Nursing,2001,10:455-65

20) Eur Urol,Dec 2005,48(6):1004-11

21) J Clin Endocrinol Metab,Dec 2004,89(12):6277-81

22) JAMA,Mar 20 2002,287(11):1420-6

23) Altern Med Rev,Oct 1999,4(5):360-370;Mutat Res,Feb-Mar 2003,523:201-208

24) J Sex Med,2008 Aug;5(8):1932-40

27) Nitric Oxide,Aug 2007 ;17(1):50-4. Epub 2007 May 5

28) Nippon Eiseigaku Zasshi,Oct 1993,48(4):864-72

29) Chinese Geographical Science,Mar 2001,(11):87-91

31) Am J Clin Nutr, Jan 2005,81(1):64-8

32) Am J Epidemiol, 2002, 156:1035-1042

33) Eur J of Clin Nutr, 2005, 59:1059 1063

39) https://www.sciencedaily.com/releases/2008/05/080520090619.htm

41) J of Urol, Jul 2006, 176(1):217-221, “A Prospective Study of Risk Factors for Erectile Dysfunction”

42) Urol J, 2005, 2(1):, “The Relationship between Lipid Profile and Erectile Dysfunction”

43) Urology, Jan 2011, 77(1):119-22, “Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction”

           CAUTION:  Pomegranate Juice has several drug interactions, especially with statins and PDE5 inhibitors                     (Viagra, Cialis, etc.).  Consult your physician if you are taking any medications.

REFERENCES:

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

How to Improve Your Memory - Peak Testosterone

I’ve always had a very poor non-visual memory.  I think there are some logical explanations for this, including a tie to my low testosterone, which I discuss below.  And, of course, it doesn’t help to be 55 either.  The good news is that I feel I am doing very well overall – I am able to learn new things in both of my careers quite easily due to hormone and lifestyle changes.  But some aspects of my memory could definitely use some “bolstering,” and so below I cover 10 Ways to Improve Your Memory According to the Latest Research:

1. Sleep. None of us want to hear this, but by far the most potent and research-backed memory enhancer is sleep.  Study after study has shown this.  There is even a study that shows that going to sleep after studying improves memory recall!  I doubt that anyone is shocked by these statements, so I will just cite one glowing research review to hopefully get you excited about retiring a bit earlier tonight:

“Our study provides further evidence for the notion that memory consolidation in the declarative memory system benefits from sleep. It extends previous studies in that it shows that consolidation is enhanced when the interval of intervening wakefulness between learning and sleep is short. It also shows that this beneficial effect of sleep is stable over 48 h. These findings are independent of time of day and not due to acute fatigue. Together with previous studies, these data encourage the idea that, for optimal retention, phases of intensive learning, like school, should be followed closely by intervals of sleep.” [11]

Notice that the authors basically describe sleep like a supplement:  take it if you want to improve your memory for work, school and life in general.  And, yes, research shows that sleep deprivation hammers memory as expected. [11]

2. Weight Lifting / Strength Training.  A recent study showed the power of just one (relatively short) strength training workout:

“A single, brief session of resistance exercise done immediately after a visual learning task enhances episodic memory by about 10%, new research shows. Lisa Weinberg, a psychology graduate student at the Georgia Institute of Technology, in Atlanta, and colleagues found that a resistance workout lasting as little as 20 minutes improved recall of a series of photos shown to participants 48 hours earlier.” [13]

Since I love lifitng weights, that’s great news if you ask me.

3. Exercise. Right behind sleep as a memory booster is exercise.  Of course, it will help you tremendously in the bedroom as well, boosting your nitric oxide and physical endurance as you do mighty deeds of valor.  But, most importantly, you will be able to remember what happened.

Many studies have shown the powerful pro-memory effects of exercise (and many other forms of cognition and learning) from exercise, but check out this summary:

“The hippocampus shrinks in late adulthood, leading to impaired memory and increased risk for dementia. Hippocampal and medial temporal lobe volumes are larger in higher-fit adults, and physical activity training increases hippocampal perfusion, but the extent to which aerobic exercise training can modify hippocampal volume in late adulthood remains unknown. Here we show, in a randomized controlled trial with 120 older adults, that aerobic exercise training increases the size of the anterior hippocampus, leading to improvements in spatial memory. Exercise training increased hippocampal volume by 2%, effectively reversing age-related loss in volume by 1 to 2 y. We also demonstrate that increased hippocampal volume is associated with greater serum levels of BDNF, a mediator of neurogenesis in the dentate gyrus. Hippocampal volume declined in the control group, but higher preintervention fitness partially attenuated the decline, suggesting that fitness protects against volume loss. Caudate nucleus and thalamus volumes were unaffected by the intervention. These theoretically important findings indicate that aerobic exercise training is effective at reversing hippocampal volume loss in late adulthood, which is accompanied by improved memory function.” [12]

Yes, you read that right:  exercise actually grew the hippocampuses of senior age adults and improved memory!  That should be front page news, of course, but its not a pharmaceutical and so the medical community yawned instead.

4. Meditation. There is so much research showing the positive effects of meditation on memory that it is difficult to summarize it quickly, but I’ll do my best below:

a) Meditation is associated with a larger hippocampus, the part of the brain that is associated with memory processing (and memory loss in many seniors).  Researchers stated that “We detected significantly larger gray matter volumes in meditators in the right orbito-frontal cortex (as well as in the right thalamus and left inferior temporal gyrus when co-varying for age and/or lowering applied statistical thresholds). In addition, meditators showed significantly larger volumes of the right hippocampus.” [1] A more recent study actually looked in even more detail and found even more positive results:

“Left and right hippocampal volumes were larger in meditators than in controls, significantly so for the left hippocampus. The presence and direction of this global effect was confirmed locally by mapping the exact spatial locations of the group differences. Altogether, radial distances were larger in meditators compared to controls, with up to 15% difference. These local effects were observed in several hippocampal regions in the left and right hemisphere though achieved significance primarily in the left hippocampal head. Larger hippocampal dimensions in long-term meditators may constitute part of the underlying neurological substrate for cognitive skills, mental capacities, and/or personal traits associated with the practice of meditation.” [2]

b) Okay, so meditators have a more dense memory-related brain structure than non-meditators.  So then does meditation actually improve memory?  The answer is, yes, at least in those that are experiencing some memory issues.  As an example, there is a recent study that shows that in those experiencing memory loss, the brain of those put on a meditation program were actually larger, i.e. the meditation slowed the hippocampal shrinkage in that area. [3] More directly, another recent study in the Journal of Alzheimer’s Disease found that, not only was brain blood flow improved in those who meditated after experiencing memory loss, but that “scores on neuropsychological tests of verbal fluency, Trails B, and logical memory showed improvements after training.” [4]

5. Testosterone in Hypogonadal Males:  Several studies have shown that low T is correlated to poor memory.  And it’s no wonder considering that low testosterone increases inflammation, heart disease and is hard on the brain according to many studies.  The question is if giving testosterone to low T guys could improve memory.  One study showed that it did just that, improving working and verbal memory. [16]

CAUTION:  Men on TRT should be cautious about allowing their LH to drop to near zero, which is very common after being on TRT for awhile.  The hippocampus is packed with LH (luteinizing hormone) receptors.  Since I was likely low T my entire adult life (and also likely secondary hypogonadal), perhaps this explains some of the issues I’ve had with memory?

6. Omega-3’s / Fish Oil. Studies shows correlation between omega-3 levels and memory and cognitive abilities in adults.  The question was whether or not giving someone fish oil could actually improve memory.  Of course, improving memory in young adults is no small task.  However, scientists gave high-DHA fish oil to adults with mild cognitive impairment, “early Alzheimers” and noticed marked improvments:

“The fish oil group showed significant improvement in short-term and working memory,  immediate verbal memory and delayed recall capability. The 12-month change in memory was significantly better in the fish oil group. Fish oil consumption was well tolerated, and the side effects were minimal and self-limiting. This study suggested the potential role of fish oil to improve memory function in MCI subjects. Studies with larger sample sizes, longer intervention periods, different fish oil dosages and genetic determinations should be investigated before definite recommendations can be made.” [8]

All I can say is that I am glad I consume my daily BPA-free, low mercury sardines!

7. Sage and Sage Extract. This ancient spice now has two studies under its belt in both (remarkably) young and older subjects. [9] The study that found improvement in younger adults stated that “The 50 l dose of Salvia essential oil significantly improved immediate word recall in both studies. These results represent the first systematic evidence that Salvia is capable of acute modulation of cognition in healthy young adults.” [10] Again, anything that improves memory in young adults, who have incredible memories generally to start with, is worthy of taking note.

8. Choline? Hmmm. Savvy readers, when any discussion of memory comes up, will think of acetylcholine, the “memory neurotransmitter.”  Boosting acetylcholine and memory should be as easy as taking the this common precursor, right?  There are phophatidylcholine supplements available or one can take lecithin.  As easy and common sense as this method would appear to be, there are several major issues with this approach:

a) Poor conversion rate to phosphatidylcholine.

b) Standard forms of increasing plasma choline may not do so for the brain acetylcholine in seniors. [5]

c) Oral forms of choline may increase plasma levels of TMAO, which a couple of recent animals studies have hypothisized are a root cause of heart disease.  The reason is that it alters gut bacteria. Calcififying the brain with plaque may be a root cause of Alzheimer’s, so this would not be a good thin.

d) Although poorly understood, phosphatidylcholine in particular is found concentrated in many cancer tissues.  Is this causative or coincidental?

There are other ways to try to increase brain acetylcholine that one can consider, but these are new and certainly have no long term safety studies:

NOTE:  Anything that boost plasma acetylcholine levels will likely improve erections a little.  Acetylcholine is a vasodilator, although less potent than nitric oxide.

CAUTION:  Whatever you do, do not take any anti-choinergic.  Benadryl, and the old school antihistamines, are common examples of these acetylcholine-lowering drugs.  (Benadryl is a common example that some men take to improve sleep but do not realize they may be hammering their brains.)  Why the concern?  They have been shown in seniors to lead to cognitivie and memory damage.

a) CDP (Cytidine Diphosphate) Choline. This type of choline is natural in the sense that it is an intermediary in your body’s metabolic process.  And researchers observed the same of lack of uptake in brain choline observed above after giving patients the CDP form. [6]  However, the authors believe the intracellular cytidine was combined with the choline that entered the brain to actually increase brain levels.  This is substantiated by the fact that researchers have achived memory improvements / preservation in a few animal and human studies with CDP choline.

The issue in my mind is dosing and a lack of long term safety studies.  However, CDP Choline has been given to Parkinson’s patients with a good safety profile from what I have read but discuss with your physician of course. Check out this statement from one set of researchers: “CDP-choline has also been shown to be effective as co-therapy for Parkinson’s disease. No serious side effects have been found in any of the groups of patients treated with CDP-choline, which demonstrates the safety of the treatment.” [7] That doesn’t guarantee long term safety of course, but it’s a good start and a good sign.

b) Piracetam. Piracetam is arguably the “Mother of All Nootropics.”  Rather than increasing brain acetylcholine levels, it just directly stimulates that receptor.  The problem in my opinion is that it seems to have a fair amount of anecdotal side effects.

9 and 10. Yoga and Progressive Muscle Relaxation. Several mind-body practices, including yoga and Progressive Muscle Relaxation, now have a study or two under their belt to show that they improve memory. [14][15]

MAYBE: 7-Keto DHEA, DHEA and Pregnenalone. These have been understudied and poorly studied.  Pregnenoone and and 7-Keto DHEA have solid animal studies showing memory improvements.  And DHEA has a study given to young men that showed the same.  However, the problem with this study is that young me don’t really need DHEA and the dose they gave was very large.  I think it is reasonable to assume that those over 50, with confirmed low levels, that are given low dose DHEA and pregnenalone will likely experience some improvements in memory.  Check out these links for more information:  Summary Page on DHEA and Summary Page on Pregnenolone

REFERENCES:

1)  NeuroImage, 15 April 2009, 54(3):672 678, “The underlying anatomical correlates of long-term meditation: Larger hippocampal and frontal volumes of gray matter”

2) Human Brain Mapping, Dec 2013, 34(12):3369 3375, “Global and regional alterations of hippocampal anatomy in long-term meditation practitioners”

3) Neuroscience Letters, Nov 2013, 556(27):15 19, “Meditation’s impact on default mode network and hippocampus in mild cognitive impairment: A pilot study”

4) Journal of Alzheimer’s Disease, 12 Jan 2010, 20(2):517-526, “Meditation Effects on Cognitive Function and Cerebral Blood Flow In Subjects with Memory Loss: A Preliminary Study”

5) JAMA, 1995 Sep 20, 274(11):902-7, “Decreased brain choline uptake in older adults. An in vivo proton magnetic resonance spectroscopy study”

6) Psychopharmacology (Berl), 1996 Sep, 127(2):88-94, “Differential effect of CDP-choline on brain cytosolic choline levels in younger and older subjects as measured by proton magnetic resonance spectroscopy”

7) Methods and Findings in Experimental and Clinical Pharmacology [1995, 17 Suppl B:1-54],”CDP-choline: pharmacological and clinical review”

8) Psychopharmacology, Feb 2013, 225(3):605-612, “Docosahexaenoic acid-concentrated fish oil supplementation in subjects with mild cognitive impairment (MCI): a 12-month randomised, double-blind, placebo-controlled trial”

9) Psychopharmacology, May 2008, 198(1):127-139, “An extract of Salvia (sage) with anticholinesterase properties improves memory and attention in healthy older volunteers”

10) Pharmacology Biochemistry and Behavior, Jun 2003, 75(3):669 674, “Salvia lavandulaefolia (Spanish Sage) enhances memory in healthy young volunteers”

11) Learn. Mem, 2006, 13:259-262, “Sleep after learning aids memory recall”

12) PNAS, 2011, 108:3017 3022, “Exercise training increases size of hippocampus and improves memory”

13) https://www.medscape.com/viewarticle/833066, “Strength Training Boosts Memory in a Single Session,” by Pam Harrison, October 10, 2014

14) BioPsychoSocial Medicine, Published: 13 August 2009, “Effect of two yoga-based relaxation techniques on memory scores and state anxiety”

15) Experimental Aging Research, 1982, 8*4), “Relaxation training and memory improvement in elderly normals: Correlation of anxiety ratings and recall improvement”

16) Neurology, 2001, 57(1):80-88, “Testosterone supplementation improves spatial and verbal memory in healthy older men”

HRT and Estradiol - 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 have highlighted that estradiol 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):

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

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:

PPIs(Prilosec, Prevacid,) Low Nitric Oxide, High Arterial Plaque

How about a common medication that is sold over the counter that is probably as hard on your arteries and erections as smoking?  How about a drug sold at every Walgreens and CVS that will actually lower your nitric oxide for you?  Welcome to the world of PPI’s (Proton Pump Inhibitors) – a class of medications that I conisder to be probably the nastiest widely available to the general public.  (There are other close competitors, such as Tylenol, NSAIDs and the old school antihistamines.)

PPIs (Proton Pump Inhibitors) are chock full of nasty side effects:  they can cause stomach nodules and, anecdotally, increase the risk of upper respiratory infections for starters. [1] And, because they decrease stomach acid and alter digestiion, various studies have pointed to decreased mineral absorbption – can you say magnesium deficiency? – as a common side effect as well. [2] The FDA issued this warning in 2011:

“[3-2-2011] The U.S. Food and Drug Administration (FDA) is informing the public that prescription proton pump inhibitor (PPI) drugs may cause low serum magnesium levels (hypomagnesemia) if taken for prolonged periods of time (in most cases, longer than one year). In approximately one-quarter of the cases reviewed, magnesium supplementation alone did not improve low serum magnesium levels and the PPI had to be discontinued.” [5]

Of course, the pharmaceutical industry has been very reluctant to admit or identify these underlying issues.  Look at the early praise of PPI’s in this journal article:

1) Can J Gastroenterol. 2008 Sep;22(9):761-6, “Association between proton pump inhibitors and respiratory infections: a systematic review and meta-analysis of clinical trials”

2) Curr Gastroenterol Rep. 2010 Dec; 12(6): 448 457, “Association of Long-term Proton Pump Inhibitor Therapy with Bone Fractures and effects on Absorption of Calcium, Vitamin B12, Iron, and Magnesium”

3) Am J Health Syst Pharm. 1999 Dec 1;56(23 Suppl 4):S11-7, “Safety profile of the proton-pump inhibitors.”

4) PLoS One, 2015 Jun 10;10(6), “Proton Pump Inhibitor Usage and the Risk of Myocardial Infarction in the General Population”

5) https://www.fda.gov/Drugs/DrugSafety/ucm245011.htm

6) Minerva Anestesiol, 2010 May, 76(5):325-33, “Time course of endogenous nitric oxide inhibitors in severe sepsis in humans”

7) J Am Heart Assoc, 2014; 3: “Aging of the Nitric Oxide System: Are We as Old as Our NO?”

“Not only are proton-pump inhibitors well tolerated during short-term administration, but there also do not appear to be clinically important adverse sequelae associated with their long-term use.” [3]

That bold prediction turned out to be completely wrong, and one could argue they have probably taken quite a few lives along the way for reasons that I will discuss below.  Furthermore, I am sure that many men have taken these and wondered why their erections went south, i.e. these PPI’s likely cause some men actual erectile dysfunction.  It turns out that PPI’s directly attack your precious arterial nitric oxide. This is VERY ugly, because nitric oxide is actually an anti-inflammatory.  That’s right – even though nitric oxide is a free radical – it actually acts to lower inflammation in your cardiovascular system.  This is why it is important for men, as they age in particular, to keep their nitric levels as normal as possible.

The effect of this NO-lowering effect is so profound that researchers have found that taking PPI’s increases heart disease risk by about 16%! [4] The conclusion of the authors was that “consistent with our pre-clinical findings that PPIs may adversely impact vascular function, our data-mining study supports the association of PPI exposure with risk for MI in the general population.”  MI, of course, means “heart attack.”  Basically, these medications will “age” your arteries and likely increase arterial plaque – thus the increased risk for heart attack (and potentially stroke, angina, etc.).

How do PPIs do something so nasty?  It turns out that they increase a molecule called ADMA, which is a direct inhibitor of nitric oxide. [6] This is actually something that plagues us aging males as ADMA levels tend to increase and this is one of the reasons that we have to fight harder to keep our precious nitric oxide. [7] Clearly, one of the last things that we want to do is take a medication that is going to increase ADMA!  Even smoking, which is very hard on the arteries, does not appear to increase ADMA by as much as a PPI does.

SOLUTIONS? So what does a guy with GERD or reflux do?  Does he just let his esophagus burn continually and increase risk of throad cancer?  Fortunately, there are two other possibilities available:

1. Alginates. This is a fairly recent nutraceutical solution that builds a “raft” at the top of your stomach contents and keeps the stomach acid physically from entering the esophagus.  It may lower stomach acid somewhat, which can affect nutrient absorption, but then so do PPIs.  Life Extension Foundation sells this for example.  (I have no affiliation.)

2. Other Medications.  There are other medications available as well that you can discuss with your physician.

REFERENCES:

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:

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. ”

Can't Reach the Big Orgasm? Here Is Why as per Latest Research

A lot of younger guys are not going to believe that some men can’t orgasm.  Nor would they believe that some men can get a decent erection but can’t orgasm.  I have read stories of men actually faking an orgasm due to this issue.  Yeah, it’s not just women!

The technical term for the inability to reach the Big O is anorgasmia, something that falls under the broad umbrella of orgasmic dysfunction.  And,again, you younger guys are going to be shocked to know that the prevalence of this has been estimated to be between 8% and 14% of adult male population. [2] If you consider that an even higher percentage of men probably have delayed orgasms as well, this is a real issue and a common issue – one that almost rivals premature ejaculation. And it can be just as hard on relationships and self-esteem as premature ejaculation.  Look at what one of our long time posters wrote and keep in mind that he is a young guy in his early 30’s:

“One thing I’ve noticed since 09 is I dont orgasm fast….I dont go soft, I just keep going, till I get tired or usually bored. Ive been told I made the ex-gf feel ugly and it hurt her self-esteem(she was/is 8 yrs younger, so 22/23, in the prime of her physical appeal. I thought this was due to me being overweight…” [1]

Of course, a somewhat delayed orgasm and the accompanying control that comes with it can actually be a good thing for your relationships. The extreme, though, can really cause a lot of stress as this shows.

So what can make it to where you can’t orgasm?  Unfortunately, many things can create this kind of sexual dysfunction and this helps explain the high percentage of men that struggle with it.  Below are some of the most Common Reasons for Anorgasmia.  I am going to avoid some of the more obvious causes, such as prostate surgery and excessive alcohol consumption.

1. Medications.  Many drugs can interfere with orgasm. The big culprits are antidepressants – especially SSRI’s and tricyclics – alpha blockers, Tagamet, diuretics and opiates/painkillers.  But there are many other less common ones, such as psychotropics including mood stabilizers, anti-anxiety,  and schizonphrenia pharmaceuticals for examples.  Discuss with your physician and/or pharmacist if applicable.

1) https://peaktestosterone.com/forum/index.php?topic=150.30

2) Prog Urol, 2008 Feb;18(1 Suppl FMC):F8-10, “Diagnosis of male anorgasmia”

3) Current Opinion in Urology, Nov 2011, 21(6):527 534, “Prolactin in men’s health and disease”

4) Evid Based Mental Health, 2002, 5:111

5) Andrology and Gynecology: Current Research, “Recent Advances in Hypogonadism Urologic Clinics of North Alabama P.C., USA”, by  Amit Chakrabarty

6) Harvard Men’s Health Watch, “A new option for orgasm problems in men”, POSTED MAY 29, 2012, by Daniel Pendick

2. A Few Supplements. Although not as common, it is possible for certain supplements to induce delayed ejaculation or anorgasmia.  Remember that, in general, increasing serotonin will increase the time to ejaculation, so any supplement, such as St. John’s Wort, that addresses serotonin could do that.  (And St. John’s Wort will occasionally lead to this issue.) [4]

3. Elevated Prolactin. Elevated prolactin levels are quite common and can lead to delayed ejaculation and anorgasmia. [3] Prolactin function also regulates male recuperation time between orgasms, something I discuss in my link on The Male Refractory Period. Cabergoline, a prolactin-lowering medication is often recommended as an off-label method of improving anorgasmia. One recent study found that one third of men with anorgasmia improved with .5 mg of cabergoline twice a week and another third completely recovered. [6] Again, cabergoline has a fair amount of side effects, but this seems to show that prolactin is ground zero for many men’s problems.

5. Hypogonadism and Low Testosterone. Many commentators have noted that low testosterone can in some cases cause anorgasmia.  And one study on testosterone pellets found that one of the participants reversed his anorgasmia with this kind of HRT. [5]

6. Nitric Oxide.  Anecdotally, some men on The Peak Testosterone Forum have reported that improving nitric oxide can improve time to orgasm and other parameters – pardon the formality there – surrounding orgasm. For example, one of our senior members and an occasional guest author, known as Inigo, reported the following with an NO-boosting regimen in his Review of Prelox.

“But by the fourth week there was certainly an improvement in firmness and duration of erections…but little increase in speed of erection. There was also an increase in the pleasure of orgasms. (Prelox is marketed mainly as a pleasure enhancer ).” [6]

Further evidence comes from the fact that a number of studies have shown that women can use PDE5 Inhibitors to overcome the anorgasmia associated with SSRI’s and antidepressants.  One does have to be careful though:  one of the side effects of the PDE5 Inhibitors is anorgasmia.

7. Psychogenic (Psychological) Reasons. This is difficult to estimate, but a significant percentage of men are reported to be unable to achieve an orgasm due to anxiety and stress-related issues.

8. Dopamine.  Anorgasmia probably has a dopamine-related component to it.  Examples of this:  Parkinson’s patients sometimes cannot achieve an orgasm.  And, of course, testosterone increases dopamine in the brain as well.

SOLUTIONS: Cabergoline is a medication rife with side effects.  As mentioned above, it is reportedly very effective in its off label use of helping with things like the inability to achieve an orgasm and decreasing one’s refractory period. (See #3 above.)  Considering that cabergoline works so well, macuna pruriens may help as well (since it lowers prolactin a little).  Of course, it would always be prudent to get a prolactin read before even considering such a therapy and the reason is that many men who have insulin / Metabolic Syndrome issues have low prolactin levels.  You can read about this in my page on The Causes of Low Prolactin. And always discuss with a physcian of course.

Other solutions require a bit more experimentation and include changing/dropping medications (under your physician’s guidance of course), testosterone therapies and NO-boosting supplements.  See my links on Testosterone Therapies and Erectile Supplements for more information.

NOTE: Is your wife or girflfriend having trouble reaching orgasm? I have some basic information here: How to Help an Anorgasmic Woman. (Some women may require a “jumpstart” of their system.)

REFERENCES:

Muscle 101 - 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

Pycnogenol & Erectile Strength - 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 https://www.peaktestosterone.com/. Pycnogenol, while not a food, is an example of another plant-based blood flow builder.

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.

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

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.

Thirdly, not only does Pycnogenol not cause all those Vioxx-ish symptoms, it actually lowers Blood Pressure according to a randomized, double-blind, placebo-controlled study performed in mildly hypertensive patients. [5]  And blood pressure, you may remember, is one of the number one causes of Erectile Dysfunction, so this is yet another way that pycnogenol battles erection problems.

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 https://www.peaktestosterone.com/ 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, https://journals.lww.com/cardiovascularpharm/Fulltext/1996/07000/Effects_of_In_Vivo_and_In_Vitro_L_Arginine.23.aspx 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:

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]

Testosterone Injections:Study Shows Increase Cardiovascular Risk

But are injections safe?  Or are there hidden dangers to some men giving themselves testosterone shots?  It turns out that that there is a recent study that actually examines that question directly.  Furhtermore, it compares injections to two other protocols:  patches and topicals.  Surprisingly to men like myself enjoying cypionate injections, this study asserts that injections are not as safe as other either patches or topicals.  Furthermore, the study was a very large one that pulled in massive patient populations from both the U.S. and the U.K.  The authors made the following potentially distrubing conclusions for those of us on testosterones shots: [1]

–Injections had a 26% higher risk of “cardiovascular events,” meaning heart attack, stroke or angina (chest pain) than topicals.

–Injections had a 16% higher risk of hospitalizations than  topicals.

–Injections had a 34% higher risk of death than topicals.

This was basically the conclusion of a female endocrinologist (Dr. Margarent Weirman), who stated in an accompanying editorial, that “the study raises the issue of whether injectable depo-testosterone or other formulations that consistently result in levels outside the physiologic range should be restricted or at least more carefully monitored for [CV] risk. [2]

This is a huge admission in my opinion, because Dr. Weirman is an endocrinologist admitting that driving men supraphysiological, i.e. greater than 1200 ng/dl, could be putting men at risk for cardiovascular issues. The reason that this is so significant is that, at least from what I have seen, it is generally endocrinologists who are administering these kind of injection protocols.  For reasons that are completely unclear to me to this day, they typically will give a man a massive dose of testosterone cypionate (200-400 mg), which shoots the poor patients testosterone and estradiol through the roof. These protocols are always on an every 2-3 week schedule and about 10 days after the injection the poor guy’s testosterone actually crashes through his old levels and for a few days.  This means that he will end up with testosterone lower than his old baseline!  I document in this page:  Testosterone Cypionate – Weekly Versus Every Two Weeks?

Some of you may be wondering why this kind of protocol would increase risk for cardiovascular problems.  The reason is likely that elevated estradiol increases the risk of clotting and clotting is what strokes and heart attacks are all about.  A heart attack begins with a clot in the arteries and a stroke is simply a clot that reaches the brain.

CONCLUSION:  In my opinion, injectibles will be exonerated by future research when a frequent and physiological profile is followed, but I certainly cannot prove that. I try to follow a safe philosophy and am currently using a subQ testosterone cypionate protocol myself and inject every other day and my latest total testosterone lab draws were 700 and 800 ng/dl.  These are the numbers of a healthy middle-aged male and equivalent to what is reached by many men on the topicals.  This helps keep my estradiol at a reasonable level:  my last read was 27 pg/ml, i.e. my testosterone and estradiol are within normal youthful ranges.

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

However, I am playing by the rules and not all men on TRT do.  Some men (and their physicians) let blood pressure and hemtocrit / hemoglobin go too high.  Some men have clotting disorders.  And, finally, some men on testosterone deliberately go above 1200 ng/dl, which sends their estradiol through the roof generally.  I see this fairly often on The Peak Testosterone Forum, where men are clearly deliberatly injecting way too much testosterone. They are not going to steroid levels, but they are definitely going above 1200 during part of the week.

NOTE:  See also my page on Other Potential Risks of Testosterone Therapy.

1)   JAMA Intern Med, 2015 Jul 1;175(7):1187-96, “Comparative Safety of Testosterone Dosage Forms”

2) JAMA Intern Med. 2015;175(7):1197-1198, “Risks of Different Testosterone Preparations: Too Much, Too Little, Just Right”

Vegetarianism and a Low Fat Diet: - Peak Testosterone

So why would anyone want to consume a Low Fat Vegetarian diet? Obviously, one could easily follow one or the other, so why put the two together?

NOTE: If you are a die-hard meat eater, then please do us both a favor and just skip this page.  I’m not trying to offend anyone here – just presenting men with an alternative that I believe will help their arteries, erections and general health.

My answer to that is simple: low fat vegetarianism is the safest way to follow BOTH the best of the supercultures around the globe and the latest research that we have to date. Now that is a bold statement that many men would consider controversial at best, but I think I can back that up with some good evidence which I will outline below.

Another thing to consider is that lacto-ovo-vegetarianism, whether low fat or not, has a nice advantage in my opinion, because it allows some dairy and eggs in one’s diet and that really improves the flavor for many Westerners.  It’s an adjustment, but not a quantum adjustment.  Of course, if you are going to go Low Fat vegetarian, you have to stick with largely non fat dairy/yogurts and egg whites, but that still allows for a substantial amount of good tasting food for most men.

1. Elite Supercultures. John Robbins wrote a health bestseller where he chose the four most elite supercultures from around the globe (Hunza, Vilcabambans, Abkhasians and Okainawans).  He did a great job at documenting their diet, exercise and social routines. These supercultures are simply astonishing to read about – see my page on https://www.peaktestosterone.com/ – because they simply have NO chronic disease. Imagine a society with NO hypertension, heart attacks, cancer, diabetes, autoimmune disease, Alzheimer’s, etc. These peoples actually have achieved nearly perfect health. The eyes of the Hunza do not even age! Their lenses do not atrophy and harden like ours!

You may be objecting and saying, “Well, sure, I could live without a heart attack or cancer if I died at age 43!”  However, these four people groups are known for incredible longevity.  John Robbins chose them because of the high number of people that live into their 90’s and past 100.  Again, someone in their late 80’s and 90’s in these cultures are anything but feeble:  they usually are walking long hours, climbing up hills and mountains with minds still sharp and full of humor and life.

These people have done with ease and simplicity what we have not been able to achieve in the West with the 100’s of billions that we have spent on health care. I would also add that there is fifth very similar group:  the Tarahumara native people of northern Mexico who also have incredible longevity and live a very similar lifestyle without hypertension, heart disease and all the other chronic disease conditions that plague the U.S. and Europe.

So how do they do it?  First of all, they don’t take Prozac or statins.  Amazing, eh?  They don’t even take supplements!  Can you imagine someone in their senior years not on four medications and a half dozen supplements?!? .

Remember: meat eaters are trying to play catch up.  Perhaps they will some day.  Perhaps some brand of Paleo will win eventually and become the new gold standard – who knows?  But, for now, it’s hard to beat vegetarian / plant-based eating, especially when you consider that many vegetarian foods tend to boost nitric oxide and lower blood pressure.  And, according to one large study, Vegetarians Have Equal or Better Testosterone. So you get solid testosterone, improved blood flow and nitric oxide and stellar longevity. What’s not to like??

NOTE: Realistically, most vegetarians probably eat a lot of wheat.  Wheat is a highly genetically modified food and is also high glycemic compared to all the other whole grains. Many vegetarians probably often eat a lot of fructose from fruit, dried fruit, honey. In other words, they often do many of the things that the omnivores accuse them of. But here is the key: in spite of it all their “sins”, they still have done better than meat eaters in study after study.  (You can read about my issues with wheat in this page on A Review of Wheat Belly by Dr. William Davis.

Now this is where I am headed:  eating an imperfect vegetarian produces good results.  Imagine what is possible if you tune a vegetian diet.  You start to see why the most elite supercultures live without chronic heart disease.  And this is where I argue that combining a low glycemic Low Fat Diet with vegetarian diet provides the best of all possible outcomes.  In other words, why not just eat like the above supercultures?

BAD SCIENCE: There were a few mortality studies that showed that low cholesterol increased mortality risks. As expected, the Paleo and Low Carb advocates jumped all over this without really thinking it through. Of course, a low fat diet, which leads to much lower cholesterol levels, is healthier as the above cultures all show. So why the negative mortality results? Let me quote from Dr. Gould, a doctor who successfully reversed arteriosclerosis in many of his patients: “In these large population studies, there is a small percentage of people who have preexisting medical conditions, such as cancer, depression, alcoholism, gastrointestinal diseases, or addictive behavior such as drug addiction or smoking, all of which reduce appetite and may impair nutrition in association with every low cholesterol levels. These preexisting conditions not only lower cholesterol levels but may also cause death unrelated to cardiovascular disease. Therefore, in such studies, there may be an association between death caused by the preexisting nonvascular disease and low cholesterol levels. However, if the people with these preexisting nonvascular medical conditions are screened out and removed from the analysis, there is no increase in deaths associated with the low cholesterol levels.” [1] He then cites three large population studies that support the above.

Look at the benefits that you would likely get from low glycemic Low Fat vegetarianism:

a) Diabetes and Prediabetes Reversal (Partial or Complete). Dr. Bernard has done extensive research and found that a plant-based, low glycemic, Low Fat Diet – contrary to what critics say about higher carb diets – usually partially or even completely reverse prediabetes and diabetes. Of course, exercise, weight loss and sometimes HRT (testosterone therapy) are required to gain complete victory. See my links on Low Fat Diets and Diatetes and Testosterone and Diabetes for more information.

b) Low Fat Diet Benefits. I have documented 10+ Benefits of a Low Fat Diet, including prostate cancer protection, telomere improvements, increased blood flow – most fats slow down blood flow – decreased blood pressure, an improved testosterone-to-estradiol ratio – the list goes on and on! And the one most important benefit for many men is a partial reversal of their arteriosclerosis. Most men over the age of about 35-40 with erectile dysfunction and/or low testosterone are going to have significant arteriosclerosis. This gives them a chance to improve that naturally and get the lining of those arteries pumping out more nitric oxide once again!

c) Fruit and Vegetable Benefits. The research-backed benefits of fruit and vegetable consumption also go on and on and includes everything from improved erections, decreased stroke, heart disease, diabetes and hypertension risk, less dementia, lowered inflammation and protection from many kinds of cancer.  (Try to purchase organic when possible.)  For details, see my link on 15 Benefits of Fruit and Vegetable Consumption.

So if you combine a Low Fat Diet with Vegetarianism, you are bound to get some incredible synergies.  By the way, do NOT listen to the standard Paleo and Low Carb arguments that eating a lot of fat is natural.  With the exception of fish, which is high in heart healthy, inflammation-lowering omega-3’s, and nuts, which are packed with arginine and antioxidants, virtually all foods prior to a few thousand years ago were low fat. Wild game is usually low fat.  Almost all plants and fruits are low fat. Low Fat is how humans developed and all the modern oils and fatty dairy are a modern invention.

Even if you believe that Paleo is the way to go, it’s impossibly impractical in my opinion.  Why?  Because it is very difficult to eat fish more than once a week without getting significant methylmercury and PCB exposure.  And modern livestock and poultry are almost always corn fed, hormone-injected and high fat. This is just not natural and makes eating meat like the natives impractical for modern man.  Sure, there is range-fed beef out there with good omega-3 levels and less fat.  But have you seen the price?  The great majority of us cannot afford range-fed beef or poultry and will end up eating the nasty stuff.

If I could find inexpensive low fat meat cuts out there, I would probably eat a little meat similar to the Okinawans or some of the other supercultures mentioned above.  By the way, the Apostle of Low Fat, Nathan Pritikin, ate meat regularly – but just a little – and he died with perfectly clean and clear arteries.  But I simply cannot afford it and don’t have time to drive all over the place looking for decent low fat cuts of meat.  It’s much easier just to stick to vegetarian.

REFERENCES:

1) Heal Your Heart, by K. Lance Gould, M.D., p. 67

Their secret is their lifestyle and, if you look at their diet, a couple of things stand out immediately:

Yes, the Masai and the Eskimos are impressive cultures with great cardiovascular health and eat a lot of meat and fat. But the best of the best supercultures with unprecedented longevity are cultures that rely almost entire on plants for their nutrition. In addition, we do not have access to the kinds of meats that the Masai and Eskimos (at a reasonable cost) for reasons I’ll discuss below.

2.  Vegetarians and Mortality. Low carb and Paleo folks love to criticize the way most vegetarians eat, saying that 1) grains high glycemic, anti-nutrient foods; the high carb levels cause loss of insulin/glucose control; and on and on.  However, these criticisms of vegetarian diets ignore one important fact:  vegetarians do VERY well in mortality studies.  Sure, many vegetarians eat too much wheat and refined carbs.  But, in spite of that, I document in my Vegetarians and Longevity page four large studies that show that vegetarians have the best mortality rates and live the longest.  Now Paleo and Low Carb folks argue that vegetarians live longer simply because they live healthier lifestyles, i.e. don’t smoke and manage their weight better.  There may be some truth to this, but the fact is that the research shows that a largely or entirely plant-based eating regimen is the current gold standard.

Androxal: When Will It Be Approved by the FDA?.

REFERENCES:

1)  https://www.fdareview.org/approval_process.shtml

2) https://www.fda.gov/ForIndustry/UserFees/PrescriptionDrugUserFee/ucm143135.htm

3) https://www.investopedia.com/stock-analysis/060915/repros-therapeutics-inc-poised-move-higher-rprx

So just when will the FDA approve this hopefully helpful men’s testosterone booster?  To answer that, we have to realize that Androxal has already pass many key FDA milestones:

1. Successfully completion of all phase III trials.

2. The submittal of an NDA (New Drug Application) in Feb. of 2014.

At this point Repros Pharmaceuticals is just waiting to hear from the FDA if the drug will be approved or not.  The new should be favorable in my opinion, because a) Androxal did well in Phase III trials and b) the stock price has held up quite well since the NDA:  the stock peaked at about $9.85 in February, then fell a little and came back to $8.53 as of this writing in August of 2015.  So investors and instititions still clearly believe the Androxal situation looks favorable.

At this point, it is strictly a matter of timing.  For awhile drugs were generally approved in 0.6 to 2.0 years from the time of the NDA application. [1] However, the environment has completely changed with the Prescription Drug User Fee Act which now requires that the lion’s share of FDA NDA be approved within 10 months.  Here are the arguments for short and long scenarios:

i) Longer.  I think it is reasonable to assume that it will be on the longer side rather than shorter, i.e. in the 8-10 month range.  And the reason is simply that there has been a good deal of controversy of late centering around testosterone-related products.  Last year, there was a a wave of litigation that arose against the big pharmaceutical testosterone manufacturers, something I cover in the page called Testosterone Pharmaceutical Class Action Lawsuits after a couple of studies that showed increased cardiovascular risk for men on HRT.

ii) Shorter. Recently Aveed (Nebido) did an NDA application in September of 2013 and was approved by the FDA in March.  This shorter six month approval time was suprising considering the reports of a couple of anaphalytic shock victims and the procedures necessary to comfort the FDA, etc.  One cold argue that Androxal’s approval should actually be easier than Aveed.

CONCLUSION:  The optimistic time for FDA approval is September of 2015 and the pessimistic December of 2015.

NEWS FLASH: Investopedia is reporting the following: “The company anticipates an FDA approval decision by November 30, 2015 for Androxal, a potential treatment for secondary hypogonadism. The FDA is also planning to hold an advisory committee (ADCOM) meeting to discuss the approvability of Androxal, on November 3, 2015. If the ADCOM recommends Androxal for approval, it will significantly impact share price.” []

NOTE:  A potential issue with Androxal is that it may not provide much of a T boost.  See my page on Testosterone and Androxal for more information.

Nitric Oxide and Walking - Increase Baseline Nitric Oxide -

Lots of men despise exercise.  One of the most notable is William Faloon, the head of Life Extension Foundation.  He is trying to bring all his health markers in line mostly via the use of supplements.

There are a lot of reasons for such a dislike and one of them are that weight lifting and resistance training can be downright painful.  I can be a little masochistic and so that’s probably why I love weights!  Still other men are significantly overweight and are somewhat embarassed to go to the gym or jog.  Regardless of your reason, there is a simple, natural way to exercise that virtually anyone can do:  brisk walking.  This is what our bodies were intended to do and all of the healthy supercultures in the world do hours of it virtually every day.  Of course, brisk walking just refers to a “fast walk,” i.e. not leisurely walking at a reduced pace.

The benefits of this to your body, brain and bedroom are simply astonishing and we list 20 of them below:

1) European Journal of Applied Physiology and Occupational Physiology, 1994, 68(6):531-537, “The influence of a 1-year programme of brisk walking on endurance fitness and body composition in previously sedentary men aged 42 59 years”

2) JAMA, 2002, 288(16), “Exercise Type and Intensity in Relation to Coronary Heart Disease in Men”

3) Metabolism, Aug 2007, 56(8):1037-1043, “A single bout of brisk walking increases basal very low-density lipoprotein triacylglycerol clearance in young men”

4) Int J Sports Med, 2004, 25(7):539-546, “Effects of Brisk Walking on Static and Dynamic Balance, Locomotion, Body Composition, and Aerobic Capacity in Ageing Healthy Active Men”

5) Preventive Medicine, August 2005, 41(2):622 628, “Brisk walking, fitness, and cardiovascular risk: A randomized controlled trial in primary care”

6) Metabolism, Jul 1994, 43(7):836 841, “The effect of a single bout of brisk walking on postprandial lipemia in normolipidemic young adults”

7) Journal of Psychosomatic Research, May 1992, 36(4):361 370, “Efficacy of Tai Chi, brisk walking, meditation, and reading in reducing mental and emotional stress”

8) Health Educ. Res. (1999) 14 (6): 803-815, “The efficacy of accumulated short bouts versus single daily bouts of brisk walking in improving aerobic fitness and blood lipid profiles “

9) Appetite, Feb 2009, 52(1):155 160, “Acute effects of brisk walking on urges to eat chocolate, affect, and responses to a stressor and chocolate cue. An experimental study”

10) Journal of Psychosomatic Research, May 1992, 36(4):361 370, “Efficacy of Tai Chi, brisk walking, meditation, and reading in reducing mental and emotional stress”

11) J Cardiopulm Rehabil, 2002 Nov-Dec, 22(6):385-98, “Lipids, lipoproteins, and exercise”

12) JAMA, Jun 25 2001, 161(12), “Physical Activity and Television Watching in Relation to Risk for Type 2 Diabetes Mellitus in Men”

13) Circulation, 2003, 107:2435-2439, “Physical Activity in Relation to Cardiovascular Disease and Total Mortality Among Men With Type 2 Diabetes”

14) Medicine & Science in Sports & Exercise, 34(9): 1468-1474, “Accumulating brisk walking for fitness, cardiovascular risk, and psychological health.”

15) Am J Clin Nutr, Sept 1979, 32(9):1776-1787, “Effects of a vigorous walking program on body composition, and carbohydrate and lipid metabolism of obese young men”

16) https://www.sciencedaily.com/releases/2011/05/110524153416.htm

17) Preventive Medicine, May 2007, 44(5):377-385, “The effect of walking on fitness, fatness and resting blood pressure: A meta-analysis of randomised, controlled trials”

18) https://www.health.harvard.edu/newsweek/Exercise-and-Depression-report-excerpt.htm

19) Circulation, 1999, 100:1194-1202, “Regular Aerobic Exercise Augments Endothelium-Dependent Vascular Relaxation in Normotensive As Well As Hypertensive Subjects”

20) JAMA, 1988, 259(18):2720-2724, “Walking for Health and Fitness”

21) Medicine and Science in Sports and Exercise, 42(3):485-492, “Influence of brisk walking on appetite, energy intake, and plasma acylated ghrelin”

REFERENCES:

-Supplements - Five Erectile Supplements with a Solid Track Records

One thing that I find rather shocking is that most guys experiencing a decline in bedroom performance generally have no idea that there are erectile supplements with solid research behind them and a good safety profile as well. Most males turn immediately to the PDE5 Inhibitors, Cialis, Levitra and Viagra, without even considering that there are much less expensive alternatives available that, in some cases, have been used by men effectively for decades or even centuries.

The potential tragedy of this is that PDE5 Inhibitors such as Cialis and Levitra are full of side effects and it is highly questionable that these can be used for decades without some sort of negative lasting effects.  (See my link on The Side Effects of PDE5 Inhibitors for more details, especially regarding how PDE5 inhibitors often effect the eyes, ears and stomach.)

Science has shown us many inexpensive supplements that can help improve erectile dysfunction and significantly eliminate impotence very quickly, within a matter of a week or two in some cases. Furthermore, some of these supplements increase libido and my give a little boost to testosterone as well.

NOTE: If you have any medical condition or are on any medication, check with a doctor before taking a supplement.  Also, for potential side effect, please go to any links mentioned below which have a more detailed information page. I also recommend implementing one new supplement per two weeks and not all at once.

1) L-Citrulline. Citrulline is the new wonder supplement on the block. The beauty of Citrulline is that even small amounts will increase baseline nitric oxide levels, especially in men with endothelial dysfunction. This is absolutely critical, because most middle-aged and beyond men with erection-related issues are in this catgory. Viagra and Cialis often will not work for them, because they simply do not have enough nitric oxide produced by their arteries and vessels for these medications to act upon.

For this reason many men seem to be finding Citrulline downright miraculous, restoring morning and/or daytime erections. Furthermore, there is now a study showing that this supplement significantly increases hardness factor for many men with erectile dysfunction. L-Citrulline is typically sold in 1 gram tablets and men will take 1-2 grams daily: Source Naturals L-Citrulline 1000mg. (I would not take more than that.) For more information, see this link on The Benefits of L-Citrulline.

REFERENCES:

4) Phytotherapy Research 2002,16:1-5; Nutrition Research,2001,21:1251-1260;Nutrition Research, 2003,23: 1189-1198;Life Sciences,2004,74:855-862

5) J Urol 2002; 168:2070-3

6) Asian J Androl 2007;9(2):241-4

7) Intl Journ Cardio 2005 Feb 28, 98(3):413-9

8) Eur Heart Journ 2007 28(18):2249-2255

9) Urology 2004 Apr,63(4):641-646

10) Curr Med Res Opin, 2004 Sep,20(9):1377-1384

11) Amer Jour Clin Nutr, 2007 Sep,86(3):610-7

12) Amer Jour Cardio,2007 Aug 1,100(3):455-8

13) Am Jour Clin Nutr, Apr 2007, 85(4):1068-74

15) J Cardiovasc Pharmacol,1998,32:509-515

16) Hum Psychopharmacol,2002,17:279-284

17) Gen Pharmacol,1982,13:169-171;Gen Pharmacol,1982,13:225-230;Gen Pharmacol,1983,14:277-280

18) J Clin 17) Gen Pharmacol,1982,13:169-171;Gen Pharmacol,1982,13:225-230;Gen Pharmacol,1983,14:277-280

18) J Clin Endocrinol Metab,1991,73:4-7

19) Eur J Clin Nutr, 2008 Dec, 62(12):1426-31, Epub 2007, “Fish oil supplementation improves large arterial elasticity in overweight hypertensive patients”, Wang, et. al.

20) Journal of Andrology, Sep/Oct 2008,(29):5

21) JAMA,2007,297:2351-2359932-40

24) Circulation, 1998 Jun 9, 97(22):2222-9

25) Intl J Impotence Res, 2008, 20:173-180

24) Circulation, 1998 Jun 9, 97(22):2222-9

225) Intl J Impotence Res, 2008, 20:173-180

26) Eur J Clin Nutr, 2008 Dec, 62(12):1426-31, Epub 2007, “Fish oil supplementa26) Eur J Clin Nutr, 2008 Dec, 62(12):1426-31, Epub 2007, “Fish oil supplementation improves large arterial elasticity in overweight hypertensive patients”, Wang, et. al.

27) Journal of Chromatography A, 17 June 2005, 1078(1-2):196-200, “Determination of citrulline in watermelon rind”

28) Brit J Sports Med, Oct 2003, 37: 464–70. “The Ergogenic Effects of Eurycoma Longifolia Jack: A Pilot Study”

29) https://www.prelox.com/pdf/prelox_research.pdf

2) Pycnogenol. Pycnogenol is a proprietary extract of a French maritime pine bark extract, whose remarkable powers have been known for over a century.  Pycnogenol has been shown to stimulate the enzyme nitric oxide synthase (NOS) [15] which in turn stimulates Nitric Oxide production. Furthermore, research shows, which I document in my link on Pycnogenol and Erectile Dysfunction, that it is a supplement, when coupled with L-Arginine, that improves erectile strength and heals erectile dysfunction in around 75% of guys!

This is an incredible track record if you stop and think about it and, furthermore, the studies show no side effects.  What a contrast with Viagra and Cialis!

You can do what was done in the studies by taking between about 50-150 mg of Pycnogenol, such as TwinLabs Pycnogenol Capsules, 50 Mg, 60-Count Bottle, along with about 1.5 grams daily of L-Arginine per L-Arginine (500mg).  This is much less expensive than any of the PDE5 inhibitors and, again, there have been no reported side effects in any of the studies. [29]

Research has shown that pycnogenol also lowers bad cholesterol (LDL), raises good cholesterol (HDL), decreases inflammation and lowers blood pressure, which will very likely protect a guy from future erectile dysfunction as well. (High blood pressure and inflammation are both major risk factors for erectile dysfunction.) [4]

3) Korean Ginseng. Ginseng has been one of the big guns in erectile research and has a fairly established track record.  In facit, it has been used literally for centuries. It’s (generally) potent sexual powers come from its abilities to directly boost nitric oxide, a fact that has been verified in multiple animal and human studies. Furthermore, several studies have showed that it actually helps with erectile dysfunction.  And, as I document in my link on Ginseng and Erectile Strength, it improved the sex life of almost two thirds of men directly.  It is also a libido booster and in some cases may boost testosterone as well.  Some Ginseng brands are careless and have been found to be contaminated with lead and/or pesticides. Solgar, however, sells a Korean Ginseng that passed on all accounts in recent Consumer Labs testing: Solgar – Korean Ginseng Root Extract, 60 veggie caps. (It can thin the blood a little: discuss with your doctor.)

4) Maca. Maca is not actually a direct erectile supplement, but I mention it here, because it has many studies (animal and human) that show it is agood, old fashioned – and legitimate – aphrodisiac. It probably doesn’t directly improve erectile dysfunction or cure impotence, but is a good bedroom buddy nonetheless. Many guys struggle with passion and desire and this is where Maca excels.  It also has the advantage of being consumed as a food for decades in South America and thus has a strong safety record.  The “gold standard” brand is Navitas Organic “Gelatinized” Maca. Find out more detail in my Maca Link as well.

Research has shown that pycnogenol also lowers bad cholesterol (LDL), raises good cholesterol (HDL), decreases inflammation and lowers blood pressure, which will very likely protect a guy from future erectile dysfunction as well. (High blood pressure and inflammation are both major risk factors for erectile dysfunction.) [4]

5) Neo40. One of the new kids on the block is Neo-40, the creation of one of the top nitric oxide researchers in the world.  The approach of Neo40 [Daily 30 Lozenges] – Nitric Oxide Supplement is really fairly simple and is based on utilizing two different metabolic pathways via L-Citrulline and a Hawthorn Berry Extract for nitrate/nitrite production. You can read more about here in my Interview with Neo40 Founder Nathan Bryan.

Beetroot Extract has also done very well in the studies, particularly in the area of fighting cancer interestingly enough. The good news is that jt is dirt cheap and should boost nitric oxide a little as well for beleaguered middle-aged and senior men everywhere: Nature’s Way Beet Root Powder Capsules.

7) Icariin Extact. Icariin, the chief phytochemical in Horny Goat Weed, gives this herb its erectile superpowers.  Viagra and Cialis are PDE5 Inhibitors and Icariin is one as well.  It is significantly less powerful than Viagra and Cialis but the 10+% extracts give a significant dosage and generally with many less side effects.  Icariin also has antioxidant and other properties that seem to give it actual healing properties. Many men have had excellent results with products such as Source Naturals Horny Goat Weed Extract (Epimedium) 1000mg, which has 10% Icariin. For additional information, see this link on Icariin for more information.

8) CoQ10. CoQ10 has many excellent properties and has been extensively studied.  It is well-known for its mitochondrial protective powers and is used in alternative medicine for a variety of conditions, including gum disease.  But what few men know is that it helps the body preserve nitric oxide and, yes, that has been shown in several studies to increase blood flow. The benefit is mostly for those men 40 and older and especially those with endothelial dysfunction.

9) Fish Oil. Fish Oil is not directly an erectile supplement, but I mention it here becuase one European study found that it helped endothelial function and nitric oxide output (in diabetic patients) and that is just what the doctor ordered. [14] Yet another study found that fish oil increased the elasticity of arteries, i.e. their “expandability”. [26] Yes, we males want nice expandable blood vessels that allow blood to flow into the penis. Fish oil also protects against inflammation, a huge erection-fighter, and triglycerides, which will clog up penile arteries faster than you can say, “Pass the bacon.”  It may even optimize free testosterone while it’s at it!  For more information about fish and fish oil and how it benefits the heart and penis, please read The Many Benefits of Fish and Fish Oil here. CAUTION.: It’s very easy to buy rancid fish oil, which will do more harm than good, and fish can have mercury and PCB’s. Read my link on Fish and Fish Oil for how to consume your omega-3’s safely.

CAUTION: Gingko. Gingko, like Pycnogenol, strengthens the activity of Nitric Oxide Synthase (NOS), making it a viable erectile dysfunction supplement. [16] Furthermore, animal studies have shown that Gingko relaxes in a dose-dependent fashion arteries, including those all-important ones supplying blood to the penis.[17] Direct evidence that Gingko improves erectile dysfunction and impotence in a significant way is still lacking, but any herb that increases Nitric Oxide will help males struggling in this area. (This is an herb can be purchased inexpensively even in places like Wal Mart.)  NOTE:  Gingko Biloba is often tauted as improving erections in men with erectile dysfunction that had resulted from taking antidepressants.  However, the studies have actually shown mixed results in this area.  CAUTION:  Care should be exercised with this supplement as Gingko thins the blood and has several drug interactions including NSAIDs and anticoagulants.

Diet & ED - Peak Testosterone

There are basically two reasons to eat a Low Fat (or Ornish) Diet: 1) your penis and 2) your penis. You can probably guess the third reason as well.

The reason I say this is that a typical  High Fat Diet/Low Carb Diet has negative short term AND long term effects on your blood flow.  First, let’s talk about the short term reasons.  Researchers compared for six weeks a Low Carb (or High Fat) Diet versus a Low Fat (or Ornish) Diet.  The study clearly showed less Nitric Oxide and decreased blood flow for the Low Carb (or High Fat) Diet. [4] The lead researcher of this study warned that “the reduced production from the endothelium of nitric oxide, a specific chemical, puts the vessel at higher risk of abnormal thickening, greater clotting potential, and cholesterol deposition, all part of the atherosclerosis process”.  That’s a scienfically polite way of saying that a Atkins Diet will clog your arteries, slow blood flow and make your arteries less elastic, i.e. temporarily hardened.  This, of course, is the antithesis of what you need for a good sex life.  (Read my Why Satured Fat Can Be Bad for Men link for even more details.)

Now this is very bad:  you want lots of Nitric Oxide and lots of blood flow between your legs if you know what I mean!  The typical Low Carb (or High Fat) Diet will not do this for you.  He also warned that the Low Carb (or High Fat) Diet had much less folic acid, which could easily lead to increased homocyteine levels.  (Homocysteine is a leading risk factor for heart disease.)

Besides these short term blood flow and nitric oxide issues are long term issues that will definitely effect your sex life.  First of all, cholesterol levels are directly and almost linearly associated with Erectile Dysfunction. And guess what study after study has shown raises cholesterol?  You got it – saturated fat. And saturated fat is normally the fat associated with most High Fat Diets.

And here is my point:  cholesterol levels are directly and almost linearly associated with Erectile Dysfunction. For example, researchers found that for about every 35-40 points of increase in total cholesterol, there was a 0.38 times increase in erectile dysfunction risk! [1] That makes sense, because many studies have reavealed that men with cholesterol at or below 150 have virtually no heart disease. That this should translate to better erectile function was shown in a study where researchers studied a group of men with erectile dysfunction whose only risk factor was high cholesterol.  These men were given a statin drug and erectile function improved significantly. [2] Furthermore, one study showed that exercise coupled with a low fat diet led to great improved blood flow and that that will do nothing but improve your erections. [3]

Many of you will find drastic improvements in your erectile dysfunction if you’ll just adopt a Low Fat Diet.  For more information, read my links on the The Many Benefits of a Low Fat Diet and https://www.peaktestosterone.com/. Some of you will get almost immediate relief by simply breaking the High Protein and High Saturated Fat habit.

High Protein and High Saturated Fat usually go hand in hand due to meat and dairy consumption. High Protein diets have now been implicated as well, decreasing blood flow in a recent study.Furthermore, the authors pointed out that “fibrinogen, Lp (a), and C-RP increased by an average of 14%, 106%, and 61% respectively”. [5] This is a one way ticket to heart and penis problems – avoid it like the plague. Also, remember that saturated fat raises your cholesterol and literally hardens your arteries temporarily.  I know that high saturated fat diets are the rage right now, but for most guys, this is nuthin’ but trouble for their sex life.  We know many guys who after a week on a plant-based diet cured their erection problems. If you just gotta have fat, use olive oil or have a few almonds and walnuts.

NOTE: Don’t believe the bad press that is floating around the web: read about How Incredibly Healthy Grains Are for you.

REFERENCES:

1) Am J Epidemiol 1994;140:930 7

2) J of Urology,2004,172(1)255-258

33) Circulation, 1995, 92:197-204

4) Hypertension 2008; 51: 376-82

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

Vaginal Dryness and Prescription Medications - Peaktestosterone

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

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

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

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

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

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

Beef and Eggs - Peak Testosterone

Beef and eggs.  Can you find two more hated foods?  I doubt it.  The nutritional media establishment has loved to hate these two foods for so long now that people have become scared to even touch them much less eat them.  We hear over and over messages like “if the saturated fat and cholesterol don’t kill you, then the salmonella or e. coli will.”

How much truth is there in all of this? Unfortunately, there’s no quick, pat answer. Beef and Eggs are actually like a of relatives: a little heaven, a little hell and a whole lot of contradiction.

Do you know the foods and drinks that boost Nitric Oxide and repair the veins and artieries to your penis?  Then check out the Peak Erectile Strength Diet Program where I show you how to dramatically improve your erectile strength.

Let’s start with the egg. Eggs are famous, or infamous perhaps, for their cholesterol content.  One egg yolk, after all, has about 200-250 mg of cholesterol.  (Egg whites, in contrast, have almost none.)  One would think that all this cholesterol would dramatically raise cholesterol levels, right?  As it turns out, the cholesterol is one egg yolk does not bump up your cholesterol as much as you might think.

This was re-re-verified in one recent study where researchs fed subjects three eggs for three weeks.  Their cholesterol and LDL went through the roof, right?  No! Both increased only a marginal amount. The reason?  Your body manufacturers the lion’s share of its cholesterol:  diet is a minor contributor.

Researchers also recently found that eggs do something strange and marvelous:  they substantially raise HDL (at least in overweight men on a calorie restricted diet). [11]  This study found that neither bad cholesterol nor triglycerides, the bad cholesterols, were increased significantly at all, while HDL, the good cholesterol, was increased by almost 50%!  In other words, there is a good chance, although this has not been studies either way, that a whole egg a day is actually heart healthy.

That said, we should remember that the healthiest cultures on planet earth almost all have cholesterol around 150 and eggs yolks will raise your cholesterol somewhat, so you don’t want to go crazy.

And one interesting discovery  certain peptides in eggs seem to act as powerful ACE inhibitors and should lower blood pressure. [7]  This has yet to be verified in a live study however.

However, there is one big reason I don’t consume egg yolks:  arachidonic acid (AA).  Especially if you don’t get enough omega-3’s, arachidonic acid increases Inflammation throughout the body. Of course, inflammation is a cause of heart disease, cancer, erectile dysfunction, Alzheimers, arthritis and on and on.  So this is not good, because one egg yolk has around 390 mg of AA, which is a high amount for a food source. [12]

So, while it’s true that egg yolks don’t raise cholesterol that much, the small boost in cholesterol coupled with the big boost in inflammation may be the kiss of death for your arteries.  One recent study recently found that consuming egg yolks raised carotid artery thickness, a measure of arterial plaque buildup (arteriosclerosis), as much as smoking! [13] In other words, eating egg yolks may very well be as bad for you as smoking. (Some would argue that if you get plenty of omega-3’s, you may be okay. I can’t thik of a good reason to take the chance.)

Some would argue that eggs are a fantastic source of choline and lutein, two very important nutrients in food.  However, the lutein content in eggs is relatively low and, of course, one can easily get choline in supplement form.

CAUTION:  Eggs are known for all too frequently carrying salmonella leading the FDA to action that included more stringent rules in mid 2009 for egg laying facilities, storage and transportation.  The FDA instituted these rules based on their estimates that over 140,000 people per year were infected from salmonella. [8] Cook your eggs all the way through and cooked eggs or egg dishes should be reheated to at least 165 degrees Fahrenheit or 74 degrees Celcius. [9]

Need to boost your Nitric Oxide naturally through food, drink and supplements? Check out Lee Myer’s book here: The Peak Erectile Strength Diet

Or do you need the most comprehensive testosterone book in Amazon? Here it is: Natural Versus Testosterone Therapy

Beef should be a favorite of testosterone lovers everywhere, right? It has many testosterone boosting qualities: ample zinc and a good saturated to polyunsaturate fat ratio for starters. Besides all that, beef is incredibly rich in B12, iron, selenium, phosphorous and riboflavin. It’s also one of the meats lowest in inflammatory messengers.  One 2007 Australian study veryified this by measuring C-reactive protein (and free radical damage) from replacing carbohydrate with lean, red meat. They concluded “our results suggest that partial replacement of dietary carbohydrate with protein from lean red meat does not elevate oxidative stress or inflammation”. [10]

Beef is also the core staple of the Masai tribe, one of the most heart-healthy cultures on planet earth. So beef has a lot of things going for it.

So then why the bad press? Well, there are four fundamental allegations:

We’ll have to tackle each of these separately starting with the hormone allegation. Yes, hormones are implanted in commercial North American beef. (You will have to research your own country if you’re from elsewhere around the globe.) There are six approved steroids, three synthetic and three “natural”. All six are essentially testosterone or estrogen.

Sounds scary, right? Well, it would be except that the levels of hormones that make it into a serving of beef is miniscule. There is a much greater quantity of estrogen in eggs and cabbage, for example, than in beef. Furthermore, the amount of estrogen in 6 oz. of beef, 3.8 ng, is dwarfed by the total amount of estrogen the tyical male (human) will produce in a day, 100,000 ng. So the hormone argument is  weak in my opinion.

However, the carcinogen argument is not so easily explained away. This argument stems from the fact that beef, when grilled at high temperatures, produces carcinogens such as heterocyclic amines (HCA’s) and benzopyrene. For example, Prevention magazine (3/06, p. 67) reported that one study showed that those who ate the most HCA’s and benzopyrene had a 2.4 times increase in their level of pancreatic cancer risk. Other studies have also shown red meat and/or HCA’s strongly associated with increased prostate cancer.

Animal studies have shown additional problems: HCA’s mutate prostate DNA in rodents for example. And researchers have also noted that HCA’s cause DNA mutation in the colon. So beware:  the longer (or hotter) that you cook beef, the more HCA’s and other carcinogens that you get.

So it’s obvious that HCA’s lead to prostate cancer, right? Well, yes and no. In fairness, some studies have shown the opposite, that is that HCA’s do NOT lead to prostate cancer. However, the general consensus among the nutritional community is considerable caution when the discussion of beef cooked at high temperatures.

I should also mention that one recent study showed that many common marinades will very significantly lower the amount of HCA’s (between 57 and 88 percent) produced when the beef was grilled at high temperatures. [4]  The most successful marinades were composed of spices from the mint family such as basil, thyme, mint, rosemary, savory, sage, oregano and marjoram. These herbs are all rich in three key antioxidant compounds – carnosic acid, carnosol and rosmarinic acid – that appear to be behind the inhibition of heterocyclic amines on the surface of the meat.  Of course, it should be noted, that this still left a significant amount of HCA’s on the meat.  Even an 88 percent reduction could leave someone with an unnecessarily high exposure to prostate and pancreatic cancers over a decade or two of eating cooked up marinaded meats.

The omega-6 and omega-3 argument is even more problematic.  Virtually all of today’s beef is not range fed but rather grain fed.  Grains are high in omega-6’s which leads to fatty tissue marbled with omega-6’s in our beef supply.  (Range fed animals, which feed off natural grasses, will have a much more healthy quantity of omega-3’s in their tissues.) What is the concern here?  Well, researchers at Wake Forest found that prostate cancer (in mice) was higher than normal with an omega-6 diet and lower than normal with an omega-3 based diet.  In other words, omega-6’s appear to promote prostate cancer and omega-3’s inhibit prostate cancer. [5]

Finally, modern cows are often sedentary and bred and fed to be extremely “fatty”.  Modern livestock is generally ridiculously high in fat content. For example, muscle tissue on a buffalo is about 3% fat.  But a modern, domesticated cow has been bred to be between 25-35% fat. Similarly, a wild pig is 1-3% fat, while a domestic pig is an astronomical 38-46% fat.

Unfortunately, the extremely fatty tissues of modern beef are going to be loaded with saturated fat.  Saturated fat will do a nice job of raising your testosterone, but unfortunately it’s brutal on the arteries.  It literally creates a temporarly hardening or stiffening of the arteries.  This is the opposite of what you want for good erections.  Good erections come from veins and vessels that can expand easily and let blood flow into the penis.  That’s also critical for protection against heart attacks and high blood pressure as well.

The bottom line is that saturated fat is associated with decreased endothelial function. After a large saturated fat meal, endothelial function can be decreased by as much as half. This is NOT what the typical middle aged guy needs in his life. I discuss the whole saturated fat issue in more detail here.

So, if you bake a lean, range-fed piece of beef that was cooked slowly, then you might be in good shape. It would tend to be low in saturated fat, high in omega-3’s and would probably even yield a small testosterone boost.  But how many men are going to do that?!

So, unfortunately, what should be one of nature’s healthiest and most testosterone-boosting foods has been morphed by modern livestock businesses into a food that places us steak-loving males at risk for prostate cancer and endothelial dysfunction.  For this reason, my recommendation is to eat beef sparingly.  Remember:  most of you reading this need to actually clean out your arteries, something the Ornish Diet will do.  The last thing you need is a bunch of saturated sludging around.  In fact, if you have any Erectile Dysfunction, try going without saturated fat for a couple of weeks:  you will probably see improvement from just that alone.

REFERENCES:

1) J of Nutr,2004,134:1887-1893

2) J of Nutr,2006,136:2568-2573

3) Inflammation Nation, by David Chilton, Ph. D., 2006, p. 81, 92, 94, 95.

4) J of Food Science, Aug 2008, (73)6,T100-T105(1)

5) Journ Clin Invest, 117(7):1866-1875, Jul 2 2007

6) Inflammation Nation, by David Chilton, Ph. D., 2006, p. 92.

7) J Agric Food Chem, 2009, 57(2):471–477, “Angiotensin I Converting Enzyme Inhibitory Peptides from Simulated in Vitro Gastrointestinal Digestion of Cooked Eggs”

8) https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm170640.htm

9) Consumer Reports on Health, Oct 2009, p. 3.

10) Journal Nutrition 137:363-367, 2007

EggsBeef

Propecia (Post-Finasteride) Risks - Beware! - Peak Testosterone

Imagine a drug that shuts off androgen receptivity and production in the male body, literally castrating its users. Some might say this would be a perfect drug for repeat and violent sex offenders. However, someone got a better idea and decided to sell it to the general male public and all without mentioning any of the potential risks:  Propecia in its hey day generated a little over $400 million per year in revenue!

Yes, indeed, this castrating drug is called Propecia (generic name:  finasteride) and you can buy it over the counter in countless stores for hair loss. As I cover in my link on Hair Loss, Propecia (finasteride) is rife with sexual side effects.  Around one in ten men will experience significant erectile and sexual dysfunction after starting this nasty drug.

CAUTION: This drug is also sold under the trade name Proscar.  Regardless of the name, finasteride is sometimes used for prostate issues, such as enlarged prostate.  Talk with your doctor before going off of any medication for prostate or other medical reasons.

Just what does Propecia do?  Just about everyone knows that Propecia works on 5-alpha reductase, the enzyme that converts testosterone to DHT. In the short term, researchers have found that it also lowers a downstream metabolite called 3-alpha-diol, which in turn controls a critical brain neurotransmitter called GABA.  Researchers actually used finasteride (Propecia) to study its anti-seizure properties in mice.  They wrote:  “The 5alpha-reductase inhibitor finasteride significantly reduced 3alpha-Diol levels and also blocked letrozole’s ability to inhibit the proconvulsant effects of testosterone.” [2]

And post-finasteride victims often report that their 3-alpha-diol levels are low, which, of course, is going to affect the brain and sexual function due to the impact on GABA.  This is verifed by the fact post-finasteride victims have taken drugs such as Alprazolam or Bromazepam to stimulate GABA receptors with some positive results.  (These drugs can be potentially addictive and misused.)  However, there is a study on men that showed that finasteride lowered 3-alpha-diol, but “only” by about 22%. [4] This was an average, though, and undoutedly some men experience a much greater reduction.  It is probably these men that experience Post Finasteride Syndrome.

The good news is that the industry is just now admitting the problem and a recent study in the Journal of Sexual Medicine admitted that permanent erectile damage did seem to be occurring with Propecia usage. [1] They even encouraged doctors to discuss these risks with their patients.  Imagine that – discussing the potential risk of being chemically castrated before beginning a drug for prostate enlargement or hair loss!  And the FDA is now requiring a black box warning, so that is a start as well.

SOME GOOD NEWS: Reading about the after effects of Propecia and its potential medium and long term effects can be overwhelming.  In spite of the seriousness of the condition, we have had a few men on Peak Testosterone Forum who have largely recovered and I document just how they did it in my page on Propecia_Cures.

Below are two emails from a man who describes classic Post Finasteride Syndrome, with loss of erections, numbness in the penis and so on.

Here is his first email:

“I found your website very interesting. I wonder if you have ever heard of the condition “Post Finasteride Syndrome?” Finasteride is more commonly called “Propecia,” which is a hair loss drug that prevents the conversion of testosterone into DHT. I took this horrible drug for several years, and now I have a great deal of sexual side effects that I don’t think are going to go away. I’m curious if you have heard of the disorder, and whether you know if it is curable?”

Here is his 2nd email after I requested him to write down his symptoms and what he has been dealing with since beginning Propecia:

“Symptoms are varying. The main two which have not gone away at all since stopping the drug are complete numbness of the penis, and impotence. The numbness is to the point that I could stab it with a needle and not feel it. It is the most frightening of all my symptoms because I’m thinking there was permanent nerve damage.”

“Additionally, I am able to get an erection if I try hard enough, but it goes away very quickly without constant stimulus; coupled with the numbness this makes sex impossible without viagra — though that has recently stopped working as well.”

“Two other rather frequency side effects are prostate pain which goes from slight burning to sharp random pains; a lot of men with this condition seem to get prostate infections often, so that could explain these. In addition to the above, I get “brain fog” which is a strange feeling in the front part of my head and behind the eyes that makes concentrating and absorbing new information much more difficult.”

“The brain fog went away initially after stopping the drug, but it seems to be coming back, which is really terrible news and has me pretty severely depressed. My sleep pattern is also totally messed up, I wake up every night multiple times, and I very rarely dream. When I was on Propecia, I had almost no dreams; I have started getting some dreams back of late, so I’m hoping that is a positive sign.”

“Finally, when I really feel bad (which seems to come and go in cycles) there is a horrible feeling like my penis is VERY cold; it is not cold to the touch, but for some reason it feels like it’s extremely cold “mentally,” and it hangs very shriveled and looks wrinkly. This has happened to me twice since quitting. I believe these are the times when penile fibrosis (a symptom other men complain about) is setting in.”

“Sadly, all of the above symptoms are very common for other men who have quit this drug. I was taking approximately 0.8 mg of finasteride (which is under the standard recommended dosage) for 3.5 years for hair loss reasons. Before this, I was an otherwise totally healthy 20 something year old. Several men on a forum I visit complain about muscle loss and inability to gain muscle by working out, and I have read other accounts of men growing breasts from Propecia.”

“I believe the muscle loss is related to a loss of testosterone, and the breasts are from a spike in estrogen. I do not have any breast growth, and I don’t seem to have the muscle loss issue, but I am still concerned about my testosterone, and have begun working out in an attempt to raise it.”

“Thanks very much for the advice! I have been off the drug for approximately 8 months, with little to no improvement (in fact, I seem to be getting worse), so I will be going to see a doctor as soon as possible.”

It should be noted that the mental side effects from Propecia are easily as severe as the physical, because 5 alpha reductase is key to production of certain androgen-related neurotransmitters.  Some experts believe that this loss in brain function is what actually causes much of the sexual dysfunction. Thus, the risk is not just to the penis, but to the brain as well.

What has Merck’s response been?  As far as I have been able to document:  nothing.  Every year that they can stall and procrastinate hundreds of millions keep rolling in. Of course, class action lawsuits have started and so, as always, attorneys will be the only ones who will get the attention of these executives.

The prognosis currently for many men with Post Finasteride Syndrome from taking Propecia now appears to be grim.  However, I urge you not to give up and, if you have any symptoms after taking Propecia, read up on it, do your research and try to find a doctor that specializes in recovery from this medicaiton as soon as possible.  There is some chance that high testosterone or HCG therapy may help, but talk to a medical professional with considerable expertise in this area.  Currently the medical industry has not owned up to this major health issue, much less come up with treatment protocols.

In the meantime, spread the word about the risks of this dangerous drug.  It is simply not fair that someone would take Propecia for hair loss without realizing that he was potentially putting all he held dear as a male on the line.

REFERENCES:

1)  J Sex Med, 2011 Mar, 8(3):872-84. “Adverse side effects of 5?-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients”

2) Neuroscience, 2004, 129(1):195-207, “Testosterone modulation of seizure susceptibility is mediated by neurosteroids 3alpha-androstanediol and 17beta-estradiol”

3) PNAS, 98(14), “Excitatory versus inhibitory GABA as a divergence point in steroid-mediated sexual differentiation of the brain”

4) The Journal of Steroid Biochemistry and Molecular Biology, Nov 2013, 138:10-16, “Effect of finasteride on serum levels of androstenedione, testosterone and their 5α-reduced metabolites in men at risk for prostate cancer”

Men on Testosterone Cypionate: Here is a Way to Boost DHT

However, men on injections of testosteorne cypionate or enanthate can actually end up with levels of DHT that are not high enough to sufficiently boost libido.  Usually this is not the case, but it can happen.  There is an enzyme (5-alpha reductase) that converts your testosterone into DHT and so the amount of DHT that you end up with is dependent on this metabolic process, and it is quite unpredictable.

So, if you are on injections, and end up with a) low libido and b) DHT levels in the lower part of the lab range for men, what do you do?  Do you switch to some other type of testosterone therapy, i.e. another delivery system?  You could, of course, switch to the topicals / transdermals.  For example, Androgel works very well for some men.  If you need a less expensive alternative or, if Androgel does not work for you, you can also try this:   Compounded Testosterone Transdermals. (Compounded testosterone has a huge advantage:  it can be written for any strength.)

Transdermal testosterone, because it is rubbed into the skin, has a very high conversion rate to DHT.  From what I have seen on the Peak Testosterone Forum, men using transdermals will usually end up with DHT well over the top of the lab range, i.e. “supraphysiological.” Supraphyiological means that your DHT is actually at unnatrually high levels that simply don’t occur in healthy, young men.  I would add, actually, that DHT very often ends up 2-4 times the top of the lab range actually, and this is one of the things that I personally don’t like about transdermals.  I just personally feel uncomfortable driving hormones to very high levels, and with DHT you could potentially accelerate male pattern baldness and/or cause prostate issues, so you want to stay within the lab range and try to hit the targets you and your (hopefullly knowledgeable) doctor set.

1)  https://www.peaktestosterone.com/forum/index.php?topic=8125.0

Men on TRT (testosterone replacement therapy) should always have good levels of DHT (dihydrotestosterone), right?  After all, we get our DHT from testosterone and so men with good levels of testosterone from TRT should have good levels of DHT.  And DHT is very important, since it is responsible for a good portion of our libido.

So is there a better solution out there?  One of our senior forum members (JustAskin) alerted me to a clever solution that takes advantage of this property of transdermals. JustAskin’s TRT physician, by the way, is the legendary Dr. Shippen, who has been a pioneer and apostle of almost all the good T-raising protocols that savvy doctors use today. Note that JustAskin’s TRT protocol was testosterone cypionate injections, but he still had a low libido and DHT on the low side.

“I found thru many labs ran that my libido is like in my twenties when my DHT is around 105. Caution: If you take 2 Grams of L-Citrulline when your libido is high, it will get so hard it actually hurts.” [1]

By the way, I will add that JustAskin is in his 60’s and so this turned back the clock about four decades!  No one can promise that will happen for any given individual – JustAskin’s arteries are clearly in decent shape for example – but I’m just passing along information as to what has worked for some men on the Peak Testosterone Forum.

REFERENCES:

Safe Levels of Apolipoprotein B (apoB) - 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.

“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.

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.”

Drugs In Your Water - Peak Testosterone

As if Excitotoxins and Pesticides in our food wasn’t deadly enough, scientists are just now finding that there is another environmental enemy waiting to wreak havoc with our bodies and minds:  drugs in our water.  Ironically, we won’t have to wait for terrorists to poison our water supply:  we’ve got a great head start doing it to ourselves.

The government estimates that at least 270 million pounds of drugs are dumped into our nations water supply every year.  (The actual number if probably much, much greater.)  And, yup, it’s all legal. If a medical company, hospital or drug manufacturer dumped pharmaceuticals onto the ground they’d probably have a dozen governmental agencies after their throats.  However, if the same companies flush or rinse the same pharmaceuticals, there is no penalty whatsoever.  These drugs also get into the water supply through many ways, of course, including us urinating, city dumps leaking into landfills, flushing drugs down toilets as well as various industrial processes that use drugs for manufacturing.

So how concerned should we be.  Let me quote from the 4/19/2009 AP Press release:  “Researchers have found that even extremely diluted concentrations of drugs harm fish, frogs and other aquatic species. Also, researchers report that human cells fail to grow normally in the laboratory when exposed to trace concentrations of certain drugs. Some scientists say they are increasingly concerned that the consumption of combinations of many drugs, even in small amounts, could harm humans over decades”.

Another reason that there is such widespread concern is the kind and quantity of drugs found.  Here’s a partial listing:

This list could go on and on as you can well imagine, but you get the idea: if you drink tap water, you may are putting yourself at potential risk because you are almost for sure ingesting regular amounts of various drugs.  (Don’t tell the drug companies or they’ll probably want a cut!) These are often potent and sometimes even toxic chemicals.  Our advice:  stick to red wine and green tea made from bottled water!

NOTE: Scientists have long been concerned at the level of estrogens in drinking water.  Researchers recently found that these estrogens do not come from pharmaceuticals but rather dairy, soy, animal waste (used as fertilizer) and human urine. [3][4] Pretty comforting, eh?

You should also be aware that the chlorine in tap water is associated with a slight risk of bladder and rectal cancers. A 1992 meta-analysis found a linear-like relationship between chlorinated water consumption and these deadly cancers. [1] Apparently, chlorine is great for disinfecting pools and keeping the malaria and typhoid in check, but not so good for GI tissues.  NOTE:  Did you know that baby carrots are cut from crooked and malformed carrots and then washed in a chlorine, i.e. bleach solution?  It might just be worth the extra minute or two to peel a regular carrot!  (Carrots, until recently, were on the “worst pesticide” list as well.)

The Environmental Working Group recently published a study showing that 25 of 35 cities had overly elevated levels of the carcinogen hexavalent chromium in drinking water. [5] This is the same chemical was center stage in the famous Erin Brokovich case in soutern California. And, by the way, the utilities have absolutely no plans to remove this any time soon.  Furthermore, hexavalent chromium is not going away any time soon:  it is prevalent in many industrial compounds and processes, including numerous steels and dyes.

CAUTION:  There are other reason to be very wary of tap water. Drug residues may actually be the least of your worries.  Tap water also generally contains high levels of nitrates, which is dangerous for pregnant women, and is a potential endocrine disruptor for guys.  Besides that, city tap water often contains substantial aluminum, which produces damage to the brain similar to Alzheimers when consumed for an extended period of time. And remember:  this is not just an American phenomenon.

1.  Buy Water.  Buying filtered water is probably the best solution assuming it is a reliable supplier of course.

2. Home Water Filter System.  These systems are known to remove chlorine and pesticides and so should filter out any drugs of a similar size or larger.  However, this has not been tested yet and no one knows how reliable these kind of systems will be. [2]

REFERENCES:

1) Morris, The American Journal of Public Health, Jul 1992

2) Consumer Reports on Health, Sep 2009, p. 12.

3) https://www.physorg.com/news/2010-12-dont-blame-pill-estrogen.html

4) Environ Sci Technol, 2010 Oct 26, [Epub ahead of print], “Are Oral Contraceptives a Significant Contributor to the Estrogenicity of Drinking Water?”

5) https://www.nytimes.com/gwire/2011/04/04/04greenwire-water-utilities-failed-to-alert-public-to-pres-16753.html

Other parts of the world have been more aware of the issue.  But in the U.S., this all started when the AP last year (2008) reported trace amounts of various drugs (sex hormones, antibiotics, anti-convulsants just to name a few) in various city water supplies.  Further studies, some around the globe, have verified the same phenomenon and it is now estimated by American researchers that they have tested the water supplies of around 60 million Americans, i.e. there is little doubt at this point that the lion’s share of communities are affected.  (There are many other nasty things in water besides drugs:  see the Safe USA Water site.)

And, for any non-American readers:  keep in mind that this is a global phenomenon.  It all started about ten years ago when German researchers found cholesterol-lowering drugs, analgesics and NSAIDs in their water supply.  Canadian and British scientists have found similar results showing that this is clearly a problem for all societies with substantial pharmaceuticals, industrialization and manufacturing.

Drug in Tap Water – Solutions

Coffee: Ten Reasons to Drink The Stuff - Peak Testosterone

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

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

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

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

REFERENCES:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Mushrooms: A Natural Aromatse Inhibitor - Peak Testosterone

I have a whole page of fairly commonly used Natural Estrogen Blockers. Of course, one of the ways you can “block” estradiol (the “Mother Estrogen”) is by blocking the aromatase enzyme. For all practical purposes, men get all of their estradiol from the conversion of testosterone to estradiol via this enzyme.  If you limit that enzyme in some way, then you slow down this conversion process and up with lower estradiol levels. And one of the reasons that men want to control estradiol is that as they age, are under chronic stress and/or gain weight, their estradiol levels can rise to unhealthy levels.

When it comes to estradiol, the smart thing to do is to get it measured using your lab’s most sensitive test – it has to be appropriate for men who have lower levels – and see where you are at.  You do not want to lower estradiol too low nor do you want it too high in my opinion.  Going too low can result in osteoporosis and, as far as going too high, see these pages: High Estradiol and the Link with Prostate Cancer / Enlarged Prostate and High Estradiol Increases Arterial Plaque.

Unfortunately, many doctors are completely unaware of the crticality of estradiol to the male neurological, cardiovascular and erectile systems.  And they are often constrained by insurance costs and protocols.  For this reason, you may have to pull the number yourself and go to your doctor with the information.  If interested, you can get some ideas in my Testosterone Labs page.

“A 50% inhibition of aromatase activity was achieved with 50 μL of 7.5XH2O mushroom extract. The active component in the mushroom extract appeared to be water soluble and heat stable. Of the other extracts evaluated, celery had a modest inhibitory effect. Extracts prepared from green onion, carrot, bell pepper, broccoli and spinach did not inhibit aromatase under these experimental conditions.” [1]

Of course, the question is dosage, but this study showed that mushrooms do at least have the potential to be a decent AI (aromatase inhibitor).  So just how many mushrooms would you have to eat to have a clinical impact?  Well, a recent study on breast cancer survivors provides some insight at least.  Basically, the researchers prepared a white button extract that was the equivalent of 10 times the same amount in actual mushrooms.  In other words, a gram of the extract was the equivalent of 10 grams of white button mushrooms, which are the common kind found in grocery stores here in the U.S.

The researchers tested different quantities of the mushroom extract and found that at dosages of 10 and 13 grams of extract, which is the equivalent of 100 and 130 grams of white button mushrooms daily, that aromatase inhibition did occur.  The researchers had very amibitious goals – to reduce estradiol by 50% – and, therefore, did not achieve their goals.  However, these are not necessarily the goals of a senior male or a man on HRT.  I have not been able to find that actual amount of estradiol reduction that occurred, but it is reasonable to assume that is was at least 10%.  If this is the case, even this amount is a nice bump downward, considering that white button mushrooms are a common food that should have minimal side effects. [2] (Arimidex can negatively effect the clotting cascade.)

Can a man really reduce estradiol levels with white button mushrooms?  My guess is that, if he eats enough, he can get a little bump downward.  I see virtually nothing written about this in the steroid forums and so there cannot be much of an effect there, or it undoubtedly would be quite popular in that setting.  Another issue may be the quantity required.  70 grams of white button mushrooms is about a cup and, therefore, we are talking about eating a cup-and-a-half to two cups daily, something most men would probably not be too excited about doing.  Again, though, combine with a zinc/copper combination supplement, this may achieve some modest effects.

CAUTION: Always discuss new supplements with your doctor, especially if you have an existing medical condition or are on any medications.

REFERENCES:

1)  J. Nutr, Dec 1 2001, 131(12):3288-3293, “White Button Mushroom Phytochemicals Inhibit Aromatase Activity and Breast Cancer Cell Proliferation”

2) https://foodforbreastcancer.com/news/white-button-mushroom-extract-has-mild-influence-on-aromatase-activity , “White button mushroom extract has mild influence on aromatase activity”, Posted: Jun 15 2011, Breast cancer study, Conference: American Society of Clinical Oncology (ASCO) Meeting, June 2011 Study name: “A dose-finding clinical trial of mushroom powder in postmenopausal breast cancer survivors for secondary breast cancer prevention”

3) https://www.peaktestosterone.com/forum/index.php?topic=7661.0

However, if you find your estradiol is genuinely too high, you may want to consider lowering it a bit naturally.  One ideal way to do this would be through food, eh?  I had one man write to me and claim that he may have actually been able to do just this.  The poster (Regulus) was on HRT and is a very sharp guy.  He told a story as to how his estradiol went from 25 pg/ml to 79 pg/ml when he quit eating mushrooms for dinner with no other change that he knew of! [3] Of course, that got me to do a little research and I found out that he was likely onto something.  He also wrote:

“I had symptoms of high estradiol, but started making sure to include plenty of cruciferous vegetables, mushrooms, and a moderate amount of soy in my diet. Don’t know what worked or what didn’t, or if it just would have worked out on its own, but my estradiol is now actually on the low side. I make sure to eat mushrooms at least once a week. It’s not a burden, they’re cheap, nutritious and I really like them, so even if they aren’t doing anything no loss.”

Now I know some guys are scared of soy for reasons I document in my link on Soy and Men, but I know of no evidence that soy changes estradiol significantly in men. And cruciferous vegetables will not lower your estradiol measurably according to a lot of research.  Basically, cruciferous vegetables primarily switch estrogens from negative to positive metabolites. White muschrooms, however, may be a completely different matter.  One study, in the hopes of finding a way to naturally treat breast cancer, looked at seven different plants to see which one inhibited (did not inhibit) aromatase activity.  Here were the their conclusions:

Prostate and Testosterone - Peak Testosterone

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

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

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

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

1) Men s Health 9/05 p 74

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

3) JAMA, 2004,291:1578-86

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

24) UUrology,2007,70:672-676

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

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

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

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

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

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

31) Harvard Men’s Health Watch, June 2007

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

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

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

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

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

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

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

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

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

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

Benign Prostate Hypertrophy (BPH)

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

REFERENCES:

Androgel: Controversial Testosterone Topical

What testosterone product has by far the most problems on The Peak Testosterone Forum? If you guessed Androgel, you’d be spot on.  Of course, Androgel is a very popular HRT delivery system, so one would expect a proportionately high number of complaints and side effects.  However, this just does not explain one simple fact:  one man after another has written in complaining that Androgel actually lowered his testosterone or raised it by just a few percentage points.

This is a scary state of affairs, because most men with low testosterone have some combination of elevated insulin, weight gain, borderline anemia, possible bone loss and erectile dysfunction.  These men usually go into their doctors desperate and in poor health and the last thing they  need is to find out several months later that their testosterone has actually gone down or remained unchanged!

This just does not happen with other delivery methods such as injections, patches or pellets (assuming any reasonable knowledge level of the physician).  But with Androgel, it appears to be shockingly common.  And, even worse, Androgel is quite expensive at this point, so some patients are paying a substantial amount out of pocket only to find their situation worsening instead of improving.

Just look at these comments and complaints below:

1)   https://peaktestosterone.com/forum/index.php?topic=849.msg7672#msg7672

2)   https://peaktestosterone.com/forum/index.php?topic=651.msg5981#msg5981

3) https://peaktestosterone.com/forum/index.php?topic=190.msg1357#msg1357

4) https://peaktestosterone.com/forum/index.php?topic=419.msg3778

5) https://peaktestosterone.com/forum/index.php?topic=246.msg2177#msg2177

6) https://peaktestosterone.com/forum/index.php?topic=416.msg5760#msg5760

7) https://peaktestosterone.com/forum/index.php?topic=629.msg5998#msg5998

8) https://peaktestosterone.com/forum/index.php?topic=728.msg6600#msg6600

9) https://peaktestosterone.com/forum/index.php?topic=311.msg2873

10) https://peaktestosterone.com/forum/index.php?topic=513.msg8138#msg8138

11) https://peaktestosterone.com/forum/index.php?topic=180.msg1254#msg1254

12) The Journal of Clinical Endocrinology & Metabolism, May 1 2004,89(5):2085-2098, “Long-Term Testosterone Gel (AndroGel) Treatment Maintains Beneficial Effects on Sexual Function and Mood, Lean and Fat Mass, and Bone Mineral Density in Hypogonadal Men”

13) https://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=4279

14) https://peaktestosterone.com/forum/index.php?topic=914.0

–“Had natural [total testosterone] production around 240, got on Androgel and it sunk to 44. Wasted a lot of time trying more gel, then a 10% compounded cream to no avail. Finally started T cypionate shots on Sept 4th. Feel a lot better!” [1]

–“After that my doctor agreed they were quite low for my age. So she put me on 1.67 androgel two pumps once a day. A month later I had another test done. Results one month later w/ Androgel two pumps a day. Testosterone 203 Low ng/dL.” [2]

–“I have been taking Androgel for the past four months by a 5.0 packet and my testosterone level is 3 and should be 6 according to my endoc doctor. The 5.0 is not increasing my level so the doctor has increase the dosage to a 7.5 packet. I rub it on my stomach and shoulders.” [3]

–“The regular price is $300 per 120 ml bottle. Depending on your dose that could be anywhere from 1 – 4 months.” [5]

–“Androgel was aslo a failure for me.” [6]

–“it’s that I’m paying out the nose for Androgel and seeing minimal (if any) improvement” [7]

–“The fertility doctor also works at a men’s health clinic and said Clomid hasn’t been proven safe for long-term use so we switched to Androgel. Eventually after getting to 3 pumps per day, my TT only made it to 300.” [8]

—-“Yes, I had a blood test 2 weeks after starting on 2 pumps of Androgel which came in at 218. My prior T was around 180 a week before starting the gel.” [9]

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

–“Once I finally realized and tried to improve myself and seek medical help and made it through the aweful Androgel which did absolutely nothing to me, I got the correct treatment of T injections and Armidex.” [10]

–“So I had my T checked it was 140, I went to my doctor and he put me on 1% Androgel. Which I used for about 6 months, yes it worked to get my T up to 320 but not enough.” [11]

There have been even more complaints, but the above are representative.  You get the idea.  Androgel is often poorly absorbed.  Does this mean that Androgel should never be tried?  Well, of course not.  Remember that the forum will mostly get men writing in when they have problems.  And keep in mind that part of the issue could be the method of application, which we will go into below.

NOTE:  I cover many of the other methods of Hormone Replacement Therapy, including some of the more successful, such as Testosterone Pellets, Compounding and Axiron.

Furthermore, it should be pointed out that the official study on Androgel showed overall very good results.  For example, here are just a few outcomes: [12]

e) Lean body mass increased and fat mass decreased.

In other words, Androgel did pretty much just what you would expect testosterone therapy to do and relieved most of the Classic Testosterone Symptoms. However, there are indications that many men do indeed have problems, based on the standard deviations listed on a governmental Androgel fact sheet. [13] If you are taking a lower dose of Androgel, average total testosterone levels climbed to 555 ng/dl.

That’s not really that high compared to injections or pellets and, more importantly, one standard deviation was 225 ng/dl.  That means there are a lot of men below 330 ng/dl and still more below about 400 ng/dl.  If you’re hypogonadal and your physician takes you into the 330-400 range, it’s quite likely that that is not going to produce any noticeable results.  And, of course, it is these men that are writing into the forum.

So then what is the answer?  Well, of course, more Androgel undoubtedly sometimes helps.  Average testosterone levels per the above fact sheet were 555 ng/dl with 5 grams and 713 ng/dl with 10 grams.  This means 10 grams, while more expensive, will likely pull you into much more solid territory to where, even if you are a poor absorber, you stand a better chance of not falling back into lowish T levels.

Another way to possibly absorb more Androgel – and, of course, discuss this with your physician – is to consider Dr. Crisler’s method of applying the Androgel to the forearms.  Dr. Crisler, who is one of the “online HRT docs” that has been around for years, has a video where he shows how to apply Androgel without getting any onto your hands and then applying it to the forearms.  This technique makes a lot of sense because a) a significant amount of Androgel will be lost on the hands and b) the forearms are a common area recommended by compounders as being the best place for topical absorption.  See Dr. Crisler’s Androgel Video for details.  And this in contrast, by the way, with the standard recommendation to apply the gel on the upper body.

TIP?  One forum member, who has had reasonable success with Androgel, suggested the following application strategy:

“In the morning once I get done with the shower I turn on the hot water only and get my skin red and hot. I think this opens up the pores and gets skin ready to go. Then I dry off real quick and apply to my shoulders or my butt.” [14] Of course, discuss this with your doctor first.

CAUTION:  No skin-to-skin contact should ever be allowed with any topically treated area with women or children.  This can cause issues such as male pattern baldness and facial hair in women and, potentially, can negatively affect the brain and future pubertal development of younger children.  Talk to your doctor!

REFERENCES:

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

Evidence-Based Weight Loss Supplements - Peak Testosterone

If you read any bodybuilding site or go into health food or vitamin store, you will instantly be bombarded with expensive weight and fat loss supplements.  As we all know, those Extra Pounds Cause Many Health Issues. Below I have summarized which of these supplements for weight loss have actually withstood the test of peer-reviewed research.

The weight loss market is a HUGE market and the supplement sector in particular abounds with unsubstantiated claims and overly expensive products.  In addition, the FDA has found two dozen weight loss products with carcinogens, controlled substances and other dangerous additives. In my opinion, it’s far safer to go with a name brand supplement for one ingredient that you know has a proven research track record.

I would also recommend extreme caution with some of the prescription drugs for weight loss, especially Alli and Xenical, both of which use orlistat as their active ingredient.  Among the side effects, which unfortunately aren’t all that uncommon, are rectal bleeding, anal leakage and kidney and liver problems.

3) Caffeine. A couple of studies show good ol’ fashioned caffeine increases metabolism and calorie-burning.  Don’t go crazy though as it can interfere with your Sleep and sleep can raise appetite and make you too doggone lazy to exercise among other things. [4]

4) Capsaicin, Green Tea and CH-19 Sweet Pepper.  Several studies show this combination is a powerful fat burner with no significant side cardiovascular side effects. [5]

5) Capsaicin, Green Tea Extract (w/ Caffeine), Tyrosine, and Calcium. This combo was found in one European study to be a potent fat burner. [7]  In fact, it increased daily energy expenditure by 2%!

6) Calcium Pyruvate. Most studies show this fat-metabolizing compound, if ingested in quantities greater than 6g/day, does help participants lose modest amounts of weight. [6]

7) CLA. Several studies show positive fat loss results. [8]  How does this weight loss supplement work?  CLA interferes with lipoprotein lipase that helps store fat in your body and even helps your body use existing fat stores more efficiently. CAUTION: One animal study showed that CLA caused accumulation of fat around the liver, potentially increasing or exacerbating insulin resistance. [11] Other researchers are arguing that it should be classified as a trans fat. [12]

8) L-Arginine. Arginine has been shown to promote weight loss.  If you are not eating much meat (or nuts), you may want to consider supplemental L-Arginine.  See my link on a What L-Arginine Can Do For You and Potential Side Effects.

9) Glucomannan. This is another weight loss supplement that started with somewhat mixed results because the sample size of the studies were all comparatively small.  One recent meta-analysis aggregated the results and found that glucomannan was effective as a weight loss supplement. [9] Furthermore, similar to Invingia, this product also improves many cardiovascular makers:  the study above found that glucomannan also significantly lowered triglycerides, total cholesterol and LDL. It apparently works by slowing absorption of glucose and cholesterol from the intestines.  Again, you can buy this at a greatly discounted price through Amazon.  For example, one well known distributor, Nature’s Way is about half off: Nature’s Way Glucomannan Capsules, 100-Count Bottle.

10) Calcium. Scientists are not sure why it works, but several studies (on women) show Calcium accelerates weight loss. For example, one study showed participants lost 4.43, 3.46 and 3.89 pounds, respectively, on high milk, soy milk and supplemenatal calcium versus 2.87 pounds for controls. [10]  CAUTION:  Guys must be careful not to have too much Calcium, as it elevates calcitrol levels, which have been linked to prostate cancer. And soy probably deserves caution as well, as it has been linked to brain shrinkage in males.

11) Water Before Meals. Okay, water isn’t a supplement.  Still, researchers have recently discovered that one of the best ways to lose weight is simply to consume water before meals. [13] One of the triggers that tells your brain, “I’ve had enough” is weight in the stomach. Putting some water in your stomach ahead of eating satiates you much sooner than normal and helps you with appetite control.

YOUR GUESS IS AS GOOD AS MINE:  Hoodia and Bitter Orange Extract have no well-controlled studies backing their claims of being a fat metabolizer and appetite suppressor, respectively.  You can certainly try them but just realize it is guesswork, not science, at this point.

CAUTION:  Most studies show that you should not buy Chromium Picolinate or Carnitine for weight loss, i.e. they are ineffective.  These supplements do actually have other good uses, but weight reduction is not one of them.  HCA is in the same category by the way:  one study at least showed no improvement in appetite or weight loss for the participants.

I cannot think of any good reason to use these when there are so many excellent over-the-counter supplements available with much a much safer profile. Below I have given you a nice summary of the products that really work.  Yes, as always, I’m trying to save everyone a lot of wasted time and money.

Keep in mind that none of these products are a substitute for diet and exercise when it comes to dropping those pounds. The list below should be looked at as an aid or a help, not as an end in itself.

And remember:  be serious about losing those pounds.  Those Love Handles Can Be Deadly.

CAUTION:  Talk to your doctor if you have any medical conditions.

1) Irvingia. There is an interesting new weight loss supplement  called Irvingia that looks extremely promising. [1] One study found that, with no change in diet, study participants dropped 28 pounds in 10 weeks.  This is a phenomenol amount of weight loss and is doubly remarkable because those in the study continued to eat as they always ate!  What is even more remarkable about this supplement is that it lowers glucose, cholesterol, LDL and CRP (inflammation). A previous study found that it also dramatically lowered triglycerides.  [2] In other words, not only does it drop weight, which is the cause of so many health issues, but it also lowers most of the key markers for heart disease. One of the key ways that it works is by lowering leptin, which is a hormone that signals your body to basically store fat.  Leptin is also key to appetite control and so this also helps moderate hunger as well.  It also inhibits the amylase enzyme, which converts starches to sugars in the intestine.  In other words, it seems to almost magically help virtually every metabolic pathway dealing with weight retention. The only caution that I have is that you should talk to your doctor first, of course, and realize that this is a very new supplement, i.e. there is not a lot of history at this point.  It may effect digestion, absorption or any number of metabolic processes.

2) Green Tea.  Several studies show that Green Tea or its extract raises metabolism, i.e. burns more calories. [3]

Hair Testing Clearly Detects Testosterone - Peak Testosterone

Canned tuna is a great source of protein but has two big problems normally:  a) it is stored in BPA-lined cans and b) it is a high mercury (methylmercury) fish.  I have had a couple of men on the Peak Testosterone Forum who did not feel well after consuming tuna for a significant period of time. You can read about a documented case of mercury poisoning from canned tuna in a well-known actress (Denise Zuniga) here: Testosterone and Mercury. Mercury causes many nasty issues, including binding to many enzyme systems and hard-to-remove storage within neurons.

So how do you find out if you have mercury overload?  Well, there essentially two ways to do it, depending on the stage of your mercury overload from what I understand:

a) an initial overload stage where high levels of mercury can show up in your plasma and hair or

In an email, EH elaborated that his mom stated that she had been consuming canned tuna at least 4-5 times per week.  This is way too much and, as you can see, there should be warning label on tuna!  It simply should not be eaten more than once per week at the most according to most of the experts I have read.  Furthermore, a certain percentage of the population has a glutathione-related mutation that makes them very vulnerable to heavy metals.  Their mercury levels will spike tremendously after consumption of a high mercury food like this.

The clear point in all of this is that hair testing can literally save you years of poor health and possibly even chronic disease.

EH very graciously shared his Mom’s charts before and after so that you can see the tremendous improvement:

NOTE:  Hair testing was done via Direct Labs / Doctor’s Data.  (I have no affiliation.)

CONCLUSION: Hair testing can be a powerful way to find potential issues and toxicities. Hair testing likely saved this forum member’s mother years of poor health.  For more information, see these links:  Summary Pages on Hair Testing and Inexpensive Self-Testing Labs.

REFERENCES:

1) https://www.peaktestosterone.com/forum/index.php?topic=9492.0

b) a storage stage where mercury is bound and stored in various tissues and disrupting multiple metabolic pathways (including potentially testosterone production)

I deal with the longer term stage here: Hair Testing for Mercury (Stage II). On this page I want to deal a) where the body is loading up on ,mercury and it is readily detectable in your blood and hair.

Unfortunately, one of the senior members on Peak Testosterone Forum  discovered this was an issue with his mother.  The forum member (EH) actually found out about the high mercury levels by testing his mother’s hair.  He wasn’t actually looking for mercury but found out about by testing.  Here is what he wrote:

“My mother had high aluminum and mercury levels last year when she tested her hair (done via ICP-MS method by DirectLabs). After a long discussion about her diet, she mentioned that she was eating Kirkland [Costco] Signature Canned Tuna frequently. I asked her to discontinue eating any canned tuna for a while and test again. She just tested again after 9 months of not eating the tuna. Her new results were dramatically improved. Her aluminum numbers dropped by 50% and her mercury numbers dropped by 90%. It is well known that tuna are contaminated but I had never seen personal evidence of it until now.” [1]

Low Fat Diets: Do They Affect Testosterone? - Peak Testosterone

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

How to Meditate without the Mumbo Jumbo - Peak Testosterone

There are dozens of life-changing reasons to meditate but most men won’t do it for one simple reason:  they associate it with religious or spiritual beliefs (or the lack thereof) that do not match their own.  And, almost without exception, if you pick up a book on the subject, you will be bombarded with religious terminology that can make it a barrier for most men.  Another problem can also be the fact that meditation is actually quite simple, but many articles and books add pages and pages of “fluff” that you really don’t need to know.

But fear not!  Below I am going to give you some very simple step-by-step approaches to meditation.  In fact, before I go on, let me just mention that there are really just three basic approaches to meditation:  concentration, mindfulness and mantra.  These three overlap and are not perfectly separate as you’ll see below, but do not be concerned because all 3 of these have stellar research records as far as cortisol control, psychological improvement, cardiovascular health and – it’s true! – brain building.

Many guys also struggle with just sitting there.  It seems a tad bit unmanly to just sit their doing nothing and it just seems like a big waste of time.  However, nothing could be further from the truth and secular meditation can helpyou directly with your sex life, career and other things that are important to virtually any man on planet earth.  Stress, especially in modern societies, is a root cause for almost every nasty medical condition that plagues us.  We have to learn approaches that will help us overcome this enemy and secular meditation should certainly be a the top of the list in this category.

Here are just a few examples as to why meditation should be front and center to every man and why meditation is actually downright manly:

1.  Cortisol Reduction and Visceral Fat. Cortisol accelerates the most dangerous kind of fat:  visceral or stomach fat. This kind of fat is associated with insulin resistance, endothelial dysfunction, heart disease and, ultimately, that’s not going to be good for your erections.

2.  Muscle Preservation. This could go under #1, but anything that controls cortisol will help keep your precious muscle mass.  Testosterone buildeth;  cortisol taketh away.

3. Erections. Remember:  one of the stress hormones puts the brakes on erections, in order to prevent priapism.  Lowering stress will, in general, increase your libido and optime your erectile strength.

4. Anxiety. Meditation helps with a host of anxiety-related psychological issues.  Many of you need to admit you’re overly stressed out and this is impacting your relationships and/or family.

5.  Repetitive Thoughts. Meditation teaches you to control runaway and repetitive thoughts.  This is a HUGE problem for many men.  When the consequences of something seem too horrible to bear, just about the only thing that can help is meditation.  It teaches you to control your thoughts

So I urge you to get over your bias against meditation – it’s mostly cultural after all – and try it out.  I can’t emphasize this enough, but it takes time – usually a few weeks.  Meditation is just exercise for the brain.  And when you start working out for the first time in your life, it can be painful when you start.  Keep that in mind when you start to meditate.

Again, you will be plagued with thought flooding your head, sleepiness and various other distractions.  But stick it out:  you won’t regret.  As a motivator, look at this summary as well:  The Many Benefits of the Relaxation Response.

NOTE:  PMR (Progressive Muscle Relaxation) is a related technique but not really true meditation.  It is, however, uniquely powerful and has some distinguising properties, such as being a nice cure for insomnia.  It is VERY good at lowering cortisol and stress and is also known for improving many of the worst psychological issues.  However, it does not yet have the documented brain building benefits of meditation and I would also argue that it may not help as much with learning to control your thought life.  But it is VERY powerful and can produce a relaxation response any time and anywhere!

Concentration Meditation

1) Choose an Object. You have to start by choosing something to focus on. The most common is your breathing.  If you choose breating, it can either be the sound of your breath or the feeling of the breath entering/exiting your nostrils. Other common meditiation “objects” are the end of your nose or the forehead at the top of your nose between your eyebrows, called cosmically the “third eye point” by some.

2) Close Your Eyes. I recommend closing your eyes as you will find it much easier to relax and concentrate.  However, you certainly do not have to and many practioners meditate sometimes with their eyes open.  If you leave your eyes open, you can either concentrate on your breath or on an object in the room, preferably something neutral.  Leaving your eyes open can be a useful technique for those who easily fall asleep.

3) Counting or Alarm. I’m a numbers guy and love to count.  It really helps me with each breath to count up from 1 to some preset number.  I usually find that when I hit about 50, the relaxation response kicks in.  For some of you, setting an alarm – preferably your phone on a gentle vibration mode – is what you need.  I encourage this, though, so that you know there is a time limit and won’t be stressed out about time management-related issues.  Many studies show just two times of 15 minutes per day will achieve the benefits mentioned above.

4) Distractions. The most important thing to remember when you start meditation is that you will initially have great trouble with distracting thoughts.  The normal person will think of a 100 different things besides your breath in a relatively short amount of time. But do NOT get frustrated with this.  It is natural and is part of the learning curve.  When you notice your mind off on a tangent, just gently bring it back to your breating (or whatever other object you decided to focus upon). You will get better as time goes on and may take weeks before you can focus consistently.  However, it is well worth the patience and effort. Also, you will notice that if you do 15 minutes of meditiation, your mind will slowly calm down and enjoy the peace and quiet after a few minutes. It will get easier and easier later in your meditation session.

One of the big advantages that I see with Concentration Meditation is its ability to quickly bring about a relaxation response.  With just a few weeks practice, you should be able to produce significant stress reduction after just a few minutes.  This is worth gold.

Here are a few other items that you may wonder about:

a) Posture. Forget about posture or whether you are sitting or standing or what position your hands are in.  All that matters is that you focus your mind.

b) Mudras.  Forget about finger and hand position.There is some interesting research that ties the standard “lotus” finger positions to brain activity, but this is for the advanced class.  You will get 90% of the benefit from just the above simple techniques.

NOTE:  Just to give you an idea how bad most meditational guides are, I remember one that was carefully giving directions on how to do meditational breathing.  Their advice?  “First in, then out.” Okay, I guess there are a couple of alternatives, such as non-stop exhaling, but, really, did we need that reminder?  How many of their students continuously inhale until they hyperventilate or pass out?  I doubt it’s very many…

Mindfulness Meditation

The apostle of Mindfulness Meditation here in the U.S. is a man named Jon Kabat-Zinn, an M.I.T. Ph. D. molecular biologist that left behind his original training to study meditation and its effects on the brain and body in an M.I.T.-based research center. He has authored many books and scientific papers on the subject and is considered one of the foremost experts on meditation in the world.  For those interested, some of his lectures are on YouTube and are enjoyable for their lucidity and unpretentiousness.

I find Mindfulness Meditation to be the easiest, but some say it is the opposite.  Regardless, it is packed with proven benefits to one’s health and well-being.  Here is all you have to do:

1.  Close Your Eyes.  Again, it’s not a requirement, but I recommend closing your eyes, especially when you are first learning this technique. However, you can engage in Mindfulness Meditation anywhere, even when you are on a stationary bike at the gym for example.  But start with your eyes shut.

2.  Be Aware (~33%). Sound like I’m giving Stranger Danger training to your kids? Well, Mindfulness Meditiation requires you to actually be aware of your environment and not try to tune it out as you do in large part with Concentration Meditation. The noise of air blowing through a vent, your son dropping his PS3 controller in the room above you or the neighbor talking outside are all to be “embraced” instead of dismissed.  However, this is the key:  you pay attention to these outside noises only briefly for a few seconds and then return to “being aware”.

3.  Stray Thoughts (~33%). One unique thing about Mindfulness Meditation is that it actually emphasizes the fact that you will have stray thoughts entering your brain as you meditate.  It’s part of being a stressed-out human in the 21st century, eh? However, rather than dwelling or analyzing or attaching emotion to these thoughts, you simply “look at them” and pass onto something else.

The power of this technique cannot be overestimated.  It takes several weeks to really be able to do it effectively, but, eventually, you learn to not react with dread or anxiety or panic at thoughts entering your brain.  I think Mindfulness Meditation is the most powerful technique to show you how to control repetitive and destrutive thought patterns.  Some day the light bulb just seems to go off and you realize, “Everything is going to be okay.  The world isn’t going to melt down if X happens.”

4.  Breathing (~33%). Mindfulness also encourages you to go back and listen to your breathing.  No intense concentration here.  The idea is that you let your mind gently go back between focus on your breathing, stray thoughts and sounds and stimuli around you. You are merely an “aware onlooker” and spend no more than a second or two on each.

This may sound like the most useless activity that you’ve heard of, but trust me:  Mindfulness Meditation produces big results.  If you stop to think about it, you end up building up the ability to, in a relaxed and focused way, deal with whatever crosses your path throughout the day.  And you learn to control your mind and thought patterns.  That is something that can help your health, your career and your relationships.

Mantra Meditation

Ever heard of Transcental Meditation? You probably have, but it is nothing more than an expensive and popularized version of one of the oldest meditational techniques on planet earth, Mantra Meditation. TM is a licensed, trademarked program that will set you back a few grand from what I have read.  Now this may seem like a bad thing to some – making money on something like meditation – but the truth is that it was very good to increase our understanding because it led to a slew of studies that greatly advanced our knowledge of meditation.  Mindfulness and TM Meditations have accumulated the greatest number of studies over the decades, both with great success.

So is taking a TM course worth it? My take on it is that it is analagous to hiring a personal trainer in the gym. In other words, if you need one-on-one attention and learn better with a tutor or mentor, then TM may be right for you. However, I should point out that some people claim that Transcental Meditation display many cult-like qualities and you can read some of them at Suggestibility.

Reall there is no reason not to just get started with the techniques below. It is VERY simple and easy to get powerful resuls almost right away and will cost you nothing but a little time each day:

1.  Choose a Mantra. TM practitioners receive a “special” mantra.  Now it is true that chanting of any sort likely stimulates the pituitary and hypothalamus which are very near the back of the throat.  However, I think it’s a real stretch to say that we have evidence that certain vowels or consonants produce differing results.  Even if that is true, I doubt that TM instructors have any idea what those sounds would be.  So pick short phrase of about three syllables, such as “Wah tah hey” and you’re done.  You want something that is easy to say, flows well and will produce a nice vibrational effect at the back of your throat.

2.  Say the Mantra. You knew I was going to say that?  Yes, you have to repeat the mantra and the key here is for it to slow, repetitive and monotonous – er, excuse me – soothing.  You want to say each syllable about every half second or second.  In other words, you want a pattern that will produce a relaxed, calming effect on the mind – no reggae beats here please.

3.  Return to the Mantra. If you are human, you will have stray thoughts.  As in concentration meditation, you simply return your mind, without stress or self-judgement, to repeating the mantra.

NOTE: You may not realize it, but you should really thank me for this simple three step procedure. I just read a 15 step procedure that included as step five: “Take bath in holy river.”

Mantra Meditation for some people will produce a relaxation response even more pronounced and rapid than standard Concentration Meditation.  One could argue, actually, that Mantra Meditation is actually just a subcategory of the Concentration anyway.  However, I see them as separate entities because of the powerful effect of chanting and sound upon the brain in many people.  So try all three techniques and see which one works best for you.  If you can, do about a half hour per day.

NOTE:  Some say that stimulating the pituitary through Mantra Meditation could in turn stimulate signaling to the testes and increased testosterone and androgen output.  As far as I know, this has not been verified by any studies however.

Why does meditation work so well?  Well, no one really knows the answer to that yet. It somewhat reminds me of laughter, which has incredible and poorly understood benefits, such as Increasing Growth Hormone. The bottom line is that meditation just plain works you’ll want to use its superpowers in your life while scientists take another decade or two to figure out its source of powers.

Now there are actually several kinds, such as Zen, (certain exercises in Kundalini Yoga and so called “loving kindness” meditation.  These all have value, but, again, the above three meditational techniques (Concentration, Mantra and Mindfulness) have heavy backing in the research and literally dozens and dozens of studies backing up their value.

Testopel: An Interview with a Reader - Peak Testosterone

It is important to note that this reader has had a very positive testosterone therapy experience and, of course, that is not universal:  there can be side effects. Nevertheless, I think many guys will find his comments and perspective helpful.

So why did you and your doctor choose testosterone pellets instead of some other standard methods of HRT such as gels or injections?

I was first placed on Testim which I read had better absorption rates than Androgel. I applied it faithfully each morning after my shower but my body didn t absorb the testosterone. My total testosterone levels after two months on Testim came back at 325 ng/dl. My urologist started me on ten pellets last December. He has since increased me to twelve pellets. There is very little doubt about testosterone absorption when placed on pellets.

You were hypogonadal, right? Can you describe which of your symptoms the pellets helped? And how long did it take before you started noticing a change?

Last summer I initially saw a urologist for prostatitis. He also checked my total testosterone levels which came back at 307 ng/dl. Was told that level was normal and placed on Cipro to cure the prostatitis. Subsequent measurements prior to getting the pellets were always in the ballpark of 325 ng/dl.

Depending on what levels the doctors use as a cut off which varies, I guess I am hypogonadal or considered to have lower testosterone levels.

About two weeks after my first pellet insertion I noticed I was waking up with fuller erections and was thinking about sex in the middle of the day (like I used to do). Sexual relations just naturally resumed with my wife as I now had it on my mind and I would wake up in the middle of the night or morning needing to have sex. It wasn t a disruptive urge, but an urge that for several months had basically vanished from my life. There are no guidelines out there that really tell one what is normal for a guy at fifty years old.

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

What sensations do you feel during the procedure?

I was nervous before the first insertion in anticipation of the unknown, but in retrospect it really is a piece of cake. I felt a slight sensation when my doc initially injects anesthesia in my buttocks, but after that there is absolutely no pain or discomfort.

How long did the prep work and procedure itself take in your case?

The prep work and procedure are done at my urologist s office and take no longer than ten minutes every three to four months.

Were you able to go back to work after the procedure? What is the downtime?

There is no downtime. I went back to work and resumed all normal activities immediately after. You can t go in a hot tub or sit in a bath for the first three days after the insertion. For me this isn t an issue.

So did you have any complications? What about bruising or bleeding?

There is minimal bleeding and steri-strips are used which are kept on the insertion site for the first week. For me, the day after the procedure was key as the anesthetic effects are gone there was minimal discomfort for a few days but never anything that I d consider painful. Believe me that would have been my first and last time for me had it been painful. There is bruising at the site for the first two weeks about the size of your clenched fist. It s on your buttocks and since there is minimal discomfort, for me it s not an issue.

I know you re a fan of the pellets. Can you explain why? Would you recommend them for most other guys?

Pellets work for me because you essentially forget that you have them for a three to four month span. That is tremendous. I didn t miss applying the gel on a daily basis or having it stick to my shirts or hearing my wife tell me that she didn t like the smell. I was also afraid of transferring the gel to my family so the shirt was always kept on and my hands were always washed thoroughly after each application. For me the daily application of the gel was a reminder that I have an issue. With the pellets you really do forget that you have an issue.

The best reason for me is that I feel like a man again. I m having sex between three and four times a week vs. one or two times a month. I m waking up with strong erections each morning even mornings after having sex the night before. My marriage has spice in it again and my wife and I are much happier.

I would definitely recommend pellets to other guys out there.

So do the implants get removed at a later time? How in the world does the doc find them?

The pellets are totally absorbed by your body so there is no need to remove them. You can feel them slightly with your fingers after they are inserted but you really have to be looking for them to find and feel them.

Have you had one of the implants work its way to the surface?

The pellets have never surfaced or come out. The insertion site has never become infected.

Can I ask if the pellets were covered by insurance? Or was only the office visit?

For me, the in-office procedure and the pellets are covered by my insurance carrier.

So I assume you ll continue with testosterone pellets?

Absolutely!

Any last words for the guys out there?

We all try to do what we think works best for us. For me, I performed my own due diligence and research on all forms of testosterone therapy along with their benefits and risks and became knowledgeable as possible so that I could best understand each treatment option. There is plenty of information out there. You just need to expend the time and energy to gather the information and assess your options.

Also, I went through a few doctors before I found my current doc. It s a matter of being comfortable with your doctor based on his/her credentials and how they treat me as a person. The docs do this sort of thing all of the time, but it was new to me and I needed a doc who truly cared about my needs and understood my issues, etc. For me this is very important.

Most important if you truly believe that you have a testosterone issue or any issue for that matter never give up your quest to help yourself. It may take you a bit of time to find what works best for you but with patience and perseverance you will get there.

Depression and Erectile Dysfunction - Peak Testosterone

If you’ve ever been around someone clinically depressed, it becomes painfully obvious how debilitating this condition is on friends, family and career.  But, what few people realized until recently, is the incredibly negative physical consequences that depression carries along with it.  Depression is definitely not all in someone’s head.

NOTE:  Read about some of the Not-So-Common Symptoms of Depression.

For example, researchers have long known that there is a connection between testosterone and depression. Men in the lowest 20% of free testosterone, after controlling for other common factors, were found to have three times the rate of depression. [9]  Depression stresses the body – as in a real, tangible stress reaction – and anything that stresses the body can lower testosterone.

Similarly, it is not too surprising to anyone that depression would lead to erectile dysfunction. One would expect to be less sexually stimulated if one was feeling down after all, right?  But actually there is a less obvious reason that depression leads so easily to erectile dysfunction:  depression is a major contributor to heart disease.  One recent study found that the reason for this was simply inactivity. [1] And that makes sense:  if you’re depressed, the last thing you feel like doing is going to the gym or out for a jog.  What does it matter, right? Other factors in that same study were also that the depressed were less likely to take their medications and also smoked twice as much.

So with depression directly leading to heart disease and undoubtedly lowering of libido and physical activity, no one has been suprised to find that depression leads to erectile dysfunction as well.  One excellent study surveyed men before and after a five year period, which allowed the researchers to examine causations.  They found that depression can cause erectile dysfunction and erectile dysfunction can cause depression, or is, in their own words, bidirectional. [2]

Even more astonishing is the fact that a previous study, the Massachusetts Male Aging Study [3], had discovered that the problem of either moderate or complete erectile dysfunction was nearly 90% versus 25% in the highest to lowest cohort of depressed patients.  A 90% rate of ANY condition is scary indeed.

I have to mention that depression is INCREDIBLY hard on the brain.  It literally destroys neurons and whack neurotransmitter levels.  How does it do this?  Around 50 percent of people with significant depression have elevated corisol levels and elevated cortisol levels literally shred the brain. [7] One study from Washington University School of Medicine that those who had been depresses at ANY time of their life had a 12-15% shrinkage in their hippocampus.  Again, depression destroys brain cells and must be dealt with.  On top of that, elevated cortisol levels increase the risk of getting diabetes which also accelerates aging throughout the body including the brain. (Some researchers have speculated that low testosterone often plays a role in depressed individuals developing diabetes. [8])  Because of this, it is absolutely critical to get any and all depression under control as soon as possible.

By the way, an item of interest is the question, “When in life does depression generally lead to erectile dysfunction?”  One study looked at this and found that, in general, this bridge occurred in the late 40s and early 50s. [4] In other words, the freight train of depression will usually result in erectile dysfunction during these two decades of middle age.

Because of the heavy consequences to your brain and body, I emphasize getting professional help for your depression.  I have also prepared a page that discusses Natural Cures for Depression. Depression can be complex and difficult to completely overcome, but I believe you or someone you care about will find considerable help from this link.

Antidepressants are also a common cause of erectile dysfunction for guys. However, there is one potential solution:  Gingko Biloba.  See my link on Gingko Biloba and Antidepressants if applicable.

REFERENCES:

1) JAMA, 2008, 300(20):2379-2388

2) J of Urol, 2007, 177(2):669-673

3) J of Urol, 1997, 15(1):54-61

4) Sex Med, May 2005, 2(3):390-396

5) J of clin Psychopharmacology, 2007, 27(1):62-66

6) Amer J of Psychiatry, Oct 2001, p.1623

7) Saving the Brain, Jeff Victoroff, 2003, p. 85.

8) Endocr Rev, Oct 1, 2005, 26(6): 833 – 876

9) Arch Gen Psychiatry, 2008, 65[3]:283-289

Female Libido and Exercise - Peak Testosterone

You’re going to have to trust me on this one:  if you can get your wife or girlfriend to start exercising, if she’s not of course, you will have a lioness in the bedroom.  Not only will her libido light up, but her strength and endurance as well.  In other words, you better be ready – you might get hurt, Big Boy!

Now why do I say that you’ll have to trust me on this one?  Because I cannot find a study to support that statement, but I do know it works. And I’ve read it on many sites as well:  exercise improves libido, decreases PMS and many other wondeful things for the fairer sex.  It also does all the same wonders that it does for guys that I have already documented in my Exercise link. Again, females are different that males – oo la la! – but the foundations of their libido is similar.  Almost always, what boosts your libido will also boost hers.

NOTE:  One of the not-so-well-known reasons that exercise may boost libido for women is that it affects their body self-image so significantly. It’s undoubtedly is the same with guys:  if you don’t feel good about yourself, your libido and bedroom performance can fade quickly.  For example, the womens magazine, Self, recently found that 71% of women who were happy with their looks worked out at least three times per week. [1] By the way, body self-image may also be tied into happiness:  61% of happy women say their body is ‘just right’ as well. [1]

So the question of a lot of guys, who already know the Power of Exercise, are asking is:

“How do I get my spouse exercising?”

That can be a tough question, admittedly, because many women were never in sports or their families didn’t take care of themselves or they feel overwhelmed with work and kids or they’re the “ultra-feminine” type or any number of other things. Never fear, though, because you can lure almost all females into some basic exercising through one of the following exercise methodologies that I list below.

An important point is that hopefully you’ve been modelling the fantastic things that exercise does for you.  With your spouse or girlfriend, or anyone you are close to for that matter, nothing speaks quite as loud as pure example.  People admire someone who is disciplined and who gets results and, if you haven’t already, use your own life to lay the foundation.

Some females don’t want to exercise, but they do want to lose weight and realize how it is all but impossible to lose weight without moving one’s booty at the same time.  Again, in your sweet and gentle way, you can occasionally bring up the advantages of Exercise and good, clean livin’.

Remember, guys:  this will be well worth your effort.  Of course, the important thing is that she’ll be healthier.  Hopefully, you guys are in it for the long haul and, of course, exercise is probably the #1 thing you can do to improve her health.  However, also keep in mind that exercise will likely decrease her PMS symptoms, improve her general mood, and boost her self-image as she loses weight and gains muscle. (We all know self-image is an all-important bedroom concept for both males and females.) And, yes, you will find that her libido will skyrocket as well.

Here are some great ideas that should get her moving if she’s not already:

1.  Yoga Classes. Many ignorant guys have said, “Yoga?  That ain’t exercise!”  Then the dull fellow tried one of the simpler moves and cried like a little girl.  Just one standard Yoga move will leave most guys quivering in pain and begging for mercy.  Seriously, most yoga instructors are lean, muscular and emphasize a healthy lifestyle, all of which will benefits your wife’s libido.  CAUTION:  Some yoga instructors lead students down a path of “overstretching” and injury.  Watch out for those “down dogs”!

2.  Pole Dancing. No, I’m not asking you to send your wife or girlfriend down a new career path.  I’m talking about her learning to pole dance either in an exercise class or in the privacy of your own home.  This ain’t for every girl, but a lot of females find this a fine form of exercise that is a complete strength and aerobic workout. You’ll have to check locally, but in a decent-sized city, there are usually pole dance classes that are both legitimate and popular. Alternatively, you can install a pole at home either permanently or non-fixed.  Of course, with the non-fixed variety, your woman can’t do those Cirque du Soleil moves that you were hoping for. Finally, if the female in your life does let you watch her pole dance, be sure to put your tongue back in your mouth!

2.  Gym Classes. You may enjoy weights and the treadmill, but have you noticed there’s more guys out on the floor than females.  The reason is simple:  most of the women are in taking classes.  These classes often emphasize things like dance and group participation that us muscle-bound hunks avoid like the swine flu.  When I play basketball, I barely notice that I am working and sweating like a pig because I’m having so much fun.  Well, these classes are the same thing for a good percentage of females out there. And, again, don’t give me a “that ain’t no exercise” excuse:  most of these classes are brutal and will leave you whimpering. Break out the card and sign her up!

3.  Dance.  If you enjoy dancing – I’ve seen pictures of people who do – sign the two of you up for dance classes.  Most dance is darn good exercise and will achieve the goal of blood flow and circulation.  Plus, a huge block of women out there enjoy dancing (assuming you don’t remove a toe nail off of her as I once did).  Remember:  not only will the exercise boost her libido, but you may find that you score a few additional points as well!

4.  Walking. Assuming a walk in your neighborhood doesn’t require packing heat or a Marine escort, there is no better way to burn calories.  Walking is steady and enjoyable.  In fact, why don’t you guys walk together sometimes.  A romantic walk coupled with your witty humor and thought-provoking insights could very well score even more points than #3.

5.  Exercise Videos.  Many women love this form of exercise.  They can buy a video of kickboxing, aerobics, dance, yoga or whatever they want and sweat and breathe heavy in the privacy of their own bedroom (where that sort of thing ought to be done).

6. Boot Camps. Boot camps are becoming increasingly popular, where women enroll in a gym or fitness program’s one or two hour program several days per week. Turning fat to muscle and burning lots of calories are usually the big goals.  Because these are done in a group and with good intensity, results can be very good.

7. Zumba.  Zumba is becoming very popular.  It is often taught in gyms and other fitness locations.  This is quite popular with some females as it is high energy and dance oriented.  Calories for many women are burned off without even noticing. It emphasized latin dancing and is designed to be relatively easy to learn and follow. A Google search can pull up a mountain of information including classes in your area.

8. The Dailey Method. The Dailey Method recently went national.and is quite popular as it combines ballet movements with core conditioning and stretching.

9. Trainer. For some people, a personal trainer is a huge asset, supplying a much needed dose of accountability and expertise. This is especially true for females with definite weight loss and other goals but limited time to research the best way to do it. Plus, just having to show up every few days and explain to someone what you have and haven’t done is a big motivator.

10. Cardio Tennis.  This is a natural for both women and men.  Tennis is one of those pleasurable sports where you don’t even notice you are getting a fantastic workout because it is so enjoyable. Even if you haven’t played, get yourself a few lessons and start playing.  Most decent-sized cities (in the U.S. at least) have organized Cardio Tennis.  You can expect a good dose of fat-burning, growth-hormone-producing intensity along with the standard workout paces.  See the Cardio Tennis Site for locations and details.

11. Weight Training. Many women really enjoy weight training once they learn that muscle burns fat. Women also greatly other women with “toned arms and shoulders” and want the same.  Females also have several advantages over us testosterone-laden males, including a shorter recovery time.  Sroll down to this link on  for some interesting details.  And this can be a nice way for you and her to do something mutually beneficial together, eh Pierre?

Again, if you can just get her started, everything will take care of itself.  She’ll start to get that endorphin high from the workouts.  She’ll look better, feel better, lose weight and many other things that will be highly appealing to women.  In fact, after she drops a dress size, she’ll be hooked.

Some of these can involve time and money.  Yes, you may have to watch the kids for her while she heads out to burn some calories and, yes, you may need to forego that compressor for a month or two so she can get a gym membership. It’s well worth it, though, and will pay off in almost every aspect of both her life and yours – yes, even in the sheets.

REFERENCES:

1) Self, 2/2010, p. 102.

Creatine: Building Muscle - Peak Testosterone

REFERENCES:

1)   The Journal of Physiology, Jun 2006, 573(2):525-534, “Creatine supplementation augments the increase in satellite cell and myonuclei number in human skeletal muscle induced by strength training”

2) EBS Lett, 2004 Jan 16, 557(1-3):243-7, “Creatine increases IGF-I and myogenic regulatory factor mRNA in C(2)C(12) cells”

3) Med Sci Sports Exerc. 2005 May, 37(5):731-6, “Increased IGF mRNA in human skeletal muscle after creatine supplementation”

4) Mol Nutr Food Res, 2009 Sep, 53(9):1187-204, “Creatine supplementation prevents the inhibition of myogenic differentiation in oxidatively injured C2C12 murine myoblasts”

5) https://www.brjb.com.br/files/brjb_128_4201012_id2.pdf, “Benefits of creatine supplementation in older adults”

6) Amino Acids, 2011 May, 40(5):1349-62, “Use of creatine in the elderly and evidence for effects on cognitive function in young and old”

7) Clinical Chemistry, 1989, 35(8), p.1802

8) Kidney International, 2003, 64:1331 1337; “Creatine supplementation decreases homocysteine in an animal model of uremia”

10) Behaviour, Appetite and Obesity, Received February 03 2010, “The influence of creatine supplementation on the cognitive functioning of vegetarians and omnivores”

11) Nutrition, 2004 Jul-Aug, 20(7-8):696-703, “Nutritional considerations for vegetarian athletes”

12) Int J Sport Nutr Exerc Metab, 2002 Sep, 12(3):336-48, “Effect of creatine supplementation and a lacto-ovo-vegetarian diet on muscle creatine concentration”

The advantages of plant-based eating are many and include everything from improved mortality rates to potentially short term and long term testosterone. (See my link on Plant-Based Nutrition and Vegetarians and Testosterone for some basic information.) I also eat a plant-based diet, because it the foundation of what I call Orgasmatarianism, eating to maximize nitric oxide and erectile strength and minimizing the chance for future erectile dysfunction.

NOTE: I actually do eat a little meat, which is why I actually prefer the label plant-based.  My own dietary regimen includes the consumption of abundant egg whites along with some undenatured whey – what I call the Whey of Life – and nonfat milk.

Eating plant-based has really helped me and I would never go back, but I do have to admit something:  there are some nutrients that are predominantly in meats and animal products that have incredible advantages.  Examples of this are Vitamin B12, Choline and the subject of this page:  creatine.

Many men, especially those involved in sports or bodybuilding, have heard of some of the common advantages of creatine.  I would like to quickly cover some of these that, although well-covered in the popular health press, many men may not have heard of them:

CAUTION: Creatine has a lot of nice properties, but may put some men at risk. For example, did you know that one study says creatine raises DHT levels and may put some men at risk who have kidney issues? For more information, see my link on Potential Creatine Dangers.

1. Satellite Cells. One of the most important things you can do for your long term health is maintain your muscle mass over the decades. And, actually, most men will slowly lose muscle mass over the years from poor diet, loss of testosterone and a sedentary lifestyle. To build (and repair) muscle, you need a certain kind of specialized cell called “satellite cells”.  Testosterone, the amino acid leucine – present in Branched Chain Amino Acids and whey – and IGF-1 are all well-known to the bodybuilding and athletic communities.  And all three of these have part of their reputation based on the fact that they increase muscle satellite cell counts.

However, it’s not just these big boys that will increase satellite cells:  creatine has been shown in a few animal and human studies to do the same thing. [1]  Again, this is absolutely critical for “hypertrophy” or “muscle-building.”

2.  IGF-1.  Everyone has heard of testosterone, but IGF-1 is another hormone absolutely critical for muscle growth and development.  IGF-1 and Growth Hormone often go hand-in-hand and have many important properties for maintaining a youthful physique. This is where creatine comes in again:  it increases the activity of muscle IGF-1 according to both in vitro and in vivo studies. [2][3]

3.  Muscle Oxidation. Weight lifting and strength training can put a significant oxidative (free radical) load on the body.  And is it any wonder consider that cells are damaged and must be rebuilt?  It turns out that creatine actually is highly protective of muscle tissue by increasing oxidative protection. Researchers have discovered that it does this not only by acting as an antioxidant but by stimulating other metabolic antioxidant activities. [4]

Furthermore, the benefits of creatine supplementation probably increase as you age.  The reason is probably most that muscle mass is so cardioprotective as the years go by.  As mentioned, most men (and women) slowly lose muscle – about 10 pounds per decade! – and replace it with fat.  Let’s say that you are one of the few that still weight the same as you do in college.  You may be feeling good about yourself not realizing that you have probably lost at least 10 pounds of muscle and replaced it with 10 pounds of fat (unless you are a pretty avid exerciser).

Studies on seniors and the elderly have found one benefit after another from creatine supplementation:  muscle building, increased strength, increased fat free mass and so on. [5] However, one very interesting benefit is improved cognition. One study on seniors found this from dosages of “about 20 g/day for 5 days or about 2 g/day for 30 days.” [6]

These benefits to both young and old are actually remarkable when you consider that there is considerable creatine in meat and most people in modern societies eat a lot of meat. However, to even get a 5 gram dose of creatine would require one to eat 2.5 pounds of raw beef as cooking the beef removes most of the creatine. Fish has more creatine per unit weight, but, again, cooking removes most of it.

Regardless, carnivores have higher muscle creatine levels on average than vegetarians, because, even after cooking, their dietary consumption of creatine is much higher.  For this reason, one study that compared vegetarians to carnivores found on average that meat-eaters had about 60% higher plasma creatine levels for example. [7]

NOTE:  One nice benefit of creatine supplement is that it likely lowers homocysteine levels in some populations, at least according to some animal studies. [8]

And this leads to an important question that researchers decided to study:  would vegetarians actually get the most benefit from creatine supplementation, since they tend to get the least amount in their diet? The studies have been somewhat limited, but, so far, the results seem to show that vegetarians would definitely benefit in certain key areas from additional supplemental creatine.  Here are a few examples from the research:

1. Cognition.  Two studies now have shown that creatine supplementation significantly helps the brain. It all started with a study of male and female vegetarians that showed improvements in both working memory and intelligence from creatine supplementation. [9] A follow-up study on female vegetarians found that they signficantly improved memory (and choice reaction time in certain ways). [9] Again, most men think of creatine as helping muscles only, but it profoundly improves mitochodrial function and that, in turn, help the brain and all its heavy processing activities.

2.  Exercise Performance. There is evidence that lower creatine levels affect max level exercise performance and that vegetarians would benefit from supplementation. [11]

3.  Muscle Benefits.  Vegetarians should get all the muscle benefits of omnivores, because with creatine supplementation, their muscle creatine levels quickly equal that of meat-eaters.  This is because muscle can only store so much creatine anyway, so supplementation quickly “levels the playing field”.  So, if you’re plant-based or vegetarian, get ready to “rock” with creatine.

4.  Lowering Post-Exercise Inflammation. Creatine does a nice job of lowering both TNF alpha and CRP (C-Reactive Protein) according to one recent study. See #21 on my page on How to Lower Inflammation for more details.

CAUTION: Creatine was fairly recently studied by Brazilian scientists, who monitored kidney function in young men who consumed higher dosages (10 grams/day) of creatine for about 90 days.  Their conclusion?  Creatine caused absolutely no issues in kideny function.  However, a little more caution is definitely in order, perhaps, for middle-aged and beyond men with kidney issues.  It is probably wise to drink some extra water when consuming creatine and, of course, talk to your doctor as there have been reports of men with kidney issues having trouble with creatine.

9) Proc. R. Soc. Lond. B, Oct 2003, 270(1529):2147-2150, “Oral creatine monohydrate supplementation improves brain performance: a double blind, placebo controlled, cross over trial”

Can You Go Natural? - Peak Testosterone

Increase Testosterone

STEP 6B:  Examine other alternative ways to raise your testosterone 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.

40+ Ways to Increase and Protect Your Testosterone

Anti-Juice sentiment - Peak Testosterone

There is a lot of anti-juice sentiment currently.  These opinions are mostly enunciated by followers of Paleo and Low Carb Diets.  Of course, individuals on such diets dislike carbs in general and, not too surprisingly, find the most evil of carbs to be fructose. And what has more fructose than fruit juice, eh?  (For more information on the potential problems with overconsumption of fructose, see my links on https://www.peaktestosterone.com/ and How Fructose Sabotages Weight Loss.)

Now the anti-juice folks probably do have a good point:  clearly you should not over-consume juice.  As you may have read in my link on How Much Fructose is Safe?, most experts do not recomment more than about 50 grams of fructose per day. This is well over what one would normally get from even two 8 oz. glasses of most juices.

REFERENCES:

1)  https://www.askmen.com/sports/foodcourt_400/447_fruit-fat.html

2) BioFactors, Volume 37(2):121 130, March/April 2011, “Iron chelation by cranberry juice and its impact on Escherichia coli growth”

However, Tim Ferriss, a well-known time management author and Paleo diet advocate, recently articulated other concerns about juice in a post on AskMen at even lower consumption levels. [1] His contention was that when he consumed 12 ounces of orange juice per day, his cholesterol, iron and albumin levels increased significantly. Is this possible? Of course, and some of these effects are seen in those who consume large amounts of table sugar (which is half fructose).

Unfortunately, there are a couple of big problems with this and other similar articles. First of all, Tim Ferriss’ “study” is not controlled and has a sample size of 1.  Beyond that, he just happend to pick one of the three most common sweet juices sold on shelves today, the others being apple and grape juice. All of these juices have admirable properties – apple on memory and orange and grape juice on blood pressure – but with the pulp, fiber and flavonoids removed, they are of debatable value and can be potentially harmful if overconsumed.  Even common sense tells asks, “Why consume a lot of sugary juice when I could just eat an orange or apple instead?”

Does this mean, though, that all juices will produce the negative effects that Tim Ferris talks about?  Certainly not!  First of all, some juices have much lower levels of sugar.  8 oz of orange juice has 28-32 grams of sugar, where juices such as cranberry and/or beetroot juice have only 10-14 grams.

Most importantly, not all fruits are created equal.  Pomegranate Juice, as I document in my link, is incredibly powerful and will actually do the opposite of what Tim Ferriss described according to the studies:  it will lower cholesterol and blood pressure and increase nitric oxide while its at it.  It is so powerful that it will even clean out arteries in some men and improve erectile dysfunction.  Read my link on https://www.peaktestosterone.com/pomegranate for more information.

Furthermore, cranberry juice is known for its iron chelation powers. [2] Yes, that’s right – cranberry juice will actually remove iron from your system and so much that, in the above study, it can be used as a partial treatment to inhibit E. Coli growth. So one simply cannot generalize about all juices.  (Cranberry is also low in fructose and boosts nitric oxide and protects against overgrowth of many bacteria!)

Again, Pomegranate Juice is another example of a juice that should be a bad boy, but is anything but.  Although seemingly quite sweet – it has 32 grams of sugars per 8 ounces – it lowers blood pressure, boosts nitric oxide and so on.  So, by assuming that all fruit juice will cause problems, is a generalization that simply does not always apply. Many guys struggling with arteriosclerosis and erectile strength issues may be missing one of their strongest allies with this kind of thinking.

Cranberry is no less impressive and actually raises good cholesterol (HDL) according to a couple of studies – see my link on How to Raise HDL for more details.  Even more significant is the fact that it combats the TNF-alpha inflammatory response.  Anyone who ignores cranberries’ superpowers, especially with its low sugar count, is being short-sighted at best. (See my link on https://www.peaktestosterone.com/.)

Pomegranate and cranberry juice also likely protect against prostate and stomach cancer, respectively, as well.  So be cautious about the recent anti-juice atmosphere that currently prevails:  you may be missing out on some of nature’s most powerful foods.

The Most Common and Most Powerful Erection Killer.

Why are Viagra and Cialis such powerful cures for erectile dysfunction?  The answer is simple:  they affect the arteries.  The problem is that Viagra and Cialis often do not work.  There can be a number of reasons for this, but the most common is that some men simply do not produce enough basline nitric oxide (NO). Viagra and Cialis work on preserving cGMP, a molecule triggered by NO.  I cover this in my page on  Viagra Failure for example.

1) https://peaktestosterone.com/forum/index.php?topic=2858.0

2) J Urol, 2005 Feb, 173(2):526-9, “Intima-media thickening of common carotid arteries is a risk factor for severe erectile dysfunction in men with vascular risk factors but no clinical evidence of atherosclerosis.”

3) J Urol, 1994 Jan,151(1):54-61, “Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study”

4) J Endovasc Ther, 2008 Feb, 15(1): 117 125, “Angiography Underestimates Peripheral Atherosclerosis: Lumenography Revisited”

5)  https://www.medscape.com/viewarticle/709967 , Shelley Wood, Oct 05 2009, “Drug-Eluting Stents for Erectile Dysfunction”

6) International Journal of Impotence Research, 2005, 17:523 526, “The relationship between lipid profile and erectile dysfunction”

7) Diabetes Care May 2005 vol. 28 no. 5 1201-1203, “High Proportions of Erectile Dysfunction in Men With the Metabolic Syndrome”

8) 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”

9) Hypertension, 1996, 28: 859-862, “Erectile Dysfunction in Hypertensive Subjects”

Now stop and ask yourself an all-important question:  why would a man not have enough baseline nitric oxide?  The answer is usually atherosclerosis, the buildup of arterial plaque. When the lining of your arteries, the endothelium, is covered with plaque, how is nitric oxide supposed to be released in youthful quantities?  It doesn’t!  Atherosclerosis in your penile arteries is going to decrease nitric oxide levels and slowly decrease your hardness factor.  In addition, the plaque buildup can make arteries less flexible, which is so important for improved blood flow.   The bottom line is that, for most men at least, the best, most efficient way to improve bedroom performance is to focus on reducing arterial plaque and other natural techniques for improving blood flow and nitric oxide.  Of course, the big problem is that the Western lifestyle is incredibly hard on your arteries. In fact, it’s really hard to imagine designing a way of living that would be worse.  (Yes, hormones are VERY important to erections.  But, in my opinion, nitric oxide and arterial health are kings.)

NOTE:  This is a vicious circle, because nitric oxide helps protect against arterial plaque through it’s anti-inflammatory properties, i.e. plaque lowers nitric oxide and lower nitric oxide increases plaque.

DO I HAVE PROOF?  I know that many men are skeptical that arterial plaque could be a root cause of troubles in the bedroom, so let me offer Four Reasons to Believe Arterial Plaque Usually Causes Erectile Dysfunction::

1. The Pudendal Artery Study.  Ever heard of the pudendal artery?  Neither had I.  It turns out it is the most important artery in the body, because it is the one that supplies blood to the penis in the pelvic region. Researchers recently performaned angiograms (to estimate arterial plaque) [4] of the heart and pudendal arteries of men who were not responding to PDE5 inhibitors such as Viagra and Cialis.  What they found was direct evidence that atherosclerosis was responsible for their severe erectile dysfunction:

“Rogers and colleagues have already completed a pilot study, called the Pelvic Angiography in Non-Responders to PDE-5 Inhibitors (PANPI), which correlated angiographic evidence of coronary disease with pudendal arterial disease. In PANPI, 10 patients undergoing coronary angiography for CAD symptoms who also reported a poor response to PDE-5 inhibitors underwent a pelvic angiogram as well. Results showed that stenosis [narrowing] in the coronary arteries typically mirrored that of the pudendal artery, which ranged from a mean of 52% in the right internal pudendal artery to 60% in the left. We basically found a 100% correlation” between coronary artery disease and pudendal artery disease…” [5]

Just to make sure this is clear, they found that plaque in the cardiac arteries, which is what can kill you from a heart attack, was strongly associated with plaque in the artery that supplies blood to the penis, which can kill your sex life.  The authors gave some other profound statistics:

—4 out of 5 cases of erectile dysfuncton have to do with the arteries.

—70% of men with heart disease (significant arterial plaque) also have erectile dysfunction.

Often men are focused on hormones.  Why?  Because that is easier in many ways.  If your testosterone is low, you can simply take testosterone, Clomid or HCG for example.  However, it is non-trivial to reverse arterial plaque.  It usually requires weight loss, careful attention to diet, and possibly a couple of supplements, something I cover in my pages on Penile Arterial Plaque Regression.  It also takes time – months and months or even a few years depending..

2. The Connection of IMT to Erectile Dysfunction. Younger men in particular can boost their testosterone or perhaps lower their estradiol and get back in the game.  But, if plaque is building up in their arteries, they are simply delaying the inevitable. Look at what this man wrote on The Peak Testosterone Forum:

“I agree peak my problem probably is not testostorone. But I have been extremely active and fit over the last 4 years and have been trying even harder.  Could i still have atherosclerosis?  I have lost weight over the last 6 months from 102 kg to 85kg and in the best of shape.  I know sometimes even fit athletes have atherosclerosis too.” [1]

The answer to his question is ‘yes’, he could very likely have atherosclerosi,s especially since he has E.D.  Studies show that about half of young men in their 20’s have significant plaque.  I have a number of pages on the subject and those interested may want to read my page on How to Clear Your Arteries.

One study showed the erection-to-arteriosclerosis connection particularly well.  It looked specificially at the association by examining men with erectile dysfunction but not clinical atherosclerosis (which probably means clinical loss of blood flow to the extremities or the heart). [2] Basically, they were looking at men in the earlier stages of erectile dysfunction.

What they found was that when their IMT (intima-media thickness) was examined – IMT is a measure of the amount of plaque in the neck artery – there was a significant correlation to the amount of erectile issues the men were experiencing.  Typically, IMT measurements are done by ultrasound and on the large arteries that go up your neck and they are a reasonably good gauge of the plaque buildup in your extremities, such as the arms, legs and penis.

“Men with VRFs (vascular risk factors) and a high carotid IMT score demonstrated more severe ED, were older and had a higher serum level of C-reactive protein compared to men with VRFs and an IMT of less than 1.00 mm.”

“A high IMT score but not an increased measure for each VRF, including aging, significantly increased the risk of severe ED (odds ratio 2.6, confidence interval 1.1 to 5.9) even after controlling for smoking and drugs associated with ED.”

In other words, men with significant cardiovascular risk factors and arteriosclerosis had the worst erectile dysfunction. Is this any surprise?  Basically, the link between arterial health and E.D. was verified by the fact that  1) as atherosclerosis increased, erectile dysfunction rose and 2) as cardiovascular risk factors increased, erecitle dysfunction increased (in many circumstances).

NOTE:  They also found that high inflammation, i.e. a high CRP score, was associated with most severe erectile dysfunction (as well as general aging).  Inflammation plays an important role in the buildup of arterial plaque and you can help protect yourself by scanning through my Lowering Inflammation 101 pages.

3. Risk Factors for Heart Disease are Risk Factors for Erectile Dysfunction. If heart disease really is the general root cause of erectile dysfunction, then one would expect that the risk factors for heart disease would also be risk factors for erectile dysfunction.  This is indeed the case for almost all the major players.  Here are just a few examples:

a) CRP (Inflammation).  Researchers split men with no and severe erectile dysfunction into two study cohorts.  What they found was that the men with severe E.D. has over four times the CRP levels of the men with no E.D. They also estimated the plaque in the penile arteries using ultrasound and found that “CRP levels correlate significantly with increasing severity of penile vascular disease as measured by penile Doppler.” [8]

b) Prediabetes (Metabolic Syndrome).  Men with prediabetes had double the risk of erectile dysfunction when compared with age and BMI-matched controls. [7]

c) High LDL and Cholesterol. I know that some men will point out correctly that LDL-P is a better predictor of heart disease than LDL-C, the “regular” LDL, and total cholesterol, something I discuss at length on my site.  However, the fact is that most men with high “regular” LDL or cholesterol will also have high LDL-P and that is the point of this study tthat found that their “results showed that there was a significant difference between mean plasma cholesterol and LDL levels in the individuals suffering from ED and the control group.” [6]

d) Smoking. Smoking, interestingly enough, slightly increases testosterone usually and so it should be good for erections, right?  Wrong!  Smoking is incredibly hard on the lining of the arteries and a big risk factor for heart disease.  And, as expected, it is a also a risk factor for erectile dysfunction according to a number of studies. For example, the well-known Massachusetts Male Aging Study found that “Cigarette smoking was associated with a greater probability of complete impotence in men with heart disease and hypertension.” [3] In other words, cigarrette smoking is great way to accelerate a complete loss of erections!

e) Apnea.  Another example is apnea.  While it is true that apnea lowers testosterone somewhat – see my link on Apnea and Testosterone – the usual drop is “only” about 30%. Most men can lose 30% of their testosterone and not suffer erectile dysfunction. However, apnea has an even more sinister side, because it causes the release of a peptide..

NOTE: Again, I am NOT saying that hormones are not important.  Testosterone now has several solid studies behind it showing that, in most men anyway, TRT can improve cardiovascular disease and, of course, it can also improve erections.  See my page on Testosterone and Heart Disease for a more complete discussion. (I personally believe that a small percentage of men may be at risk, something I discuss in my page on The Potential Risks of Testosterone Replacement Therapy. Also, there is a very interesting study out there that shows men with hypertension has little increased risk of erectile dysfunction when controlled for testosterone. [9] Keep in mind, though, that this is an older study and a lot of other research shows high blood pressure is associated with E.D.

4.  Erectile Dysfunction Predicts Heart Attacks. Suppose just for a minute that erectile dysfunction is a sign of failing arterial health as the above suggests.  If this was true, then we would expect that erectile dysfunction would actually be a valid cardiovascular risk factor.  And researchers have found that this is exactly the case.  In fact, erectile dysfunction is such a powerful predictor that one study found that men had, on average, about five years after developing E.D. before the occurrence of a cardiovascular event such as an M.I. (heart attack), etc.!

This means that, generally speaking, if you have developed erectile dysfunction, you have five years to fix the problem or it could be game over around five years later.  Fortunately, this also gives you time to change course and take care of the underlying cardiovasclar issues.  For the studies that support this, see my page on The Dangers of Erectile Dysfunction.

REFERENCES:

An Easy Nitric Oxide Boost! - Peak Testosterone

Looking for an easy way to boost your nitric oxide that is both cheap and measurable? Just eat nitrates!  (Always talk to your physician if you are on any medications or have a medical condition.) Nitrates are in abundance in arugula lettuce, spinach, iceberg lettuce, celery, carrots and beets.  In my opinion, this is an incredibly powerful option, especially when combined with citrulline. (It should also work very well in those of you that are on a low dosage of any of the PDE5 inhibitors such as Cialis or Viagra.)  Furthermore, I argue that this is part of what every guy over about 35 should consider, because his native nitric oxide levels are likely so decreased as I describe in my link on Nitric Oxide Replacement Therapy.

Now you may be thinking that eating a bunch of greens is a lame solution.  And, to be honest, I had my doubts. However, I have proven to myself that this is rocket fuel for your cardiovascular and erectile systems with a recent experiment – one that you can do yourself.  Here is what I did:

Day 1. (2/12/2014)

11:34 a.m.  Tested myself with the Berkeley Nitric Oxide Test Strips and found that I was sitting a little below the 2nd most depleted level – “Low” per the instructions.  I have to admit that, while I didn’t have E.D., my erectile strength was not where it should be and I was taking my 2.5 mg of Cialis daily.

4 p.m. to 6 p.m.  Ate lots of arugula lettuce and carrots.  Took 1 gram of citrulline.

8:30 p.m.  Retested with the test strips and had moved up one level to “Threshold”, which is the 3rd (middle) of five possible levels.

So this proved to me that consuming food sources of nitrates could make a difference and help me boost my nitric oxide levels.  However, a question nagged the back of my mind: could I actually regain youthful nitric oxide levels? Sure, it is nice to experience any improvement, but I wanted to get my levels to where a I was, say, 20 years ago.

Day 2. (2/13/2014)

8 a.m. to 2 p.m. This lead to an experiment where I ate nearly a whole bag of arugula lettuce. Arugula is probably higher in nitrates than even beets and spinach and so I put it to the test.  I also added in carrots, spinach and some celery in a steady stream of nitrate-containing foods throughout the day.

4 p.m.  The results were incredible.  (I also included Citrulline.) I could literally feel my ears burning from the fantastic circulation.  My hands felt warm. (I’m one of those “cold hands, warm heart guys.”)

5 p.m.  I re-tested with the test strips and – finally! – I was at “Target,” the second highest level and I may have even been above it a bit.  Why did I keep going higher even though I did not really eat more nitrates? I believe that the answer may go back to this idea: the first nitrates that you eat just go to satisfying your body’s basic needs.  However, you need to go past the filling up point and even pass the saturation point to see results that last over a few hours.

Days 3 and 4.

The next couple of days I tried the same pattern:  eating at least a half bag of arugula and 3 grams of Citrulline spread throughout the day, plus an abundance of carrots, spinach and celery as well.  And each time that I tested myself, I found that I was at Target. Furthermore, morning erections were unusually strong.

Another side benefit:  I found my libido increased significantly and feelings came back from many years ago.  My theory is that as your nitric oxide (and/or testosterone) decline, general brain function declines and you lose the ability to feel and experience life as you did in your youth.  This took me a step back in time. No, I didn’t feel 16, but I felt much better. Also, I occasionally have prehypertension due – I am pretty sure – to overwork, stress and lack of sleep depending on the day.  (Two jobs, three kids, the gym and an attractive wife – these all take time!) The nitrates dropped by blood pressure below 120/80 – nice!

Again, the nitrates appear to be supplying a nice baseline level of nitric oxide that my arteries no longer produce due to aging and injury.  (I do have Clear Cardiac Arteries per a heart scan. However, I believe I had some atherosclerosis before going on a Low Fat Diet and clearing out some plaque.)  The beauty of this is that it should give the Cialis something to work on.  Viagra and Cialis do not work very well in men who have low levels of baseline nitric oxide.  PDE5 inhibitors basically “extend the half life” of the enzyme involved, but what good does that do if there is little to no nitric oxide in the first place?  Thus, nitrates will probably work very well when paired up with other proven erectile dysfunction supplements/foods, such as Pomegranate Juice and/or Pycnogenol. (I need to confirm this theory with a researcher.)

UPDATE: My baseline nitric oxide levels are now at Threshold first thing in the morning!  Berkeley test recommends testing your baseline nitric oxide levels first thing in the morning as the “acid test” of your nitric oxide status.  And, when I have tested myself in the past, I have always registered Low or Depleted, so this is a big change for me. My libido is up; I am longer getting dry hands; morning erections are strong; and, most importantly, I woke up with 120/80 blood pressure.  This is making a huge difference.

But keep in mind that I am eating probably 3/4ths of a Trader Joe’s bag of arugula; a half bag of spinach and lots of baby carrots and celery.  Yeah, it’s a little cow like, but I don’t know about you – I’d eat half of a sandbag to improve my erectile strength! This isn’t so bad…

CAUTION: Be careful in combining multiple erectile strategies:  priapism is rare but can occur. If you have an erection that lasts over 2 hours, go immediately to an emergency room.  See my post on The Causes of Priapism.

ORGANIC: I recommend that you eat organic if at all possible. Most men feel indestructible, but some of what they spray on food is pretty nasty.  Examples are in my link on Testosterone and Pesticides. Trader Joe’s has very reasonably priced organic produce – better than any other store from what I have seen.

MY NEXT GOAL:  Of course, it’s nice to feel better and have a little better bedroom prowess, but, practically speaking I hope to use this to further lower my Cialis dosage.  I’d like to get down to just 1.0 gram per day and maybe even get off it entirely.

Nitric Oxide Boosting Protocol

CAUTIONS? Are there are any additional cautions with this plan?  Well, nitrates can combine with amine foods and create nitrosamines, which are potentially carcinogenic foods.  However, I personally do not buy into this. Example: spinach has both high amines and nitrates and thus should cause cancer.  However, there is no evidence for this at all – in fact, quite the opposite. However, you should do your own research and ask your doc his/her opinion.

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:

High Estradiol? It Can Accelerate Prostate Cancer and BPH - PT

Do you have high estradiol? Consider the evidence that it can make (or perhaps even fuel) prostate cancer and/or BPH (enlarged prostate):

I occasionally get some criticism for insisting that high estradiol levels are as potentially dangerous for men as low.  I also have seen many men on The Peak Testosterone Forum whose doctors have told them that high estradiol levels were actually protective. I could not disagree with this more for many reasons, especially the fact that it accelerates arterial plaque according to a number of studies.  Considering that heart disease is the #1 killer of men, it should be obvious in my opinion that high estradiol is not a good idea for the great majority of men.  You can read more about it here: Estradiol and Arterial Plaque.

However, there are a number of other great reasons to avoid high estradiol and a couple of them have to do with the prostate.  Below I will present evidence that high estradiol levels often the most significant prostate problems, including cancer and BPH:

1) Estradiol Likely Fuels Prostate Cancer. Some researchers have long protested the idea that testosterone is the primary culprit in prostate cancer.  They have noted that prostate cancer risk increases in one’s middle and senior years, right when testosterone is generally decreasing and estradiol is generally rising: [6]

“Paradoxically, the incidence of prostate disease increases with age when serum androgen levels are in decline and emerging evidence suggests that estrogens may also be important in the normal prostate, as well as in the etiology of prostate disease. Both estrogen receptor subtypes are present in the prostate, demonstrating that the gland responds directly to estrogens. Recent data suggests that estrogens play a role in prostate disease and has demonstrated that high doses of estrogens induce premalignant dysplasia and in combination with high doses of androgens, malignancy. “

Studies, however, have been somewhat mixed with regards to showing estradiol playing a role in prostate cancer development, that is until it was noticed that testosterone deprivation therapy resulted in GREATER incidence of aggressive, advanced prostate cancers.  In other words, something else was fueling the nastiest kind of prostate cancer when testosterone was taken out of the way:

“In recent years, there has been an increasing focus on chemoprevention with agents such as finasteride being employed to reduce the risk of developing CaP [prostate cancer]. Significantly, such chemoprevention strategies are also based on 5alpha-reductase inhibition thus reducing intraprostatic dihydrotestosterone levels. Although there may be an overall reduction in CaP incidence in cohorts using such chemoprevention, in a subset of users who do develop this pathology there results a more aggressive, higher-grade disease. There have also been suggestions regarding the protective role of androgens against high-grade CaP [prostate cancer]. This leads to the intriguing notion that 17beta-oestradiol (E2) may be an initiating driver of CaP; in fact, in old studies in which CaP [prostate cancer] was induced in rodents, E2 often accelerated the effect of the carcinogen.” [7]

Potentially this means that the cure may be worse than the disease in some men.  A 2015 study attempted to look into this issue further and found the following:

[8]

Of course, PSA is not the perfect measurement of prostate cancer as many of us know.  Nevertheless, the results above seem reasonably clear and at the same time counterintuitive:  estradiol seems to be tied to prostate cancer and testosterone actually protective if anything! (Discuss with your doctor:  that’s their job is to explain research like this to you and correlate it to their actual practice.)

NOTE:  See my pages on The Testosterone-to-Estrogen (Estradiol specifically) Ratio and my https://www.peaktestosterone.com/ for more information. I would also encourage you to read Dr. Morgentaler’s stellar research summary on the subject, where he explains that testosterone does fuel cancer but only near castrate levels:  https://www.lifeextension.com/magazine/2008/12/destroying-the-myth-about-testosterone-replacement-prostate-cancer. [5] (Again, talk to your urologist if you have existing prostate cancer.)

2) Enlarged Prostate (BPH or Benign Prostatic Hyperplasia). An enlarged prostate can bite men of almost any age but by the senior years, the great majority of senior men will struggle with it.  One research summary noted that “the histologic prevalence of BPH, which has been examined in several autopsy studies around the world, is approximately 10% for men in their 30s, 20% for men in their 40s, reaches 50% to 60% for men in their 60s, and is 80% to 90% for men in their 70s and 80s.” [4]

And just about everyone knows that DHT plays the primary role in any growth in the prostate, during puberty, during HRT (if applicable) and middle age. For example, “studies demonstrate that across a wide spectrum of racial and ethnic groups, prostate size increases from 25 g to 30 g for men in their 40s to 30 g to 40 g for men in their 50s and to 35 g to 45 g for men in their 60s. At the same time, the transition zone of the prostate, which is quite small at approximately 15 g in men in their 40s, increases to approximately 25 g for men in their 60s and 70s.” [4]

But is DHT really the only culprit?  As it turns out, there is a growing body of research that estradiol plays a significant role as well.  For example, one recent research summary wrote that “However, BPH is a multifactorial disease and not all men respond well to currently available treatments, suggesting factors other than androgens are involved. Testosterone, the primary circulating androgen in men, can also be metabolized via CYP19/aromatase into the potent estrogen, estradiol-17ß. The prostate is an estrogen target tissue and estrogens directly and indirectly affect growth and differentiation of prostate.” [1] Researchers have even found the possible mechanism of action by which estradiol induces BPH. [2]

This still has, as of yet, to be directly tested in humans.  However, it has been verifed in dogs where prostate growth was found to increase prostate volume in a dose dependent fashion. [3] Furthermore, this was done in the absence of androgens (DHT, testosterone, etc.) as the animals had been castrated. This study, though, was rather clear: they lowered testosterone down to the minimum and then gave the animals estradiol. The more estradiol they gave, the bigger the prostate. Again, higher estradiol levels are just hard on the prostate and likely a culprit in many issues for men.   I remember getting chewed out by a member on  The Peak Testosterone Forum for suggesting that estradiol could cause prostate growth. I didn’t say much, because this poor guy had struggled with BPH and other medical issues.

CONCLUSION:  There is a very good chance that high estradiol is very hard on the prostate and potentially dangerous for men.  Hopefully, more study work will be done to determine just what a “high estradiol” level may be.  (Considerable individual variation does occur however.)  What can you do to lower estradiol?  Of course, the number one thing is to lose weight.  Fat cells store aromatase, the enzyme that converts testosterone into estradiol.  So the more body fat you carry, the most aromatase and the higher your estradiol levels tend to be.  (It’s actually a bit more complicated that that and you can read the discussion in my page on Testosterone and Weight Loss.

So I encourage you to drop the pounds.  I like Clarence Bass’ approach and how he encourages men to drop their body fat percentage below 15%.  He personally kept his body fat year round well below 10 percent and had considerable muscle mass as well.  See my pages on Challenge Yourself (Clarence Bass) and An Interview with Clarence Bass on Bodybuilding and Losing Weight.

REFERENCES:

1) Differentiation. 2011 Nov-Dec;82(4-5):184-99, “Androgens and estrogens in benign prostatic hyperplasia: past, present and future”

2) Toxicol Appl Pharmacol, 1996 Feb, 136(2):211-9, “Possible mechanism of induction of benign prostatic hyperplasia by estradiol and dihydrotestosterone in dogs”

3) The Prostate (Impact Factor: 3.57), 44(1):8-18. “Estradiol causes a dose-dependent stimulation of prostate growth in castrated beagle dogs.”

4) Rev Urol. 2005, 7(Suppl 9): S3–S14., “Benign Prostatic Hyperplasia: An Overview”

5) Life Extension Magazine, Dec 2008, “Destroying the Myth About Testosterone Replacement and Prostate Cancer”, By Abraham Morgentaler, MD, Facs

6) Minerva Endocrinol. 2006 Mar;31(1):1-12, “Aromatase and prostate cancer”

7) Eur J Cancer, 2008 May, 44(7):928-36, “A potential paradox in prostate adenocarcinoma progression: oestrogen as the initiating driver”

8) Indian J Clin Biochem, 2015 Jan, 30(1):59-65, “Serum Testosterone, 17β-Estradiol and PSA Levels in Subjects with Prostate Disorders”

Testosterone-to-Estrogen Ratio - Peak Testosterone

So what is a good T/E ratio?  A solid number for a 20 year old male is 30-40 with some guys shooting near 50.  Of course, some would argue that a T/E ratio that high makes it to where most guys can’t think straight.  Regardless, youthful testosterone-to-estradiol ratios are quite high and are certainly ideal in terms of maintaining male health.

NOTE: Estradiol is the most powerful estrogen in us guys and is termed E2.  Most testosterone-to-estrogen ratios are actually testosterone-to-estradiol ratio in the literature from what I have read, and I use them interchangeably below.

NEWS FLASH: A recent study showed that lower testosterone-to-estradiol ratios were actually tied to higher PSA’s. [6] In fact, this study showed that testosterone may actually be protective and estradiol the prime culprit in fueling cancer.  See my page on High Estradiol’s Links to BPH and Prostate Cancer.

What causes these rapid changes on both top and bottom in the negative direction.  Well, some of it is aging.  Males just naturally lose a little testosterone as they age due to mitochondrial dysfunction, DNA and oxidative damage and so on.  However, one of the greatest culprits is the extra pounds around our middle. Extra fat pumps out more aromatase which in turn pumps out more estrogen into our system.

That creates a viscious cycle because the extra estrogen will “crowd out” testosterone and lower the body’s testosterone output.  Then, as testosterone is lowered, muscle is lost and as muscle is lost, fatty tissue is increased and so on.

1.  Body Fat.  Of course, it’s not secret that body fat and male estrogen levels go hand-in-hand. Many studies show this, but let’s look at one study of guys with fertility problems.  These were relatively young guys within a decade on either side of the average age of 39.  They split them up into two groups: those with a BMI > 25 and those with a BMI less than 25.  The difference in testosterone-to-estrogen ratios was signficantly different:  12 versus 17.  That is a 42% difference!

Does this make sense that body fat would make such a significant difference in the T/E ratio?  Remember that the more fat, the more aromatase and the more aromatase the more estrogen and the more estrogen, the less testosterone.  Excess body weight is correlated with both lowered testosterone and increased estrogen.  In other words, being overweight will hit both sides of the fraction negatively.

By the way, this may explain why weight lifting has been associated with increased long term testosterone levels.  Weight will increase muscle mass and “muscle burns fat”.  Adding muscle, however you do it, will actually change your metabolism for the better so that the same calories go farther.

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

And I should add that some men, generally obese, can experience MONSTROUS increases in testosterone by losing lots of weight (once the restore their calories).  The reason is that obesity can lead to a type of secondary hypogonadism where the signaling from the hypothalamus-pituitary-testes axis gets dramatically reduced.

2.  Low Fat Diet. Most men believe that a Low Fat Diet is very negative for your endocrine profile and, in particular, will devastate testosterone.  However, preliminary evidence shows just the opposite.  One small study found that estradiol (the “bad” estrogen or E2) fell from 47.2 to 23.8 pg/ml on average, which is obviously a big change.  This is a reduction of over 50% and cut their estrogen levels in half! [3] And the remarkable thing is that their testosterone stayed steady before and after at 510 ng/dl.

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. For additional information, see my link on Low Fat Diets and Testosterone.

Increasing your T/E Ratio by a factor of 2+ should grab every man’s attention, especially considering it was done simply by diet.  Check out The Incredible Benefits of a Low Fat Diet.

3.  Sexual Intercourse (via Cialis). As an example, let’s look at an eye-opening Cialis study.  Of course, Cialis is the 36-hour PDE5 inhibitor that has put so many middle-aged and beyond guys back in the game.  And getting back into the game has a profound effect for most much guys:  it boosts  their testosterone to estrogen ratio by 24% on average according to one study. [1]

The reason?  Cialis gives guys who are struggling confidence and that all-important Nitric Oxide boost that leads to more sex.  And more sex boosts testosterone and a host of other changes.  What is interesting is that in the above study, testosterone only increased 5.5% on average but estrogen lowered by about 15%.  And the net boost in the T/E ratio exceed the sum of those two by a few percentage points as well.

Now this is a remarkable change if you think about it.  The “concentration” of testosterone and estrogen – estradiol is what really counts – changed by 24% from just one lifestyle change.  Imagine what could happen as you pile on some of the other Testosterone Increasing Techniques and Estrogen Lowering Strategies that I have mentioned on the web site.  There is no reason that you cannot dramatically improve your ratio of testosterone to estradiol (unless you happen to be training for the Olympics with a professional trainer).

4.  Arimidex. Arimidex (anastrolozole) is an aromatase inhibitor that, not too surprisingly, can do wonders your T/E ratio.  It works by actually binding to the aromatase enzyme that converts testosterone to estrogen. And if you want to best your testosterone-to-estradiol ratio, it’s hard to beat.  For example, one study showed that in hypogonadal senior men, the T/E ratio was increased on average by 115%!  It produced a 62% in testosterone and a 24% decrease in estradiol. [4]  Of course, it is a pharmaceutical and thus has side effects and unknown long term safety.  But it’s hard to argue against its great hormonal properties.  NOTE:  Other AI’s (aromatase inhibitors) can produce similarly spectaculr changes in the testosterone to estrogen ratio as well.  For example, one study showed Teslac (testolactone) also produced an improvement of over 100%. [5]

The point is that, at least using #1-#2, you can use some very natural strategies that will very likely make a very substantial change to your testosterone/estrogen ratio and, as a consequence, feel much better and lower your risk for many diseases and conditions.

CAUTION:  Most guys probably do not know that caffeine increases both cortisol AND testosterone.  Unfortunately, it does not raise testosterone enough proportionately thus lowering the overall testosterone-to-estrogen ratio. [3]

1) The Journal of Sexual Medicine, Jul 2006, 3(4):716-722, “Testosterone:Estradiol Ratio Changes Associated with Long-Term Tadalafil Administration: A Pilot Study”

2) Systems Biology in Reproductive Medicine, 2006, 52(2):97-102, “EFFECT OF BODY WEIGHT ON TESTOSTERONE/ESTRADIOL RATIO IN OLIGOZOOSPERMIC PATIENTS”3) Int J Sport Nutr Exerc Metab, 2008 Apr, 18(2):131-41, “Dose effect of caffeine on testosterone and cortisol responses to resistance exercise”

3) 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”

4) Clin Endocrinology, 2009, vol. 70(1)”116-123, “Effects of aromatase inhibition in hypogonadal older men : a randomized, double-blind, placebo-controlled trial”

5) The Journal of Urology, Feb 2002, 167(1):624-629, “AROMATASE INHIBITORS FOR MALE INFERTILITY”

6) Indian J Clin Biochem, 2015 Jan, 30(1):59-65, “Serum Testosterone, 17β-Estradiol and PSA Levels in Subjects with Prostate Disorders”

Mood and Testosterone - Peak Testosterone

As we point out often on this site, testosterone effects everything for us guys and, especially, the male brain. One of the surpising things that testosterone alters rapidly is mood.  Yes, testosterone can make us guys “bitchy.”  In fact, believe it or not, researchers have a term for it:  Irritable Male Syndrome. [1]

Researchers first noticed the effects of low testosterone in animals and have since studied this effect in a wide variety of mammals. What is counterintuitive is that instead of becoming docile and quiet, males with decreased testosterone become much more prone to fighting. Researchers noted that it could likely be due to a drop in brain opiods that are necessary for mood elevation. Thus they become both fearful and irritable at the same time – a toxic combination by any standards.  (Think of that next time you make fun of a woman with PMS, eh?)

So just what do researchers mean by “mood?”  Generally, questionaires are used and monitor psychological items such as “positive mood responses (alert, friendly, full of energy, well/good feelings) and negative mood responses (angry, irritable, sad, tired, nervous).” [4]  Other studies have looked at similar attributes, such as “angry, alert, irritable, full of pep (energy), sad/blue, tired, friendly, nervous, and well/good.” [7]

However, changes in mood parameters such as this are generally only experienced by men with hypogonadal testosterone levels. Several studies have shown that men with normal or even low normal testosterone levels experience little to no benefit in this area from testosterone therapy for example. [2] Young, healthy males may be more resilient as well to low testosterone according to one study, although the researchers found that they had “hot flashes” and were “emotionally charged.” [3] Can you say PMS?

As a side note, you can, in fact, swing the pendulum too far the other way:  researchers have actually increased testosterone to supraphysiological (abnormally high) levels and some of the men displayed signs of hypomania, i.e. symptoms such as euphoria and hypersexuality. [6]  And I have heard this from an HRT clinic:  if they go too high with a man’s testosterone, he gets “amped” as the clinician put it and can lose their temper easily, etc.

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

The main point, though, is that raising one’s testosterone, either naturally or through HRT, can be a definite mood-booster.  On The Peak Testosterone Forum I find this to be the one of the most common benefits of going on testosterone.  Men describe the incredible change to their mood and attitude from HRT (Hormone Replacement Therapy).  Look at just a few of the comments:

“I am on day 25 and have lost over 24 pounds and feel like I am living again.I feel better than I have in years. Having spontaneous erections again, more energy and a better emotional state.” [8]

“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.” [9]

“I am still taking my 1cc of 200 ml of Testosterone Cypionate a week and .5mg-1mg daily dose of Armidex. My next follow up blood work is in February. Words cannot describe how I been but in one word it will have to be INCREDIBLE. 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.” [10]

(See this link on Hormone Replacement Therapy (HRT) for more information on testosterone therapy.)

The Depression Connection

Hopefully, the above quotes are a few real-life examples that show you just how important testosterone can be to mood.  No, it is not a silver bullet that always works, but it is very often a major player.  One of the sign that is a root cause of many mood disorders is the very recent recognition by the practicing medical community that correcting endocrine issues, especially testosterone, can greatly help with depression.

Physicians and those in the mental health fields suddenly noticed that a substantial percentage of depressed men were low T and giving them testosterone helped very often.  The subject of Testosterone and Depression is so important that I did a page on it and documented the many kind of depression and mood conditions that HRT can help with.  In my opinion, if a man is struggling with depression, one of the first numbers that should be pulled is testosterone.

1) Reprod Fertil Dev, 2001, 13(7-8):567-76, “The irritable male syndrome”

2) Maturitas, 2005 Feb 14, 50(2):124-33, “Effect of oral testosterone undecanoate on visuospatial cognition, mood and quality of life in elderly men with low-normal gonadal status”

3) Arch Gen Psychiatry, 2004 Oct, 61(10):997-1004, “The effects of pharmacologically induced hypogonadism on mood in healthy men”

4) 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”

5) The Journal of Clinical Endocrinology & Metabolism, May 1 2004, 89(5):2085-2098, “Long-Term Testosterone Gel (AndroGel) Treatment Maintains Beneficial Effects on Sexual Function and Mood, Lean and Fat Mass, and Bone Mineral Density in Hypogonadal Men”

6) Archives of General Psychiatry, Feb 2000, 57(2), “Effects of Supraphysiologic Doses of Testosterone on Mood and Aggression in Normal Men”

7) J Clin Endocrinol Metab, 1996 Oct, 81(10):3578-83, “Testosterone replacement therapy improves mood in hypogonadal men–a clinical research center study”

8) https://peaktestosterone.com/forum/index.php?topic=638.0

9)  https://peaktestosterone.com/forum/index.php?topic=433.0

10) https://peaktestosterone.com/forum/index.php?topic=513.105

The Potential Dangers of Coffee and Caffeine.

I’ve already documented the Many Health-Promoting of Drinking Coffee.  But is there a dark side?  Can drinking all that java and caffeine really be good for you?

As is so often the case, there is always a potential downside and one has to weigh the pros versus cons. Below are some of the things about coffee drinking and caffeine that could get you into trouble:

1) Homocysteine.  Coffee is a known increaser of homocysteine, the bad boy of the cardiovascular world. One study found, though, that 200 micrograms of folic acid negated this effect [1] and so it is possible that a healthy diet with ample B vitamins may keep coffee’s homocysteine-raising properties in check. Homocysteine is, by the way, not only a risk factor for heart disease but for erectile dysfunction as well. [5]

REFERENCES:

1) European Journal of Clinical Nutrition, 2003, 57:1411 1417, “Folic acid supplement decreases the homocysteine increasing effect of filtered coffee. A randomised placebo-controlled study”2) Psychosomatic Medicine, 2005, 67:734-739, “Caffeine Stimulation of Cortisol Secretion Across the Waking Hours in Relation to Caffeine Intake Levels”

3) Int J Sport Nutr Exerc Metab, 2008 Apr, 18(2):131-41, “Dose effect of caffeine on testosterone and cortisol responses to resistance exercise”

4) Hypertension, 1999, 33:647 52, “The effect of chronic coffee drinking on blood pressure: a meta-analysis of controlled clinical trials”

5) Metabolism, 2006 Dec, 55(12):1564-8, “Hyperhomocysteinemia: a novel risk factor for erectile dysfunction”

6) American Journal of Clinical Nutrition, Mar 2005, 81(3):539-540, “Caffeine and arrhythmia”

2) Cortisol.  Caffeine increases midafternoon cortisol levels. [2]  Of course, cortisol is a muscle-destroying, visceral-fat-building, neuron-killing nightmare.

3) Testosterone to Estrogen Ratio.  Interestingly enough, caffeine increases testosterone.  Unfortunately, it does not raise testosterone enough proportionately to compensate for the rise in cortisol, leaving one with a lowered testosterone-to-estrogen ratio. [3]

4) Blood Pressure. There are mixed results here, but one prominent meta-analysis showed that long term caffeine increased blood pressure. [4]

5) Skin Wrinkling. Many experts feel that caffeine’s dehydrating effects may accelerate skin aging and wrinkling.

6) Arrythmia. Some sensitive individuals will experience heart “flutters” while on caffeine. However, it should be noted that, according to one recent meta-analysis, this is a low probability concern [6]

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.

Supplements, Dangers - Peak Testosterone

Erectile dysfunction is something to be taken very, very seriously.  And, no, not just because it takes the life out of your sex life.  Erectile Dysfunction is almost always a warning shot over your bow, a warning of impending heart disease.  In other words, if you do not take care of your erectile dysfunction now, you almost for sure have a life of angina, angioplasties and MIs just around the corner.

What is tragic is that so many doctors treat erectile dysfunction as if it is purely psychological.  How many guys have walked out of a physician’s office with the idea planted in his mind that it must “all be in his head”.

Well, if you have few to no morning erections and difficulty even getting or staying erect, you do not need some Ph. D. to imply that it is all in your mind:  you know different.  And the reason is simple:  the veins and arteries in the penis are smaller than those in the heart area and thus tend to have trouble first.  And problems downstairs are “non-ignorable” for us guys, because it effects our sex life.  We will limp along with half clogged arteries that are blocking circulation to our brains and legs, but if the ol’ penis is affected we take notice immediately!

But in some ways we should be thankful.  For many of you erectile dysfunction is going to give you a second chance on life so that hopefully a heart attack will not suddenly kill you in five to ten years. By the way, I am not exagerrating to make a point:  one study found that erectile dysfunction preceded cardiovascular events by five years on average. [1]

Let me put that in plain terms:  you guys out there with erectile dysfunction have five years, on average, to straighten yourself out physically or there is a freight train coming your way.  And remember that five years was the middle point – it could be much less.  Are you going to gamble with your future?

NOTE:  For more information, see my page on How Arterial Plaque Is The Number One Factor in Most Erectile Dysfunction.

Furthermore, one study found that “that a single question on erectile rigidity proved to be a predictor for the combined outcome of acute MI, stroke and sudden death”. [2] In other words, men were given a questionaire about erectile function and if they answered a problem on just ONE of those problems, it strongly predicted some of the nastiest things that can happen to a human including heart attack, dying instantly and a clot damaging (usually) the brain.

So don’t think that just because your erectile dysfunction is “mild” that you can avoid the consequences.

Another study “showed [that] men with a history of ED had a 40% greater risk of subsequently developing CVD over the seven-year course of the study than those with normal erectile function.” [3] Yet another study found a 26% and 43% increase in all-cause and cardiovascular mortality rates, respectively. [4] And this was after adjusting for “age, body mass index, alcohol consumption, physical activity, cigarette smoking, self-assessed health, and self-reported heart disease, hypertension, and diabetes.”  In other words, erectile dysfunction was found to be a potential death warrant  not just because the underlying population was “diseased” or “sickly.”

So what’s a fella to do?  Are you supposed to just give up and die and let the clock tick down until your time is up?  Of course not.  Below I give you the top links that can save your erections AND your heart and your life.

1)  Low Fat Diet.  A Low Fat Diet can actually reverse heart disease and that means reversing the plaque that has built up in the veins and arteries of your penis.

2) I have a link called Sexercise and for good reason:  exercise can give you your sex life back!

3) Please read this link on Improving Your Erectile Dysfunction. It has many research-proven ideas to help your heart and penis.

4) Finally, you need to learn the dangers of Inflammation, Metabolic Syndrome, High Blood Pressure and being Overweight – these are all strongly correlated with heart disease.

REFERENCES:

1) International Journal of Clinical Practice, 2007, 61(12):2019-2025

2) International Journal of Impotence Research, 2008, 20:(1):92-9

3) Nursing Times, 2008, 104(46):26 27

4) The Journal of Sexual Medicine, Sep 2009, 6(9):2445-2454, “Erectile Dysfunction and Mortality”

Female Libido and Estrogen - Peak Testosterone

Estrogen, as I discuss below, is intimately related with many aspects of female sexual health.  And us guys are interested in any and all things dealing with female sexual health, eh?

To begin with, estrogen is associated with sex drive in women.  Estrogen plays a somewhat analagous role to testosterone in males in the sense that testosterone is a “mood elevator” and gives us guys the confidence and drive that we need in the bedroom.  Estrogen, likewise, is very important to her libido and sex drive. [12]

Most men know this indirectly, because they know what a couple of drinks can do to a female’s libido.  Beside decreasing “inhibition”, alcohol definitely raises – actually “prolongs” would be a better word – a female’s estrogen levels. (It does the same to males also!)  Estrogen even acts on her genital area making sex feel, well, way better and is a “sensation heightener” as well.

So then if you want to raise a woman’s flagging libido, you just put her on Hormone (Estrogen) Replacement Therapy, right? Actually, this question is where the story of estrogen and female libido gets even more interesting. Remarkably, it turns out one of the side effects of female Hormone Replacement Therapy is actually decreased libido in the case of a large percentage of women. Researchers have found that “The Pill” actually greatly increases SHBG and, as you hopefully know from my link on Free Testosterone, that decreases free testosterone.

CAUTION:  Depo-Provera was shown in an International Journal of Obesity study to put an average of 13 pounds on female users! [14] And the Ortho Evra Patch is just as scary:  it puts out about 60% more estrogen than most other birth control pills, putting the average females at tremendous risk. [14] (Yaz, the new no-period pill, has BOTH of the above side effect profiles!)  In addition, Depo-Provera has been shown in several studies to result in bone loss and, even worse, a bone loss that may be irreversible. [15]

This decrease in free testosterone – testosterone is also important for a woman’s sex drive [18] – is what many researchers suspect is the culprit in the decreased libido that so many women experience with oral contraceptives. [10]  In fact, the lead researcher (Claudia Panzer, M.D.) of that study estimates that “about half of women experience a change in libido”. [11]  If your woman does not want sex, you may want to consider a different form of contraception!

Some doctors will actually recommend supplemental testosterone for some women experiencing low libido. Yes, testosterone is a libido booster for her just like it is for you.  So, if her libido is flagging and you’ve ruled out the other standard possibilites, you may want to ask her doctor if supplemental testosterone would help.

I should mention, though, that there was at one time some controversy as to whether supplemental testosterone for women could lead to an increased risk of breast cancer.  [16]  The latest study shows this not to be an issue [17], but you’d definitely want her to discuss this with her doctor.

There is an “underground” movement pointing out that all these counterintuitive results from female hormones are because they are NOT bioidentical. That’s right – you, big fella, almost always get bioidentical testosterone when you get HRT, but your women will find it difficult to impossible through her doctor.  Why?  The reason is simple:  anything bioidentical is not patentable.

Big Pharma, realizing they could not patent true estrogen (and progesterone) decided to slightly alter it in order lock in patent protection and make solid profits. Critics charge that it is these slight alterations, all for the sake of a patent, in the estrogens that cause many of the studies to go awry since they are no longer “natural”.  And it is suspicious that HRT (Hormone Replacement Therapy) in males, which is in general bioidentical, has done so well compared to the female studies where there have been all kinds of issues.  It is also disconcerting by almost any standard of logic to think about the fact that the woman you live, trying to improve libido, use contraception or decrease the symptoms of menopause, is forced to use synthetic, non-natural versions of estrogen just for the sake of Wall Street.

NOTE:  Historically, some cultures have used the urine of younger females to decrease symptoms of menopause.  Maybe there is something to it:  one of the best-selling synthetic estrogens, Premarin, is derived from Horse Urine.

These sorts of concerns have fueled the rapid growth of an “underground”, bioidentical-estrogen movement:  compounding pharmacies have created bioidentical estrogens and progesterones from plants such as soy.  According to critics of Big Pharma, women do much better on these bioidentical forms.

As noble as the bioidentical hormone movement is, I would still urge some caution:  there is considerable evidence that any estrogen, natural or not, can increase breast cancer risk.  For example, drinking even one drink per day, which merely increases the amount of time that estrogen remains in one’s system, is tied to an increased breast cancer rate in females.  And higher estrogen without hormone replacement therapy is also associated with risks as well.

This is in direct contrast, with the situation for males where youthful testosterone levels are not associated with increased prostate cancer levels.  Every female will have to do her own research and weigh the options with her doctor:  it is actually a very involved decision.  In other words, don’t just go with what Oprah and Suzanne Summers say:  they’re not giving you all the facts.  You may even want to read this US News and World Report interview that discusses what the European studies actually say about bioidentical estrogen.

NOTE #2: Non-bioidentical estrogens have been linked to brain shrinkage [11], breast cancer [13] and a host of side effects. Furthermore, pesticides and fungicides are increasingly being correlated with thyroid disease as well.  One 2009 study based in Nebraska found that women exposed to the most of organochlorine pesticides and fungicides were much (40%) more likely to develop hypothyroidism, which results often in weight gain, loss of libido and other serious medical conditions. [19]

REFERENCES:

1) J Urol, 2000, 163: 888 893

2) J of Sex & Marital Therapy, 2006, 32:369 378.   (Note that a previous study showed good results as well: J Sex Marital Ther, 2001, 27:541-549.)

3) Arch Sex Behav, 2002, 31(4):323-332

5) J Urol, 2000, 163: 888 893

6) J of Urology, 2005, 174(5):1921-1925

7) Glamour, Apr 2008, p. 200.

8) J Clin Endocrinol Metab, Apr 1995, 80(4):1429-30, “Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women”

9) Endocrine Abstracts, 2007, 13:P286, “Effect of Glycaemic index of the diet on salivary cortisol and testosterone levels in females”

10) Fitness Magazine, May 2006, p. 52

11) https://www.sciencedaily.com/releases/2009/01/090112201027.htm

12) https://www.webmd.com/sex-relationships/features/sex-drive-and-menopause

13) : s0:a16:g12:r3:c0.336868:b25653392:z10

14) Fitness, April 2006, p. 48

15) The J of Pediatrics, Nov 1996, 129(5):671-676, “A prospective comparison of bone density in adolescent girls receiving depot medroxyprogesterone acetate (Depo-Provera), levonorgestrel (Norplant), or oral contraceptives”; For a complete list of references, see https://www.reproductiveaccess.org/resources/ contraception/hormonal/depo_boneloss.htm

16) Maturitas, Dec 10 2004, 49(4):267-275, “Postmenopausal testosterone therapy and breast cancer risk”

17) Journal of Sexual Medicine, Published Online: 24 Apr 2009, 6(7):1850-1856, “The Incidence of Invasive Breast Cancer Among Women Prescribed Testosterone for Low Libido”

18) New England Journal of Medicine, Nov 6 2008, 359:2005-2017, “Testosterone for Low Libido in Postmenopausal Women Not Taking Estrogen”

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

Cialis, Dangers - Peak Testosterone

Cialis (tadalafil) is yet another medication that is both sinner and saint.  We have already presented many of Cialis’ excellent properties and you can read my link on The Long Term Benefits of Cialis for more details.  However, Cialis also has a darker side as well, one that your doctor is unlikely to tell you about.  It is important to examine the potentially ugly side of any drug, but especially Cialis since most guys are so glad to get rid of their erectile dysfunction that they think, “Side effects, schmide effects – I’m in the saddle again!”

NOTE:  Cialis has recently come out with a Cialis Daily lower dose version that can keep a guy in the game 24/7.  Eli Lilly’s info page is here.

Below are some of the concerns that researchers and medical professionals have noted with Cialis on a daily basis:

1)  Brain. Headaches are extemely common with Cialis (tadalafil).  In one 4 week study, 7.2 percent of patients experienced headaches. [1] This is almost one out of every 14 patients and shows that Cialis is affecting something in the brain.  Viagra, a fellow PDE5 Inhibitor like Cialis, has actually been studied more extensively and found to effect the brain on the neurotransmitter level.  For example, researchers have found that it 1) causes anxiety in rodents and 2) exhibits some antidepressant like qualities. [2] The bottom line is that Cialis and the other PDE5 inhibitors are clearly affecting the brain in a profound way and researchers have almost no understanding as to how.  So I will ask the question, “Is something that causes headaches in one out of 14 men really going to be good for your long term health after decades of use?”

2) Backache and Muscle Pain. These are quite common with Cialis and often do not go away for 24-48 hours. [3] Again, what is disconcerting is that researchers have no explanation. Just what is Cialis affecting?

3) Retina.  Cialis also effects PDE6 to a significant extent.  PDE6 is another related phosphodiesterase enzyme and is present in the retina.  Here are the kind of all-too-common side effects reported with regular tadalafil (Cialis) use: “Transient changes in vision, transient and mild impairment in color discrimination, eye pain, eyelid swelling, electroretinographic abnormalities, abnormal histopathologic findings,4 pupil-sparing third nerve palsy, and central serous choroidopathy have been reported.” [4] Again, after decades of use, what is this going to do to your vision?

4) Cortisol. Cortisol is one of the biggest enemies of the middle-aged and beyond male.  If too high for too long of a time, it decreases testosterone, increases visceral fat, increases insulin resistance and destroys neurons just for starters. [5]  Now Cialis has also been found to improve the testosterone to estrogen ratio, but the truth is that we just do not  know if the increase in cortisol could cause long term issues.  Could it slightly increase the chances for visceral fat?  metabolic syndrome?  We just don’t know.

REFERENCES:

1) European Urology, Sep 2004, 46(3):362-369, “Efficacy and Treatment Satisfaction with On-Demand Tadalafil (Cialis ) in Men with Erectile Dysfunction”

2) J Neural Transm, 2007 Sep 7, “Appearance of antidepressant-like effect by sildenafil in rats after central muscarinic receptor blockade: evidence from behavioural and neuro-receptor studies”

3) https://www.pharmainfo.net/reviews/pde5-target-erectile-dysfunction

4) Archives of Ophthalmology, Jul 2006, 124(7), “Tadalafil-Induced Subretinal and Choroidal Hemorrhage in a Patient With an Unsuspected Uveal (Choroidal and Ciliary Body) Melanoma”

5) J Clin Endocrinol Metab, 2008 Sep, 93(9):3510-4, Epub 2008 Jun 17, “The type 5 phosphodiesterase inhibitor tadalafil influences salivary cortisol, testosterone, and dehydroepiandrosterone sulphate responses to maximal exercise in healthy men”

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.

Exercise and 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]

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.

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”

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:

Progesterone Lowers Estradiol - Peak Testosterone

Many men know that progesterone lowers DHT (dihydrotestosterone), which could be good or bad depending on your situation.  What is not as well known is that progesterone can also lower estradiol levels in us guys.  Many men, especially as they age, end up with high estradiol levels – usually due to weight gain – and are wondering how to control it naturally.  Of course, the first order of business should be to drop those extra pounds through diet and exercise.  But one also might want to pull one’s progeseterone levels as this could be a partial explanation as well.

Here is a summary of the research-based evidence that progesterone lowers estradiol by modifying aromatase activity. Aromatase is the enzyme in fat tissue that converts some of your testosterone into estradiol.  This is why overweight men tend to have higher estradiol and lower testosterone:  the more fat tissue, the more aromatase.

I will mention that all of the studies below are in women.  Furthermore, it is not really that common for men to take progesterone and then monitor their estradiol, and so it is difficult to even find confirmation out on the forums.  However, we had man on the The Peak Testosterone Forum who, when asked if progesterone lowers estradiol, wrote, “Yes it does. I proved it on myself.” [3]

Here are some of the studies that state the same thing:

1. Fat Cells. An in vitro study shows that progesterone inhibits aromatase in a dose dependent manner, i.e. the more progesterone, the greater the inhibition:

Regardless, it seems clear that a solid amount of evidence indicates that progesterone inhibits aromatase.  (Of course, it would be nice to have a study or two in men confirming this fact.)

Also, I am not encouraging anyone to necessarily try progesterone.  It does have some risks, which I list here:  The Potential Dangers of Progesterone. And there is a potential backdoor route:  supplemental pregnenalone can raise progesterone in some men.

REFERENCES:

1)  Anticancer Res, 2008 Jul-Aug, 28(4B):2129-33, “The anti-aromatase effect of progesterone and of its natural metabolites 20alpha- and 5alpha-dihydroprogesterone in the MCF-7aro breast cancer cell line

2) Biochem Pharmacol, 2008 Jul 15, 76(2):208-15, “MCF-7aro/ERE, a novel cell line for rapid screening of aromatase inhibitors, ERalpha ligands and ERRalpha”

3) https://www.peaktestosterone.com/forum/index.php?topic=7927.0

3) Acta Endocrinol (Copenh), 1975 Nov, 80(3):569-76, “Progesterone, 20 alpha-dihydroprogesterone and 20 beta-dihydroprogesterone in mother and child at birth”

4) Journal of Endocrinology, 1998, 158:401 407, “Progesterone inhibits glucocorticoid-dependent aromatase induction in human adipose fibroblasts”

5) J Steroid Biochem, 1986 May, 24(5):1033-9, “Aromatase activity and concentrations of cortisol, progesterone and testosterone in breast and abdominal adipose tissue”

“In fibroblasts derived from human adipose tissue, aromatase induction is observed after exposure to 1 M cortisol in the presence of serum or platelet-derived growth factor (PDGF). Progesterone suppresses this induction in a dose-dependent manner, 10 M resulting in complete inhibition. A reduced cortisol concentration (0 1 M) concomitantly reduces the progesterone concentration required for effective inhibition (10 100 nM). This effect of progesterone is specific, as neither the release of cellular enzymes nor aromatase induction by dibutyrylcAMP, which acts independently from cortisol, are affected.” [4]

NOTE:  Progesterone seems like the most controversial of the big gun, common hormones for men.  It has some stellar results as you can read about in my page on Progesterone and Erectile Dysfunction and The Benefits of Progesterone in Men. However, it also has some decided risks, which I discuss in my page The Potential Dangers of Progesterone.

2. Aromatase Activity. One study took pre and post menopausal women, in order to get a wide range of hormonal values, and basically evaluated all their hormonal data points beside aromatase activity.  What they found was that aromatase activity was not correlated with testosterone or cortisol, but was inversely related with progesterone.  This means that the more the progesterone, the less the aromatase activity. [5]

3. Cancer Breast Cell Line.  One study looked at a breast cancer cell line that produces high levels of aromatase and found that a metabolite of progesterone (20alphaDHP) is an aromatase inhibitor. It did not find progesterone itself to be one however. [1] And don’t get hung up on the fact that this is a breast cancer line – they use it for rapid screening of AIs (aromatase inhibitors). [2]

Do males have significant amounts of 20alphaDHP?  I had trouble finding confirmation of that fact but did find this:

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:

The High Testosterone Diet - Peak Testosterone

Want to raise your testosterone through diet?  Is that even possible?  This link covers the diet of other cultures around the world that have a low rate of cardiovascular disease and eat what some have called a High Testosterone Diet.

Now, before I go on, I want to say that I don’t necessarily advise what’s in this link. If you are not extremely careful, you will probably find yourself in the Land of Erectile Dysfunction.  But for those interested in optimizing and increasing testosterone through diet and throwing “caution to the wind” (and after talking to your doctor of course), let’s take a look at the some rural, third world ethnic groups that have very low rates of cardiovascular disease and yet have diets that are pro-testosterone. Here’s the basic stats for the Tokeluau and Pukapuka, two peoples from Pacific islands (Am J Clin Nutr 34:1552-1561, 1981):

Notice that both of these cultures have similar testosterone increasing diets and lifestyles:

Here’s a summary of how you could implement their general diet to increase and raise testosterone:

CAUTION #1: If you’re a beef or egg eater, then PLEASE read this link to understand the issues for and against these key testosterone increasing dietary foods.  In addition, significant research shows that vegetarians and vegans have equal or even slightly higher testosterone levels than their carnivore counterparts.  See my link on Testosterone and Vegetarianism for more details.

CAUTION #2:  Satured fat can temporarily “stiffen” arteries and blood vessels. So if you want to increase testosterone through diet, you need to remember that these Polynesian cultures exercise almost constantly because of their rural lifestyle.  This is important because exercise has been shown to help nullify the effects of saturated fat in the diet.  Please read more at these links on the Great Diet Smackdown, Part I and Part II, where I discuss this in greater detail.

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

I realize that some may not know how to calculate the percentage fat or protein in your diet. So let me give you an easy methodology for controlling your dietary fat intake. Simply eat six meals/day with the approximate proportions:

Again, this diet should increase your testosterone by giving you 2400 calories, a carb/protein ratio of 2.6 and 45% dietary fat.

This is not as hard as it looks.  Let me give you a few examples of meals that will fit int this ratio:

1) 1/2 C uncooked oatmeal + 1C frozen blueberries + 1.5T Olive Oil

2) 3 egg whites + 1 slice whole wheat bread + 1.5T Olive Oil

3) #T Olive Oil, 1/2 C Brown Rice

NOTE: You can include coconut oil, but keep in mind that saturated fat impedes blood flow unless you are going to exercise right after the meal.  Saturated fat will also put you at risk for heart disease eventually unless you are extremely careful, i.e. exercise like a wild man.

So you can see how easy this High Testerone Diet really is.  And that’s important because I can safely predict that you are just like me trying desperately to figure out ways to take time out of your already overburdened and saturated schedule. Again, you can follow this program and boost your testosterone without adding any significant time to your day.

Most of you need your testosterone ramped up through diet without any additional burden to your day. Family, career, commuting, house and yard work – you name it it s as if modern life was designed to fill up every minute of your schedule. And that s why most fitness programs fail they are impossibly demanding for the typical person in this century.

The examples that I gave above show that the High Testosterone Diet is incredibly easy and fast and requires only simple food preparation. And then you need to exercise for 30-45 minutes per day. It s that easy.

So then how can I say there is no net time out of your day if you have a new diet and you have to exercise? Easy actually! First of all, I exercise religiously over lunch by going to the gym. I never miss except sometimes on Fridays to go out to lunch with colleagues. There may be another time of the day that works better for you. But make sure it s a time that can happen easily.

Again, the diet is VERY simple. Forget cooking. Forget recipes. Your time in the kitchen will be the equivalent of making a sandwich. You are going to do simple food preparation NOT cooking.

Of course, if you want to do some cooking, then the door is wide open. But I would guess only one in twenty of you will take the time to do it, since the great majority of you have demanding families and careers and you need velocity more than anything else. In my case, for example, I have many goals that I want to accomplish and one of them is not being a good cook. Yes, I will sometimes do something in the kitchen, but I mostly want the increased testosterone, vitality and youth.

I also urge you to think of food as medicine. Remember: food is not for comfort. It is not to make you feel good when you re lonely and sad. It is not to cheer you up when your boss is mean and nasty and the wife and kids are mad at you. Using food for comfort is as deadly as drinking for comfort. It will kill you and I don t need to tell some of you about that.

I say that because food has a clinical effect. Broccoli, for example, will lower the bad estrogen enough to where it has confounded research effects. Many foods, such as pomegranates, walnuts and cacao, will actually cause your arteries to dilate and pump out precious nitric oxide and come to the aid of your penis. The High Testosterone Diet is yet another example: it can actually raise total testosterone levels. The list could go on and on.

So, again, you are going to spend just a few minutes in the kitchen every day and you are going to exercise some over your lunch and that s it! You can do more if you want, but you don t need to. My goal in this packet is to give you a cheat sheet with everything summarized and some quick and dirty ways to accomplish what you most need to know. So here at Peak Testosterone we endeavor to get real, to give you a program to increase your testosterone that you can actually do and still have a life.

I know some of you may ask, “How Much Will the High Testosterone Diet Boost My Testosterone?”  It depends. Some of you may get no testosterone boost at all because you are eating so unhealthily. If you are eating a high meat, high saturated fat diet with little fiber, then your testosterone will probably remain unchanged through this diet. However, remember that a Western Diet eventually catches up to you through oxidative and mitochondrial damage, which indirectly and sometimes directly lowers testosterone in the long term.

So for those of you in that situation, the High Testosterone Diet will be a way to optimize your testosterone levels with a relatively healthy diet. In other words, you don t want high testosterone at any cost such as dementia, heart disease and impotence. You want high testosterone and high health at the same time and the High Testosterone Diet will offer you that. (Again, I emphasize that Olive Oil is turning out to be rather ugly.)

The High Testosterone Diet may increase your testosterone levels fairly quickly. If so, remember that any change in diet or lifestyle that you do will raise your testosterone almost immediately, but, unfortunately, it will probably weeks or months before you begin to feel the change. This is important to note: you do not usually feel a high or a surge of energy or anything when your testosterone is initially boosted. We re not talking about caffeine or yohimbe here.

That s because you are literally rebuilding tissues, receptors and neurotransmitters and that usually does not happen overnight. Testosterone will make you feel better, but it takes awhile for your body s hormonal infrastructure to get built up to support it. A realistic expectation is from one to three months.

I have to make a quick comment about weight: I receive quite a few emails from desperate guys with low testosterone. After a correspondence or two, I very often find that they are overweight. Remember that being overweight is a primary risk factor for low testosterone and high estrogen and diet is going to do you little good if you are significantly overweight.

So how do you lose weight? The key is that you must drop those pounds gradually, because studies have shown that lowering your calories too rapidly will greatly decrease your testosterone. One study in particular showed testosterone going bye bye at 15% below baseline. Fast weight loss will also compromise immunity in most guys. Having low testosterone is bad enough. Who wants to be sick along with it? (See my links on The Extreme Dangers of Fat and How to Lose Weight Safely for more details.)

How to Lose Weight the Right Way - Peaktestosterone

A lot of guys on a new weight loss program don’t realize that weight loss can be very hard on the body and mind if not done correctly.  Furthermore, some weight loss programs can actually sabotage the very goals of losing weight that you’re trying to achieve.

This is the reason I put together a list of three items that show the “right way” to lose weight according to the latest research:

3) Consume High Protein Levels. When dieting, you may want to consider very high protein levels in order to keep your muscle mass.  Of course, one of the curses of dropping pounds is that you drop muscle along with fat.  (This can be exacerbated by #1 as well.)  One 2010 study found that consuming about 35% of calories, or 2.3 g/kg of body weight, signficantly protected male dieters from muscle loss when compared to participants consuming the more traditional 1.0 g/kg of protein (15% of calories). [7]  The latter, 1.0 g/kg, is the minimum that you’ll see most bodybuilding and weight training sites recommend for muscle building.  Consuming 35% of calories from protein is a very high level indeed, but maintaining muscle is crucial, since if you lose muscle it is much harder to maintain your weight post-diet.  Why?  Muscle is a much more efficient fat-burner.

REFERENCES:

2) J of Clin Endocrinology & Metabolism,May 1997,82(5):1543-8

4) Nov. 6, 2007, presentations, American Heart Association annual meeting, Orlando, Fla

5) Nutritional Reviews, 2008, 66:506-516

6) Journal of Exercise Physiology, 2009, 12(6): 33-39, “Dietary Carbohydrate and Protein Manipulation and Exercise Recovery in Novice Weight-Lifters”

7) Medicine & Science in Sports & Exercise, Feb 2010, 42(2):326-337, “Increased Protein Intake Reduces Lean Body Mass Loss during Weight Loss in Athletes”

1)  Maintain Adequate Calorie Levels.  Be cautious about cutting calories too fast and too deep:  it can whack your testosterone. The body goes into “starvation mode” and that includes starving your system of precious hormones such as testosterone.  For example, after just a few days of fasting, you testosterone levels can lower by a third or more.  [2]  Not only does dropping calories too fast whack your total testosterone, but it also raises SHBG. [5] SHBG is Serum Hormone-Binding Globulin, a protein that binds to the lion’s share of your testosterone. The little bit left over, around 2% of the total, is what your body can actually use since it is bioavailable.  So, if you increase SHBG through dieting – and incresing SHBG is a problem for aging males anyway – more testosterone is bound leaving you with less free testosterone.    So how many calories should you cut?  Well, one study found that subjects that lowered caloric intake by 15% did not experience a loss in total testosterone. [4] Again, it is better to lose weight gradually, relying on exercise and a balanced diet than the typical crash and burn programs that so many people engage in. And, if you will follow the Low Fat (or Ornish) Diet, you can lose weight and barely cut back on calories at all, thus avoiding a nasty fall in total and free testosterone.

2) Avoid Low Carb (Atkins) Diets.  If you want to put on muscle,  carbohydrates have been found to be just as critical to muscle growth and recovery as protein. [6]  Those with adequate carbohydrates had much improved protein synthesis over low carb study participants and protein synthesis is critical for rebuilding muscle tissue. (See my page on other Potential Dangers of Low Carb or Atkins Diet for more information.)

Recreational Viagra: The Dangers - Peak Testosterone

It was just a matter of time – an army of guys, most of them young, began using Viagra and the other PDE5 inhibitors for recreational purposes almost from the day they came out. Of course, middle aged guys often need to use these because of low nitric oxide levels, but there is a tidal wave of younger guys using these, not because they need them, but because they want additional confidence, ehancement and insurance if you will.  Can you say “Erection Steroids?” That is essentially what Viagra and other similar drugs have become – recreational vehicles for pleasure and assurance.

It’s no wonder as males today are under tremendous pressure to perform:  Hollywood, advertisements, even porn present guys as needing almost superhuman physical powers. The Guardian recently reported that a fourth of guys feel “completely inadequate in the bedroom“. [1] One study as far as back as 1999 showed 3% of young club attenders had tried Viagra (sildenafil) [4] and that percentage has been steadily increasing under societal pressure ever since.  As early as 2004 Express Scripts found that among its 5 million members, by far the fastest growing segment was the younger male 18 to 45 crowd. [5]  Express Scripts, a PBM that handles prescriptions for insurance companies and other corporations, also noted that scripts for Viagra were frequently declined because the drug was not for medical purposes, i.e. it was likely being used recreationally.

One more recent 2008 study [2] performed a survey of young (average age = 21 years) medical students and found that 9% had used Viagra, Levitra or Cialis and 46.7% of those had used them more than 3 times.  (NOTE: The above study reported that some of the young males used these to get past condom-related erectile dysfunction.) Again, it is very unlikely that a 21 year old has nitric oxide-related erectile dysfunction and so the great majority of these 9% were undoubtedly off label or recreational usages.

Of course, for most guys everything depends on that erection and so there is a lot of pressure anyway: an orgasm yields a mind-blowing high, a quasi-state of euphoria for about 24 hours and is a nearly essential ingredient for many modern, not-so-forgiving females. Couple all of this with the fact that many females have the ignorant belief that “if the guy is not rock hard, he’s not excited,” you have the recipe for younger guys to experiment recreationally with PDE5 inhibitors.

The irony is that PDE5 inhibitors such as Viagra have been shown not to help with hardness or erectile strength in young men.  If you’re middle-aged, that’s likely another story but one study of young males showed that there was no improvement in rigidity from taking Viagra. [6]  The only thing that was improved in these young guys was a mild improvement in recovery time.  That’s not quite the whole story however, as Viagra has been shown to help with psychogenic, or psychological erectile dysfunction as well. [9] And many younger guys feel that they are not using recreationally but rather to get them over fear and other psychological issues.

So all of this leads to the question, “So what?”  In other words, is there a problem with young, or even middle aged guys taking these drugs when they really do not have a nitric oxide deficiency? To answer that question we need to observe that these drugs do NOT just inhibit the PDE enzyme associated with nitric oxide release:  they also, to one degree or another, affect PDE enzymes in the ear, eye and stomach.  The NY Times reported, for example, that about 2.5% of men “deveolp vision problems that include seeing a blue haze, temporary increased brightness, and even temporary vision loss in a few cases”. [3] Furthermore, yet other guys have reported hearing loss, tinnitis and damage to the optic nerve, which occasionally is permanent.  (I cover all of this in more detail in my link on The Pros and Cons of Viagra and Other PDE5 Inhibitors.)

So there are signs that this is affecting multiple tissues in the body in a negative way and yet does not generally cause the kind of major damage needed to cause a pronounced side effect.  And that leads to an important question:  what if someone uses these drugs for decades? Will there be slow, incremental damage that builds up over a lifetime and increases the risk of stomach cancer or visual/hearing loss? We just don’t know and probably won’t for a long time.

In addition, there may be a rebound or withdrawal effect in young guys. Anecdotally, this is the case and one animal study shows that in young rats PDE5 was sensitized, which is not something that you want. [7] This has not been verified in humans, but it does make you wonder if there is some truth to the stories told by recreational Viagra users.  By the way, this is NOT true with middle aged and beyond males with erectile dysfunction:  studies have shown that Viagra can actually restore normal erectile function and the reason is likely oxygenation of the penis. [8] Middle aged guys with some impotence have more and better nighttime erections with PDE5 inhibitors and this oxygenation protects certain tissues that trap blood within the penis.

I would highly encourage anyone who is using Viagra or one of the other PDE5 inhibitors recreationally to wean themselves off of these.  The side effects can be signficant and we do not know of the long term effects.  Also, remember that true erectile dysfunction, even in young males, can be a result of an organic issues such as a varicocele or low testosterone. These are serious and need to be medically evaluated.

In addition, do everything you can to get your confidence back through 1) psychological means (one study demonstrated the benefits of cognitive behavioral therapy for example [10]), 2) Nitric Oxide Boosting Foods, 3) lots of exercise and 4) adequate sleep.  Most younger guys can easily recover using these simple techniques.

REFERENCES:

1) The Guaridan UK, Dec 7 2008, Amelia Hill, “Men lack confidence in boardroom and bedroom”

2) Journal of Sexual Medicine, pub’d online on Mar 4 2008, 5(10):2414-2418, “Recreational Use of PDE5 Inhibitors by Young Healthy Men: Recognizing This Issue Among Medical Students”

3) NY Times, Monday, June 7, 2010, Health Guide, Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc

4) BMJ, 1999 March 6, 318(7184):669, “Sildenafil (Viagra) is used as a recreational drug in England”

5) https://www.medicalnewstoday.com/articles/11733.php

6) International Journal of Impotence Research, 2003, 15:225 228, “Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time”

7) Molecular Pharmacology, Jul 2005, 68(1):226-232, “Erection Capability Is Potentiated by Long-Term Sildenafil Treatment: Role of Blood Flow-Induced Endothelial Nitric-Oxide Synthase Phosphorylation”

8) https://www.medscape.com/viewarticle/477592

9) Int J Clin Pract, 2000 Nov, 54(9):561-6, “Sildenafil citrate (Viagra) is effective and well tolerated for treating erectile dysfunction of psychogenic or mixed aetiology”

10) J Sex Med, 2007 Jul; 4(4 Pt 2):1117-25, “Integrated sildenafil and cognitive-behavior sex therapy for psychogenic erectile dysfunction: a pilot study”

Nutritional Hair Testing: A Valuable Tool - Peak Testosterone

We recently has a man on the Peak Testosterone Forum that was suffering from low testosterone and classic low testosterone symptoms.  Since he is a young guy, he had many voices (including myself) encouraging him to try to find the root cause of his low testosterone.  In the course of the discussion, he asked the following question:

“Question – should I push for a full micronutrient blood panel? That might shed some light on what I am missing if it’s a micronutrient problem. Tim Ferriss wrote extensively about this in The 4-Hour Body but shelling out a ton of money for these tests will be hard for me.” [1]

The “ton of money” that he is talking about involves Spectracell nutrient testing, which, as of this writing, runs $390 to $520 per test. Is there any alternative that is less expensive and yet can provide good information that I can suggest to this young guy?

Well, there is one considerably cheaper alternative out there – and I have no affiliation by the way – for a number of the key electrolytes and minerals:  hair testing with Doctor’s Data using Direct Labs.  The cost is $120 to $150 depending on the coupons you have, and in my opinion the results are quite accurate and revealing.  I have documented a number of great case studies here:  Pages Showing the Accuracy of Hair Testing. I used hair testing, for example, to verify that I was likely getting high levels of arsenic from rice protein that I was consuming.

On this same hair test, I found very revealing information about my nutritional status, which I will show below including excerpts from the acoompanying Doctor’s Data report:

1. Low Potassium.  “The level of Potassium (K) in hair does not reflect nutritional status or dietary intake. However, hair K levels may provide clinically relevant information pertaining to adrenal function and/or electrolyte balance. K is an electrolyte and a potentiator of enzyme functions in cells, but neither of theses functions takes place in hair. K can be low in the body as the result of gastrointestinal or renal dysfunction, or as a side effect of some diuretics. In adrenocortical hyperactivity, blood levels of K are depressed, while urinary K is increased. Low hair K should be viewed as a screening test. Observations at DDI indicate that hair levels of sodium and K are commonly low in association with emotional stress. The low levels of sodium and K are frequently concomitant with high levels of calcium and magnesium in hair. This apparent emotional stress pattern requires further investigation.”

2. Low Manganese.   “Hair Manganese (Mn) levels correlate well with Mn levels in other body tissues. Hair Mn levels are commonly low, in part due to low dietary Mn intake and the interaction of Mn with phosphates in the gut. Intestinal malabsorption also limits Mn uptake.”

3. Low Chromium. “Low Hair Chromium (Cr) is a good indicator of tissue levels and may provide a better indication of status than do urine or blood plasma/serum (Nielsen, F.H. In Modern Nutrition on Health and Disease; 8th Edition, 1994. Ed. Shils, Olson and Shike. Lea and Febiger, Philadelphia). Hair Cr is seldom affected by permanent solutions, dyes and bleaches. Marginal or insufficient Cr is common in the U.S., where average tissue levels are low compared to those found in many other countries… Common causes of deficiency are ingestion of highly processed foods, inadequate soil levels of Cr, gastrointestinal dysfunction, and insufficient vitamin B-6.”

4. Low Molybdenum.  “Low Molybdenum (Mo) in hair is a possible indication of Mo deficiency. Hair is very rarely contaminated with exogenous Mo…Mo is an essential trace element that is an activator of specific enzymes such as: xanthine oxidase (catalyzes formation of uric acid), sulfite oxidase (catalyzes oxidation of sulfite to sulfate), and aldehyde dehydrogenase (catalyzes oxidation of aldehydes). Possible effects or symptoms consistent with Mo deficiency are: subnormal uric acid in blood and urine, sensitivity or reactivity to sulfites, protein intolerance (specifically to sulfur-bearing amino acids), and sensitivity or reactivity to aldehydes…True Mo deficiency is uncommon but may result from: a poor-quality diet, gastrointestinal dysfunctions, or tungsten , or tungsten exposure.”

CAUTION:  I highly encourage you to take your results to a pro that works with nutrition and hair testing data.  Below you will find some of my thinking regarding these results, but obviously getting someone with experience is the way to go.  I am providing the following just to show you the power of hair testing to improve and protect your health:

Putting the above all together, I believe that I have several things to look at and work on (besides ditching the rice protein):

a) Low Stomach Acid. Atrophic gastritis could cause #2-4.  There is an alternative test for this condition involving Betaine HCL that I may try.  (The report suggested it could be GI issues, but I highly doubt that is the case, because I have no gut irritation and am very regular due to my high fiber, largely plant-based flexitarian diet.)

b) High Stress. At the time I took this test, I did indeed have high stress, not enough sleep, etc.  Verifying this is the fact that, as the report suggests, I also had pretty high calcium (~85th percentile) and magnesium (~75th percentile) levels.  This would explain #1 and shows me something I should work on.  My sodium levels (~50th percentile) were not that low however.

NOTE:  I eat lots of whole and raw foods every day and have actually calculated the nutrition that I should get.  All of the above nutrients should be more than adequately met with my current diet.  This is why I am looking at other issues than just diet.

Now I hate to admit that their could be a third issue going on that could probably explain ALL of the above results:

c)  Overhydration. I had never really thought about it before, but drinking too many fluids – I drink a lot of water, tea and coffee – can also explain all of the results above.  Doing this can also be hard on the kidneys, so there is simply no good argument not to correct this, and it may help out my results.

CONCLUSION:  Hair testing showed me valuable nutritional information that potentially could be health or even life saving, and it included data that would probably never be received from an insurance-based physician.  Furthermore, I was able to come up with some good things to work on over the next few months and good questions for an alternative practitioner that works in this area. I have also already included some supplementation of chromium and manganese to help as well.

REFERENCES:

1) https://www.peaktestosterone.com/forum/index.php?topic=10313.0

Gingko, Antidepressants and Erectile Dysfunction

Gingko Biloba has well-known blood flow increasing properties and it also helps acetylcholine bind to receptors, both of which could be a help with erectile dysfunction.  And that appears to be the case, at least according to one older study where about half of patients with erectile dysfunction were helped.

However, I have always been cautious about recommending it, because the studies on its erection-enhancing powers are quite old and it has a number of drug interactions. In addition, there are many other excellent herbs and supplements that can help with erectile dysfunction and so Gingko Biloba simply seemed secondary.

However, one study put Gingko Biloba into prominence for those using antidepressant medications. Antidepressants usage is very widespread, covering probably 10% of the population, and one of the common side effects is erectile dysfunction. The majority of antidepressants are SSRI which boost seratonin levels in the brain.  Seratonin is the relaxed, feel good neurotransmitter and, unfortunately, can relax one’s sexual response as well.

1) Journal of Marital and Sex Therapy, 1998 Apr-Jun 24 (2):139-143, “Ginkgo Biloba for Antidepressant-Induced Sexual Dysfunction”

2) PLoS Med, 2008, 5(2):e45, “Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration”

3) Psychiatr Serv, Aug 1999, 50:1076-1078, “Sildenafil for Women Patients With Antidepressant-Induced Sexual Dysfunction”

1) Journal of Marital and Sex Therapy, 1998 Apr-Jun 24 (2):139-143, “Ginkgo Biloba for Antidepressant-Induced Sexual Dysfunction”

2) PLoS Med, 2008, 5(2):e45, “Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration”

3) Psychiatr Serv, Aug 1999, 50:1076-1078, “Sildenafil for Women Patients With Antidepressant-Induced Sexual Dysfunction”

So many individuals on antidepressants must deal with the unwelcome and discouraging side effect of erectile dysfunction and this is where Gingko Biloba can come to the rescue.  One journal reported that 76% of men (and 91% of women) were effectively helped from anti-depressant induced sexual dysfunction by taking Gingko.

Often those with antipressant-indused sexual dysfunction will go to their doctor and try a different medication that is either less effective in treating their depression and/or does not improve their erectile dysfunction. Of course, do not take Gingko until you’ve talked to your doctor, but it may be a nice to have the best of both worlds:  the antidepressant medication of choice and restored sexual function as well.

FEMALE LIBIDO: By the way, consider the remarkable efficacy rate for women:  91%. More females than males are on antidepressants due to their lower seratonin levels and so the sex lives of many couples could possibly be assisted if the woman took Gingko Biloba.  One study also showed that Viagra could help women out in this area as well. [3]

NOTE: SSRI’s have been under a lot of heat lately.  One recent study of some of the blockbuster drugs in this category (such as Paxil, Effexor and Prozac), found that they are no better than a placebo. [2] Basically, sugar pills/placebos improved symptoms just as much as the drugs. The study did find a small benefit for severely depressed patients, but for mild to moderate symptoms, there appears to be no significant benefit. Talk to your doctor, of course, and you may want to look at my link on Natural Depression Cures as well.

REFERENCES:

However, I have always been cautious about recommending it, because the studies on its erection-enhancing powers are quite old and it has a number of drug interactions. In addition, there are many other excellent herbs and supplements that can help with erectile dysfunction and so Gingko Biloba simply seemed secondary.

However, one study put Gingko Biloba into prominence for those using antidepressant medications. Antidepressants usage is very widespread, covering probably 10% of the population, and one of the common side effects is erectile dysfunction. The majority of antidepressants are SSRI which boost seratonin levels in the brain.  Seratonin is the relaxed, feel good neurotransmitter and, unfortunately, can relax one’s sexual response as well.

So many individuals on antidepressants must deal with the unwelcome and discouraging side effect of erectile dysfunction and this is where Gingko Biloba can come to the rescue.  One journal reported that 76% of men (and 91% of women) were effectively helped from anti-depressant induced sexual dysfunction by taking Gingko.

FEMALE LIBIDO: By the way, consider the remarkable efficacy rate for women:  91%. More females than males are on antidepressants due to their lower seratonin levels and so the sex lives of many couples could possibly be assisted if the woman took Gingko Biloba.  One study also showed that Viagra could help women out in this area as well. [3]

NOTE: SSRI’s have been under a lot of heat lately.  One recent study of some of the blockbuster drugs in this category (such as Paxil, Effexor and Prozac), found that they are no better than a placebo. [2] Basically, sugar pills/placebos improved symptoms just as much as the drugs. The study did find a small benefit for severely depressed patients, but for mild to moderate symptoms, there appears to be no significant benefit. Talk to your doctor, of course, and you may want to look at my link on Natural Depression Cures as well.

Antipsychotics and Testosterone - Peak Testosterone

REFERENCES:

1) Journal of Clinical Psychopharmacology, 2002, 22:109-114, “The effects of anti-psychotic induced hyperprolactinaemia on the hypothalamic-pituitary-gonadal axis”

2) Neuroendocrinology Letters, Nos.1/2, Feb-Apr Vol.25, 2004, “Impact of a switch from typical to atypical antipsychotic drugs on quality of life and gonadal hormones in male patients with schizophrenia”

3) J Psychopharmacol, Jun 2007, 21(4):428-434, “The effect of chronic antipsychotic treatment on sexual behaviour, hormones and organ size in the male rat&https://priory.com/psych/sexdys.htm

5) Am J Psychiatry, Apr 2002, 159:561-566, “Association of Diabetes Mellitus With Use of Atypical Neuroleptics in the Treatment of Schizophrenia”

6) Psychopharmacol Bull, 2009; 42(1):1-21, “Atypical Antipsychotic Drugs and Diabetes Mellitus in the US Food and Drug Administration Adverse Event Database: A Systematic Bayesian Signal Detection Analysis”

7) Journal of Endocrinology, 2003, 179:357 365, “Effects of acute prolactin manipulation on sexual drive and function in males”

Antipsychotic drugs can be life-saving for many men with bipolar, schizophrenic, manic and other disorders.  Unfortunately, they can also negatively impact testosterone levels and sexual function in a variety of ways.  This should not be surprising as psychotropic drugs of any sort are very powerful medications and hormones are often impacted.

Antipsychotic medications are a very involved subject and one can’t help but wonder how well understood they are by even the experts.  However, there are several key categories of these drugs, which helps in understanding their potential impact on testosterone.  One category are the “typical antipsychotics,” which have a relatively common side effect of Parkinson-like symtpoms, including tremors and rigidity since they block dopamine receptors in the brain. (NOTE:  These symptoms can become permanent.)

The atypical, second generation antipsychotics do not have the advantage of avoiding Parkinson-like symptoms, but, of course, have a separate set of nasty side effects that pateints must be aware of and watch out for, including diabetes, movement disorders and stroke just for starters.

It is the typical antipsychotics that were known for potentially lowering testosterone.  The reason is that these medications can lead to hyperprolactinemia, or elevated prolactin levels.  As you hopefully know from my link on Prolactin and Prolactinomas, overly high prolactin levels can hammer your testosterone.

One study showed that in females testosterone was strongly affected by these medications, but in males not as much. [1] Another study on male schizophrenics found that switching from the typicals to the atypicals did, indeed, lower prolactin levels.  However, testosterone levels remained largely unchanged. [2]  In other words, these typical medications likely lower testosterone a little, but not enough to make a significant difference.

CAUTION: This is informational only.  Do not go off or change any medication without consulting your physician.

Or is that really the whole story?  Actually, some of these drugs have been found to lower testosterone. For example, the second generation antipsychotic Risperdal (risperidone) was shown to lower testosterone in rats. [3] Interestingly enough, it not affect leutinizing hormone, but still lowered testosterone through some other mechanism.  In addition, the drug carbamazepine (Carbatrol, Tegretol, Equetro, Epitol) used for bipolar and manic disorders has also been shown to increase clearance of testosterone and thus likely decrease plasma testosterone levels. [4]

Regardless of short term affects on testosterone according to the studies, it is unlikely that these drugs will do anything but lower testosterone in the long term.  Consider these risk factors for lower testosterone that are generally negatively impaced:

1.  Dopamine.  Decreased levels of dopamine lead to sexual dysfunction and decreased sexual desire.  This will likely lead to less sexual activity and less sexual activity will tend to decrease testosterone.

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

2. Diabetes and Metabolic Disorders. A significant risk factor for erectile dysfunction is type II (adult onset) diabetes.  This is no surprise as diabetes is incredibly hard on the body and ages many tissues at an accelerated rate. The atypical antipsychotics are known to increase risk for diabetes. [5] Follow up research has verified this affect across a wide variety of the atypicals. [6] Blood sugar disorders will do nothing but lower testosterone, potentially total and free testosterone with time, due to the increased oxidative and inflammatory load placed on the body.

3.  Prolactin. Elevated prolactin levels are a known libido killer in and of itself. [7] Again, this will tend to lead to decreased sex and sexual interest, which will probably lower testosterone long term (and even short term as mentioned above).

Therefore, long term studies my show other decreases in testosterone levels as well.

Branched Chain Amino Acids - Peak Testosterone

Branched Chain Amino Acids are a magical set of aminos called L-Leucine, L-Valine and L-Isoleucine.  Ever wonder why you need protein to put on muscle?  The correct answer is “Branched Chain Amino Acids”.  There are many aminos in animal and vegetable proteins, but it is just the BCAA’s that signal your body to rebuild your muscles, initiate protein synthesis and promote recovery.

Below are some of the wonder-working powers of BCAA’s for us males according to the research:

1) Protein Synthesis. BCAA’s increase protein synthesis and decrease protein degradation in muscle tissue due to activation of certain key enzymes. [1]

Well, one could go on and on about the near miraculous properties of these BCAA’s when it comes to muscle.  Now some guys might be asking, “Well, I don’t want to look like Arnold.  Who cares about putting on a bunch of muscle mass, anyway?”

To those naysayers, I have to explain that muscle mass is likely one of the keys to anti-aging.  (It’s also a key to your bedroom success and self-image.) Preserving your muscle is very critical, because “muscle burns fat”.  As we age, it’s easy to simultaneously lose muscle and gain fat tissue.  This reduction of our muscle to fat ration is very dangerous and makes it even easier to put on more fat. And extra body fat, as I document in my links on the Dangers of the Bulge and Nasty Visceral Fat, kills your health and your sex life.

However, Branched Chain Amino Acids do not just fight fat metabolism issues long term – studies show they fight them short term as well according to several animal studies.  For example, one 2007 study on mice showed that in overweight mice on a high fat diet, doubling leucine resulted in a dramatic reduction in weight gain and reduction in fat tissues. [8] This has translated to human studies as well.  A 2010 study of middle-aged people found that those with the lowest (by quartile) intake of BCAA’s versus those with the highest had a 30% greater risk of being overweight. [5] In other words, BCAA’s do just as billed:  helping the middle aged and beyond  “lean out” and win the battle the bulge.

How do Branched Chain Amino Acids work their magic?  One way may be through impressive changes in blood sugar metabolism once one has Metabolic Syndrome or prediabetes. To demonstrate this, researchers gave mice a high fat diet, which induces insulin resistance, fatty liver disease and inflammation. They then doubled the mice’s leucine intake and the results were near miraculous:  it improved their insulin resistance and prediabetic state in many key metabolic pathways. [9][10]

Again, this is incredibly important because so many middle-aged and beyond adults in a modern lifestyle struggle with M, prediabetes and insulin resistance.  BCAA’s is likely another potent weapon in their glucose metabolism arsenal.  (See my link on Prediabetes Prevention for more information.)

All of this may be why a study of middle-aged mice showed even more impressive gains: a 12 percent average increase in life span from Branched Chain Amino supplementation. [6] Of course, longevity studies on mice don’t always translate into the equivalent gains in humans, but one can’t help but see that the current  research is showing that BCAA’s are likely just as beneficial for the middle-aged – and maybe more – than for young, healthy bodybuilders.  The middle-aged may be able to avoid much of the muscle-wasting effects of the latter years by taking just a few grams of this supplement or making sure to include enough protein in the their diet.

REFERENCES:

1) J. Nutr, 136 (1 Suppl):269S 73S, “Branched-chain amino acids activate key enzymes in protein synthesis after physical exercise”

2)  Int J Sport Nutr Exerc Metab, 2010 Jun, 20(3):236-44, “Branched-chain amino acid supplementation before squat exercise and delayed-onset muscle soreness”

3) Med Sci Sports Exerc, 2000 Jul, 32(7):1214-9, “The effect of BCAA supplementation upon the immune response of triathletes”

4) Journal of the International Society of Sports Nutrition, 2009, 6(Suppl 1):P1, “Consuming a supplement containing branched-chain amino acids during a resistance-training program increases lean mass, muscle strength and fat loss”

5) J. Nutr, Dec 15 2010, “Higher Branched-Chain Amino Acid Intake Is Associated with a Lower Prevalence of Being Overweight or Obese in Middle-Aged East Asian and Western Adults”

6) https://www.eurekalert.org/pub_releases/2010-10/cp-aas092910.php

7) Cell Metab, 2009 Apr, 9(4):311-26, “A branched-chain amino acid-related metabolic signature that differentiates obese and lean humans and contributes to insulin resistance”

8) Diabetes, Jun 2007, 56(6):1647-1654, “Increasing Dietary Leucine Intake Reduces Diet-Induced Obesity and Improves Glucose and Cholesterol Metabolism in Mice via Multimechanisms”

9) PLoS ONE, 2011, 6(6):e21187, “Dietary Leucine – An Environmental Modifier of Insulin Resistance Acting on Multiple Levels of Metabolism”

10) https://esciencenews.com/articles/2011/06/23/ dietary.leucine.may.fight.prediabetes.metabolic.syndrome

Testosterone Injections:Study Shows Increase Cardiovascular Risk

But are injections safe?  Or are there hidden dangers to some men giving themselves testosterone shots?  It turns out that that there is a recent study that actually examines that question directly.  Furhtermore, it compares injections to two other protocols:  patches and topicals.  Surprisingly to men like myself enjoying cypionate injections, this study asserts that injections are not as safe as other either patches or topicals.  Furthermore, the study was a very large one that pulled in massive patient populations from both the U.S. and the U.K.  The authors made the following potentially distrubing conclusions for those of us on testosterones shots: [1]

–Injections had a 26% higher risk of “cardiovascular events,” meaning heart attack, stroke or angina (chest pain) than topicals.

–Injections had a 16% higher risk of hospitalizations than  topicals.

–Injections had a 34% higher risk of death than topicals.

This was basically the conclusion of a female endocrinologist (Dr. Margarent Weirman), who stated in an accompanying editorial, that “the study raises the issue of whether injectable depo-testosterone or other formulations that consistently result in levels outside the physiologic range should be restricted or at least more carefully monitored for [CV] risk. [2]

This is a huge admission in my opinion, because Dr. Weirman is an endocrinologist admitting that driving men supraphysiological, i.e. greater than 1200 ng/dl, could be putting men at risk for cardiovascular issues. The reason that this is so significant is that, at least from what I have seen, it is generally endocrinologists who are administering these kind of injection protocols.  For reasons that are completely unclear to me to this day, they typically will give a man a massive dose of testosterone cypionate (200-400 mg), which shoots the poor patients testosterone and estradiol through the roof. These protocols are always on an every 2-3 week schedule and about 10 days after the injection the poor guy’s testosterone actually crashes through his old levels and for a few days.  This means that he will end up with testosterone lower than his old baseline!  I document in this page:  Testosterone Cypionate – Weekly Versus Every Two Weeks?

Some of you may be wondering why this kind of protocol would increase risk for cardiovascular problems.  The reason is likely that elevated estradiol increases the risk of clotting and clotting is what strokes and heart attacks are all about.  A heart attack begins with a clot in the arteries and a stroke is simply a clot that reaches the brain.

CONCLUSION:  In my opinion, injectibles will be exonerated by future research when a frequent and physiological profile is followed, but I certainly cannot prove that. I try to follow a safe philosophy and am currently using a subQ testosterone cypionate protocol myself and inject every other day and my latest total testosterone lab draws were 700 and 800 ng/dl.  These are the numbers of a healthy middle-aged male and equivalent to what is reached by many men on the topicals.  This helps keep my estradiol at a reasonable level:  my last read was 27 pg/ml, i.e. my testosterone and estradiol are within normal youthful ranges.

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

However, I am playing by the rules and not all men on TRT do.  Some men (and their physicians) let blood pressure and hemtocrit / hemoglobin go too high.  Some men have clotting disorders.  And, finally, some men on testosterone deliberately go above 1200 ng/dl, which sends their estradiol through the roof generally.  I see this fairly often on The Peak Testosterone Forum, where men are clearly deliberatly injecting way too much testosterone. They are not going to steroid levels, but they are definitely going above 1200 during part of the week.

NOTE:  See also my page on Other Potential Risks of Testosterone Therapy.

1)   JAMA Intern Med, 2015 Jul 1;175(7):1187-96, “Comparative Safety of Testosterone Dosage Forms”

2) JAMA Intern Med. 2015;175(7):1197-1198, “Risks of Different Testosterone Preparations: Too Much, Too Little, Just Right”

Dr. Esselstyn's Method for Plaque Reversal - Peak Testosterone

The book Prevent and Reverse Heart Disease by Dr. Caldwell Esselstyn is now a classic. Dr. Esselstyn was one of the early pioneers of plaque reversal and enjoyed considerable success at the well-known and respected Cleveland Clinic. What is particularly remarkable is that he achieved recognition in spite of the fact that he was a surgeon and not a cardiologist. Not only is he not a cardiologist, but he is a rare individual among M.D.’s, because he has devoted his time and energy to disease prevention and disease reversal through lifestyle means. What a concept!

Seriously, how many physicians do you know that believe lifestyle changes can cure medical conditions and discuss the same in any detail with their patients?  From what I have seen, the great majority of physicians are almost completely ignorant of this kind of preventative medicine and much prefer and respect pharmaceutical and surgical solutions. So kudos to Dr. Esselstyn for going against the current.

So just how does Dr. Esselstyn reverse plaque? Basially, the game plan is simple: eat a low fat vegan diet composed of legumes, fruit, vegetables and whole grains with the goal of dropping your total cholesterol below 150 and LDL less than 80. If you can’t achieve these numbers through diet alone, he will give a statin. But, in his case, a statin is a last resort and I have the impression used a relatively low percentage of the time with patients.

Again, the point is that Dr. Esselstyn believes that plaque reversal has been made too complex and summarized his philosophy nicely here:

“If you follow a plant-based nutrition program to reduce your total cholesterol to below 150 mg/dl and the LDL levels to less than 80 mg/dl, you cannot deposit fat and cholesterol into your coronary arteries. Period.” [1]

1)   Prevent and Reverse Heart Disease, by Caldwell Esselstyn, Jr., M.D., p. 33.

Sound too good to be true?  Well, Esselstyn states that his patients have cleared out between 10-30% of their arterial plaque just through following his dietary advice.  And thus leads to big improvements in blood flow.   He insists that his patients follow a strictly plant-based diet. Again, his rules are simple, but many would find them hard to follow, and include whole plant foods without nuts, oils or avocados. So he is very strict: no animal products, oils, fats, margarines, etc.

Again, this is so simple:  you eat four kinds of food – nothing more and nothing less.  Dr. Esselstyn does not emphasize stress management or exercise and believes those do not affect plaque reversal.  I also do not see any mention of triglycerides or HDL.  Again, his strategy relies on bringing LDL way down below the concentration at which it can be deposited in the arterial walls.

The reasoning here is based on the principles some of us learned in high school chemistry:  the concentration on one side of a membrane must be high enough to move molecules across that membrane.  In this case the membrane is the endothelium and the concentration at which LDL can be pushed into the arterial walls is right at 80 mg/dl according to a variety of research. So basically if you lower the concentration below 80, then atherosclerosis cannot progress.

He also is a big believer in plant-based nutrition, because it a) is so powerfully anti-inflammatory and b) promotes endothelial function.  I don’t remember him directly saying this in the book, but low fat plant foods tend to increase nitric oxide and nitric oxide is a powerful anti-inflammatory. Furthermore, low fat plant foods tend to lower blood pressure, which is critical, because even mildly increased blood pressure above 120/80 is very hard on arterial walls.  All of this is the subject of my book, The Peak Erectile Strength Diet, for example.

b) Drs. Gould and Davis allow for some meat consumption and Dr. Gould for the consumption of dairy.  (Dr. Esselstyn started out allowing low fat dairy, but stopped that recommendation, because he believe that dairy may fuel some types of cancer.)

c) Drs. Gould and Davis do not exactly emphasize exercise but insist that you do some.  Dr. Esselstyn does not even make exercise part of his program.

This list could go on, but let me stop there and say also that the packed with lots of excellent information.  He has lots of practical tips, such as how to eat low fat when travelling and with family, recipes, case studies and on and on.  Again, this is another book that should be on your nightstand and read every night – it’s that important.

NOTE:  For those unfamiliar, I have discussed the other plaque-reversing strategies here:   A Review of Heal Your Heart by Dr. K. Lance Gould and A Review of Track Your Plaque by Dr. William Davis.

REFERENCES:

The G Spot, A Suprising History - Peak Testosterone

The history of the G Spot is an interesting read:  it’s the story of a whole bunch of male researchers who, after years of study, realized they didn’t understand female anatomy. It’s also a story of otherwise staid and phlegmatic white coat Ph.D.’s getting rather ugly and jumping into the cage for a little laboratorial face thumping. The whole story even includes a dozen cadavers along the way.

And that’s good, because reading about female anatomy in the research can be a little “dry” shall we say?  Consider this ground-breaking, mouth-watering description of the clitoris:  “The clitoris is a multiplanar structure with a broad attachment to the pubic arch and via extensive supporting tissue to the mons pubis and labia. Centrally it is attached to the urethra and vagina. Its components include the erectile bodies (paired bulbs and paired corpora, which are continuous with the crura) and the glans clitoris. The glans is a midline, densely neural, nonerectile structure that is the only external manifestation of the clitoris”. [1]  I’ve included the reference in case you want to do a little reading.

Actually, this journal article is trying to point out that the clitoris is actually a much more complex structure than was initially realized.  Us guys – we’re simple.  We’re easy.  But females are just as complex physically as they are in every other way!

The G Spot is no different. Researchers in 2001 stated that the G Spot was a complete fabrication because it could not be located. [3] Another researcher actually wrote a paper entitled “The G-spot: a modern gynecologic myth“. [2] One team even noted that vaginal stimulation caused blood to rush to the clitoris and thus a vaginal orgasm was really a clitoral orgasm.

Case closed, right?  Well, the next year a researcher examined fourteen cadavers and found that 9/14 had Skene’s glands and 12/14 had erectile tissues in the general vaginal G Spot area.  (The Skene’s glands are responsible for female ejaculation and are the female version of the prostate.) [4]  In other words, most females examined had analagous structures to us males within the vagina itself.  (The 2001 researchers were strangely silent thereafter.)

Several years later researchers examined the G Spot areas of women who said that they had vaginal orgasms.  All of the women had a thickened G Spot area or “urethrovaginal space”.  The researcher did further investigation and found that only women that had this thickened area were able to achieve vaginal orgasms. [5]

This researcher, Emmanuele Jannini, is the king of the G Spot and also found that PDE5 was mostly clustered around the G Spot, especially in women that had an thickened G Spot area by the way.  The significance of this is that PDE5 is the same enzyme that Viagra works on in males.  (PDE5 actually depletes Nitric Oxide.)  In other words, most women have erectile tissue right in the area of the G Spot confirming what many enthusiastic males have been saying for years:  this area can become engorged.

So what does all this mean?  Well, there are a couple of important points.  The first is that us males can actually learn something about females after years of intense and painful effort. The second is that it appears that some women, although no one has a hard – no pun intended of course – number, will have great difficulty achieving a vaginal orgasm because they do not have a thickened G Spot area and/or low PDE5.

Perhaps the G Spot Shot (or G Spot Augmentation) can help these women?  I don’t think anyone knows the answer to that question fully, but if you’ve been trying like a mad dog to stimulate the G Spot and nothing much is happening, there may be an anatomical reason for it.  Remember that about one third of women report not being able to achieve a vaginal orgasm and perhaps this explains a lot of that phenomenon.

However, the opposite point can also be made:  most women have actual erectile tissues in their vagina, Skene’s glands, PDE5 and a whole lot of other fun stuff. So guys get busy if you haven’t already and you can add a whole new dimension to your woman’s sexuality. Most importantly, I can only encourage you to do a little “verification” of the research yourself…

NEWS FLASH:  One large study of 1,800 female identical twins (Jan 2010) asked each twin if they had a G-spot.  The researchers argued that if one twin had a G-Spot, the other should as well and, therefore, the answers of one twin should match the other. They actually did not find that to be the case and concluded that the G-Spot “doesn’t appear to exist”. [6] Back and forth go the arguments, eh? In my opinion, it is a flawed approach to rely on a subjective answer from a woman on this topic:  many women struggle to even have an orgasm or know its location for a variety of reasons.

REFERENCES:

1) Journal of Urology, 174(4):1189-1195, H. O’CONNELL, K. SANJEEVAN, J. HUTSON, “ANATOMY OF THE CLITORIS”

2) American J of Obstetrics and Gynecology, Jan 9 2001, 185(2):359-62, “The G-spot: a modern gynecologic myth”

3) Am J Obstet Gynecol, 2001, 185:359-362

4) Urology, 2002, 60(2):1077-1082

5) J Sexual Med, published online Mar 4, 2008, Jannini, “Measurement of the Thickness of the Urethrovaginal Space in Women with or without Vaginal Orgasm.”

6) http://news.bbc.co.uk/2/hi/health/8439000.stm

Inflammation: The Root of All Evil and Your #1 Enemy - Peaktestosterone

Don’t believe it? Then just look at this short list of nasty conditions that are aided and abetted by inflammation:

1.  Heart Disease. One of the root causes of cardiovascular disease is inflammation.  In fact, what is interesting is that some experts are arguing that inflammation is THE root of heart disease.  For example, studies have shown that 1) hs-CRP (highly sensitive C-Reactive Protein) is the strongest predictor of heart disease and 2) individuals with relatively low LDL ( < 120 mg/dl) but high hs-CRP had a high risk of cardiovascular risk. [1]

2.  Erectile Dysfunction.  This is such an important that I covered it in another link on Inflammation and Erections. Suffice it to say, though, that some experts have argued that low-grade inflammation is actually the root cause of most erectile dysfunction.

3. Cancer. TNF-alpha, the infamous inflammatory cytokine, can easily become a cancer-causing machine:  if you have enough of this, it singlehandedly will help birth new cancers cells, aid in their survival and promote their spread throughout the body. It also increases a host of other pro-cancer cytokines. [2] This is why research is beginning to link inflammation to colon [3], breast/lung [4] and prostate cancer [5]. NOTE:  For additional information, see my link on How to Prevent Cancer.

4. Insulin Resistance. This plague of modern man and core symptom of Metabolic Syndrome has TNF-alpha as one of its primary root causes. [6]

5. Diabetes (Type II).  Not too surprisingly, based on #4, C-Reactive protein is a risk factor the development of diabetes. [7]

6. Multiple Sclerosis, Crohn’s Disease and Rheumatoid Arthritis. TNF-alpha has been associated with all of these nasty autoimmune disorders. [8]

This list could continue, but the point is that inflammation causes and exacerbates all of the Big Three Killers of modern man:  cardiovascular disease, cancer and autoimmune disorders. If you can keep these three in check, obviously your risk of death and debilitating disease will go down dramatically.

Ironically, almost everything we do in a modern, Western lifestyle actually promotes inflammation, as I outline in my link on How to Reduce Inflammation. It would be difficult to live a more pro-inflammatory lifestyle than that experienced by modern man.  Almost all of us are trained, from early childhood, in a lifestyle that literally maximizes systemic inflammation and puts us at risk for a potentially miserable life before a premature death, unless we get this monster under control.

REFERENCES:

1)  https://www.ajmc.com/media/pdf/ A33jul02SymRprtrRIDKER_hs_CRP.pdf

2) Biochemical Pharmacology, 2006, 72:1605-1621, “Inflammation and cancer: How hot is the link?”

3) Gastroenterology, 2010 Jun, 138(6):2101-2114, “Inflammation and colon cancer”

4) J Clin Invest, 2007 Dec 3, 117(12):3660 3663, “IL-6 involvement in epithelial cancers”

5) Nature, 2007 Apr 5, 446(7136):690-4, “Nuclear cytokine-activated IKKalpha controls prostate cancer metastasis by repressing Maspin”

6) Journal of Clin Investigation, May 2 2005, 115(5), “Inflammation, stress, and diabetes”

7) Diabetes Care, 2007 Oct, 30(10):2695-9, “Risk of type 2 diabetes attributable to C-reactive protein and other risk factors”

8) Arthritis Rheum, 2001 Sep, 44(9):1977-83., “Demyelinating and neurologic events reported in association with tumor necrosis factor alpha antagonism”

Cortisol: Test for Low or High Levels - Peak Testosterone

Test for Low or High Cortisol.

Both low and high cortisol can be debilitating and, interestingly enough, they can produce symptoms similar to those often experienced by men with low testosterone.  Low cortisol is often in capacitating and can lead to severe fatigue, shakiness and heart palpitation.  High estradiol is little better and is associated with prediabetes, visceral fat, cardiovascular disease and memory deficits.  (It also will lower testosterone levels.) In my opinion, cortisol testing should be part of any yearly physical – it’s simply that important. However, that is not likely to happen anytime soon due to our nearly bankrupt healthcare systems worldwide.

The bottom line is that, if you want cortisol testing done, you are probably going to have to do it yourself.  If you can afford to pay cash for an anti-aging doctor or naturopath, then that, of course, is preferable.  Most of us, though, will have to self-test to take a peek at our basic stress hormones.

And I have good news:  it does NOT have to cost a lot of money.  Testing prices have come down significantly in the last 5 years and placed many basic tests within the reach of most pocketbooks.  (These are U.S. prices, but many countries have even better pricing available.  Here is a sampling from various labs (and I currently have no affiliation with any of them):

1. Discounted Labs  $199 (4-Tube Saliva Cortisol).  Check out this link to order.

2. Health Tests Direct (Blood Test AM/PM Cortisol).  $67.70.  Check out this link to order.

3. Life Extension Foundation (Blood Test AM/PM Cortisol).  $72 (members only).  Check out this link to order.

4. Saveon Labs (2-Point Cortisol).  $74  Check out this link to order.

Now why did I put the most expensive lab work on the top? Because, as far as I know, all the other tests use blood testing, which means that it will be total cortisol. Total cortisol is valuable, but some men with high cortisol binding globulin (CBG) will end up with low free cortisol that will not be revealed by a blood test. If you really want to cover your bases, it has to be done with a saliva test, because that measure free cortisol.

Now what I feel is important is at least a 2-point test, i.e. one in the morning and one in the evening, because this is so predicitive of certain symptoms based on what I have seen on Peak Testosterone Forum. For example, men with low morning cortisol often suffer from fatigue and other classic low cortisol symptoms. Men with high morning cortisol often struggle with anxiety and some of the medical issues associated with elevated cortisol levels. Men with high evening cortisol often have sleep difficulties. So this may seem like overkill, but it actually quite be quite useful.

NOTE:  Once you pull your numbers, what should you do?  In my opinion you should continue reading the Peak Testosterone Cortisol Program for more information and more things to discuss with your doctor.

CTE's in Young Men:School Athletes Found Have Brain Damage

1) https://www.historyvshollywood.com/reelfaces/concussion/

2) https://www.mensjournal.com/magazine/dave-duerson-the-ferocious-life-and-tragic-death-of-a-super-bowl-star-20121002

3) https://www.mypalmbeachpost.com/news/sports/football/andre-waters-loved-ones-denounce-portrayal-of-him-/npp9t/

4) https://www.pbs.org/wgbh/frontline/article/76-of-79-deceased-nfl-players-found-to-have-brain-disease/

5) https://blogs.edweek.org/edweek/schooled_in_sports/2012/12/long-term_brain_damage_found_in_six_former_hs_football_players.html?qs=High+School+Football+Can+Lead+to+Long-Term+Brain+Damage,+Study+Says

1. CTE = Devastation. I have read many cases of CTE and the end game is something you would not wish on your worst enemy much less your own child. There are no “nice outcomes,” and very often the results can be extremely tragic or violent.  Consider these stories of former NFL players diagnosed with CTE:

a. Dave Duerson shot himself in the chest: to donate his brain.  Why?  Consider this description of his life in the years before his suicide: “Mostly, though, he talked about a raft of ailments that pained and depressed him past all tolerance: starburst headaches and blurred vision, maddening craters in his short-term memory, and his helplessness getting around the towns he knew. Once a man so acute he aced his finals at Notre Dame with little study time, he found himself now having to dash down memos about what he was doing and when. Names, simple words, what he’d eaten for dinner it was all washing out in one long wave.” [2]

b. Jovian Belcher killed both himself and his girlfriend at age 25:   “In 2012, the former Kansas City Chiefs linebacker shot and killed his girlfriend before driving to a Chiefs practice facility, where he committed suicide in front of team officials.” [4]

c.  Andre Waters committed suicide at age 44.

d. Tyler Sash died of an overdose of pain medications at age 27.

2. CTE Can Occur At Any Position. These young men suffered severe brain deterioration and became some combination of disoriented, angry and functionally incapacitated.  What sport for God’s sake is worth risking that?  And, dads, I know that some of you may think, “Well, if I keep him out of the high contact positions such as lineman and safety, then everything should be okay.”  However, that is simply not the case and Ken Stabler – one of the greatest quarterbacks in NFL history – was diagnosed with CTE.  .

By the way, I grew up watching football and playing it in parks, backyards and school yards whenever and wherever we could get a chance.  It was without a doubt the favorite sport for myself and all my friends.  However, I essentially stopped watching it a few years ago when I found out that the average age of an NFL lineman was 51.  That was it for me.  As a society we supposedly call on young men to sacrifice their lives in defending our country and our liberty.  But for the sake of entertaining me on Sundays?  I just could not justify that.

3.  CTE Occurs Often in High School and College Athletes. Again, some dads out there will argue that NFL players experience CTE because these guys are superhuman bone-crushing machines.  All of them are a combination of ungodly strong and fast.  Just look at typical NFL combine stats and you’ll see what I mean! While it is true that these are incredibly genetically gifted athletes, that simply does not explain a big percentage of the cases of CTE.

I say that because CTE does not just affect those who play with such elite athletes. Research has shown that CTE is showing up in the brains of those who played only high school and college football.  Yes, you read that right:  high school football is capable of producing CTE:

Researchers from the BU Center examined the brains of 85 deceased former athletes and military veterans to check for traces of chronic traumatic encephalopathy (CTE), a progressive neurodegenerative disease that can be triggered by repetitive mild traumatic brain injuries. Another 18 subjects without a history of mild traumatic brain injury were used as the control group.

Of the 85 brains examined outside of the control group (84 male, 1 female, ranging from 14-98 years old), 68 were found to have CTE, including 34 former professional football players and one semi-professional football player. Fifteen of the 68 brains with CTE were in people who had played only high school football (six) or college football (nine).” [5]

4. CTE Leads to a Shriveled, Discolored, Shrunken Brain.  Concussion is without a doubt one of the most important movies that I have ever seen.  It is about a young Nigerian forensic pathologist, Dr. Bennet Omahu, who was very troubled by the death of former NFL player Mike Webster.  What troubled him was that Mike Webster was a relatively young man that clearly went mad and yet was not hearing voices or suffering from the typical symptoms that are associated with insanity.  In real life Dr. Omahu became obsessed with the case and even took the brain home to his apartment. [1]

Of course, what he found is now history:  the autopsy revealed a brain that was extremely aged, discolored and shriveled. (Researchers have since discoverd that this occurs primarily from the infamous tau protein accumulating in brain neurons.) Mike Webster was only 50 at the time of his death and so this startled Dr. Omahu.  Being from Nigeria he began researching football and estimated that Mike Webster, as a lineman, received 70,000 blows to his head in his long 17 year career.

5. It’s Not Just Football.  Researchers have now found CTE in former boxers, professional wrestlers and hockey.

6. Amateur Athletes.  CTE has now been found in a former amateur boxer and hockey player.  [5]

7. The Human Brain is Particularly Vulnerable to Head Blows. We are good-sized animals and fairly impressive in many respects.  However, in the movie Concussion, Dr. Omalu point out that many animals have protection built into their brains against head blows – something that we completely lack.  He discusses, for example, a woodpecker that has a tongue that wraps around the brain as a cushion.  But the human brain has no such protection and is one of those creatures that is extremely vulnerable to head blows.  Young men suffering head blows simply have no protections no matter how strong and well-trained – it’s that simple.

CONCLUSION: This subject is near and dear to my heart, because I have little doubt that a significant percentage of men with low testosterone showing up to my site and forum have CTE or concussion-related damage as a root cause.  Simple math shows that a big percentage of young men have played organized football, hockey, boxing or been in the military, all of which have been shown to have a risk for developing CTE.  I have no doubt that sports such as soccer and rugby will also be found to be associated with the condition as concussions and head blows often occur in these sports as well. See my page on Testosterone and Concussions for an interview with an elite Xgames athlete who suffered multiple concussions and how it affected his testosterone levels.

The tragedy in my opinion is that the NFL has done virtually nothing practical to protect its players.  They are not even willing to have the lineman start in a squatting position which would eliminate a lot of the head blows in that position.  Clearly it is all about the money and revenue has even gone up since the discovery of CTE!  And Dr. Omahu is searching for a pharmacological solution to the issue – a drug that would prevent the buildup of the tau proteins in the brain.

However, the brain suffers blows of up to 100G on the football field and 20-30G blow are quite common.  Can we possibly plug all the holes created by this?  I seriously doubt it.  That is the equivalent of taking someone out to a park and letting a group of thugs beat the crap out of him with clubs and then handing him a pill in the hopes that it will magically cure all the damage.

In any event, for now we can protect our kids by having them play and get involved more safe sports.

Magnesium: An Inexpensive Life Saver - Peak Testosterone

Other than Vitamin D, there is probably no vitamin or mineral that is so critcal to so many functions within the body.  Of course, the modern diet high in processed foods leaves the great majority of people deficient in Magnesium.  This leads to a host of illnesses that research has uncovered in the last fifteen years.

NEWS FLASH:  A recent study of senior men found that magnesium was very correlated with testosterone levels. [9] Yes, this means that optimizing your magnesium levels could actually boost your testosterone.  More research needs to be done, but it looks like this all-important mineral ramps up androgen production as well. CAUTION: The study showed that IGF-1 levels are also raised with magnesium and some researchers believe that raising IGF-1 could increase cancer risk.

Look at the nasty list of syndromes, diseases and conditions below.  All of these can be avoided by taking a simple Magnesium supplement.

1.  Heart arrhythmias [1]

2. Heart disease [2]

3. High blood pressure [3]

4. Metabolic Syndrome [4]

5. Diabetes [5]

9.  TNF-Alpha / Inflammation [See my link on TNF Inhibitors for more information.]

REFERENCES:

1) Am J Cardiol,1993,Nov 15 1972,(15):1156-62;Am J Clin Nutr,2002,75:550-4

2) Int J Epidemiol,1999,28:645-651

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

4) Am J Med,1992,93(2A):11S-20S;J Am Soc Nephrol,1992,3(4Suppl):S78-85

5) Magnes Bul,2000,22:53-59

6) Eur J Nutr,Oct 2001,40(5):231-7

7) Cephalalgia,1996;16:257-63;Pediatr Med Chir,1993,15(5):481-8

8) J Clin Endocrinol Metab,1997,82:3783-3785

9) Int J Androl, 2011 Dec, 34(6 Pt 2):e594-600, “Magnesium and anabolic hormones in older men”

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”

Low Carb Diets: Side Effects and Risks - Peak Testosterone

Low carb diet have had several major blogging defectors in recent years, such as Matt Jones and Anthony Colpo, and has received some gentle criticism from leaders such as Chris Kresser. I believe that Chris Kresser has handled the subject very well, who basically points out that a certain percentage of his patients begin to experience rather severe side effects from low carb diets after a few months or years. From what I have read, around a third of men will struggle. In addition, many men consuming Paleo are essentially on a low carb diet and experience many of the same issues. If you’re struggling just add in some good low glycemic carbs. (There are good carbs and bad carbs, somewhat similar good fats and bad fats.) Please note that I am NOT saying all men will do poorly on a low carb diet or that it is not appropriate in some situations.

Investigate Testosterone Therapy You Can Afford

STEP 11:  Investigate Testosterone Therapy Options that You Can Afford:

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]

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!

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

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.

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

Soda and Erectile Dysfunction - Peak Testosterone

Could drinking just one soda per day take out your sex life and put you at risk for erectile dysfunction? Well, there is no study showing that directly, but it’s just a matter of time.  The research, as I show below, suggests that it could raised your risk factors for a loss in the ol’ hardness factor.

NOTE:  This will be no surprise to those who have browsed at all around my site as soda is packed with high fructose corn syrup and I have already covered extensively, in my link on Fructose and Erectile Dysfunction, can take out both your general and sexual health.

Of course, soda is okay if you are an Olympic athlete burning a couple of thousand calories per day, but most of us struggle to get to the gym for an hour a day. However, for the rest of us, soda consumption is something you want to be very cautious about.

1) Circulation, 2007; “Soft Drink Consumption and Risk of Developing Cardiometabolic Risk Factors and the Metabolic Syndrome in Middle-Aged Adults in the Community”

2) JAMA, 2004, 292(8):978-979, “Sugar-Sweetened Soft Drinks, Obesity, and Type 2 Diabetes”

3) JAMA, 2005, 294(18):2330-2335, “Habitual Caffeine Intake and the Risk of Hypertension in Women”

Need an alternative?  After you read below the nasty stuff coke can do to your erectile strength, you may want to consider Coffee’s Many Beneftis:

1.  Metabolic Syndrome. Soda consumption has been linked to Metabolic Syndrome and this bad boy will take out your hormones, your brain, your heart and your erections in due time.[1] Metabolic Syndrome is a cluster of symptoms including insulin resistance and just one soda per day raised the risk of getting Metabolic Syndrome by a beefy 50%.

3. Hypertension and High Blood Pressure. Sodas have now been associated with high blood pressure (at least in women). [3]  Of course, this will likely be found in males, too, as one of the hallmark symptoms of Metabolic Syndrome is increased blood pressure. (See my link on High Blood Pressure and Erections for more details.)

REFERENCES:

Do It Yourself Skin Care: The Best Sites - Peak Testosterone

I simply cannot believe what some women pay for skin care products:  $80-120 for just one (of many) bottles, vials and jars is not uncommon as many of us men know.  The sad thing is that many of the active ingredients will have degraded by the time your woman opens the container up and, sadder still, is the fact that the chemicals inside almost always cost just a few dollars to manufacture.  You’re basically paying for someone’s chalet, servants and Ferrari.

This is where DIY (Do It Yourself) Skin Care comes in. An entire cottage industry has sprung up as a reaction against the gross overpricing and frequent misrepresenations of the skin care industry.  Yes, you have to follow the recipe carefully and monitor your skin to make sure the product is doing what you think it is, but many people cannot resist taking years off their appearance for just a few dollars.

By the way, I am NOT talking about obsessing over your personal appearance or stressing out as is often the case with some of the women that you have known. (Yes, some guys are the same way.)

I am talking about quietly and privately and quickly making products that can actually reduce the wrinkles on your face or decrease those bags under your eyes for just a few dollars a month and just a few minutes per day of your time

Sure, if you’ve got the cash, just get some plastic surgery done or just do nothing and look like hell.  But, for those interested in boosting their sex appeal to the woman in their life with minimal investment, check these sites out:

CAUTION:  I recommend that you get everything cleared through your dermatologist before trying anything below. And, after that, be sure to apply a small test patch of the product in a not-so-visible area for testing first.

1.  Smart Skin Care.  The Smart Skin Care site is one of the gems on the web and is headed up by Dr. German Todorov, an actual researcher in microbiology and anti-aging. I believe he got his big start on Oprah.  Regardless, his site is very popular and yet he is a down-to-earth fellow that tries to answer emails on his forum and post cutting edge articles that are readable and understandable for the layman.  His info packs are excellent and he shows you how to reduce wrinkles inexpensively and in the privacy of your own home. His site is low pressure and packed with good skin care information. Every middle-aged person, male or female, should spend some time on it in my humble opinion.

2.  Personal Formulator.  The Personal Formulator has a very easy to use site with formulas that any guy can apply in the privacy of his bedroom.  What I like is the easy-to-read formulations that give the base and active ingredients necessary along with proper proportions.  Here are a couple of examples:  the eye and the anti-wrinkle formula.

3.  Essential Day Spa.  This site, Essential Day Spa, is one of the oldest on the web in its niche, without a doubt, the best part of it is the established and active forum. Of course, you always have to take forum posts for what they are, but it’s a great way to gather preliminary information on almost any skin care subject you can imagine.

4. Lotion Crafter. The Lotion Crafter site is a little quirky, but i site is definitely one of the older, more established sites. It’s hard to be beat the base price of their ingredients.  For example, look here at the sample prices of various anti-aging products, such as CoQ10 and Eyeseryl, which can reduce wrinkles and improve bags under the eyes, respectively.

5.  Skin Actives.  The SkinActives site is a little weak on information.  However, the integrity seems fairly high from what I can tell on their site.  Example:  In their FAQs, they state regarding DMAE that “there have been a couple of such scientific papers, and the quality of that research is so bad (yes, there is such a thing as bad quality scientific research) that no conclusions can be extracted from the results. So I have to say to our clients ‘use DMAE for short term only’ and make up the rest of plumping and firming using actives that are better known.”  In addition, there products are generally reasonably priced.

6. Garden of Wisdom. The Garden of Wisdom is another DIY site worth researching.  They have ingredients at a very reasonable price that are difficult to find.  For example, you can find such gems raw ascorbic acid powder, a research-proven wrinkle remover, and Vitamin K (for undereye circles).

6. Making Cosmetics. The Making Cosmetics site has lots of great products but is a little more expensive than some of the other DIY sites.  Of course, you’ll still save a bundle over buying skin care products in almost any retail store, but there is a definite premium here. For example, they have Haloxyl for dark undereye circles as of this writing for $28.80 for.

7. Skin Care Talk. The Skin Care Talk is an active forum community for those trying to look better. Of course, it is primarily frequented by females, but it is a good starter source of information for the typical uninitiated male. They also have a DIY subforum that is specifically for all us do-it-yourselfers.

8. Bulk Actives. The Bulk Actives site is a little quirky, but if they have a product you are interested in, it will be extremely well-priced. Here are some sample prices of pre-made antioxidant formulas, which can in some cases reduce wrinkles.

Low Carb Diets: How It Potentially Be Sabotaging Your Sex Life

Low Carb (or Ketogenic) Diets are incredibly popular right now here in the U.S. and I see men on that diet all the time on Peak Testosterone Forum. Altthough, Low Carb Diets have been around for decades with various names and in various forms, they have recently flourished as never before due to the fact that a significant number of doctors and researchers have become apostles of the movement. Weight loss is rapid, due to loss of water attached to glycogen stores, and lipids usually improve in some positive ways, such as rising HDL and falling triglycerides.  If you’re a meat and dairy lover, this diet seems like a dream-come-true.

But behind the scenes, ugly side effects and research have been surfacing and literally tens of millions have jumped aboard.  I see over and over men that show up on The Forum with standard symptoms that they assume are testosterone or estradiol related.  In fact, I find that they are likely experiencing one or more of the common side effects of Low Carb Diets. Some men even get incredibly ill, and I did an interview with one of them here:  A Low Carb Diet Made Me Sick.

To be clear,  I am NOT saying that all of these side effects occur in all men on a Low Carb Diet. I am just saying that they occur often enough that men should be aware and monitoring themselves.  Plus, many men on a Low Carb Diet are feeling terrible and do not know why.  For all these reasons, I urge you to read for yourselves The Top Twelve (Dirty Dozen) Potential Dangers of a Low Carb Diet:

1. Heart Palpitations and Arrhythmias. Perhaps the most dangerous aspect of a low carb diet are the ketones.  What?!?  That’s not what you heard, right?  Low carb bloggers love to go on and on about the benefits of ketones – and there are some – but there is also a dark side.  (Low carb diets are labelled ketogenic, becausse ketone levels in the blood are elevated.)  What you are not going to hear about is the fact that high ketone levels can disturb the heart nodes responsible for your heart beat.  There is actually a growing body of research on the subject and I discuss it in page on Low Carb Diets and Arrhymias.

6) Clin Biochem,2004 Sep,37(9):830

7) J Nutr,Jun 2005,135:1339-1342

8) Nutr Metab (Lond),Nov 16 2005,2:31

9) Circulation, 2007, 116:II_819, “Abstract 3610: Comparative Effects of 3 Popular Diets on Lipids, Endothelial Function and Biomarkers of Atherothrombosis in the Absence of Weight Loss”

10) J Clin Endocrinology Metabolism, published online Sep 4, 2007

11) New England J of Med, Nov 9 2006, 355(19):1991-2002

12) Diabetes, 2005, 54:1926-1933

13) Diabetes Care, 2005, 28:1636-1642

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

15) Amer J Clin Nutr, Received for publication February 3, 2009. Accepted for publication May 21, 2009; Emiliano Albanese, et al; “Dietary fish and meat intake and dementia in Latin America, China, and India: a 10/66 Dementia Research Group population-based study”

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

17) Amer J Clin Nutr, Received for publication February 3, 2009. Accepted for publication May 21, 2009; Emiliano Albanese, et al; “Dietary fish and meat intake and dementia in Latin America, China, and India: a 10/66 Dementia Research Group population-based study”

18) FASEB J, 2009 Aug 10. [Epub ahead of print], Murray, et. al., “Deterioration of physical performance and cognitive function in rats with short-term high-fat feeding”

19) “Vascular effects of a low-carbohydrate high-protein diet”, Proceedings of the National Academy of Science, Published online 25 August 2009, Foo S, Heller ER, W20) Prevention, Apr 2010, p. 45.

20) European journal of applied physiology, 2010 Apr, 108:1125-1131, “Influence of dietary carbohydrate intake on the free testosterone: cortisol ratio responses to short-term intensive exercise training.”

21) Journal of Exercise Physiology, 2009, 12(6): 33-39, “Dietary Carbohydrate and Protein Manipulation and Exercise Recovery in Novice Weight-Lifters”

22) https://news.temple.edu/news/2012-03-06/study-shows-how-high-fat-diets-increase-colon-cancer-risk

23) Environ Health Prev Med, 2002 Jul, 7(3):95 102, “Types and amount of dietary fat and colon cancer risk: Prevention by omega-3 fatty acid-rich diets”

24) Am. J. Epidemiol, 2007, 166(2):181-195, “Dietary Fatty Acids and Colorectal Cancer: A Case-Control Study”

25) https://www.diseaseproof.com/archives/cancer-highfat-foods-no-good-for-colon-cancer.html

26) https://www.livescience.com/36458-saturated-fats-diet-gut-diseases.html

27) Environ Health Prev Med, 2002 Jul, 7(3):95-102, “Types and amount of dietary fat and colon cancer risk: Prevention by omega-3 fatty acid-rich diets”

28) https://www.actscelerate.com/viewtopic.php?p=662918&sid=fa9a999b6c335d067ebf6bf316278e8f

29) Current Opinion in Gastroenterology, Jan 2008, 24(1):51-58, “Nutrition and colonic health: the critical role of the microbiota”

30) American Journal of Physiology, 1 Aug 2010, 299(2):G440-G448, “Propensity to high-fat diet-induced obesity in rats is associated with changes in the gut microbiota and gut inflammation”

On this page I explain that the researchers believe it is the ketones themselves causing these issues.  However, there no doubt that the increased cortsiol and other stress hormones that result from Low Carb Diets may contribute as well.  (See #2 below.)

2. Increased Cortisol and Adrenaline. Did you know that it is quite common for men on low carb diets to have elevated cortisol or adrenaline? This is actually how these type of diets work interestingly enough.

For example, some researchers have found that another danger of the Atkins (Low Carb) Diet is increased cortisol levels by allowing cortisol to stay in one’s system longer. [10] High cortisol levels are bad for many reasons, including the fact that they attack neurons, cause visceral fat depostion (“beer belly” or “pot belly”), lower testosterone and increase the risk of heart disease and disturb sleep. (Read this link on the Brain for more details.)  This was verified in a study on athletes were cortisol was increased by 17% on a low carb diet. [15]

What I have noticed is that it is always the younger guys pushing low carbohydrate diets.  The reason is simple:  young guys have enough buffer in their nitric oxide levels to withstand a high saturated fat meal usually.  But, as you age, you realize that all that fat is just going to sludge your blood and causes noticeable trouble.

>4. High Fasting Blood Sugar. Dr. Greger points out that there is an insulin-producing index that was created for a variety of foods. Counterintuitively for many, beef has a pretty high insulin index.  What?!?  How can a food with virtually no carbs produce an insulin spike?

The reason is simple:  modern beef is very fatty and these fats get broken down into fatty acids that end up stored in muscle and liver cells.  When these cells start getting packed with fat, insulin resistance sets in.  In fact, researchers use high fat diets all the time to induce insulin resistance in lab animals.

The irony in this is that many low carb men do not realize that they are actually quite insulin resistant in spite of the fact that they have consumed very few carbs.  Because of this, they often have high fasting blood glucose levels.  Now, if they are just a little high, it may not be much of an issue.  However, to play it safe, many physicians now urge low carb followers to pull their A1C also and make sure that average blood glucose levels are not too high.  Again, some men just do not do well with low carb and higher glucose levels will age tissues and potentially lead to chronic disease(s).

5. High Fasting Insulin Levels. Some low carb men – again, I am not saying all – have sky high fasting insulin levels.  I was just chatting with one whose numbers were 15+.  Of course, this is potentially dangerous for many reasons, including the fact that high insulin levels are pro-cancer and pro-inflammatory.  Again, the irony here is that a low carb person can have just as many blood insulin and glucose issues as men eating a lot of refined carbohydrates.

6. Decreased Exercise Performance (Higher Intensities). Have you had a low carb person tell you that their diet has been shown in the studies to increase exercise performance.  I have.  The person left out one little detail:  this is only true at lower exercise intensity levels!   And they also failed to mention was that still other research shows that at higher intensity levels, low carb or ketogenic diets actually lower exercise performance.

So, if you plan on slowly pedaling your say from New York to LA, a low carb diet may be a decent alternative.  But if you are doing almost any sport, or are weight lifting or strength training or doing more serious cycling or running, you’ll need carbs and you’ll need a decen tamount.  This has been shown over and over again. This is old news to anyone in the fitness business or athletics.  Just do a quick search on glycogen replacement and stores and you will see that loading yourself with carbs post-workout is critical.  In fact, some of you will be surprised to know that:

a) It is critical for athletes to consume a good amount of carbs post-workout in order to in order to activate their glycolytic enzymes sufficiently to handle the ensuing (and necessary) glycogen loading sequence.

b) Those interested in gaining muscle need to eat a good amount of carbs post-workout in order to insure adequate hypertrophy.  (Insulin is highly anabolic.)

NOTE:  Many of my readers are interested in enhancing their exercise performance, endurance, power and so on.  The above 2009 study on rats found that animals on a high fat diet could run only about half as far as those on a low fat diet.  [18] This is simple chemistry:  fat is an inefficient energy source for your muscles.  Just as bad is the fact that a recent study found that carbohydrates are just as essential as protein go muscle gains. [21]

7. Decreased Mood. A Low Carb diet has also been shown to be worse for your mood and outlook. Australian scientists placed participants on a Low Fat Diet or Low Carb Diet and, not surprisingly, found that both groups lost an equal amount of weight. However, the low carb group “felt more angry, depressed and confused” than the Low Fat cohort. [20]

8. High LDL Particle Counts. As I mentioned, low carb bloggers love to discuss how their HDL has gone up and their triglycerides have gone down..  There is even a study out there that shows that a Low Carb Diet can regress plaque.  (Keep in mnd that this study looked at 3 diets where the partipants losetweight and ALL 3 diets showed plaque regression simply due to the fact that their was weight loss.) What these bloggers never mention to their followers as far as I can tell is that low carb diets will astronomically raise LDL-P (LDL Particle Count) in about a third of men.  Interestingly enough, low carb blogger Jimmy Moore is one of those men and I posted his numbers in my page on Low Carb Diets and Heart Disease. His particle count number – and particle count is the #1 predictor of heart disease right now – was over three times the level that Dr. Davis recommends to regress plaque. It’s just simple chemistry: when the particle count is high, LDL will get pushed into the arterial wall. I find it very hard to believe that Low Carb men with this situation will somehow be magically protected from building up atherosclerotic plaque. And, once those penile arteries clog up, erectile function will go out the window.

49 Left Ventricular Dysfunction. One recent animal study found that a ketogenic diet negatively alterted the heart itself.  Of course, this would not be too surprising considered the changes that occur that lead at times to arrhythmias.  See my page on Low Carb Diets and heart disease for more information.

10. Gut Issues. Have you ever thought about what a carnivore’s colon has to do handle? It gets little to no fiber and is filled with a slow moving, decaying, fatty animal leftovers.  To adapt to this potentially toxic situation, carnivores have very short, straight colons.

Thank God we have short straight intestinal tracts, right?  Wrong!!  Nothing could be further than the truth.  Our intestines are very long with many convolutions.  We can pretend all we want, but we have the gut of an herbivore.  Yes, we can eat some meat and all virtually all cultures on planet earth eat at least some animal foods, but dumping the typical low carb meal into our GI tract is simply fighting against Mother Nature.  Your gut is cursing the darkness as this  rancidifing, decomposing, lardy mass slowly scrapes its way through the many twists and turns of the small intestine. Many low carbers consume lots of heme iron, which is pro-inflammatory just to complete the package.

If you wonder why low carbers often complain of gut-related issues,  it starts to make a lot of sense.  You’re throwing the diet of a wolf or bear and forcing it through the GI tract of essentially a gorilla or chimp.  Some day we will face this fact:  it is our brain that has put us at the top of the food chain, not our gut!  But mounds of meat is very ingrained in the American BBQ Culture.  It is often a part of our status and identity.  “Potatoes and rice are for those po’ folk – not us…”

Anyway, just do a search and you’ll see that low carb dieters are often complaining of gut issues – diarrhea, constipation and many of the above conditions.  For example, check out this poster:

“Rodney Mullins Just a warning about the Low Carb Diets… diverticulitis. It almost took my life and ended me in ICU for 7 days. The Doctors told me it was a direct result of the Low Carb Diet. After getting off the low carb diet I have never had another issue. If it is healthy and works for you that is great but for some people the need for carbs is life saving.” [28]

Now, as far as I know, there has been no direct study on Low Carb Diets and most issues surrounding gut health.  However, check out just a few of the studies that show how saturated and high fat meals, in particular, are likely a culprit:

““The increase in colitis stemmed from an uncontrolled growth of a certain type of bacteria, according to the researchers. These bacteria grow quickly in environments where saturated fats are broken down, and this overgrowth results in an immune response that leads to inflammation and colitis.” [26]”

“These results suggest that decreasing the intake of n-6 PUFAs and saturated fats and increasing that of n-3 PUFAs, particularly eicosapentaenoic acid and docosahexaenoic acid has the potential to be a major component of colon cancer control.” [27]

Unfortunately, the microbiota may also elaborate toxic products from food residues such as genotoxic hydrogen sulfide by sulfur-reducing bacteria in response to a high-meat diet.” [29]

“In conclusion, this study showed a strong link between gut inflammation and obesity, and the ensuing increase in plasma level of LPS seems to play an important role. Thus the sequence of events could be an increase in luminal LPS due to altered gut microbiota, a decrease in IAP activity, and an increase in TLR4 activation at the epithelium, leading to altered tight junction permeability and an increase in gut inflammation. An increase in gut permeability could increase passage of LPS from the lumen to the lamina propria, resulting in an increase in plasma levels of LPS, metabolic endotoxemia [30]

“Results from ecologic studies indicate that diets high in animal fat (rich in saturated fatty acids) are associated with increased risk of colorectal cancer in contrast to diets high in fish and fish products (rich in ?3 PUFAs), which are associated with reduced risk.” [24]

“Red meat is not the only problem. The consumption of chicken and fish are also linked to colon cancer. A large recent study examined the eating habits of 32,000 adults for six years and then watched the incidence of cancer for these subjects over the next six years. Those who avoided red meat but ate white meat regularly had a more than 300 percent increase in colon cancer incidence. The same study showed that eating beans, peas, or lentils, at least twice a week was associated with a 50 percent lower risk than never eating these foods.” [25]

11. Decreased Thyroid Function.  Many men struggle with hypothyroidism and do not realize that their low carb diet may very well be lowering their thyroid function.  Anthony Colpo did a nice job of summarizing the research and you can see his discussion here.

12. CCK Resistance. Finally, it has recently been found that rats fed a high fat diet developed cholecystokinin (CCK) resistance. [16] Cholecystokinin, or CCK, controls blood sugar production in the liver. A high fat diet limits CCK, leading to overly high CCK levels.  Being CCK resistant will very likely prove to be just as bad as insulin resistant and a high fat diet appears to lead to this condition.

CONCLUSION: Just as there are “good fats” and “bad fats,” there are good carbs and bad carbs.  Many men are now scared of carbs, but there is no need to be as long as you are consuming low glycemic load carbs.  In my opinion, many men out there will feel better and have better workout if they just add some of these good carbohydrates back into their diet.

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