PT 6

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:

Supplements, Safe - Peak Testosterone

As you know I am very cautious about supplements, vitamins and minerals. The reason is that the research show taking a vitamin or supplement is simply not natural.  Our bodies have been around for ages eating natural foods from the environment and isolating one or two molecules from foods is, as it turns, simply not the same and often quite detrimental.

With just a couple of exceptions, your nutrients need to come from natural foods. This is a tried and true method that has worked for many of supercultures around the world, such as the Okinawans, the Kuna, the Ikarians, the Tarahumara, the Hunza – the list goes on and on.  These native peoples have proven time and again that superlative health comes from natural foods, abundant exercise and other common sense lifestyle factors and not from a pill.

Here are just a few examples:

Magnesium. This, like Vitamin D, is another must take supplement unless you’re eating extremely well.  Magnesium helps you sleep better, decreases migraine frequency for migraine sufferers, aids in glucose regulation, prevents insulin resistance [5], assists in protein synthesis and energy production [1], lowers risk of diabetes [4] and blood pressure [2] and decreases cardiovascular risk [3]. Again, you just want to make sure that you have enough:  low magnesium levels are bad enough and can lead to the opposite of all I wrote above.And keep in mind that  as you age, the kidneys excrete more Magnesium than during your youthful days.  It is suprisingly easy to become deficient in this all important molecule which is used in literally hundreds of bodily systems and reactions.

REFERENCES:

1) Am J Clin Nutr, 1987, 45:1305-12;Clinica Chimica Acta, 2000, 294:1-26

2) Circulation, 1992, 86:1475-84

3) Intl J of Epidem, 199928:645-51; Am Heart J, 1998, 136:480-90

5) Am Fam Physician, 1998, 58:1323-30

7) American Journal of Preventive Medicine, Feb 2007, 32(3):210-216

Core Training and Your Sex Life - Peak Testosterone

One of the things I cover extensively is how Exercise Increases Nitric Oxide and Erectile Strength and Weight Training Increases Testosterone. In other words, almost any exercise is great for your sex life.  However, there is one type that may be best of all:  core training.

There are many reasons for this, but stop and think about what muscles you actually use most in the bedroom.  The answer is clearly those right around your midsection:  the abs, gluts and pelvic muscles. And, for those who don’t know, core training is by definition training of those very muscles.  Core training also gives you better posture, more definition in the ab area and a butt that’s not flat, all of which are attractive to women the world over.  (See my link on Females and Looks for the importance of your appearance.)

The importance of core training goes way beyond all of this, however.  Core training helps males internally, especially in the areas of 1) oxygenating the penis and 2) building the pelvic floor muscles.  These are especially critical for guys that are middle aged and beyond and  males of any age experiencing a loss of erectile strength.

Oxygenation of the penis is absolutely criticial in order to keep the tissues within the penis that trap blood for an erection flexible.  If these tissue become “hardened and inflexible“, then it becomes increasingly difficult for a male to keep blood trapped in the penis.  This isn’t an issue for the young guys, but middle-aged and beyond males can almost always use some help in this area, especially if their morning erection count and duration begin to decrease.

Pelvic floor muscle strength is critical in a similar way.  The muscles at the base of the penis are activated upon arousal and tighten trapping blood in the penis.  Of course, Kegel Exercises help in this area, but core training is likely just as good.  If these pelvic floor muscles weaken or atrophy due to disuse (or low testosterone), then exercising them becomes critical in order to achieve and maintain an erection.

Frank Sommer actually studied which core training exercises led to the greatest oxygenation and muscle strengthening and put it in a set of books called   Vigorrobic: Increased Potency Through Specific Fitness Training. For most guys the difference that these exercises can make to their sex life is very significant.  Sure, running a couple of miles is great, but when it comes to bedroom performance:  go for the core!

The pioneer in this area is Frank Sommer, a physician and researcher in the area of erectile strength, sports medicine and urology.  He has many interesting papers, including ones that show 1) regular use of PDE5 inhibitors can be partially curative of ED, 2) improved erectile function in men taking Viagra daily for a year and 3) a study of cycling and erectile dysfunction.

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:

Testosterone and Metabolic Syndrome - Peak Testosterone

Metabolic Syndrome is a curse on modern society and a risk factor for cardiovascular disease, erectile dysfunction and many other chronic diseases. It is extraordinarily common and probably around 50 million Americans have the condition.  We’ll discuss just exactly what it is, but, before I go on, I want to start by saying that below I will give a “miracle solution” for the Metabolic Sydrome.  This solution had an 83% success rate, which means it completely reversed the Metabolic Syndrome in about 5 out of 6 of the males in the study!  Not bad, eh?

Living in a developed country ain’t as easy as it sounds.  Our lives of comparitive luxury lead us (unless we are careful) to a loss of blood sugar and insulin control in middle age and beyond.  Of course, this manifests itself eventually in the full blown plague of type II diabetes. But long before diabetes sets in, prediabetes will rear its ugly head. Similar to the way that prehypertension is now considered a huge warning sign before full-fledged hypertension, prediabetes was found to be a potent medical condition in and of itself.

Prediabetes is actually insulin resistance, an ugly condition where insulin receptors and processing lose their sensitivity. This allows blood sugar levels to build up and eventually damage accumulates to the beta cells of the pancreas and diabetes results.  One curious thing about prediabetes is the fact that it is usually accompanied by a suite of symptoms including high blood pressure,  stomach/visceral fat, low HDL, and high triglycerides (and elevated glucose).

And even though it sounds somewhat benign because it is termed prediabetes, implying it’s not yet a problem, Metabolic Syndrome has been tied to an increased risk of cardiovascular death and all-cause mortality. [1][2] As mentioned above, it also been linked to erection issues, a fact I cover in my link on Metabolic Syndrome and Erectile Dysfunction.

But what does Metabolic Syndrome have to do with low testosterone? Low testosterone raises insulin levels very significantly and I go into detail about this fact in my link on Testosterone and Insulin. And this is the reason that it directly worsens Metabolic Syndrome. For example, one study of middle-aged men found that those in the lowest fourth of total testosterone were 1.9-2.5X as likely to develop Metabolic Syndrome over the next 11 years. The threshold for the quartile of total testosterone was 450 ng/dl (15.6 nmol/l). [3] 450 ng/dl would be considered reasonable testosterone by most doctors and yet this study indicates that many men may be getting into trouble near this threshold.

1) Circulation, 2004, 110:1245-1250, “Impact of the Metabolic Syndrome on Mortality From Coronary Heart Disease, Cardiovascular Disease, and All Causes in United States Adults”

2) JAMA, 2002, 288(21):2709-2716, “The Metabolic Syndrome and Total and Cardiovascular Disease Mortality in Middle-aged Men”

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

4) Journal of Andrology, November/December 2009, 30(6), “Fifty-two–Week Treatment With Diet and Exercise Plus Transdermal Testosterone Reverses the Metabolic Syndrome and Improves Glycemic Control in Men With Newly Diagnosed Type 2 Diabetes and Subnormal Plasma Testosterone”

5) Nature Reviews Endocrinology, December 2009, 5:673-681, “Testosterone deficiency, insulin resistance and the metabolic syndrome”

6) The Journal of Urology, Sep 2005, “HYPOGONADISM AND METABOLIC SYNDROME: IMPLICATIONS FOR TESTOSTERONE THERAPY”

I often have men writing into The Peak Testosterone Forum in the 400’s who just don’t feel well.  This is undoubtedly one of the primary reasons:  they are beginning to lose insulin sensitivity.  Some good tests for men to monitor are a post-prandial blood glucose, A1C, and fasting blood glucose.

So we know that Metabolic Syndrome is nasty and can be accelerated by low testosterone.  But is there a solution for men who have already developed the condition?

Yes!  One study showed that 83% of men who ate a supervised diet, exercised and went on testosterone therapy completely reversed their Metabolic Syndrome. [4] By simply engaging in various natural and quasi-natural solutions:  exercise, diet and adding Bioidentical Testosterone back to more youthful levels, a man can (generally) undo this nasty condition.

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

Think of how difficult it is is to treat and reverse cancer.  Or consider how many chronic diseases cannot be reversed at all, such as Parkinson’s and Alzheimer’s.  But, fortunately, with Metabolic Syndrome, the great majority of men can actually escape this death trap.  And that is good news!

NOTE:  See also my link on Testosterone and Diabetes, where I discuss a similar anecdotal story on the reversal of diabetes. And how does testosterone work its magic on Metabolic Syndrome and insulin resistance?  One review lists a number of reasons: [5]

1. “Influencing the commitment of pluripotent stem cells” [in muscle, i.e. accelerating muscle growth].

2. Insulin sensitivity of muscle cells is increased by augmenting mitochondrial capacity

3. Insulin sensitivity of muscle cells is increased by “fostering expression of oxidative phosphorylation genes”

4. Protectig pancreatic β cells” [which produce insulin]

5 “Influence of inflammatory cytokines” (See this page on Testosterone and Inflammation for more information.)

It would be remarkable if a drug or supplement did any one of these five things, but having one thing doing all five??  Well, no wonder testosterone can usually produce downright spectacular results for men with Metabolic Sydrome (or adult onset diabetes)!

REFERENCES:

Zinc Dangers (Neurotoxic, Prediabetes, Cancer, etc )

The recent research is particularly disturbing, because correcting low levels of zinc can double a guy’s testosterone: see my on Zinc Deficiencies and Low Testosterone. Furthermore, some studies show zinc supplementation can increase the average, healthy male’s testosterone a bit, although not all. Because of all of this coverage in the health press, a significant percentage of men are taking rather high doses of zinc – sometimes 3 + times the RDA for example – on a daily basis. Below I will show you why this may not be a good idea.

Before I cover some of the dangers of zinc, I do want to say that it would be very easy for a man to become zinc deficient for many reasons:

a) poor absorption due to GI disorders, which are incredibly common

b) poorly done vegetarian and vegan diets.  (I eat an almost entirely plant-based diet, so this is not a criticism of anyone out there.)

c) caffeine, tannins, tea/coffee, iron, etc. can slow zinc absorption

d) a man loses about 5 mg of zinc when he ejaculates.

Here are some of the (potential) risks that have recently been uncovered regarding zinc. (Thanks to the guys on Peak Testosterone Forum who pointed out some of these studies – seppuku!)

1. Possible Increased Prostate Cancer Risk.  Some researchers believe that too much zinc could fuel prostate cancer:

“The high concentration of zinc in the prostate suggests that zinc may play a role in prostate health. We examined the association between supplemental zinc intake and prostate cancer risk among 46 974 U.S. men participating in the Health Professionals Follow-Up Study…Although we cannot rule out residual confounding by supplemental calcium intake or some unmeasured correlate of zinc supplement use, our findings, that chronic zinc oversupply may play a role in prostate carcinogenesis, warrant further investigation.” [6]

Men on HRT should particularly take notice, because, if one’s PSA rises, the doctor or clinic will likely immediately take you off of HRT.  So that will be adding insult to injury…

MEN ON HRT: Some of you are taking lots of zinc in order to control your estradiol levels. For all the reasons on here, that may not be such a good idea.

2. Prediabetes and Metabolic Syndrome. Suppversity has a great article on how an animal study shows that zinc induces Metabolic Syndrome. [1] For those who don’t know, Metabolic Syndrome is the suite of symptoms that is a plaque in Western socieities, characterized by prediabetes (insulin resistance), high triglycerides and high blood pressure.  It’s very hard on arteries and hormones and leads to a host of chronic diseases.  The last thing you want to do is to push the pedal on this one.  Also, the article calculated the human equivalent and 30 mg, according to this calculation, could potentially cause trouble.

“Can you think of any reason why 50mg of zinc absolutely kills my libido i read it should do the opposite. Any theory? Copper deficiency…. low estrogen?” [2]

4 Dementia.  Few guys know that zinc is neurotoxic and probably at pretty low levels.  No one knows exactly what that level is, but why take a chance, eh?  As an example as to just how this level probably is, consider this statement from one set of researchers:

“Increasing evidence has suggested that zinc (Zn) is central to ischemia-induced neuronal death and, finally, to the pathogenesis of VD [Vascular-Type Dementia].” [5]

In other words, they believe that even the relatively low levels of zinc in the standard Western Diet may be playing a role in many of the dementias that we see in our seniors.  Now imagine a guy taking 3+ times the RDA of zinc.

5. Nasty Lipid Changes. The common supplemental amount that bodybuilders and health nuts take here in the U.S. is 50 mg.  I believe that is what is in the standard ZMA supplement that many men take for example.  A study out of China showed that giving just 40 mg per day to healthy males showed that “total cholesterol (TC), triglyceride (TG), Low density lipoprotein cholesterol (LDL-C) and apolipoprotein B100 (ApoB100) increased significantly, high density lipoprotein cholesterol (HLD-C) and apolipoprotein A1 (ApoA1) decreased after supplementation..” [3] This is ugly and could lead to increased arterial plaque and, yes, that can eventually affect you in the bedroom.

6. Lowered Iron Absorption. Too much zinc can slow down iron absorption. [4] Now this effect may actually help some guys who are eating red meat and getting too much heme iron in their diet.  For still other men, though, decreasing iron levels could be an issue.  Examples of this are men with undiagnosed hypothyroidism and gut issues, who end up with low iron stores.  For example, on the Peak Testosterone Forum, we have had several posters with low ferritin levels.

NOTE:  Zinc will also lower copper absorption.  Overly high levels of copper from pipes is a probably a huge problem and so this may be an advantage.  (Copper has been implicated in Parkinson’s Disease for example.)

7. Lowered Magnesium Levels. Some experts say that taking supplemental zinc can lower magnesium levels – never a good idea. [7] Magnesium plays a huge role in arterial health, testosterone and serotonin production and blood glucose / insulin control (just for starters).

1)  https://suppversity.blogspot.co.uk/2012/06/zinc-15mg-are-plenty-after-120-days.html?m=1

2) https://www.peaktestosterone.com/forum/index.php?topic=4090.0

3) Wei Sheng Yan Jiu, 2004 Nov, 33(6):727-31, “Effects of high level Zn intake on metabolism in man”

4) Pediatric Research, 2006, 60:636 636, “Inhibition of Iron Absorption by Zinc: Effect of Physiological and Pharmacological Doses: TL015”

5) Int J Mol Sci, Nov 2013, “The Molecular Mechanisms of Zinc Neurotoxicity and the Pathogenesis of Vascular Type Senile Dementia”

6) J Natl Cancer Ins, 2003 Jul 2, 95(13):1004-7, “Zinc supplement use and risk of prostate cancer”

7) https://www.thedcasite.com/zinc_magnesium_levels.html

Prolactin In Men And Why You Should Monitor It - Peak Testosterone

There is a common suite of symptoms that bring men over to Peak Testosterone or to the Peak Testosterone Forum, such as fatigue, low libido, erectile dysfunction, mental fog, loss of morning erections and depression – been there myself! One thing that is problematic is that there are many conditions and underlying root issues that can produce these symptoms. And trying to discover the cause of these kind of more vague symptoms is not something doctors usually want or, frankly, are often equipped to handle.  And a perfect example is prolactin.

Prolactin is something that should be pulled much, much more frequently by physicians in my opinion.  It’s a cheap test and high and low values are surprisingly common.  And, as I will show below, high and low values can show the underlying cause of many common chronic conditions.  However, with health care costs spiraling out of control, most docs rarely pull it.  For example, I was low testosterone for probably five years before anyone pulled my prolactin.  This is really troubling, because I had almost every symptoms above.

For those of you who may be struggling unnecessarily, I have made pulling prolactin part of my “Peak Testosterone Program,” and below is STEP 6:  Six Great Reasons to Monitor and Test Prolactin in Men:

1. High Prolactin Can Lower Testosterone and Libido. One study used testosterone less than 400 ng/dl and/or low libido as a sign of a man with possible high prolactin. [1]  Of course, the reason is that, as prolactin rises, it generally tends to lower testosterone.  Dopamine and prolactin have a yin and yang relationship.  Thus, as prolactin rises, dopamine will probably be lower and, of course, that is never good for one’s sex life (or career).  Low dopamine is associated with many psychological conditions, including some forms of depression, OCD, ADHD, neuroticism, etc.  (Low dopamine and RLS (Restless Leg Syndrome also often occur together.)

Many young men, who should have a raging libido, show up at the doctor’s office not knowing why they have little to no desire for sex.  Most doctors will hand them a Cialis or recommend counseling.  Why not pull prolactin instead of just making huge assumptions?

NOTE:  Another common problem that I see on the Peak Testosterone Forum is men in the upper part of the lab range for prolactin.  Of course, their prolactin is not high enough to warrant one of the powerful medications such as cabergonine, since it is often full of side effects.  Yet my experience is that even moderately high levels like this can cause some men issues.  Again, isn’t it better to know the root cause?

CAUTION:  Macuna pruriens, according to one study anyway, can lower prolactin and raise testosterone by about 30% and will likely provide some relief to these men.  You can read about it on my page on How to Lower Prolactin Naturally. As a caution, though, a couple of men on our forum got arrhythmias (heart palpiations) from taking macuna, so please discuss with your doctor first.

2. High Prolactin May Be a Sign of Zinc Deficiency. Some men may have high prolactin, because they just need some zinc.  Again, pulling prolactin might be a way to discover this hidden issue.  Zinc is an expensive supplement and low levels can negiatively impact literally dozens of metabolic pathways in the body.

3. High Prolactin Can Cause Gynecomastic, a.k.a. “Man Boobs.”  The same study mentioned above also used gynecomastia as a possible sign of high prolactin levels. [1] Many men are struggling with gyno and so why not pull this number if that is the case?  The good news is that, even if the doctor does not pull a man’s prolactin, it is fairly common to prescribe tamoxifen for gyno and one study showed that this lowered prolactin.  See my page on Tamoxifen and Prolactin for additional information.

4. High Prolactin Can Be a Sign of a Prolactinoma. Prolactinomas seem to be a fairly common kind of tumor.  They are usually benign but can cause visual issues and headaches if they get large enough.  Again, we have had quite a few posters who have had some kind of pituitary tumor.

5. Low Prolactin May Signal Metabolic Syndrome: It might seem low prolactin would be a good thing – a sign of high dopamine and high testosterone.  Unfortunately, that is usually not the case.  In fact, low prolactin is actually strongly associated with Metabolic Syndrome according to one recent Journal of Sexual Medicine study. [2] It is also linked with arterial plaque!  So, in actuality, low prolactin is not only something non-desireable, but is usually dangerous.  If you do have low prolactin, then you may want to look for other signs of fatty liver, prediabetes and insulin resistance here:  Blood Glucose and Insulin Pages.

6. Low Prolactin May Cause Premature Ejaculation.  Low dopamine and high prolactin can cause anorgasmia in some men or delayed orgasm in still others.  See my page on Men That Cannot Orgasm for more information.

7. High Prolactin Can Be Caused By Hypothyroidism. Check your thyroid hormones as low thyroid function can mildly elevate prolactin levels.  Obviously, there can be synergies in symptoms, since high prolactin and hypothyroidism can lower testosterone, dopamine and libido and also increase fatigue.  One of our forum members wrote the following story his personal experience with exactly this issue:

“I got 4 tests with prolactine at 32-48 and tsh 1.2-4, then i have 4 tests with prolactine in the middle of range with tsh 0.07-0.53, i also noticed this winter i got swollen breasts when i didnt use levothyroxine and the breasts returned to normal in a few days when i started with levothyroxine. Not sure if my memory works but i think range for prolactin is 4-20 g/L” [3]

REFERENCES:

1)  The Journal of Urology, 1997, 158(5):1764-1767, “Endocrine screening in 1,022 men with erectile dysfunction: clinical significance and cost-effective strategy.”

2) 4) J Sex Med, 2009 May, 6(5):1457-66, “Hypoprolactinemia: a new clinical syndrome in patients with sexual dysfunction”

3) https://www.peaktestosterone.com/forum/index.php?topic=7194.0

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:

Is Testosterone Actually Protective? - Peak Testosterone

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”

Aggression and Testosterone - Peak Testosterone

Does testosterone cause aggression? What does testosterone do to us poor males anyway?  After all, if you look at all that goes in planet earth, it’s pretty obvious that us males are responsible for lion’s share of violent crime, war and other nasty stuff. Is testosterone somehow to blame?

In animals the answer is a pretty clear ‘yes’. High levels of testosterone make furry and feathered critters do strange things.  For example, if you give testosterone to lizards, they “get stupid” and start to make themselves conspicuous and more vulnerable to predators. [1]  You can give birds extra testosterone and find that they will ascend higher in the pecking order. [2]  Many other studies have tied testosterone to aggression in animals as well.

However, castrated males and steroid users are decidely the two extremes.  What about men in normal physiological ranges?  Does a high normal man generally have more aggressiveness than a normal man?  This has actually been studied quite extensively and some studies said yes and still others no.

So, bottom line, is that we cannot really blame testosterone for bad behavior.  Interestingly enough, researchers have found that estrogen/artomatase likely plays just as much of a role along with certain stress hormones.

What about men with very low (hypogonadal) testosterone?  Are they particularly sensitive to the extra testosterone in a negative way?  The studies show no significant increase in aggressive behavior in this group either. [5] In fact, this same study showed a decrease in many negative emotions, i.e. “significant reductions in negative mood (tension, anger, and fatigue) followed by an increase in vigor were found in response to T treatment in the hypogonadal group”. [5]  Still other studies have shown that Hormone Replacement Therapy improves mood and outlooks as well.

1) BEHAVIORAL ECOLOGY AND SOCIOBIOLOGY, 23(1):21-26, “Evolutionary costs of aggression revealed by testosterone manipulations in free-living male lizards”

2) Rev. Bras. Cienc. Avic. Jan./Mar. 2006, 8(1), “Aggressive behavior in the genus Gallus sp”

3) Arch Gen Psychiatry. 2000, 57:133-140, “Effects of Supraphysiologic Doses of Testosterone on Mood and Aggression in Normal Men”

4) Aggression and Violent Behavior, Nov-Dec 2001, 6(6):579-599, “The relationship between testosterone and aggression: a meta-analysis”

5) Physiol Behav, 2002 Apr 1, 75(4):557-66, “Exogenous testosterone, aggression, and mood in eugonadal and hypogonadal men”

Cortisol and Vitamin C - 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:

Improving Your Fertility Naturally - Peak Testosterone

I occasionally get letters asking how to increase male fertility so I felt it was time to cover some of the basics.  But, first and foremost, let me congratulate you because “it’s time to party!”  That’s right – did you know that the average couple takes 104 times in six months to get pregnant and has sex four times per week! [28] Okay, you’re going to pay the price for the next 18 years, but it’s going to be the best half year of your life in the meantime!  One in ten women said they literally jumped their man as he walked in the door and another one in ten said they called him home from work for a little love making. Get busy and populate!

Now, in spite of the fact you’d like that to probably last forever, you’ve got to do your part and maximize your chances for a pregnancy.  The drive to have children is incredibly deep for women and you could have a frustrated or even depressed woman on your hands otherwise.  And, in spite of what a lot of guys think, often infertility issues have to do with the male not the females.  A lot of guys think, “Look! Sperm came out – it can’t be my problem.”  However, it has been recently estimated that the male plays a role in a quarter to a half of all couples with fertility problems. [4]

So my purpose is to show you males how to give it “your best shot” and optimize the probability of pregnancy from the man’s side.  Below are the key ways that researchers have found to help you do just that:

CAUTION:  Always check with your doctor before taking a supplement.  It is his or her job to know the latest research on fertility.

1) Zinc. Low levels of zinc can lead to a reduction in male fertility.  Let me quote from one journal article:  “Studies have demonstrated that zinc therapy results in significant improvement in sperm quality with increases in sperm density, progressive motility and improved conception and pregnancy outcome.” [1]

2) Saturated Fat.  A few recent studies have found that diets high in saturated fat dietary lead to significantly decreased fertility and a tremendous difference in sperm quality. [30]  One of the studies found a dose dependent response to saturated fat in the diet, i.e. the more saturated fat, the less the fertility.  In this study, the effect of high levels of saturated fat in the diet was so powerful that the researchers basically speculated that this may explain the decreases in fertility that we have been seeing in many countries around the globe: [38]

“Our findings are of potentially great public interest, because changes in diet over the past decades may be part of the explanation for the recently reported high frequency of subnormal human sperm counts. A reduction in saturated fat intake may be beneficial for both general and reproductive health.”

3) Fruits and Vegetables. Since they help with almost every other physiological function, is it any wonder that fruits and vegetables also improve sperm quality?  [13] And I don’t know about you, but I want to be a quality guy. And remember:  it’s much better to guy organic more than likely – see #4:

TRIVIA: Did you know that your fertility could have been affected by your mother’s beef consumption during pregnancy?  Read this link on The Importance of the Prenatal Lifestyle.

4) Pesticides. Harvard University recently uncovered evidence that pesticides in fruit and vegetables can actually affect sperm counts and fertility. [40] Okay, I doubt you’re picking yourself up off the floor with that bit of news, but it is nice when science confirms common sense, eh?  Basically, they took a group of men and controlled for various known fertility factors and still found an association based on pesticide consumption.  Now, admittedly, it involved a lot of assumptions, but it would help explain why sperm counts are so decreased in the last few decades.  Again, buy organic if at all possible.

5) Heat. You probably already heard this from the doctor, but heat and sperm do not go together. You might want to consider boxers and, whatever you do, do not set the laptop you know where!  Even pants that are too snug can do a number on the little guys.  So remember:  keep the spring breezes blowing down there.

6) Scrotal Fat. This is an expression for fat in the area of the scrotum (nuts, huevos, balls, etc.).  The problem is that fat in this area acts like a nice, warm winter blanket and elevates temperatures of your little swimmers.  And as you probably know, this kills and immobilizes sperm.  One study found that five out of six infertile males had high scrotal fat. [7] Yet another study found that lipectomy, a surgical fat-removing procedure, greatly increased sperm count, motility and pregnancy rates. [8]  So what generally causes increased scrotal fat?  You guessed it – being overweight.

7) Overweight. If you have a gut around your waste, you should be aware that it is associated with decreased male fertility. Now I have to be careful here:  I do not want to make anyone feel guilty about not having children simply because they have some extra pounds.  But, on the other hand, I have to tell you the truth and the truth is that a spare tire can lower your odds for pregnancy.  Increased BMI (Body Mass Index) in particular has been associated with male infertility.  One study found, for example, that men with fertility issues were three times as likely to be overweight with a high BMI (BMI > 30). [5]  Many studies have confirmed this same finding. One study in particular went into great detail and found in 81 infertile men that total sperm count, sperm motility and semen volume were all negatively correlated with various combinations of waist circumference, hip circumference and BMI. [6] Why are those extra pounds such an issue in pregnancy?  Three simple reasons:  1) decreased testosterone, 2) oxidative stress (which can damage sperm DNA amoung other things) and 3) increased temperatures in the scrotum (from fat in the area of the scrotum and from a sedentary lifestyle).  Being overweight also can lower follicle-stimulating hormone, FSH, and luteinizing hormone, LH, in overweight men as well, another risk factor.

WARNINGS: 1) If you don’t know: Chlamydia is a bacterial STD that is often symptomless. In females, it can potentially result in loss of fertility due to damage to the end of the fallopian tubes and lead to increased likelihood of tubal pregnancies. The solution? Have her get tested yearly with a simple swab or urine test if applicable. 2) Also, read the discussion below for how Viagra and other PDE5 inhibitors may affect fertility! 3) In addition, I would recommend reading this link on Excitotoxins and Your Child: these have the potential to be much more deadly to your childs testosterone and fertility than even pesticides.

8) Stress. We have told you many of the evils associated with Stress and Cortisol: it destroys your brain, your arteries and your testosterone.  And you can probably guess where I’m going next:  it can also cause fertility issues.  This is probably because stress lowers testosterone.  In fact, scientists have found out how stress lowers your testosterone:  through a tricky little enzyme called 11 HSD-1led 11 HSD-1. [3] Your body produces most of its testosterone in the “Leydig Cells” and this enzyme keeps cortisol, the primary stress hormone, from pushing down your testosterone.  It literally puts the brakes on cortisol from destroying your testosterone.  However, in times of stress, there is simply too much coristol versus 11 HSD-1 and this leads to a decrease in your testosterone production.  Of course, anything that lowers testosterone is bad for fertility.

In addition, researchers at Berkeley found that cortisol from the adrenals lowers GnRH, thus lowering testosterone and estrogen, and boosts GnIH, which hammers fertility. [36] So to have a kid you gotta relax!  See my links on Stress Management, The Relaxation Response, Secular Meditation and PMR for some good ideas on how to do just that.

9) Excitotoxins.  These nasty chemicals, found in many items in your supermarket, can kill your fertility.  Be informed and read this section on Excitotoxins.  These are also a tremendous risk to your children as well.

10) CoQ10. CoQ10 is more than just an antioxidant:  it is also involved in energy production.  And, apprently, they give energy to your little swimmers as well.  Research shows that in men with male fertility issues, i.e. low male-factor fertility rates, that 60 mg/day of CoQ10 increased sperm motility and fertilization rates significantly. [9]  Another study showed CoQ10 correlated not just with sperm motility but also with sperm count as well.  [10]

11) HRT/Androgel/Testim/Testosterone.  CAUTION: Take care with testosterone if you are trying to get your woman pregnant. (You really need to take care if you are trying to get someone else’s woman pregnant for completely different reasons.)  Supplemental testosterone of any form can lower Leutinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) levels and lead to lower sperm counts and fertility.  This requires a urologist or endocrinologist that specializes in this area and is willing to carefully monitor you.

12) Varicoceles. These are basically varicose veins in the testicle area.  Some studies have shown that they can decrease fertility and others have shown the opposite. However, WebMD’s is unambiguous and states that varicoceles “affect 10% to 15% of men and can interfere with sperm function.” [15] The same article goes on to report a new minimally invasive procedure that uses a small catheter with great success.  This procedure was found to significantly improve sperm activity and counts and, in addition, 26% of the couples tested were pregnant six months later. Again, a specialist is recommended if you have this kind of issue. Varicoceles, and the ensuing loss of blood supply to the testicle, can effect all the hormonal output of the affected testicle.  One study showed that varicocele surgery boosted testosterone an average of 28% in a test group of 53 infertile males. [19]

13) Soy. Watch the soy. In a recent study men who had a half serving or more of soy had decreased sperm concentrations to the tune of 41 million less sperm per ml, which sounds like a lot to us. No other sperm parameters were affected, such as motility or quality or semen volume. [11] But the bottom line is that soy gives you less sperm which could impact fertility rates.

14) L-Arginine.  A deficiency in L-Arginine can lead to a low sperm count. Several researchers have used it successfully in his practice to improve fertility and sperm counts (in one case 4 g orally daily).

15) Vitamin E.  Sperm actually store Vitamin E and animal studies have shown that it increases sperm motility [17] and viability (in adverse, post-thaw conditions). [18]

16) Marijuana or Cannabis. Please tell us you are not a regular cannabis user.  Besides problems with fertility, marijuana can effect hormones and erectile strength.  Please read this link on How Marijuana Can Destroy Your Hormones, Fertility and Lead to Impotence.

17) Viagra. There is a laboratory study that shows that Viagra negatively impacts sperm.  Again, this in the laboratory only and has not been shown in vivo. The researchers found that Viagra actually overstimulated the sperm by affecting something called the “acrosome reaction”, which is a critical process whereby sperm releases enzymes to makes its way into the egg for fertilization.  This seems to be primarily by ushering more calcium into the cell and also changing the energy levels of the sperm, causing the sperm to be overly active.  Again, this is something to consider as many guys take Viagra in order to increase fertility.  (Pfizer has gone on record stating that there is no effect on fertility.  And if you can’t trust a huge pharmaceutical giant, who can you trust?)

However, it should be mentioned that a more recent study on actual human subjects showed that Viagra did actually increase sperm motility by about 30%. [23] Cialis, on the other hand, decrease sperm motility in the same study by about 25%.

18) Ejaculate.  As you know I often point out How Sex is Good for Erectile Dysfunction and Sex is Good for Hormones, but that’s not the end of the story:  it looks like sex is also good for sperm!  Probably because the little guys spend less time in storage, sperm shows higher quality and less DNA damage.  (Heat, oxidative damage and other factors can damage sperm as they sit in the male body.) In one recent study males with fertility problems were asked to ejaculate once per day and that signficantly helped reduce DNA damage. [14]

19) CoQ10. A 2004 study found that CoQ10 improved both sperm counts and motility. [16]  Participants were males aged 25-39 who took a rather hefty 200 mg/day dose for six months.

20) Phthalates.  Avoid these bad boys like a plague. These softeners of plastic are linked to lowered sperm quality [20] and DNA damage [21]. For more information, see this link on Common Chemicals That Lower Testosterone.

21) Chlamydia. Get screened for this STD:  a recent study linked it to infertility in both men and women. [22]

22) Bisphenol-A (BPA). This xenoestrogen is prevalent in plastics and foods and causes a host of health issues, including increased sterility in males. See this link on on Bisphenol-A for more details.

23) Chronic Non-Moderate Alcohol Consumption. Chronic and non-moderate alcohol consumption is strongly associated with lowered testosterone in animal studies.  Interestingly enough, lowered testosterone is usually followed by a protective feedback loop where LH (Leutinizing Hormone) and FSH (Follicle Stimulating Hormone) are increased.  Unfortunately, in these case alcohol actually lowers all three:  testosterone, LH and FSH in unison, which will of course lead to decreased fertility. [24]

24) Soda. Scientists have found a correlation between coke consumption and lousy sperm counts. [25] It could be because the Sugar Lowers Testosterone or some other factor that we do not yet understand. At this point, it could also just be the lifestyle of soda drinkers. Regardless, drinking a lot of coke is probably not a good idea if you are trying for children.

25) Panax (Korean) Ginseng. One study on rats showed increased sperm count and motility from Ginseng. [26]  This was verified in a (small) study on male subjects as well. [27]

26) Avoid Cell Phones? One recent study shows that cell phone usage may lower male fertility levels. [29] Researchers have not yet isolated an underlying cause, but a likely culprit is alterations in the brain’s pituitary output since the men had lowered levels of Luteinizing Hormone.

27) Pomegranate. Fruits and vegetables, in general, improve fertility.  So it is not too surprising that one animal study shows the pomegranate increases sperm quality. [39] (It also can help with erectile function – see my page on Pomegranate Juice and Erectile Benefits.

28) Elevated Prolactin. A very common cause of inferility in men can be elevated prolactin levels. [31] For some additional information, see this link on Testosterone, Prolactin and Prolactinomas.

29) Tongkat Ali (Eurycoma Longfolia). This herb has been shown in a number of animal studies to greatly improve male fertility.  One study on rats found that not only was only plasma testosterone increased but testosterone in the testes as well and sperm counts, motility and morphology were all improved. [32] Another side benefit of Tongkat Ali is that it also is tied to improved libido in a number of animal studies. [33][34]

30) Triglycerides and VLDL. Elevated triglycerides are a risk factor for heart disease and erectile dysfunction, so why not infertility as well, eh? That is what one study found. Not surprisingly, researchers also found VLDL (small dense “bad cholesterol” particles) were also a significant risk factor. Of course, the reason is that these are a sign of the Metabolic Syndrome and Insulin Resistance. [35] This is a big subject, but elevated triglycerides are generally related to too many refined carbohydrates in the diet.  And both VLDL and triglycerides follow around individuals eating high glycemic load carbohydrates like an attack dog, clogging arteries and, apparently, damaging sperm parameters as well.

31) Progesterone. 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. [37] You can get your levels checked at one of these Man Friendly Labs.

REFERENCES:

1)  J of Andrology, Feb 2000, 21(1):53-57

2) Indian J Physiol Pharmacol, 1987, 31:30-34; Eur J Obstet Gynecol Reprod Biol, 1998, 79:179-184; Andrologia, 1988, 20:21-22

3) J Androl, 1997, 18:475-479

4) Campbell’s Urology, M Sigman and J Jarow, 2002, p. 1475-1531

5) WHO Laboratory Manual for the Examination of Human Semen and Sperm Cervical Interaction, 1999

6) Andrologia, 2005, 37(5):155-159

7) Br J Urol, 1981, 53(1):50-54

8) Br J Urol, 1981, 53(1):55-61

9) Molecular Aspects of Medicine, 1997, 18(1):213-219

10) Journal of Andrology, 1994, 15(6):591-594

11) Jorge E. Chavarro, Thomas L. Toth3, Sonita M. Sadio4 and Russ Hauser, Hum. Reproduction,. advance access published online on July 23, 2008, Soy food and isoflavone intake in relation to semen quality parameters among men from an infertility clinic

12) Hendler, M.D., Ph.D., Sheldon Saul, The Doctor’s Vitamin and Mineral Encyclopedia, 1990, p. 209-215;  Quillin, Ph.D., R.D., Patrick, Healing Nutrients, 1989, p. 274, 368

13) Fertility and Sterility, Still online published only, “A low intake of antioxidant nutrients is associated with poor semen quality in patients attending fertility clinics”; Jaime Mendiola, Ph.D.ab, Alberto M. Torres-Cantero, M.D., Dr.P.H.bc, Jes s Vioque, M.D., Ph.D.cd, Jos M. Moreno-Grau, Ph.D.e, Jorge Ten, Ph.D.a, Manuela Roca, M.D., Ph.D.b, Stella Moreno-Grau, Ph.D.e, Rafael Bernabeu, M.D., Ph.D.

14) Dr. David Greening, Jun 2009, presented at the 25th annual meeting of the European Society of Human Reproduction and Embryology in Amsterdam.

15) WebMD The Magazine, Nov/Dec 2008,  p. 14.

16) Fertil Steril, 2004, 81:93-98

17) J Androl, 1996 Sep-Oct, 17(5):530-7, “Lipid peroxidation and human sperm motility: protective role of vitamin E”

18) Arch Androl, 1994 Jul-Aug, 33(1):11-5, “Effect of natural antioxidants tocopherol and ascorbic acids in maintenance of sperm activity during freeze-thaw process”

19) The J of Urol, 154(5):1752-1755, “The Effect of Varicocelectomy on Serum Testosterone Levels in Infertile Men with Varicoceles”

20) Epidemiology, 2003, 14:269-277, “Phthalate Exposure and Human Semen Parameters”

21) Environ Health Perspect, 2003, 111:1164-1169, “The Relationship between Environmental Exposures to Phthalates and DNA Damage in Human Sperm Using the Neutral Comet Assay”

22) Human Reproduction, 19(5):1121-1126.”Demonstration of Chlamydia trachomatis IgG antibodies in the male partner of the infertile couple is correlated with a reduced likelihood of achieving pregnancy”

23) Fertility and Sterility, 88(4):860-865, “Alterations in sperm motility after acute oral administration of sildenafil or tadalafil in young, infertile men”

24) Natl Inst on Alcohol Abuse and Alcoholism, “Alcohol and the Male Reproductive System”, Mary Ann Emanuele, M.D., and Nicholas Emanuele, M.D.

25) American Journal of Epidemiology, 2010, originally published online on March 25, 2010 ,171(8):883-891, “Caffeine Intake and Semen Quality in a Population of 2,554 Young Danish Men”

26) Fertility and Sterility, Oct 2007, 88(4):1000-1002, “Korean ginseng induces spermatogenesis in rats through the activation of cAMP-responsive element modulator (CREM)”

27) Panminerva-Med, 1996 Dec, 38(4): 249-54, “Effects of Panax Ginseng C.A. Meyer saponins on male fertility”

28) Dailymail.co.uk, DAILY MAIL REPORTER, Last updated at 12:31 PM on 16th August 2010, “104th time lucky: Average couple has sex more than 100 times before falling pregnant”

29) ScienceDaily, 19 May 2011. Web. 23 May 2011, Queen’s University, “Cell phone use may reduce male fertility, Austrian-Canadian study suggests.”

30) Hum Reprod, 2012, 27(4), “Dietary fat and semen quality among men attending a fertility clinic”

31) Rev Fr Gynecol Obstet, 1977 Oct, 72(10):631-40, 641-4, “[Investigation of the gonadotrophins and prolactin in sterile men (the LH-RH + TRH test) (author’s transl)]”

32) Natural Product Communications, 2009, 4(10):1331-1336, “The effect of Eurycoma longifolia on sperm quality of male rats”

33) Fundam Clin Pharmacol, 2002 Dec, 16(6):479-83, “Effect of Eurycoma longifolia Jack on orientation activities in middle-aged male rats”

34) J Basic Clin Physiol Pharmacol, 2003, 14(3):301-8, “Eurycoma longifolia Jack enhances sexual motivation in middle-aged male mice”

35) Systems Biology in Reproductive Medicine, “Correlation of Seminal Parameters with Serum Lipid Profile and Sex Hormones”

36) https://www.berkeley.edu/news/media/releases/2009/06/15_stress.shtml

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

38) Am J Clin Nutr, Feb 2013, 97(2):411-418, “High dietary intake of saturated fat is associated with reduced semen quality among 701 young Danish men from the general population”

39) Clin Nutr, 2008 Apr, 27(2):289-96, “Effects of pomegranate juice consumption on sperm quality, spermatogenic cell density, antioxidant activity and testosterone level in male rats”

40) Hum. Reprod, 2015, First published online: March 30, 2015, “Fruit and vegetable intake and their pesticide residues in relation to semen quality among men from a fertility clinic”

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”

How to Lower SHBG and Increase Free Testosterone.

Some researchers believe that free testosterone is the only testosterone that really counts, since it is the testosterone ready and able to actually “work” on your tissues. And there is a lot of truth to this. The reason is that about two thirds of non-free, or bound testosterone is actually chemically bonded to a protein called Sex Hormone-Binding Globulin (SHBG) and about 1/3 to a protein called albumin.  Therefore, according to one school of thought, only a small percentage (about 2 percent) is actually free to supercharge our brains, blood, muscles, sex lives and all the other things we associate with testosterone.

Well, kind of.

It turns out that the testosterone bound to albumin is actually only bonded loosely and is readily available to do work on your tissues.  In fact, researchers have come up with the following formula:

And they point out that it is really bioavailable testosterone that is the true free testosterone.  Furthermore, still other experts counter that total testosterone is really the better number, because it acts as reserve or bank to build from.

Well, I will leave that debate for the men in white, but, in the meantime, it’s best to realize that free testosterone is an incredibly important number for men to monitor and maintain.

So what then controls your free testosterone?  It turns out that your level of albumin is relatively fixed with minimal fluctuation in most men.  However, SHBG can vary widely and lab results clearly show that as SHBG goes up, the percentage of free testosterone as a percentage of total goes down and, as SHBG goes down, the percentage of free testosterone goes up.  Thus, it is SHBG that has tremendous control over free testosterone.

Normal aging, as many of us know all too painfully, leads to substantial drops in androgens such as testosterone and a corresponding rise in SHBG.  Think how ugly this is:  decreasing testosterone leads to increasing SHBG which leads to decreased free testosterone.  And, practically speaking, low free testosterone levels will yield low testosterone symptoms just as surely as low total testosterone will.

There are also many other reasons for low and high SHBG, including liver dysfunction, estradiol levels, thyroid function and much more.  I cover these in my links on Low SHBG and High SHBG.

So how do you know if your free testosterone is low?  It starts with a simple test from your doctor.  You sometimes have to ask for this, as some doctors just stick with total testosterone.  Generally, free testosterone is given as a percentage of total testosterone, the typically acceptable range according to the lab listed as 1.5%-2.5%.

NOTE: Men on HRT (Hormone Replacement Therarpy or testosterone therapy) will often have an elevated free testosterone percentage, because HRT tends to lower SHBG. Also, some men have low SHBG even before starting HRT. These men often have great difficulty with achieving successful results from testosterone therapy for reasons that are not totally understood.

Let me give you 10 Natural Ways to Lower SHBG and Raise Free Testosterone:

1) Testosterone and Lowering Estradiol. On this page, I’ll show some ways to uniquely raise free testosterone levels.  However, the most straightforward way to raise free testosterone levels is by raising total testosterone levels. In general, as you raise total testosterone, free testosterone tends to rise with it.  I have already created a page with 40+ Ways to Raise Testosterone Naturally. Again, though, on this page we’ll look at some ways to raise your percentage of free testosterone (out of total testosterone).

Similarly, if you can lower your estradiol levels, you can generally get a boost in total and free testosterone.  Research shows that normal aging as well as an increase in adipose – that’s a nice way of saying fat – tissue leads to ever increasing levels of the estrogens. And here’s the key:  increasing estrogen leads to increasing SHBG, which will lower your free testosterone as a percentage of your total.  Please read the important link on How to Control Estrogen.

2) Protein-to-Carbohydrate Ratio. The protein/carbohydrate ratio has an interesting effect on free testosterone and SHBG. Several studies have shown that increasing carbs versus protein boosts total testosterone. However, before you start pounding granola bars, one study found that increasing the protein/carb ratio not only increased total testosterone but also SHBG. [4] This means that free testosterone may not have been increased significantly because of SHBG’s opposing effects. (Increasing the protein to carbohydrate ratio also increased cortisol, a fact I cover elsewhere on this site.)

3) DHEA.  Researchers examined untrained young and middle males and found that giving them 50 mg of DHEA daily raised their free testosterone significantly.  They also noted that normally HIIT substantially lowers testosterone, but with the DHEA no such decrease in free testosterone at least occurred.  [7] There are warnings out there that DHEA can increase estradiol disproportionately, but I have seen no actual research evidence of this.  The real concern with DHEA is more brain-related. Ray Peat, in particular, has noted:

“One study has found that the only hormone abnormality in a groupt of Alzheimers patients’ brains was an excess of DHEA. In cell culture, DHEA can cause changes in glial cells resembling those seen in the aging brain. These observations suggest that DHEA should be used with caution. Supplements of pregnenolone and thyroid seem to be the safest way to optimize DHEA production.”  In spite of this, DHEA seems to be widely used in the alternative and anti-aging communities.  Do your own research and talk to your doc is all I can say.

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

REFERENCES:

1) J Korean Diabetes Assoc, 1998 Sep,22(3):328-337

2) Planta Med, 1995 Feb, 61(1):31-32; Fortschr Med, Nov 10 1996, 114(31):407-411; Z Naturforsch [C], 1995 Jan-Feb,50(1-2):98-104

3) Clin Endocrinol (Oxf), 2009 Dec 29, [Epub ahead of print], “Association of vitamin D status with serum androgen levels in men”

4) Life Sciences, May 4 1987, 40(18)1761-1768, “Diet-hormone interactions: Protein/carbohydrate ratio alters reciprocally the plasma levels of testosterone and cortisol and their respective binding globulins in man”

5) Phytomedicine, 2003, 10(5):405-15, “Modulatory effect of Urtica dioica L. (Urticaceae) leaf extract on biotransformation enzyme systems, antioxidant enzymes, lactate dehydrogenase and lipid peroxidation in mice”

6) https://robthoburn.wordpress.com/2011/02/02/boron-increases-testosterone-again/

7) Eur J Appl Physiol, 2013 Jul, 113(7):1783-92, “Effect of acute DHEA administration on free testosterone in middle-aged and young men following high-intensity interval training.

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

9) Br J Sports Med, 2003, 37(5), “THE ERGOGENIC EFFECTS OF EURYCOMA LONGIFOLIA JACK: A PILOT STUDY”

10)  https://www.prosource.net/content/articles/Articles-by-ProSource/tribulus-real-anabolic-alternative

Bioavailable Testosterone = Albumin-Bonded Testosterone + Free Testosterone

Testosterone Labs for Self-Testing - Peak Testosterone

1) https://store.zrtlab.com/index.php?option=com_content&view=article&id=106&Itemid=612

2) https://www.peaktestosterone.com/forum/index.php?topic=1250.15

3) https://www.saveonlabs.com/Dr-Mark-Hyman-Saveonlabs-com-s/1889.htm

4) https://www.saveonlabs.com/product-p/30740.htm

5) https://www.peaktestosterone.com/forum/index.php?topic=571.0

6) https://www.peaktestosterone.com/forum/index.php?topic=456.30

7) https://www.peaktestosterone.com/forum/index.php?topic=1453.0

8) https://www.peaktestosterone.com/forum/index.php?topic=1431.0

Pull Your Testosterone. The first step in evaluating your testosterone status should start with pulling your total testosterone.  In my opinion, evey guy should just pull this number periodically, symptoms or not, in order to have a good baseline.  As you’ll see below, it’s about $25 now here in the U.S.  It is fast, cheap and very important to your health.

One of the things that I have discovered as I have begun to research and monitor my own health is that my physicians – God love ’em – do not always test everything they should test nor monitor as frequently as is necessary. This is nothing against them, of course, as they have limited time and are under obligation to insurance companies and fellow physicians to minimize costs as much as reasonably possible. I know that in my own life I was low testosterone for years before I convinced my PCP to finally pull my T.  And it was years after that that anyone pulled my prolactin, estradiol and TSH. These all should have been looked at, but it simply never happened. And I could have probably avoided a great deal of heartache and suffering if I had simply had done these tests myself and shown them the results.

I am NOT suggesting that you become your own doctor, but in the U.S. and many other countries, there is considerable medical freedom and one has the right to monitor one’s health.  Think of this: your body and mind are an incredibly complex and highly tuned machine. It makes a combustion engine look like a play toy. Does your doctor really have the time to see if you need a tune up? 99% of the time your doctor is too busy just trying to keep patients alive and semi-functional.

This is the reason that I compiled a list of testosterone labs that pull various hormones for men based on Peak Testosterone Forum posts that I have received over the years. I have also included some commentary about what some of these specialize in and what they can and can/cannot be used for. I am NOT suggesting that you become your own doctor, but in the U.S. and many other countries, there is considerable medical freedom and one has the right to monitor one’s health.

NOTE: There are four states that will not let you pull your own labs. Yes, you read that right.  Even if you PAY CASH, you cannot pull your own labs.  Now please tell me that America is a free country when many of its citizens cannot even monitor their OWN health when they pay for service with their OWN money.

Think of this: your body and mind is an incredibly complex and highly tuned machine. It makes a combustion engine look like a play toy. Does your doctor really have the time to see if you need a tune up? 99% of the time your doctor is too busy just trying to keep patients alive and semi-functional? Consider my situation:

–I have never had homocysteine pulled by any doctor.

–I have had ferritin pulled only once.

–I have never had any thyroid hormones pulled except TSH and total T4.

–I have had CRP pulled maybe twice.

–I never had LH, FSH or prolactin pulled in my hypogonadal days.

Is my situation unusual? Certainly not. There just aren’t the financial and time resources available for decent testing in the great majority of insurance-backed systems. The bottom line is that you are probably going to have to do some yourself, or perhaps find a doctor or naturopath on a cash basis that can help you do the same.

For all these reasons I compiled a list of testosterone labs that pull various hormones for men based on Peak Testosterone Forum posts that I have received over the years. I have also included some commentary about what some of these specialize in and what they can/cannot be used for. Almost all of these labs are U.S. only, but there are a couple of exceptions as you will see:

CAUTION:I do not have any personal knowledge or affiliation with any of these labs. You must do your own research, i.e. “caveat emptor”.

1. DiscountedLabs.com.  If you are looking for the best prices for self-testing with the biggest, most respected lab (Lab Corp) in the country, then Discounted Labs is a good starting point. Nelson Vergel started Discounted Labs, and many of you will recognized his name as one of the most established names in the TRT/HRT community. He sent me an email where he promised to beat anyone else’s prices, and it sure seems to be the case! NOTE:  I have used Discounted Labs and had a good experience. Again, one big advantage is that the use Lab Corp, which is the largest lab here in the U.S. (NOTE: Discounted Labs is a site sponsor.)

2 Health Tests Direct.  I first found out about this lab company, because one of our longtime posters used them with great success.  They were unique for a long time, because they offered not only LabCorp pricing but also Sonora Quest. NOTE:  I have used them and had a good experience.

3.  Life Extension Foundation. One of the older and more respected supplement companies, LEF is known for its in depth articles and good support staff.  One very interesting thing that you can get, through them, a wide variety of lab panels at some of the big labs.  They have for example an Inflammation Panel and a Cardiac Panel that I have wanted to get myself that includes many of the key heart disease risk factors such as “Chemistry Profile (Complete metabolic panel with lipids) Complete Blood Count (CBC), C-Reactive Protein (high sensitivity), Fibrinogen, Homocysteine Vitamin D 25-OH.”  They also have some more specific blood draws for things like CoQ10, anemia and cortisol. The prices are quite reasonable and, of course, it’s nice to deal with a well-established company. NOTE:  I have used them and had a good experience.

One of the panels many men would be interested in is the Male Panel, which includes the “Chemistry panel (complete metabolic panel with lipids), CBC, DHEA-S, DHT, Estradiol, PSA, Pregnenolone, Total and Free Testosterone, Sex Hormone Binding Globulin (SHBG), TSH, Free T3.”  So in one shot you’ve got a lot of questions answered dealing with male hormones, especially the ones that can directly impact your sexual health.  The cost as of this writing was about $224 for members and $399 for nonmembers where a one year membership cost $75.

NOTE: You’ll want to check out that the above test uses the correct estradiol test for males. If you happen to be low estradiol, then the standard test will often not give you correct results based on what I have seen. Talk to the lab and make sure you are getting the correct test.

Also, they use LabCorp, which is I believe the biggest general lab in the U.S. and most states are available to LEF members.  For general information, see these https://www.lifeextension.com/ and https://www.lifeextension.com/.

NOTE: I have purchased a number of items from LEF with good success and been quite impressed with their support staff.  However, I have never ordered lab work through them.

4.  ZRT Labs. This is another reasonably priced lab.  The offer both saliva and blood spot testing. One of our senior posters used them several times to examine some standard male hormones as well as adrenal and thyroid function. One intriguing panel is called the Female/Male Saliva Profile I and includes the following: “five (5) tests: Estradiol (E2), Progesterone (Pg), Testosterone (T), DHEA-S, and morning Cortisol (C1)” for $170 as of this writing. [1] Blood spot testing tends to be a little more but is still (relatively) inexpensive.

6. (U.K. Testing) Private Blood Tests.  U.K. guys, from what I have seen on the Peak Testosterone Forum, have a notoriously difficult time getting treatment and testing.   “I’ve found a useful website here in the UK, www.privatebloodtests.co.uk , this allows you to run bloods at a local hospital without going through your GP, which is useful for tracking things like Clomid.” [5] Again, I do not know anything about them, other than what was mentioned in this post, so do your own research.

7.  (U.K. Testing) Blood Tests London. One of our posters also recommended bloodtestslondon.com.  His comments were that “the prices were very competitive, and they turned my thyroid blood work around in less than 1 working day. If any of the blood results are out of range then they get a doctor to comment on them (included in the price).” Again, I do not know anything about them, so do your own research.

8.  PrivateMDLabs.  This lab, according to one of our veteran posters, uses blood draws through LabCorp.  This one has been used by a couple of men and the only negative comment was that “they have a male panel that is not as comprehensive as I’d like, but includes some things that are worth monitoring.” [7]

9.  Genova.  One of our posters that has been around awhile used Genova labs for a metabolic and digestive panel. [8] One of the established Paleo media personalities has used them.

10.  Rhein Labs. This lab specializes in testosterone and estrogen-related metabolites and can really help you diagnose the root cause of your hormonal issues.  Check out https://www.peaktestosterone.com/forum/index.php?topic=3311.0 for sample results and costs from one of the senior posters on the Peak Testosterone Forum.

11.  Direct Labs.  I have used this lab for hair testing.  However, they have many other tests available as well.

REFERENCES:

Exercise & Nitric Oxide - Peak Testosterone

One thing that I see quite often in emails is that some men seem to be only seeking a pharmaceutical or supplement solution to their health and/or bedroom issues. What they do not realize is just how powerful lifestyle changes, such as exercise, can be. Our history here on planet earth involves lots of movement and walking in particular – almost nonstop – and the Western lifestyle is the polar opposite.  But some men still struggle to exercise because they see no short term motivators.

Well, here is one big short term reason for you to exercise:  boosting nitric oxide.  Yes, exercise is a huge nitric oxide and blood flow booster and we’ll show you just how much with some of the key studies below.

1. Restore Youthful Blood Flow. If you are a senior or middle-aged and are seeing possible signs of endothelial dysfunction, such as erectile issues or high blood pressure, then there is one study in particular that should really grab your attention. In this study the authors found that sedentary younger men (22 to 35 years old) had 25% less forearm blood flow (to a standard stimulation test) than that of sedentary older men (ages 50 to 76).  That’s no shock – youth has its advantages after all.

However, the interesting part of the study came when looked at endurance-trained men, i.e. men that did cardio.  The endurance trained senior men had virtually equal blood flow to endurance trained younger men to the same stimulation test. In other words, this study points to the fact that the age-related loss in blood flow “responsiveness” can be reversed with exercise and that you can, indeed, make your arteries young again.. And, by the way, this exercise was primarily “home-based” and walking. It was NOT any spectacular triathlon or marathon training.  The authors concluded that “our results indicate that regular aerobic exercise can prevent the age-associated loss in endothelium-dependent vasodilation and restore levels in previously sedentary middle aged and older healthy men.” [1]

1) Circulation, 2000, 102:1351-1357, “Regular Aerobic Exercise Prevents and Restores Age-Related Declines in Endothelium-Dependent Vasodilation in Healthy Men”

2) Circulation, 2003; 108:530-535, “Effect of Different Intensities of Exercise on Endothelium-Dependent Vasodilation in Humans: Role of Endothelium-Dependent Nitric Oxide and Oxidative Stress”

3) Med Sci Sports Exerc, 2008 Jul, 40(7):1336-43, “Effect of intensity of aerobic training on VO2max”

4) Journal of Applied Physiology, Mar 1 1997, 82(3):760-764, “Both physical fitness and acute exercise regulate nitric oxide formation in healthy humans”

5) Arteriosclerosis, Thrombosis, and Vascular Biology, 1999 19:2782-2787, “Exercise Training Increases Basal Nitric Oxide Production From the Forearm in Hypercholesterolemic Patients”

6) Circulation, 1999, 100:1194-1202, “Regular Aerobic Exercise Augments Endothelium-Dependent Vascular Relaxation in Normotensive As Well As Hypertensive Subjects”

7) J Am Coll Cardiol, 1995,25(2s1):298A-298A, “Exercise Increases Systemic Nitric Oxide Production in Men “

8) JAMA, 2004, 291(24):2978-2984, “Effect of Lifestyle Changes on Erectile Dysfunction in Obese Men A Randomized Controlled Trial”

2.  High Blood Pressure Patients. A study in Circulation found that men with with hypertension got a nice increase (25%) using the same stimulation as in the study above. [6] This is important, because it shows that you should begin where you are and not assume that you are so damaged that you cannot get a boost in blood flow or nitric oxide.

CAUTION:  If you have existing an existing medical condition, especially heart disease, consult with your doctor first before undergoing an exercise program.

3.  High Cholesterol Patients. One study looked at high cholesterol patients and found that they got a nice bump in nitric oxide through exercise. [5] Again, this is yet another study showing that, even if you are a high risk patient, you can significantly improve things.

CAUTION:  If you have any cardiovascular issues, clear exercise through your doctor first.  This sounds like an overly cautious statement, but many men have had heart attacks during exercise and it is simply because they went too fast for their damaged cardiovascular systems.  Go easy and talk to a doc if you have atrial fibrillation, angina, heart medications, high blood pressure, etc.

Exercise Intensity Levels for Best Nitric Oxide Levels

What is the best exercise intensity level to increase blood flow?  The more intense the better, right?

Actually, one study shows that moderate intensity exercise is probably the best way to go.  They evaluated this by splitting up a group of healthy, younger men into 3 exercise groups (5-7 times per week) based on the percentage of VO2max in their sessions.  Specifically, their definition was “mild, 25% V̇O2max; moderate, 50% V̇O2max; and high, 75% V̇O2max.” [2]  (VO2max is a standard measure of intensity used in many studies and refers to the maximum ability of an individual’s body to use oxygen during exercise.) [3]

Now it kind of makes sense that very mild exercise would not stimulate nitric oxide much.  But why did the intense exercise not increase nitric oxide and blood flow even more than moderate and mild intensity levels?  The answer lies in the fact that intense exercise increased oxidative stress, i.e. raised free radical production so much that it overwhelmed the body’s ability to adapt.

Now does this mean you should not push yourself and just “coast” in your workouts?  No, not really.  Another study showed that trained individuals had 32% more baseline nitrate levels, a measure of nitric oxide, than less trained individuals. [4] So as you slowly build up your ability to exercise and train, you should see your baseline nitric oxide, i.e. resting plasma nitrate levels increase over time.

Exercise As An Erectile Dysfunction Cure?

One natural question is the following:

“If exericise can do such a nice job boosting nitric oxide, can it be used to “treat” erectile dysfunction?”

Well, yes and no.  First of all, practically speaking, you can’t really exercise and then try to grab your wife or girlfriend while you still have the elevated nitric oxide levels.  Well, if YOU can do that, it just might work, because one study showed that nitric oxide levels increase by well over double post-exercise (~125% increase) in both trained and untrained individuals. [7]  That is an incredible boost from just one lifestyle change.

There is just one problem though:  after two hours nitric oxide levels returned to baseline.  So that gives you maybe an hour-and-a-half to drive home from the gym, kick the kids out of the house, shower and convince the little woman that “now is the time!”  Well, this isn’t too practical obviously and so you may be wondering just how practical exericse really is.

Well, before you give up on exercise, remember the study above:  trained individuals have 32% more baseline nitric oxide levels than untrained.  Yes, you can increase your baseline nitric oxide levels through regular and diligent workouts. In other words, these research results point out that exercise should be part of a total “Nitric Oxide Program” that helps maintain and/or restore youthful nitric oxide levels, thus helping any erectile dysfunction you may be experiencing. (Of course, there are other non-endothelial reason for erectile dysfunction, including Venous Leakage and Neuropathy for example. But, usually, a loss of nitric oxide-induced blood flow is a primary culprit.

And one study (in obese men) has already found that exercise can improve erectile dysfunction. [8] And no doubt more studies will follow.

CAUTION:  Few lifestyle factors are harder on the body than being sedentary, something I discuss in my link How Sitting Will Kill You. You may also want to read my article on Erectile Dysfunction and Exercise for some additional information.

REFERENCES:

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

Popcorn: The Benefits of This Erection -Promoting Food-

The benefits of popcorn for us guys are many and can even extend into the bedroom. Of course, I am assuming that you leave off the copious amounts of butter, fat, salt and excitotoxins that people typically put onto their popcorn.  Natural popcorn that is lightly salted, though, is a great snack and below I give you three erection-promoting reasons why:

1) Nitric Oxide. Popcorn is a great source of L-Arginine. For example, let’s say that you have 240 calories of popcorn or 2 ounces (56 grams).  This will supply you with a reasonable 42 grams of carbohydrate and, most importantly, about 340 mg of all-natural Arginine. [1] Furthermore, popcorn has a favorable Arginine-to-Lysine ratio, which means that the popcorn will ramp up the powerful nitric oxide, blood-dilating pathway.

Will popcorn lower your blood pressure and cure your erectile dysfunction?  No, of course not, but it is one of many foods that, when put together as a complete dietary regimen can make a big difference in how you feel and even how you can perform in the bedroom.  (For more erectile-boosting foods, see my book The Peak Erectile Strength Diet.)

1)  https://nutritiondata.self.com/foods-023089000000000000000-1w.html

2) https://nutritiondata.self.com/facts/snacks/5659/2

3) 46) JAMA, 2008, 300(8):907-914, “Nut, Corn, and Popcorn Consumption and the Incidence of Diverticular Disease”

4) https://www.naturalnews.com/030480_microwave_popcorn_PFCAs.html

Contrast this will foods like refined sugars and breads and How and Why Saturated Fat Can Be Bad For You, which will hammer nitric oxide and slow down blood flow.  Popcorn is the opposite:  a food you can eat with confidence before heading to the bedroom.

2) Testosterone Maintenance. Popcorn is certainly not going to boost your testosterone.  However, many snacks will likely lower your testosterone a little.  The reason?  As you know from my link on Testosterone and Glucose, high glycemic foods will likely lead to a post-meal drop in testosterone that last for several hours according to the latest research.  However, straight air-popped popcorn only has a Glycemic Index of 55 and a very low Glycemic Load – around 6 for a standard serving.

3) Minerals.  Another surprising benefit of popcorn: it has a nice balance of nutrients that will bolster your energy, strength and health in general.  Yes, popcorn has received a bad reputation over the years, but that’s largely because of all the “extras” that people put on it.  Under the covers, popcorn is a very nutritious food that is literally a mini-vitamin pill.

Consider that fact that three cups of air-popped popcorn will supply you with 0.9 grams of Zinc.  That’s about 6% of the RDA (15 grams) and is very absorbable, unlike many of the zinc supplements out there. [2]  In my link on The Benefits of Zinc, I discuss how Zinc can be a big help with testosterone and other sexual health-related issues.

The same amount of popcorn will also supply you with about 32 grams of Magnesium [2], or almost 10% of your RDA, which can help with sleep, cardiovascular health and, potentially, a little with erections as well.

CAUTIONS:  There are a few, relatively minor in my opinion, cautions associated with popcorn:

1. Genetic Modification. Corn, in general, is a significantly GMOed food, i.e. it’s genome has been altered in the last fifty years or so to increase yield, durability and other issues.  In my link on Wheat Belly, I outline how this has become an issue with wheat.  Fortunately, it does not yet appear to be as much of an issue with corn.

2. Diverticulitis. Also, some experts have asserted that popcorn (and possibly nuts) could increase the risk for diverticulitis. However, one large study found this not to be the case. [3] Talk to you physician, though, with any concerns.

3. Chemicals. Microwave popcorn can spread a minute residue of a toxic chemical called PFCAs, the best known of which is perfluorooctanoic acid (PFOA). [4] Is this enough to cause health issues?  No one knows the answer yet, but it may be prudent to make your popcorn the old-fashioned way.

4.  Herpes.  One of the benefits, the boost in Arginine levels, coming from eating popcorn could, for some men, be a curse actually.  The reason is that in some sensitive men, raising the L-Arginine to L-Lysine ratio of their diet will result in herpes infection outbreaks.  .

REFERENCES:

Estrogen: Do Men Need It? - Peak Testosterone

Do men need estrogen? The truth is that you need estrogen almost as much as the woman in your life needs testosterone.” And she needs testosterone – believe me.  It contributes greatly to her mood, libido, weight maintenance and insulin control just for starters.  Of course, if she gets too much, it can cause her issues – just read about what happens to most women with PCOS.

Estrogen is analagous in many ways for males. We all know that overly high estrogen levels will likely lead to prostate cancer, andropause and loss of erectile strength and libido. You can read my links on The Dangers of Estrogen for more details. At the same time we very much need some estrogen for certain critical health functions.

So just how does estrogen fall too low in males?  The primary way is  in senior males with long term andropause.  The typical pattern for an aging male is that his testosterone slowly declines by a percent or two per year after about his early to mid 20’s.  This decline in testosterone  leads to slow weight gain, which in turn leads to increased estrogen levels due to the additional aromatization of testosterone from extra body fat.

However, as the years go by, it is quite common for testosterone levels to fall so low that even with the increased aromatization rates, a man can find that his estrogen falls to dangerously low levels.  Thus, one could generalize and say that elevated estrogen is a middle-aged man’s nightmare and decreased estrogen a senior man’s.

NOTE:  Estrogen actually has several different subforms. The most “dangerous” estrogen is E2, or estradiol. Typically, when one is talking about estrogen, this is the form being referred to. Sister molecules are estrone (E1) and estrial (E3).

Here are three key ways showing how badly men need adequate estrogen levels and how low estrogen can endanger a man’s career, relationships and health:

1.  Bone Maintenance.  Estrogen is critically important for brain function, even in the men. Researchers have found that it is important for verbal memory in particular. [2] Estrogen is also essential for the growth of new neuronal connections and neuron maintenance. [3] Yes, testosterone has a profound effect on the male brain, but adequate estrogen is no less important.

2. Erectile Dysfunction. Results are preliminary, but it is clear that estrogen in males actually plays a significant role in nitric oxide production. [4] Of course, it is no secret that testosterone stimulates nitric oxide, but researchers were suprised to find that in men there were critical estrogen receptors that stimulate eNOS as well. Therefore, it may be almost as important to check estrogen levels as testosterone in aging males.

3. Verbal Memory and Brain Function. Estrogen is critically important for brain function, even in the men. Researchers have found that it is important for verbal memory in particular. [2] Estrogen is also essential for the growth of new neuronal connections and neuron maintenance. [3] Yes, testosterone has a profound effect on the male brain, but adequate estrogen is no less important.

4. HDL. Estradiol increases HDL and so it stands to reason that low estradiol levels could lead to low HDL levels as well.  See my page on Estradiol and HDL for additional information.

Many experts emphasize that the criticality of the ratio of testeosterone to estrogen. For more information, read my link on The Testosterone-to-Estrogen Ratio, where I discuss how it changes over the years and even how Cialis can affect it in a positive way.

CAUTION: I had one extremely fit and athletic young man write in who was taking a variety of supplements and foods that decreased testosterone’s aromatization to estrogen.  This included zinc supplementation and green tea extracts (EGCG). His claim was that, because he was so thin and had very low body fat, that his estrogen was likely too low and leading to a variety of health issues. It may be something to consider for the young and fit.

REFERENCES:

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

2) https://www.webmd.com/brain/news/20001107/male-brains-need-estrogen-for-good-memory

3) https://news.columbia.edu/research/1983

4) Med Sci Monit. 2003 Mar;9(3):RA63-8,  “The nongenomic protective effects of estrogen on the male cardiovascular system: clinical and therapeutic implications in aging men”

Hair Loss and Male Pattern Baldness - Peak Testosterone

Are you ready to put Super Laser Power to work for you?  Are you ready for the Little Woman to once again be able to run her fingers through your hair once again?  Well, it can happen for you.  Most guys will probably tell you that the most humiliating part of aging is was losing those golden locks.  So how can we regain lost youth from the tip of our toes to the top of our scalps?

Well, there’s a right way and a wrong way to do it if you ask me.  Most guys have heard of Proscar/Finasteride and Rogaine/Minoxidil as science-based hair loss solutions.  However, what guys are not told, usually until it’s too late, is that these have very nasty and fairly common side effects, including erectile dysfuntion and arrythmias, respectively.  (See below for more details.)  In addition, real life results seem to be significantly less than the studies.  Consumer Reports found that only 27% and 4% of respondents felt that Propecia and Rogaine, respectively, were “very effective”.. [17]

It takes about a half dozen treatments to generally stop the progression of hair loss and a half dozen more until you start seeing those precious new buds breaking out of the soil. (If you’ve been bald for ten years, don’t expect a miracle.  This is for those who still have some warriors on the moutain top.)

Side effects are minimal, sometimes a little redness and tenderness, and that’s about it. Treatments are usually done a few days or few weeks apart.  The cost is not cheap – around $2,000 – $4,000 for a full year of treatments – but doable for many guys.

NOTE:  The study showed that this was effective with both males and females.

Quite often in the world of health, the counterintuitive is actually correct.  This applies to the case of caffeine as a hair growth stimulant. Caffeine is known as a vasoconstrictor, i.e. it decreases blood flow which is generally bad for hair growth.  However, in vitro (lab/test tube) results show that caffeine is a potent stimulator of hair growth.  Basically, one study removed follicles from the scalps of men with male pattern baldness (androgenic alopecia) and put them in a test tube with and without caffeine. [9] Those in the presence of caffeine grew much more rapidly.

Why, you may ask, am I losing my hair when I have a couple of cups of coffee every morning?  Dr. Weil estimates that you would have to down 60 cups of joe to deliver enough caffeine to your hair follicles for this to work, so the only realistic solution is a topical one applied directly to the skin. [10]

Currently, there are several manufacturers creating caffeine shampoos that seem to be having some positive reviews.  Revita is an example on Amazon:  DS Labs Revita Hair Growth Stimulating Shampoo (2). And I have also read that there is a Swiss company making a line called Alpecin as well. There is a study that shows that shampoos can effectively deliver caffeine to the scalp, but so far there has been no study on whether or not caffeine actually gets rid of male pattern baldness or not.  In the meantime, you can try it if you like…

A small, but well-designed study showed that a combination of saw palmetto and beta-sisterol results in 60% of patients with improved hair growth. [8] These are high numbers, indeed, and saw palmetto likely will help with enlarged prostate and other male issues as well. Life Extension, for example, puts together a product that clearly tries to target this study, i.e. it contains both extracts of saw palmetto and beta-sisterol.  CAUTION:  Although side effects are much less pronounced than Proscar or Propecia, some men report some loss of erectile strength and other similar side effects while using Saw Palmetto.

One study demonstrated that ketoconazole, the primary active ingredient in Nizoral Shampoo, can maintain hair and actually increase its thickness, strength and thus negate the “thinning” effects of aging. [14]  Can it actually grow hair?  So far the only evidence for that is one study on mice. [15]

Of course, Zinc can potentially boost testosterone and reduce estrogen.  But did you know that one form of zinc may be able to put hair on your head as well. Yes, indeed, one study shows real, live, actual hair growth from use of a zinc pyrithione shampoo. [16]  Both Selsun and Head and Shoulders make products with this ingredient: Head & Shoulders and Selsun Salon Pyrithione Zinc Dandruff Shampoo. Better buy a blow dryer and brush while you’re at it.

Any discussion of legitimate hair loss treatments has to begin and end with Finasteride, i.e. Propecia or Proscar Lite, because it’s hard to beat its clinical results.  For example, one study shows that 80% of men were helped with additional hair regrowth is actually achieved. [1]  In this same study it beat Minoxidil’s 50% cure rate rather handily.

The problem with finasteride is that it works too good:  it lowers DHT throughout the body when, in actuality, all that is needed is for DHT to be lowered in the scalp.  This lowering of DHT systemically can cause muliple side effects for guys.  In fact, the side effect profile gets rather ugly rather quickly:

FINASTERIDE SIDE EFFECTS: The biggest concerns with finasteride, a.k.a. Propecia or Proscar, are erection-related and pregnancy-related.  First of all, every decent source that I know of warns against a pregnant woman coming into any kind of contact with this drug as the data strongly suggests that it can cause birth defects in the male fetus. This is scary indeed, because the majority of guys using finasteride are with females who are capable of becoming pregnant even if the likelihood is remote.

The other concern with finasteride is the commond side effect of erectile dysfunction and loss of libido. One study reported the percentage of men with such side effects to be about 15%, which is a very high number indeed. [2]  However, this documented that there is a strong “nocebo” effect from doctors warning that “this drug may cause loss of libido and impotence”.  Apparently, those words from a doctors can create quite the negative effect in many guys!

The well-known PLESS study reported a smaller figure of about 8% in the first year decreasing to 5% in years 2-4. [3] In fact, what is interesting is that 5% was also reported by the placebo group and so we are left the counterintuitive finding that fnasteride start out with a negative side effect that essentially disappears after a year or two.

And that’s not the end of the story. About one in fifty men on Propecia will experience permanent erectile loss due to androgen deficiency and/or resistance. This amounts to chemical castration and I cover the symptoms and one’s readers description of it in my link on The Risks of Propecia.

Studies show that number 2 in the hair repair category has got to be Minoxidil (Rogaine). [4]  Minoxidil induces hair growth in the 30%-50% range and thus is quite effective and with greatly reduced side effects when given in a 5% topical solution.  Minoxidil also has the significant advantage of being over the counter.

What about side effects?  Interestingly enough, minoxidil actually got its start as a blood pressure medication.  It appears to mimic your friend and mine, Nitric Oxide, and derive its magical powers from the same.  The side effects, when used for hypertension, are somewhat scary, including edema in about 7% of patients and altered brain waves. [5]

However, when applied topically on the scalp, the side effect profile is very low – please read the Caution section below! – with by far the most common reported issue being dryness of the scalp and/or or dandruff.  The reason for this is probably that minoxidil must immersed in a base of alcohol and/or propylene glycol, both of which can cause drying of the skin. You can combat this oftentimes by simply using one of the shampoo/conditioner combos that tend to moisturize the scalp.

CAUTION:  Minoxidil, in tablet form, is actually a powerful antihypertensive agent and, as such, can cause drops in blood pressure and irregular heartbeats. This is less common with topical applications on the scalp but can definitely occur. Discuss immediately with your doc if you have any such symptoms.  I personally shy away from minoxidil, because it is notorious (in tablet form) for increasing heart attack risk in lab animals. [11]  That same study found that minoxidil actually changed the ventricular (heart chamber) weights and coronary artery occlusions.  Again, these changes in the heart are not supposed to happen with topical minoxidil but does in some guys using only a lower dose 2% solution. [12]. “Don’t mess with Mother Nature”, I always say, “unless you  really know what you are doing” and this is an example where we don’t understand everything yet.  By the way, minoxidil is a potassium channel opener as well.  Who knows what effect that will have over decades of use??

However, there is one big turnoff for some guys:  the twice a day application with no showering for four hours afterward.  That’s right – you have to apply this morning and evening and then let it sit for four hours, which is a significant time commitment and can, depending on your hair, leave an oily look.

Some people will also be disturbed by the very non-natural propylene glycol, but this is much less problematic than ethylene glycol, bettter known as antifreeze.  In fact, propylene glycol is actually a food additive and used in many household products as well.  Studies show no toxicity or cancer-causing effects except at very high doses.

Several studies have shown that when you combine the active chemical in Retin-A with Minoxidil, superior results are achieved. [6]  In fact, one study showed hair regrowth in 66% of subject which is at finasteride levels. [7]  Researchers believe this is because the Retin-A increases absorption of the minoxidil, allowing it to be more effective.

This has been combined in a product called MinSaw-A and marketed as such. I do not know a cheap way to obtain this product, but mention it.  Again, see the warnings for minoxidil above.

REFERENCES:

1) Dermatology, 2004, 209(2):117-25, “An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia”

2) Sexologies, 17(1):S102, Apr 2008, “T07-O-05 Finasteride 5 mg and sexual side effects. How many of these are related to a nocebo phenomenon?”

3) N Engl J Med 338:557, 1998, “The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group”

4) J Am Acad Dermatol. 2007 Nov;57(5):767-74,  Epub 2007 Aug 29, “A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men”

5) https://www.drugs.com/sfx/minoxidil-side-effects.html

6) Am J Clin Dermatol. 2007;8(5):285-90, “Efficacy of 5% minoxidil versus combined 5% minoxidil and 0.01% tretinoin for male pattern hair loss: a randomized, double-blind, comparative clinical trial”

7) J Am Acad Dermatol. 1986 Oct;15(4 Pt 2):880-3, 890-3, “Topical tretinoin for hair growth promotion”

8) J Altern Complement Med, 2006 Mar;12(2):199, “A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia”

9)

10) https://www.drweil.com/drw/u/id/QAA400216

11) Hypertension, 2001, 37(2):209-215, “Mortality after coronary artery occlusion in different models of cardiac hypertrophy in rats”

12) https://www.drugs.com/sfx/rogaine-side-effects.html

13) International Journal of Cosmetic Surgery and Aesthetic Dermatology, Aug 2003, 5(2):113-117, “Hair Regrowth and Increased Hair Tensile Strength Using the HairMax LaserComb for Low-Level Laser Therapy”

14) “Ketoconazole Shampoo:  Effect of Long-Term Use in Androgenic Alopecia”, https://www.hairlosstalk.com/hair-loss-pdf/nizoral-study.pdf

15) J Dermatol, 2005, 32 (4):243-247, “Topical Application of Ketoconazole Stimulates Hair Growth in C3H/HeN Mice”

16) Br J Dermatol, 2003 Aug, 149(2):354-62, “The effects of minoxidil, 1% pyrithione zinc and a combination of both on hair density: a randomized controlled trial”

17) WebMd Magazine, Jun 2010, p. 13.

18) Prevention, May 2010, p. 16.

CAUTION: If you’re currently taking medications, you should definitely check with your doctor or pharmacist if they could be causing or exacerbating your thinning hair.  Many blockbuster drug categories, including angiotensins, beta-blockers, ACE inhibitors, diuretics and blood thinners, can negatively effect hair. [18]

So is there no hope for us with Scalp Dysfunction Syndrome?  See my link on Hair Loss Factors for more natural solutions and protection.

Below I have outlined the approaches that have achieved good success in the research, although the pharmaceuticals are downright dangerous as I cover below:

Solution #1: Low Level Laser Therapy

Of course, surgical hair replacement is always an option to restoring your hair.  It is, however, quite expensive, time consuming and physically uncomfortable.  The hot new cosmetic technology involves firing up a good ol’ fashioned laser beam and directing that right at the top of your head. (Actually, it’s a bunch of laser beams.)  Who would have thought that laser technology might one day turn you back into a rock star? The treatment methodology is actually called LLLT, for Low Level Laser Therapy and produced solid results in one recent study where the number of hairs and the strength of existing hairs was increased. [13] What else could you ask for, eh?

Solution #2: Caffeine ShampooSolution #3: Saw Palmetto with Beta-SisterolSolution #4: Nizoral (Ketoconazole)Solution #5: Zinc Pyrithione ShampooSolution #6: Finasteride, Proscar or PropeciaSolution #7: Minoxidil or Rogaine

Work and Testosterone - Peak Testosterone

Can your work and the state of your career affect your testosterone?  Well, of course, it can, but I have noticed several questions about this on the forum:  there seems to be considerable confusion.  For example, look at this man’s post:

“Why is it necessary to have a Testosterone test as close to 8am as possible? Is this because it is assumed that one goes to bed at midnight and sleeps for a solid 8 hours? Is it connected to daylight or circadian rhythm? Does it have to be done at 8am or as close as possible? Because of my disturbed routine, I go to bed late and get up late. So I think that my ‘8am’ is actually 11am.” [10]

We’ll cover shift work below, but notice that this man was very certain if it could have any sort of negative impace on health.  It is my impression that most men do not realize just how important their job is to their health and hormones. Plus, most men feel, “Well, I have to work and I have bills to pay!”

Okay, that’s true, but our exact job position is not usually set in concret and there is no good reason for us to be trapped indefinitely in ugly financial and career situations.  Below I will show the many ways that this can negatively alter testosterone levels:

1.  Shift Work. Many men feel it is necessary to take on shift work. And, of course, the wheels of industry, call centers, and many other sectors of the economy spin out jobs that fit this sector.  While these jobs may increase your income, they are very likely to lower your testosterone. Most of us know that our bodies and brains are naturally tuned to a dark/light circadian cycle that affects hormones like melatonin. However, as I document in my link on Sleep and Testosterone, this same cycle prime engine of your testosterone production.  And any disruption or alteration will generally lower your testosterone output.

Shift work is the best example of this and several studies show that shift work can negatively impact your androgens.  One study of shift workers found exactly what one would expect:  increased cortisol and decreased testosterone output. [1] However, the reasons for this actually may have less to do with circadian cycle disruption that how much one likes their shift work.

It should be pointed out that one study felt that the primary problem with shift work related to satisfaction/dissatisfaction, i.e. they noted lower testosterone levels and increased need for recovery among dissatisfied workers. [4] This model makes a lot of sense, since the brain and one’s attitude can make a very big difference in testosterone levels.

1)   Eur J of Applied Physiology, 1990, 60:288-292, “Effect of shift work on the night-time secretory patterns of melatonin, prolactin, cortisol and testosterone”

2) Chronobiology Intl, 2007, 24(1):115-128, “Elevated Plasma Homocysteine in older Shift Workers: A Potential Risk Factor for Cardiovascular Morbidity”

3) Am. J. Epidemiol, 15 Sep 2006, 164(6):549-555, “Prospective Cohort Study of the Risk of Prostate Cancer among Rotating-Shift Workers: Findings from the Japan Collaborative Cohort Study”

4) Journal of Applied Physiology, Nov 1 2003, 95(5):2099-2105, “Hormonal changes in satisfied and dissatisfied shift workers across a shift cycle”

5) https://www.eurekalert.org/pub_releases/2008-06/uom-2vs052808.php

6) https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2006.086900

7) Stress and Health, April 1998 , 14(2):91-97(7), “Increased free cortisol secretion after awakening in chronically stressed individuals due to work overload”

8) Journal of Psychosomatic Research, 1979, 23(3):181 192, “White collar work load and cortisol: Disruption of a circadian rhythm by job stress?”

9) Biological Psychology, Oct 2006, 73(3):280 287, “Psychosocial factors at home and at work and levels of salivary cortisol”

10) https://peaktestosterone.com/forum/index.php?topic=420.msg3783#msg3783

NOTE: Shift work can also increase several big risk factors for erectile dysfunction.  One of the big ones that they discovered were elevated homocystein levels in older shift works. [2] This means increased risk for cardiovascular disease and likely erectile issues as well.  Shift work also puts you at risk for many other negative medical conditions that could affect your hardness factor, including obesity and prostate cancer. [3]

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

2.  Stress. One massive study of 21,000 Victorians found that about 13% of men had stress-related depression related to their job.  [5] In other words, about 1 in 7 men in this study were depressed simply because their work stress was too high.  Some study works shows that repetitive work, bullying, isolation, job insecurity – just what you’d expected, eh? – are the items that can increase job stress.

One other very important job-related factor has been found that can increase stress:  long hours.  Yep, the more overtime the more likely one is to be depressed and have many other psychological and physical issues. [6]

Now none of these has actually been tied to lower testosterone, but that is simply because researchers have not studied it yet.  Depression is strongly associated with higher cortisol and lower testosterone levels, something I discuss in my link on  Depression and Testosterone.

4. Obesity. Your job can also increase your body fat.  Some people will immediately object to such a statement, insisting that is it is “calories in, calories out” that counts and nothing else.  But this ignores how a poor working environment can negatively impact things like stress, insulin and appetite levels.  If you’re in a negative work environment, it is going to be much easier to put on weight is the bottom linke.  One medical newletter word it like this:  “In particular, the risk of obesity may increase in highdemand, low-control work environments, and for those who work long hours.”

Now, again, these studies did not show a decrease in testosterone directly.  However, anything that increases body fat significantly will put your testosterone at risk.  In fact, if you put on enough weight, you can actually induce a kind of secondary hypogonadism, where you turn off the signaling for testosterone production for the pituitary and hypothalamus.

REFERENCES:

Viagra Failure - Peak Testosterone

Viagra. Cialis.  Levitra.  These are a miracle in a bottle, right?  Well, not for a huge percentage – around a third – of middle-aged and beyond men. These drugs fail and fail miserably for them – they simply do not work.  (And sometimes failure occurs with these PDE5 Inhibitors due to nasty side effects including headaches and hearing, vision and stomach disturbances.)

I have already documented many reasons for their lack of effectiveness in my link on Why Viagra Doesn’t Work.  However, I want to cover another important reason for Viagra failure here:  lack of baseline nitric oxide production in men that are 40+.

This point was emphasized in a Recent Interview with Nathan Bryan, one of the world’s foremost experts on nitric oxide. In this interview, Dr. Bryan explained how PDE5 Inhibitors work, which is by inhibiting the activity of an enzyme that breaks down nitric oxide. In other words, and as I have explained often on this site, Viagra and other similar drugs do not actually directly increase NO, they merely allow it to stay in your system longer.  This is only effective if you have sufficient baseline nitric oxide production in the first place. As Dr. Bryan put it, “Without production of NO, this pathway does not and cannot work. In fact, this is why Viagra and Cialis do not work in 100% of the population.”

And Dr. Bryan himself has pointed out that most 40-year-old men will only produce half of the nitric oxide that they did when they were 20. [1] This is a drastic reduction! It’s a wonder us old timers can even have an erection, eh?

Now imagine what happens when a man has “endothelial dysfunction.”  His arteries and veins have been damaged, inflamed and coated with extra plaque after years of lifestyle abuse.  His nitric oxide is will be in even worse shape. The reduction in blood flow will affect almost every system in his body, including those affect his sex life. And for him taking Viagra, Cialis or Levitra is doomed to failure.

So is there any hope?  Are there any natural ways to boost nitric oxide for a man with nitric oxide insufficiency?

Yes! I hope that you’ve already found many of these ways as you’ve searched around my site, but let me summarize some of the key ways that you can get your nitric oxide levels back in shape:

1.  Diet.  One of the ways you can increase baseline nitric oxide production is through consumption of nitrates.  I discuss many of these in my book on book Peak Erectile Strength Diet, but spinach and beetroot juice are classic examples. Nitrates are converted to nitrites by bacteria on your tongue and to NO in your stomach and gut.  In addition, many of these foods will also enhance and protect your nitric oxide, thus effectively raising nitric oxide levels farther downstream.

CAUTION:  Avoid amines when consuming nitrates in the diet. Certain cheeses and meats may combine with nitrates and create carcinogenic compounds called nitrosamines.  In addition, avoid consuming supplemental Vitamin C with any fat in the stomach for a similar reason.

2.  Neo40.  This new supplement works via not allowing supplying baseline nitrates, but also by adding an enzyme that helps the body convert the nitrates more easily to nitric oxide. [1]

NOTE:  You can boost the power of all of these through exercise.  Exercise is a potent booster of nitric oxide and researchers believe it works primarily by increasing the bioavailability of the same enzyme that Viagra works on. So then does it really increase baseline nitric oxide production?  Well, exercise gets you to the same point through a different route:  it increases the number of new capillaries and veins throughout the body, a fact I cover in my link on Exercise and Erectile Dysfunction.  This has a similar net effect as #1 and #2 above – more blood flow to more tissues.  See my link on Sexercise for a dozen other reasons to exercise as well.

REFERENCES:

1) https://findarticles.com/p/articles/mi_7396/is_334/ai_n57416886/pg_4/ ?tag=content;col1

Weight Loss and Testosterone - Peak Testosterone

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/

Why I Believe Plant Based and Vegetarian Diets win Eventually

REFERENCES:

1)  https://ajcn.nutrition.org/content/78/3/660S.full

Some of you aren’t going to like me saying this, but I sincerely believe that plant-based diets are going to take over the men’s health community eventually here in the U.S., a space traditionally dominated by Paleo and Low Carb.  And I believe it’s going to be sooner rather than later. I think I am somewhat unusual in the sense that I am plant-based (whole foods vegan) and yet have read a large body of Paleo and Low Carb writing and research.  In spite of that, I still think meat eating is going to dramatically decrease over the next 20 years and plant based eating will rise to ascendancy rapidly.

First of all, Low Carb Diets are already dying a fairly quick death for all the reasons I outline here:  The Best Summary of the Research-Backed Dangers of Low Carb Diets. That leaves the Americanized version of Paleo, and I think it, too, will rapidly die out and be replaced by the following three types of diets:

a) Vegan and Plant Based. These diets are 100% plant based.  Generally speaking, plant based means now someone who is vegan but eats only whole plant foods.

b) Vegetarians.  Vegetarians generally, eat 90+% plants and 10% a combination of eggs or dairy.

c) Flexitarian. If you feel that you have to have some meat, then there is a diet called flexitarian.  This simply means someone who eats 90+% plants and 10% meat, eggs or dairy.

I am sure that some if not most of you are very skeptical, but I think you’ll see why I say this when I explain Five Great Reasons to Go At Least 90+% Plant-Based:

1. Testosterone. Did you know that the best study that we have to date shows that vegetarians have testosterone equal to meat eaters and that vegans have the highest total testosterone? I discuss the study in detail in my page on Testosterone and Vegetarianism. Now vegans actually probably don’t have higher free testosterone, since their SHBG will tend to be a bit higher.  But the real point is that you can eat a TON of plants and no animals and have total testosterone at least equal to the meat eaters around you. Yes, it is a complete myth that plant foods lower testosterone, and there is no research whatsoever to support the ludicrous statements that I hear to the contrary.

2. Nitric Oxide and Blood Flow. Let me give you the #1 reason that diets with at least 90% plant are going to win with men:  plants are incredibly powerful boosters of nitric oxide and blood flow and animal foods and meat suck at it.  This is the reason I wrote my book The Peak Erectile Strength Diet. In my book – and at the time I wrote I was the only one who wrote about the subject as far as I know – I documented one reason after another that plant foods were such powerful aids in erectile strength. They are packed with nitrates, flavonoids, polyphenols, anti-inflammatories, antioxidants – the list goes on and on – and many other phytochemicals that protect your arteries from plaque and boost nitric oxide.

This is in direct contrast with animal foods which have no such ability whatsoever.  If you sit down and eat a steak or chicken, will it boost your blood flow and lower your blood pressure?  No way!  Quite the opposite.  This is a unique property of plant foods, and again you can read about it in my book.

CRITICAL POINT: So why is this so important?  Because guys are all about erections and plant foods can be a life saver in the bedroom, especially as you age. If you eat a ton of plant foods, you boost your nitric oxide AND you get to keep your testosterone.  Is this an unbeatable formula or what?

So what’s not to like?!  You basically get to have your cake and eat it too.

Again, men are short-changing themselves in the bedroom with low carb and certain Paleo Diets that load up on animal foods.  Yes, young guys can eat that way and have great erections because they have a lot of buffer and nice clean arteries.  Most middle-aged and senior men have no such “luxury.”

3. Gut Health. One of the things that just floors me is that men don’t stop and think about how much we look like an ape.  We are incredibly similar both internally and externally.  Nowhere is that more apparent than in our GI tract.  Our gut, in particular, is almost totally that of a herbivore.  It is long, twisting and convoluted.  This in direct contrast with the typical carnivore that has a short and straight gut.  It’s basically a pipe to shoot that stuff out as rapidly as possible.

Stop and think about why this is the case:  iff you eat a a large amount of meat, the contents of the bowel are going to be a rapidly putrifying, slowly moving, fatty blob.  This mass needs to “get in and get out” which is why a carnivore’s gut makes that so easy.

Plant eaters instead have a long twisting gut that requires a lot of fiber and bulk for obvious reasons.  What a disaster to shove a steaming pile of fat and meat into our poor gut, where it moves slowly and painfully through our herbivore-like GI tract!  No wonder Crohn’s, diverticulitis, IBS, colitis, etc. are at epidemic levels.  And no wonder our gut flora is a disaster.  One study after another has come out about the important of gut flora on health.  And high fiber, whole foods, plant-based diets are king in this area.

If you don’t have two easy, non runny and non-constipated bowel movements per day, then you need to get to a plant-based regimen.

4. Sustainability. I get amused with people who are worried about the fact that we have an aging population. I’m not being callous to demographic effects on the economy, but this is just the beginning!  There are now huge players in anti-aging, regenerative medicine and life extension that are going to revolutionize and extend both healthspan and lifespan very soon.  And I am not talking about supplements here:  I am talking CRISPR (gene editing), sterm cell therapies, nano technology and so on.

Already we already curing several types of blood cancer.  And the progress against cancer has been so impressive that it is not at all unreasonable to believe that cancer will be completely defeated in the next forty years.  As I write this, several of the nastiest genetic diseases have clinical trials underway to be eradicated with gene editing.  This research is going to rapidly accelerate.

So how does this fit  into an argument for plant foods?  Because as the population ages, there will simply be no way to feed men significant percentages of animal foods and products.  At some point we all have to admit that plant foods are much more sustainable.  Check out these stats as examples:

–Livestock produces more greenhouse gases than all cars, planes and trucks combined.

–To produce a pound of meat generally takes between 500 and 2000 gallons of water.  To produce a pound of most plant foods is between 30 and 200 gallons.

–“In the United States, more than 9 billion livestock are maintained to supply the animal protein consumed each year.” [1]

–“This livestock population on average outweighs the US human population by about 5 times.” [1]

–“At present, the US livestock population consumes more than 7 times as much grain as is consumed directly by the entire American population.” [1]

–“The amount of grains fed to US livestock is sufficient to feed about 840 million people who follow a plant-based diet.” [1]

I know lots of men on my forum who are into sustainable energy sources and get excited to hear about advances in solar power and other similar technologies. What they don’t realize is that shifting to a largely plant-based diet can have easily the same level of impact in achieving sustainability on our planet.

5. Supercultures. There are a handful of supercultures that have a unique combination of qualities:  they live without chronic disease (heart attack, autoimmune disorders, stroke or cancer) and also have extreme longevity.  These cultures typically have a high percentage of centenarians and men and women in their 90’s are usually very alert and mentally and physically active.  The Tarahumara of northern Mexico are a great example of this. John Robbins provides four other examples in his book, which I review here:  Healthy at 100. All of the supercultures have several things in common, but one of them are diets that are very high in and based upon plants.  This is powerful evidence in  my opinion that optimal performance and longevity is obtained with a 90+% plant-based diet.

So get busy and choose one of those diets and get started!  Solid testosterone, high nitric oxide, great gut health and maximum longevity. What’s not to like?

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:

Excitotoxins: and Testosterone - Peak Testosterone

REFERENCES:

1) Eur J Oncol, 2005, (10)(2):00-00

2) Neuroendocrinology, 1978, 26:220-228; 1986, 42:158-166; 1980, 30:280-284

3) American Society of Nephrology (2009, November 2). Diets High In Sodium And Artificially Sweetened Soda Linked To Kidney Function Decline. ScienceDaily. Retrieved November 2, 2009, from https://www.sciencedaily.com /releases/2009/11/091101132543.htm

4) Neurology, 2009, 73:920-927, “Kidney function is associated with the rate of cognitive decline in the elderly”

5https://esciencenews.com/articles/2009/11/05/small.increases.phosphorus. mean.higher.risk.heart.disease

6)https://esciencenews.com/articles/2009/11/05/kidney.function.decline. increases.risk.heart.failure.and.premature.death

Sound unbelievable?  Well, here is a partial list of the hormonal vampires:

All of these ingredients have several things in common:  they are used in the food industry as “flavor enhancers” but are under the covers what biologists call excitotoxins and contain either aspartate or glutamate.  Glutamate is the most studied of the two compounds, but aspartate is definitely glutamate’s evil little sibling.

Together these two have something in common:  when ingested, they love to destroy neurons.  And, just as bad, when they destroy neurons in the right places, they can take out your entire hormonal cascade, including testosterone.

Animal studies, and not at overly high doses by the way, have shown that when pregnant mothers are fed glutamate the offspring is born normally but then during puberty a host of reproductive issues surface including shrunken testes. In other words, these molecules would better be called eunuch-o-toxins.

Interestingly, these key molecules are actually used by your brain for energy and as a type of neurotransmitter. In fact, they are involved in the switching mechanism of your neurons and are called excitotoxins because they literally overexcite the neurons to death if ingested in even relatively small quantities.  Neurons that receive too much glutamate or aspartate allow a flood of calcium – calcium is used for turning neurons on and off – into the cell.  The neurons under these conditions become swollen and damaged and eventually die.  So a little glutamate and aspartate is essential for the brain but too much is neuronal death.  Yes, your cells can literally get overexcited to death.

Furthermore, animals that are fed relatively low levels of glutamate can actually develop too many synaptic connections.  The brain becomes literally miswired.  In fact, studies show animals on glutamate become hyper and unable to perform normal tests of intelligence (for animals of course). This, of course, is because their brains are slowly getting mangled.  It is like taking a race horse or an elite bodybuilder and forcing him to work out until the muscles are literally shredded irreparably.

The tragedy is that many otherwise health-conscious people think that MSG, or monosodium glutamate, is only a health problem because it contains extra sodium or causes allergic-type reactions in sensitive people.  And probably an even greater tragedy is that many people, trying to be healthy by drinking diet sodas, are soaking their hypothalmuses (and in some cases brains) with excitotoxins. (Aspartame is so named because of the aspartate in its chemical composition which is released upon digestion in the stomach.)

So what do the studies show?  One animal study in a prestigious European journal already found “a statistically significant, dose-related increase in lymphomas and leukaemias in females” at about the equivalent level of three diet sodas per day. [1] This study was conducted on 1,800 rats and the control animals had no lymphomas.  In contrast, the animals aspartame had 10 malignant gliomas, 1 medulloblastoma and 1 malignant meningioma.  Yet somehow pro-aspartame proponents argue that this is not statistically significant!

Before I go on, I need to mention that, while I had read some basic information about excitotoxins, the book that really opened my eyes was Russell Blaylock’s The Taste That Kills. I cannot possibly do justice to this book in just one web page, but keep in mind that the author is a neurosurgeon and has packed this book with studes and references.

So why, you might ask, would the FDA allow these excitotoxins into our food supply?  Well, here is the FDA’s (extremely weak) argument:  the brain is protected by the blood-brain barrier which does not allow the passage of either glutamate or aspartate into your precious grey matter.  This is deadly and foolish thinking, because there are parts of your brain completely unprotected by the blood-brain barrier. Secondly, the blood brain barrier is not perfect and will under certain circumstances allow passage of glutamate and aspartate sized molecules directly into the brain.

But let’s focus on the problem that is going to be an issue for almost everyone.  There is a very key region of the brain where MSG and aspartate can march in and rape and pillage during their stay: the hypothalamus. This region of the brain essentially couples the nervous system and the endocrine system together. The hypothalamus pumps many key “factors” into the pituitary and the pituitary in turn controls your many of the hormones that you hold most dear as a male, including leutinizing hormone, i.e. LH, follicle-stimulating hormone, i.e. FSH, and growth hormone, i.e. GH.  And I should mention that testosterone is strongly effected by leutinizing hormone and, to a lesser extent, growth hormone.

Thus, it would stand to reason that damage to the hypothalamus from glutamate (and aspartate) could negatively effect all these key hormones effecting masculinity and fertility.  And that is exactly what the animal studies have found.  Growth hormone, leutinizing hormone, prolactin and several other hormones are all hit by the ravages of glutamate [2] resulting in animals that are so damaged that they obese with decreased fertility and often shrunken testes and pituitaries.

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By the way, I should mention that these changes do not necessarily show up right away.  They often show up only when the animal goes through puberty.  In other words, the excitotoxin damage can sit their dormant for years, relatively unnoticed, yet hitting your body years later like a freight train.  How many middle aged guys out there have wondered why their testosterone has vaporized in middle age seemingly inexplicably due to the ravages of MSG ingestion during their formative years?  We will never know the answer to that question and, more importantly, nor should we have had to.

NOTE:  Do you feel like crap and don’t know why?  You may have Excitotoxin Syndrome.  If so, please read about it here.

Regardless, the damage to us middle aged and beyond guys from glutamate and aspartate is probably rather extensive.  Throughout the 60’s, many manufacturers laced baby food with glutamate! (And you older guys wonder why you’ve been having problems, eh?) In addition, many women probably at more glutamate at meals during the very vulnerable first trimester when our entire brain is much more exposed to all that our moms ate and drank.  Again, animal studies show horrific brain damage from just these situations.

Okay, you can’t the past – we all know that.  But how do you protect yourself from excitotoxins from this point forward?  First of all, do NOT ever consume any of the items on the list at the top of this link.  That’s a no-brainer – no pun intended.  In fact, I strongly recommend that you do not consume these even in minute amounts.

You also must be extremely careful when it comes to packaged foods (and eating out).  Somehow the food manufacturers got the FDA to not only allow MSG but to allow it in many foods without being labeled.  Monosodium glutamate can be added to your food under labels like “spices”, “natural flavorings” and so on in many cases without actually labelling it glutamate or anything similar. You also get substantail amounts of MSG generally in “sodium casseinate”, “autolyzed yeast extract” and “maltodextrin”. So beware! The only way to really protect yourself is to buy foods packaged without absolutely no ambiguous or vague entries whatsoever.

NOTE:  I have documented some of the Fast Food Chains and Restaurants that Pack their Foods with MSG.

Remember that you probably have considerable damage to your hypothalamus and possibly other regions of your brain from the past decades of your life.  Many neurological diseases are based on a critical threshold being passed.  For example, in the case of Parkinson’s, one can have 50, 60 or even 70% of the cells in a certain area of the brain destroyed without any symptoms showing up.  But once we you pass the 80% threshold, that is when the devastating symptoms of Parkinson’s manifest themselves.

There are probably many areas of your brain where you probably at the 50% point.  The last think you want to do is anything that may take you down the home stretch to neurological disease and possibly dementia.  Remember:  your brain and your hypothalamus in particular sit vulnerable and exposed like a little child.  You are the only one that can protect them.  I highly recommend that you read my link on the Brain as well for other critical ways to protect yourself.

NEWS FLASH: Researchers have just linked kidney decline to diet drink consumption. [3] Aspartame, the artificial sweetener in most diet drinks such as Diet Coke and Diet Pepsi, breaks down into formaldehyde. Formaldehyde can accumulate in the kidneys and other organs and cause damage. This can potentially have far-reaching consequences as kidney decline has been linked with cognitive decline and loss of memory in seniors. [4]  Kidney decline has also been linked to an increase in phosphorous [5] and ensuing heart disease. [6]

The bottom line:  preserve what you got!  “Your grey matter is all that matters”.

Fructose and Weight Loss - Peak Testosterone

You can almost always find something nice to say about someone if you think hard enough.  But – let’s be honest – there’s a few people that you think are just pure evil.  It’s the same with some foods.  Trans fats, mangled souls of the nutritional underworld, are a prime example:  they destroy your lipid profile and wreak havoc throughout the body.  Fructose is the same way:  the more science researches fructose, the scarier it gets.  In this link we’re going to look at how fructose sabotages all attempts at weight loss.

Some of you may be thinking that you never eat fructose since you don’t really like or buy fruit.  Well, it’s not that simple:  sucrose, or table sugar, is composed of a glucose and fructose molecule bonded together.  In other words, when you consume table sugar, your body quickly breaks the table sugar into one half glucose and one half fructose.  The glucose can go in its merry way annihilating your testosterone and the fructose can do its job of adding fat and keeping your from any weight loss you might be attempting.

So how does fructose go about its mischief?  First of all, fructose has a strange effect on insulin levels or, better said, it has little to no effect on them.  We are all used to the idea that eating carbs raises blood sugar levels after a meal, which then triggers the pancreas to pump out insulin in response, right?  Fructose does not cooperate with theory, however, and insulin (after consuming fructose) remains relatively unchanged.

NEWS FLASH: Researchers just announced that mercury contamination is extremely common in high fructose corn syrup:  50% of products tested by researchers were contaminated! [4] The issue apparently is that there are no standards for mercury residue in hydrochloric acid and hydrochloric acid is used to make high fructose corn syrup. This is dangerous for anyone but particularly for children.  (NOTE:  Mercury can affect testosterone!)

This happens because glucose is pulled into cells through the glut-4 system, which raises insulin as expected.  Fructose completely bypasses this system and uses the glut-5 system, which few cells in the body have by the way, thus achieving a greatly muted insulin response.  Now this might seem like a godsend to all you insulin resistant middle aged males out there, but it’s definitely not.  This lack of insulin response actually backends weight loss because it has a negative impact on the appetite-suppression hormones leptin and gherlin.  These appetite hormones normally kick in in reaction to insulin, which makes sense because if you’ve just filled your gut with carbs, you want your body to respond by signalling that you’re not as hungry any more.  This signal is much, much more muted with fructose and so you stay hungry even though significant calories have been ingested.

So, again, let me summarize what some of the key ways – besides needless calories! – that fructose attacks any weight loss plans you might have:

1)  Insulin Resistance. Fructose puts your cells’ energy burning mechanisms on overdrive.  For those of you who can remember your high school biology, fructose exhausts intracellular ATP supplies.  Fat cells react by bloating and becoming insulin resistant.  Most research shows that, particularly in subjects at or past middle age, fructose leads to Insulin Resistance. And you hopefully know from my page on How to Lose Weight that Insulin Resistance slows down fat loss.  (It is also a huge health risk:  read my page on Metabolic Syndrome for more details.)

2) Leptin Resistance. Fructose not only makes you insulin resistant but also leptin resistant. Normally, eating sugars and high-glycemic carbs cause a rapid rise in insulin, which affects leptin, which in turn turns off your appetite.  Frutctose, though, is unique in that it turns off the pancreas normal output of insulin.  The ensuing small rise in insulin is not enough to significantly affect leptin and so your hunger remains.  In other words, with fructose you eat a lot of calories and still feel hungry.  Even worse, if you continue to consume fructose regularly, your body becomes leptin resistant, which means your hunger never abates.

Stop for a mintue and consider what a daily combination fructose-induced insulin resistance and leptin resistance pose:  insulin resistance packs on the pounds more easily and leptin resistance makes it much, much more easy for you to overeat so that you give your insulin resistance a nice, steady supply of calories.  This creates an almost impossible environment for a dieter:  his hormones and appetite are working against him.  No wonder some guys just give up!

Needless to say, if you’re on a diet and attempting any sort of weight loss, you need to go easy on the sugars because of the fructose.  However, one question you may be asking is, “Should I give up fruit while I’m dieting?”  Remember that blueberries are fantastic for the brain and cherries for your heart.  Likewise, pomegranate juice is good for the heart and penis.  And an apple a day will literally keep the doctor away.  So my opinion is that you should eat fruit moderately and pick the heavy hitters that have solid clinical track records.  But, above all, leave out all sugars and corn syrup – it’s neither necessary nor worth the risk.

In fact, it may be prudent to only eat one of the “heavy hitter” fruits, such as berries and cherries, that are low in fructose.  But fruit has many health benefits, so you may have to see how your body responds.

Also, I want to point out again that Jack LaLanne was many decades ahead of his time on this and has consistently preached against sugar.  See this link on , pomegranate juice is good for the heart and penis.  And an apple a day will literally keep the doctor away.  So my opinion is that you should eat fruit moderately and pick the heavy hitters that have solid clinical track records.  But, above all, leave out all sugars and corn syrup – it’s neither necessary nor worth the risk.

REFERENCES:

1) J of Pharmacology and Experimental Therapeutics, Accepted for publication 11/12/08;”Increase Endothelial Nitric oxide Synthase Expression Reduces Hyptertension and Hyperinsulinemia in Fructose-Treated Rats; Chun Xia Zhao, et. al.

2) J Nutr, June 2008, 138:1039-1046

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

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”.

The problem doesn’t just stop there.  Remember how I said that fructose does not produce an insulin response?  Well, this is counterintuitive, but fructose also leads to insulin resistance and, as you may have read on my site, insulin resitance has been found to lead to weight gain.  By the way, fructose is so powerful at inducing insulin resistance that researchers use it like a drug in lab studies to create insulin resistance. [1] Of course, insulin resistance is bad for many other reasons besides just assaulting weight loss and you shoud read this link on Metabolic Syndrome if you are unfamilar with the issues involved.

And don’t think you can get away with eating table sugar (sucrose) and corn syrup instead of fructose. Table sugar and corn syrup are about one half fructose and so downing a 64 oz. Coke from a convenience store will flood your system with fructose.  By the way, researchers actually use sucrose (and sometimes direct fructose as well) to induce insulin resistance! [3] Think of the food industry, which has known for decades of the evils of fructose and sucrose, and yet still choose to drown us in the stuff!

So what else could this bad boy do besides sabotaging appetite and increasing insulin resistance?  Well, how about turn to fat fast – say that three times fast! – so that it even negatively affects how your body processes carbs at the next meal. The reason lies in the fact that fructose is actually metabolized by the liver and thus is rapidly turned into fat signalling the body to store the next meal as fat.

Some of you may be wondering if you should eat fruit, since fructose is often heavily in fruit.  My opinion is that fruit is the least of your worries unless you’re a juice-a-holic or eat fruit like a monkey at a zoo.  Most guys get into trouble from a sweet tooth:  table sugar (sucrose) and corn syrup, as I mentioned, are one half glucose and one half fructose.  Many guys drink a 64 oz. Mountain Dew and later have a slice of cake and this will deliver a substantial amount of glucose into their system.  Let’s face it:  much of Western Diet is packed with sugar and corn syrup and this can cause trouble with weight loss.

Again, don’t forget that table sugar has a glucose molecule bonded to a sucrose molecule. So if you have table sugar, you’re also having fructose after the body breaks apart that bond.  Corn syrup and high fructose are no better:  they are also roughly the same percentage of fructose – not exactly but close enough for discussion purposes.  So if you drink a can of coke, you’ll ingest 42g of sugars. And here is the key: after your body digests the corn syrup, approximately half of that will be fructose, i.e. a little over 20g.  And, of course, nowadays, who has one can of Coke?  Most people have bottles or 64 ouncers!

This is how many of you are ingesting large quantities of fructose without even realizing it.  It is also in many, many packaged goods as well.  Many Western vegans, trying to eat well and live good, eat a lot of sweets and fruit and consume a disproportionately high quantity of fructose thus confounding what may be an otherwise healthy lifestyle.

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/

Is Testosterone good for Anemia - Peak Testosterone

Testosterone affects many different hormonal and metabolic systems in us men, and one of them is blood cell production.  Although red blood cell creation is done primarily in the bone marrow, it is also strongly influenced by a renal (kidney) hormone called erythropoietin that is responsible for triggering stem cell involvement. Who would have guessed that the kidneys are sending messages to the bones, which in turn build red blood cells, eh?  And, if you stop and think about, this means that testosterone is responsible, albeit indirectly, for delivering oxygen to every cell in your body.

Here is the key point though:  when testosterone falls due to hypogonadism (clinically low testosterone), red blood cell counts usually fall as well due to the kidney hormone issue. Because of this, anemia is a fairly common side effect for men with low testosterone and can explain some of their low energy levels and general fatigue.  Having your sex life go down the toilet is misery enough, but anemia will make you so tired you don’t care!

NOTE: Low testosterone also profoundly affects the male brain, perhaps more so than any other factor.  It can also disturb sleep.  Testosterone is the “passion hormone” and, without it, a man often feel unmotivated and zombie like. All of these factors can also affect a man’s energy levels.

Of course, physicians often see this issue in some of the extreme cases.  For example, when men with a pituitary adenoma are receiving anti-androgen (testosterone blocking) medications, they will often develop anemia. [4]  And men that have chronic kidney disease and low testosterone have been found to be less responsive to erythropoietin-stimulating agents. [3]

For these kind of reasons, researchers were not surprised to find, then, that senior men in the lowest quartile of testosterone had a much more significant – about double – chance of having anemia when compared to those in the highest quartile. The range for the lowest quartile was 346 ng/dl (11.8 nmol/l) and below. [5]

This brings up a very important point.  Many doctors and labs are still using 260-280 ng/dl as their standard for hypogonadism.  But the above study shows that issues with anemia may start to arise at around 350 ng/dl or even higher. This underscores the importance, if you have low T, of getting your red blood cell count checked.  Remember that anemia is potentially a serious issue:  besides the fatigue and lethargy, it can lead to a racing heartbeat, dizziness, shortness of breath and muscle cramps. Anemia can even cause an enlarged spleen.

How do doctors usually test for anemia?  Usually, they will order a CBC, which is a complete blood cell workup that includes things like hematocrit, hemoglobin and red blood cell counts.  It’s a common test that is usually covered by insurance, so discuss this with your physician. The doctor may also order a ferritin and other tests to make sure the underlying cause of your anemia is determined. Yes, if you are low or lowish T, that is probably the reason. But it could be other medical issues, such as an immune attack on your blood cells, vitamin deficiencies and so on.

To test their theory of the tie in between testosterone and anemia, researchers looked at what happens to red blood cell counts with men on Testosterone Therapy.  As expected, administration of testosterone therapy improved red blood cell counts. [6]

CAUTION:  Men on Hormone Replacement Therapy can have as a side effect overly elevated red blood cell counts, polycythemia, that can increase the risk for stroke. This is why it is very important that your red blood cell counts be monitored regularly by your doctor if you are on testosterone therapy. Discuss this with him or her. I discuss this issue in my link on Ways to Lower Hemoglobin levels.

REFERENCES:

3) Nephrol. Dial. Transplant, 2011), “Testosterone deficiency is a cause of anaemia and reduced responsiveness to erythropoiesis-stimulating agents in men with chronic kidney disease”

4) J of Neurosurgery, May 2003, 98(5), “Anemia, testosterone, and pituitary adenoma in men”

5) ARCH INTERN MED, JUL 10 2006, 166:1380-1387, “Low Testosterone Levels and the Risk of Anemia in Older Men and Women”

6) American Journal of Kidney Diseases, Feb 2006, 47(2):251-262, “”Transdermal Androgen Therapy to Augment EPO in the Treatment of Anemia of Chronic Renal Disease”

Testosterone and AnemiaSTEP 4A. Is low testosterone making you anemic? Yes, it can happen and, in fact, is actually quite common. Hypogonadism is known for causing fatigue and anemia can contribute.

Testosterone and Empathy - Peak Testosterone

1. Decreased Oxytocin.  In my page discussing the Potential Risks of Testosterone, I discuss that as one increases testosterone oxytocin appears to decrease.  Of course, oxytocin is known as the empathy and bonding hormone.  Therefore, those with an anti-testosterone bias, are quick to point to this factoid.

2. Decreased Brain Connections in Empathy Regions. There is some evidence that testosterone lowers the number of connections in the area of the brain where empathy is expressed most actively:

3. Testosterone and DHT Lower Generosity. One study looked at how much generosity was exhibited during the “Ultimatum Game” and found the following:

“Men in the lowest decile of DHT were 560% more generous than men in the highest decile of DHT. We also found that men with elevated testosterone were more likely to use their own money punish those who were ungenerous toward them. Our results continue to hold after controlling for altruism. We conclude that elevated testosterone causes men to behave antisocially.” [3]

Since the authors of this study go on to point out that past research has linked generosity to empathy, the conclusion that they want you to come to seem obvious, eh?

REBUTTAL:  Sounds horrible, doesn’t it?  One of the most important traits for relationships is empathy – being able to feel the emotions of others – and a complete lack of empathy is well known as one of the hallmark behaviors of psychopaths. Upon first glance, it would sound as if testosterone was, frankly, somewhat evil – antisocial as study #4 termed it.

The evidence actually shows that normal, physiological levels of testosterone and DHT in men are associated with significant empathy, perhaps as much as females.

Let’s start with study #3.  They showed that men in lowest decile of DHT were 5.6 times more generous than men in the highest decile of DHT.  What they don’t tell you is that, if you pull up the charts in that study, the top decile of DHT in that study is about 1575 – 1750 pg/ml.  This is very high DHT.  Typical lab ranges for healthy adult males are 300 – 900 pg/ml.  Yes, you read that right:  this study drew conclusions from men that were twice the top of the lab range for a health young male!

Now I have no doubt that these researchers knew what they were doing, because they gave the men Androgel. Any topical / transdermal testosterone cream / gel will jack up DHT levels artificially and the above results are both expected and common – I see it all the time on the Peak Testosterone Forum for example.  This is one of the reasons that I am cautious about transdermals.

And, if you look at study #2, one should realize that the study was actually on women.  And, while it is true that testosterone probably affects brain connections in many key ways, some research shows that normal testosterone levels do not affect empathy. [3] Still other research shows that men are just as good at empathy if they are told to be empathetic.

“Jamil Zaki, assistant professor of psychology at Stanford University and director of the university s social neuroscience laboratory,…points to studies where men and women were given a test designed to assess their ability to read other people s emotions. Some of the participants were told beforehand that they were taking an empathy test and some weren’t. When the participants were told what kind of test it was, women did better than men. But when the participants weren’t told, the men did just as well.” [4]

In other words, the root issue of any lack of empathy in us guys isn’t hormones but rather that society has taught us not to be empathetic.

My personal takeaway from this research is simply the following:

a) This is yet another reason that one does not want to go supraphysiological with testosterone and possibly DHT.

b) Men must guard against cultural and familial influences to avoid empathy.

c) Normal testosterone and DHT levels do not hinder empathy assumping empathy is taught.

1)   Social Neuroscience, 2006, 1(2), “Fetal testosterone and empathy: Evidence from the Empathy Quotient (EQ) and the Reading the Mind in the Eyes Test”

2) Psychoneuroendocrinology, Jun 2016, 68:194 201, “Testosterone reduces functional connectivity during the Reading the Mind in the Eyes Test”

3) Personality and Individual Differences, Dec 2006, 41(8):1481 1491, “Lack of correlation between digit ratio (2D:4D) and Baron-Cohen s Reading the Mind in the Eyes test, empathy, systemising, and autism-spectrum quotients in a general population sample

4) https://www.wsj.com/articles/why-you-should-have-more-empathy-1462210724

Large Particle LDL Can Take Out Your Heart & Erections

Before I go into the research that shows that all LDL can cause arteriosclerosis, let me give you a little history.  The argument that only small particle LDL particles cause arterial issues almost always comes from those who want to justify having high LDL numbers.  Western societies have notoriously high LDL numbers and we all want to feel good about the way we eat.  So it’s very convenient to ignore LDL.  However, below I will show you many reasons from the research why this is very naive thinking.

CAUTION:  Some researchers have noted that it is the LDL-P that really counts and not the the LDL-C.  LDL-C is the traditional LDL number that you and I are used to and that physicians commonly pull for our annual physical.  LDL-P is known as the “particle count” and it is this nummber that correlates most powerfully with heart disease and atherosclerosis.  So why do we use LDL-C?  Well, the reason, at least in my mind is simple:  most people who have hgih LDL-C problem usually have an LDL-P problem as problem.  Now that is certainly not always true, especially for men who are on lower fat diets like myself, and who can sometimes have low LDL-C but higher LDL-P.

Also, many readers do not understand why I repeatedly emphasize arterial health.  Again, as Dr. Steven Lamm emphasized: what’s good for the heart is good for the penis. Common sense tells you that you have to keep those penile arteries plaque-free if you want to maintain your erectile strength.  Remember:  that plaque will harden the arteries and limit nitric oxide – both of which are bad for erections.

1. Unoxidized LDL. Another apologetic argument of LDL disbelievers:  “inflammation and oxidation are the causes of arteriosclerosis, not LDL!”  Unfortunately, this simply does not hold in real life.  One study noted that “native, unoxidized LDL has direct atherogenic effects, for example to enhance activated monocytes to produce the inflammatory mediators TNF-α and IL-8.” [2] Of course, TNF-alpha is the inflammatory cytokine playing a role in heart disease and dozens of other nasty chronic conditions.

2.  Large, “Fluffy” LDL.  Not only is large LDL plaque-building, but it is also a major player.  The same study above stated:

“Finally, large cholesterol-rich LDL is the predominant type of LDL in familial hypercholesterolemia (44), and it is firmly established that this LDL is responsible for their premature atherosclerosis. Thus, large and small LDL are atherogenic, and it is not possible to judge which if any is more harmful, overall.” [2]

3.  Intermediate LDL. Yes, there are all different sizes of LDL and even ones in the middle. Researchers call this kind IDL.  And some kinds of IDL can be artherogenic: “These data suggest that IDL CE content may be a determinant of progression of coronary lesions and may be influenced by compliance with or metabolic response to lipid-lowering dietary advice in patients with coronary artery disease during simvastatin treatment.” [5]

[2]And the research does indeed show that this kind of LDL is particularly viscious. [4] A number of studies have shown this clearly:  “Particularly atherogenic forms of LDL include small, dense LDL particles and oxidized LDL. All lipoproteins that contain apolipoprotein B, such as LDL, very-low-density lipoprotein, and intermediate-density lipoprotein, tend to promote atherosclerosis.” [3]

5.  All Arterial Plaque Reversers. There are a number of well-known doctors out there who are actually reversing arteriosclerosis.  This is a remarkable accomplishment if you think about it, because heart disease is the number one killer of men.  Every one of these clinicians includes in their practice a strong LDL-lowering in strategy.  This includes the famous physicians Drs. Davis, Esselstyn and Gould for example.  Each of them has their own protocol for lowering LDL, but all of them have a proven track record of reducing arteriosclerosis by starting with LDL as their base technique.

And what LDL levels do they want?  Is LDL of 120+ like the typical American okay?  Each of them wants LDL to be in the 60-85 range, something I document in my link on LDL Thresholds for Arterial Health. By the way, the books of these authors are a fascinating read and not all of them are traditional Low Fat. One rule that I really like Dr. Davis’ “Rule of 60” for plaque reversal: LDL < 60; HDL > 60; Triglycerides < 60.

6. Primal Cultures.  Loren Cordain documented, in one of his early papers, how every modern primal culture with no heart disease had cholesterol below 150. [2] Of course, Loren Cordain is the founder and cheif apostle of the Paleo Diet, and many Paleo followers will be shocked to learn that Loren Cordain originally advocated LDL in the 50-70 range, because of the overwhelming eviden’ce of good health from these supposedly “primitive” peoples that were so heart healthy. [2]

Now cholesterol is not that relevant of a number, but cholesterol of 150 will almost always mean low LDL. If your cholesterol is low, then your LDL is very likely to be low as well and this is why Loren Cordain came to his original conclusions.  Even the Masai, who ate boatloads of saturated fat had cholesterol right at 150.  Some people say the Eskimo/Intuits had cholesterol greater than 150, but they also ate mountains of fish and suffered with severe osteoporosis-related issues because of their diet.

Large Particle LDL: What Can You Do?

Again, do not fall for the idea that your LDL number does not matter and that it is only inflammation and triclycerides that count. Consider what these authors wrote: “Thus, large and small LDL are atherogenic, and it is not possible to judge which if any is more harmful, overall.” [2] Does this mean that all men with medium or high levels of LDL will develop arteriosclerosis?  None of us can say always of course.  But it does mean that you are taking your life into your own hands.

So what can you do? It is simple. I have a link with good starter information called How to Clear Your Arteries and I also highly recommend that you read the books of the above doctors. Particularly relevant is Prevent and Reverse Heart Disease by Dr. Esselstyn, both of whom generally advocate a drug-free approach.

1)  https://thepaleodiet.com/wp-content/uploads/2012/11/JACC-LDL-Final.pdf, JACC, June 2, 2004:2142–62004, 43(11), “Optimal Low-Density Lipoprotein Is 50 to 70 mg/dl: Lower Is Better and Physiologically Normal”

2) The Journal of Clinical Endocrinology & Metabolism, Oct 1 2003, 88(10), “Low-Density Lipoprotein Size and Cardiovascular Disease: A Reappraisal”

3) Circulation, 2004, 109:III-2-III-7, “Atherosclerosis: Evolving Vascular Biology and Clinical Implications: Atherogenic Lipoprotein Particles in Atherosclerosis”

4) Can J Cardiol, 2001 Aug, 17(8):859-65, “A prospective, population-based study of low density lipoprotein particle size as a risk factor for ischemic heart disease in men”

5) Arteriosclerosis, Thrombosis, and Vascular Biology, 1998, 18:577-583, “IDL Composition and Angiographically Determined Progression of Atherosclerotic Lesions During Simvastatin Therapy”

Progesterone: The Potential Dangers and Risks - Peak Testosterone

Just about everybody knows about testosterone and estradiol, the rock stars of the hormone world. However, some of the “backup players,” such as progesterone, as not nearly as well-understood by most guys. A lot of us think of progesterone as a “female hormone,” but this is simply not true. After all, progesterone is the precursor to the critical downstream hormones cortisol and aldosterone in us males and raising and lowering progesterone levels can have a profound effect on many men.  It can be just as powerful as testosterone in improving male general and sexual health, something I document in my links on Progesterone and Erectile Dysfunction and Progesterone in Men.

As HRT (Hormone Replacement Therapy) has grown up and matured – actually, we are still in our infancy as far as understanding – some physicians and anti-aging clinics are experimenting with progesterone.  Again, the results can be very powerful in some cases.  Of course, the burning question is safety.  Could long term progesterone use in men cause some kind of unforeseen negative issue?

That is going to be a very difficult issue to answer definitively.  Testosterone gets almost all the research for a number of reasons and background players like progesterone are seldom studies, especially in studies of men using them on a regular basis.  This is why a physician (or naturopath) with a lot of knowledge and experience is critical with progesterone.

Also, don’t forget that you should never assume that you are low in a particular hormone just based on symptoms.  Savvy doctors use a combination of symptoms and lab readings for their hormonal evaluations.  This is no different with progesterone and, if your doctor will not test you for some reason, remember that you can check it out for yourself by simply going to my link Labs for Hormone Monitoring and Self-Testing.

So, let’s go back to the original question: are their any risks associated with increasing progesterone levels in men? I believe there are for certain men in certain cirsumstances. Here are a few to consider and discuss with your physician (or naturopath):

1.  DHT. Progesterone is a strong 5-alpha-reductase inhibitor, i.e. it tends to lower DHT (dihydrotestosterone) levels.  Of course, many middle-aged and senior men struggle with the effects of DHT, especially male pattern baldness.  And, yes, limiting DHT in some aging males could be of some benefit.  However, as you can read about in my link on Testosterone and DHT, it is critical to libido as well. Many 40+ guys are low or lowish in DHT and reducing this further could negatively impact them in the bedroom. DHT also influences hypertrophy (muscle growth) and brain function, so some discretion is required.

2. Accumulation in the Fat Tissue. Dr. Mercola has noted accumulation of progesterone in the fat tissue in men taking some of the more concentrated creams.  He recommends regular saliva monitoring of progesterone to make sure it is not building up in tissues.

3.  Lack of Research in Men. Progesterone therapy in men has not been nearly as well-studied as testosterone therapy. There are a number of progressive physicians who have used it, but ideally that should really should be verified in some longer term studies before widespread adoption.  Some argue that it should be safe as long as you restore to normal physiological levels.  There are reports of progesterone regressing prostate cancer.  However, prostate cancer is very tricky and, of course, a study should be undertaken to verify results.

4.  Gynocomastia. Progesterone and progesterone receptors play a role in male gynocomastia (“bitch tits”) in men. Furthermore, elevated levels of progesterone have been documented to increase the risk of gyno at least in some men. [3][4] (Estrogen and progesterone are the engines of breast development in females.)  However, I should point out that one of our members claimed that using a progesterone cream completely got rid of his gyno in just a few weeks, i.e. it did the opposite of what is expected. [5]

5.  Sedative Effect. Progesterone can have a relaxing effect. [1] Unfortunately, anything that has even a mild sedative effect can have a negative impact on libido and/or erections.  On the other hand, progesterone can improve sleep, which will generally help improve sexual function.  The rebuttal to this argument is the fact that progesterone is being researched as a possible treatment for erectile dysfunction in some men.  (See this link for more information.

6. Raise SHBG. Quite a few men have high SHBG, which lowers their free testosterone. Raising progesterone levels may raise SHBG even further and, thereforme, make their situation more difficult.

7. Prostate. Some experts believe that progesterone will be good for the prostate since it seems to control both estradiol and DHT.  However, this is far from a certainty and has not been studied in even a  small study (as far as I know).  Furthermore, you can read about how it seemed to raise the PSA of couple of men in my link on Progesterone and Erectile Dysfunction.

8. Blood Pressure.  Progesterone tends to lower blood pressure.  However, if you are on blood pressure meds, this could potentially be an issue.

REFERENCES:

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) https://peaktestosterone.com/forum/index.php?topic=3286.0

Testosterone and Mike Mahler's New Testosterone Booster.

Mike Mahler’s Testosterone BoosterWell, Mike Mahler did it again!  First, he was one of the pioneers in vegan strength training and bodybuilding.  He became a vegan in the mid 90’s and, back then, many in the muscle industry doubted that one could build strength and mass on a vegan diet.  Mike Mahler showed it could be done and is one of the leading kettleball teachers and instructors right now. Yes, plant protein can PACK on the muscle.

NOTE:  I am not a vegan but rather plant-based (almost entirely for health reasons), i.e. I eat an almost entirely vegetarian diet but will occasionally eat meat if on the road or in social settings.  See My Bio if you want a little more background information.

This time Mike Mahler probably did what the FDA was hoping no one could do: come up with a legitimate herbal testosterone booster that falls outside, as far as I know, of the FDA’s scope and regulations.  (Time will tell regarding that.)  More on that in a minute, but let’s go first to the ingredients in Mike’s new formulation called Aggressive Strength:  bulbine natalensis, mucuna pruriens and Stinging Nettle Root. Now mucuna pruriens and Stinging Nettle Root have been around for years and years, but, here in the U.S., bulbine is not as well-known. Of course, like almost every herb, it has been used for probably centuries in Africa, including the well-known Zulu tribe, as an herbal remedy.  However, to those of us in the U.S., it definitely seems like a newcomer.

However, that unknown factor has allowed it to sneak in under the rader and now shine as a potential superstar.  This all started from a 2009 study in the International Journal of Andrology that showed that bulbine actually increased mounting frequency in rats more than Viagra. [1] The researchers found something else that I doubt they anticipated:  the heightened sexual interest likely came from a HUGE testosterone boost in the animals.  Ergo-log has a Great Summary of the 2009 Bulbine Study if you are interested. It turns out the animals on the hightest dosage of this herb approximately tripled their testosterone levels. Of course, this got the attention of the bodybuilding world.

Well, apparently, Mike Mahler was all over it and contracted with a high quality manufacturer that has run their own studies.  According to this manufacturer – ProLensis is the brand – their high quality bulbine “has been shown in studies to increase testosterone by a whopping 347% and crush estrogen by 35%.” Based on the results in the above animal study, it is not hard to believe.

This has got to have the FDA agents sweating just a little!  Even if most men who tried Aggressive Strength got half of those results, it would be profound to say the least.  This just leaves the latest testosterone booster, D-Aspartic Acid, in the dust, since it ony produces an average boost in testosterone of around 35% and has a reputation for disproportionately increaseing estradiol.

Having a well-known and well-liked fitness figure like Mike Mahler behind the product only enhaces the presentation and lend credibility to the fact that this does, indeed, very likely raise testosterone although none of the Peak Testosterone Forum members have tried it yet to verify.  So should you try it if you’re low testosterone? Well, this is product is so new that I will have to leave that to you and your own personal research. However, I do want to point out several areas of concerns that I have and the answers and solutions that Mike Mahler has developed to hopefully overcome them:

1. Lipids. Bulbine natalensis works by pushing cholesterol into the testes. (It also greatly increases LH (leutinizing hormone) apparently, something you can read about in Mike Mahler’s Fact Sheet.) However, there is an animal study out there that shows it does not just increase cholesterol in the testes but also in the plasma. [2] This study was published just six months prior to the testosterone study and it gave rats identical dosages (25, 50 and 100 mg/kg body weight).

What they found was that bulbine had a profound initial affect on total cholesterol, more than doubling it on day one for example.  After 14 days, the values had decayed somewhat to a lower value, but still cholesterol remained about 50% higher than the starting point.  This is obviously still a huge increase in cholesterol.  Just as troubling was a big drop in HDL in the animals after 14 days.  In fact, the motivation for the study itself may have been concern over this issue and the authors point out that “alterations in the serum lipids of animals administered with extract of medicinal plants appear to be a significant factor in the development of premature atherosclerosis.”

I actually got the opportunity to ask Mike Mahler out about this via Twitter and he stated the following:

“@PeakT Personally I have not seen any negatives with lipids on 8 week cycles or less which is what I recommend.”

“‏@PeakT Cholesterol is increased initially to convert into testosterone into testes but normalized after a few weeks is my experience.”

So what he is saying is that in his experience, you can protect yourself by 1) 8 weeks on and 8 weeks off and 2) realizing that your lipids will normalize after a few weeks.  Again, since no formal study has been done on humans, so I would recommend doing your own testing and verify that your own physiology does not react poorly.  After all, it does little good to boost your testosterone if you’ve blown out your arteries!

2.  Liver. Again, in that same year – you can tell bulbine was red hot! – researchers found in a study of rats some signs of liver damage. [3] In fact, they concluded that “histological examination revealed slight distortions in the architecture of the liver lobules as well as proximal and convoluted tubules of the kidney. The alterations produced in some of the functional indices as well as in the hepatorenal architecture may adversely affect the normal hepatic and renal functions. The parameter-specific effect of the extract suggests selective toxicity. This is an indication that the extract is not completely “safe” as an oral remedy.”

ProLensis, the supplier of bulbine in Mike’s formulation, followed up and actually a followup study on men in 2012. [4] They looks at a variety of kidney and liver function tests and found that “alkaline phosphatase (AP) increased marginally in the ProLensisâ„¢group.” In other words, there was a slight effect on liver function (and possibly kidney) but they felt it was not enough to be a concern.

However, one thing that is interesting, and I don’t know whether is deliberate or not, but Aggressive Strength contains Stinging Nettle Root, a known liver protector.  It has in various studies been shown to protect the liver of lab animals from various toxins and poisons, such as aflatoxin and carbon tetracholoride.  Since the bulbine already decreases estradiol, there really is no need from an E2 standpoint for the Stinging Nettle Root.  Regardless, my point is that this formulation coupled with the cycling should protect your liver enzymes.  Again, though, it would probably be prudent to be tested before and after as men have a wide range of liver reactivities and, again, it is always best if you can afford it to monitor your own personal physiology.

3.  Distraction.  Another concern I have is that hypogonadal men may become distracted from getting the testosterone therapy that they need, assuming they have very low testosterone, if there is an herbal solution.  Low testosterone puts a man at increased risk for arteriosclerosis, erectile dysfunction, heart disease, diabetes, venous leakge, osteoporosis, Metabolic Syndrome and so on.  The 8 weeks off during cycling may not provide the kind of relief that he needs to make a dent in some of these issues for him. Again HRT (or possibly Clomid or HCG monotherapy if fertility is an issue) seems like the more consistent therapeutic response imo so that the man is not left for several weeks in a hypogonadal state.

4.  Lack of Long Term Studies. This herb is potent.  Most of the properties seem good.  For example, one study shows that bulbine speeds wound healing. [5] It also has strong anti-clotting abilities as well. [6] So who knows?  Perhaps this herb will be shown to be part of a nice anti-againg strategy eventually.  But, in the meantime, there are really very few studies on this herb:  it’s just not like a Ginseng that has a broad swath of research behind it..  It is simply not that well-studied of a plant yet.  The good news is that it has been used by the Zulus and other South African tribes for a long time now.

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

Should you take it if you are low or lowish testosterone?  Well, I will leave that up to you and your own personal research.  Regardless, it is an interesting product and that there are athletes and bodybuilders world wide that will be using this to enhance their performance and hypertrophy.

And I can hardly wait to see what the FDA will do this supplement.  You only have to back to 1994 to remember when they pulled androstenedione off the market – can you say Mark McGuire? – for being “adulterated”.  The FDA used this term, because they are allowed to pull products that are adulterated if they meet the following criterion:

“a significant or unreasonable risk of illness or injury under … conditions of use recommended or suggested in labeling”

” or … if no conditions of use are suggested or recommended in the labeling, under ordinary conditions of use” [7]

And the paper also points out that the FDA does not even have to provide evidence that any consumers have been injured!  Clearly an herb like bulbine natalensis is in a different category than a direct prohormone such as androstendione.  I think the public at large does NOT want the FDA telling them what herbs they can and cannot buy and I suspect the FDA will be very cautious in touching this one.

2) Indian Journal of Experimental Biology, Apr 2009, 47:283-288, “Effect of aqueous extract of Bulbine natalensis Baker stem on haematological and serum lipid profile of male Wistar rats”

3) J Med Food, 2009 Aug, 12(4):814-20, “Effect of Bulbine natalensis Baker stem extract on the functional indices and histology of the liver and kidney of male Wistar rats”

4) Int Soc Sports Nutr, 2012, 9(Suppl 1):P33, “Short term safety of bulbine natalensis supplementation in healthy men”

5) Journal of Ethnopharmacology, 18 December 2012, 144(3): 523–532, “Bulbine Natalensis and Bulbine Frutescens promote cutaneous wound healing”

6) https://uzspace.uzulu.ac.za/handle/10530/613, “In vitro anti-platelet aggregation activity of the extracts of bulbine natalensis”

7) Journal of the International Society of Sports Nutrition, 2004, 1:52-60, “Adulterated Androstenedione: What FDA’s Action against Andro Means for Industry”

Natural Arterial Plaque Reduction - Peak Testosterone

This leads to an important question:

Can arterial plaque be reduced without losing weight, i.e. when the person is in maintenance mode?

This is critical for any person wanting to have and maintain clean and clear arteries as the decades roll by.  We all can only lose weight for so long after all.  The winning diet will be the one that can regress plaque under ANY circumstance.

As some of you know, the most famous plaque reduction studies were done by low fat apostle Dr. Dean Ornish.  However, in his studies the particpants lost weight on average, so this actually proved little other than plaque reversal was indeed possible.  For example, his study noted that “patients in the experimental group lost 10.9 kg (23.9 lbs) at 1 year and sustained a weight loss of 5.8 kg (12.8 lbs) at 5 years, whereas weight in the control group changed little from baseline.” [2] Initially, it appeared that the low fat diet regressed the plaque, but, in fact, it was most likely simply the weight loss. Again, the acid test comes during maintenance mode, ie when he is neither gaining or losing weight.

1. Bantus. The first example comes from one of Nathan Pritikins low fat diet classics.[3] Pritikin points out an interesting study that compared an arterial autopsy examination of 42 Bantus to 22 Europeans.  The comparison was shocking:  only one Bantu had atherosclerosis, compared to all of the Europeans who had significant atherosclerosis.  What was the Bantu’s secret?  You guessed it:  they ate a low fat with about 15-20% of calories from fat with their staple being a type of corn. [5]

A similar study noted that “the severe degrees of atherosclerosis observed in the majority of these European aortas have not been seen by us in the Bantu subjects…These observations are in accordance with the observance that populations with low serum cholesterol tend to have lower incidence of severe atheoslcerosis.” [4] There is also a humorous paper that only reluctantly admits the dramatic reduction in heart disease among the Bantus:

“A proportion of urban Bantu, admittedly small, is exposed to all the influences that, among white populations, are believed to favor coronary heart disease; yet in Johannesburg, with approaching two thirds of a million Bantu, at least 10,000 being over 65 years, it is doubted whether more than 10 die annually from coronary heart disease.”  And no wonder – considering they have no arterial plaque! [5]

NOTE: On this page I cover evidence that low fat diets, when properly done, can lower or control arterial plaque.  However, I give more complete coverage and other methodologies on this page: How to Clear the Plaque Out of Your Arteries.

2.  Tarahumara. These native peoples from northern Mexico consume a low fat diet and have cholesterol in the 120’s.  The are one of the longest lived peoples on planet earth and have NO hypertension.  Again, think how incredible that is the men and women living past 80, 90 and 100 have no rise in blood pressure.  The reason most likely lies in the fact that their low cholesterol levels protect them from atherosclerosis.  Nathan Pritikin cites example from other low fat cultures as well.  I give very detailed coverage on this page:  The Tarahumara Diet. (The Tarahumara are my personal fitness heroes:  they are famed ultramarathoners on top of everything else.)

4. Statin Studies. The researchers reversing plaque in patients have noted that plaque reversal seems to occur (generally speaking) with LDL at about 80.  (Dr. Davis goes even lower.)  Dr. Esselstyn notes that you cannot get plaque in your arteries if your cholesterol is below 80, something I cover in my page, A Review of Prevent and Reverse Heart Disease. He also insists on plant-based nutrition to limit inflammation and increase nitric oxide boosting phytochemicals. Regardless as to the exact level, the point is that these plaque reducers believes that there is a point an LDL theshold at which atherosclerosis greatly slows down and/or halts altogether. One way to test that theory is to look at the studies on statins.

Now I am no fan of statin drugs for a variety of reasons, but they do lower cholesterol and if lowering cholesterol is actually important in regressing plaque, we should be able to see some results in the literature.  And this is indeed the case:  multiple studies on statins show that plaque is reversed with these drugs.  I will quote just one which used Mevacor:

“In men and women with moderately elevated LDL cholesterol, lovastatin reverses progression of IMT in the carotid arteries and appears to reduce the risk of major cardiovascular events and mortality.” [7]  (Cholesterol was reduced from 159 to 113.)

Statins can have side effects and their long term safety is unknown.  That said, they definitely can regress plaque and this is further evidence that low cholesterol does usually help keep those arteries free of plaque.

CAUTION:  A poorly done low fat diet is just as bad as a Western Diet.  Many men load up on white rice and wheat and dried fruit and call that “low fat.”  These high glycemic foods do little except spike blood sugar and pour triglycerides into the blood stream.  They can also switch lipids to a deadly “pattern B” mode, where the LDL particles grow smaler and more atherosclerotic.  Remember;  a low fat diet, even though it is fairly high in carbs, can actually regress diabetes.  But it has to be low glycemic.  I discuss this in my page on Regressing Diabetes with a Low Fat Diet.

NOTE: One very confusing point is that a low fat diet acoeding to fbe popular meaning of the word is total fat calories less than about 15% of total. However, researchers use very low fat diet as less than 15%. To researchers anlow fat diet is about at Mediiterrnean Diet levels, which is about 35%! Usually, when I see a Low Carb blogger criticizing low fat, they are citing a study that does not apply for this reason.

1)  Circulation, 2010 Mar 16, 121(10):1200-8, “Dietary intervention to reverse carotid atherosclerosis”

2) https://jama.jamanetwork.com/article?articleid=188274, JAMA, Dec 16 1998, 280(23), “Intensive Lifestyle Changes for Reversal of Coronary Heart Disease”

3) The Pritkin Program for Diet and Exercise, by Nathan Pritikin with Patrick M. McGrady, Bantam, 1990, p. 375-376.

4) J Clin Invest, Oct 1954, 33(10): 1366 1371, “Fat Intake, Serum Cholesterol Concentration, and Atherosclerosis in the South African Bantu. Part II. Atherosclerosis and Coronary Artery Disease”

5) Circulation, Jan 1964, 29(1), “Coronary Heart Disease. Limitations to the Application to White Populations of Lessons Learned from the Underprivileged ”

6) N Engl J Med, 1985, 313:52, “Nathan Pritikin’s Heart”, https://www.pritikin.com/eperspective/specialissues/pritikinatkins/

7) Circulation, 1994 Oct, 90(4):1679-87, “Effect of lovastatin on early carotid atherosclerosis and cardiovascular events. Asymptomatic Carotid Artery Progression Study (ACAPS) Research Group”

What PSA Level(s) Will Your Doctor Use to Take You Off of TRT?.

When I started my testosterone cypionate shots, I found out a few months later that they had a policy that, if your PSA was over 2.5 or you had a rolling one year rise greater than 1.0, you would have to get urological clearance to continue TRT.  Of course, that is something I believe should be communicated before you start testosterone therapy, not afterwards!  I later wondered if these guidelines were grounded on best practices and resarch or were just something to keep the attorneys happy.

Below I attempt to go into detail on that question but first want to point out that some PSA increase is to be expected when you go on testosterone therapy. This is simply because some of your new found testosterone will be converted to DHT (dihydrotestosterone) through the 5-alpha reductase enzyme.  And this increase in DHT will enlarge the prostate a little and increase PSA.  One review found that “averaging several investigations of the effect of TRT on PSA, men receiving testosterone will have an associated increase of 0.30 ng/mL/y in serum PSA, with older men experiencing a greater increase of 0.43 ng/mL/y.” [1]

Of course, the question is in the cases where prostate increases exceed the norms.  Let me give you some Examples of PSA Levels That Could Make you Quit Testosterone Therapy:

1. PSA Cutoff of 3.0, 4.0 or 5.4 ng/ml. Urologists and endocrinologists have a term called “PSA Cutoff for Biopsy,” which is just what it says.  Values for this threshold have varied considerably over the years.  The initial values started at 4.0 ng/ml from what I have read.  However, a followup study in 2005 said that a significant number of lives could be saved by lowering that threshold down to 3.0. [2] However, this was contradicted by a recent study that recommended that the value be raised actually to 5.4 ng/ml. [4] One study even concluded that no reasonable PSA value could be select due to the fact that “an optimal PSA level must weigh detection of cancer with discernment of cancer and non-cancerous conditions…The researchers concluded that the optimal PSA level from which to recommend a prostate biopsy remains unclear since no level appeared to provide both high sensitivity and specificity.” [4]

Out of this chaos, your physician will have to select a threshold at which he would pull you off of testosterone therapy. As you can see, it could be just about anything from 2.5 to 5.5, so discuss the subject with him or her ahead of time.

2. Rolling 1-Year PSA Rise Greater Than 1.4-1.5 ng/ml. One well-known set of TRT guidelines recommended that a “rolling PSA Rise > 1.4” would be the threshold of concern. [5][8] This is a concept that my HRT clinic used for example.  They looked for a rise of 1.0 from year to year and , therefore, were even more strict.

2A.  A Rise in PSA Velocity of Greater Than 0.4 – 2.0 ng/ml per Year. PSA Velocity is a concept similar to the rolling data points mentioned in #2.  The difference is mostly philosophical:  the idea is based on initial study work that showed that rapid rises in PSA tended to precede the more deadly forms of prostate cancer. [5] Wide variations in guidelines existed as in #2 and a larger, a more recent study concluded essentially that PSA velocity was useless and should not be used in any clinical guidelines. [7] Again, though, what counts is the number that your physician will use to make you stop your treatments.

CONCLUSION: Various PSA levels have been proposed removing a man from testosterone replacement and/or screening with a biopsy.  However, considerable controversy exists over the validity of these levels with the more recent studies showing that they are largely useless.  I still value the PSA though and have self-tested for it, because I want to know if I have hidden inflammation.  (See my Inexpensive Testosterone Labs for ways to self-test using Labcorp and Sonora Quest to do your testing without a doctor’s order at a price that is the typical copay through insurance!) It should also be pointed out that some experts are concerned about “needle tracking,” which is the idea that a biopsy needle often punctures a prostate cancer nodule and spreads it.  In other words, biopsies could potentially be dangerous. [9] Some urologists are using MRI’s now.

NOTE:  I have many other pages on prostate cancer, BPH, etc. here in my page called A Summary Page for Prostate Issues.

This issue is near and dear to my heart, because it is something that did actually happened to me.  My testosterone rose rapidly from one 3 month test to the next, something I discuss on my page High PSA But No Prostate Cancer, thus violating about 3 or 4 of these guidelines at one time.  And I was yanked off of TRT immediately despite my pleadings to be allowed to stay on testosterone at least until I talked to the urologist.  It was a simple “Do Not Pass Go. Go Directly to Jail” card.  I was able to get back on my original testosterone protocol about a month later, but I recmmend that you proactively discuss all of this ahead of time with your physician.  I was definitely caught flat-footed but won’t again.

REFERENCES:

Rev Urol, 2004; 6(Suppl 6):S41 S43, “Rising PSA during Testosterone Replacement Therapy”

2) Urology, 2005 Feb, 65(2):343-6, “Is additional testing necessary in men with prostate-specific antigen levels of 1.0 ng/mL or less in a population-based screening setting? (ERSPC, section Rotterdam)”

3) Indian J Med Res, 2014 Jun, 139(6): 851 856, “Raising cut-off value of prostate specific antigen (PSA) for biopsy in symptomatic men in India to reduce unnecessary biopsy”

4) Journal of the American Medical Association. 2005;294:66-70 as summarized by Cancer Connect, “No Definitive PSA Cutoff for Prostate Biopsies”

5) J Clin Endocrinol Metab, 2010 Jun, 95(6):2536-59, “Testosterone Therapy in Men with Androgen Deficiency Syndromes: An Endocrine Society Clinical Practice Guideline”

6) N Engl J Med, 2004 Ju6) N Engl J Med, 2004 Jul 8, 351(2):125-35, “Preoperative PSA velocity and the risk of death from prostate cancer after radical prostatectomy”

7) J Natl Cancer Inst. 2011 Mar 16;103(6):462-9, “An empirical evaluation of guidelines on prostate-specific antigen velocity in prostate cancer detection”

8) Ther Clin Risk Manag. 2009; 5: 427 448, “The benefits and risks of testosterone replacement therapy: a review”

9) https://www.mrisusa.com/testosterone-risks-prostate-cancer.php

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

Pomegranate Juice: Side Effects - Peaktestosterone

Pomegranate juice has been an erectile dysfunction miracle worker on the Peak Testosterone Forum and has rescued many guys from bedroom difficulties. What is particularly amazing is how it seems to really help some of the young guys out, who supposedly have clean arteries and should be without erectile issues. For example, check out what this young man recently wrote in:

1) https://peaktestosterone.com/forum/index.php?topic=5101.0

2) Neurobiology of Aging, May 2014,  35(5):1162 1176, “Pomegranate juice exacerbates oxidative stress and nigrostriatal degeneration in Parkinson’s disease”

3) Neurobiology of Disease December 2006, 24(3):506 515, “Pomegranate juice decreases amyloid load and improves behavior in a mouse model of Alzheimer’s disease”

4) Urol Ann, 2012 May-Aug, 4(2):108 110, “Priapism, pomegranate juice, and sildenafil: Is there a connection?”

5) DMD, February 2007, 35(2):302-305, “Effects of Pomegranate Juice on Human Cytochrome P450 2C9 and Tolbutamide Pharmacokinetics in Rats”

6) https://www.rxlist.com/pomegranate-page3/supplements.htm

7) DMD, May 2005, 33(5):644-648, “EFFECTS OF POMEGRANATE JUICE ON HUMAN CYTOCHROME P450 3A (CYP3A) AND CARBAMAZEPINE PHARMACOKINETICS IN RATS”

7) Phytother Res. 2009 Aug;23(8):1123-7. doi: 10.1002/ptr.2759. Pomegranate extract mouth rinsing effects on saliva measures relevant to gingivitis risk.

“Pomegranate juice is the bomb. I’m 35 and was suffering from weak erections for about a year. I then read Peak’s articles on pomegranate juice, especially how it could possiblly reverse plaque buildup, and I figured I’d give it a whirl. Generally a 1/2 hour after consuming it I notice that I have no erection issues. Consuming 4-8 oz. before bed results in morning wood most mornings. This stuff has improved my relationship with my girlfriend, and it’s all natural! I was afraid that I would have to start taking Viagara.” [1]

And this is just one of probably a dozen guys that have written in and said how pomegranate juice has helped them dramatically.  Of course, the temptation with anything that is so effective is to take a lot.  Us guys will do just about anything to get back in the game, right?  And the studies on pomegranate look very, very good:  as I document in my page on The Benefits of Pomegranate Juice, it helps nearly every arterial parameter you can conceive of from lipids to inflammation to plaque, etc. It’s just a cardiovascular wonder worker.

However, you have to step back and ask yourself if something that powerful could actually cause some issues for some men potentially.  For example, caffeine can be miracle worker as well, but in some men it can cause arrythmias and other issues.  Although research is very preliminary, pomegranate juice may end up falling into this same category for some men, although I suspect the real issue will be dosage.

In any event, check out these studies for some potential concerns with Pomegranate Juice that are poorly understood and understudied.  I currently consume pomegranate juice but have cut back my dose.  My take on it is that pomegranates have been consumed heavily for hundreds of years, so I find it hard to believe that reasonable amounts of of pomegranate juice that correspond to a couple of pomegranates would cause major issues.  But who knows?  Again, look at these studies and do your own research:

1. Potential Damage to Neurons (a mock Parkinson’s)?  One study on mice sought to verify Pomegranate’s protective effect in a mouse model of Parkinson’s Disease. Parkinson’s basically occurs when one loses too many of the dopamine-producing cells in the brain’s substantia nigra region (80-90%).  Now Pomegranate has powerful antioxidant effects and, undoubtedly, for this reason it has shown some protective effects from Parkinson’s (in animal models). [3] However, pomegranate juice is also a potent stimulator of nitric oxide, a free radical.  So, theoretically, any stimulator of nitric oxide could create too much NO and cause actual oxidative damage.  This is exactly what a later study found and the researchers noted the following:

“The present study was assigned to examine the potential neuroprotective effects of PJ [pomegranate juice] in the rotenone model of PD [Parkinson’s Disease]. Oral administration of PJ did not mitigate or prevent experimental PD but instead increased nigrostriatal terminal depletion, DA neuron loss, the inflammatory response, and caspase activation, thereby heightening neurodegeneration.” [2]

So you have one study showing it may help with Parkinson’s and another that says it might worsen it.  Again, I suspect it is a matter of dosage, but there is no doubt that more studywork and research needs to be done.

3. Interaction with Medications.  Pomegranate juice can affect literally dozens of different medications – not just PDE5 Inhibitors.  The reason is that it inhibits several of the liver’s cytochrome enzyme families. Check with your doctor first if you are on any medications. [5]

4.  Mouth and Gum Issues. I know that after a few weeks of taking pomegranate juice, my mouth begins to develop sores.  The tongue and gums will be painful to the touch and then I’ll quit pomegrante and the problem will go away within 48 hours.  I have repeated this experiment several times, so I do not doubt that pomeranate is the root cause.   And realize that pomegranate completely changes many oral (mouth) properties.  (Yes, you have mouth flora just like you have gut (intestinal) flora and both are very important to your health.)  One study considered thise changes to be positive and the researchers concluded that:

“The changes were: reduced total protein (which can correlate with plaque forming bacteria readings), reduced activities of aspartate aminotransferase (an indicator of cell injury), reduced alpha-glucosidase activity (a sucrose degrading enzyme), increased activities of the antioxidant enzyme ceruloplasmin (which could give better protection against oral oxidant stress) and increased radical scavenging capacity (though this increase was significant only by nonparametric statistical analysis). A placebo of cornstarch in water did not affect these measures. These data raise the possibility of using pomegranate extracts in oral health products such as toothpaste and mouthwashes.” [7]

So this sounds positive, but I cannot help but wonder if pomegranate is too powerful in some people, thus causing some oral issues in some men (like myself).  And I am not the only one reporting this effect.  Just do a search on “pomegranate mouth ulcers” or “pomegrante mouth sores” and you’ll see dozens of entries come up.

REFERENCES:

DHEA: Possible Dangers? - Peak Testosterone

Testosterone Replacement Therapy (TRT) has been a large success to date and improved the lives of many hypogonadal men (such as myself), so why not some of the other hormones? DHEA is an example of a hormone with considerable promise. One study shows, that when combined with HIIT (High Intensity Interval Training), it can boost free testosterone levels substantially. (See my page How to Increase Your Testosterone Levels Naturally for details.) And, as I mentioned in my page on How to Increase DHEA, we had one man claim that DHEA restored his morning erections. And DHEA seems to have very powerful anti-diabetes, anti-Metabolic Syndrome properties.

So DHEA definitely has some excellent properties, but is there a dark side?  I think the argument is weak against DHEA, assuming it is taken within physiological dosages.  To protect against taking too much, what I see the savvy doctors doing is the following:

a) Testing a man’s DHEA-S first and making sure he is in the lower part of the lab’s range.  Many men are actually high in DHEA-S, so taking DHEA makes no sense in that case.

b) Giving a man low dose (usually oral) DHEA-S in order to hit a DHEA-S target that is usually in the upper mid range of DHEA-S.

c) Making sure with continuted monitoring that the man does not go too high in DHEA-S on an ongoing basis.

I believe the above precautions will avoid almost all problems, but, of course, it’s always best to consult with a physician or naturopath first.

NOTE:  A combination of DHEA and pregnenolone got rid of my lifelong struggle with some anxiety.  Read more about here:  Low Dose DHEA and Pregnenalone.

1.  Arrhythmia. Ray Sahelian has stated that many users of DHEA, especially in medium and higher dosages, have experienced arrhythmias. [1] It is too early to tell in what subpopulations and circumstances this occurs.  Adding to the confusion is the fact that one study showed that the higher the (non-supplemented) levels of DHEA, actually DHEA-S, the lower the risk of atrial fibrillation, which is the most common kind of arrhythmia. [5] However, the fact that someone naturally has high levels of DHEA does not necessarily equate to the same physiological situation as someone being low and then supplementing.  An underlying, predisposing condition could remain.  Or it could be that those who are already high and supplement occasionally have an arrhythmia.

2. Negative Brain Effects?  Ray Peat warns against overly elevated DHEA levels:

“One study has found that the only hormone abnormality in a groupt of Alzheimers patients’ brains was an excess of DHEA. In cell culture, DHEA can cause changes in glial cells resembling those seen in the aging brain. These observations suggest that DHEA should be used with caution. Supplements of pregnenolone and thyroid seem to be the safest way to optimize DHEA production.” [2]

Again, holding DHEA-S levels to mid range values should alleviate these kind of concerns, but keep in mind that there are no long term studies with DHEA that I know of.

3.  Possible Increasing PSA?. In general, DHEA is thought to be anti-cancer.  However, there are reports of men taking DHEA who have spiked their PSA’s. [3][4] Is this coincidence?  Well, without some study work, it is difficult to say.  But you may want to take your PSA before and after to make sure.  And, if you have had issues with your PSA, discuss with your doctor.  Again, this should not be an issue with the lower dosages that I am used to seeing.  See my page on DHEA Dosages for more information.

4. Possible Gynecomatia. The steroid boards have quite a few posts of men getting gyno from taking larger doses of DHEA.  However, from what I can tell, this is from taking very large dosages of DHEA – 500 mg +.

5. Increased IGF-1. DHEA has done fairly well in the cancer studies from what I have read. However, one distrubing property:  it increases IGF-1.  IGF-1 is the growth factor that is ground zero for a lot of anti-aging research, i.e. elevated IGF-1 levels are associated with accelerated aging.  In addition, abundant research shows that higher levels tend to fuel epilthelail cancers and adult onset diabetes. Of course, one would not want to go too low since IGF-1 is anabolic and supports many key metabolic processes. In any event,  there are several studies that show that DHEA supplementation increases IGF-1 in men. [6] The good news is that it seems to minimally raise IGF-1, assuming one is using a reasonable dose <= 25mg.  I discuss that the research that shows in my page on DHEA and IGF-1.

FINAL COMMENT: Many experts point out that the great majority of side effects with DHEA occur at higher dosages. For this reason, they recommend much lower dosage of DHEA, such as Ray Sahelian who believes 5 mg is the most appropriate dosage considering our bodies only make 10-15 mg/day probably..

NOTE:  Keep in mind that most people who take DHEA do not test to see if they are low. You can test your DHEA levles very inexpensive here:  Inexpensive Testing Labs (Mostly U.S.). I make this comment, because boosting a little very low DHEA levels is probably a different thing that a man with high levels pushing his DHEA even higher. Deficiencies usually need correcting and pushing yourself supraphysiological is often not a good thing when it comes to hormones.

REFERENCES:

1)   https://www.tldp.com/issue/175-6/Caution.html

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

3) https://www.nasw.org/users/nbauman/dhea.htm

4) https://www.medhelp.org/posts/Prostate-Cancer/Sudden-PSA-Rise–Hormonal-changes/show/1781895

5) Eur J Prev Cardiol. 2014 Mar;21(3):291-8, “Dehydroepiandrosterone sulfate levels and risk of atrial fibrillation: the Rotterdam Study”

6) The Journal of Clinical Endocrinology & Metabolism, Published Online: July 01, 2013, “Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age.”

Axiron Review - Peak Testosterone

“Now,why would anyone want to apply testosterone into their armpit area.  Isn’t there enough going on there already?”  The reasons, we suspect, mostly have to do with the Two A’s:  Attorneys and Absorbability.

For example, a signfiicant problem for Androgel and Testim has been absorbing enough of the product to boost T levels significantly. Axiron attempts to overcome this through application to the relatively thin skin “down under.”  However, there is limited surface area in the armpits obviously and so it looks like this may have been that the makers of Axiron boosted the concentration to 2%, double that of the original 1% Androgel, for increased absorption.

NOTE:  Androgel now comes in a 1.62% concentration.  Don’t ask me what pointy-headed wizard came up with that figure.

However, Axiron’s major plus is its inaccessibility:  contact by family members with the armpit area is much less likely for obvious reasons.  One big issue for the topicals, such as Testim and Androgel that are applied to the upper body, is such contact with family members. (You can read the warnings right on the front page of Androgel’s web site.[1])

Children who have come into contact with these topical, in particular, have been documented to almost spontaneously go through precocious puberty.  Granted – this is almost always from a man that is simply not being careful and giving skin-to-skin contact, but, regardless, it is very dangerous and, undoubtedly, there are great concerns over potential litigation issues.  Even adult females, because they generally only have about a tenth of the testosterone levels of their middle-aged plus men, are at potential health risks from repeated exposure.  A product like Axiron removes much of this concern.

Axiron also gives Lilly another “big gun” in its arsenal for treating men’s sexual health issues:  it is owner and operator of the blockbuster PDE5 inhibitor, Cialis. By acquiring Axiron (from an Australian company) [2], it now has treatment options for the two primary underlying causes of post middle-age erectile dysfunction, age-onset low testosterone (hypoganadism) and endothelial dysfunction (decreased nitric oxide).

So how has Axiron been received? So far doctors seem to be very receptive to the product.  Users seem to like it except for the strange solution that requires pumping the right number of pumps and getting it into an applicator.  For example, one man wrote me and described the application as:

“It’s an alcohol based liquid that you apply to your armpits. Ever tried putting a liquid on your pits without using a roll on applicator? It’s not easy. The liquid feels fine, however. They give you a cup with a flexible rim. You fill the cup and slowly (or you lose everything) begin to slide it across your skin until the cup is empty. You really have to keep the cup perpendicular to the ground because you can lose it all when you try to go vertically into your pits. It’s the one pain in the…with their product. ”

Below is a question and answer review that one reader gave about his experience with Axiron:

Q. You applied the Axiron to your arm pits, correct? Or did your doctor recommend it in the thigh area? thigh area?

A. Yes, you apply under arms only – doctor said no other place.

Q. Do you use deodorant before or after application of Axiron?

A. You apply deodorant about 5 mins after.

Q. It is a solution, correct? Did you have trouble with it dripping or running during application?

A. Yes it is a solution,and if you are not careful it will run.Its a learning experience.

Q. That s a delicate area. Did it dry your skin or irritate it in any way or lead to redness, nodules, skin tags, etc.?

A. At first no problems but after 6wks I noticed it left a white dry flaking material under my arms. But it caused no other problems – no redness,no tags, nothing.

Q. I know that you tried a variety of testosterones unsuccessfully, including Androgel and Testim. Why did your doctor put you on Axiron?

A. As for the Testim, I was on it for 18 months and my levels were not going up and staying up. When I started, my total was 150.  At one point my total went to 475 but just two months later down to 172.  That’s when my doc said lets try axiron.  I was on axiron for three months and now I went to see endo who said it was an absobtion problem. The endo said lets try androgel 1.6 which I have been on now for three months. I go back in Dec for levels.  Hope this works.  I can not get a straight anwser on why it can only be applied on the upper chest and arms.  My wife applys her hrt to inner thighs – why cant I?

Q. My understanding is that Axiron is given in dosages between 30 and 120 mg. What was your dosage level?

A. My levels were 60mg per arm,but I went to 120mg per arm on my own to see if it would make me feel better but not.

Q. Do you want to share any experiences about HRT? Any words of advice for other guys out there?

A. I know a lot of us guys struggle with this issuse,my only advice is to pressure the doctors for answers if you do not get the results change docs.

A. I know a lot of us guys struggle with this issue. My only advice is to pressure the doctors for answers if you do not get the results change docs.

REFERENCES:

1)  https://www.androgel.com/

2) https://www.lilly.com/news?releaseid=452131

HRT: Does It Even Work? - Peak Testosterone

1)  Nature Reviews Endocrinology July 2013, 9:414-424, “Risks and benefits of testosterone therapy in older men”

2) Ann Intern Med, 2012, 157(10):681-691, “Effect of Testosterone Replacement on Response to Sildenafil Citrate in Men With Erectile Dysfunction: A Parallel, Randomized Trial”

3) Andrology, May 2013, 1(3):475 482, “The effect of testosterone on mood and well-being in men with erectile dysfunction in a randomized, placebo-controlled trial”

4) The Journal of Sexual Medicine, Jan 2011, 8(1):284 293, “Hypogonadal Men Nonresponders to the PDE5 Inhibitor Tadalafil Benefit from Normalization of Testosterone Levels with a 1% Hydroalcoholic Testosterone Gel in the Treatment of Erectile Dysfunction (TADTEST Study)”

5) Andrologia, Apr 2006, 38(2):61 68, April 2006″Testosterone and erectile function in hypogonadal men unresponsive to tadalafil: results from an open-label uncontrolled study”

6) The Journal of Urology, Aug 2004, 172(2)658-663,

“RANDOMIZED STUDY OF TESTOSTERONE GEL AS ADJUNCTIVE THERAPY TO SILDENAFIL IN HYPOGONADAL MEN WITH ERECTILE DYSFUNCTION WHO DO NOT RESPOND TO SILDENAFIL ALONE”

7) Urology, Mar 2006, 67(3):571-574, “Adjunctive use of AndroGel (testosterone gel) with sildenafil to treat erectile dysfunction in men with acquired androgen deficiency syndrome after failure using sildenafil alone”

If you put these #1 and #2 together, the conclusion is obvious: just use drugs! That’s right: Viagra and Cialis are the answer.  Don’t believe me?  Check out what he and his coauthors wrote:

“In cohort studies, testosterone levels are associated weakly but consistently with muscle mass, strength, physical function, anaemia, BMD and bone quality, visceral adiposity, and with the risk of diabetes mellitus, coronary artery disease, falls, fractures and mortality. However, the clinical benefits and long-term risks of testosterone therapy especially prostate-related and cardiovascular-related adverse events have not been adequately assessed in large, randomized clinical trials involving older men (defined as age >65 years) with androgen deficiency. Therefore, a general policy of testosterone replacement in all older men with age-related decline in testosterone levels is not justified.” [1]

Now look at how curious his position is.  He basically admits that HRT should help men with diabetes and heart disease and should even improve mortality rates.  Now in my book, Low Testosterone by the Numbers, I show how testosterone therapy has reversed every condition that Dr. Spitzer lists and some more as well.  There is research that it can partially regress diabetes and insulin resistance, unharden arteries, improve osteoporosis, help men lose weight – the list goes on and on.  At the clinic where I can my HRT, they have found that they have gotten virtually every type II diabetic man off of his insulin! So how can HRT not be a net positive for most men, considering that most of them are likely struggling with Metabolic Syndrome (prediabetes) or diabetes?  HRT clearly helps with almost all of the major killers of us guys.

And, again in my book, I discuss how testosterone helps with many of the huge issues that can make a big difference for us guys on a practical level:  decreasing depression, improving venous leakage and boosting libido.  Many, many guys on the Peak Testosterone Forum can also tell you how testosterone therapy cleared out their “mental fog”, got rid of crippling fatigue, greatly improved sleep and made them feel human again.

So then why would he conclude that HRT should not generally be given to men with androgen deficiency?  Well, he explained his reasoning with the following:

First of all, all the major studies have shown that HRT does not increase prostate cancer risk in any cohort that they have looked at.  Now there may be some special circumstances where it does increase risk.  Never say never, eh?  I know I don’t have a crystal ball and neither do any of the researchers.  However, good-sized, well done studies have been done and so far they are very positive.  And Dr. Morgentaler, also out of Massachusetts, has explained why:  according to his research testosterone only fuels prostate cancer near castrate levels.  If you want to read a great rebuttal and a fantastic piece of scientific investigative research, read his article entitled  Destroying the Myth About Testosterone Replacement and Prostate Cancer.

Now heart-related issues are a bit more problematic and the reason is that there have been two recent studies that show that HRT may cause some cardiovascular problems in men. Personally, I do not think the studies were well done and believe that time will show that most of the troubles occur from poorly run HRT as I discuss in my page on  The Recent HRT Class Action Lawsuits. (One of the two CVD studies were also from Massachusetts.) It’s no secret to anyone that has done their homework that men on HRT need to have their estradiol and hematocrit / hemoglobin managed and they should be screened for rises in blood pressure.  None of these studies did that as far as I know.

WARNING:  It may be that the topicals have a unique cardiovascular risk profile as I discuss in my page on the Risks of Testosterone. ZRT labs makes note of the fact that topicals greatly increase capillary and extremity testosterone and estradiol levels – something that does not happen with injections for example.  One of the studies that showed cardiovascular issues with HRT was exclusively topicals.

However, a caution is definitely in order:  there does appear to be good evidence that some men with clotting disorders may be at an increased risk from HRT and I discuss that on the same page. Thus, it is possible that certain heart patients and some men with hypertension and stroke risk factors need to be more carefully screened and/or monitored.

But to be quite blunt, why would you take HRT away from the majority of men who have no such risk factors?  I simply do not see the logic in this.  My blood pressure is good; I have no cardiac arterial plaque; I have no known kidney issues/ and I was clearly greatly helped by exogenous testosterone.  So why would Dr. Spitzer argue that guys like me should not have testosterone until more study work is done?

1.  Erectile Dysfunction. A group of middle-aged and senior men with erectile dysfunction were put on Viagra and, in general, they improved of course.  Then Dr. Spitzer put half of them on HRT and half on a placebo.  The results?  HRT did no better than the placebo. [2] The conclusion is that you can just put men on Viagra and you really don’t need HRT, right?  Well, more about that later.

2.  Mood.  From what I can tell, Dr. Spitzer used the same study participants and basically used the same basic methods and design but this time looking at mood and “sense of well-being.”  [3] Again, what he found was that HRT offered no real improvement in mood over what the Viagra did.  The conclusion was clearly intended to be that you can just put men on Viagra and you really don’t need HRT.

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

I don’t know whether Dr. Spitzer is going to try to continue with similar studies that basically try to discredit the need for HRT, but let’s step back and go to the most fundamental question:  is it heathful to restore a man’s hormones to physiological, youthful levels?  This question is clearly what is being ignored here.  For example, we know that increasing testosterone will add some muscle and decrease some body fat in most men.  Is not this an excellent anti-aging strategy?  We also know that HRT will lower most men’s insulin levels and thus give him greater blood glucose control.  Is not this also an excellent anti-aging strategy?  We also know that HRT will usually unharden arteries and activate eNOS, the all-important enzyme responsible for arterial nitric oxide.  Is not this an excellent anti-aging strategy?

Dr. Spitzer is an endocrinologist I believe and, as such, he has undoubtedly prescribed insulin to many of his diabetic patients when they lost their ability to produce insulin.  And, as an endocrinologist, he has also surely prescribed thyroid hormones to his patients that were hypothyroid.  So why would you not do this for your men that are hypogonadal and miserable with the symptoms of low T?  What is the difference?

The difference is simply that, for reasons I simply do not understand, there is an incredible bias among most endocrinologists against testosterone therapy.  I can tell you from practical experience on the Peak Testosterone Forum that endocrinologists are by far the most reluctant to give a man testosterone.  And I have seen this repeatedly regardless of the country.

And let’s go back to the Viagra-Makes-HRT-Unnecessary theory.  First of all, these medications are rife with side effects and you can become dependent and resistant to them.  See my Viagra and Cialis Summary for details. And, just as important, many men are not responsive to PDE5 Inhibitors. [4][5][6][7] That’s right – these magic pills just don’t work for some guys. And guess what? There are a number of studies that show when you add HRT on top of the PDE5 inhibitor, their erectile dysfunction is improved. So HRT is clearly helpful in the rather large subset of men where Viagra and Cialis just do not work or work minimally.

REFERENCES:

How to Get Off of Cialis and Viagra - Peak Testosterone

Many of the men on the Peak Testosterone Forum would like to stop Viagra or Cialis but just don’t know how. Some research indicates that you can Become Dependent on PDE5 Inhibitors and so greater dosages are needed to achieve the same effect. And since these are medications with frequent and significant side effects and so, as the dose increases, so does the chance for issues. Men realize this at a certain point and try to quit, but it’s not easy.

That is why I was excited when one of the members (TimeZones) of our forum was able to successfully stop Cialis and Viagra and, more importantly, did it using purely natural strategies. In fact, when you read his protocol, it’s basically just common sense and living the way the most elite supercultures live.  I guess it is no shock that it would work well to restore erectile function as well.  (See my pages on A Reveiew of the Longest-Lived Supercultures for additional details and my header page on PDE5 Inhibitors for some basic information on the pros and cons of Levitra, Cialis and Viagra.)

Just how did he do it?  Here is how he described his protocol in this thread:

DISCIPLINES: “The BIG THINGS you want TO DO are: WALK (at least an hour per day) JUICE (celery especially, followed by spring mixes) EAT HEALTHY (plant based, low/no fat, unprocessed, moderate/low carb)“

DIET:  “And you know what’s funny? The diet I’m on now is exactly what Jack LaLanne and Dr. Esselstyn (google “Forks Over Knives”) preached/have been preaching for years. I only found out that my diet mirrored Jack’s after googling the name on my juicer (it’s a Jack LaLanne brand juicer). Anyhow, moderate fish, 5-6 egg whites per day, and plants with more plants and pounds more juiced vegetables is the way to go…I used to think that taking PDE5i’s would — and should — cure ED while buttering up foods, adding olive oil to everything I ate because “it’s a healthy oil,” having saturated fats (e.g. cheese, animal products), etc etc then wondering why 10+ mg of cialis wouldn’t work. Now, I see that my diet is more linked to my ED than anything else.”

EXERCISE:  Plenty of WALKING (2 hours per day).

DIET PART 2: ” Again, the BIG THINGS you want to AVOID are: FATS (avocados, oils of all types [especially canola and olive]) STAYING SEDENTARY BAD DIET (anything that isn’t whole foods and plant based IS POISON)

SUPPLEMENTS: I have experimented with garlic and vitamin C, but in general, L-citrulline is the best supplement ..Cacao and ginseng are good, too.

I had many questions for him and did a follow up interview shown below.  First a few important comments and cautions:

1) Why a low fat diet?  The primary reason is that saturated fat lowers nitric oxide and sludges up the arteries. Young guys can usually eat a lot of saturated fat and not notice the different in their erections.  However, as arterial plaque builds up and a guy ages, he becomes more and more sensitive to it.  Wild game and most natural foods are relatively low fat:  we simply weren’t designed to handle the fat-marbled high fat industrial meats.

NOTE: Of course, it’s always prudent to implement lifestyle changes, because erectile dysfunction is often a sign of the beginnings of heart disease. However, I do want to point out that we also had a Peak Testosterone Forum member Quit Cialis Cold Turkey.

A. I had a history of competitive bodybuilding (AAS use) and long-distance cycling. I have always been fit, but these were the main culprits.

Q. What made you want to quit? I believe you had some nasty side effects, right?

A. I wanted to quit due to the development of PED5i tolerance development. In other words, I saw that if I continued down the path I was taking of daily cialis/viagra that total tolerance would develop.

Q. How much were you taking at the time, what drug and how often?

A. I was taking 20 mg of cialis every other day when using cialis, and when using viagra, I was taking 50-100 mg per day.

Q. And how long had you been taking PDE5 inhibitors?

A. I had been taking PED5i’s since age 28.

Q. You mentioned that you walked two hours every day. So do you walk two hours straight or break it up?

A. I walk for two hours straight. I haven’t experimented with breaking it up, but that’s a good idea that I may look into.

Q. Why not throw some jogging in there? (I like the idea of just walking so as not to overtrain, but I was wondering what your reasoning was.)

A. I have foot and knee issues, so I don’t jog. I may start jogging once my foot issues clear up. Thanks for the suggestion.

Q. Are you doing any other kind of exercise, such as weight training or HIIT?

A. I do light weight training 1x-3x per week. I don’t do any HIIT.

Q. Why two hours? Have you tried walking a lesser amount of time, but it didn’t work?

A. Two hours seems to be the most natural time to be outdoors at a stretch. I’ve been walking upwards of 3 hours, some days. Lesser time doesn’t seem to be as effective toward ED amelioration, either.

Q. Are you consuming a low fat diet? 10-15% of calories probably?

A. Yes, I consume a low fat diet. 10-15% would be an overestimate, even. I’m guessing that it’s 10% maximum.

Q. You mentioned that you follow a cross of Jack LaLanne and Dr. Esselstyn’s diet? In other words, you’re 95% vegan except for those egg whites, eh?

A. That’s correct. With the exception of fish and egg whites, my diet is exactly what Dr. Esselstyn uses. Jack LaLanne’s diet is exactly like mine. I didn’t try to mimic Jack LaLanne’s diet, either; it just came naturally to me through trial and error.

Q. How do you implement this? Cooking? Smoothies?

A. I do a lot of juicing. More on that later. As far as cooking goes, I don’t do much of it. Most of the food I eat is done with a rice cooker where I basically put different grains and legumes into a pot, and then when its almost finished cooking, I’ll put whatever vegetables I want inside with everything else. I bake salmon fillets and eat sardines out of a can. Egg whites are fairly easy to get precooked at Trader Joes.

Q. How important of a role do you think high nitrate foods plays in your protocol? And how much of those are you consuming roughly? Can you give us an exmample of a typical day?

A. High nitrate foods are very important. Probably the most important. I consume the majority of my high nitrate foods using a juicer. Celery, beets, kale, spinach, arugula, etc etc.

Here’s a typical day:

Morning:

Lunch:

Dinner:

Following meals most days I’ll have a couple of kyolic garlic pills and a cayenne pepper extract pill.

Q. Where do you get your carbs? Do you consume any wheat or refined carbs?

A. I don’t get much wheat. I avoid anything refined or processed.

Q. So you have no nuts or oils of any kinds?

A. No, I don’t have any of those. Occasionally I’ll sprinkle chia seeds over one of my meals.

Do you get morning erections?

A. No. I get them at night. The ones I get at night are the ones I use as a judge for how well my diet/activity during the day affected things.

Interview on Quitting Cialis and Viagra

2) Why primarily plants with some fish and egg whites?  Plants increase blood flow, lower blood pressure and raise nitric oxide.  This is the subject of my book The Peak Erectile Strength Diet.

3) CAUTIONS:  You have to be careful with raw cocoa as many of them were found to have high levels of cadmium.  Also, you want to get at least 10% fat in your diet from what I have read to ensure mineral and vitamin absorption.  The supercultures mentioned above are usually in the 15-20% range, but I feel better, like TimeZones, nearer 10%..

Below are the follow up questions I asked him, which outlines the underlying causes of his Cialis and Viagra usage and how he was able to quit:

GUEST INTERVIEWEE: TimeZones

Q. What is your age and how long do you think you had erectile dysfunction before you started your new program?

A. I’m 33 and my ED started at 28. My protocol started at age 32 and has been ongoing, since.

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

Aromatase Inhibitors: Can They Lead to Low Estradiol?

I wanted to report on a couple of disturbing cases that have surfaced recently on the Peak Testosterone Forum, where a couple of men have reported that aromatase inhibitors have permanently crashed their estradiol.  As I discuss on my The Need for Estradiol page, we men really do need adequate levels for endothelial (arterial and erectile) function, congitive and brain systems ( for libido), and bone mass maintenance.  So it might seem like a good thing to eradicate as much of that “nasty female hormone” as possible, but, in fact, that’s a virtual guarantee of misery and suffering.  You need some estradiol just like your wife or girlfriend needs some testosterone.

Fortunately, low estradiol is rarely an issue for men with respectable amounts of testosterone.  (Low testosterone men are often low estradiol however.)  Because we tend to gain weight as we age, estradiol levels (relative to testosterone) tend to go up.  But imagine if the natural order was disturbed and a medication somehow permanently took out your estradiol. These men aruge that this is exactly what happened to them.

Before I go on, let me just mention that literally millions of men have used these aromatase inhibitors and the vast majority do not report the kind of problem I am describing below.  But I feel that my job is simply to report what we’re seeing “on the field:”

CASE 1. Reversible Aromatase Inhibitior (Arimidex). The story of this poster is a bit unusual, but it started with him taking too much injectible testosterone accidently.  His testosterone went above 1500 ng/dl and his estradiol (sensitive) climbed to 161 pg/ml, which is very high.  Traditionally, he had been a lower estradiol guy, but this much testosterone really elevated his levels.  When he discovered the high estradiol, he decided to take action immediately and took some Arimidex (anastrazole).  Taking Arimidex as part of an HRT (testosterone therapy) protocol is actually quite common as men often find their estradiol a bit on the high side even though their testosterone is within youthful ranges.  This generally occurs from weight gain as we age, but some men are just “high converters.”

Just a few weeks after he took the Arimidex, he found that his estradiol was completely crashed.  His total testosterone had come down to 873 nd/dl, which is a youthful level, but his estradiol was < 2.5 pg/ml!  A followup blood draw 3 weeks later showed similar results and, again, abyssmally low estradiol.  It has now been about 6 weeks as of this writing since he took the Arimidex and yet his estradiol has not recovered. [3]

So the whole situation is unusual for many reasons:

a) His testosterone was quite high due to a personal HRT error..

b) Most men who crash their estradiol recover in just a few weeks.

IMPORTANT CONCEPT: Arimidex is a “reverisble aromatase inhibitor.”  Reversible aromatase inhibitors attach only weakly to the aromatase enzyme and can easily be removed with harming it.  Irreversible aromatase inhibitors are the opposite and powerfully bond to the aromatase enzyme. The chemical bonding that occurs in this case actually destroys the enzyme by effectively taking it out of commission.  However, normally a man will rebuild these enzymes a few weeks later.

Did Arimidex really permanently crash his estradiol?  See my theory section below for more details but first a similar case with Aromasin:

CASE 2. Irreversible Aromatase Inhibitior (Aromasin). Another poster, coincidentally at the same time, used an irreversible aromatase inhibitor called Aromasin (or exemestane).  This young man had used Aromasin during a steroid cycle and at a rather high dosage (25 mg per day) and, to his horror, found was that his estradiol never recovered.  He wrote:

“Everyone said its high E2 [estradiol], so I did aromasin for like 2 more weeks…I didnt recover went for blood work and found out that my E2 [estradiol] is below normal range…Testosterone 510, LH 4.1 and E2 was tested <5 where as normal range starts from 7 …I’m off steroids for about over a year and E2 is still shut down…I have all the symptoms of low estrogen.” [2]

So this man has had almost zero estradiol, even though his testosterone is currently midrange in the 500’s (ng/dl). His estradiol is very low and has been measured to be less than 5  pg/ml, which puts him at risk of osteopenia.  Now it is tempting to argue that he was damaged because he took too much Aromasin.  That argument, though, ignores the fact that there is a study out there where they gave normal 14-26 year olds 25 and 50 mg daily and found that plasma estradiol levels only decreased about a third,  (A larger dip did occur, maxing at 12 hours afterwards (62%).)  So, in this study, Aromasin did not vaporize anyone’s aromatase. [1]

CAUSE?  Theory 1:  Notice that in both cases testosterone was too high, an aromatase inhibitior was taken and then estradiol permanently tanked.  Is this – the high testosterone – the common ingredient and the reason that these men’s estradiol was set to near zero?  And, if testosterone skyrocked, estradiol likely did as well and so perhaps super elevated estradiol levels reset gene expression or receptors?  This theory seems doubtful, however, since literally thousands of steroid users use Aromasin.

CAUSE?  Theory 2: Could these men have high progesterone for some reason? High levels of progesterone would likely suppress estradiol levels through aromatase inhibition, something I discuss in my page on Progsterone Lowers Estradiol.

CAUSE?  Theory 3:  Perhaps liver issues can explain these aromatase issues? One of the men wrote in a followup post that “Saw the new naturopathic doc. As expected he’s being conservative and starting with the liver because it is so obviously overworked with a lot of different medications for various issues. Some are pretty tough on it. The liver enzymes I closely watch and treat with milk thistle and dandelion and have been in normal range over the years but according to him just because your enzymes are in range doesn’t mean that there isn’t a backlog on how the liver is addressing detoxification and protein synthesis and other things. For me, creating aromatase might just be a low-priority item that keeps getting knocked out of the queue every day. We’re going with castor oil externally to help it detox.” [2] And the poster using aromasin had been using steroids and so it is possible that some supplement or something in his cycle aggravated his liver.

CAUSE? Theory 4.  In men with a weakened liver, Aromasin will lead to very elevated levels. The FDA wrote that “The pharmacokinetics of exemestane have been investigated in subjects with moderate or severe hepatic insufficiency (Childs-Pugh B or C). Following a single 25-mg oral dose, the AUC of exemestane was approximately 3 times higher than that observed in healthy volunteers. The safety of chronic dosing in patients with moderate or severe hepatic impairment has not been studied. Based on experience with exemestane at repeated doses up to 9 200 mg daily that demonstrated a moderate increase in non-life threatening adverse events, dosage adjustment does not appear to be necessary.”  Could this affect some men?

REFERENCES:

1) J Clin Endocrinol Metab, 2003 Dec, 88(12):5951-6, “Pharmacokinetics and dose finding of a potent aromatase inhibitor, aromasin (exemestane), in young males”

2) https://www.peaktestosterone.com/forum/index.php?topic=7787.0

3) https://www.peaktestosterone.com/forum/index.php?topic=7760.0

4) https://www.accessdata.fda.gov/drugsatfda_docs/label/1999/20753LBL.PDF

Heat: Lowering Testosterone with a Time Delay.

REFERENCES:

1)   J OF ANIMAL SCIENCE , 1971, 33(4), “EFFECT OF ELEVATED AMB IENT TEMPERATURE ON TESTIS AND BLOOD LEVELS AND IN VITRO BIO – SYNTHESIS OF TESTOSTERONE IN THE RAM”

2) Int J Androl, 1988 Feb, 11(1):61-72, “Effects of local heating of the testes on the concentration of testosterone in jugular and testicular venous blood of rats and on testosterone production in vitro”

3) Endocrinology, Apr 1, 2000, 141(4):1414-1424, “Testicular Heat Exposure Enhances the Suppression of Spermatogenesis by Testosterone in Rats: The Two-Hit Approach to Male Contraceptive Development”

4) Animal Reproduction Science, Aug 1984, 7(5):391 403, “Effects of acute and chronic testicular hyperthermia on levels of testosterone and corticosteroids in plasma of boars”

5) Journal of Andrology, November/December 2002, 23(6), “Mild Testicular Hyperthermia Induces Profound Transitional Spermatogenic Suppression Through Increased Germ Cell Apoptosis in Adult Cynomolgus Monkeys (Macaca fascicularis)”

The answer to that is a little more complex and we have to go to animal studies to get some answers and insight. First of all, heat will definitely shrink the testes, something most men are not too excited about. In a study of rams, heat actually shrunk the testes by about a third by weight. [1]  This is particularly remarkable, because the rams were not subject to ultrahigh heat, but rather constant heat in the 28-23 degrees Celcius range (82-90 degrees Fahrenheit) continuously for two weeks.

Of course, shrunken testicles is a very bad sign.  But does this  mean testosterone was actually lowered?  A study on increasing heat using rats showed that that FH and LSH rose. Now testosterone, interestingly enough, did not change, but the testes became less responsive. So it is as if there was a “partial secondary hypogonadism” even though testosterone levels did immediately fall. [2] In fact, the authors concluded that “it appears that the testosterone produced by Leydig cells from heated testes may not be secreted as effectively as in normal testes.”

So, obviously, something is going on.  And, in fact, one study actually looked at using a combination of exogenous (applied from outside the body) testosterone plus heat to create a male contraceptive. [3] It was so effective that it almost reduced sperm counts to zero.

But does heat affect testosterone levels. One study on boars shows that initially heat may not affect testosterone levels [4]  However, eventually baseline T levels are actually decreased.  In other words, it appears there may be a time lag from the application of the heat to the time that testosterone actually decreases. This was verified in the study on rams that showed that testosterone decreased significantly after a two week period. [1] One study on monkeys verified the same thing:  a time lag loss of testosterone after 6 days of 30 minutes heat treatment of the testicle area. [6]

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.

Blueberries:Improve Erections and Reduce Erectile Dysfunction

I have for years been adding about a half cup of organic frozen blueberries into my nightly smoothies, and, in hindsight, that sounds like one of the smartest decisions I’ve ever made.  Why do I say that?  Because a recent study shows that blueberries were associated with reduced erectile dysfunction (along with red wine and citrus fruits). [1] The authors also noted that “a higher total fruit intake was associated with a 14 per cent reduction in the risk of erectile dysfunction. And that a combination of consuming flavonoid-rich foods with exercise can reduce the risk by 21 per cent.” Yes, it’s all about lifestyle when it comes to your heart and arteries. [2] My book, The Peak Erectile Strength Diet, covers many other foods and drinks that do the same.

1) ‘Dietary flavonoid intake and incidence of erectile dysfunction’, American Journal of Clinical Nutrition, on January 13, 2016.

2) https://medicalxpress.com/news/2016-01-blueberries-citrus-fruits-red-wine.html

3) J Acad Nutr Diet, 2015 Mar, 115(3):369-77, “Daily blueberry consumption improves blood pressure and arterial stiffness in postmenopausal women with pre- and stage 1-hypertension: a randomized, double-blind, placebo-controlled clinical trial”

4) Experimental Neurology, Dec 2005, 196(2):298 307, “Blueberry- and spirulina-enriched diets enhance striatal dopamine recovery and induce a rapid, transient microglia activation after injury of the rat nigrostriatal dopamine system”

5) Nutritional Neuroscience: An International Journal on Nutrition, Diet and Nervous System, 2006, 9(5-6), “Dietary supplementation with blueberry extract improves survival of transplanted dopamine neurons”

6) J Agric Food Chem, 2010 Apr 14, 58(7):3996-4000, “Blueberry supplementation improves memory in older adults”

7) J Med Food, 2005, 8:8-13, “Wild blueberry-rich diet affect the contractile machinery of the vascular smooth muscle in the Sprague-Dawley rat”

8) Nutrition, Metabolism & Cardiovascular Disease, 2012, 22:127-132, “The temportal effect of a wild blueberry (Vaccinium angustifolium)-enriched diet on vasomoter tone in the Sprague-Dawley rat”

So is the idea that blueberries could protect and possibly relieve erectile dysfunction without any biological plausability? Actually, it’s quite the opposite.  Below are Four Properties of Blueberries that Will Improve Hardness Factor and Decrease the Risk of Erectile Dysfunction:

1. Increased Nitric Oxide. I have dozens of ways to increase NO on this page:  Summary Page on How to Increase Nitric Oxide. Why do I give it so much coverage?  The reason is that nitric oxide is lowers blood pressure, increases blood flow and is an arterial anti-inflammatory. All of us men desperately need nitric oxide for the protections of our heart and penis. It turns out that blueberries are yet another plant food that boosts nitric oxide, at least according to a study on women that showed a huge 68% increase in nitric oxide levels. [3] Even better, these results were achieved with consumption of the equivalent of about a 1 cup of frozen blueberries each day. This is doable and berries are respected by almost every popular diet out there from Mediterranean to low fat to Paleo, so just do it!

NOTE:  Increased nitric oxide almost always means increased blood flow, including to the all-important pudendal and penile arteries.

2. Reduced Blood Pressure. The same study showed very significant drops in blood pressure, 7 and 5 mm, in systolic and disastolic blood pressures, repsectively. That drop in diastolic blood pressure is particularly significant, because many men with prehypertension find it hard to lower that one. Now it should be pointed out that this study examined post-menopausal women, and the reason is that they often struggle with high blood pressure.  This is shown by the fact that the average blood pressure levels were in the prehypertensive range.  Even, so, many men also struggle with prehypertension due to the high prevalence of prediabetes and insulin resistance, which are associated with higher blood pressure levels.

3. Lowered Arterial Stiffness. Again, the same study showed greatly decreased arterial stiffness as well in the blueberry treated group.  Obviously, stiff arteries are not going to help erections, and blueberries help in this category as well.

4. Improved Vasomotor Tone.  Arteries work through the relaxation and dilation of smooth muscle tissue. One of the issues that stress and aging can worsen is the noradrenaline-induced contraction of the arteries. Of course, this narrows arteries, decreases blood flow and is bad for erectile strength.  Blueberries have been found in a couple of animal studies to reduce that powerful contractile reaction, and thus improve the kind of stress responses that plaque us in modern societies. [7][8] This is the same pathway that alpha blockers work on but without the side effects!

5. Dopamine Protection and Possibly Stimulation. Dopamine is ground zero for libido. It also boosts mood and can help cure some types of depression.  One of the ways that TRT works is by boosting this key neurotransmitter, something I cover in my page on Testosterone and Dopamine. Blueberries at a minimum protection dopamine levels, and I’ll show evidence below that they actually boost them as well:

b) Reduced Depression. I do not know of a study that shows that blueberries actually increase dopamine levels.  However, if dopamine is increased, it will usefully help with depression, and one study on seniors and blueberry consumption shows improved depression. [6] The same study also showed improved memory!

REFERENCES:

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:

STEP 2A: Do You Have Symptoms of Low Estradiol?.

See if you have the standard low estradiol symptoms in men:

In Step 1 you pulled your estradiol and, hopefully, with the best test your lab has to offer.  If your estradiol was below about 15 pg/ml – discuss with your doctor what he or she actually considers to be low estradiol – then you want to see if you have the standard symptoms to go along with it.  Here are 10 Classic Symptoms of Low Estradiol in Men:

–Joint aches and pain.

–Low libido

–Anxiety

–Erectile dysfunction (Estradiol plays a role in blood flow and endothelial function.)

–Depression

–Poor sleep

–Loss of morning erections

–“Hot flashes”

—LONG TERM: Bone loss (osteopenia or osteoporosis).  [This will only occur if low estradiol has been going on for an extended period of time.]

ARIMIDEX:  Men on HRT sometimes “crash” their estradiol by taking too much of an aromatase inhibitor such as anastrozole (Arimidex).  It is usually a miserable few weeks (3-4) while your estradiol levels ramp back up and symptoms disappear.

Is it possible to have low estradiol according to a blood draw and yet none of the standard low estradiol symptoms?  Sure, anything is possible and there are a couple of explanations that I can think of:

1) Your estradiol is in the grey zone for most of your symptoms and it is not yet causing you difficulties.  The danger in letting this go is that you could potentially be experiencing bone loss and end up with osteoporosis.  Unfortunately, you don’t always “feel” bone loss until you are at fairly advanced stages:  we’ve had a couple of guys on the Peak Testosterone Forum with osteopenia who could attest to that fact. So Discuss with your doctor the potential risk here.

2) You had a “bad” blood draw. The lab tests are not perfect and there is considerable variability.  For example, one urological study of testosterone tests found that blood draws varied by 20-30% quite commonly on the same person same day same time.  The best way to see if this was an issue is to just retest your estradiol

Hopefully, you have a knowledgeable and proactive physician that will pull your estradiol for you and discuss results.  If he/she will not, due to costs or whatever other reason, you can pull estradiol yourself without a doctor’s order through one of these inexpensive labs:  Testosterone Labs.

natives/ triclosan alters hormone regulation - Peak Testosterone

I don’t know about you, but I have long been on the lookout for good alternatives to the standard toothpastes out on the market. I won’t get into the fluoride debates – there are pros and cons – but when it comes to triclosan, I have thought to myself about a thousand times, “This is just scary!” Seriously, is the only way we can control bacterial overgrowth in the mouth a chemical as harsh as triclosan?!?  Is there no natural alternatives” (Triclosan is in virtually all of the toothpastes that I have checked.)

I believe there now good natural alternative out there, but you and your dentist will have to decide for yourselves of course.  But keep in mind that triclosan is currently under review by the FDA!   Look at what the FDA has posted on the subject on their web site:

“Triclosan is not currently known to be hazardous to humans. But several scientific studies have come out since the last time FDA reviewed this ingredient that merit further review. Animal studies have shown that triclosan alters hormone regulation. However, data showing effects in animals don t always predict effects in humans. Other studies in bacteria have raised the possibility that triclosan contributes to making bacteria resistant to antibiotics. In light of these studies, FDA is engaged in an ongoing scientific and regulatory review of this ingredient. FDA does not have sufficient safety evidence to recommend changing consumer use of products that contain triclosan at this time.” [1]

Do you find that comforting?  Well, I sure don’t, especially when you consider that the FDA does not usually review something unless it is really bad.  And I really don’t feel good knowing that my kids are brushing their teeth with the stuff.  Look at these two studies on triclosan and I think you’ll see why this is potentially pretty frightening:

1.  Endocrine Disruption. Several animal studies have shown that triclosan in low doses can alter thyroid function in many ways:

“Tadpoles pretreated with triclosan concentrations as low as 0.15+/-0.03 microg/L for 4 days showed increased hindlimb development and a decrease in total body weight following T3 administration. Triclosan exposure also resulted in decreased T3-mediated TRbeta mRNA expression in the tadpole tail fin and increased levels of PCNA transcript in the brain within 48 h of T3 treatment whereas TRalpha was unaffected [corrected] Triclosan alone altered thyroid hormone receptor alpha transcript levels in the brain of premetamorphic tadpoles and induced a transient weight loss. In XTC-2 cells, exposure to T3 plus nominal concentrations of triclosan as low as 0.03 microg/L for 24h resulted in altered thyroid hormone receptor mRNA expression.” [2]

1) https://www.fda.gov/forconsumers/consumerupdates/ucm205999.htm, “Triclosan: What Consumers Should Know”

2) Aquat Toxicol, 2006 Dec 1, 80(3):217-27, “The bactericidal agent triclosan modulates thyroid hormone-associated gene expression and disrupts postembryonic anuran development”

3) Environmentaldefence.ca, “The Trouble with Triclosan”

4) J Oral Microbiol, 2010, “Effect of the probiotic Lactobacilli reuteri (Prodentis) in the management of periodontal disease: a preliminary randomized clinical trial”

5) Journal of the International Academy of Periodontology, 2004, 6(2):63-67, “The effects of manuka honey on plaque and gingivitis: a pilot study”

6) Journal of Dietary Supplements, 2006, 6(2):79-92, “Punica granatum (Pomegranate) Extract Is Active Against Dental Plaque”

2.  Chloroform and Dioxin. Two particularly nasty toxins are chloroform and dioxin.  The Environmental Defence organization points out that “when it reacts with other substances in water, or breaks down in sunlight, the chemical reactions create the human carcinogens chloroform, and dioxins, which are one of the most toxic groups of substances known.” [3]

The bottom line is that triclosan is using a huge gun to try to kill a very small target.  When triclosan was first approved, we simply did not have the understanding as to how serious these kind of chemicals are to human health.

Of course, the question becomes:  “do we have any current alternatives to triclosan to manage the mouth bacteria that can cause us such serious health issues?”  After all, keep in mind that the inflammation that occurs from gum disease often increases whole body inflammation and has been linked to erectile dysfunction!

1.  Probiotic Lozenges. Now this is an option that makes a lot of sense!  Instead of trying to anhilate the “bad bacteria” in your mouth with toxic chemicals, why not try to just crowd them out with good bacteria?  Is that a beautiful idea or what?  Obviously, this is a similar strategy to what many men try to do with probiotics and their gut flora. These lozenges are already out on the market and they have a study behind them showing that they can significantly improve gum disease. [4]

L. Reuteri is the type of good bacteria used to date and the particular brand tested was called Prodentis, which is sold on Amazon as G-U-M Periobalance. This is my favorite option by the way, because you want some bacteria on your tongue in order to create nitric oxide from nitrates in your food. Mouth bacteria is a powerful source – or at least it should be – of NO for men over about the age of 40, most of whom are suffering from significant arteriosclerosis and endothelial dysfunction.

2. Manuka Honey. Not just any honey will do.  This special honey from New Zealand has powerful antibacterial abilities and researchers believe it will be non-carcinogenic.  One study made “fruit leather” from the manuka honey and found that it decreased bleeding of the gum and plaque on the enamel. [5] Nice!  This option, though, has the disadvantage of probably killing off both good and bad bacteria, at least to some extent.

3.  Pomegranate Extract. A 2006 study made a mouthwash with pomegranate extract and found that it was a potent killer of mouth bacteria. [6] Again, this option has the disadvantage of potentially killing off too many bacteria, something I discuss in more detail in my link on The Additional Dangers of Toothpaste. In addition, discuss with your dentist before actually making any changes.

REFERENCES:

Coffee and Testosterone - Peak Testosterone

Can you drink your way to good health? Well, I don’t know about that. but there are a lot of natural drinks that have tremendous benefits for guys. (No, they don’t usually come in kegs.) Black tea boosts nitric oxide; green tea helps with anti-aging; and coffee has so many great properties that I created a whole page on the subject:  The Benefits of Drinking Coffee.

Some people accuse me of being biased, since I love the flavor of just straight coffee.  They say that coffee is just a “socially acceptable amphetamine” and will tax the adrenals.  I always counter with the fact that coffee is simply the typical turbocharged plant food that just happens to have caffeine in it as well.  The superpowers of coffee include diabetes / prediabetes prevention, reduced cardiovascular disease, improved mortality, lowered cancer risk and less chance of contracting Parkinson’s or Alzheimer’s.    While I don’t agree that one has to drink coffee to avoid these chronic diseases, it is difficult to argue that coffee is an ‘evil drink,’ when it clearly can provide so much benefit to the typical man on the street. The only downside that I know of is that it might lower endothelial function in some guys, which could potentially effect erections. (Dr. Greger posted a study on this, but I do not know if this holds true for long term drinkers. Often the negative effects of coffee are only short term and disappear after a few weeks.)

The benefit that you are really going to love is this one:  coffee is a testosterone booster!  Well, kind of.  As you ‘ll see below, there’s a little more to the story.  Let’s look at some of the details:

Study On Healthy, Overweight Coffee-Drinking Men.  A 2012 study put men into three groups that drank caffeinated coffes, decaffeinated coffee or no coffee (a control group).  And the significance of this study is the fact that is was on men:  previous study work had been women only.  Here is what the authors concluded:

“Our finding that caffeinated coffee, but not decaffeinated coffee, signifcantly increased total testosterone and decreased both total and free estradiol after four weeks suggest that caffeine may act as an aromatase (or CYP19) inhibitor. One intervention trail found that consumption of two cups of instant coffee had no acute effect on testosterone or estradiol concentrations after 30 minutes.” [1]

Okay, it is definitely true that coffee raised testosterone at the four week point.  However, the study downplays in my opinion the fact that at 8 weeks, there was no real significant different in either testosterone, estradiol or testosterone-to-estradiol ratio.  The reason for this is that the participants, who were all coffee drinkers before the study, had a two week washout period with no coffee or caffeine.  So, when they added coffee back into their routine, they were starting essentially as brand new coffee drinkers.  This gave a turbocharged testosterone output that then stabilized back to their old baseline by week 8.

Now the results at the four week point though were impressive in the caffeinated coffee group, where average testosterone climbed to 546 ng/dl in the caffeinated group versus 327 in the control group.  Remember that the testosterone is pretty low, because these men were quite overweight.  Also, the testosterone-to-estradiol ratio was 24.2 in the caffeinated group versus 8.4 in the control.  So clearly coffee can give you some pretty impressive in initial changes that then fade.  Again, at eight weeks, it was a different story:  total testosterone in the caffeinated coffee group was just a little higher than the control group and the testosterone-to-estradiol ratio was actually even a bit lower.

Pomegranate Juice Drinkers:  Many guys drinking pomegranate juice notice a nice change for a few weeks.  Men have had morning erections return, etc. and then suddenly the benefit fades.  This sounds similar to what we are seeing here.  Pomegranate juice also has a big effect on some of the liver’s cypochrome enzymes and so, perhaps, it’s hard to keep those liver enyzmes ramped up indefinitely.

Therefore, one could actually cycle coffee I suppose, but, other than that, I am not sure it can really be termed a testosterone booster.

MILD DHEA BOOSTER?  One thing that it did look it bumped a little bit is DHEA, although the study did not note statistical significance.  However, DHEA was higher in the caffeinated coffee group at four weeks and higher still at eight weeks.  In fact, it was 19% higher at that point than the control group’s DHEA.

Does Caffeine Raise Testosterone?

One question that may cross your mind is if it could the caffeine in coffee that boosted testosterone?  The answer is ‘probably not’ based on a study of rugby players that did resistance training (weight lifting) and were given 200, 400, 600 or 800 mg of caffeine beforehand. Only the 800 mg dose significantly raised peak testosterone levels above the control dose (0 mg).  The authors noted that “caffeine doses of >=400 mg tended to cause a small decrease in testosterone after ingestion, followed by a rapid increase after the commencement of resistance exercise. The 800-mg caffeine dose produced a 61% ( 33%) increase in testosterone after 60 min of resistance exercise.” [2]

Of course, this is a massive dose of caffeine for a relatively small effect on testosterone. Even worse, the higher dose signficantly raised cortsiol as well, which is why you don’t see this being used by every athletic program in the country.  In any event, based on this study, it does not seem that the caffeine could be responsible, since reasonable dosages of caffeine appeared to have little effect.

REFERENCES:

1)  Nutrition Journal , Oct 19 2012, Volume 11, “The effects of caffeinated and decaffeinated coffee on sex hormone-binding globulin and endogenous sex hormone levels: a randomized controlled trial”

2) Intl J of Sport Nutrition and Exercise Metabolism, 2008, 18:131-141, “Dose Effect of Caffeine on Testosterone and Cortisol Responses to Resistance Exercise”

-Testosterone (HRT / TRT): Some Pros and Cons.

THE PROS OF TESTOSTERONE THERAPY:

1) Diabetes Cure. As I discuss in my link on Testosterone and Diabetes, almost all of the (type II) diabetic men that go to the HRT clinic where I go have gotten off of their insulin. This, of course, is because testosterone has such a powerful insulin-lowering effect and improves insulin sensitivity. Now you do have to keep in mind that these men will start with testosterone below 450 ng/dl generally and have their average testosterone taken up near 850 or 900 ng/dl. This is a little higher average testosterone than a diabetic man would typicall recieve in the office of a PCP or even urologist. Nevertheless, almost any man will get a substantial benefit in the area of insulin and blood sugar control.  Many men with Metabolic Syndrome (prediabetes) will also likely be greatly relieved as well.

2)  Libido. HRT is simply king at increasing libido and passion for life in general.  None of the other testosterone-raising strategies such as Clomid or HCG Monotherapy has the consistency and dose dependence in increasing sexual desire.  Most men, from what I have seen, get some kind of libido boost.  And many men will go from “I don’t even care about sex” to “I am chasing my wife/girlfriend around the bedroom”.  (There are no guarantees however.)

4) Caring.  It is very common for low T men to say that they feel like a “zombie” and care about nothing in life.  Testosterone very often changes all that.  Suddenly, a man will say that he actually cares about life and career again.  Women pick up on this as you suddenly care about her and all aspects of daily life once again..

CAUTION:  Some men write in after a few months of testosterone therapy and ask, “When will I feel anything?”  Not everyone has a dramatic experience with HRT.

6) Improved Physique. Testosterone will usuall improve your body composition in many ways:  a variety of studies have shown that it builds muscle, lowers fat and can even fight deadly visceral fat.  The most common comment I get from men on the Peak Testosterone Forum about HRT and the body, though, is that it helps their recovery time at the gym. Basically, the perception is that they are able to lift more and lift harder.  I have heard that it is very common for men on HRT to have a variety of aches and pains.  Why?  Because they now have increased energy, passion and alertness for exercising at the gym and sometimes they overdo it!

THE CONS OF TESTOSTERONE THERAPY:

We’re going to cover some of the cons that you might not normally think of.  What I’m not going to cover is poorly executed HRT that does no monitor estradiol. If a man’s testosterone is pushed high enough by his HRT, then his estradiol will go up due to aromatization.  And the older and/or more overweight you are, the greater your estradiol levels on average.  The symptoms of high estradiol include gynocomastia, water retention/”bloating”, low libido and erectile dysfunction. Many unsuccessful HRT experiences are simply due to doctor ignorance and reflect the fact that estradiol is not monitored.  This is very unfortunate, because high estradiol is just as bad as low testosterone for most men.

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

1) Testicular Volume. If you go high enough with HRT, you may lose a little weight in your testes as production is shut down.  This is usually minimal, but some men notice it and feel very insecure about it.  I seriously doubt that the great majority of women out there would notice even if this does occur, but the important thing is that if you lose confidence, it may affect your life in the bedroom.  So you have to weigh your options:

a) Go lower with your testosterone dosage.  Anything less than 600 is unlikely to change your testes appreciably.  (Talk to your doctor though.)

b) Ignore the issue.

c) Take HCG.  (This can boost mood and libido for some men besides preserve testicular volume.)  See my link on Testosterone and HCG for more information.

2) Acne. Occasionally a man will develop acne.  For example, one man wrote into the Forum and said, “Just got back from seeing a dermatologist. He tells me “my acne is caused by testosterone, and there is nothing that Can be done to get rid of it. Every guy on T has the same problem” I need some help on how to get rid of this! If there is a way I’m certain someone here has the answer! It mainly located on my chest stomach and back.” [1] Of course, I completely disagree with the doctor’s assertion that every guy on HRT has acne.  In fact, it is more the exception from what I have seen.  However, it can occur and then must be treated just like your teenagers might get treated.

3) Fertility.  Many young men never think about the fact that if they go on HRT, their fertility will likely be strongly impaired.  There are options around this such as adding HCG into your regimen.  But that can more time and money and, from what I understand, does not always work. So talk to a fertility specialist if this might be an issue for your situation.

4) High Converter to DHT (Enlarged Prostate and/or Hair Loss). Some men seem to convert more of their testosterone to DHT (dihydrotestosterone) and this can lead to enlarged prostate and/or accelerated hair loss.  Now I have never had anyone on the Forum complain of this that I remember, but it certainly is reported.  And the medicaitons to treat hair loss can anhilate permanently your testosterone.  (See my link on Properica Risks for more information.) And finding that you have an enlarged prostate could be problematic, because urologists will usually employ alpha blockers or daily Cialis to battle BPH and, of course, both are pharmaceuticals. So you basically will probably have to either go off testosterone or take a pharmaceutical in order to deal with this.

5) Elevated Estradiol. If you are overweight or a high converter of testosterone to estradiol via aromatase, you can easily get classic high estradiol symptoms:  loss of libido, erecitle dysfunction, gynocomastia, mood swings and prostate issues.  This isn’t the end of the world as an AI (aromatase inhibitor) will usually take care of the problem.  (Generally, Arimidex is employed for this purpose.) However, then you are on a pharmaceutical, which many would consider to be unnatural and risky to their long term health.

6) High Iron.  Good physicians will monitor some combination of your hemoatocrit, hemoglobin and red blood cell counts.  This will allow them to tell if you have too much iron, which in the long term can negatively impact your cardiovascular system and brain.  So, if you come out higher than the range, then you really only have two choices:  1) donate blood regularly or 2) lower your testosterone dosage.  Neither of those may sound fun to you.

7) Cardiovascular Risks. There is some evidence that the topicals may actually cause cardiovascular issues in some men.  I discuss this in detail in my link on Testosterone Risks. Increasing heart disease is simply NOT something testosterone therapy should do, because low testosterone is a risk factor for hardening of the arteries, metabolic syndrome, diabetes, insulin resistance and a number of other known cardiovascular risk factors.  However, it turns out that the topicals actually increase peripheral estradiol levels and this may be causing issues.

NOTE:  Again, I’ve had a great overall experience with my HRT program, but I still recommend that you also read my link on Testosterone Risks, because it provides some other unusual or controversial aspects of HRT.  Again, well-run HRT clinics are growing and thriving for a reason.  But that does not mean that the ride will always be smooth for all patients.  It is also very important that your doctor know how to screen you before going into testosterone therapy:  men with a past history or existing prostate cancer, kidney issues or hypertension should get expert medical advice before adding testosterone to their regimen.

DOES HRT ALWAYS WORK?

It is important to point out that HRT does not always work. Some men are looking for HRT to cure their depression. Testosterone can definitely help, but depression is a complex and multi-faceted condition that usually must be solved through several strategies. HRT does not always cure erectile dysfunction either. An erection is VERY complex and, more often that not, the primary culprit is poor endothelial function, i.e. low nitric oxide levels. So, before you go into HRT, you have to ask yourself the question, “What will I do if I don’t feel anything?” That probably won’t be the case, but you never know.

1)  https://peaktestosterone.com/forum/index.php?topic=1060.0

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

Dostinex - E.D. Cure? - Peak Testosterone

If the cause of your erectile problem is more between your ears than between your legs, it may be that your dopamine response needs to be addressed. There are several drugs, some specifically licensed for ED, others not, which could help.

Cabergoline (Dostinex, Cabaser and Caberlin). Cabergoline is a dopamine agonist, with a half -life of three or four days. It was invented in Italy in 1982, was approved by the FDA in 1996, and is used for the treatment of hyperprolactinaemia. Prolactin reduces dopamine and so the theory is that as cabergoline reduces prolactin, dopamine levels increase. It is not licensed anywhere for erectile dysfunction.

A high level of prolactin in men is associated with a low testosterone level and so, by reducing prolactin, cabergoline tends to boost testosterone, thus potentially providing a double boost to erectile function.

There are many reports that the refractory period between orgasms is much reduced with Dostinex, and that multiple orgasms are frequently experienced. The theory being that prolactin naturally increases after orgasm to reduce your libido for a while; but with cabergoline the effect is much reduced.

Dostinex is even reported to reduce gynaecomastia, which is possibly the reverse of high levels of prolactin causing women to lactate. Prolactin s purpose in men is not known, except perhaps for causing a desire to stop after orgasm.

(Norprolac is a dopamine agonist, which seems similar, but I can find no reports of pro-sexual effects. Requip and Quinagolide are two more, and there are some reports of enhanced erectile function with these.)

NOTE:  You may also want to look at the page which discusses Natural Dopamine Increasers.

Clinical Trial 1: The International Journal of Impotence Research published, in 2007, the results of a 2005 Austro-German trial (M. Nickel et al). It reported that the effectiveness of cabergoline in 50 men with psychogenic erectile dysfunction was investigated in a 4-month, randomized, placebo-controlled, double-blind study. Cabergoline treatment was well-tolerated and resulted in normalization of hormone levels in most cases. Erectile function improved significantly. Sexual desire, orgasmic function, and the patient’s and his partner’s sexual satisfaction were also enhanced. Cabergoline may be an effective and safe alternative agent for men with psychogenic ED .

Participants were subjectively suffering from chronic stress, and anxious or depressive mood, and were recruited from the general population via advertisements. Exclusion criteria were psychotic disorders, organic ED (including smoking, hypertension and diabetes) current use of PDE5i, and an IIEF-EF score of 25 or more.

The treated men increased their average IIEF-EF score from 16.5 at baseline to 24.8 after four months. The placebo group rose from 16.4 to 19.5. Perhaps more impressively overall satisfaction increased in the treated group from 4.4 to 8.0 (in a range that spans from 2 to 10). It rose from 4.4 to 5.3 in the placebo group.

Testosterone level rose in the treated group from 14.5 nmol/l (lowish-normal) to 26 nmol/l (high-normal) range.

The men in both groups had an unusually high average prolactin level at baseline of around 32ng/ml. Normal range is 2 18ng/ml. Stress can cause elevated prolactin levels. The figures show that 18 of the 25 treated patients had moderate baseline hyperprolactinaemia, however analysis did not show significant difference in the time taken for those with high or low baseline prolactin (or low baseline testosterone) in respect of a favourable outcome. So a high prolactin level was (as confirmed by M R Safarinejad) not necessarily the problem and, it seems, dopamine response is usefully enhanced whether or not prolactin levels are high. In the treated group the prolactin level lowered to an average of 4.9ng/ml, – thus in the bottom fifth of the normal range.

As stated, treatment was well tolerated. In the treated group, five experienced nausea (as did three in the placebo group). Four experienced dizziness (against two in the PG). Three experienced constipation (against two in the PG). It was the same for headaches.

The men on the trial received 0.5mg of cabergoline twice a week (This is 14 to 42 times smaller than the dose used to treat Parkinson s Disease.)

Clinical Trial 2: An Iranian trial (by M R Safarinejad) published in 2006 in the International Journal of Impotence Research reported on cabergoline combined with sildenafil in men who failed to respond adequately to sildenafil alone.

370 men completed the six month double-blind trial. 187 were initially given 0.5mg Dostinex a week, increasing to 1mg, a week. 197 were given a placebo. All were given sildenafil, and expert guidance for usage. Average age was 41.5 years (ranging from 21 to 59). In contrast to the M. Nickel trial , men with low testosterone or elevated prolactin levels were excluded and, also in contrast, men who smoked, had hypertension, or diabetes were included. The M Nickel trial was intended for men with psychogenic dysfunction, whereas only 7.3% of men on the Safarinejad trial were so classified. Despite this the increase in IIEF-EF scores in the two trials were broadly similar

The self-assessed IIEF-EF mean average score increased from 10.5 to 19.6 in the treated group (an increase of 9.1) but only increased from 10.3 to 11.3 in the placebo group. The increase in the treated group is better than the 8.3 increase seen in the M Nickel trial; and both trials showed higher increases than shockwave therapy achieved. The average score achieved in the how much have you enjoyed sexual intercourse? question increased from 1.7 at baseline to 3.7 after six months. This seems impressive; however the report states that positive clinical results were seen in (only) 31.2% of patients in the cabergoline group , – based on patients reporting improved erections. And cabergoline treatment was described as only moderately effective . (With inferior IIEF results, M Nickel reported more positively.)

Simple arithmetic suggests that if only around a third of Dr Safarinejad s patients responded, but the average increase for the whole group was around nine points, then those who responded must have increased their score by 27 points! (And that is impossible in a questionnaire that here spans a range from 6 to 30 points.) Perhaps positive clinical results meant an increase of more than, say, five points?

The report states that cabergoline (Dostinex) significantly increased scores relating to penetration and maintenance of erections; and that the notable finding of our study is the superiority of cabergoline over a placebo in increasing all of the measured parameters . The various statements and the various IIEF scores, as so often happens, seem highly contradictory.

Patients with vasculogenic problems were, as might be expected, poor responders to cabergoline (and 62% of patients had two or more vascular risk factors). Those with other somatic conditions had a 28% to 36.4% response rate. The 7.3% of patients with only psychogenic ED had a 75% response rate. Those who responded must have enjoyed a dramatic response to have had such an impact average scores in a trial where 68.8% of patients didn t respond.

75 to 80% of the improvements seen at six months tended to be apparent at two months. A plateau was generally reached at three months.

12.2% of the treated patients reported adverse side effects. 10% reported nausea, 9% reported headaches, 9% dizziness and 6% somnolence. 5.9% of patients discontinued due to adverse effects.

My Experiment: I ordered cabergoline in March 2013, and it arrived twelve days later on 3rd April.

I took 0.25mg the day it arrived, and again three days later, then I started the first of my 0.5mg twice-weekly doses and at first experienced no obvious negative side-effects. By the twelfth days I felt that the cabergoline was having some positive effect: there being more continuous firm npt that night than I can recall, and a particularly easy self-test.

After fifteen days, I felt less sure of the positive effects, and felt a little more concerned about dizziness, tiredness, constipation, shortness of breath, and depressed mood.

I abandoned my 81 day period of p**n abstinence on 16th day of cabergoline. Fluctuations of mood and performance continued. After two months I went to bed with my new girlfriend, and my performance was poor, – worse than I had expected. I had felt exceptionally tired in the week before. Perhaps the explanation is as follows.

After the fifth week of cabergoline I reduced my testosterone supplement on the orders of my endocrinologist, after a blood test showed 29nmol/l, which is at the higher end of the normal range, and I felt unusually tired (even by my standards). Though tiredness is a side effect of cabergoline. But npt seemed to be increasing, and self-testing suggests an improvement in erectile function. Pleasure of orgasms clearly improved too.

I increased my Testosterone back to 50mg daily on 17th June, but a long weekend away with my girlfriend in late June showed (generally after half a litre of wine and a three-course dinner) no improvements. And that was after three months of cabergoline

I wonder if Caberlin isn t quite Dostinex? After four and a half months I had strong doubts that cabergoline is doing anything much for me. On 26th August I stopped taking cabergoline (Dostinex).

Blood Pressure down to around between 105/70 and 100/65 by day 12 (from the usual 120/80) but only less than 90/60 is considered low. B.P. has continued at about that level since.

Uprima & Zyprima: (Also Apokyn, Ixense, Spontane.) Uprima and Zyprima are apomorphine hydrochloride, which works on the hypothalamus as a dopamine agonist and, unlike cabergoline, was marketed specifically as a treatment for erectile dysfunction. The dopamine increases the subliminal signals required for an erection. Contrary to the Wikipedia entry there was no noticeable effect on desire. Though, of course, knowing you re going to perform well generally does act as an aphrodisiac.

Uprima was available in the UK from 2002 to 2006. It was withdrawn, because most doctors thought it ineffective, it made many patients feel sick, and most patients didn t request a second prescription; but it worked well for me every time. A little-known drug called Zyprima seems to be a generic version of Uprima and is available online at around 4 per dose.

The effects of Uprima could last for about three hours, – shorter in duration than Viagra. And so, unlike Viagra, it was better taken after a romantic dinner rather than before.

One advantage of Uprima was that it was little affected by food and alcohol. Another was its speed of onset of action, of about twenty minutes. It s a sublingual drug, absorbing into the bloodstream through the tongue, bypassing the stomach. Doses could be repeated at eight hour intervals. Disadvantages were that you had to let it dissolve for ten to fifteen minutes under your tongue, and it was not always so easy to be discreet if you re trying not to let on that you might have a problem.

The sleepiness sometimes caused by Uprima could be so extreme that I fell asleep in front of the fire before sex. But, upon being woken, I was fine. I didn t experience the reported nausea.

A dopamine agonist acts directly on dopamine receptors, mimicking dopamine.. Yet Uprima did not work for most men, perhaps because in 2002 there was, for obvious reasons, much less internet p__n addiction ? (Though, on balance, I doubt that was a major reason.)

Uprima and Zyprima can be combined with Viagra. I started taking Uprima in January 2003 and was immediately impressed (even though my Harley Street doctor said it hadn t worked on his other patients). It restored the Viagra effect back to the 1999 level. I ve never had a failure with this combination, even after most of a bottle of wine and dinner.

I ordered Zyprima in November 2012. It looks like Uprima, though the pills are round rather than diamond shape, and they taste like Uprima. My first test suggested no effect on erections and no side effects (nausea or somnolence). Unlike Uprima, Zyprima left a residue under the tongue, and gave an unpleasant sensation in the mouth for several days, and mouth ulcers developed. So I assumed Zyprima was not quite the same as Uprima, and was ineffective. However I took a second Zyprima in August 2013, after a heavy dinner and much red & white wine and whisky; and I then went to bed and quickly fell asleep. I awoke at 3am with a firm erection (unusual at 3am) and then drifting in and out of sleep till 7am with much more npt than usual. I dissolved the tablet more vigorously the first and no sore mouth or residue resulted. The following afternoon I tried again, combined with one 10mg orodispersible Levitra: again no residue or sore mouth and two very good responses to p**n-assisted self-tests . The best response I can recall for years, combined with more powerful npt that night than I can recall. No nausea or somnolence associated with either dose.

Other Methods of Dopamine Enhancement:

A blogger on Yahoo Voices opines that prolactin s actions are said to be responsible for about 80% of erection failure in men as well decreased libido . He added you can take about 300-400 mg of p-5-p; a specialized form of vitamin b6 that has been proven reduce prolactin/raise dopamine. L-Tyrosine supplements also raise dopamine levels which should in turn decrease prolactin. The best amino-acid to reduce prolactin is L-Dopa, which directly and efficiently increases dopamine .

The Social Anxiety Support website states the only things that have been reported to increase dopamine receptors are exercise, abstinence from ejaculation, stopping addictions like p____graphy and fasting .

Love and Spring: Biological anthropologist Helen Fisher explained that she had tested 75 people who were in love , with a brain scanner, and found much higher than usual activity in the ventral tegmental area of the brain, which is the area that produces dopamine. This even applied to people who d claimed to be in love after more than twenty years. After a while the anxiousness associated with love tends to vanish to give a more relaxed enjoyment of dopamine.

I recall with my amazing initial response to Viagra in 1999 was when I was more completely in love than I have ever been. My dopamine level must have been high. Perhaps love can be a cure for ED. Perhaps rejection tends to lower dopamine resulting in widower syndrome .

Melatonin levels increase in winter, so that you might feel low. Melatonin suppresses the release of gonadotropins and for many mammals means it s not the breeding season. Spring comes melatonin is reduced and gonadotropins are released, and it s breeding season.

Inhaled Apomorphine: An inhaled version of apomorphine was investigated by the British company Ventura, but Ventura are currently not taking it forward, – though they are looking for a partner to help with development.

A Warning? Serge Kreutz is a writer I ve found interesting for around twelve years. He has written numerous articles on dopaminergics (and other ways to your enhance your sex life). His initial enthusiasm for dopamine agonists is gone, and he now believes that dopamine agonists will physiologically and physically mess up the dopaminergic system of your brain, and after some time will ruin your sexual health . I m not clear why he believes that, for he doesn t explain why, perhaps the problem is similar to excessive p___ography. (Uprima didn t work for him. And he tried other forms of dopamine agonists, including cabergoline.)

Low Carb Low Fat Diet (High Protein Low Fat Diet).

Low Fat Diets are for the anemic, sick-looking muscleless types, right? Well, some implementations of it could give you that opinion. The most famous versions of low fat diets are those of Ornish, Esselstyn and Pritikin and these all are low protein, high carb, low fat diets. Now I have incredible respect for all of these men – in fact, I have no doubt that their research has probably saved my life – but I’ve never really eaten that kind of Low Fat Diet. The reason? I’m just too interested in muscle building and trying to improve my (Skinny Bastard) physique.

I remember looking at their recommended protein levels (~10% of total calories) and thinking, “Well, no way I’m doing that!”  To me it just seemed obvious that one could build upon a standard Low Fat Diet and just substitute some extra protein for all of those carbohydrates.  After all, a standard Low Fat Diet relies on a monstrous amount of carbs during maintenance mode, i.e. when you are not gaining or losing weight.

If you run the numbers, an Ornish/Esselstyn type of Low Fat Diet requires a man to consume around 500 grams of carbs per day.  To me, that seems like a lot, especially for the typical sedentary, office-working male – yeah, like me! – in modern America.  While I do exercise every day and my youngest son keeps me moving, I am pretty sedentary overall.  500 grams seems like an awful lot, unless you can somehow burn it off.

All of these numbers are desireable in my opinion, but I want to really focus on those top two numbers.  The two numbers are two of the most critical to make sure that you arrest or even regress your arteriosclerosis.  It’s no guarantee, of course, but it is a very good sign that you will have plaque under control.  And I mention it, because so many men on this site and The Peak Testosterone Forum need to clear out some plaque.  For example, Dr. Davis has very spartan requirements to regress plaque, which he calls his “Rule of 60,” i.e. LDL < 60, Triglycerides < 60 and HDL > 60.  Some other Low Fat Diet gurus have a little less stringent requirements, which I discuss in my page entitled LDL Levels to Reverse Plaque.

NOTE: Both Dr. Davis and Dr. Gould point out that a Low Fat Diet will not regress or even arrest plaque in all men.  Sometimes it takes greater inverentions. See their books Track Your Plaque and Heal Your Heart for details.

Here are my reads from two physicals where I still have the records:

LDL = 71 mg/dl; Triclycerides = 83 mg/dl (5/28/2013)

LDL = 95 mg/dl; Triglycerides = 71 mg/dl (12/7/2010)

The latter had a little higher LDL than my normal read, but you get the idea:  I have been able to keep both LDL and triglycerides low.

I realize that lowering LDL is controversial right now and that there is a “Cholesterol Doesn’t Matter” theory out there.  I’m not going to get into that here, but suppose you are more in my camp and you are concerned about arteriosclerosis and want to maximize arterial blood flow and nitric oxide.  If so, you will be wondering how one can make a Low Fat Diet practical.  I think the easiest way to do that is to discuss macronutrient ratios, i.e. the percentage of protein, carbohydrates and fat.  The typical Ornish/Esselstyn/Pritikin Low Fat Diet ratios are the following

Protein = 10%; Carbs = 80%; Fat = 10%

I have a different starting point however.  In my case, I want at least 165 grams of protein in order to follow the 1 gram per pound of body weight heuristic for muscle building and athletics in general.  And I actually tweak that up a bit because I consume mostly plant-based proteins to a) save money, b) control IGF-1 (due to a high PSA read) and c) stick to undenatured peptides.  So I actually try to eat around 180 grams of protein per day, simply because plant protein (with the exception of quinoa) are a little less bioavailable.

NOTE:  There are lots of Low Fat animal proteins out there and I discuss meat options in my page on Low Fat Meats. A Low Fat Diet does NOT has to have a lot of plants, but it definitely does not have to be strictly vegetarian: both Pritikin and Gould encourage the consumption of animal protein for example.

Another deviation for me since I am 53:  I only need about 2,300 calories per day.  In my younger days, I had a nearly infinit metabolism.  However, that has definitely ramped down and I just can’t pack it away like I used to.  Furthermore, I also like to eat a few nuts and/or dark chocolate every day.  This allows me to bump up my % Total Fat to 15%.  I am not talking about much in the way of nuts here:  a couple small squares of dark chocolate or just a few walnuts or almonds and that’s it.  But bumping this up to 15% still fits the research definition of a “very low fat diet,” and allows me to displace a few more carbohydrates.

When all is said and done, here are my targeted macronutrient ratios:

Protein = 31%; Carbs = 54%; Fat = 15%

You’ll notice that my protein / carbohydrate ratio is 1.71, which is respectable according to the theories of Dr. Barry Sears regarding inflammation.  But the key thing is that, if you run the numbers out, I only need a little over 1,200 calories from carbs or 309 grams per day.  This is a much more manageable amount of carbs, even for a middle-aged guy like myself.

Something else that I think really helps me is that I am a Grazer.  Right now eating lots of small meals is out of vogue and you have strategies such as intermitent fasting rising in popularity.  But I just feel fantastic eating a bunch of small meals throughout the day.  Eating a big meal, which can hammer testosterone as I document in my page on Testosterone and Meal Size page, often leaves me tired and groggy.

With small meals, I have excellent energy. I have even made this work in my career by eating a small amount of quinoa or fruit or some granola bars along with some protein powder as a pre and post workout meal.  (I usually go to the gym over lunch.) Doing it this way, I never have to worry about beta cell killing post-meal blood glucose spikes and I feel alert all day and evening. I cannot imagine eating any other way, but we all have our preferences I realize. The disadvantage is that at lunch and dinner, I also eat small meals. Fortunately, my wife is understanding and knows that I will keep my portions down. When we go out to eat, we usually share a meal and that works out perfectly.

In my case, I actually eat about 7 of these small meals per day.  I’ll eat first thing in the morning, 3-4 times at work and 2-3 times when I get home.  What this means is that my typical “meal” averages out to about this many grams of each macronutrient:

Protein = 26 grams; Carbohydrates = 44 grams; Fat = 5.5 grams

Notice that this is the perfect protein level for muscle building. Most protein powders have a 20-25 gram serving size and the studies show that around 20 grams is the right “dose” for hypertrophy.  Eating these small meals insures that I get a nice steady supply of protein throughout the day as well.

Now there is a theory out there that our cells need rest in order to get rid of waste and replenish/recuperate themselves.  Obviously, I do not follow that theory.  I can only say that I have eaten that way for 5+ years and feel very good.

Do I have any cautions though?  My only warning is:  don’t cheat!  What do I mean by that?  Well, I have talked to many men who have stated, “I tried low fat and I just didn’t feel good.”  Then I chat with them and find out that they they are consuming almost entirely for carbs one of the following:  wheat and oatmeal, both of which can really spike blood sugar in some men, and fruit juices, which can be high in fructose. Obviously, you’re not going to feel good unless you stick to low glycemic, whole food carbs.

So it’s very important that you eat good, low glycemic carbohydrates, or you could hurt yourself on a Low Fat Diet.  Dr. Bernard’s work showed that, if you eat a low glycemic, Low Fat Diet, you can actually reverse diabetes and very significantly lower your A1C.  For more information, I discuss this in my page on Low Fat Diets and Diabetes.

I get my carbohydrates primarily from vegetable/fruit smoothies and quinoa, millet and legumes that  Iprepare in a rice cooker.  I will also sometimes have raisins and granola bars, but I always keep the amount small.   And I religiously get at least 10 servings of fruits and vegetables every day.  If there is one thing you are going to do for your health, this is probably the most important, something I discuss in my page on The Benefits of Fruits and Vegetables.

One last comment is that I feel that a Low Fat Diet is the perfect complement to HRT. With HRT, you get a nice boost to your hormones and, therefore, neurotransmitters, and, with a Low Fat Diet, you get arterial protection and a boost in blood flow and nitric oxide.  In other words, you get the brain, gonads and arteries all supercharged. These can combine nicely and really help a middle-aged or senior guy’s sex life.  Been there!

CAUTION: There is some evidence that eating a lot of protein may not be a good anti-aging strategy. I still do it any way, due to the benefits to my physique and the excellent cardiovascular parameters it provides me. But “eyes wide open” and I recommend reading my page on The Potential Dangers of Protein for more details.

The counterargument is that many of the supercultures are low fat or pretty close and eat a LOT of carbs.  And Nathan Pritikin ate this kind of Low Fat Diet almost all of his adult life and did just fine.  He stayed thin all of this life as far as I know AND died with perfectly clear arteries.  Even so, that many carbs still made me a bit uncomfortable.

Again, my choice was obvious:  add in some protein and subtract out an equal amount of carbs.  And that is exactly what I did in proportions that I describe below.  Before we go into the numbers, I want to point out that I have found this way of low fat eating to produce great stats. I was glad that I had kind of stumbled into this way of eating when I saw that produced these kind of numbers:

A High Protein Low Fat Diet Macronutrient Ratios

Testosterone Treatments - Peak Testosterone

Ready for some unorthodox testosterone treatments that actually have either some research or a recongized expert behind them? Now, first of all, I do not advise necessarily any of these: I am mostly writing about them, because they are interesting and instructional and/or because there are some big names involved:

1.  Poloquin’s Strategies.  Chalres Poloquin is one of the premier trainers in the world and has trained many elite athletes in his day.  He is also the champion of German Volume Training.  So he’s known for getting results.  He has a unique treatment strategy for sagging testosterone through usage of various (for the most part) herbal extracts such as tribulis, licorice, etc. that supposedly help boost testosterone. [1]  (See Reference for details.)

I don’t think anyone has any idea as to long term saftey of these supplements and one should keep in mind that Poloquin has a vested interest in the supplement label.  Still, his strategy gives some interesting insights into testosterone production.

2.  Onion Juice.  We covered this in our link on Antioxidants and Testosterone, but giving onion juice to rats boosted their testosterone threefold.  However, we are not sure what it did to their social life!  (No one knows the long term safety, or even effectiveness, of onion juice on men.)

3. Good Posture and Good-Looking Women. As I cover in my link on Boosting Your Testosterone Now, standing in a powerful pose and/or hanging out around attractive women can boost your testosterone significantly. I leave you trying to figure out how to pull that one off…

There are other strange things that will raise testosterone, but no medical or health professional would ever recommend.  For example,  if you absorb enough triclocarban in hand sanitizer through your skin, it may amplify testosterone. [4] This is potentially dangerous for children, as testosterone is suspected by some experts in autism and other pediatric disorders. No one really knows how much is absorbed nor the long term effects of triclocarban a at this point.

Also, did you know that smoking actually boosts testosterone?  Of course, it also hammers the arteries and endothelium, but it does actually have a net positive effect on testosterone.

Again, I do not recommend anyone smoke or start using hand sanitizer as “the clear” Barry Bonds-style, especially good bioidentical testosterone treatment options are available. And hanging around other good looking women may get you a frying pan to the back of the head. Nevertheless, some of these solutions are interesting and may foreshadow more natural approaches that can be used in the future by men struggling with low testosterone.p>

REFERENCES:

1)  Articles/Article/47/Testosterone_Boosters_-_How_I_Help_My_Clients_the_

2)  https://www.mikemahler.com/articles/Dihydrotestosterone.html

3) https://www.lef.org/magazine/mag2000/jan00-cover2.html

4) Endocrinology, 2008 Mar, 149(3):1173-9, “Triclocarban enhances testosterone action: a new type of endocrine disruptor?”

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

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

Lower Dose Testosterone - Peak Testosterone

From what I have seen on the Peak Testosterone Forum, most men starting out on HRT (TRT) want to go as high as their doctor will let them. The reasons are obvious, right?  More libido, better erectile function, more muscle obviously?. The answers to these is not at all obvious and the honeymoon stage is often over quickly – within a few weeks or months of strong start with testosterone.  I have even seen an interesting countertrend of late: men wanting to go lower with their dosage of testosterone.  Below I have put together some interesting cases of men doing just that or of men struggling with what is clearly overly high testosterone dosages for their physiology.

Before you read the cases below, keep in mind that a good percentage – I’d guess a half or two thirds – of men on a well-run protocol experience a net positive benefit from being on testosterone therapy.  It may take a few months and some fine tuning, but they get there and are glad overall that they did.  And a pretty good percentage of men that have unsuccessful experiences have medical conditions ,such as low SHBG, severe depression and anxiety, obesity, heart disease, etc.  The stories below are not meant to scare any one away from HRT but rather point out that reasonable dosing is imperative for some men.  Remember:  dosage is everything and it’s better to play it safe and start low.  You can always boost your testosterone a little later if you need it.

Below are Seven Reasons that Low Dose Testosterone Are Often Better for Many Men. (I don’t mean ridiculously low by the way.  When I first went on HRT, my urologist put me on a weak compounded testosterone cream that did not even boost my testosterone over 500 ng/dl.  This was of minimal benefit.  However, I have found that neither do I need testosterone levels near the top of the range either, i.e. approaching 1200 ng/dl.)

1. Better Morning Erections.  There are a few of us on the Peak Testosterone Forum that have noticed that our morning erections were stronger on the last day before our cypionate injections, when testosterone and estradiol were lowest. And we also have noticed that we started our HRT cypionate experience with fairly high dosages initially and probably benefited from the “jumpstart” effect.  However, as time went on, we felt worse on the high dosages and had to slowly taper off.  (You can read the commentary in  this thread if you are interested.) For example, I have been doing very well on a 40 mg every 3.5 day protocol, i.e. about 80 mg/week.  This is about half the dose that my initial HRT clinic put me on!

And notice the irony:  his doctor gave him more testosterone to feel better, but it actually produced the opposite response.  No, more is not always better.

3. Sexual Dysfunction. This is a story about a man put on Nebido and, unfortunately, once you are injected with it, there is no going back.  It is based on the long-lasting testosterone ester undecanoate and injection frequency varies widely between 8 and 12 weeks generally.  Therefore, one injection will affect you for months afterward and this man started off with nightmare experience:

“Hi, been on nebido for 10 months and it doesnt work, its not that i dont feel any effect it actually makes me worse the higher T gets. When I take an injection its very quickly complete loss of erection, lower libido, fatigue, harder to sleep, less energy and lots more. The first 4 weeks is the worst then it slowly starts going back, after 12 weeks when T is down to 8-9 most of the problems from the injection have disappeared and now I get an injection every 8 week so its anything but pleasant, with injection every 8 week my T level is 19 right before next injection, range for testosterone is 10-30.” [2]

Some of you more savvy readers will note that in the case of #1 and #2, there was either inadequate estradiol management or none.  That is true, but I would point out that men often feel worse even when Arimidex is used.  And Arimidex can effect the clotting cascade as well.

5. Anxiety, Agitation and Nightmares. One man on our forum was put on a high dose of 200 mg of testosterone cypionate every two weeks.  Of course, this is an antiquated and outdated protocol, but it underscores what can happen if a man takes too much:

“After the second injection, I felt agitated and anxious later that night. (last Friday).I had a follow up appointment today, and told the Doc that I’ve had anxiety attacks, and surges of energy- completely amped up, vivid nightmares, and completely agitated. He said it was extremely rare, and usually only on extremely high overdoses.” [4]

A similar story was echoed by one of our senior posters, who said, after being boosted into the mid 900’s, that “this is exactly what I am experimenting for the past 2 weeks or so I switched my injection protocol to be: 60mgT E3d with 250IU HCG, IM. Between 1/9 and 2/3 My T and E came up to 949(tt) 32.5(FreeT) and 29(ultrasensitive E2) I slowly, began waking up with more and more anxiety. Caused by nothing. Yesterday I could barely sit still at work, everything drove me nuts, every email, every person…. I felt so [expletive deleted] anxious.” [5]

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

6. Elevated Blood Pressure and Pulse. This is quite common and, of course, is counterproductive to your long term health.  Research has shown that prehypertension is dangerous to your arteries and read this page to see why an elevated heart rate is the same:  The Cardiovascular Dangers of an Elevated Pulse Rate. Notice how quickly and powerfully it hit this man: “”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.” [6]

7. High Hematocrit. If you go too high with testosterone, you can end up with hematocrit, hemoglobin and/or RBC counts.  This is because testosterone is involved in red blood cell production and so, if you go too high with your testosterone dosage, you can put your body into overdrive.  This can have very serious side effects that we have seen from time to time on the forum, including shortness of breath, facial flushing, high blood pressure, etc.  Potentially, it is very dangerous, as illustrated in this Story of Abusing Testosterone. Occasionally, a man cannot lower his hematocrit low enough (by donating blood usually) and will have to actually go off of HRT entirely.

SUMMARY:  Many men actually do better with their peak testosterone in the mid upper range of testosterone. In some cases, the mid range or even lower mid range may produce better results.  Testosterone levels are very individual and no one size fits all.  Going for a lower dosage on your testosterone level will generally produce less side effects and decrease your risk of having to actually quit HRT (TRT) altogether.

1)  https://www.peaktestosterone.com/forum/index.php?topic=6216.0

2)  https://www.peaktestosterone.com/forum/index.php?topic=5492.0

3) https://www.peaktestosterone.com/forum/index.php?topic=4575.0

4) https://www.peaktestosterone.com/forum/index.php?topic=2262.0

5) https://www.peaktestosterone.com/forum/index.php?topic=6611.0

6) https://peaktestosterone.com/forum/index.php?topic=1250.0

Progressive Muscle: An Easy to Lower Stress - Peak Testosterone

The Benefits of Progressive Muscle RelaxationWhat’s a little neuroses among friends? Not much nowadays. Mental disorders are shockingly common in modern, industrialized societies. There are many reasons for this, including poor diet, chronic stress, lack of social support, lack of sleep and so on. Low testosterone can also increase anxiety, mood disorders and depression. Regardless of the reason, men are struggling with maintaining mental health and very often turning to pharmaceuticals for help.

This is problematic for many reasons including the many side effects of the typical drugs in this class.  And long term safetly is simply not known either.  Even worse, these medications often punch below the belt and lead to erectile dysfunction, orgasmic dysfunction or loss of libido.  (See this link on Erectile Dysfunction Drugs for some information.)

Sadly, many men turn to a pharmaceutical answer simply because it’s easy and seems legitimized by the fact a physician recommended it without even thinking there might be a more natural alternative.  Here is where Progressive Muscle Relaxation (PMR) can step into help and provide huge benefits.  Progressive Muscle Relaxation is a very simple technique that can be done by anyone in a relatively short amount of time.

And it has huge benefits.  Most of these benefits are in the psychological realm, because PMR is a proven cortisol reducer.  However, Progressive Muscle Relaxation also has the huge benefit of optimizing testosterone and erection through this same cortisol-lowering mechanism. Remember: anytime you lower cortisol, you are likely going to support and even improve testosterone (and muscle gains).  (NOTE: Elevated cortisol can even destroy neurons!  In fact, I have a number of (I hope) informative articles on How Cortisol Affects Men.

1) Holist Nurs Pract., 2003 Jan-Feb, 17(1):41-7. “Effects of progressive muscle relaxation on blood pressure and psychosocial status for clients with essential hypertension in Taiwan”

2) JCO, June 1991, 9(6):1004-1011, “A randomized clinical trial of alprazolam versus progressive muscle relaxation in cancer patients with anxiety and depressive symptoms”

3) Psychother Psychosom 2008;77:119-125, “Effects of Progressive Muscle Relaxation Training on Anxiety and Depression in Patients Enrolled in an Outpatient Pulmonary Rehabilitation Program”

4) APPLIED PSYCHOPHYSIOLOGY AND BIOFEEDBACK, 1976, 1(3):253-271, “Biofeedback and progressive relaxation treatment of sleep-onset insomnia: A controlled, all-night investigation”

5) Journal of Behavior Therapy and Experimental Psychiatry, Sep 1983, 14(3):251-256, “Treatment of insomnia in cancer patients using muscle relaxation training”

6) Journal of Abnormal Psychology, Jun 1974, 83(3):253-260, “A comparison of progressive relaxation and autogenic training as treatments for insomnia”

7) Journal of Consulting and Clinical Psychology, Jun 1978, 46(3):389-404, “Psychophysiological effects of progressive relaxation in anxiety neurotic patients and of progressive relaxation and alpha feedback in nonpatients”

8) SUPPORTIVE CARE IN CANCER, (2005), 13(10):826-833, “Efficacy of progressive muscle relaxation training and guided imagery in reducing chemotherapy side effects in patients with breast cancer and in improving their quality of life”

9) Behavior Therapy, Spring 1989, 20(2):261 282, “Behavioral treatment of panic disorder”

10) Behaviour Research and Therapy, 2988, 26(1):13-22, “Applied relaxation vs progressive relaxation in the treatment of panic disorder”

11) Journal of Behavior Therapy and Experimental Psychiatry, Dec 1994, 25(4):283 291, “A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder”

12) Journal of Substance Abuse Treatment, Aug 1992, 9(4):365 370, “The treatment of substance abusers diagnosed with obsessive-compulsive disorder: An outcome study”

13) APPLIED PSYCHOPHYSIOLOGY AND BIOFEEDBACK, 2005, 30(4):375-387, “The Impact of Abbreviated Progressive Muscle Relaxation on Salivary Cortisol and Salivary Immunoglobulin A (sIgA)”

14) Biological Psychology, July 2002, 60(1):1-16, “The impact of abbreviated progressivemuscle relaxation on salivary cortisol”

15) International Journal of Stress Management, Aug 2006, 13(3):273-290, “Effects of a single session of large-group meditation and progressive muscle relaxation training on stress reduction, reactivity, and recovery”

16) Journal of Bodywork and Movement Therapies, Jul 2002, 6(3):177-182, “Parkinson’s disease symptoms are differentially affected by massage therapy vs. progressivemusclerelaxation: a pilot study”

19) Journal of Psychosomatic Research, Dec 2001, 51(6):721-728, “The effects of stress management on symptoms of upperrespiratory tract infection, secretory immunoglobulin A, and mood in young adults”

20) Brain, Behavior and Immunity, Accepted Jun 27 2008, “Counter-stress effects of relaxation on proinflammatory and anti-inflammatory cytokines”

21) Exp Aging Res, 1984 Winter;10(4):211-4, “Effects of relaxation and mnemonics on memory, attention and anxiety in the elderly”

22) Neuropsychological Rehabilitation, 1999, 9(1):31-34, “Progressive Muscle Relaxation in the Management of Behavioural Disturbance in Alzheimer’s Disease”

23) Journal of Nervous & Mental Disease, Mar 1993, 181(3), “A Comparison of Behavioral Group Therapy and Individual Behavior Therapy in Treating Obsessive-Compulsive Disorder”

Remember that one of our biggest enemies is cortisol.  In fact, I have a number of (I hope) informative articles on How Cortisol Affects Men. And PMR is a specialist when it comes to cortisol control.  Again, although, no studies echo this, anything that effective manages cortisol, stress and poor mental states is going to improve erection-related issues (and relationships in general).

What about meditation instead?  Meditation is great but 1) generally requires a greater time commitment and 2) often comes with spiritual overtones which makes many men uncomfortable.  Progressive Muscle Relaxation is a straightforward,. secular technique widely used in the psychological community that was designed by a physician and psychotherapist, i.e. no gurus need be involved.  (There are several good books and many web articles on secular meditation as well for those interested.)

So consider these 15 Great Benefits of Progressive Muscle Relaxation and get started asap:

1.  Blood Pressure. One study out of Taiwan on men with hypertension (high blood pressure) showed that PMR had an immediate effect on both systolic and diastolic blood pressure, lowering them by an average of 5.44 and 3.48 mm, respectively. [1] And four weeks later, the participants had any additonal decreases in blood pressure of  5.1 and 3.1 mm, respectively.

These are very respectable improvements, but one study showed even more amazing gains.  For even more – more than 30 actually – ways to lower blood pressure, see the this link on Erectile Dysfunction and Hypertension.

2.  Pulse. The first study above showed a powerful ability to lower pulse rate, lowering it by 2.35 beats/min initially and 2.9 beat/min additionally (after four weeks). [1] For more information on the important of your heart rate, see the this link on Pulse and Cardiovascular Health.

3. Cortisol. Progressive Muscle Relaxation has been shown in several studies to decrease cortisol levels. Furthermore, it works very well even when the abbreviated form of PMR is used. [13][14]

4. Dopamine. PMR, at least, was found in Parkinson’s patients to increase dopamine levels. [16] Many of us, undoubtedly, have lost some of our ability to make dopamine as we age and thus it seems likely that PMR can raise dopamine somewhat even in non-Parkinson’s men.

5.  Anxiety. A number of studies have shown in a variety of populations that Progressive Muscle Relaxation can help relieve the actual symptoms of stress as well. For example, one study of victims with cancer showed that PMR was as very close to being as effective as a medication cocktail. [2] PMR did the same thing with patients who were suffering from chronic breathing difficulties. [3]

6.  Depression.  Both of the above studies showed patients significantly improving their depression. [2][3] Again, these studies and a few other like them show that this simple relaxation technique helps the men that need it most.  The higher your stress, the more likely Progressive Muscle Relaxation is to make a big difference. For additional information, see this link on Research-Backed Depression Cures.

7. Insomnia. Many studies have shown that Progressive Muscle Relaxation help with many kinds of insomnia.[4][5][6] I know that I have received significant positive feedback after giving this to many men to help with falling asleep. For other research-backed methods, see this link on Practical Sleep Aids.

8. Neurotic Persons. Are you a high stress person? One study showed that PMR helped lower the stress response in neurotic individuals. [7] It will likely help almost anyone under chronic stress and acting a little “eccentric” as well.  (See #6.)

9) Unusually Stressful Situations.  Several studies show that muscle relaxation can help with stressful situations, one of the most severe being a study on chemo patients. [8] It also decreased the nausea and vomiting associated before and after the therapy.

10. Panic Disorder. A couple of studies show that PMR can help reduce symptoms of panic disorder. [9] However, it doesn’t seem to work in all patients in this area, but is certainly worth a try.  It may best be used incombination with other therapies. One study found that it improved signficantly 38% of patients though, even when used by itself. [10]

11. Post Traumatic Stress Disorder (PTSD). Returning war veterans and many other men who have suffered a traumatic past can suffer from this debilitating condition that is very hard on heart and brain health.  Progressive Muscle Relaxation has done well in a couple of studies with PTSD, both solo and in conjunction with other therapies. [11]

12. Obsessive Compulsive Disorder (OCD). One study showed good results and the authors wrote that “Both individual and group interventions proved to be equally effective at reducing distress caused by OCD symptoms, general depression, and anxiety by the end of treatment, although patients in the individual behavior therapy condition demonstrated faster reductions in OCD symptom severity. Patients in the group and individual behavioral interventions were able to maintain their gains at 6-month follow-up. Implications of these findings for outpatient treatment are discussed..” [23]

13. Handling Stress. Many studies have shown that practitioners manage stress more effectively than controls. [15] PMR affects the stress hormone – see #3 – as well as perceived stress and stress reactions as well.

14. Inflammation (TNF Alpha and IL-6). A number of studies have shown that many men can lower their TNF alpha and IL-6 through PMR. The two cytokines play a valuable role in the body but also trigger the nasty inflammatory cascades that cause so many problems and lead to hardening of the arteries, diabetes and many autoimmune disease and cancers. One study took second year med students – a pretty stressed out crowd if there ever was one – and put them under stress. It was found that those who practice Progressive Muscle Relaxation twice per day (for 15 minutes using an Abbreviated form that concentrated on the upper extremities) had greatly reduced TNF alpha levels (and IL-6). [20] If your stress levels are low, the benefit will undoubtedly be less, but how many reading this are not under a nearly constant assault of various stressors that are part of modern life?

15. Memory. It is no secret that cortisol is hard on neurons and the brain in general. Stress can literally unwire your neurons and one of the most vulnerable locations is the hippocampus, which has been shown to actually shrink under a variety of stressful conditions. This is why several studies have found that PMR can increase memory in several subpopulations, such as seniors and those with mild to medium dementia. [21][22] If you are middle-aged or beyond, you will very likely experience a memory boost from regular practice.

As you can see, Progressive Muscle Relaxation helps with almost every major psychological issue.  Few doubt that it will not help with the everyday stressors of life and offer cognitive and psychological protection and maintenance at the same time.ors of life and offer cognitive and psychological protection and maintenance at the same time.

HOW DO YOU DO PROGRESSIVE MUSCLE RELAXATION? One of the nice things about Progressive Muscle Relaxation is that it is very easy to do. Medititation can take significantly more discipline and experience – it’s well worth it of course! – but with PMR you can get started almost instantly. Basically, you just tense and release all the muscle groups one by one. I have always started at my feet and worked my way up to the face. However, you can start north and head south as well. I tense for about 10 seconds and then release for 20 seconds and do this most nights before sleep, because it is so helpful in getting me to instantly fall asleep. Here is an article that describes more detail as to how to do it but recommends 5 seconds of tension and 10 of release: PMR Protocol (Australian Government Site). The key thing is that you should feel VERY relaxed after doing this, and, of course, you don’t want to overtense any injured areas.

WEIGHT LIFTERS:  Notice that PMR will likely help protect your hard-earned muscle by limiting cortisol levels.

REFERENCES:

Dopamine, Sleep and Erectile Dysfunction - Peak Testosterone

The late night light exposure significantly lowers melatonin release that often accompanies this, which disturbs sleep even further.Sleep deprivation, again from the late nights watching p**rn, further lowers dopamine as we will discuss below.

1) See the Psychology Today Blog post by Marnia Robinson & Gary Wilson entitled “P**rn-Induced Sexual Dysfunction: A Growing Problem.”

2) PLOS Biology, Received: November 25, 2011; Accepted: May 10, 2012; Published: June 19, 2012, “Circadian-Related Heteromerization of Adrenergic and Dopamine D4 Receptors Modulates Melatonin Synthesis and Release in the Pineal Gland”

3) Neurosci, 2012 May 9, 32(19):6711-7, “Evidence that sleep deprivation downregulates dopamine D2R in ventral striatum in the human brain”

4) The Journal of Neuroscience, 11 October 2006, 26(41): 10577-10589, “Dopaminergic Control of Sleep Wake States”

5) https://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm

6) Neurology, Mar 1 1999, 52(5):932, “Striatal dopaminergic function in restless legs syndrome”

7)  Neural Transm, 1981;50(1):39-45, “Effect of sleep deprivation on dopamine receptor function in normal subjects”

8) https://blogs.scientificamerican.com/scicurious-brain/2012/06/04/sleep-deprived-mind-your-dopamine/

9) Neuropsychiatr Dis Treat, 2007 Feb, 3(1):145 152, “Prodromal non-motor symptoms of Parkinson s disease”

10) Psychiatry (Edgmont), 2006 July, 3(7):62 68, “Sleep-Disordered Breathing”

11) https://www.psychologytoday.com/blog/the-power- rest/201011/are-you-restless-sleep-loss- irritability-and-violence

12) Rush University Medical Center, Released: 7/26/2013, “Sudden Decline in Testosterone May Cause Parkinson s Disease Symptoms in Men”

Yes, if you put 1-3 together, you havee a recipe for bedroom problems and even young men, who normally have ample physicial buffers to weather any sexual storm, can end up with some erectile dysfunction.

How Sleep Controls Dopamine

Many people joke around about sleep and are proud of their quasi-insomnia and ability to put off sleep. It’s really nothing to be proud of:

1.  Downregulation of Dopamine Receptors. Researchers have shown that lack of sleep downregulates, or “numbs” if you will, brain dopamine receptors. [3] This means that these receptors are less responsive to external stimuli, such as those in the bedroom. Why would your brain play such a nasty trick on you?  Because the brain needs repair – something I hope to cover on another page soon – and is trying to force you to sleep.  Basically, you are not going to enjoy or be stimulated by anything until you put in that pillow time.

Sleep is NOT a relaxing time for your brain.  Yes, the body is shut off and resting, but for your brain, it is a highly active time for restoring neurotransmitter levels and remapping memories from short term to permanent storage and discarding irrelevant information. You need both ample NREM (non-REM) and REM (Rapid Eye Movement) sleep cycles for maximum brain and bedroom health.

It should also be noted that , in this case, the researchers found significant evidence that there was NOT an increase in brain dopamine causing the loss of receptor sensitivity. [8] Either way, it does not really matter:   the net effect is the same.  Your key hormones and many other processes are effected.

What Does This Sleep-to-Dopamine Connection Do To You?

The hallmark symptoms for the early (prodromal) stages of Parkinson’s Disease, where the brain has almost lost all of its dopamine-producing cells, are depression as well as “feeling of incapability, reduced reaction to emotional stimuli, and inability to experience pleasure, reduced reaction to emotional stimuli, and inability to experience pleasure.” [9] Now notice this symptoms list from pre-Parkinson’s where the brain is struggling with a big decrease in dopamine.  Notice anything unusual about it?  Yes, it matches the symptoms of sleep deprivation almost exactly. [10][11]

Researchers have also documented what we all know is inherently obvious about losing a lot of sleep:  we usually become irritable, unemotional; our mood sours and we become “zombielike”.  This is more than coincidence.  Part of the reason for this is the affect on dopamine receptors.

NOTE: It’s actually a little more complicated than this as Parkinson’s Disease will affect other neurotransmitters as well.  Nevertheless, dopamine is “smoking gun” associated with this condition.

How Dopamine Controls Sleep

What many men do not realize is that dopamine affects the quality of our sleep in many key ways.  This is important to emphasize, because it so critical that we protect our brains and neurotransmitters.  Consider these factors:

1.  Melatonin Control.  Unknown until very recently, dopamine plays a critical role in controlling melatonin release. [2] This neurotransmitter actually carries out a yin yang activity in the pineal gland and will actually inhibit norepinephrine and, correspondingly, melatonin release.

2.  REM Sleep Governance. Researchers also found that dopamine regulates our critical REM sleep cycle.  Mice whose dopamine is pharmaceutical suppressed can actually have their REM cycle completely eliminated! [4] When dopamine is allowed to return, REM sleep patterns come back as well.

3.  RLS (Restless Leg Syndrome). As brain dopamine levels fall, RLS, a fairly common sleep disorder, can set in.  Researchers can treat it with “dopaminergic agents” – drugs that increase dopamine – showing the correlation between the two. (This can lead to a long term worsening of symptoms, however, that begin to creep into the daytime hours as well.) [5][6] These drugs come straight from Parkinson’s treatment therapies, because Parkinson’s also results from decreased brain dopamine levels.

NOTE:  How can you protect your brain?  See these links on Hdr_Brain_Learning_Memory for many ideas.

NEWS FLASH: Researchers recently found that low testosterone actually induces Parkinson’s like symptoms in mice. [12]  Could low testosterone play a role in the onset of this disease?  It’s too early too tell and it should be pointed out that Parkinson’s Disease has been associated with other environmental and nutritional risk factors such as pesticides and copper.  (See my link on Pesticides and Parkinson’s for example.)

REFERENCES:

Blood Pressure and Testosterone - Peak Testosterone

Well, like I always say: “Testosterone affects EVERYTHING in men.”

Sure, that’s an exaggeration.  But not by much and a great example of that is blood pressure. A muscle-building, libido-increasing hormone androgen like testosterone might seem completely unrelated to arterial blood pressure but nothing could be further from the truth.  Testosterone not only can lower your blood pressure a little in the short term but can definitely protect it long term and the studies show this quite clearly.

Now we’ll discuss just why in more detail, but let me say that if you have hypertension (or prehypertension), testosterone is not going to be a miracle cure for you. Getting your testosterone to respectable levels will probably help though, but for much more powerful solutions, see my pages on Natural Ways to Lower Blood Pressure and How I Lowered High Blood Pressure.

CAUTION: It is important to mention that a side effect for a small minority of men on HRT (TRT) is elevated blood pressure however. Many doctors do not realize this, so get him or her measuring your blood pressure.

However, if your testosterone is low and you boost it sufficiently, you can lower your blood pressure. The reason is that testosterone boosts the activity of eNOS (endothelial nitric oxide synthase) and, if you’ll recall, eNOS is the same enzyme that Viagra and Cialis affect.  While testosterone does not have as powerful of an effect as these pharmaceauticals, it does make a difference. And this effectively means higher nitric oxide levels which means more relaxed arteries and lower blood pressure.

Is there any evidence for this phenomenon? One 1988 study found that the higher the testosterone, the lower the blood pressure. Of course, the first thing one might suspect is that the this relationship had only to do with the weight of the participants of the study. However, the researchers had the foresight to look at this and found that not all of the decrease in blood pressure with increasing testosterone could be explained by BMI (obesity levels). [1] A follow-up study year later verified the same result:  testosterone was strongly correlated with blood pressure and only part of it could be explained by extra body fat levels. [2]

One test that researchers have done is looking at the reverse direction, that is whether or not testosterone therapy can improve blood pressure.  If testosterone impacts blood pressure directly, then lower testosterone men who receive HRT should find their blood pressure lowered. One older (1992) study on obese men receiving testosterone therapy noted that “insulin resistance … improved and blood glucose, diastolic blood pressure and serum cholesterol decreased.” [4]

A follow-up study a few years later found similarly remarkable results, which included “decrease of visceral fat mass…, by increased insulin sensitivity…, by a decrease in fasting blood glucose, plasma cholesterol and triglycerides as well as a decrease in diastolic blood pressure.” [5]

Notice the incredible changes in multiple cardiovascular risk factors that were improved with testosterone therapy, including the lowering of blood pressure.  Blood pressure is dangerous to many tissues of the body, because even small increases can lead to “scarring” of arteries and damage to smaller blood vessels and even connective tissue. The kidneys, eyes and brain are very vulnerable and often incur long term damage.

A more pronounced effects is testosterone’s ability to protect men from high blood pressure and hypertension in the long term. The reason is simple:  testosterone is inversely correlated with arteriosclerosis and hardening of the arteries. [3] Again, one might not think that testosterone would protect arteries, but that is, in fact, the case.  Testosterone’s ability to raise nitric oxide levels helps protect arteries.  Just as important, it also 1)  lowers insulin levels, which significantly reduces the risk for insulin resistance and 2) helps men maintain and even lose weight.  Both #1 and #2 are good for the entire cardiovascular system and help prevent hypertension and prehypertension.  It also can help prevent erectile dysfunction as well.

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

NOTE: Hormone levels, especially testosterone and estradiol, can powerfully affect a man’s sex life and much of it centers around how this hormone affects our blood pressure:  for more information, see my link on Testosterone and Erectile Dysfunction.   Hormone levels, especially testosterone and estradiol, can powerfully affect a man’s sex life and a little of it probably centers around how this hormone affects our blood pressure. In most men, testosterone will have a slight blood pressure lowering effect, raising nitric oxide, boosting libido and decreasing hardening of the arteries. Again, the biggest signs of low testosterone have been found to be sexual in nature, as I document in my link on Hypogonadism and Testosterone.

CAUTION: Not all researchers are as positive about testosterone and blood pressure.  In fact, one recent study coming from the standpoint of the kidneys, which are front and center in the regulation of blood pressure, stated that “in sum, net effects of androgen action seem to be vasoconstriction, atherosclerosis and stimulation of the renin-angiotensin-aldosterone system.” [6]

1)  Journal of Hypertension, 1988, 6(4):329-332, “Blood pressure and endogenous testosterone in men: an inverse relationship”

2) Eur J Endocrinol, Jan 1 2004, 150:65-71, “Association of endogenous testosterone with blood pressure and left ventricular mass in men. The Tromso Study”

3) The Journal of Clinical Endocrinology & Metabolism, Feb 1 1997, 82(2):682-685, “Association between Plasma Total Testosterone and Cardiovascular Risk Factors

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

5) Obes Res, 1995 Nov, 3 Suppl 4:609S-612S, “Testosterone and regional fat distribution”

6) Kidney and Blood Pressure Research, 2008, 31(2), “Testosterone and Blood Pressure Regulation”

Hormones, HRT and Cholesterol - Peak Testosterone

However, a 2011 book called The Magic of Cholesterol Numbers by Dr. Dzugan found a way to turbocharge these results and apparently even exceed that which is seen with standard TRT.  It may also make results even more consistent.

The importance of Dr. Dzugan’s works is incredibly profound, and I think, unfortunately, largely ignored.  I believe that implementing his ideas could save literally tens of millions of lives every year and billions in health care costs on top of that.  That is how important this is, and so I hope, after you read this article, you will spread the word.  Dr. Dzugan’s protocol can greatly lower cholesterol levels even with no changes in your diet.  (I highly encourage you to improve your diet if you have not of course!  Check out my pages on https://www.peaktestosterone.com/.)

Here is a summary of what he Dr. Dzugan did in a couple of studies from the above (must-read) book:

1.  He measured pregnenolone, testosterone, DHEA-S, cortisol, vitamin D  and progesterone.  (p. 170)

3. He only used bioidentical hormones, i.e. hormones identical to the ones the body naturally produces.

Hormonodeficit Hypothesis of Hypercholesteremia. Now why does he concentrate on the above hormones?  Why not melatonin or T3/T4 or prolactin., etc.?  The answer lies in the following “Hormone Production Lines:”

Cholesterol ==> Pregnenolone ==> DHEA ==> Testosterone ==> Estradiol and DHT

Cholesterol ==> Pregnenolone ==> Progesterone ==> Cortisol

Note that both of these hormonal pathways start with cholesterol at the top.  Now let’s say that, for whatever reason, one of the downstream hormones resulting from cholesterol is low, i.e. pregnenolone, DHEA, testosterone, progesterone or cortisol.  The Hormonodeficit Hypothesis of Hypercholesteremia posits that the body will do what it needs to do to try to boost that hormonal deficiency, i.e. it will boost cholesterol production in order to try to jack up all downstream hormones.  .

Check out the results of his two studies:

1.  Study on Adults of All Ages with High Cholesterol.  The above protocol dropped cholesterol levels 30% in men from 253 mg/dl to 191! (p. 171)

2.  2002 Study.  This study looked at 12 early senior aged men and found their total cholesterol dropped an average of 22% from 228 to 177 mg/dl.

Study #2’s results were particularly profound, because HDL remained unchanged.  Statins will lower both HDL and cholesterol, but by restoring hormones, you appear to get nothing but benefits.

This may partially explain some of the very impressive results that we have seen in the TRT cardiovascular studies lately.  The most recent study showed that in men that were low testosterone and had severe heart disease, TRT lowered cardovascular incidents by 80%!  This is much better than a statin, although statins are given to those with any testosterone level.  For details, see my on The Latest Testosterone Therapy Cardiovascular Studies. I would add that cholesterol-lowering is not the only cardiovascular benefit from TRT, something I cover in depth here:  Testosterone and Heart Disease.

CONCLUSION:  Current standards of practice are often decades behind the research and Dr. Dzugan’s work is one example of this.  Patients with cardiovascular issues are typically prescribed statins and maybe a baby aspirin and sent on their way.  Of course, lifestyle changes are the most important, but, clinically, it is clear that checking for certain hormonal deficiencies is nearly as critical.  Again, I recommend reading Dr. Dzugan’s book above and checking out the details of his protocols and findings.  He methodically and thoroughly describes the underlying issues and solutions.

One interesting and practical story having to do with with all of this is the famous low fat plant-based plaque regresser Dr. Esselstyn, who I cover on this page:  https://www.peaktestosterone.com/. Dr. Esselstyn commented that his diet will almost always lower cholesterol below 150 mg/dl but there are a certain percentage of men that he has to give a statin to in order to achieve that target cholesterol value. These men may very well be deficient in one of these hormones and just need bioidentical hormone therapy in order to avoid having to take a statin. (They could also be hypothyroid which wil artificially raise total cholesterol levels.)

This, by the way, is not is not a criticism of Dr. Esselstyn, whose work has undoubtedly saved literally tens of thousands of lives.  I am just pointing out that some men have stubborningly high cholesterol and hormonal issues is probably often the problem.  Why is this important?  Because statins are rife with side effects, something I cover here:  https://www.peaktestosterone.com/.

1)   The Magic of Cholesterol Numbers by Dr. Sergey Dzugan and Konstantine Dzugan

Weight Lifting: How It Can Boost Your Sex Life.

Will weight lifting help you in the bedroom? Oh yeah!

I think it’s pretty obvious that a muscular bod is going to be much more appealing to the great majority of females.  But weight lifting has much, much power in the bedroom than simple sex appeal: it’s a performance booster extraordinaire as I’ll outline below

Lest you think I’m exagerrating, here are five ways that weight lifting should greatly enhance your sex life:

1. Testosterone. We have already covered how weight lifting can boost baseline testosterone long term in our link on Testosterone and Weights. One of the most well-known studies showed increases in LH, FSH and testosterone in strength trained athletes over a two-year period. [1]

2. Testosterone to Cortisol Ratio. Senior males had significant positive improvements in total testosterone and their testosterone/cortisol ratios from weight lifting. [5] Obviously, this ratio along with testosterone to estrogen are, arguably, the two key hormonal ratios that men need to control and improve in most cases. This was verified (in the short term) in another study where T increased significantly but C remained relatively the same. [7]

1)  Journal of Applied Physiology, Dec 1988, 65(6):2406-2412, “Neuromuscular and hormonal adaptations in athletes to strength training in two years”

2) Sports Medicine, Oct 2000, 30(4):249-268(20), “Strength Training in the Elderly: Effects on Risk Factors for Age-Related Diseases”

3) Journal of Abnormal Psychology, Feb 1985, 94(1):102-105, “Sex differences in perceptions of desirable body shape”

4) Journal of the American College of Cardiology, Sep 2003, 42(5):861 868, “Anti-inflammatory effects of exercise training in the skeletal muscle of patients with chronic heart failure”

5) Acta Physiologica Scandinavica, Feb 1994, 150(2):211-219, “Serum hormones and strength development during strength training in middle-aged and elderly males and females”

6) Annals of Internal Medicine, Mar 1996, 124(6):568-572, “Weight Training Improves Walking Endurance in Healthy Elderly Persons”

7) Journal of Applied Physiology, January 1997, 82(1):49-54, “Testosterone and cortisol in relationship to dietary nutrients and resistance exercise”

3. Improves Endurance. One study of seniors found that weight lifting improved walking endurance. [6] This is the kind of result that has been found by many athletes:  strength helps athletic performance in many ways.  And let’s face it:  what you are often doing in the bedroom is downright athletic, O Weekend Warrior! In other words, weight lifting can help you go that extra mile without collapsing on the floor just before the big event.

5) Weight Management.  Forget the idea that men like big “hunks.” That may be true for a few women, but research shows that men think that women like a “bigger” man than they really do. [3] That means most of us guys need to manage and even lose a little weight, especially as we age.  Of course, any and all exercise will help us lose weight, but weight lifting has special powers:  it ramps up your metabolism for literally days afterwards.

6) New Sex Positions.  Need some spice in your love life?  Well, weight lifting can open up a whole new world for you.  Imagine being able to actually lift your women without passing out or falling backward.  That will get her to take notice.  Here are some ideas: 10 Sex Positions That Burn Serious Calories. Now don’t hurt yourself of course, but the point is that even if you don’t do one of these more exotic position, you are going to be able to do a lot more than you could before.

CAUTION:  Read my Weight Lifting Arterial Cautions about the high blood pressure and arterial stiffening potentially associated with weight lifting.  You may want to consider Volume as an alternative.

REFERENCES:

SHBG: Causes and Natural Solutions for Low SHBG.

Many men have learned that SHBG binds to a little over half of their testosterone molecules and renders them “inactive”.  Because of this, as SHBG goes up, unbound testosterone goes down.  Many physicians like to focus on free testosterone, which is your T that is not bound to SHBG or another protein called albumin.  And the rule is simple:  as SHBG goes down, free testosterone goes up.  And free testosterone is considered the form of testosterone that is active and available to act on tissues.

NOTE: It is actually a little more complicated than that as testosterone bound to albumin can be easily unbound and used as well.  But the point remains the same.

So clearly a man wants low SHBG, since it indicates that his free testosterone would be improved, right?

Wrong! As it turns out, low SHBG is often a sign of many of the worst chronic diseases that we face in modern, civlized societies.

1.  Obesity and Being Overweight.  Low SHBG is associated with obesity. [1] The reason is probably due to a loss of insulin sensitivity as we’ll discuss below.

2.  Lower Insulin Levels. There is evidence that increasing insulin lowers SHBG. [2]  Studies have found this both in vitor and in vivo as well, i.e. on human subjects and male ones at that. [3] Therefore, SHBG is often a flag or warning signal of insulin and blood sugar issues. In other words, SHBG does not cause insulin resistance but does indicate it.

NOTE:  You may also want to read my link on The Causes of High SHBG.

3.  Cardiovascular Disease, Diabetes, Metabolic Syndrome and Decreased Longevity. Due to #1 and #2, mumerous studies have shown that low SHBG can actually indicate decreased longevity.  For example, one study found:

“Low SHBG and IGFBP-1 were both associated with an increased prevalence of abnormal glucose tolerance and the metabolic syndrome, but only SHBG was associated with diabetes mellitus. SHBG was less influenced by body mass index than IGFBP-1. Low SHBG indicated increased cardiovascular and coronary disease mortality; the association remained after adjustment for abnormal glucose tolerance, but not after adjustment for prevalent cardiovascular disease.” [1]

This is about as ugly as it gets.  Low SHBG is correlated with three of the biggest killers of  men:  heart disease, diabetes and Metabolic Syndrome.  A more recent and larger scale study verified the above results but did find that all mortality risk was due to its association with diabetes, lowered HDL and weight gain. So SHBG does not seem causative, but rather often a sign that something else is wrong.  By the way, it was “ischemic heart disease” risk that was associated with lowered SHBG in this case, which basically means accelerated arteriosclerosis and decreased blood supply to the heart.

4. Apnea. I document in my link on Apnea and Testosterone how apnea can affect your baseline testosterone levels by 30 percent or more. Other studies have shown that apnea significantly lowers SHBG as well. [7] So if you have low testosterone and low SHBG, this is something to consider.

5. Obesity.  Because weight gain can lead to loss of insulin sensitivity, low SHBG values are correlated to extra weight.

6. Inflammation. One study (in women) found that lowered SHBG was associated with elevated CRP (C-Reactive Protein), one of the “gold standard” markers of systemic inflammation that is linked to heart disease, dementia and autoimmune disorders. [8]

7. Hypothyroidism. One study found that low SHBG was associated with hypothyroidism and could even be reversed by correcting the underlying thyroid issue. [9]

8. Elevated Triglycerides. Several studies have found that elevated triglycerides, which are a risk factor for both heart disease and erectile dysfunction, are also tied in with low SHBG. [10] Of course, this should be no shock since elevated triglycerides usually come from eating meals with an overly high glycemic load and refined carbohydrates.

NOTE:  HRT will lower SHBG some and steroid usage even moreso.

So, as you can see, having low SHBG and the supposedly elevated free testosterone that accompanies it, is usually nothing to brag about. This means that, in general, if you have low SHBG, you should find the underlying cause and correct it.

This may not be as easy to do as you might think, because most doctors are very unlikely to do anything about a lowish value of SHBG, because the lab ranges are VERY wide.  On the Peak Testosterone Forum I have seen ranges such as 7-47 nmol/l, 10-50 nmol/l or even 10-80 nmol/l. In all cases the lower value for SHBG is extremely low and so will not even be on your doctor’s radar. However, values below about 20 can be indications of underlying issues and should not be ignored in my opinion.

Hopefully, one way or another you can get your doctor to consider doing the following:

1. Monitor. Test you for any of the (appropriate) conditions above.  Many of these you can get as part of a standard physical or well-being check, so you may want to ask your physicain about that possibility.

2. Correct Medical Conditions. Correct any issues found in #1.  Work with your doctor and do what you have to do:  treat your thyroid dysfunction; exercise; lower the glycemic load of your diet;  lose those extra pounds; get a CPAP machine.

3. Natural Cure #1. The root cause for low shbg is generally the beginnings of fatty liver and insulin resistance and, as mentioned above, low SHBG is good predictor of future diabetes.  One of our posters went after his low SHBG with a vengeance in this regard and exercised (heavily), took berberine and liver cleanses, lost weight and did other things to get rid of the fatty liver and insulin resistance.  He actually more than doubled his SHBG and is one of the very few men I know that have done so.  You can read his story here in my page on How to Cure Low SHBG.

4. Natural Cure #2 (For Men With High Estradiol)? I had a report from a long time poster who was suffering with low SHBG and high estradiol levels.  This man actually took an AI (aromatase inhibitor which lowers estradiol) and found that his SHBG increased significantly, an outcome that is counterintuitive in my mind.  This is a little scary, because I think the original poster did estradiol conversions incorrectly and the man did not have high estradiol.  Thus an AI could drive his estradiol too low and possibly lead to bone loss if done long enough.

In any event, it seem to have cured this man’s low SHBG.   The description and possible explanation is as follows:

“A young male presented with chronically elevated E2 [estradiol] and low SHBG. Physicians prescribed testosterone, which only exacerbated the SHBG/E2 imbalance. His problems persisted for years. His entire youth, in fact. I suggested that he try an AI-only mode of treatment.

This worked to bring his E2 within normal range, and … surprisingly, his SHBG increased to from the single digits and low teens to 30! SHBG has remained at 30, even though AI has been discontinued. He claims that he is “85% cured.” His FT is now a bit low (FAI of 0.65) and I have suggested that with T supplementation, he might actually bring himself to a completely normal hormonal profile.

It seems like he was able to wake up dormant SHBG expression by simply starving E2. I have no other explanation for this case. I have never, in 10+ years of reading about these kinds of cases, seen a liver completely correct itself with regard to SHBG expression. Perhaps, like insulin receptors, receptors in the liver can become increasingly desensitized to estrogen? In these cases, a course of AI over a 3 month period can completely resensitize them… or so it seems.” [17]

NOTE:  Be sure to measure your estradiol with the correct test (LC-MS/MS) for men.

There are also many natural ways to raise SHBG as well.  I have a few ideas below.  Of course, it is most important to correct underlying medical conditions, but here are some other methods that can help which perhaps could be combined synergistically to really raise SHBG:

5. Coffee.  Several studies on women showed that coffee raised SHBG.  Finally, this was verified in a study on men as well. [12]

6. Green Tea. A couple of studies, admittedly on women, have shown that green tea increases SHBG levels. [13]

7. Lower Fat Diets and Fiber. One study on men showed that low fat diets increased SHBG, probably due to the fact that they increase insulin sensitivity. [14] So one simply way to likely raise your SHBG a little is to eat a low glycemic, low fat diet.  I discuss in my link on Low Fat Diets and Diabetes that this way of eating will likely reverse any prediabetes or diabetes that you have and lower arterial plaque at the same time.  A smiliar study echoed the same result and suggested that fiber may play a role as well. [15]

8. T3 and T4 (If Hypothyroid). One study found that “Thyroid hormones (triiodothyronine (T3) and thyroxine (T4)) increase SHBG accumulation in HepG2 cell culture medium over 5 days, and increase cellular SHBG mRNA levels.” [16] A hypothyroid man that goes on thyroid medication will often see his low SHBG rise.

NOTE:  If you actually have high SHBG and not low, see my link on the Causes of High SHBG and Natural Solutions.

The concerns here are that 1) adding HRT may lower an already low SHBG even further, 2) may sidetrack a man from dealing with underlying medical issues and 3) will simply create an overabundance of free estradiol.

Now I definitely agree with 2.  All reasonable underlying issues should be tracked and investigatedby by or with your doctor.  Argument 1, however, may be weak.  To test this hypothesis, it would be best to look for research with participants that are likely to have low SHBG.  One such study was done on senior men with Metabolic Syndrome (prediabetes) and the researchers found that giving these men testosterone gel did indeed lower their SHBG a little.  However, this was for a very small net change in testosterone. [12]

The same study boosted men’s testosteorne much more significantly with testosterone undecanoate and actually found that the particpants’ SHBG rose.  Thus in this case, the testosterone actually helped.  Why did the undecanoate do the trick where the gel did not?  The reason is probably the fact that the undecanoate gave over a 100% increase in testosterone and testeosterone lowers insulin.

As far as #3, one has to realize that the difference in, say, free testosterone from low to midrange SHBG is not that great.  For example, let’s say you were a lowish testosteorne guy with total testosterone of 400 ng/dl and had SHBG of 32, which is a very “normal amount”.  That SHBG of 32 nmol/l would give you a free testosterone level of 8.31 ng/dl.  A man with SHBG of 20 and total T of 400 would have free testosterone of 10.5.

This is an increase of 26% in free T. Now this is a bump, admittedly, but it is not the kind of bump that is going to make that much difference. Thus SHBG does matter, but it is not the force of nature that many men think it is when it comes to elavating testosterone levels.  However, it does matter in the sense that it can foreshadown many medical conditions that need to be dealt with.

However, what I hear “on the streets” is that men who are low SHBG or just high converters to estrogen tend to do better with 3X weekly subQ injections. I believe the reason for this is that with smaller doses of testosterone cypionate more often, you get a smoother ride with lower estradiol peaks.  The reason this is probably important is that if you are low SHBG, then you are going to be higher free estradiol. And, of course, elevated free estradiol causes many issues for us men.

REFERENCES:

1)   The Journal of Clinical Endocrinology & Metabolism, Mar 1 2005, 90(3):1550-1556, “Sex Hormone-Binding Globulin and Insulin-Like Growth Factor-Binding Protein-1 as Indicators of Metabolic Syndrome, Cardiovascular Risk, and Mortality in Elderly Men”

2) The Journal of Steroid Biochemistry and Molecular Biology, Jun 1995, 53(1-6): “Interrelations between sex hormone-binding globulin (SHBG), plasma lipoproteins and cardiovascular risk”

3) The Journal of Clinical Endocrinology & Metabolism, Jul 1 1996, 81(7):2515-2519, “Acute and chronic regulation of serum sex hormone-binding globulin levels by plasma insulin concentrations in male noninsulin-dependent diabetes mellitus patients”

4) Diabetes Care, May 2004, 27(5):1036-1041, “Testosterone and Sex Hormone Binding Globulin Predict the Metabolic Syndrome and Diabetes in Middle-Aged Men”

5) Arch Intern Med. 2007; 167(12):1252-1260, “Sex Steroids and All-Cause and Cause-Specific Mortality in Men”

6) International Journal of Impotence Research, 2003, 15(Suppl 4):S14 S20, “Hypogonadism and diabetes”

7) J Clin Endocrinol Metab, 1989 Feb, 68(2):352-8, “Neuroendocrine dysfunction in sleep apnea: reversal by continuous positive airways pressure therapy”

8) Ann Epidemiol, 2006 Feb, 16(2):105-12, Epub 2005 Oct 10, “Sex hormone-binding globulin and serum testosterone are inversely associated with C-reactive protein levels in postmenopausal women at high risk for cardiovascular disease”

9) Horm Res, 1990,34:215 218, “Reproductive Endocrine Functions in Men with Primary Hypothyroidism: Effect of Thyroxine Replacement”

10) Am J Clin Nutr, l996, 63:22-3l, “Association of dietary factors and selected plasma variables with sex hormone-binding globulin in rural Chinese women”

11) Journal of Andrology, 29(1):102 105, January-February 2008″A Dose-Response Study of Testosterone on Sexual Dysfunction and Features of the Metabolic Syndrome Using Testosterone Gel and Parenteral Testosterone Undecanoate”

12) Eur J Endocrinol, Aug 1 2003, 149:145-152, “The associations of age, lifestyle factors and chronic disease with testosterone in men: the Tromso Study”

13) Reproductive Sciences, Jan 2006, 13(1):63-68, “Effects of Chinese Green Tea on Weight, and Hormonal and Biochemical Profiles in Obese Patients With Polycystic Ovary Syndrome A Randomized Placebo-Controlled Trial”

14) The Journal of Clinical Endocrinology & Metabolism, May 1 1987, 64(5):1083-1085, “DIETARY LIPIDS : AN ADDITIONAL REGULATOR OF PLASMA LEVELS OF SEX HORMONE BINDING GLOBULIN”

15) Am J Clin Nutr, Dec 1996 64(6):850-855, “Effects of dietary fat and fiber on plasma and urine androgens and estrogens in men: a controlled feeding study”

16) Journal of Molecular Endocrinology, 2009, 43, 19 27, “Thyroid hormones act indirectly to increase sex hormone-binding globulin production by liver via hepatocyte nuclear factor-4a”

17) https://www.peaktestosterone.com/forum/index.php?topic=5794.0

Low SHBG SolutionsWhat about HRT and Low SHBG?

Yes, Regressing Plaque Reduces Heart Attacks and Angina.

The reality is that most of these bloggers know that LDL-P and arterial plaque matter.  Furthermore, they also know that the majority of men with high cholesterol and high regular LDL will also have high LDL-P.  Yet they leave out those key details from their unsuspecting readers in almost every case, leaving them more vulnerable to developing heart disease.

And all of this is why I will list the Evidences that Reducing Plaque Reduces Heart Attacks and Angina:

NOTE:  Angina is the excruciating heart pain that many men with advanced heart disease experience.

But the fact remains that statins can not only regress plaque, but they also reduce significantly the risk of heart attacks and angina.  There are at least a half dozen studies that show that statins can do all of these, but let me cite a interesting example below:

The ACAPS Study.  Lovastatin was found to result in the following:

“In men and women with moderately elevated LDL cholesterol, lovastatin reverses progression of IMT in the carotid arteries and appears to reduce the risk of major cardiovascular events and mortality.” [2]

The POSCH study is another one that shows similar results.  And, again, there are several dozen studies that show improved heart outcomes with statins and ins some cases even reversal of atherosclerosis.  Furthermore, it is well-accepted by just about everyone:  statins reduce the relative risk of a heart attack by about 15-30%.

Is a 15-30% risk reduction worth the risk of side effects?  I’ll leave that up to you and your situation, but my point here is that statins work and they often regress plaque while they are at it.  No, they’re not perfect due to their side effect profile, but they do clearly show that one can regress plaque and decrease MI risk at the same time.

2. Diet + Statins.  The next logical question  is the following:

“What would happen if you combined both statins and anti-plaque dietary and lifestyle modifcations at the same time?”

This is exactly what Dr. K. Lance Gould did in his clinical practice and his results are stellar. Basically Dr. Gould believes in a Low Carb, Low Fat Diet.  He attempts with this type of diet to bridge the gap between the low carb and low fat folks by limiting both carbs and fat thus getting the best of both worlds.  As an fyi, his diet is low medium carb and not a true ketogenic diet.  However, he significantly limits carbs by insisting that you consume fruit, low fat meats and dairy to displace grains.  You can have some grains, but it needs to be quite limited.

Now, for those of you, concerned about fruit, remember that fructose, interestingly enough, does not cause much of a spike in insulin.  And keeping control of one’s insulin is the key in keeping yourself from going into a pattern B lipid profile.  He also wants you to eat lean proteins and non-fat dairy so that they extra protein will displace more carbs.  This is nice for men doing weight lifting or strength training as they want to consume a solid amount of protein anyway.

So what kind of results do you achieve by eating Low Fat, Low Carb + a Statin?  The results are very impressive: to say the least:

“1.  Reverses or stops progression of disease in over 90% of people.

2.  Decrease incidence of heart attacks, balloon dilation, bypass surgery by 90%.

3.  Improves coronary blood flow by PET.

4.  Relieves angina, increasess activity level, energy, sense of well-being.

5.  Treats diffuse disease, throughout length of arteries.

6.  Heals endothelium lining of arteries.

7.  Serves as valid alternative or supplementation to balloon dilation, bypass surgery.” [7]

3.  Lifestyle Only. Of course, most men reading this probably do not want anything to do with statins.  We all know they have lots of side effects and can increase the risk of muscle damage and diabetes – the cure can be worse at times than the disease, eh?  This is why a couple of researchers stepped in and looked at solutions with no statins and only lifestyle changes.  Here are the two most famous:

a. Esselstyn. Dr. Caldwell Esselstyn advocates a largely vegan, low fat, whole foods diet.  My understanding is that he pushes the vegan aspect because plants do much a great job of boosting nitric oxide and nitric oxide is nature’s anti-inflammatory.  Of course, I agree with him in the sense that consuming a lot of plant foods boost nitric oxide, and this was a large part of my book:  The Peak Erectile Strength Diet.

And it’s hard to argue with Dr. Esselstyn as he also achieved excellent results, some of which he tracked long term:

“In contrast, a 5-year experience has shown excellent results in patients with severe coronary artery disease who followed a plant-based diet containing <10% fat and who took cholesterol-lowering medication.  During this arrest and reversal therapy their lipid levels fell significantly, they experienced no new coronary events, and angiography showed that their disease had stabilized and in some cases selectively reversed. The goal at study onset in 1985 had been to achieve a total serum cholesterol of <150 mg/dl, the level seen in cultures where coronary artery disease is virtually absent.” [6]

He also followed up his own patients who were generally placed only on a low fat plant-based diet and, again, noted excellent results among these patients.  See reference #6 for details.

b. Ornish. Dean Ornish low fat diet study is arguably the most famous in this lifestyle-only category.  His study participants made not just dietary changes but also engaged in stress management, moderate exercise, smoking cessation and social interactions.  His results were also excellent:

“The average percentage diameter stenosis regressed from 40 0 (SD 16 9)% to 37 8 (16 5)% in the experimental group yet progressed from 42 7 (15 5)% to 46 1 (18 5)% in the control group. When only lesions greater than 50% stenosed were analysed, the average percentage diameter stenosis regressed from 61 1 (8 8)% to 55 8 (11 0)% in the experimental group and progressed from 61 7 (9 5)% to 64 4 (16 3)% in the control group. Overall, 82% of experimental-group patients had an average change towards regression.” [3]

Esssentially, 5/6ths of the particpants regressed plaque.  Furthermore, this same study logged a 90% reduction in angina rates after one year!  And, perhaps best of all, plaque regression continued to improve for up to five years!

CONCLUSION:  There are many ways to regress plaque pharmaceutically or with lifestyle changes or both.

1)   J Am Coll Cardiol. 2004 Jun 2;43(11):2142-6. Optimal low-density lipoprotein is 50 to 70 mg/dl: lower is better and physiologically normal.

22) Circulation, 1994 Oct, 90(4):1679-87, “Effect of lovastatin on early carotid atherosclerosis and cardiovascular events. Asymptomatic Carotid Artery Progression Study (ACAPS) Research Group”

3) The Lancet, 21 July 1990, 336(8708):129 133, “Can lifestyle changes reverse coronary heart disease?”

4) JAMA, Dec 16 1998, 280(23), “Intensive Lifestyle Changes for Reversal of Coronary Heart Disease”

5) Lancet, 1994 Nov 19, 344(8934):1383-9, “Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S)”

6) https://www.dresselstyn.com/reversal01.htm

7) Heal Your Heart, Dr. K Lance Gould, p. 194

Orgasmatarianism - Peak Testosterone

I consider myself an Orgasmatarian. Simply put, that is eating in order to maximize one’s ability to achieve an erection and orgasm. Furthermore, I eat this way not, mind you, out of simple hedonism, but rather because of the solid research that stands behind such a way of living. Yes, indeed, in the same way that the eye is the window of the soul, the penis is the window of a man’s general health.  In fact, researchers have found that erectile dysfunction is a decent predictor of future heart disease.

The reason for this is simple:  erectile dysfunction is generally caused in large part by endothelial dysfunction, meaning that the lining of the arteries has become damaged.  And damaged arteries mean less flexibility, responsiveness and nitric oxide.  Most of the risk factors for endothelial dysfunction and damaged arteries have same risk factors as cardiovascular disease, dementia and cancer:  Elevated Inflammation, High Blood Pressure and Metabolic Syndrome just for starters.

One study even showed that a man has, on average, five years after the inception of his erectile dysfunction before he has a cardiovacular event of some sort.  See my link The Dangers of Erectile Dysfunction for more details.  The bottom line is that you likely just have a few years to straighten yourself and your penis.

If this is an issue for you, my sympathies are with you.  The tragic irony is that Western culture has twisted everything and made it very difficult for a man to maintain and preserve his erections and testosterone.  Steak and fries are a “man’s meal”.  But are they?  A consistent diet of steak and fries will leave most men with fried arteries, blood vessels and capillaries.

And beer is supposed to be the ultimate “manly drink”.  Well, there’s nothing wrong with a beer or two – it won’t kill you.  I love tequila myself as much as the next guy.  But why is any drink that lowers testosterone and raises estrogen manly in any way? (See my link on Beer and Testosterone for the research behind this.) I’ll take Pomegranate Juice any day as a real manly drink:  it will boost nitric oxide, lower inflammation, lower blood pressure and possibly clean out your penile arteries.  (Pomegranate juice can interact with some medications.) It may even Boost Testosterone a little.

At some point I just stopped and jumped out of the cage. Did I want to be the typical guy on six pharaceuticals for blood pressure, cholesterol and diabetes?    No thank you.  Instead, I decided to eat the way that the healthy cultures eat and boost my nitric oxide and blood flow with every meal I eat instead of slamming those into the pavement every time I opened my mouth.

At some point, if it’s not too late, you have to try to Go Natural.  I changed my diet to clean, whole foods instead of processed, packaged foods. I increased my exercise.  I started sleeping more.  All of these things are what our bodies are naturally used to.

Sleep, exercise, diet (and weight loss for some of you) – these are big engines that can give you your life back. You don’t have to limp around like all the guys around you.  There is simply no reason not to get your health back.  Remember:  the body can generally heal itself if you feed it the right nutrients and get rid of all the toxic garbage.  But you have to give it a rest.

NOTE:  Remember that plant-based nutrition has INCREDIBLE advantages for erections and testosterone.  This is countercultural right now, but read this link on The Benefits for Men of Plant-Based Nutrition.

So become an Orgasmatarian.  Go natural.  All I know is that since I become an Orgasmatarian, I’ve never regretted a day…

Saturated Fat: Why Is It Bad For You? - Peak Testosterone

“What is saturated fat bad for you?” One reader wrote in with essentially this question.

Many men have heard from their doctors and others that saturated fat is the root of all dietary evil. However, then they find many sites that claim the exact opposite:  saturated fat is not only good for you but will boost testosterone and improve your health.  When all is said and done, most guys just walk away from the subject figuring that there is no resolution.  Now, before I go on, let me say that I am actually talking about the excess saturated fat that is in the typical American Diet.  So keep that in mind as you read the detailed response I gave tto a reader, but the bottom line is this:

While saturated fat is slightly pro-testosterone – see my page on   – it has many studies showing that it will lower nitric oxide levels, clump together cells in the blood and lower blood flow.

Of course, it DOES matter how much saturated fat that you have.  But, if you have too much, it will hamper the ability of your arteries to relax unless you diligiently exercise post meal, and, yes, that will be bad for erections for men over about 45+.  So this is the primary reason that you will see me opposed to higher saturated fat levels in the diet for most men in modern, urban settings.  I am not saying saturated fat is consummate evil, but it can definitely be problematic for middle-aged and senior men, and this is the reason I flag it on this site.

Again, For those interested, read below my response to this reader:

QUESTION:

Hi thanks for the quick reply. I’ve read through alot of articles lately that saturated fat is actually good for you, and that it was a “myth” that it was bad. Just curious… have you seen these articles?

ANSWER:

This is a great question and one that I actually cover in depth on my site. However, Peak Testosterone has grown so large over time that it is probably difficult for guys to find out my coverage on the subject.

Below is a bullet point summary of the position that I take on the rather involved issues of saturated fat, cholesterol, diet, testosterone and the like:

CAUTION: Please talk to your doctor before making any changes, especially if you have any medications or medical conditions.

1. Constant Exercise Required. Some cultures do very well on a high saturated fat diet. These cultures, however, have very high activity and exercise levels and low stress levels.  Studies have shown that post-meal exercise can overcome the negative arterial effects of high saturated fat diets.  However, most men in Western societies do not exercise after every meal, so this is a moot point, except to those extremely athletic.

2. Decreased Blood Flow and Nitric Oxide.  I’ll let the research speak for itself:

a) “Consumption of a meal containing saturated fat reduced the antiinflammatory potential of HDL and impaired arterial endothelial function, whereas the antiinflammatory potential of HDL improved after consumption of polyunsaturated fat.” [1] NOTE: Endothelial function is what you need for good erectile, because it refers to the ability of arteries to relax and allow lowered blood pressure and improved blood flow.

b) “Serum lipoproteins and glucose were determined before eating and 2 and 4 hours postprandially. Serum triglycerides increased from 94 55 mg/dl preprandially to 147 80 mg/dl 2 hours after the high-fat meal (p = 0.05). Flow-dependent vasoactivity decreased from 21 5% preprandially to 11 4%, 11 6%, and 10 3% at 2, 3, and 4 hours after the high-fat meal, respectively (all p <0.05 compared with low-fat meal data). No changes in lipoproteins or flow-mediated vasoactivity were observed after the low-fat meal.” [2] NOTE:  Again, vasoactivity refers to the ability of the arteries to relax or dilate and allow increased blood flow.

c) “The saturated fat diet was associated with enhanced noradrenaline sensitivity in small mesenteric arteries from VHF rats (VHF vs. VC, P < 0 05) and blunted endotheliumdependent relaxation in VHF and PHF rats (VHF vs. VC, P < 0 001; PHF vs. PC, P < 0 05). Endothelial dysfunction was attributable to a reduced nitric oxide component of relaxation in VHF rats, and blunted prostacyclin and endothelium-derived hyperpolarizing factor components in PHF rats.” [3]

Again, if you’re a young guy, you’ll probably never notice.  However, as you age, you’ll probably see that these higher fat meals simply do not work for you.

3. High LDL-P and apoB In Some Men. As many of you know, LDL-P is the most important cholesterol number and NOT the standard LDL-C that your doctor pulls during your annual physicial.  (Alternatively, you can use apoB, which is cheaper.)  However, often high LDL-C and high LDL-P go hand in hand.  And what often happens with men consuming a lot of saturated fat is their LDL-C and their LDL-P jump to overly high levels.  High LDL-P can lead to deadly arterial plaque buildup (atherosclerosis) and so this is another reason I oppose high saturated fat levels, unless you are going to carefully monitor LDL-P (or apoB).  I have many pages on the subject here:   How to Regress Arterial Plaque and Reverse Atherosclerosis. (NOTE:  I am not saying that all men on high fat diets have this issue.) Remember that plaque in your penile arteries means less nitric oxide down there and you know what that means.

One myth is that only small LDL particles will cause plaque.  This is simply not true and abundant research shows that large LDL particles also cause hardening of the arteries: Large Particle LDL and Arterial Plaque Buildup.

By the way, some of you may protest and say, “What about the Masai?”  The poster children for high fat diets are the Masai, who eat copious amounts of saturated fat. However, their cholesterol is around 150.  The Masai have very low body fat levels and each pound of fat lost leads to a drop in cholesterol of about a point.  One third of Americans are overweight and another third obese, so eating this much saturated fat will often lead to artificially elevated cholesterol levels – saturated fat does boost cholesterol and LDL-C.  There are studies that show that saturated fat does not boost LDL by much.  However, all I can tell you is that men on Low Fat Diets like myself see their LDL and cholesterol drop like a rock.

And virtually all primal societies had cholesterol of 150 or below and they had no heart disease. In contrast, in the U.S. and most modern societies, heart disease is, by far, the number one killer.  Again, it’s not actually not the total cholesterol number that is most important.  It is your LDL-P that really counts and, to date, almost all studies showing plaque reversal involve very low LDL numbers.  I give some thresholds in my link the LDL Levels Required to Lower Arteriosclerosis. And, by the way, the Masai actually were found to have significant atherosclerosis and are not known for tremendous longevity like the cultures that eat lower saturated fat levels, such as the Tarahumara, Hunza, Abkhasians, Vilcabambans, etc.

4. Insulin Resistance.  If you consume enough carbs, consuming a lot of saturated (and total) fat will lead to massive insulin resistance.  Researchers use high fat and high saturated fat diets to induce insulin resistance in research animals all the time! This link has been known for awhile and has been verified in humans on (nondiabetic) participants. [2] Insulin resistance is a male curse and is associated with Metabolic Syndrome, which in turn is associated with decreased testosterone, heart disease and erectile dysfunction. Again, if you exercise like a wild man, you can probably overcome insulin resistance.  But how many of us can commit to walking four hours per day or spending two hours in the gym?

Also, guys who eat Low Carb may or may not have insulin resistance, due to their extremely low carb levels, and should test their post-prandial (post meal) blood sugar levels according to this page:  Normal Postprandial Blood Glucose Levels.

REFERENCES:

1) Lipids And Cardiovascular Disease, August 2006, “Consumption of Saturated Fat Impairs the Anti-Inflammatory Properties of High-Density Lipoproteins and Endothelial Function”

2) Amer J of Cardiology, Feb 1 1997, 79(3):350 354, “Effect of a Single High-Fat Meal on Endothelial Function in Healthy Subjects”

3) The Journal of Physiology, 8 SEP 2004, 517(2), “Cholesterol-independent endothelial dysfunction in virgin and pregnant rats fed a diet high in saturated fat”

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

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

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

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

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

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

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

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

What are the actual numbers of the Tarahumara?

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

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

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

Health Myths That the Tarahumara Shatter

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

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

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

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

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

REFERENCES:

FDA Exposes the Issues with Recent Anti-HRT Cardiovascular

When I read this letter, my jaw dropped, because in it the FDA rebutted the anti-HRT studies better than any other corporate or private source that I have read.  The charges against testosterone therapy were very serious, claiming thatte that HRT increases the risk of cardovascular disease.  For a year or two, I was on pins and needles wondering if the FDA would create restriction or limit access to testosterone.  To my great delight, the FDA actually did the opposite and left detractor licking their wounds.  For once, I feel that the FDA is powerfully watching for us little guys – the ones whose lives have been so transformed by the “Power of T.”  (Not everyone has a great experience with HRT, but for many of us, it was a miraculous and life-changing experience.)

The FDA’s response was so compelling, in my opinion at least, that I would urge anyone that is either on or considering going on testosterone therapy to read it. It is definitely not light reading but is definitely worth the effort.

NEWS FLASH:  There have been two major studies, one in 2014 and one in 2015, that showed greatly improved cardiovascular outcomes for men on TRT.  The latter, in particular, showed a 50% reduction in all cause mortality and an 18% and 30% reduction in risk of heart attacks and stroke, respectively.   See my page on The Latest Testosterone Therapy Cardiovascular Studies for details.

BACKGROUND: The letter is actually responding to a petition filed by two physicians, Drs. Wolfe and Carome, who were asking for the FDA to force a black box warning on testosterone products that would state increased CVD (cardiovascular disease) risks.  I looked up these doctors, expecting them to be endocrinologists, who seem to almost universely dislike HRT, and found that they were actually part of an organization called Public Citizen’s Health Research Group, a Big Pharma watchdog lobbying organization.  Now, while I agree that the pharmaceutical industry needs some monitoring, the authors seem to be assuming that everything they do is big, bad and ugly.

However, I always thought the study was laughable when I heard the following fact:  the post-HRT testosterone levels were on average 332 ng/dl!!  And the FDA went for the jugular with that argument.  After all, that is the testosterone of an 85-year-old man and probably not a very healthy one at that!  In my book, Low Testosterone by the Numbers, I document how right around 350 ng/dl, the risk factors increase for many chronic diseases, including osteoporosis, diabetes, Metabolic Syndrome, anemia, depression, erectile dysfunction and hardening of the arteries. In other words, this study deliberately left most of the participants at a testosterone level that has been shown to elevate their risk to be sick. This is a completely unfair way to study HRT as more youthful levels of testosterone greatly lower insulin levels and improve arterial health. It also shows how many docs out there administer crappy HRT protocols!

Some of the other criticisms and analysis of the data are much more involved.  One study was not actually designed to measure heart outcomes but just used peripheral data.  One of the other studies on testosterone did not have the testosterone levels of the patients available – oy vay!  The FDA pulled no punches and pointed out what I stated above:  a significant block of the patients might have had low testosterone and thus been exposed to increased risk of heart disease not lowered.  The devil is always in the details, eh?

The bottom line is that the FDA insisted upon better data and better research and that is entirely appropriate in my opinion. And this is especially true in light of the fact that two recent studies have shown the exact opposite of these four studies, i.e. that testosterone therapy actually improves cardiovascular outcomes.  And, in my page on the recent Testosterone Class Action Lawsuits, I discuss the fact that the original anti-HRT studies do not control estradiol levels, which can have a significant effect on cardiovascular outcomes according to some research.

Testosterone survived all the early attacks surrounding prostate cancer and I believe it will weather this storm as well.  Now, I do want to say that in my non-researcher, non-physician opinion, there are 3 cases where heart disease outcomes may be worse when going on HRT and that these need to be studied or education increase based on what I have seen:

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Vitamin C and Erectile Dysfunction - Peak Testosterone

Sometimes I think Vitamin C should be called the Sex Vitamin. The reason is simple:  it helps in so many ways with bedroom performance, including increasing oxytocin, lowering stress hormones and increasing mood just for starters. However, on this page I want to concentrate on how Vitamin C improves nitric oxide, or the ability of the arteries to dilate and allow more blood to flow.

As we’ll show below, Vitamin C actually excels in these areas, which can best be termed as endothelial function. So what just what does “endothelial” refer to? If you’ve browsed through my site much, you already knows that this refers to damage to the delicate inner lining of your arteries. Classic endothelial dysfunction comes from the typical Western diet and lifestyle that leads to hardening of the arteries and arteriosclerosis. The reason that this is SO critical is that the lining of the arteries are what pumps out nitric oxide. This is critical for heart health, blood pressure control and, yes, erections.

Ascorbic acid improves the endothelial output through five different mechanisms according to one research summary:

“1) decreases in low-density lipoprotein (LDL) oxidation,

2) scavenging of intracellular superoxide,

3) release of NO from circulating or tissue S-nitrosothiols

4) direct reduction of nitrite to NO, and

5) activation of either endothelial NO synthase.” [4]  (A recent study, though, argued against option e. [5])

Now I know these are pretty heady items, but trust me, this is all a beautiful fantasy for us men. And, to make things even better, I would add a couple of other pro-Vitamin C blood flow boosting properties on top of these:

6.  Vitamin C will likely help with maintaining and/or increasing acetylcholine levels, something I talk about in my link on Vitamin C and S-PS (Phosphatidylserine). Acetylcholine is also a vasodilator.  Although it is not quite as potent as nitric oxide, it is important nonetheless for allowing your penile arteries to relax and let blood flow in.

7. Vitamin C (ascorbic acid) “stimulate endothelial nitric oxide (NO) synthesis in a time- and concentration-dependent fashion.” [12] This basically means the more the Vitamin C, the more the nitric oxide.  Woo hoo!

Could this all really be true?  Could such an inexpensive molecule as Vitamin C actually be a significant partner in helping men with their erectile dysfunction by boosting nitric oxide output, lowering blood pressure and increaseing blood flow? The answer is a definitive ‘yes’.

1) https://www.cdc.gov/nchs/data/nhsr/nhsr013.pdf

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

3) Circulation, 1996, 93: 1107-1113, “Ascorbic Acid Reverses Endothelial Vasomotor Dysfunction in Patients With Coronary Artery Disease”

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

5) Free Radic Biol Med, 2004 Jan 1;36(1):123-30, “Coronary endothelial dysfunction is not rapidly reversible with ascorbic acid”

6) Am J Physiol Heart Circ Physiol, 2001 Feb, 280(2):H528-34, “Effect of ascorbic acid treatment on conduit vessel endothelial dysfunction in patients with hypertension”

7) J Cardiovasc Pharmacol, 1999 Nov, 34(5):690-3, “Oral vitamin C reduces arterial stiffness and platelet aggregation in humans”

8) American Journal of Hypertension, Apr 2007, 20(4):392 397, “Supplementation With Vitamins C and E Improves Arterial Stiffness and Endothelial Function in Essential Hypertensive Patients”

9) Clin Cardiol, 2002 May, 25(5):219-24, “Vitamin C preserves endothelial function in patients with coronary heart disease after a high-fat meal”

10) Am J Clin Nutr, 2004 Dec, 80(6):1508-20, “Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts”

11) Biological Psychiatry, 15 August 2002, 52(4)371-374, “High-dose ascorbic acid increases intercourse frequency and improves mood: a randomized controlled clinical trial”

12) Journal of Biological Chemistry, 276, 40-47, “L-Ascorbic Acid Potentiates Endothelial Nitric Oxide Synthesis via a Chemical Stabilization of Tetrahydrobiopterin”

Now you may wonder why you have not heard about this?  Well, this research is a relatively new development, coming mostly out of studies in the last 10-15 years  (See below.)  And there is little profit in Vitamin C, so supplement manufacturers are not spending money marketing this fact.  Yet just look at how many categories of men that Vitamin C is likely to help:

1. Men with Heart Disease. One study of men with existing cardiovascular disease, specifically Coronary Artery Disease (CAD), showed a 53% in FMD (flow mediated dilation, the clinical measurement for blood flow) after a single 2 grams dose.  Even better news followed in the second part of the study where they found that long term administration of a mere 500 mg/day led to a sustained 33% increased in blood flow. [2] Vitamin C likely does this by neutralizing the potent free radical superoxide anion that has been implicated in arterial disease.

Yet another study on CAD patients found similarly astonishing results after a 2 g oral dose of Vitamin C:  “ascorbic acid produced marked improvement in dilation (2.0 0.6% to 9.7 2.0%), whereas placebo had no effect (1.1 1.5% to 1.7 1.5%, P=.003).” [3] Of course, 2 grams in one dose is quite high, but patients would very likely get substantial benefit in vasodilation, i.e. opening or relaxing fo the arteries, from even the more common 500 mg dose.

2.  Men with Hypertension. One study on patients with hypertension (clinically high blood pressure) found that a relatively small dose of 500 mg daily lowered blood pressure significantly. [6]  While it is true that the study found no improvement in blood flow, it is notable that Vitamin C helped these patients with what they needed help with – their high blood pressure.   In other words, Vitamin C seems to help with exactly what is needed in men with artery disease and in men with hypertension.

4.  Men Eating High Fat.  One of the rules on The Peak Testosterone Forum is no pushing of high fat diets.  My reasons for this are many, but the primary ones are that high fat meals induce insulin resistance and endothelial dysfunction, the polar opposite of what men need who are coming to my site.  One example of this is a study where researchers gave men a high fat meal (50 grams of fat) and then 2 grams of Vitamin C to try to compensate for the artery-numbing effects of all the blubber then men has just eaten. Amazingly enough, it worked! [9] Am I suggesting that you megadose Vitamin C in order to handle eating a bunch of fat? Of course not as the obvious solution is simply to not consume all that fat in the first place.

Many other conditions from Metabolic Syndrome to intermittant claudication to homocystinuria also show improvements in endothelial dysfunction and/or some related parameters, testifying to Vitamin C’s miraculous ability to “help just where needed.”  For all of the above reasons – endothelial function, lowered blood pressure, decreased arterial stiffness and vasodilation, Vitamin C shoud be a significant help in improving erectile dysfunction as well.  Of course, the question is this:  is there an actual study showing Vitamin C as improving erectile dysfunction similar to the  Well-Documented Erectile Supplements I discuss elsewhere on my site?

So now comes the all-important question:  has Vitamin C been shown in the studies to improve erectile dysfunction directly?  The answer is ‘no’ – at least as far as I know.  So the hard evidence is not there.  However, there are some good signs and research that point vigorously to such a conclusion;

a) Heart Disease Reduction.  One study found a 25% reduction in heart disease when comparing those taking greater than 700 mg/day versus those who took no supplemental Vitamin C.  This is a significant difference for just one vitamin and is more remarkable considering the fact that the authors used a pool of 7 studies to come up with results. [10] Again, anything that improves heart disease is very likely to improve one’s erections and hardness factor.

b) Frequency of Sexual Intercourse. One study of healthy young males found that Vitamin C increased the intercourse frequency.  The dosage was definitely in the megadose range (3 grams/day), but who cares?!?

Finally, Vitamin C very likely protects your arteries not just with shorter term endothelial dysfunction but in the long term as well. Examples of this abound, including the recent discovery that Vitamin C can lower inflammation (C-Reactive Protein) in at risk men. See my link on How to Reduce Inflammation for more information. There are many other properties of Vitamin C that will do the same, including its ability to lower cortisol and boost mood, all documented in The Many Benefits of Vitamin C.

CAUTIONS: Are there any cautions associated with Vitamin C use?  Well, any supplement as studies as Vitamin C is bound to have a few black eyes along the way and discuss those in my link on Are There Risks with Vitamin C?

DOSAGE: As of this writing, I take 1.5 grams of Vitamin C divided in three doses of 500 mg via Ester-C.  (There are now “generic” versions of Ester-C that are less expensive, but Vitamin C is inexpensive to begin with.  This dosage is definitely megadosing, something I normally do not like to do.  However, my justification for this is that humans are one of the only animals that does not make its own Vitamin C and, therefore, it looks like this was a “bad” mutation that severely decreased our levels of this all-important molecule.  Again, though, read my discussion of Vitamin C – Angel or Devil? for the counterargument.

REFERENCES:

Metformin and Testosterone - Peak Testosterone

REFERENCES:

1) Medical News Today, “Metformin diabetes drug could extend lifespan”, last updated: 8 August 2014, https://www.medicalnewstoday.com/articles/280725.php

2) Can Fam Physician, Apr 2009, 55(4):363 369, “Systematic review and meta-analysis”

3) Reproductive Biology and Endocrinology, 2014, 12:98, “Metformin induces a prompt decrease in LH-stimulated testosterone response in women with PCOS independent of its insulin-sensitizing effects”

4) Obesity Research, Nov 2001, 9(11):662 667, “The Effects of Metformin and Diet on Plasma Testosterone and Leptin Levels in Obese Men”

Metformin also – and this is atypical for medications – may actually help with some of the “Holy Grails” of health:

a) Both an animal and human study show that Metformin may extend life span. [1]

b) Metformin lowers the risk of going from prediabetes to full-blown adult onset diabetes. [2] [Prediabetes is another health epidemic in our culture.]

I’m not much of a pharmaceutically-oriented person, but I admit these are impressive results.  And we have had a number of men on the Peak Testosterone Forum using Metformin with good results.

That said, almost everything comes at a price and it looks like there may be a one with Metformin.  There are now two studies out there that indicate that it may lower testosterone levels, or at least suppress natural rises in T at times:

1.  Women with PCOS. Admittedly, everything is Opposite World with women in the area of hormones (and – I don’t need to tell you – a lot of other things in life as well).  Nevertheless, one recent study showed that in women with PCOS, Metformin led to a decrease in LH-stimulated testosterone. [3]  Women with PCOS usually are insulin resistant and have visceral fat.  Considering that men usually put on visceral fat first and a high percentage over about 35 are struggling with some insulin resistance, this is potentially portentous for males.

2.  Obese Men. Does Metformin lower testosterone in men?  It turns out that a couple of years prior to the above research on women, a study indicated, subtely, that this might be the case.  Unfortunately it was subtle enough that I think it escaped recognition.  First of all, we have to start by reviewing an even earlier study that showed something surprising:  dieting in obese men could actually raise testosterone levels.  This is actually counterintuitive, because normally dropping your calories significantly leads to a corresponding drop in testosterone.  This can make dieting even more miserable for some men.

However, obesity will usually lead to a significant drop in testosterone in and of itself, something I cover in my link on Testosterone and Weight Loss. And the reason is that, as you gain fat, you also increase aromatase and this converts an ever-increasing amount of your testosterone into estradiol, the so-called “bad” estrogen. (Men do actually need estradiol.) Obese men often experience such a large decrease in testosterone from this process that they end up hypogonadal – it happens all the time.

These low T levels in obese men are undoubtedly the reason that, contrary to the general population, dieting for them actually boosts their testosterone levels somewhat.  Yes, obese men can increase (their already low) testosterone through calorie reduction.

Now what does that have to do with Metformin?  Well, a 2012 study found that obese men with and without diabetes who took Metformin did NOT experience a rise in testosterone as they should have. [4] This means that the Metformin likely suppressed the rise in testosterone and one can, without much of a stretch, assume that Metformin may actually lower testosterone in some men.  The exact conclusions were:

“We conclude that metformin treatment combined with a hypocaloric diet leads to reduced FT [free testosterone] levels in obese nondiabetic men and to reduced TT [total testosterone] levels in obese men with type 2 diabetes. Increased SHBG levels may account for the decrease in FT levels in the former group.”

CONCLUSION: The idea that testosterone could potentially lower testosterone or suppress it’s rise in some cases is certainly preliminary.  What I would think prudent for someone about to start Metformin is to measure testosterone, SHBG and possibly LH before and after.  There are now many very inexpensive Labs for Self-Testing Testosterone out there.  So I can’t think of any good reason not to just pull your numbers.

CAUTION: If you are diabetic, do not change any medication or treatment without first discussing it with your doctor.  Metformin can be life changing, so keep in mind that lowering your testerone a bit, assuming it even does, may be a more-than-reasonable trade off.

NOTE: If you are in the early stages of diabetes, there is a good chance you can actually reverse your diabetes.  I cover two ways to do this in my pages called Reversing Diabetes with a Low Glycemic, Low Fat Diet and A Review of Reversing Diabetes by Julian Whitaker. In addition, testosterone therapy can have a powerful insulin-lowering effect, something I discuss in my page on Testosterone and Diabetes.

Intermittent Fasting Lowers Testosterone Anti-Aging Benefits

REFERENCES:

1) Journal of Translational Medicine, 2016, 14:290,  “Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males”

Researchers recently conducted an 8 week study on resistant trained subjects to answer that question and found some interesting results:

Let’s look at each of these and see just how much the matter:

Q1. The Drop in Testosterone. The first question that would come to my mind is if that drop in testosterone of 21% would be noticed by most men?  After all, a healthy young male will experience a drop of at least 30% in his testosterone levels from early morning to late afternoon.  My guess is that for the typical younger male, the 20% drop from intermittent fasting would not make much of a difference in how he feels..  If you have nice, high youthful testosterone levels, a 20% drop is not that much.

The case where this may be more important is in men that are already low in testosterone.  I am pretty sure that I was low testosterone all my adult life, and I can tell you that fasting of any form was miserable for me.  My testosterone was probably in the low 300’s and 20% lower from the low 300’s is pretty ugly.

Q2. The Drop in Hypertrophy Hormones. The next question that would pop into my mind is if I would lose muscle mass.  Traditional muscle building theory states that testosterone, IGF-1 and insulin are the three most important hormones for hypertrophy.  Wouldn’t a sag in any one of these make it hard to put on mass much less a drop in all three?

Surprisingly, the answer to this question seems to be ‘no.’  For reasons poorly understood, intermittent fasting (with weight / resistance / strength) training is actually a great way to lose fat and preserve muscle according to this study.  The authors noted the following for example:

“After 8 weeks, the 2 Way ANOVA (Time * Diet interaction) showed a decrease in fat mass in TRF [time restricted feed or intermittent fasting] compared to ND [normal diet] (p = 0.0448), while fat-free mass, muscle area of the arm and thigh, and maximal strength were maintained in both groups.” [1]

Men already low in T3 or IGF-1 may struggle with intermittent fasting however.  Testing beforehand could be prudent and can be done using these labs (here in the U.S.):  Testosterone Labs.

ANTI-AGING COMMMENTS:  I would add that all of the drops in the above hormones are generally associated with anti-aging.  In particular, lower IGF-1 and insulin levels are all core markers for improved healthspan and potentially lifespan.  Lowered T3 has also been informally associated with the same benefits.  I would also add that too much testosterone also probably has negative anti-aging properties, due to overactivation of the mTOR pathway.  Reasonable doses of testosterone likely improve mortality:  Testosterone and Aging.

CONCLUSION:  Intermittent fasting using an 8 hour eating window helps to lose weight without losing muscle, even though the traditional muscle building hormones are significantly lowered..  This is very important, because normally, when one loses fat, muscle is also lost as well.  The accompanying loss of muscle can make weight maintenance more difficult on an ongoing basis.  Intermittent fasting aso results in powerful anti-aging benefits.The wild card in all of this is if the lowered testosterone will negatively impact some men, and, hopefully, more study work will be done in the future on this subject.

WHAT KIND OF INTERMITTENT FASTING?  As an fyi, the scientiic name for intermittent fasting is time restricted feeding.  This study looked solely at the 16/8 form, i.e. only eating during a certain daily window of 8 hours.  Other forms of intermittent fasting include 5/2, where you eat normally 5 days per week and then drop calories very low on the weekend, and lowering calories every other day.  It is likely in my opinion that any of these methods that drops caories significantly will also lower testosterone as well.

Cialis, Dependency - Peak Testosterone

Can you become dependent on Cialis?  That is a question many guys, both young and middle-aged, ask themselves after a time.  Cialis has a long half-life, lasting most guys about 36 hours and so many men take it about three times a week and thus are covered virtually every day of the year.

Then the unthinkable happens:  they forget their prescription or maybe the prescription ran out.  This is when it gets terrifying for some men, because they find themselves having great difficulty getting an erection without their little yellow friend.  They then make the assumption:  no Cialis, no erections.

Most docs are no help and imply or directly tell their male patients with erectile dysfunction that losing one’s erectile strength is just a normal part of aging. The typical male walks out of the office thinking, “This pill is my only solution.”  Plus, let’s face it:  taking Cialis is SO easy.  You just pop a pill a few times of week and you’re rockin’ and rollin’

However, as time goes on, you may start to get headaches, or a little tinnitis or some visual issues. The nagging thought as to what these drugs are doing to you long term bothers you. You’ve read enough to know that no drug comes without side effects and you are beginning to have doubts as to the wisdom of taking these every day.

In addition, the research clearly shows that many men develop Cialis and Viagra Resistance.  This means that dosage for this drugs must be increased over time, because their effectiveness steadily decreases.

NOTE:  You may want to read my pages on the Dangers of Cialis or The Many Side Effects of PDE5 Inhibitors for additional information as well.

Regardless, there is a much more subtle reason to get off of Cialis (or Viagra):  it can hide major underlying health issues. If you can’t get an erection, there is almost always a reason and it is usually cardiovascular or low testosterone or both. These are not things that you want to sweep under the rug with a little pill that suddenly makes everything seem better.

Does taking that little pill magically clear the plaque out of your arteries?  Or does it miraculously get rid of the excessive inflammation that is damaging your endothelium hour-by-hour and day-by-day?  Of course, the answer is ‘no’ and so that is why I outline a program below for those of you who want to try to get off the juice.

CAUTION:  Please clear everything with your doctor first.

Get ready for a battle!  This is going to be one of the toughest things you’ve ever done.  Anything that risks your bedroom performance can be terrifying. But remember that this is fight

1.  Gradual Dose Reduction. Cut back on your Cialis dosage gradually.  If you are currently taking 20 mg every other day, then start by backing off to 15 mg, then 10 mg, then 5, etc.

2.  Exercise.  Exercise is a huge nitric oxide booster and blood pressure lowerer. Exercise throughout the day. Exercise several times per day.  Don’t kid yourself:  20 minutes per day isn’t going to cut it unless your job is very physically active.  You will be shocked at how much of a difference this makes.

3.  Saturated Fat. Unless you’re exercising like an Olympic athlete, you’ve got to reduce saturated fat to almost nothing. For the great majority of middle-aged men, saturated fat will slow down blood flow and damage their endothelium even further.  Read my link on Why Saturated Fat Can Be Bad for Men for more details.

4.  Largely Plant-Based Diet.  You need to go on a flexitarian, vegan, vegetarian, Low Fat (Ornish) Diet or some other plant-based diet.  Plant-based foods are what heal and stimulate your endothelium. You can, of course, also read my eBook called the Peak Erectile Strength Diet for foods that specifically stimulate blood flow and I also explain the latest research showing how and why plant foods are so powerful for erections. (I am not a “tree hugger.”  I’m just pointing out what the research shows.)

4.  OPTIONAL: Short Term Supplementation. If necessary, consider short term supplementation. I do not recommend most supplements long term, but they may be necessary to get you over the hump – no pun intended of course.  I have a link covering Erectile Dysfunction Supplements with some research behind them.  In addition, I have an eBook that covers some of the new research in this area Peak Erectile Strength Diet, i.e. taking more than one erectile supplement to get additive boosts in nitric oxide and erectile strength. (This is the latter half of the book.)

5.  Daily Erections.  If you’re not getting morning erectionss, you must force yourself to get erections.  Somehow, someway this has got to happen for your penile tissue to stay healthy and not harden or atrophy.  You need to essentially do what morning erections do:  build an erection that lasts for 10-20 minutes 2-3 times per day.

6. Testosterone. Get your testosterone checked if you have not already. Anyone with erectile difficulties should double check their testosterone, especially if they are having any of the classic Low Testosterone Symptoms.

Finally, build your confidence by checking for erectile strength. You’ve got to be confident that you can “pull the trigger” in the bedroom.  Avoid sex late at night when your are fatigued and testosterone is lower, i.e. be careful not to set yourself for failure.

Low Carb Diets: Do They Fuel Inflammation? - Peak Testosterone

I have gotten some heat, because I state that Low Carb Diets often increase inflammation.  And, for the record, I didn’t make this up:  a number of studies have shown this to indeed be the case.  However, I do have to admit that there are two sides and so, to be fair, I’ll cover some of the key research, both pro and con, so you can make up your own mind.

Also, keep in mind that I am not biased against meat eating per se and eat some meat myself:  I just prefer low fat cuts for arterial and nitric oxide protection.  Furthermore, I love weight lifting and consume a lot of protein, so I’m not biased against protein.  So, while it is true that I have my biases against high fat meals – you can see this in my page on The Potential Negative Consequences of a High Fat Meal (including Testosterone) – I do try to be open-minded.

That said, I’ll start with some of the studies that show issues with Low Carb Diets and increased inflammation:

4. Overweight Men and Women with Reduced Calories.  In this study, participants were put on either a “Low Fat Diet” or a Low Carb Diet. [5] Now, first of all, notice that this is not really a Low Fat Diet. As I often point out, what is a Low Fat Diet to you and me (10-15%) is not a Low Fat Diet to researchers.  Here were the macronutrient percentages so that we all know exactly what is being talked about here:

Low Carb:  28%/12%/60% (Protein/Carb/Fat))

Low Fat:  20%/56%/24% (Protein/Carb/Fat)

Again, 24% fat is not even close to a Low Fat Diet. That said, the most important take away from these two studies is that both diets dramatically reduced virtually all inflammation parameters.

Which diet produced the greatest reductions in inflammation?  Interestingly enough, the Low Carb Diet reduced the two ultra-critical cytokines the most:

IL-6  5.5 (Low Carb) versus 6.3 (Low Fat) [pg/ml]]

TNF Alpha   1.9 (Low Carb) versus 2.3 (Low Fat) pg/ml

Part of this may be because the Low Carb group dropped their calories the most, from an average of 2351 to 1504, whereas the Low Fat cohort only dropped their calories from 2082 to 1478.  Nevertheless, one can’t avoid the fact that the Low Carb Diet did a fantastic job of lowering inflammation, seemingly contradicting the three studies above.

“But I thought Low Fat Diets were the king of inflammation lowering?”  Well, under weight loss conditions, this study shows that in some cases Low Carb Diets do remarkably well. The authors concluded that “these data implicate dietary carbohydrate rather than dietary fat as a more significant nutritional factor contributing to inflammatory processes; although increased fat in the presence of high carbohydrate may be particularly deleterious.” [5]

5. Overweight and Obese Young Adults. Now let’s go to a second study that looked at 3 diets in “weight loss maintenance mode”. [6] All cohorts had calorie levels around 1,600, which to me is dieting and not maintenance, but the results are interesting.  The press widely reported that this study showed that Low Carb Diets were higher in inflammation.  That is true, but only by a small amount (~10%) and the real point is that all diets showed CRP < 1.0.  In other words, inflammation was low regardless of macronutrient composition.

So what is a fella to do? One large, very well done study shows that Low Carb Diets do excellent with inflammation and yet a significant body of previous work says that Low Carb Diets can boost inflammation and other cardiovascular risks. My guess is that it really depends on several key factors:

Personally, I think the safest way to go is to just avoid Low Carb Diets. However, there is another option: monitor inflammation before and after a Low Carb Diet. Hopefully, your doctor will work with you on this. Perhaps you can get some of your testing covered by insurance. If not, then check out my page on Reasonable Labs for Self-Monitoring. If you go on a Low Carb Diet and you see that your inflammation and other heart disease parameters are looking good, then all may be well and you may have found the sweet spot for these kind of diets.

REFERENCES:

1) https://www.atkinsexposed.org/atkins/192/ Atkins_Ignores_More_Important_Risk_Factors_which_Worsen_on_Atkins.htm

2) Mayo Clin Proc, 2003 Nov, 78(11):1331-6, “Effect of a high saturated fat and no-starch diet on serum lipid subfractions in patients with documented atherosclerotic cardiovascular disease”

3) Prev Cardiol, 2002 Summer, 5(3):110-8, “The effect of high-, moderate-, and low-fat diets on weight loss and cardiovascular disease risk factors”

4) Circulation, 2007, 116:II_819, “Abstract 3610: Comparative Effects of 3 Popular Diets on Lipids, Endothelial Function and Biomarkers of Atherothrombosis in the Absence of Weight Loss”

5)  Lipids (2008) 43:65–77, “Comparison of Low Fat and Low Carbohydrate Diets on Circulating Fatty Acid Composition and Markers of Inflammation”

6) JAMA, Jun 27 2012, 307(24), “Effects of Dietary Composition on Energy Expenditure During Weight-Loss Maintenance”

1. Obese Men with Heart Disease. One study found that after six weeks on a “high saturated fat, no starch diet”, participants lost weight yet doubled their CRP. Of course, CRP is C-Reactive Protein and is considered an excellent broad range marker of systemic inflammation. [1][2] And it has been shown in various studies to be a risk factor for heart disease, autoimmune conditions and even Alzheimers.

2. Normal Men and Women. This study found that fibrinogen – a clotting-related inflammatory risk factor – and MANY cardiovascular disease markers were uniquely worsened on a Low Carb Diet. [3] The authors stated that “only patients following HF [high fat] diets showed a worsening of each cardiovascular disease risk factor (LDL-C, TG, TC, HDL-C, TC/HDL ratio, Ho, Lp(a), and fibrinogen), despite achieving statistically significant weight loss.”  Like #1, this was particularly surprising because usually patients improve during weight loss no matter what is eaten.

3. Young Adults.  Other research looked at a Low Carb diet with 50% fat versus a true Low Fat (10%) Diet and found that “in the absence of weight loss, the high fat Atkins [Low Carb] diet is associated with increased LDL-C, reduced endothelial vasoreactivity and increased expression of biomarkers of atherothrombosis.” [4] In other words, once you stop cutting calories and the dieting is over, your inflammation will rise and your blood flow will decrease.

A Low Carb Diets: Inflammation Action Summary

Pharmaceutical Solutions? Arimidex and Estradiol.

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://peaktestosterone.com/forum/index.php?topic=295.msg2616#msg2616

2) https://peaktestosterone.com/forum/index.php?topic=433.msg4718#msg4718

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

4) https://hrt-rx.com/2012/06/05/ arimidex-vs-femara-for-increasing-testosterone-in-men-hrt/

5) Fertility and Sterility, Jul 2012, 98(1):48-51, “Changes in hormonal profile and seminal parameters with use of aromatase inhibitors in management of infertile men with low testosterone to estradiol ratios”

6) Molecular and Cellular Endocrinology, 16 May 2006, 250(1-2):2-7, “Hormonal approaches to male contraception: Approaching reality”

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

8) J Sex Med, 2012 Jun, 9(6):1681-96, “Estrogens in Men: Clinical Implications for Sexual Function and the Treatment of Testosterone Deficiency”

9) J Urol, 2013 Feb, 189(2):647-50, “Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy”

Some of the more forward thinking doctors are now prescribing Arimidex in conjunction with HCG.  HCG, of course, stimulates the testes to produce testosterone and is used primarily to avoid testicular shrinkage, but it can also cause estradiol problems downstream.  One of the more famous “internet hormone doctors” is Dr. Eugene Shippen and one of our Peak Testosterone posters went to him.  Dr. Shippen’s overall protocol for this man, whose testosterone was 296 ng/dl, was as follows:

“He sent back a letter and a prescription for Clomid. (for 7 day stimulation test) My results showed I had Secondary Hypogonadism. My T had risen to 541, My E2=47, and DHEA was below the bottom of normal and D3 was low. On May 30th I went to Pa. to meet with him, he spent over 2 hours going over all my test results and did a physical that included a prostate check. He order[ed] the following meds: HGC, Arimidex, and 25mg DHEA oral supplement. I must have a followup blood test in 3 weeks for T, E2, and DHEA-S. Then in 6 weeks a full blood workup for Endocrine testing. He wants me to take D3 4000mg daily and drink Pomergranate juice plus Vit. C 1000mg.” [1]

Of course, in this case Arimidex was used in conjunction with HCG, but it is also often used by itself. Look at what one of the men on the Peak Testosterone Forum experienced:

“Having said that, Arimidex has done wonders for me in the 2 months i’ve been taking it, and my E2 was only 48 after a few months on hcg. the doc prescribed me 0.5mg ED, which is higher than what most people I read about on msg boards take. I tried that at first, felt nothing for about 10 days, then all of a sudden I started waking up with the biggest erections I had experienced in many years. and libido came back and now I think about sex all the time. just the hcg alone wasnt doing it for me even though it did raise my T levels. i have now cut back to 0.5mg EOD, which is still higher than most people seem to take, but it seems to be working for me. I read a comment on another more steroid oriented forum where a guy was saying to calibrate the Arimidex dosage based on morning wood, because if it gets too low you wont have it, but if it’s just right it will be huge and powerful.” [2]

NOTE:  Arimidex is not the only way to clinically lower estradiol.  There are other aromatase inhibitors, such as letrozole (Femara), for example.  There are also irreversible aromatase inhibitors.  See my page Suicide Inhibitors for some background information.

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

Arimidex also has a big advantage for younger men wanting to possibly have kids: it does a much job at preserving fertility than traditional testosterone therapy.  Classic HRT (Hormone Replacement Therapy) will generally significantly decrease fertility, making childbearing difficult to impossible.  In fact, the new 6-week testosterone therapy injectable, Nebido, is actually being used as a quasi-contraceptive by some men.  And there is considerable research going on to find the best way to use HRT to achive a reliable male contraceptive. One research summary even wrote that “current hormonal combinations completely suppress spermatogenesis without severe side-effects in 80 90% of men, with significant suppression in the remainder of individuals. Recent trials with newer, long-acting forms of testosterone combined with progestogens have yielded promising results and may soon result in the marketing of a safe, reversible and effective hormonal contraceptive for men..” [6]

The aromatase inhibitors (AI’s) can sometimes bypass that concern.  (Confirm with your doctor, of course.)  In fact, Arimidex will actually improve some fertility parameters.  One recent study looked at Arimidex and found that, besides delivering a nice boost in testosterone, FSH was largely unchanged and sperm density was increased by 78%. [4][5] For these reasons, fertility doctors will sometimes use Arimidex to treat male fertility issues.  For example, you might be started on Clomid for a few months and, if your testosterone is too high, Arimidex (anastrozole) may be prescribed in combination.  Or some men are started with both immediately and then monitored.  Again, I’m not a big fan of Arimidex due to the above four concerns, but some physicians do make use of it.

These types of fertility treatments for men are much more common than generally realized:  male fertility is probably impacting up to a fourth of all troubled pregnancies. Fertility doctors also tend to be much more cutting edge when it comes to boosting testosterone than many traditional doctors, such as urologists, endocrinologists and primary care physicians. Why? Fertility specialists have been treating men for over a decade with alternative treatments and are interested in preserving libido, which requires good testosterone levels, along with boosting sperm parameters. Thus, they have on average built up a lot more experience than most other specialities.

However, I should point out that some physicians are now using low dose HCG in conjunction with testosterone therapy in order to maintain fertility.  For those interested, see a fertility specialist familiar with Dr. Lipschultz’s work.  [9]

Arimidex and Testosterone Therapy

Arimidex (anastrozole) is also quite commonly used in men who are on testosterone therapy (HRT or TRT).  The reason is that 80% of a man’s estradiol comes from the conversion of testosterone into estradiol in the fat tissue through the aromatase enzyme.  The more weight that a man has gained, the higher the estradiol levels that he will have on average.  Furthermore, some TRT providers push men to very beefy levels of testosterone, say 1000-1200 ng/dl, which may be above the man’s natural set points.

When I first started cypionate injections at an HRT clinic, they put me on low Arimidex just a couple of months later. This really surprised me, because I really did not want to have to “medicate my TRT.”  The argued that the dose was very low compared to, say, a cancer patient, and it has no real side effects when done properly, i.e. estradiol is not sent overly low.

So for a few months I took .5 mg twice a week.  I then pushed them to let me lower it to .25 mg twice per week.  Both of these doses are pretty common for men on testosterone, and I see it quite often on the Peak Testosterone Forum. But I did everything in my power to get off of Arimidex and used a threefold approach to actually accomplish the task:

This allowed me to get off of Arimidex completely.  My testosterone levels are still very solid and in the 700-800 ng/dl range.  And in my opinion almost every guy on TRT should endeavor to do the same, because this will generally be more physiological, or natural.  Plus, the cautions and risks cited above for Arimidex Monotherapy also apply here as well.

Of course, Arimidex is often used by steroid users to decrease over-aromatization from driving their testosterone into supraphysiological zones, i.e. way above normal, which in turn leads to elevated estradiol.  They aslo use it post-cycle period when they are desperately trying to get their testosterone jumpstarted – sometimes unsucccessfully I might add. As strange and annoying as this is, steroid users and fertility doctors were some of the early pioneers of Armidex usage.

CAUTIONS: However, Arimidex is not something that should be used unless it is under a doctor’s supervision, primarily because estradiol, the E2 estrogen, needs to be monitored.  One of the problem’s with Arimidex is that one can easily push estrogen levels too low.  In the short term this can lead to joint pain.  Scientists are not sure why, but, when estrogen gets too low on Armidex, the joints can begin to be very painful.

Even more dangerous, though, would be long term damage fromm overly low estrogen levels.  Low E2 will eventually lead to bone mass loss, i.e. osteopenia and ultimately osteoporosis.  See my link on Why Men Need Estrogen for more details.

Arimidex can also negatively effect libido.  The thinking is that if estradiol gets driven too low that sex drive goes with it.  Again, estrogen in males has a fairly tight therapeutic range with too much or little decreasing sexual desire. (It can also send libido thorugh the roof!)

The Liver: How It Can Affect Erections - Peaktestosterone

Non-alcoholic fatty liver disease (NAFLD) is nothing short of an epidemic in the U.S. and other modern, industrialized countries. If you read my link on Insulin Resistance and the Liver, you’ll see that NAFLD is very tied to insulin resistance and Metabolic Syndrome, so it is no wonder. Again, it is not unreasonable to assume about half of the men reading this page have NAFLD and that this is a very serious threat to not only their sex life but their life in general.  The moral of the story:  you can’t ignore your liver!

Yes, the liver is important and, as you probably remember from your high school biology, is that the liver performs many critical functions:  detoxification, processing medications, building proteins – the list could go on and on. And here is why you absolutely MUST take fatty liver disease very seriously:

1)   Postgrad Med J, 2006, 82:315-322 “Treatment of non-alcoholic fatty liver disease”

2) World J Gastroenterol, 2006 Dec 28, 12(48):7826-31, “Insulin sensitizers in treatment of nonalcoholic fatty liver disease: Systematic review.

3) World J Gastroenterol, 2007 March 14, 13(10):1579-1584, Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease”

4) HEPATOLOGY, 2010, 52(5), “Evolution of Inflammation in Nonalcoholic Fatty Liver Disease: The Multiple Parallel Hits Hypothesis”

5) J Clin Invest. 2003, 112(1):91–100, “The fat-derived hormone adiponectin alleviates alcoholic and nonalcoholic fatty liver diseases in mice”

6) The Journal of Clinical Endocrinology & Metabolism, Jun 1 2005, 90(6):3498-3504, “Plasma Adiponectin in Nonalcoholic Fatty Liver Is Related to Hepatic Insulin Resistance and Hepatic Fat Content, Not to Liver Disease Severity”

7) J Mol Med (Berl), 2002 Nov, 80(11):696-702, “Adiponectin: a link between excess adiposity and associated comorbidities?”

8) Ann Med, 2005, 37(5):347-56, “Fat in the liver and insulin resistance”

9) Cancer Cell, 17 Feb 2010, 17(2):115-117, “Obesity, Inflammatory Signaling, and Hepatocellular Carcinoma—An Enlarging Link”

10) Gastroenterology, Jul 2005, 129(1):113–121, “The Natural History of Nonalcoholic FattyLiver Disease: A Population-Based Cohort Study”

1. NASH.  Non-alcoholic steatohepatitis (NASH) is the ugly end point for some men who develop NAFLD.  All men with NAFLD have steatosis, which simply means fatty acids accumulating in the liver cells.  However, in some men this turns very ugly and you end up with steatohepatitis, or a form of liver disease that mimics classic hepatitis.  NASH is basically a condition that includes an inflamed liver with classic cirrhosis that is often debilitating and in some cases life-threatening. [10] Scientists have noted that there is little difference between the damaged liver that results from non-alcoholic fatty liver disease versus alcoholic fatty liver disease – it’s all bad news.

2.  Cardiovascular Risk Factors. NAFLD has become one of the many new risk factors for heart disease.  In other words, if you develop this type of liver disease, you are at increased risk for cardiovascular events and even death.  So one should treat NAFLD as erectile dysfunction, which also is a new predictor of impending heart problems.

3.  Type II Diabetes.  A fatty liver also increases your risk for type 2 diabetes. (The two conditions are highly interrelated.)

NAFLD appears to be such a powerful predictor that one recent study out of Japan found that it even foretold heart disease strongly than Metabolic Syndrome. Furthermore, it was found to be an independent risk factor for cardiovascular disease independent of all others.[3]  Researchers have noted that it is no wonder since “the liver, once fatty, overproduces most of the known cardiovascular risk factors such as very low density lipoprotein (VLDL), glucose, C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), fibrinogen and coagulation factors.” [8]

All of that said, what makes this type of liver disease so problematic is that it appears benign to the men diagnosed with it. In fact, many men have it and do not even know it. NAFLD is definitely not an immediate death warrant and the great majority of men with this type of liver disease – 90% and above – do not even have symptoms. It is somewhat like most prostate cancers:  it exists for years often before it rears its ugly head.

When one overconsumes calories or has an increased oxidative (free radical) load due to being overweight, the liver begins to accumulate these to protect itself from toxic triglyceride byproducts.  Evidence is mounting in animal studies that endotoxins, which result from out-of-whack intestinal bacteria and dysfunctional TLRs (toll-like receptors), which result from being overweight, increase systemic inflammation and lead to NAFLD. [4]  Several studies have also shown that adiponectin, a key inflammatory cytokine, regulates liver fat. [5][6] As you put on weight, your body lowers adiponectin levels and your liver fat increases – it’s that simple.  Furthermore, adiponectin is strongly (and inversely) correlated to body fat. [7]  And our old archenemies TNF alpha and IL-6 also have been found in animal studies to directly cause liver inflammation, which can accelerate the nasty liver-destroying cirrhosis called NASH mentioned above. [9]

The bottom line is that almost every major inflammatory cytokine involved in disease and cancer plays an active role in the initiation and progression of non-alcoholic fatty liver disease as well.  And these cytokines all become misaligned through growing body fat.  That has lead researchers to observe that your fat (adipose) tissue literally attacks your liver.  Your liver is ground zero when it comes to the battle for your health.

When you put on enough weight, you are literally pitting one organ against the other and creating a sort of internal war on yourself:  the fat tissue makes war on the liver, which in turn assails both the heart and penis.

So what will your physician do if you are diagnosed with non-alcoholic fatty liver disease?  You and your physician need to agree on a course of action andt there are several common elements in current treatment. [1]

1. Treat any underlying diabetes, insulin resistance or Metabolic Syndrome.  This can involve pharmeutical solutions in some cases.  Metformin and thiazolidinediones, insulin sensitizing drugs, have been popular in studies and done quite well. [2]

2. Improve insulin sensitivity by encouraging exercise and weight loss.

NOTE: A higher fat diet will also actually induce insulin resistance and so care must be taken. Although consuming a diet higher than about 40% fat is probably not that common, care should be taken.

3. Protect the liver through antioxidants and other supplements and agents.

Obviously, this is not where you want to be in the sense that you want to stay off of pharmaceuticals if at all possible. Phamaceuticals always have side effects and long term unintended consequences.  It is always better to let the body heal itself if one can and go about things naturally.

Here are some ideas to keep your liver fat free:

1. Insulin Resistance.  Read my link on Insulin Resistance and the Liver and battle the underlying insulin resistance at the same time that you battle the underlying inflammation.

2. Dietary Fat. Be very careful with dietary fat levels.  Remember that high fat diets are used in laboratory animals to induce insulin resistance and high fat diets will often increase inflammation as well.  Fat is also very calorically dense and can lead to weight gain, leading to a viscious cycle of increasing inflammation and insulin resistance. (By the way, this is yet another reason that many of the Atkins, Paleo and Low Carb diets can get you into trouble quickly. They seem like a good idea but can be very hard on the heart and liver.)

3. Weight Loss and a Low Fat Diet.  A whole foods Low Fat Diet can decrease control and even decrease liver fat content.  One study noted that “liver fat content can be decreased by weight loss and by a low as compared to a high fat diet.” [8]

4.  Fructose.  Watch your fructose!  It is known for both increasing insulin resistance and inflammation.  Read my links on

5.  Anti-inflammation. Yes, a little inflammation is a good things for figthing infections and basic immunity.  However, the vast majority of us in modern societies have the opposite problem:  an overactive inflammatory response.  Read this link on How to Control Inflammation for many ideas on how to get out of the inflammation rat race.

REFERENCES:

Stress and Testosterone - Peak Testosterone

We all joke around about being under stress, but, as you’ll see below, it’s really not that funny. There are many definitions of stress, but here I am primarily talking about the kind of stress that produces elevated cortisol levels. When you are under stress, your body releases increased levels of adrenaline and other “fight or flight” hormones and chemicals.  The adrenaline does a certain amount of damage, raising pulse rates and blood pressure (especially in Type A personalities).  But it is the cortisol that comes shortly after that does the most devastating long term damage.

HRT (Hormone Replacement Therapy) Can Lower Cholesterol.

However, a 2011 book called The Magic of Cholesterol Numbers by Dr. Dzugan found a way to turbocharge these results and apparently even exceed that which is seen with standard TRT.  It may also make results even more consistent.

The importance of Dr. Dzugan’s works is incredibly profound, and I think, unfortunately, largely ignored.  I believe that implementing his ideas could save literally tens of millions of lives every year and billions in health care costs on top of that.  That is how important this is, and so I hope, after you read this article, you will spread the word.  Dr. Dzugan’s protocol can greatly lower cholesterol levels even with no changes in your diet.  (I highly encourage you to improve your diet if you have not of course!  Check out my pages on https://www.peaktestosterone.com/.)

Here is a summary of what he Dr. Dzugan did in a couple of studies from the above (must-read) book:

1.  He measured pregnenolone, testosterone, DHEA-S, cortisol, vitamin D  and progesterone.  (p. 170)

3. He only used bioidentical hormones, i.e. hormones identical to the ones the body naturally produces.

Hormonodeficit Hypothesis of Hypercholesteremia. Now why does he concentrate on the above hormones?  Why not melatonin or T3/T4 or prolactin., etc.?  The answer lies in the following “Hormone Production Lines:”

Cholesterol ==> Pregnenolone ==> DHEA ==> Testosterone ==> Estradiol and DHT

Cholesterol ==> Pregnenolone ==> Progesterone ==> Cortisol

Note that both of these hormonal pathways start with cholesterol at the top.  Now let’s say that, for whatever reason, one of the downstream hormones resulting from cholesterol is low, i.e. pregnenolone, DHEA, testosterone, progesterone or cortisol.  The Hormonodeficit Hypothesis of Hypercholesteremia posits that the body will do what it needs to do to try to boost that hormonal deficiency, i.e. it will boost cholesterol production in order to try to jack up all downstream hormones.  .

Check out the results of his two studies:

1.  Study on Adults of All Ages with High Cholesterol.  The above protocol dropped cholesterol levels 30% in men from 253 mg/dl to 191! (p. 171)

2.  2002 Study.  This study looked at 12 early senior aged men and found their total cholesterol dropped an average of 22% from 228 to 177 mg/dl.

Study #2’s results were particularly profound, because HDL remained unchanged.  Statins will lower both HDL and cholesterol, but by restoring hormones, you appear to get nothing but benefits.

This may partially explain some of the very impressive results that we have seen in the TRT cardiovascular studies lately.  The most recent study showed that in men that were low testosterone and had severe heart disease, TRT lowered cardovascular incidents by 80%!  This is much better than a statin, although statins are given to those with any testosterone level.  For details, see my on The Latest Testosterone Therapy Cardiovascular Studies. I would add that cholesterol-lowering is not the only cardiovascular benefit from TRT, something I cover in depth here:  Testosterone and Heart Disease.

CONCLUSION:  Current standards of practice are often decades behind the research and Dr. Dzugan’s work is one example of this.  Patients with cardiovascular issues are typically prescribed statins and maybe a baby aspirin and sent on their way.  Of course, lifestyle changes are the most important, but, clinically, it is clear that checking for certain hormonal deficiencies is nearly as critical.  Again, I recommend reading Dr. Dzugan’s book above and checking out the details of his protocols and findings.  He methodically and thoroughly describes the underlying issues and solutions.

One interesting and practical story having to do with with all of this is the famous low fat plant-based plaque regresser Dr. Esselstyn, who I cover on this page:  https://www.peaktestosterone.com/. Dr. Esselstyn commented that his diet will almost always lower cholesterol below 150 mg/dl but there are a certain percentage of men that he has to give a statin to in order to achieve that target cholesterol value. These men may very well be deficient in one of these hormones and just need bioidentical hormone therapy in order to avoid having to take a statin. (They could also be hypothyroid which wil artificially raise total cholesterol levels.)

This, by the way, is not is not a criticism of Dr. Esselstyn, whose work has undoubtedly saved literally tens of thousands of lives.  I am just pointing out that some men have stubborningly high cholesterol and hormonal issues is probably often the problem.  Why is this important?  Because statins are rife with side effects, something I cover here:  https://www.peaktestosterone.com/.

1)   The Magic of Cholesterol Numbers by Dr. Sergey Dzugan and Konstantine Dzugan

Volume: Build Muscle and Strength Injury Free - Peak Testosterone

This page on Volume Training is for those of you who want to put on muscle but don’t want to risk life and limb lifting heavy weights. In fact, I would say that this page is primarily for weight lifters who are middle age and beyond and who want to save their joints and back from the rigors of typical bodybuilding routines (and yet still put on muscle of course). Volume Training is a godsend for those of you who want to look good and train more naturally.  Seriously, how are you going to squat or bench press heavily by yourself anyway?  How many of us can find a training partner that wants to be at the gym the same time as we do?

In spite of all these obstacles, virtually all the body building sites and magazines that I know ignore Volume Training and emphasize heavy, “Olympic-type” lifts:  benches, dead lifts, squats and so on. What they don’t tell you is that eventually the price will be paid for lifting like this.  There are very few weight lifters who can make it into their 40’s and 50’s doing these kind of heavy lifts without joint injuries. If only they had stuck to lifting that our bodies were built for:  repeated lifting or Volume Training.

Fitness Rx is one of the few fitness and bodybuilding magazines that is honest with its readers and it cites a recent journal article that reports that almost all lifters who do regular and heavy bench pressing experience shoulder injuries. [1]  Tendon ruptures of the biceps are surprisingly common for those doing big bench presses as well. [4]  Even my fitness idol, Jack LaLanne, struggled with injuries because of the intensity of his workouts during his youth.  In the last half of his life, he had to do the majority of his exercising and feats of strength in the water because of the damage done from overuse and overexertion to his joints and tendons.  Again, I have never heard of anyone saying that they have suffered a significant injury from Volume Training.

So can it be done?  Can you put on mass using less heavy weights?  Certainly!  Not only will volume, if done right of course, help keep you injury free but it will pack on muscle while its at it.

What is Volume Training?  Volume Training simply refers to the non-traditional idea of building muscle through a lot of sets and repetitions and lower weight.  (The technical definition is simply the total sum of weight lifted, i.e. the sum of sets multiplied by reps multiplied by weight.)  One of the most well-known of these techniques is to take about 60% of your one rep max (the most you can lift for that exercise with one repetition) and then do ten sets of ten repetitions. (Google on German Volume Training.)

Example: Let’s say that you can curl 70 lbs maximum for one repetition.  You would, as an initial guess, take 60% of 70 lbs, or 42 lbs and do ten sets of ten reps with that.  The following week you would try again but increase slightly the weight and so on.

NEWS FLASH: A 2010 study recently found that doing about 24 reps at 30% of your one rep max put on as much muscle as doing 5-10 reps at 80-90% of your best. [5] [6] The key, according to the study findings, was to go to fatigue. In other words, it doesn’t matter that much how you do exhaust your muscles just so you do it.  But let me ask this:  who is more likely to get hurt:  the guy benching 5-10 reps or the guy benching 24 reps?

Of course, most guys don’t want to do Volume Training because it requires you to work with less weight.  We want to lift as much as possible because, after all, someone might be watching us.  Well, swallow your pride and realize that Volume Training works:  it packs on muscle AND is much safer than traditional lift-a-baby-grand-piano techniques.  Volume Training will make you very sore by the way.

Remember: your goal with Volume Training is to avoid the kind of debilating injuries that plague body builders and power lifters in their 40’s and beyond.  I can only tell you tell you that I have never hurt myself doing Volume Training, but I have hurt myself any number of times doing the traditional, balls-to-the-wall lifting with heavy weights.  And, by the way, I am a fairly careful lifter, but one small mistake with heavy weights and you’ve got yourself a nasty, months-to-heal injury on your hands.  Better to stick with Volume Training, especially for those of those pushing forty.

One might say that, once again, you’ve got to use brain over braun.  Is that anything new? Let the younger guys rack up the stacks of 45 lb plates.  Trust me:  half or more of them will be limping around in ten to twenty years from hurting their backs or elbows or shoulders or hips or knees.  It’s easy to do as you start getting to those heavy weights.  as the body building magazines recommend – Olympic lifts like the squat, bench press and dead lift – you’re going to be lifting a lot of weight.  You only get one mistake and you’re hurt for potentially years or decades.

Does Volume Training really work?  You instinctively know the answer.  Ever seen a mechanics forearms?  He doesn’t generally lift that much, yet he looks like Popeye, matey.  Why?  Because he does hundreds of smaller “lifts” with his arms throughout the day and the net result are forearms that would grab the attention of any woman. Again, it’s volume, volume, volume. And who has the biggest cuads you’ve ever seen?  Olympic power skaters are right at the top.  In fact, male ballet dancers have huge quads and gluts that would put most guys in a gym to shame.  None of these guys use weights!  They are essentially doing Volume Training with their own body weight.

Finally, who has the type of build that women admire most? Is it the freakishly massive steroid-built body builders doing Olympic lifts?  No, it’s gymnasts who lift nothing more than their own body weight in a unique type of Volume Training over and over and over again.

Note: There is quasi-verification of using Volume Training in a recent study.  Scientists recently found [2] that doing 40% of your one rep max, a low weight indeed, at a slow pace – three seconds up and three seconds back – done to exhaustion gave greater growth hormone response than traditional weight lifting techniques.  This has left the researchers scratching their heads.  These results should be considered preliminary, but maybe going to very low weights and slowing down your reps is just what the Endocrinologist ordered.

Does Volume Training take more time at the gym?  Not really, because you should not do more than one exercise per muscle group.  Furthermore, you should generally not exercise any muscle group more than one time per week.  (You won’t want to if you’ve done it right:  you’ll stay sore for days.)

One other question that may have crossed your mind is “what should I do if I’m not going to lift heavy, Olympic Style lifts”?  Well, I would recommend Isolation instead.  Now that is blasphemy in weight lifting circles.  But let me tell you why I’ve never believed in Olympic lifts:  I’ve got a huge chest for my body type and weight and I’ve rarely done a bench press.  That’s right – I started with flyes in college and that’s really the only exercise that I’ve eever done for my chest.  And my pecs are large enough that I actually don’t want them any bigger.

So why are flyes so effective?  Because they hit nothing but your chest.  If you do them right, your chest will be screaming the next couple of days without risking life and limb like you have to do with trying a bench press by yourself. There are similar isolation-type exercises for all the muscle groups and they all work just great.

What really counts in putting on muscle is Muscle Tension.  Several studies have shown that it’s really the amount of tension put on the muscle that is so critical for growth. [3]  A beautiful example of this is lying tricep extensions where one lays on one’s back on a bench and brings the weights down to the forehead and then back up.  This leave the tricep in a stretched out, high tension state and will make the back of your arms scream with pain the next day.  You will also find they make your triceps grow very fast even though you have not lifted that much weight.  You can probably do double the weight if you do the standard cable triceps pushdown.  But you will get less muscle growth with those because tension is so critical.  This is not really an example of Volume Training but illustrates that you do not have to lift heavy to get big significant mucle gains.

CAUTION: It is possible to hurt your joints if you move jerkily and stretch the tendon or muscle too far.  Be careful and study the basic lifts to understand the way to lift properly.  And, of course, work with your doctor if you have any medical condition whatsoever!

CAUTION:  Also, studies have shown that it is probably dangerous to do weight training without cardio afterwards. If you’re a weight lifter, and I hope you are, see the Sexercise link for details. You may also want to consider reading the Overtraining link if you’re the over-zealous type.

Finally, feel free to Contact Me with any questions about these strategies.

REFERENCES:

1)  Fitness Rx, 9/08, p.24.

2)  Physiological Sciences,2008,58(1):7-14

3) Intl J Sports Physiol Perf,2008,3:279-293

4) Sports Med Arthroscopy Review,2008,148-161

5) PLoS ONE, 2010, 5(8):e12033, “Low-Load High Volume Resistance Exercise Stimulates Muscle Protein Synthesis More Than High-Load Low Volume Resistance Exercise in Young Men”

6) https://www.eurekalert.org/pub_releases/2010-08/mu-bmd081110.php

Is There A Dosage for Chocolate? - Peak Testosterone

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

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

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

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

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

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

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

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

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

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

REFERENCES:

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

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

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

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

Low Fat Diet: Dangers? - Peak Testosterone

I eat a Low Fat Diet and love it.  I am currently eating a low fat, whole foods lacto ovo vegetarian diet.  One thing that I have noticed is that Low Fat now is extremely unpopular right now with men, at least here in the U.S.  As far as I can tell, Paleo and Low Carb fans have almost completely taken over the American health universe.  And, because of this, I have heard time and again of all the dangers of low fat and how low fat eating is responsible for all of our health ills, etc.  The latter accusation is ridiculous, of course, because so few American eat a Low Fat Diet.  I personally do not know anyone who eats a Low Fat Diet and I doubt most of you do either.

Anyway, most of the objections that you hear about Low Fat Diets are just silly.  But a few require serious consideration and I believe we can lump them into five general categories, which I summarize below:

1. Increased Arteriosclerosis. Dr. William Davis is one of the leading clinicans practicing plaque reversal and author of the popular book Track Your Plaque. He is probably the most popular speaker and writer that I know of in the cardiovascular arenta and has popularized his own flavor of reversing arteriosclerosis that has moved away from of the previous low fat-based techiques used by, say, the well-known Dr. Ornish. In fact, Dr. Davis is openly critical of Low Fat Diets and clearly states that some people will acclerate their plaque on a Low Fat Diet, not reverse it.

Now this is definitely a controversial assertion, because Dr. Dean Ornish showed in his studies that Low Fat Diets could reverse plaque. In fact, it was Dr. Ornish who really popularized the notion. Critics note, however, that participants in Dr. Ornish’s studies underwent some weight loss and almost any diet can reverse plaque during weight loss. In fact, one recent study showed just that by putting participants on a low fat, low carb or Mediterranean Diet and all of them reversed IMT plaque approximately equally. [1] (IMT is intima-media thickness, i.e. the amount of plaque in the neck artery.)  So any arterial study needs to show success under weight maintenance conditions to truly be valid.

However, let’s go back to Dr.Davis’ assertion that in some men a Low Fat Diet is a foe rather than a friend and may actually add arterial plaque instead of reversing it. The reason, according to Dr. Davis, is that low fat usually means high carbs and high carbs for some men means that their lipid profile will switch to the deadly “pattern B” mode.  Pattern B is simply when your cholesterol profile has a greater percentage of atherogenic small LDL particles and increased triglcyerides.

REBUTTAL:  Prior to Dr. Davis, there were a couple of huge clinician researchers that were well-established in plaque reversal:  Drs. Esselstyn and Gould. Both of these researchers used Low Fat Diets as the base of their treatment strategy.  Dr. Esselstyn is part of the Cleveland Heart Clinic and is world renowned in his research on reducing arterial plaque and author of a back entitled Prevent and Reverse Heart Disease.  His formula is pretty simple: [2]

And one last comment:  this is where the work of Dr. Gould comes in.  Dr. Esselstyn only reversed arterial plaque in three quarters of his patients.  However, Dr. Gould was able to reverse it in virtually everyone by putting them on a Low Fat Diet and coupling it with a statin.  This is very impressive to say the least, because heart patients often only have a few more years to live and this essentially allows them to gain back decades of their life by reversing arteriosclerosis.  I know many people do not like statins and I don’t either  – see my page on The Dangers of Statins – but for those with arteriosclerosis, this is a critical situation.

As a side note, I actually feel that this is what happened to me. In my late 40’s I developed a significant amount of erectile dysfunction after years of a fast food and questionable eating habits. I also had had decades of low testosterone – something you can read about in My Personal Health Story – and low T is known for leading to hardening of the arteries. I tried consuming coconut oil and diets that I modeled after the Tokeluau and Pukapuka. These are essentially classic Paleo Diets and they simply did not work for me – quite the opposite. I got immediate relief, though, from eating Low Fat. And here is my point: I had a Heart Scan, also called a Calcium Score, in 2013 and they found that my cardiac arteries were perfectly clear! Basically, I had apparently cleared out all the arterial plaque from the decades previous through eating Low Fat, something you can read about in my page My Heart Scan Results.

2. Vitamin E. One of the criticisms of Low Fat Diets that you quite often hear is that fat in the diet is required to trigger the release of bile from the liver and, therefore, those that consume a Low Fat Diet could be deficient in Vitamin E. For example, children who have blocked or missing bile ducts can become Vitamin E deficient and require supplementation. [3] Furthermore, low fat critics often state that other fat soluble vitamins (A, D and K) may be poorly absorbed in a low fat environment.

REBUTTAL:  A “Low Fat” Diet is really not low fat. Even the most strict Low Fat Diet is around 10% of calories as total fat.  So, if a man consumes 2,500 calories in a day, 250 calories would be from fat.  This translates to 28 grams of fat, which is a significant amount of fat.  I know of no evidence that those eating Low Fat Diets have been shown to be deficient in any of the above vitamins.  If this was an issue with Low Fat Diets, it would have been exposed years ago.  And consider this:

Wild game is around 10% fat.  Most of the plant foods that we eat are around 10% fat.  Furthermore, the supercultures with the greatest longevity and nearly impeccable health records eat in the 10-20% fat range. How can the healthiest cultures on planet earth all be deficient in vitamins A, E and K?

And, if you are concerned about it, simply raise your fat levels to 15%.  I have never eaten a pure 10% and have somehow managed to clear out my arteries for example. But raising your fat levels to 15% will add another another 14 grams of fat per day.  This allows for a few nuts or some dressings/sauces that can really add flavor to what you are eating.

3. Your Cholesterol Will Be Too Low For Your Brain’s Needs. The human brain needs a large amount of cholesterol and I have seen stats that about a quarter of all the body’s cholesterol is between our ears. Based on these observations, some say that a Low Fat Diet will lead to cognitive, memory and psychological issues due to lack of proper supply of cholesterol.  Other similar criticisms come from the fact that pregnenalone, a key brain hormone, is synthesized from cholesterol (LDL specifically) and, so the thinking goes, low cholesterol will lead to deficiencies here as well.  Adding fuel to the fire was the fact that a mortality study showed that low cholesterol levels were correlated with an increased risk for possibly non-heart disease deaths and possibly suicide.

REBUTTAL:  The body manufacturers virtually all the cholesterol that we need.  We simply do not need to add cholesterol to our diet or eat a lot of fat to artificially inflate cholesterol levels.  And think about this:

The Father of the Modern Paleo Movement is a researcher named Loren Cordain.  One of his earlier research projects was a study of all the primal cultures in the world.  His motive was to document how these ultrahealthy cultures ate and one thing that he found would shock most modern Paleo folks:  EVERY culture had cholesterol below 150.

Of course, this hurts the you-gotta-have-beefy-cholesterol theories.  If every one of our healthiest cultures has cholesterol below 150, then how can low cholesterol be unhealthy?  In fact, couldn’t it be argued that low cholesterol is actually the most brain healthy way to live?  After all, in these cultures dementia and Alzheimers is unheard of.  One of the low fat researchers has uncovered a significant body of evidence that increased levels of saturated fat is associated with Alzheimer’s risk. [4] And the extra fat in our diet is likely a root cause of many migraines.  Researchers explained that “a review of the literature indicates that high levels of blood lipids and high levels of free fatty acids are among the important factors involved in triggering migraine headaches. Under these conditions, platelet aggregability, which is associated with decreased serotonin and heightened prostaglandin levels, is increased. This leads to vasodilation, the immediate precursor of migraine headache. A high-fat diet is one factor that may directly affect this process.” [5] This study put migraine-suffering women on a Low Fat Diet and they experienced significant relief.

As far as the supposedly negative mortality studies, Dr. Gould explained:

“In these large population studies, there is a small percentage of people who have preexisting medical conditions, such as cancer, depression, alcoholism, gastrointestinal disease, or addictive behavior such as drug addiction or smoking, all of which reduce appetitie and may impair nutrition in association with very low cholesterol levels.  These preexisting conditions not only lower cholesterol levels but may also cause death unrelated to cardiovascular disease.  Therefore, in such studies, there may be an association between death caused by the preexisting nonvascular disease and low cholesterol levels.  However, if the people with these preexisting nonvascular medical conditions are screened out and removed from the analysis, there is no increase in deaths associated with low cholesterol levels.” [6]

4. Weight Loss is Harder. One third of all men in the U.S. are overweight and one third are obese.  So weight loss is a big issue in most Western countries.  When a guy is 40 or 50 pounds overweight, he wants to lose weight and lose it quickly.  One study shows that low carb diets are the fastest way to lose weight.  Anecdotally, many men have reported that this is true, assuring its superstardom in the health world.

REBUTTAL: Low carb diets cause rapid loss of liver glycogen stores, which are bound up in a bunch of water.  When someone loses weight via low carb, there is an initial rapid burst of water loss on top of the regular weight loss.  Atkins himself admitted this was a huge problem, because the minute that the dieter starts adding in carbs again and increasing glycogen stores, the water weight comes right back on.

Plus, Low Fat Diets have the huge advantage of weight loss without suffering.  Okay, that’s a slight exaggeration, but higher carb diets tend to have much greater volume and bulk than high fat diets.  This allows a man to eat until his stomach is largely full and thus feel minimal hunger.  Example:  a large baby carrot is about 5 calories.  To even get 200 calories, one would have to eat 40 baby carrots!  If you do a Low Fat Diet correctly, you can lose weight almost effortlessly.  Yes, that’s part of the reason that a lot of Asian peoples are thin.

5. Carb Intolerance. There is a school of thought out there now that some men are “carb intolerant,” i.e. simply cannot handle carbs any more.  The backbone of this theory is that some men have essentially entered the prediabetic, Metabolic Syndrome stage and even moderate carbs will give them fatigue, brain fog and, in some cases, high blood pressure.  Phil Maffetone, the overtraining expert, and others have two week carbohydrate intolerance tests out there to see if you are in this category.

REBUTTAL:  Perhaps this is the case for some men.  However, consider if the following five criterion were met:

a) all simple carbohydrates including wheat were avoided

b) fructose was limited to 50 grams per day or less

c) testosterone levels were maintained at youthful levels

d) all carbs were low glycemic (non-wheat whole grains, legumes, beans, etc.)

e) exercise was at least an hour per day

Of course, a man with testosterone of 400 ng/dl is going to struggle:  low testosterone raises insulin levels.  But how many men with youthful T levels who are exercising an hour per day need lower carbs??  I’m sure it happens, but my experience is that most men who have youthful health and hormones have youthful appetities and metabolisms based on what I have seen on The Peak Testosterone Forum.

And one other important comment: Dr. Neal Barnard has a book on reversing diabetes and he directly addressed this issue by doing a study of men with high A1C placed on a low glycemic, Low Fat Diet. The high carbs made these diabetics worse, right? Actually, the results were impressive and the opposite: he found that he could lower their A1C as much as medication even though the men were eating a high carb diet. I discuss all of this in a page on Low Fat and Diabetes. Remember that insulin resistance is caused by the buildup of lipids (fats) within the cells and a Low Fat Diet, even though it is high carb, greatly helps this process.

REFERENCES:

1) Circulation, 2010, 121: 1200-1208, “Dietary Intervention to Reverse Carotid Atherosclerosis”

2)  https://www.heartattackproof.com/reversal01.htm

3) Am J Clin Nutr, 1984 Aug, 40(2):246-50, “Serum vitamin E levels in children with corrected biliary atresia”

4) https://www.nealbarnard.org/books/brain/

5) J of Women’s Health and Gender-Based Med, May 7 2009, 8(5), “The Influence of a Low-Fat Diet on Incidence and Severity of Migraine Headaches”

6) Heal Your Heart:  How You Can Prevent or Reverse Heart Disease, Dr. K Lance Gould, M.D., p. 67.

7) https://philmaffetone.com/2-week-test

What Dr. Esselstyn did was to follow his patients for five years.  And keep in mind that all of his patients were heart disease pateints. Dr. Esselstyn found that those that did not follow his program had an average of close to 4 cardiac events in five years on average. It means that these patients had one case of angina, a heart attack, or maybe a stroke on average about every year and a quarter. The contrast between those who did follow his program was striking: they had NO cardiac events. (There was one arrhythmia case which could not be attributed to diet.)  In other words, Esselstyn’s Low Fat Diet program gave these heart patients back their life and made them essentially free from heart disease.

And, wait, it gets better:  arterial examinations showed that ALL of the complaint patients arrested their heart disease and three fourths of them reversed it! [2] Now how many guys that have erectile dysfunction need to reverse plaque? Well, I don’t know what percentage, but it’s got to be a big percentage.  This is verified by the fact that the research shows that the average man has some kind of a cardiac even five years after his first signs of erectile dysfunction. And the reason is simple: you can have quite a bit of plaque in a neck or heart artery and not suffer from a heart attack or angina initially. However, that same plaque in your penile arteries will cause you substantial erectile dysfunction. Once those penile arteries are covered in plaque, nitric oxide levels go down significantly.

Electrosmog and Excitotoxins - Peak Testosterone

Would you volunteer your back yard as a dump site for spent fuel rods?  Of course not, because the invisible radiation would penetrate your dwelling, alter your DNA and other tissues and greatly increase your risk of cancer.  Unfortunately, this is very likely what you are doing every time you hold a cell phone up to your head to one degree or another. [1]

The issue surfaced when staff and students at a school in California developed cancers at an extraordinary rate.  Reminiscent of Erin Brokovich, researcher Sam Milham investigated and found that the school, due to wiring and other issues, was rife with “dirty electricity”.  Dirty electricity is the kind produced from computers, cell phones and TV’s that are low power. This Interview with Sam Milham is very informative.

Prevention Magazine (Jan 2010) just broke this story and did a fantastic job of showing that Emag radiation is far more dangerous than previously thought and very likely causing significant cancers and other health issues. I had already been pointing out on my twitter account that one study had recently found that cell phones may cause bone loss in the hip area of cell phone carriers. [2]  However, the damage from electrical radition is probably far more insidious than just a little bone loss here and there:

1. EMF signals (at levels even as low as wi-fi) can overstimulate the immune system and may be partially responsible for some of the allergic and auto-immune epidemic seen in modern societies. [3]

2. There is likely a small, but significant risk of a brain tumor just from work exposure alone. [4]

3. Up to 80% of childhood leukemias may be attributable to EMF exposure during pregnancy and infancy. [6]

This list could go on and on. However, I want to focus on something extremely dangerous:  mobile phone radiation can alter the permeability of the blood-brain barrier. This had been verified in mammalian studies using standard cell phone signals and standard GMS signals. [5]  Even worse, the researchers found that effects from this electrical radiation persisted for weeks afterwards.

Furthermore, some researchers have identified that there are “hot spot” areas where electrosmog levels are significantly higher than others, including elevators, trains, cars and airplanes. [7] This is because cell phones actually emit microwave radiation and in these areas the microwaves are simply reflected and bounce around undampened, reaching levels much higher than normal.  Furthermore, it only takes a few cell phone users to produce these levels in many cases.  So this is not something that can be eliminated by avoiding cell phone usage and is analagous to the dangers of second hand smoke.

What does this mean?  It means that modern urban dwellers are potentially at much greater risk for excitotoxin damage than previous thought.  Hopefully, you have read my Excitotoxin page and know that excitotoxins, such as MSG and those in Diet drinks, can damage the hypothalamus and cause Excitotoxin Syndrome.  However, excitotoxins can cause their greatest damage in the brain itself. The food industry has always justified their use of excitotoxins in food on the argument that the blood-brain barrier will protect your precious neurons from damage. That, as it turns out, is a very poor assumption indeed:  even cell phone usage can allow significantly greater flow of any such chemicals into the brain.

To play it safe, I recommend that you do not come with ten feet of any excitotoxin.  It only takes minute amounts in the animal studies to do incredible damage to the mammalian brain and if indeed our blood-brain barrier has been even mildly compromised, the danger is substantial.  There is no one except you that can guard that all-important stuff in your cranium from the food industry.

Finally, be cautious about using a cell phone directly against your head or ear. It is much safer to use the speaker phone or ear phones. Blue tooth devices are also not considered safe. Remember that there is already a study showing a tenfold risk in childhood brain tumors and exposure to higher-than-average electronic emissions. [8] Why take a chance?

NOTE:  See my link on Cell Phone Dangers for additional information.

REFERENCES:

1) Bioinitiative Working Group, July 2007, “Evidence for Effects on Gene and Protein Expression”, Z. Xu, et. al.

2) https://www.webmd.com/news/20091027/cell-phone-on-hip-may-weaken-bone

3) Bioinitiative Working Group, July 2007, “Evidence for Effects on the Immune System”, Johannson, et. al.

4) Bioinitiative Working Group, July 2007, “Evidence for Brain Tumors and Acoustic Neuromas”, Hardrell, et. al.  (See also Brit J of Cancer, 2005, 93(7):842-848, “Mobile phone use and risk of acoustic neuroma: Results of the Interphone case-control study in five North European countries” and Revue d’Epidemiologie et de Sante Publique, 2007, 55(5):321-332, “Cell phones and risk of brain and acoustic nerve tumours: The French INTERPHONE case-control study”

5) Pathophysiology, 2009 Aug, 16(2-3):103-12, Epub 2009 Apr 2, “Increased blood-brain barrier permeability in mammalian brain 7 days after exposure to the radiation from a GSM-900 mobile phone”

6) Bioinitiative Working Group, July 2007, “Evidence for Childhood Cancers (Leukemia)”, Kundi, et. al.

7) Journal of the Physical Society of Japan, 2006, Received March 14, 2006; Revised May 18, 2006; Accepted May 23, 2006; Published July 25, 2006, “Passive Exposure to Mobile Phones: Enhancement of Intensity by Reflection”

8) J Epidemiol, 2010, 20(1):54-61. Epub 2009 Nov 14, “Power-frequency magnetic fields and childhood brain tumors: a case-control study in Japan”

Pomegranate Juice: Testosterone Booster? - Peak Testosterone

We have aleady covered how Pomegranate Juice Boosts Erectile Strength, but did you know that a study on rats showed it giving a nice boost to testosterone? [1] So put down the beer and tequila and start slamming down some pomegranate.  Seriously, what other beverage will make your hormones and your penis stand at attention?

Another good sign is that sperm motility (movement) and concentration were increased as well.  In other words, both fertility and hormones were helped.

CAUTION: Talk to your doctor if you are on any medications.  Pomegranate juice is so powerful that it can definitely interact with certain medications negatively. In addition, there are three reported cases of priapism occurring in men simultaneously taking Viagra. [3] Again, pomegranate juice is very powerful. In addition, please read my link on The Potential Side Effects of Pomegranate Juice : there was an animal study showing it increase the risk of Parkinson’s.

So how pomegranate juice would you have to consume?  Well, the rats were given small, medium and/or large amounts of pomegranate juice.  A large amount of juice was 1 ml. [2] Now if the typical rat is 400 mg, that translates to 182 ml or 6 ounces for an adult 160-lb male. Now I’m not a researcher and don’t know if a one-to-one ratio is most appropriate, but assuming that is the case, 6 ounces of pomegranate juice is entirely reasonable.

Will just 6 oz. per day of pomegranate juice give a male a nice increase in testosterone?  We don’t know the answer to that question.  But remember that pomegranate juice has huge cardiovascular benefits anyway:  decreased inflammation, lowered cholesterol, plaque removal – the list goes on and on.  And who knows?  Maybe your T will head north at the same time.

REFERENCES:

1) Clin Nutr, 2008 Apr, 27(2):289-96, Epub 2008 Jan 28, “Effects of pomegranate juice consumption on sperm quality, spermatogenic cell density, antioxidant activity and testosterone level in male rats”

2) https://www.ergo-log.com/pomegranate.html

3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3355694/

Low Carb Low Fat Diet (High Protein Low Fat Diet).

Low Fat Diets are for the anemic, sick-looking muscleless types, right? Well, some implementations of it could give you that opinion. The most famous versions of low fat diets are those of Ornish, Esselstyn and Pritikin and these all are low protein, high carb, low fat diets. Now I have incredible respect for all of these men – in fact, I have no doubt that their research has probably saved my life – but I’ve never really eaten that kind of Low Fat Diet. The reason? I’m just too interested in muscle building and trying to improve my (Skinny Bastard) physique.

I remember looking at their recommended protein levels (~10% of total calories) and thinking, “Well, no way I’m doing that!”  To me it just seemed obvious that one could build upon a standard Low Fat Diet and just substitute some extra protein for all of those carbohydrates.  After all, a standard Low Fat Diet relies on a monstrous amount of carbs during maintenance mode, i.e. when you are not gaining or losing weight.

If you run the numbers, an Ornish/Esselstyn type of Low Fat Diet requires a man to consume around 500 grams of carbs per day.  To me, that seems like a lot, especially for the typical sedentary, office-working male – yeah, like me! – in modern America.  While I do exercise every day and my youngest son keeps me moving, I am pretty sedentary overall.  500 grams seems like an awful lot, unless you can somehow burn it off.

All of these numbers are desireable in my opinion, but I want to really focus on those top two numbers.  The two numbers are two of the most critical to make sure that you arrest or even regress your arteriosclerosis.  It’s no guarantee, of course, but it is a very good sign that you will have plaque under control.  And I mention it, because so many men on this site and The Peak Testosterone Forum need to clear out some plaque.  For example, Dr. Davis has very spartan requirements to regress plaque, which he calls his “Rule of 60,” i.e. LDL < 60, Triglycerides < 60 and HDL > 60.  Some other Low Fat Diet gurus have a little less stringent requirements, which I discuss in my page entitled LDL Levels to Reverse Plaque.

NOTE: Both Dr. Davis and Dr. Gould point out that a Low Fat Diet will not regress or even arrest plaque in all men.  Sometimes it takes greater inverentions. See their books Track Your Plaque and Heal Your Heart for details.

Here are my reads from two physicals where I still have the records:

LDL = 71 mg/dl; Triclycerides = 83 mg/dl (5/28/2013)

LDL = 95 mg/dl; Triglycerides = 71 mg/dl (12/7/2010)

The latter had a little higher LDL than my normal read, but you get the idea:  I have been able to keep both LDL and triglycerides low.

I realize that lowering LDL is controversial right now and that there is a “Cholesterol Doesn’t Matter” theory out there.  I’m not going to get into that here, but suppose you are more in my camp and you are concerned about arteriosclerosis and want to maximize arterial blood flow and nitric oxide.  If so, you will be wondering how one can make a Low Fat Diet practical.  I think the easiest way to do that is to discuss macronutrient ratios, i.e. the percentage of protein, carbohydrates and fat.  The typical Ornish/Esselstyn/Pritikin Low Fat Diet ratios are the following

Protein = 10%; Carbs = 80%; Fat = 10%

I have a different starting point however.  In my case, I want at least 165 grams of protein in order to follow the 1 gram per pound of body weight heuristic for muscle building and athletics in general.  And I actually tweak that up a bit because I consume mostly plant-based proteins to a) save money, b) control IGF-1 (due to a high PSA read) and c) stick to undenatured peptides.  So I actually try to eat around 180 grams of protein per day, simply because plant protein (with the exception of quinoa) are a little less bioavailable.

NOTE:  There are lots of Low Fat animal proteins out there and I discuss meat options in my page on Low Fat Meats. A Low Fat Diet does NOT has to have a lot of plants, but it definitely does not have to be strictly vegetarian: both Pritikin and Gould encourage the consumption of animal protein for example.

Another deviation for me since I am 53:  I only need about 2,300 calories per day.  In my younger days, I had a nearly infinit metabolism.  However, that has definitely ramped down and I just can’t pack it away like I used to.  Furthermore, I also like to eat a few nuts and/or dark chocolate every day.  This allows me to bump up my % Total Fat to 15%.  I am not talking about much in the way of nuts here:  a couple small squares of dark chocolate or just a few walnuts or almonds and that’s it.  But bumping this up to 15% still fits the research definition of a “very low fat diet,” and allows me to displace a few more carbohydrates.

When all is said and done, here are my targeted macronutrient ratios:

Protein = 31%; Carbs = 54%; Fat = 15%

You’ll notice that my protein / carbohydrate ratio is 1.71, which is respectable according to the theories of Dr. Barry Sears regarding inflammation.  But the key thing is that, if you run the numbers out, I only need a little over 1,200 calories from carbs or 309 grams per day.  This is a much more manageable amount of carbs, even for a middle-aged guy like myself.

Something else that I think really helps me is that I am a Grazer.  Right now eating lots of small meals is out of vogue and you have strategies such as intermitent fasting rising in popularity.  But I just feel fantastic eating a bunch of small meals throughout the day.  Eating a big meal, which can hammer testosterone as I document in my page on Testosterone and Meal Size page, often leaves me tired and groggy.

With small meals, I have excellent energy. I have even made this work in my career by eating a small amount of quinoa or fruit or some granola bars along with some protein powder as a pre and post workout meal.  (I usually go to the gym over lunch.) Doing it this way, I never have to worry about beta cell killing post-meal blood glucose spikes and I feel alert all day and evening. I cannot imagine eating any other way, but we all have our preferences I realize. The disadvantage is that at lunch and dinner, I also eat small meals. Fortunately, my wife is understanding and knows that I will keep my portions down. When we go out to eat, we usually share a meal and that works out perfectly.

In my case, I actually eat about 7 of these small meals per day.  I’ll eat first thing in the morning, 3-4 times at work and 2-3 times when I get home.  What this means is that my typical “meal” averages out to about this many grams of each macronutrient:

Protein = 26 grams; Carbohydrates = 44 grams; Fat = 5.5 grams

Notice that this is the perfect protein level for muscle building. Most protein powders have a 20-25 gram serving size and the studies show that around 20 grams is the right “dose” for hypertrophy.  Eating these small meals insures that I get a nice steady supply of protein throughout the day as well.

Now there is a theory out there that our cells need rest in order to get rid of waste and replenish/recuperate themselves.  Obviously, I do not follow that theory.  I can only say that I have eaten that way for 5+ years and feel very good.

Do I have any cautions though?  My only warning is:  don’t cheat!  What do I mean by that?  Well, I have talked to many men who have stated, “I tried low fat and I just didn’t feel good.”  Then I chat with them and find out that they they are consuming almost entirely for carbs one of the following:  wheat and oatmeal, both of which can really spike blood sugar in some men, and fruit juices, which can be high in fructose. Obviously, you’re not going to feel good unless you stick to low glycemic, whole food carbs.

So it’s very important that you eat good, low glycemic carbohydrates, or you could hurt yourself on a Low Fat Diet.  Dr. Bernard’s work showed that, if you eat a low glycemic, Low Fat Diet, you can actually reverse diabetes and very significantly lower your A1C.  For more information, I discuss this in my page on Low Fat Diets and Diabetes.

I get my carbohydrates primarily from vegetable/fruit smoothies and quinoa, millet and legumes that  Iprepare in a rice cooker.  I will also sometimes have raisins and granola bars, but I always keep the amount small.   And I religiously get at least 10 servings of fruits and vegetables every day.  If there is one thing you are going to do for your health, this is probably the most important, something I discuss in my page on The Benefits of Fruits and Vegetables.

One last comment is that I feel that a Low Fat Diet is the perfect complement to HRT. With HRT, you get a nice boost to your hormones and, therefore, neurotransmitters, and, with a Low Fat Diet, you get arterial protection and a boost in blood flow and nitric oxide.  In other words, you get the brain, gonads and arteries all supercharged. These can combine nicely and really help a middle-aged or senior guy’s sex life.  Been there!

CAUTION: There is some evidence that eating a lot of protein may not be a good anti-aging strategy. I still do it any way, due to the benefits to my physique and the excellent cardiovascular parameters it provides me. But “eyes wide open” and I recommend reading my page on The Potential Dangers of Protein for more details.

The counterargument is that many of the supercultures are low fat or pretty close and eat a LOT of carbs.  And Nathan Pritikin ate this kind of Low Fat Diet almost all of his adult life and did just fine.  He stayed thin all of this life as far as I know AND died with perfectly clear arteries.  Even so, that many carbs still made me a bit uncomfortable.

Again, my choice was obvious:  add in some protein and subtract out an equal amount of carbs.  And that is exactly what I did in proportions that I describe below.  Before we go into the numbers, I want to point out that I have found this way of low fat eating to produce great stats. I was glad that I had kind of stumbled into this way of eating when I saw that produced these kind of numbers:

A High Protein Low Fat Diet Macronutrient Ratios

Vitamin D: A True Miracle Pill - Peak Testosterone

Vitamin DI wake up every morning and take my Vitamin D with a smile on my face and a song in my heart.  Exagerration?  A little but not much. First of all, Vitamin D is the Muscle Vitamin.  That’s right – muscle cells have Vitamin D receptors and low levels can decrease muscle strength and performance.

Vitamin D is also the Great Forgiver. Let’s face it – none of us guys have been perfect with our health:  we’ve all abused our bodies and pushed our luck in one way or another.  Vitamin D is one of our best insurance policies against our inability to be perfectly disciplined.  It lets us forgive and forget.  (Exercise is the same way.  Remember:  “exercise covers a multitude of sins”.)

NOTE:  Be sure to read my link on Boosting Your Testosterone with Vitamin D.

Why do I say this?  The beauty of Vitamin D is that it dramatically improves outcomes for what I call the Big Three Killers of us males:  heart disease, cancer and autoimmune disorders. In fact, let’s face it:  two of the scariest things about middle age are the idea of a sudden heart attack dramatically taking away our life or a cancer and/or autoimmune disease slowly and painfully doing the same.  This is where Vitamin D comes to the rescue.

In the last five years study after study has uncovered Vitamin D’s almost magical and uniquitous powers over our health.  It regulates and is involved in over 2000 genes.  Almost every system and part of our bodies are affected by Vitamin D levels.  And the beauty of Vitamin D is that it is a cheap and readily available supplement.

Think about this:  one of the stressors in life is to stay in good health and keep from dying.  Seriously, if you can stave off cancer, diabetes and heart disease, then you very likely have decades of productive and enjoyable life ahead of you.

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

1.  Heart Disease. Vitamin D deficiency has been oft associated with cardiovascular disease [1] and the reason is likely that it seem to affect arterial inflammation levels.

2.  Cancer.  Vitamin D is a cell growth controller, which explains why Vitamin D offers strong All Around Cancer Protection, GI Cancer Protection and Prostate Cancer Prevention.

3. Brain. “Maintain your brain”.  That’s a good motto if ever we’ve heard one and Vitamin D is one major key to holding onto your memory and ability to learn.  Read about Vitamin D and the Brain.

4.  Flus, Colds and Immunity. As it turns out, low levels of Vitamin D were recently found in one study to be linked with a significantly greater incidence of colds and flus.  See this link on Immunity for details.

5. Autoimmune Disorders including Diabetes. The studies look very promising and show that higher levels of Vitamin D may be strongly protective against diabetes –  yet another major killer of us males. [2] [3]  Crohn’s disease, multiple sclerosis [5] and rheumatoid arthritis [6] also seem to be linked to lower Vitamin D levels as well.  Again, this is probably because of Vitamin D’s centrality to immune function.

6. Bone Health. Calcium gets all the glory, but Vitamin D is every bit as important for bone health.  Why?  Calcium is regulated by Vitamin D.

7. Diabetes. 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. [10]  Another study found that those with the lowest Vitamin D levels had a 47% greater chance of developing prediabes. [11]

8. Testosterone.  Some people consider Vitamin D a hormone – that’s how powerful it is.  Regardless as to what you call it, it can also profoundly affect our hormone levels, including testosterone. For more information, read my link on Boosting Your Testosterone with Vitamin D.

9. Nitric Oxide and Blood Pressure. Getting your Vitamin D levels out of the basement may actually increase your arterial nitrix oxide levels, something I discuss in my page on Nitric Oxide and Vitamin D.

You may have read that sometimes it is a deficiency of Vitamin D that actually causes issues and so this may not seem to be an issue for you. Unfortunately, it is actually difficult to get adequate levels of Vitamin D for urban dwellers for many reasons and for this reason one study found that three fourths of adult and younger Americans are deficient for example. [4] Here’s some of the top reasons why:

So how much should you take? Almost every export now agrees that the old RDA’s (200 IU for those < 50 and 400 IU for those > 50) are not enough.  [7]  Many nasty diseases and overall mortality is clearly associated with a Vitamin D deficiency below about 15 ng/ml,  measured by blood levels of 25(OH)D or serum 25-hyroxyvitamin D, and the current post-age-50 RDA will put you right in this neighborhood.  However, a 2010 study, for example, found improvements up to 43 ng/ml in “death, diabetes, cardiovascular disease, myocardial infarction, heart failure, high blood pressure, depression, and kidney failure.” [8] There are other studies as well that show substantial benefits above the old 15 ng/ml level.

So how much Vitamin D would you have to take to get the maxiumum benefit mentioned above of 43 ng/ml?  Well, this is where it gets interesting:  43 ng/ml corresponds for 25(OH)D to 107 nmol/l.  And to get your plasma levels up to this level, you would need to take about 4000 IU of Vitamin D per day, according to one recent study. [9]

This is why you will see almost all experts now recommending at least 1000 IU per day and perhaps even more.  Always talk to your doc, but I take 1200 IU per day, especially since I avoid the sun and put on sun screen.

REFERENCES:

1) Circulation, 2008, 117:503-511, “Vitamin D Deficiency and Risk of Cardiovascular Disease”

2) J. Nutr, Feb 2005, 135:323-325, “Symposium: Vitamin D Insufficiency: A Significant Risk Factor in Chronic Diseases and Potential Disease-Specific Biomarkers of Vitamin D Sufficiency”

3) Ann Rheum Dis, 2007, 66:1137-1142 “Vitamin D and autoimmunity: new aetiological and therapeutic considerations”

4) Archives of Internal Medicine, 2009, 169(6):626-632, “Demographic Differences and Trends of Vitamin D Insufficiency in the US Population, 1988-2004”

5) Environ Health Perspect, 2009, 117:A196-A196, “Vitamin D Regulates MS Gene”

6) https://www.physorg.com/news189863205.html

7) WebMD, “Are You Getting Enough Vitamin D?”

8) https://www.physorg.com/news187879711.html

9) American Journal of Clinical Nutrition, May 1999, 69(5):842-856, “Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety”

10) 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

11) Men’s Health, Jul/Aug 2011, p. 33

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]

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..

Antioxidants: Testosterone Increasers? - Peak Testosterone

There’s a lot going on in those testes of yours, including sperm and testosterone production. Yeah, it’s a big factory down there and researchers have found increasing evidence that “oxidative stress”, i.e. free radical damage, is one of the leading causes of lowered testosterone.  Damage to the mitochondria appears to play a key role. [4]  In an eye-opening study, researchers found that the Vitamin E, a antioxidant that quenches several free radicals, actually slowed down the age-related decline in testosterone in lab rats. [1] This may mean that one can significantly slow down andropause if one starts at a young enough age. Life is full of regrets, eh?

Researchers have also discovered reduced levels of key antioxidants, such as the heavy hitters SOD and glutathione, in aging rat Leydig cells, thus adding weight to the above oxidative stress theory and the need for adequate antioxidant dietary support. [2]  However, here is what should really catch your attention:

1.  Pomegranate Juice.  We have aleady covered how Pomegranate Juice Boosts Erectile Strength, but did you know that a study on rats showed a nice boost to testosterone as well? [3]  In fact, the rats drinking the most pomegranate juice got a nice 27% in testosterone! In my link on Pomegranate Juice and Testosterone, I show just what dosage may achieve these kind of gains.

Of course, the problem with this is that for the typical 160 pound male, you are talking about a megadose of over 3 grams of quercetin in us humans. Nevertheless, it shows the power of some antioxidants to power up testosterone production in the ol’ Leydig cells.  NOTE:  I do not know the human-to-equivalent ratio for the rats used in this study.

3. Onion Juice. Based on #2, it probably will be no surprise that onions, if consumed in large enough quantities, can boost testosterone.  Of course, the question of the day becomes “how in the world do I eat an onion or two and still live in polite society”?  Researchers came up with a nice solution:  onion juice. They just blended one standard onion and – shazam! – the juice boosted rat testosterone by 300+%. [5]

The only problem is that the amount of onion juice these rats consumed was 1 gram per kilogram, which translates to about 73 grams of onion juice for the typical 72 kg guy.  However, it should be noted that even taking half that amount of onion juice created a nice testosterone boost as well, so it is likely dose dependent, i.e. even a smaller amount of onion juice may give you a little lift.  NOTE:  I do not know the human-to-equivalent ratio for the rats used in this study.

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4. Melatonin.  Data is very limited but the antioxidant and hormone melatonin appears to protect testosterone in Leydig cells as well. [1]

So should you start gulping gallons of juice?  Well, that’s a little premature for a variety of reasons. First of all, all of the above studies are on animals and may not translate to humanoids such as ourselves.  Furthermore, perhaps it’s possible to overdo antioxidant consumption.  For example, some experts have posited that if you overdo ingestion of antioxidants, it shuts down the body’s own natural antioxidant production.  In fact, some studies have shown that antioxidants in supplement form may actually be dangerous to your heart or promote cancer as I document in my links Antioxidants and Your Heart and The Dangers of Antioxidant Supplements.

However, a solid diet loaded loaded with ample antioxidants will likely protect and possibly boost your testosterone and give you multiple additional health benefits as well.

1) Experimental Gerontology, Aug-Sep 2005, 40(8-9):728-736, “Vitamin E, aging and Leydig cell steroidogenesis”

2) The Journal of Steroid Biochemistry and Molecular Biology, Jan 2004, 88(1):61-67, “Aging alters the functional expression of enzymatic and non-enzymatic anti-oxidant defense systems in testicular rat Leydig cells”

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

4) Endocrinology, 2002, 144(7):2882-2891, “Reactive Oxygen Disrupts Mitochondria in MA-10 Tumor Leydig Cells and Inhibits Steroidogenic Acute Regulatory (StAR) Protein and Steroidogenesis”

5) https://www.ergo-log.com/onionjuice.html

6) J Endocrinol, 2004 Jun, 181(3):493-507, “Reduction of rat prostate weight by combined quercetin-finasteride treatment is associated with cell cycle deregulation”

Low Testosterone Cause Bone Loss(Osteopenia or Osteoporosis)

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 our forum posters 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 this research summary 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://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

LDL- Predictor of Arterial Plaque,Heart Disease-Not Regular LDL

I have written a little about this before, but a Peak Testosterone Forum member asked the following, and I realized that I had not done enough to show the extreme importance of LDL-P in predicting arterial plaque and heart disease in general:

“Thanks for the response and the info, bud! I really appreciate it. Sorry that it took so long to respond, I have been traveling and also been swamped with work. With regards to LDL-P, I don’t know if a specific study that states that LDL-P (regardless of composition of sizes) is the best indicator of CVD risk. I’m not saying that it doesn’t exist, I just dont know if it does. That would be pretty compelling.” [1]

To answer this poster’s question, I would say that not only is there evidence LDL-P is the best predictor of future heart disease, but there is abundant evidence that it is so.  Here are Five Powerful Examples from the Research (and there are many more):

Therefore, it is prudent to work on every 100 points of LDL-P that you can.  Keep working on it and bring it down. CAUTION: There is a small percentage of men with extremely low cholesterol and lipid numbers.  These men do not need to bring their numbers down and may even need to try to boost them.

This same study in the journal Atherosclerosis basically showed the LDL-P blew away LDL-C as far a predicting heart events:

“Particularly in patients whose LDL-P and LDL-c levels are discordant, LDL-P seems to better predict cardiovascular (CV) events than LDL-C levels [6-8]. Several expert panels and guidelines already advocate the use of LDL-P as target of therapy in certain at-risk patients. This report aimed to provide real world evidence that confirms that clinical management aided by LDL-P.” [3]

BUT WHY?  Why is LDL-P so important and clearly so much more predictive than LDL-C?  Because LDL-P essentially measure the concentration of LDL particles in your plasma and it is the concentration of LDL that determines if it will be pushed into your artery walls.

2. Arterial Plaque (via IMT) in Healthy Men.  Many studies show that LDL-P is associated strongly with the buildup of arterial plaque, the Great Bedroom Killer. One way to measure plaque is via an IMT, an ultrasound that measures the thickness of your carotid (neck) artery, i.e. plaque buildup.  Researchers in one study found that LDL-P was a powerful and independent predictor of IMT:

“In a community-based sample of Japanese men, free of clinical CVD, LDL-P was a robust marker for subclinical atherosclerosis, independent of LDL-C and other lipid measures. Associations of LDL-C and other lipid measures with either cIMT or CAC were generally not independent of LDL-P.” [6]

Again, notice that they said that, while LDL-C cannot be entirely ignored, LDL-P was the more powerful and independent predictor.

3. Framingham Offspring Study.  Researchers examined this set of data and concluded that “in a large community-based sample, LDL-P was a more sensitive indicator of low CVD risk than either LDL-C or non-HDL-C, suggesting a potential clinical role for LDL-P as a goal of LDL management.” [2] And the event rate was much improved over other CVD markers examined as well:

“Subjects with a low level of LDL-P (<25th percentile) had a lower CVD event rate (59 events per 1000 person-years) than those with an equivalently low level of LDL-C or non-HDL-C (81 and 74 events per 1000 person-years, respectively).”

4. PLAC-I Trial (Statin Treated Men).  In this study, the authors found that “within treatment groups, CAD progression was strongly associated with total LDL-P, after adjusting for other lipid levels, and a small LDL-P level of over 30 mg/dl was associated with a ninefold increased risk in CAD progression.” [5] In other words, it doesn’t matter whether you are on statins or off, LDL-P is the big gun. And notice that your heart disease risk goes up exponentially if you have a high small particle count number.

5. Quebec Cardiovascular Study.  Again, researchers emphasized the critical importance of apo B, which is an alternative and parallel lipid measurement:  “The results of this prospective study confirm the importance of both elevated plasma cholesterol and decreased high-density lipoprotein cholesterol levels as risk factors for ischemic heart disease. They also emphasize the high prevalence of an elevated apo B dyslipidemic state in ischemic heart disease.” [4] NOTE:  ApoB is also less expensive to pull than LDL-P and gives the same information.  However, the only disadvantage is that thresholds for plaque control and reversal do not seem to be as well-researched.  See my pages on Penile Arterial Plaque Regression for more information.

CAUTION: There are many other important predictors of heart disease and events, including CRP, Lp(a), fibrinogen, blood pressure, etc.  So do NOT monitor your heart disease risk with just one number.  That said, it’s hard to beat LDL-P as the biggest cardiovascular market now and many notable high fat, Paleo and Low Carb bloggers have discussed this.

1) https://www.peaktestosterone.com/forum/index.php?topic=9550.0

2) J Clin Lipidol, 2007 Dec 1, 1(6):583 592, “LDL Particle Number and Risk of Future Cardiovascular Disease in the Framingham Offspring Study Implications for LDL Management”

3) Atherosclerosis, 2014 Aug, 235(2):585-91, “Cardiovascular risk in patients achieving low-density lipoprotein cholesterol and particle targets”

4) Am J Cardiol, 1995 Jun 15, 75(17):1189-95, “Prevalence of dyslipidemic phenotypes in ischemic heart disease (prospective results from the Qu bec Cardiovascular Study)”

5) https://www.medscape.com/viewarticle/712122_3

6) J of Clin Lipidology, “Associations of serum LDL particle concentration with carotid intima-media thickness and coronary artery calcification”

The Mind - The Natural Testosterone Booster.

REFERENCES:

1) Psychosomatic Med,1999,61:292-296

2) Behavioural and Brain Sciences, 1998, (21):353-363

3) J of Personality and Social Psych, Oct 2006, 37(11)

4) Hormones and Behav, 1989, 23: 556-571

5) Aggressive Behavior, 1981, 7: 215-224

6) Social Psychology Quarterly, 1992, 55:70-77

Your attitudes about life, about yourself and about sex have a profound impact on your testosterone (and libido for that matter). Psychology is incredibly important for all guys and is arguably the most powerful of all the natural testosterone boosters.

Now, before I go on, I want you to know that I am not saying that low testosterone is “all in your head”.  Some of you have had bad experiences with doctors regarding low testosterone and/or erectile dysfunction where the doctor said or implied it was all psychological on your part and that is certainly not always the case.

That’s not what I’m talking about here:  I’m talking about using your mind as an actual testosterone booster that is completely natural and totally free.  There’s nothing to feel guilty about:  I am simply giving you a “mental supplement”, if you will, to take as part of your solution. Below I am going to give you some key ways to use your attitude and your outlook on life as a legitimate natural testosterone booster.

“But I want a pill”, some of you are probably saying.  Well, forget that idea:  the FDA has banned every legitimate testosterone booster that has hit the market.  6-OXO is a classic example.  The manufacturer had a synthetic steroid in this supplement and it definitely increased testosterone according to several studies.  Of course, it was just a matter of time before the FDA yanked it off the shelves. Other supplements, including prohormones such as Mark-McGwire-made-famous androstenedione, have suffered the same fate.

The bottom line is that anything that is a significant testosterone booster will go away and you are much better to rely on natural means.  Plus, if you try everything on this site to boost your testosterone naturally without success, then the testosterone booster you should really try is your body’s own bioidentical hormone, i.e. Hormone Replacement Therapy, instead of some synthetic annd untested steroid-like product added to a supplement.

Natural Testosterone Boosters: Winning and Competition

Researchers have found what us males have discovered instinctively: winning and winning attitudes stimulate testosterone (and dopamine) levels. Losing and losing attitudes are, in contrast, anything but a natural testosterone booster.  As you might expect, they actually depress testosterone levels. The rush, the high of competition effects everything if you are male. Like it or not, that s part of what life for us guys is all about. Long term non-competitiveness and losing in any area of our life is just not good for us. Sure, a few losses are good for the soul and build humility and all that. But don t stay there. Feeling like a loser is hormonal death.

Numerous studies have shown just what I m talking about:

There’s another key mental condition that can be a powerful natural testosterone booster:  sexual anticipation.  In another link I cover how Sex itself can increase testosterone. But it turns out that just the anticipation of sex does the same thing.

Let s look at just one example of the effects of psychology on testosterone: research has shown that there is a large difference in testosterone levels between married and unmarried males. Who do you think has the higher average testosterone? If you guessed unmarried, you d be right. Married males have significantly lower testosterone levels on average.

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Of course, for those of us who believe in the merits of monogamy, this is disturbing to say the least. But there is a subtlety here that escapes the initial analysis:  single life is a testosterone booster likely because of competition rather than any, in general, huge disappointments with their wife or married life.  Competition is, after all, one of the keys to raising testosterone.

That is why, married or not, you must battle for your woman’s heart.  You need competition.  You need the anticipation of battle, romance and you-know-what. O mighty T warrior, you must, above all else, never give up.  Giving up is the surest way to lose the key to that natural testosterone booster that I am presenting you with.  Don t get arrested or anything, but without competition and a winning attitude, you’ll be swimming upstream..

Does anticipation of sex really make a significant difference? And what kind of numbers are we talking about?  One study of Air Force vets found unmarried males with up to 20% higher average testosterone readings than married males! If your testosterone is sitting at a marginal 360, that s around 70 points. Ouch! And think of it going the other direction: getting your attitudes healthy and active regarding sex and romance can could be a natural testosterone booster of up to 70+ points as well.

Another study found that men who had cheated or would consider cheating had considerably higher testosterone levels.  In fact, their testosterone levels were as high as single males. [3] Of course, I’m not suggesting you cheat as a testosterone booster.  What good will it do you to jack up your testosterone by 25% but have brain damage after a frying pan hits you in the back of the skull?  However, I am suggesting that you build your life around a good, healthy dose of competitive endeavors, including those in your relationships.

I’ve concentrated on relationships above, but studies show that sports of all kinds are also excellent and natural testosterone boosters. In fact, several studies have shown that just the anticipation of a competitive sporting event (in which one participated of course) significantly raises testosterone. [4]  The same holds true after matches, for winners.  [4][5]  In fact, the studies show that winners boost their testosterone for several hours after competition.

Does it have to be a sport with strenuous physical activity?  The answer is no:  one study showed that chess can be a significant testosterone booster. [6]  Again, the key attribute of a legitimate psychological testosterone booster is not so much activity but rather competing and sometimes winning while you’re at it.

CAUTION:  Negative attitudes and mental states, such as Depression and Stress, have been shown in studies to whack testosterone.  I would go so far as to say that if you want to neuter yourself, just wake up each morning with a I m a worm attitude. For example, one 1999 study showed that depression not only whacked nighttime and 24-hour testosterone levels but, just as bad, raised cortisol by 68%!  [1] (Cortisol and depression will destroy your brain.  For more information, read about these effects on the Brain.)

So, again, for a completely natural testosterone booster, build as many of these ideas as you can into your life:  winning, a winning attitude, competition, sexual anticipation.  Your mind – it’s the ultimate testosterone booster.

CAUTION: It generally takes at least a month before you can feel any change in your testosterone levels.  Remember:  tissues, receptors and neurotransmitters take a while to rebuild. Anything that you try to increase your testosterone must be implemented for a minimum two month test period.

Ideal Testosterone: What Is It? - Peak Testosterone

REFERENCES:

1) https://peaktestosterone.com/forum/index.php?topic=4351.0

“I maintain total testosterone between 400 and 500 using gels or injections.” [1]

So this physician, a urologist in this case, basically ignores all symptoms and maintains pretty low levels of testosterone compared to the clinics.  In his mind, he is “playing it safe.”

The is in direct contrast with the typical anti-aging doctor or HRT clinic out there, who insists that you want youthful peak testosterone levels, where youthful by their definition is usually around 1200 ng/dl peak.  (Their average testosterone levels are usually around 800-900 ng/dl.)  That is a wide difference, of course, so who is right?

Let me tell you why I believe both of the above approaches are wrong and the truth lies in a much more rational middle ground.  First of all, let’s look at four things that need to be considered with regards to HRT:

1. Classic Low Testosterone Symptoms. This includes items like low libido, erectile dysfunction, lack of morning erections, fatigue, poor sleep, depression, anxiety, mental fog, etc.  These are the symptoms that plague so many hypogonadal men out there and get them in the doctors office in the first place.  “I don’t feel right, doc!”  One more I would add is like of gains and motivation to go to the gym.

2. Medical Conditions. This can include things like prediabetes, elevated insulin levels, elevated blood glucose level, osteoporosis, and anemia. Venous leakage is another big one and I urge you to read my link on The Symptoms and Causes of Venous Leakage. Low testosterone can can be a root cause for venous leakage or any of the other medical conditions.  Why?  Testosterone almost always lower insulin levels and increases insulin sensitivity;  it increase red blood cell production; and one of its “byproducts,” estradiol, keep your bone mass healthy.  (I have many links on these subject, so use the Search button above if they apply.)

3. Side Effects. Unfortunately, HRT is not without side effects from time to time.  These include acne, enlarged prostate, elevated blood pressure, gyno, hair loss and elevated red blood cell counts. None if these are very common from what I have seen but they do happen from time to time.

4. Estradiol Symptoms. If a man goes high enough with his testosterone, estradiol will follow behind and also go higher.  These leads to symptoms like bloating, water retention, gynocomastia and moodiness. Some doctors will, instead of lowering testosterone, put a man on Arimidex.

NOTE: Of course, many men can lower the symptoms by losing weight. Even losing 10 pounds or 20 pounds for some men can make a big difference in these types of symptoms.so high estradiol symptoms can be a combination of extra fat and overly high testosterone levels. And some men are just “high converters.”

So here is my formula for testosterone:

Go as low as possible to eliminate your low testosterone symptoms, side effects and any high estradiol issues but high enough to cure any medical conditions that have resulted from being hypogonadal.

The key thing is that you need lots of adequate testing and a physician that knows what he is doing to do the above.  The alternative is to just start out high and go all out with higher testosterone levels.  The clinics will often do this so the guy gets that “wow!” effect and is a paying customer from what I have seen.  However, I would argue that this may not be the safest strategy.  One of the reasons is that there is some evidence that, for men with certain clotting issues, higher testosterone, estradiol and Arimidex levels may be putting him at risk. Read my page on Testosterone Risks for more information.

Of course, your situation will be very different from mine and so you will have to make your own judgement, working of course with your doctor. The strategy is always similar though:  you want to minimize negative issues and still reach your baseline goals.

So is the magic number for you 600? 900? 1200? Again, the answer is that it really depends. In my case I started out a little high in testosterone and this is not necessarily a good thing.  I believe that it did get me over my venous leakage more quickly, but I ended up with a bit of gyno for a few months.

The truth is that I probably only need testosterone levels of six or seven hundred. This is when I have noticed that my morning erections are frequent. I also have noticed that I seem to feel pretty good mentally with testosterone around six or seven hundred and near the end of mine weekly injections cycle. But there are many who feel very good in the 400’s and 500’s. So every case is different and every man’s situation and requirements will be different.

In my opinion, you want to be as safe as possible. The word here is sustainable. Is this something that you can do the year after year, decade after decade and end up more healthy and more fit and better able to produce at your job and make you a better parent (if applicable)?

Phthalates and Testosterone - Peak Testosterone

REFERENCES:

1) https://www.sciencedaily.com/releases/2009/11/091116085040.htm

2) International Journal of Andrology, 29(1):172-180, Published Online 7 Feb 2006, “Possible impact of phthalates on infant reproductive health”

3) Toxicological Sciences, 2008, 105(1):153-165, “A Mixture of Five Phthalate Esters Inhibits Fetal Testicular Testosterone Production in the Sprague-Dawley Rat in a Cum7) J Appl Toxicol, 1989 Aug, 9(4):277-83, “Mechanism of testicular atrophy induced by di-n-butyl phthalate in rats”. Part 1.

4) Toxicological Sciences, 2008, 105(1):153-165, “A Mixture of Five Phthalate Esters Inhibits Fetal Testicular Testosterone Production in the Sprague-Dawley Rat in a Cumulative, Dose-Additive Manner”

5) Environ Health Perspect, 2003, 111:1164-1169, “The Relationship between Environmental Exposures to Phthalates and DNA Damage in Human Sperm Using the Neutral Comet Assay”

6) Human Reproduction, 19(5):1121-1126.”Demonstration of Chlamydia trachomatis IgG antibodies in the male partner of the infertile couple is correlated with a reduced likelihood of achieving pregnancy”

8) Biological Psychiatry, 15 Nov 15 2009, 66(10):958-963, “Phthalates Exposure and Attention-Deficit/Hyperactivity Disorder in School-Age Children”

9) European Journal of Endocrinology, 2006, 154(5):599-611, “Environmental chemicals and thyroid function”

10) https://www.medicalnewstoday.com/articles/247857.php

11) Environ Health Perspect, 2007 June, 115(6): 876 882, “Concentrations of Urinary Phthalate Metabolites Are Associated with Increased Waist Circumference and Insulin Resistance in Adult U.S. Males”

Phthalates are not the nastiest chemical in our environment, but they are everywhere.  They are added in large quantities in most plastic products you buy and are used in hundreds of agricultural, commercial, residential and consumer products. They are in shampoos, pesticides, soaps, nail polish, lotions, cosmetics, vinyl and fragranced detergents.  Even worse, they are used as the coating of some pills and supplements and in air fresheners sprayed throughout homes and businesses.

What’s a few phthalates amoung friends?  Well, if you’re a male, it’s bad news:  phthalates are nasty xenoestrogens now associated with a host of ills.  Hardly a month goes by now without some new study showing the negative effects of phthalates on both us and the environment.

Phthalates are particularly damaging to children.  If you have kids or know anyone with children, I hope you’ll encourage them to only use glass and stainless steel for cooking.  (Also I urge you to keep your use of canned products to an absolute minimum around any boy pre-puberty. See this link on Bisphenol-A for more details.)

What is so tragic is that scientists have known for 30+ years of the dangers of phthalates, yet no one has done anything about it.  One 1982 study for example showed that phthalates shunted testosterone-boosting zinc away from the testes. [6]  A study a few years later verifed this and noted actual testicular atrophy (shrinkage). [7]

Lest you think I am exagerrating, let me point out just a few of the studies showing problems with phthalates:

1.  Effeminization. A recent study demonstrated that the higher the levels of phlthates in the mother’s urine, the less likely their boys were to play with regular male toys, i.e. they appeared to be effeminized. [1] Extra estrogens during these critical years can permanently alter the young male brain. Animal studies clearly show that phthalate exposure can alter SHBG, testosterone and LH (leutinizing hormone) levels. [2]

2. Testosterone. These are potent endocrine disruptors that every hormone-luvin’ male should avoid like the plague. One study examined dosages of 100, 80, 60, 40, 20, 10, 5, or 0% of the mixture.on fetal rates and found a dose-dependent decrease in testosterone, meaning the more phthalates, the less the testosterone. [4]  Needless to say, this is very, very bad for males in the fetus or young children.

3.  Fertility. Further proof of phthalates’ gonad-killing properties are linked to lowered sperm quality [5] and DNA damage [6].  See my link on Male Fertility for additional information.

4.  ADHD. The decreased testosterone and other attributes of phthalates actually alter the male brain and one study showed a link to ADHD. [8]  For more information, see my link on Environmental Causes of ADHD.

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

5.  Thyroid. Many studies have verified that phthalates alter thyroid function.  This is particularly dangerous for the little ones and one study warned “even small changes in thyroid homeostasis may adversely affect human health, and especially fetal neurological development may be vulnerable.” [9]

6. Insulin Resistance and Diabetes.  These chemicals seem to wreak havoc with the body’s blood glucose systems and have been implicated in several studies (on both men and women) as a contributor to insulin resistance, metabolic disorder, prediabetes and diabetes. [10][11][12] The reason?  Testosterone, as I document in my book Low Testosterone by the Numbers, regulates insulin sensitivity in men.

This list could go on and on.  Again, one should be as cautious as one’s budget will allow, buying organic – many pesticides are phthalates – and using only stainless steel/glass for cooking and natural means for pest control.

Estrogen and Your Thyroid - Peak Testosterone

I have discussed the importance of SHBG, the protein that binds tightly to your testosterone in the plasma, as a sign of health.  Too much SHBG and  you may find your free testosterone significantly lowered. Actually, men who have low or high SHBG tend to not feel well.  The key is that this binding protein, SHBG, is at ground zero for men’s health.

And what is one of the things that can raise a man’s SHBG?  Estradiol.

The story does not end there:  both men and women actually have many binding proteins.  We have one for cortisol.  And we have one for thyroid hormones, which is called TBG.  And guess what can also raise a man’s TBG?  Again, the answer is estradiol.

TBG actually stands for Thyroxine-Binding Hormone, where thyroxine is T4.  In spite of its name, it binds to both of the major thyroid hormones (T3 and T4) and, again like SHBG, can lower the free forms of both.  This has several important effects on your thyroid function, which I outline below:

NOTE:  T4 is converted into T3.  However, T3 is the more biologically active form of your two major thyroid hormones.  Hypothyroidism is very common in men and getting checked for this condition is part of what I call the PeakT Program.  (See my home page for information.) As you’ll see in my link  Testosterone and the Thyroid, hypothyroidism can lower testosterone levels.

Now, if you’re struggling with a lot of extra pounds, I’m not being critical, but I think it’s important to let you know that you could be greatly increasing the estradiol load on your body.  And researchers have noted that  too much weight gain can make you hypothyroid as well. Do you see the vicious circle?  Now you need to lose weight to get your testosterone and thyroid function back, but you’ve slowed down your metabolism.  This means weight loss is just that much harder.

Of course, there are guys with 30 pounds of extra weight that have decent testosterone and no signs of hypothyroidism.  But why take your chances?  Getting in a duel with Mother Nature is just not a good idea.

And for those of you with hypothyroidism from high estradiol and weight gain, can you really get rid of your hypothyroidism by dropping the exta pounds?  Look at what these researchers wrote:

“A moderate elevation of thyrotropin (TSH) concentrations, which is associated with triiodothyronine (T3) values in or slightly above the upper normal range, is frequently found in obese humans. These alterations seem rather a consequence than a cause of obesity since weight loss leads to a normalization of elevated thyroid hormone levels. Elevated thyroid hormone concentrations increase the resting energy expenditure (REE)…Leptin seems to be a promising link between obesity and alterations of thyroid hormones since leptin concentrations influence TSH release.” [3]

There is another equally sinister way that those extra pounds may negatively impact your thyroid.  Significantly overweight and obese men tend to have higher inflammation levels and inflammation slows the conversion of T4 to T3.  Remember that T3 is the most powerful thyroid hormone.

HRT (Testosterone Therapy) Impact? Traditionally HRT clinics have tried to keep men in the 20-30 pg/ml range for estradiol from what I have seen.  The explanation was that these represented healthy, youthful estradiol levels and that many men feel better lowering their estradiol.  I would concur that many men on the The Peak Testosterone Forum have reported improved morning erections and other symptoms if their estradiol is not too high as well.

However, there is a new “movement” among many docs to just let estradiol go and not control it.  There are many reasons for this and I am certainly not being critical.  However, if your estradiol is high from HRT and you are hypothyroid, it may be worth discussing with your doctor.  Contradicting this is the fact that Arimidex is not supposed to affect thyroid function in healthy individuals.

REFERENCES:

1)  N Engl J Med, 2001 Jun 7, 344(23):1743-9, “Increased need for thyroxine in women with hypothyroidism during estrogen therapy”

2) Journal of Thyroid Research, 2011, “Role of Estrogen in Thyroid Function and Growth Regulation”

3) Molecular and Cellular Endocrinology, Mar 25 2010, 316(2):165-171, “Obesity and thyroid function”

1.  Decreased Free T3 and T4.  All things being equal, as TBG goes up, you have less free T3 and T4 to work on your tissues. Again, this is similar to men with high SHBG, who end up with less free testosterone. [1]  Researchers have noted that “estrogen has a well-known indirect effect on thyroid economy, increasing the thyroxine binding globulin, and the need for thyroid hormone in hypothyroid women.” [2] In other words, if you give a woman estrogen, she will actually need more thyroid medication.  Although understudied, the same relationship will hold in men.

2. Increased TSH. This decrease in thyroid hormones, the free form, can lead to increased TSH production.  Of course, this is a sign of hypothyroidism, i.e. the pituitary “feels” it has to send out more of the signaling hormone to compensate.  Actually, I don’t believe this has been studied in men, but studies in women have clearly shown this relationship. [1]

3. Increased Thyroid Conditions and Diseases. It turns out that estradiol can trigger thyroid complications, which of course can eventually lead to libido-killing and testosterone-lowering hypothyroidism. The same study as above noted that estrogens are tied to thyroid cancers and other conditions in both epidemiological data and women’s studies, who obviously have more E2 (estradiol) than us men. [2]

4. Increased Risk of Hypothyroidism. Women have 8 times the risk of developing hypothyroidism compared to men.  It seems to be well-accepted that this is due to their estradiol levels.

Okay, so estradiol can possibly make one hypothyroid.  What is the significance?  First of all, the typical male, as he heads into middle or senior age, may easily be packing on anywhere from 30-60 extra pounds of weight.  This is extremely common, especially in the U.S. where a third of adults are overweight and a third are obese.  A typical BMI for a middle-aged male might be 25.  If he is in his early senior years, this probably translates to about 26% body fat.  (There are are formulas for estimating body fat from BMI by age for males.  You can run through the numbers if you’d like.)  Now a man probably should be around 13 or 14% body fat and, sure enough, if you do the math, this means losing about 26 pounds of fat.

Now that may not seem like that much, but it’s a lot of adipose (fatty) tissue.  And remember that fat cells, as they increase in size from weight gain, accumulate extra aromatase enzyme.  This means that more and more of a man’s testosterone is converted into estradiol by that extra fatty tissue.  Yes, enough weight gain literally emasculates you.  In fact, as you can read in my link on Testosterone and Weight Loss, a man can actually make himself hypogonadal if he is 50+ pound overweight. It is quite common actually.

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

Naltrexone (Low Dose) : T-Booster in Some Hypothyroid Men ?

REFERENCES:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

More Naltrexone Superpowers

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

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

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

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

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

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

Whey and Free Glutamine - Peak 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.

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”

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:

Stress and Erectile Dysfunction - Peak Testosterone

So can stress cause erectile dysfunction?  One European study put elevated psychological stress right alongside high blood pressure as a risk factor. [1]  Still other studies have shown that men with erectile dysfunction have higher reported stress levels. [2]

2.  Penile Arteries.  There have been many studies showing that stress leads to heart disease [10] and we all know that heart disease will directly affect your erectile strength.  How does stress do its damage?  One set of researchers looked into this and found that chronic work stress led to poor lifestyle choices and behaviors, such as smoking, excessive drinking, lack of exercise and Metabolic Syndrome. [11] Metabolic Syndrome is deadly to both heart and penis.

3.  Cortisol. The same study above [11] found that chronic work stress led to an increased morning rise in cortisol. Other studies have made a similar finding. This is bad for erections, becuase 1) elevated cortisol is associated with insulin resistance [13] and 2) decreased nitric oxide. [14]

4. Visceral Fat.  Cortisol and stress are also associated with increased visceral fat (“beer belly”, “gut”, “spare tire”, etc.), both of which are very hard on erections. [9]   Visceral, or abdominal fat, is considered the most deadly form of body fat as it rapidly accelerates the risk for cardiovascular disease, stroke and Alzheimer’s just for starters.

5. Weight Gain.  Researchers recently found out that chronic psychological stress resulted in greater weight gain, especially in sensitive individuals. [12]  The reason?  The study authors noted that stressed people eat excessivly whether hungry or not.  The old expression “comfort food” is apparently a very real crutch that most lean on.

6.  Noradrenaline (Norepinephrine). One little known fact about the penis is the fact that one of the stress hormones, noradrenaline, actually is responsible for keeping you limp.  After all, you don’t want to walk around with an erection at your next staff meeting, eh?  The job of nitric oxide is actually to overcome the effects of this stress hormone and relax your penile arteries enough to let blood to flow into the corpus cavernosus for an erection to occur.  However, too much stress and you are swimming upstream.

So is there any way to beat stress and cortisol?  Please read my link on Practical Stress Management Solutions for possibilities based on the latest research.

REFERENCES:

Nymphomania: Causes and Conditions - Peak Testosterone

Imagine a woman that thinks about sex night and day.  She has trouble controlling her sexual urges and is “hypersexual” by almost any standards.  She often struggles with nearly constant erotic dreams, fantasies and the need for orgasms.

Some of you are thinking, “How do I find a woman like this?”   Well, life with a nymphomaniac is not always what it might seem:  she often struggles with emotional detachment, compulsive behaviors and relational infidelities. True nymphomania can actually be not just a woman with a healthy libido, but a woman with an underlying medical condition.

So if your woman has an excessive, to the point where it is interfering with her daily life, sexual desire, consider these organic causes of nymphomania.  This is especially true if she has had a sudden dramatic increase in libido and desire as well.

ERELATED ARTICLE:  Can a Christian be a nymphomaniac?    These women say ‘Yes’!

1.  Hypothyroidism.  An overactive thyroid can cause sexual desires to spiral out of control.  /p>

2. Ovarian (follicular) cysts. Strangely enough, some ovarian cysts can lead to hypersexuality, because sometimes the growth is estrogenic.  The increases estrogen boost libido dramatically, in some cases to unhealthy levels.

3. Parkinson’s Medications.  These drugs, which are dopamine agonists, can lead to all sorts of compulsive behaviors, from gambling to nymphomania. [3]  Around 25% of patients will struggle with some sort of impulsive behavior.

4.  Obsessive-Compulsive Disorder.  OCD behaviors and hypersexuality can often go hand-in-hand. [3]  One journal article relates the story of an obsessive-compulsive woman who was “having intercourse up to 30 times in 24 hours”. [4] After medications and considerable therapy, the clinicians felt relieved to get her down to bring her sexual activity down to no more than three or four days per week and no more than four or five partners per day!

5.  Temporal Lobe Disorders and/or Epilepsy.  Conditions in this area of the brain have long been assoiciated with nyphomania.

The bottom line is that if your woman suddenly develops nympomania, rather than breaking out the champagne, you may want to take some time to research whether or not there there is an underlying physiological issue.

REFERENCES:

1) hhttps://www.okmagazine.com/2010/03/dr-oz-prescribes-sex-twice-a-week/

2) https://www.medicalnewstoday.com/articles/220014.php

3) Am J Psychiatry, Oct 2001, 158:1590-1594, “Hypersexual Disorder and Preoccupation With Internet Pornography”

4) https://www.ijpm.org/content/pdf/121/nymphom.pdf, “A variant of nymphomania associated in association with obsessive-compulsive disorder”

5) Rev Esp Otoneurooftalmol Neurocir, 1968 Jul-Aug, 27(158):259-71, “[Nymphomania and epilepsy in childhood. Report of 4 cases]”

Zinc and Testosterone - Peak Testosterone

Scientists have for decades known that a zinc deficiency is associated with decreased testosterone production and other medical conditions.  However, lately zinc has been considered a big disappointment by researchers.  Studies have shown, for example, that it does not generally increase testosterone significantly or protect from colds as originally thought.

But does that mean you should give up on this mineral altogether?  No way!  Some guys, like Casanova, have reported near miraculous powers from supplemental zinc. Could there by something to it?  Below are five reasons that zinc may in some cases dramatically boost testosterone and substantially improve your sex life:

NOTE:  ZMA is a special formulation of zinc and magnesium.  The Magnesium is a nice side benefit of ZMA and will likely help you sleep better and avoid Metabolic Syndrome and heart disease. An alternative way of getting your zinc is through oysters, although I certainly wouldn’t recommend doing that every day.  But we had one poster write in the following:

“On the subject of shellfish, here’s another anomaly: one night recently I ate a large plate of raw oysters for dinner, and later experienced very firm nocturnal erections and very sexual dreams (practically to the point of nocturnal emission). This, when it’s very rare for me to have a nocturnal erection at all, and never a firm one. I never put much stock in oysters’ reputation as an aphrodisiac, but I am now convinced there is something to it.” [13] Casanova himself ate several dozen oysters every day for its supposed aphrodisiacal super powers and oysters do have a lot of zinc.

1.  Testosterone.  Some research has shown that zinc can increase testosterone.  It all started when an absorbable form of Zinc called ZMA (which also contains Magnesium), was created by Victor Conte of Barry Bonds fame.  Mr. Conte backed a study that shows a nice increase (34%) in testotserone in young athletes taking ZMA. [1]

1) Med and Sci in Sports & Exerc,1999, 31:483

2) European J of Clin Nutr, 2009, 63:65-70

3) Intl J Sports Med,2001,22(7)537-543

4) Am J Med Sci, 1993 Apr, 305(4):199-202, “Treatment of Wilson’s disease with zinc XII: dose regimen requirements”

5) J Nutr, 1996 Apr, 126(4):842-8, “Dietary zinc deficiency alters 5 alpha-reduction and aromatization of testosterone and androgen and estrogen receptors in rat liver”

6) Neuropharmacology, 2009, 56:531 540, “Zinc regulates the dopamine transporter in a membrane potential and chloride dependent manner”

7) Pol J Pharmacol, 2003, 55:1143 1147, “EFFECT OF ZINC SUPPLEMENTATION ON ANTIDEPRESSANT THERAPY IN UNIPOLAR DEPRESSION: A PRELIMINARY PLACEBO-CONTROLLED STUDY”

8) Journal of Neuroscience Research, 1 April 2005, 80(1):145-149, “Zinc modulation of serotonin uptake in the adult rat corpus callosum”

9) Physiol Behav, 2008 Oct 20, 95(3):365-9, “Zinc deficiency induces depression-like symptoms in adult rats”

10) Am J Clin Nutr July, 1975, 28(7):764-774, “Coronary heart disease: the zinc/copper hypothesis”

11) Biol Psychiatry. 1982 Apr;17(4):513-32, “Zinc, the brain and behavior”

12) Am J Clin Nutr July 1992 vol. 56 no. 1 148-157, “Effects of dietary zinc depletion on seminal volume and zinc loss, serum testosterone concentrations, and sperm morphology in young men”

13) https://peaktestosterone.com/forum/index.php?topic=628.msg5816#msg5816

14) https://peaktestosterone.com/forum/index.php?topic=758.msg7141#msg7141

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

16) J Hum Reprod Sci. 2010 Sep-Dec; 3(3): 124 128, “Relationship between seminal plasma zinc and semen quality in a subfertile population”

Sounds good, eh? Unfortunately, subsequent research has cast doubt on Mr. Conte’s work and showed no testosterone increase with ZMA. [2]  One theory is that supplemention does not boost testosterone except perhaps in individuals who are zinc-depleted.  Furthermore, it is tough to determine who is really depleted in zinc and who is not.  Some experts recommed, for example, the zinc taste test to determine this.  Regardless, it seems that normal, healthy individuals receive little to no benefit as far as testosterone.

However, there is also another interesting explanation.  One study on infertile men showed that zinc increased testosterone only in men who were lower in testosterone (less than 480 ng/dl). [15] Therefore, if you have low testosterone, it may be worth it to try some zinc and see if you can get a little boost. To test your DHT, check out these links:  Reasonable Testosterone Labs and The Cheapest Lab Tests for men for some ideas. I have not used most of the labs, so do your own due diligence and am just passing along information that I have picked up on the Peak Testosteorne Forum.

NOTE:  Zinc may also boost DHT in some men, which could be good or bad depending on your situation.  See my link on Zinc and DHT for more information.

So who might be zinc depleted?  One misconception is that, if you happen to be having a lot of sex – you lucky dog! – that you may be making yourself zinc depeleted.  However, one study shows that only about 0.3 to 0.45 mg of Zinc, or 2-3% of your body’s RDA, is lost during ejaculation. [16] I also frequently get emails from heavy porn users who have lost their sexual desire and/or erectile strength.  (I am talking about guys clearly addicted and spending hours per day and ejaculating 3+ times in a 24 hour period.)  There are probably a variety of reasons for their sexual dysfunctions, but low grade zinc depletion does not appear to be one of them.  (There is also now evidence that are “numbing” their dopamine receptors as well.)

2.  Brain Activities: Sleep and Learning.  A combination of zinc, magnesium – yes, this is starting to sound a lot like ZMA – and melatonin has been found in one study to be a potent insomnia cure. (See this link on Sleep Aids for more information.) A couple of our posters on The Peak Testosterone Forum have commented how much taking ZMA helps their sleep and, of course, ZMA is one third zinc. This poster recommended taking it about 40 minutes before bed:

“ZMA ..oh yes I like…not only the zinc as Peak mentioned to help keep T at a max (and help with everything in your body!!) but the magnesium is fantastic for helping to induce sleep. I only have one cap a day usually 40 mins before bed and it definitely makes you sleepy. One cap only equates to 10mg of zinc (about 100% RDA) and 150mg of mag which is only 40% RDA.”[14]

So there is evidence that zinc plays a role in sleep quality and/or duration.  Zinc affects the brain in other ways as well.  For example, one study review pointed out the importance of zinc to learning, memory and neuron maintenance / regeneration: “The highest levels of zinc are found in the hippocampus in synaptic vesicles, boutons, and mossy fibers…Zinc plays an important role in axonal and synaptic transmission and is necessary for nucleic acid metabolism and brain tubulin growth and phosphorylation. Lack of zinc has been implicated in impaired DNA, RNA, and protein synthesis during brain development…Furthermore, in children insufficient levels of zinc have been associated with lowered learning ability, apathy, lethargy, and mental retardation.” [11] I’ll just point out that the hippocampus is the center of memory and is involved in some higher order thinking processes as well.

3.  Estrogen.  Zinc actually inhibits the aromatase enzyme, especially in zinc-depleted individuals, and therefore could decrease estrogen. [5]  (It may also inhibit the conversion of testosterone to DHT, which could help your prostate and hair!)  At worst it is another tool in our arsenal to optimize and maintain our estrogen at reasonable levels. And, of course, this may be another reason that zinc is a testosterone booster for some men but not others.

4. Dopamine. Researchers have found that zinc is one of the most important minerals regulating dopamine. [6] It turns out that zinc is present in your neuron’s synapses and plays several major roles in neurotransmission. Zinc is known for “inhibiting the uptake” of dopamine, which means that dopamine stays around in your systems (brain) for a longer period of time. And, yes, more dopamine generally means better sex as I document in my link on Natural Dopamine Increasers . (Dopamine disorders are associated with migraines, Restless Leg Syndrome and other conditions.)

5. Depression. Zinc is a proven depression fighter. Several studies have shown that zinc levels tend to be lower in certain types of patients with depression and, furthermore, supplemental zinc has even been shown to help in treatment (25 mg along with an SSRI). [6] And, recently, researchers created depression (in animals) by inducing a zinc deficiency.

Of course, there is now a strong link established between Depression and Your Sex Life.

BONUS: Zinc can also significantly increase semen volume, something that some men are concernd about.  For other factors, see my link Naturay Ways to Increase Your Semen Volume.

Zinc – Dosage and Dangers

Zinc has some powerful properties that can really help us males. Because of this, it is very easy for to get overly enthusiastic. Zinc is extremely powerful and has a definite clinical range, i.e. you can hurt yourself if you overdo it in the ways listed below.  Again, stick to the 1-2 RDA range for zinc.

CAUTIONS: Copper Deficincy: Some experts caution about taking zinc supplementation, because it can lead to a copper deficiency. Copper is critical for the health of your heart and your collagen among other things. It doesn’t take much zinc to have a negative effect on your copper metabolism, because the two compete in the intestine for absorption. Researchers have found that it is the zinc to copper ratio that is critical and obviously taking zinc supplementation will affect this ratio significantly.

As an example, the RDA of zinc for an adult male is 11 mg and most zinc supplements have 2-3 times that, i.e. 20-35 mg or so. This is troublesome, because there is a disease (Wilson’s Syndrome) where copper accumulates in various tissues. Researchers will actually give supplemental zinc in order to reverse this condition. How much zinc do they give? One study found that only 75 mg daily will quickly start depleting copper. [4] Remember that this 75 mg is intended to yield results in just 10 days.

Now imagine a guy taking 35 mg of zinc for testosterone for months or years. It is certainly possible that he could experience lowered copper levels and this could potentially lead to elevated inflammation and the steadily increasing hypertension associated with copper deficiency. Again, there is no study showing that this is occurring, but it is certainly possilble.

CAUTION: My HRT clinic, in guys whose estradiol is not too high, will use a combination of zinc (15-30 mg) and copper (2-4 mg) per day to pull down E2 (estradiol) levels a little.  Zinc and copper compete and so many experts worry that giving supplemental could lead to copper depletion and inflammation.  However, I have some concerns with this, because copper has been implicated in a number of neurological diseases and excesses are hard on neurons. These same experts believe that we are slowly poisoning ourselves in many cases with copper pipes. You’ll have to do your own research and decide where you stand on the issue.

CAUTION #2: Neuron Damage. Before you go popping zinc like breath mints, keep in mind that some studies indicate that too much zinc is just as hard on your brain and neurons as too little.  Most minerals have a rather tight range and zinc appears to be no exception.

CAUTION #3: Heart Disease. There was a whole theory of heart disease that centered around the correct balance of copper to zinc. [10] Admittedly, this theory is outdated, but we can still learn something from it:  too much zinc can elevate cholesterol levels and possibly contribute to hyperlipidemia. (You do not want too much copper either:  it is very hard on the brain. When it comes to essential minerals, moderation and balance are definite keys.)

OTHER CAUTIONS:   There are other potential risks in taking too much zinc, from neurotoxicity to cancer to metabolic issues and I summarize some of the latest research in my page on The Potential Dangers of Zinc Supplementation.

LDL: What Must Your LDL Levels Be? - Peak Testosterone

Very few Westerners escape the rapid acceleratio of plaque buildup.  One huge issue this causes is damage to the endothelium.  What eventually happens is that the lining of your arteries, the endothelium, becomes so covered with plaque that it cannot pump out any signficant amount of nitric oxide.  This leads to a host of issues including erectile dysfunction, high blood pressure and at times angina.

So one of the huge tasks facing most men is the get their arteries back.  How can they do that?  Simple:  lowering LDL.  Many studies and clinicians have recognized the importance of lowering LDL to reverse plaque.  Yes, your arterial plaque can be actually reduced and blood flow increased.

NOTE: It’s not just the Low Fat folks who insist on and outline how to decrease arterilsclerosis:  it’s also leading cardiologists such as William Davis and the Asteroid Study researchers mentioned below.  (You can read more about the subject in my link on Clearing Your Arteries.)

1.  Your level of arteriosclerosis is related to cardiovascular events.  And, yes, cardiovascular ‘events’ are not a good thing.

2.  Decreasing arterial plaque (arteriosclerosis) improves cardiovascular risk.

3.  Decreasing LDL to a certain threshold will reverse arteriosclersosis.

And that’s the subject of this page.  Just what LDL threshold does one need to go to actually begin to reverse his arteriosclerosis?  Below I’ll show you the levels given by various experts and researchers.

Want your arteries back?  Want increased blood flow?  Then focus on your LDL and quit listening to the “Cholesterol Myth” people.  Remember that heart disease is the #1 killer of men in modern societies. Lowering LDL levels could almost completely eliminate this plague.

1.  Dr. Caldwell Esselstyn. This physician was one of the early pioneers who showed that arterial plaque could indeed be reversed.  In another link I reviewed his book, Prevent and Reverse Heart Disease, and in this book on page 67 he writes his target LDL levels with his patients:

“Here, once again, is the basic message of my research:  no one who achieves and maintains total blood cholesterol of 150 mg/dl and LDL levels below 80 mg/dl – using strict plant-based nutrition and, where necessary, low doses of cholesterol-reducing drug – experiences progression of heart disease.”quot;

2.  Dr. Neal Bernard.  I have also reviewed Dr. Bernard’s low fat book on Reversing Diabetes (with a Low Fat, low glycemic diet) – another excellent book! – and Dr. Bernard suggests therein that some men may need to go even lower (p. 105):

“…many scientists are now pushing for stricter standards, including reductions to below 70 mg/dl (1.8 mmol/l) for high risk patients.  Some authorities have called for lowering your LDL by 30 to 40 percent regardless of what your starting level is.” [1]

3.  2007 Circulation Study. The journal Circulation looked at three different diets and found that the more the fat, the less the blood flow: “BART testing revealed a significant inverse correlation between flow-mediated vasodilation and intake of total fat (r2= 0.29; P=0.03), saturated fat (r2= 0.31; P=0.02) and monounsaturated fat (r2= 0.35; P=0.01).” [2] I am inserting this comment, because it’s important to realize that fat slows down blood flow.  A lot of you middle-aged guys are going to get big benefits in erectile strength from this.  Can I hear an Amen, brother?  And in this study, the Low Fat participants went down to an average LDL of 84.6 ng/dl.

4.  Dr. Ornish. Probably the most famous Low Fat researcher is Dean Ornish.  His landmark studies in the 80’s showed that a Low Fat Diet could reverse heart disease and arteriosclerosis.  In his bestselling book The Spectrum (p. 204) he wrote:

“If that’s enough to bring it down to an LDL level less than 100 mg/dl, preferably below 70 mg/dl if you have heart disease, that may be sufficient.”

NOTE: A Low Fat Diet has also been found improve to telomere aging, turns off 100’s of prostate cancer genes, etc. and I discuss all of the list in link on The Incredible Health Benefits of a Low Fat Diet .

Now why would Dr. Ornish even mention an LDL as high as 100 mg/dl?  The reason is that this book, The Spectrum, is built on the idea that one does not HAVE to be on a Low Fat Diet unless you have heart disease.  If you do not have major cardiovascular problems, then you can get by more than likely with a more moderate approach.

But then notice the LDL target that Dr. Ornish gives after that:  70 mg/dl.This is low LDL indeed but underscores the importance of taking aggressive action if you have heart disease. Ornish’s Low Fat programs can have a profound impact on men with heart disease.  For example, one of his studies showed angina decreasing by 91% – a very impressive result to say the least. (p. 9)

5.  Asteroid Study.  This study gave patients high doses of statins and then tracked, based on their LDL levels, cardiovascular outcomes.  LDL of 70 mg/dl was the level at which the authors felt that all cardiovascular goals were achieved.  However, other commentators have noted that this study showed plaque reversal at about 60 mg/dl.

Now, because plaque reversal has been achieved at higher levels, one cannot help but wonder if some negative aspect of statins require one to go even lower than is necessary with Low Fat.  This seems reasonable to me considering that statins decimate CoQ10 levels and raise arachidonic acid levels, both of which are heart unhealthy. [5] For more negatives, see my link on The Hidden Risks of Statins.

6.  Dr. William Davis.  Some people will trust Dr. Davis a little more, because he a) hates wheat, b) is not in love with Low Fat Diets and c) likes some fat in the form of omega-3’s and monos. He has kind of been adopted by some in the Paleo crowd because of it, but what they don’t realize is that in his book, Track Your Plaque, he advocates an LDL of 50-60 for those who want to decrease arteriosclerosis! [6]

Choosing and LDL Level

As you can see there is some variation in what  level of LDL you should shoot for.  85 mg/dl is the highest number advocated by someone who has actually achieved plaque reversal.  But there is some evidence for men with serious issues that it needs to be lower, probably between 60 and 70.

So you (and your physician if he/she knows anything about the subject) have to decide for yourself.  There are many unanswered questions:

How much does exercise play a role?  Can certain superfoods (pomegranate juice, berries, etc.) play a role?

We will not know the answers to these kind of questions for probably years to come, so, in the meantime, one has to make an educated guess.

1)   Diabetes Care, 2006, 29(suppl1):S4-S42, American Diabetes Assocation, “STandards of Medical CAre in Diabetes – 2006”

2) 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”

3) American Journal of Cardiology, 2009, 104(1):29-35, “Safety and Efficacy of Achieving Very Low Low-Density Lipoprotein Cholesterol Levels With Rosuvastatin 40 mg Daily (from the ASTEROID Study0”

4) https://www.trackyourplaque.com/library/fl_05-002ldl60.asp

5) Nutr Metab Cardiovasc Dis, 2001 Apr, 11(2):88-94, “Statins enhance arachidonic acid synthesis in hypercholesterolemic patients”

6) Track Your Plaque, Dr. William Davis, p. 106.

Interview with Low Body Fat and Muscle Guru Clarence Bass! .

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

INTERVIEW WITH CLARENCE BASS

Herbs And Testosterone - Peak Testosterone

Androstenedione – banned by the FDA in April 2004.  6-OXO – banned by the FDA in July 2006.  One over the counter testosterone booster after another banned by the FDA. A fella could quickly get the idea that there are no herbs that can increase testosterone according to the research.  After all, doesn’t the FDA just instantly shut them down?

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) 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”

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 https://www.peaktestosterone.com/.

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 https://www.peaktestosterone.com/.

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 .

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

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:

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.

Plant-Based Nutrition: The Male Fantasy - Peak Testosterone

REFERENCES:

1)   https://www.sciencedaily.com/releases/2011/10/111011171553.htm

2) Am J Clin Nutr, Dec 2006, 84(6)1489-1497, “Fruit intake vegetable intake metabolic syndrome cardiovascular disease risk factors inflammation”

3) https://www.dole.com/LiveRight/Prevention/ PreventionDetails/tabid/837/Default?contentid=4228

4) Am J Clin Nutr, Nov 2005, 82(5):1052-1058, “A 4-wk intervention with high intake of carotenoid-rich vegetables and fruit reduces plasma C-reactive protein in healthy, nonsmoking men”

What is the number one thing most men can do to boost their sex life? Well, exercise is right up there along with sleep and stress management.  However, the king in this category is undoubtedly plant-based nutrition for many reasons. One huge tragedy in most modern societies is that meat is synonymous with manliness. And, for this reason in my opinion, meat-based lifestyles (Low Carb, Atkins, the high fat Americanized version of Paleo, etc.) are incredibly popular, much moreso than any other dietary regimen here in the U.S. Again, though, this is ironic, because guys are all about sex and impressing their woman and it is plants that are going to help them most in this category.

Yes, plant-based nutrition should be called the True Manly Diet in my opinion and, hopefully, below I can give you many benefits and reasons just why this is so.  I myself am a lacto ovo vegetarian, meaning I don’t eat meat but do eat egg whites and non-fat yogurt to decrease carbohydrates and for additional protein.  (I’m into buidling and maintaining muscle so want extra protein sources.)

By this definition I would be “plant-based” since I get over 90% of my calories from plants.  However, the general definition that I see out there for plant-based is basically 100% vegan or plant foods but ONLY whole plant foods.  Plant-based vegan pride themselves, as well they should, on only eating whole natural plant foods.

Regardless of what label you put on yourself, here are 8 Huge Benefits of Going On 90+% Plant-Based Diet or Even a True Whole Foods 100% Plant-Based Diet::

1. Blood Flow.  Many plant-based foods will lower blood pressure. If you’ll notice in my link on How to Lower Blood Pressure, there are probably a dozen plants that have been shown in the research to lower blood pressure.  Of course, this is very important, because high blood pressure is a risk factor for erectile dysfunction, stroke and heart disease for starters.  (It is also part of the modern plague called the Metabolic Sydrome that cripples so many men in middle age and beyond.)

NOTE: Personally, I would avoid wheat for reasons I outline in my Review of Wheat Belly by Dr. William Davis.  I would also avoid corn, because it is highly GMO’d with a pesticide called BT toxin (at least here in the U.S.).

2. Testosterone. There are indications that plant-based systems of eating tend to have testosterone levels as high or higher than their meat-eating equivalents.  One study showed that vegetarians had testosterone 6% higher than their meat-eating counterparts. (See my link on Testosterone and Vegetarianism for more information.) And what will be really counterintuitve for many men is that vegans – vegetarians that do not eat any dairy or eggs – had 16% higher testosterone than the equivalent carnivores in the study.  And the Okinawans, who eat only small amounts of meat, maintain high testosterone levels decades part the typical man in a Western society.

Yes, gone are the old myths that meat eaters are the only ones with decent testosterone.  It appears that the opposite may be the case.  And it makes sense:  many of the more vegetarian, plant-based diets emphasize monounsaturated fats, which are known to be pro-testosterone.  Furthermore, these types of diets are high in antioxidants and anti-inflammatory phytochemicals that will tend to act in a protective manner against the age-related losses of testosterone.

3. Nitric Oxide.  It’s no secret that all the big nitric oxide-boosting foods and drinks are plants.  This is one of the primary subjects of my book, The Peak Erectile Strength Diet.

4. Mortality. Wanna stay alive?  A plant-based lifestyle has been shown to do just that.  Multiple mortality studies on vegetarians have shown improved mortality rates.  What this means is that those who eat vegetarain generally die less frequently. See my link on Mortality Rates for additional information.

5. Change Your Genes. Have “bad genes”?  Fruits and vegetables have been shown to overcome this in some cases.  For example, one massive study found that ample servings of fruits and vegetables overcame the negative effects of the 9p21 gene that strongly influenes cardiovascular outcomes. [1]

6. Inflammation Protection. The number one thing that you want your natural lifestyle to do is fight inflammation. Why? Because inflammation is the Root of All Evil. It is the root cause for most of our heart disease, diabetes, autoimmune disease, cancer and erectile dysfunction. And, yes, many studies have shown that fruits and vegetables dramatically lower inflmmation. For example, a 2003 study that in just one month participants who ate a diet high in fruits, vegetables and nuts lowered this C-Reactive Protein levels by 28%. [3] Yet another study found that eating fruit lowered CRP levels by about 20% from lowest to highest consumption and vegetables by almost 30%. [2] Not bad for just one component of ones diet!  Studies on just healthy males alone have shown the same thing. [4] For additional, read my link on How to Lower Inflammation and Inflammation and Juice.

7. Metabolic Syndrome. Fruit and vegetable consumption is associated with decreased risk for developing the epidemic plague in modern societies called The Metabolic Syndrome. [2] Both fruits and vegetable consumption was tied to a reduction in risk of about a third.

8. What About Grains?? One bias that many men have is against whole grains due to the prolieration of and misinformation from many Low Carb and Paleo sites of late. This is unfortunate because WHOLE grains are every bit as outstanding for health as fruits and vegetables. Common sense tells you this, because grains are a substantial component of many of the healthiest diets around the world including the Mediterranean, the cultures in Healthy at 100 and the  Tarahumara.

As I show in my link on Grains and Your Penis, whole grains do everything you could possibly want as a man, lowering blood pressure, increasing nitric oxide and flooding your system with anti-inflammatory and antioxidant compounds. It’s literally a dream-come-true.

Of course, the key is that grains are only healthy if they are whole grains.  I also caution against too much wheat consumption, whole or not, due to its heavy GMO modifications in the last fifty years.  See my Review of Wheat Belly for details.

Cortisol, Testosterone and Brain - Peak Testosterone

We all joke around about being under stress, but, as you’ll see below, it’s really not that funny. There are many definitions of stress, but here I am primarily talking about the kind of stress that produces elevated cortisol levels. When you are under stress, your body releases increased levels of adrenaline and other “fight or flight” hormones and chemicals.  The adrenaline does a certain amount of damage, raising pulse rates and blood pressure (especially in Type A personalities).  But it is the cortisol that comes shortly after that does the most devastating long term damage.

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”

Depression and Testosterone - Peak Testosterone

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.

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

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:

Ginseng, The Many Benefits - Peak Testosterone

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

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

REFERENCES:

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

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

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

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

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

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

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

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

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

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

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

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

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

14) Int. J. Epidemiol, 1990, 19(4):871-876, “A Case-Control Study of Ginseng Intake and Cancer”

15) Annals of Pharmacotherapy, Published Online, 6 December 2005, “Systematic Review of the Effects of Ginseng on Cardiovascular Risk Factors”

CAUTION:  Ginseng does have a few drug interactions, such as with blood thinners, etc., so check with your doctor first as always.

What can Ginseng do for you?  Consider these benefits:

1) Erectile Strength and Libido.  As I document in my link on Ginseng and Erectile Dysfunction, Ginseng has been proven in many studies to boost your all-important Nitric Oxide and has even been shown to have a solid cure rate (two thirds to three fourths) for guys with erectile dysfunction.  In the same link, I also document Ginseng’s aphrodisiac qualities.

2) Blood Sugar Control.  Early work found that Ginseng had the admirable quality of lowering blood sugar in type II diabetics. [1] Of course, this was an important benefit of Ginseng considering that such a large percentage of individuals in industrialized societies struggle with blood sugar control.  Follow-up research showed that Ginseng lowered blood glucose even in non-diabetics. [2]  Many animal studies have shown Ginseng’s protective effects against insulin resistance, diabetes and hyperglycemia. [9][10][11]  This is a desireable property indeed, considering the erectile and health-damaging effects of Diabetes and Metabolic Syndrome.

4) Cancer.  Almost all males will get prostate cancer, a common and generally slow growing cancer.  One of ginseng’s many benefits, according to an in-vitro study, is likely protection against the most aggressive forms. [12] Other studies show significant protection against stomach and lung cancer [13] and cancers of all kinds. [14]

5) Blood Pressure.  Ginseng yields a small but significant blood-pressure lowering benefit. [15]

These are the major advantages that most guys are particular interested in.  However, it is important to note that Ginseng has also been found to benefit the central nervous system and battle certain neurodegenerative diseases and has excellent anti-inflammatory and antioxidant properties as well.  Again, as with Pycnogenol, the list of Ginseng’s benefits is difficult to summarize in one short page.

Hair Testing and Mercury (Example Provided) - Peak Testosterone

DISCOVERY and ANALYSIS: To actually find out if you are (probably) overloaded with mercury, you can start with a hair analysis test.  Strangely enough, you cannot just look at the hair test results and go by whether or not you are high in mercury or not.  The reason for this is simple:  high mercury individuals usually do not have high plasma levels of mercury.  The mercury is stored in various tissues, particularly the brain, where it often wreaks havoc for decades.

So how do you diagnose elevated tissue mercury then?  It turns out that you can look at something called “mineral transport.” Mercury attaches to many enzmymes and thus disrupts the body’s handling of minerals and metals and so you typically end up with numbers or patterns that do not fit the general populace.  Dr. Cutler’s claim to fame is that he came up with a way to estimate the extent of this disruption based on hair test results.

To show you how useful this can be, I’ve shown my wife’s hair test results below.  Note that the front end lab company that we used was Direct Labs, who mailed us out a hair test kit.  The name of the test was “Hair Toxic & Essential Elements-DD KIT” for those interested.  We cut samples of my wife’s hair and mailed it in the prepaid envelope. where it ends up in well-known hair analysis lab called Doctor’s Data.  Doctor’s Data then sends the lab results back to Direct Labs, who posts it on their web site for your or your practitioner’s review.  (I do not have any affiliation with Dr. Cutler, Direct Labs or Doctor’s Data.)

MY WIFE – MERCURY OVERLOAD? Doctor’s Data displays your hair test results in tabular and bar graph form as shown below.  It seems incredibly straightforward on the surface of it.  For example, check out my wife’s results below from July of 2015:

So all you have to do is look at what is low and what is high and you’re done, right? Unfortunately, it is not that easy.  Again, what you actually have to do is see if you have an unusual pattern of mineral and metal levels.  This then effectively tells you if you have dysfunctional mineral transport and likely are struggling with mercury overload.  Dr. Cutler goes into great detail in his book Hair Test Interpretation about how to do this and has basically has four rules that look for abnormally low / high values, abnormally “dead” values, and then a fifth one that covers the grey areas.  While it is true that his books are expensive, he also has made it available free online.

Of course, just a casual look at my wife’s results and it becomes apparent that she seems to have many extreme values, especially in the bottom section called “Essential and Other Elements.”  (This is actually the only section used for Cutler’s Five Rules for Deranged Mineral Transport.)  She has four values (calcium, magnesium, lithium and strontium) that are all in the red zone.  This violates Cutler’s Rule #3 and indicates mineral transport issues.

Does it makes sense that my wife could have a heavy mercury burden?  Absolutely and here is why:

a) She had a mouthful (five) of mercury fillings and had them removed about 10 years ago.

b) When they removed the fillings, they did not do anything special to protect her from the vapor.

c) Mercury that settles in brain tissue in particular can become trapped in neurons and cause issues for decades.  In other words, even though it had been ten years does not mean she was “out of the woods,” because she had never been chelated.

So are the results conclusive?  Are we going to talk someone about chelation or use Dr. Cutler’s protocol?  Unfortunately, two of her four extreme values (calcium and strontium) are, according to the inforation Doctor’s Data sends in their lab results, common in hair products.  Therefore, there is a chance that the hair samples were contaminated even after the washing that the lab does.  We decided that she would not do anything to her hair for several months and then we would retest, since it would not be at all surprising if she had high levels of stored mercury.

NOTE: I am NOT a doctor or a researcher.  This information is strictly to make men aware of the toxicity issues out there and to start investigating their own health as my wife and I have already started doing.  Your plan should be to a) get informed, b) get a good doctor (or naturopath) and c) work with him or her.

Ever wonder WHY your hormones are low and out of alignment?  Or you may have noticed a time when your health and energy seemed to inexplicably go downhill and you’re not sure why?  One of the grossly undertreated and surprisingly common reasons is undoubtedly related to  heavy metal overloads, particularly mercury.  This is something completely ignored by the vast majority of physicians here in the U.S.  I am 55, and I have never had a physician test for heavy metal exposure.

So why is it important to look for mercury overload?

Reason #1.  It is surprisingly common, mostly due to mercury (metal) fillings and thimerosol exposure.  Estimates range between 1% and 5% of men.

Reason #2.  Symptoms of mercury overload (and other heavy metals and nutritional deficiencies) can lead to symptoms very similar to low testosterone.

Reason #3.  High enough levels of mercury can actually lower testosterone levels and lead to hypothyroidism.  (See my page on Testosterone and Mercury for some examples.)

Reason #4. Mercury gets trapped in neurons behind the blood brain barrier and does not often come out easily unless “coaxed.”  Mercury overload thus affects millions of men for decades.

Even worse, until recently the general public simply did not have access to testing or inexpensive, non-invasive protocols.  Doctors will not test for it, except in rare and extreme cases, and costs for many of the standard lab tests are very expensive.  However, that all changed here in the U.S. when hair testing became publicly available and general knowledge about the subject began to spread.  Now you can get hair testing done at a top notch lab, check out your results and then bring it a practitioner. Furthermore, there are great lay textbooks out there which can give you an incredible background in mercury and how to deal with it.  Probably the most well-know of these books is Hair Test Interpretation and Amalgam Illness, Diagnosis and Treatment by Dr. Andrew Hall Cutler.  Be forewarned that these are not light reading however!  (His Ph.D. is in Chemistry.)

NOTE:  Many PCPs (primary care physicians) will criticize hair testing, even though they know next to nothing about it.  I will include many case studies, if I may use the term, in my link Hair Testing Summary Page that hopefully will convince you that hair testing can be both practical and potentially life (and hormone) saving.

Low Carb Diets and Arrhythmias - Peak Testosterone

Before, I say anything, let me say that very low carb diets in my opinion have a place in the diets of some men with certain medical conditions, such as obesity and potentially cancer and diabetes. However, I do not seem them working for the majority of men long term and have outlined some of the big issues that these diets need to overcome: poor gut health in some men; very high LDL counts in some men; decreased athletic performance for medium and high intensity exercise in most men, etc. And, more recently, very low carb diets appear to be on the receiving end of another black eye from breaking research that shows that very low carb diets may actually subtly damage the heart and appear to have a significant side effect in many men (and women) of arrhythmias.

Now, again, I am NOT saying that all men on a very low carb diet have heart damage and arrhythmia.  However, I am saying that it looks like the risk factor for the same may be increased and so one should do their own research and discuss with a good doc if he/she wants you on this diet long term.

Browsing around the Paleo and Low Carb forums, you will see that some members complain of this issue.  For example, one Reddit member wrote: “About four months ago, (after 3 months in ketosis) I went into arterial fibrillation out of the blue. I’ve never had heart problems save for a occasional missed beats (one every week or less) that I always chalked up to anxiety. (I have anxiety disorder) Blood tests were performed, and I was found to be slightly dehydrated, with microcytic anemia, but all other indicators were normal. I was shocked back into rhythm and sent home. I immediately discontinued my diet and have not had any heart issues since.” [1]

REFERENCES:

1) https://www.reddit.com/r/keto/comments/16vbdq/heart_problem_after_being_in_ketosis_for_a_while/

2) https://www.ucdmc.ucdavis.edu/welcome/features/20080820_diabetic_hearts/

3) American Journal of Physiology – Heart and Circulatory Physiology, 14 June 2014, “High-fat, low-carbohydrate diet promotes arrhythmic death and increases myocardial ischemia-reperfusion injury in rats”

Now notice what this member wrote – that he was checked for dehydration.  This is what I see as I am reading:  low carb advocates are saying that the issue must be related to things like dehydration or mineral deficiencies, etc.  In actuality, it is nothing as benign according to one study at least:  the ketones actually interact with the heart itself in a very negative way. As you know, those on a ketogenic diet end up with high levels of ketones.  High ketone levels are not all bad and have some good properties.  Unfortunately, it looks like your heart doesn’t like too many of them!

For example, one recent study looked at children with diabetes who sometimes die from irregular heart beats (arrhythmias).  Scientists initially thought it might be electrolyte imbalances, but they found instead that is was the high amount of plasma ketones that these children had. [2] The researchers said that anyone with significant ketoacidosis, the technical name for when our body has to break down fat for energy, over an extended period of time may be vulnerable to this.  Of course, those on very low carb diets all fall into this category, but alcoholics and, as mentioned above, diabetics can be as well.  Again, it is very important to point out that these patients did NOT have electrolyte or any other known issues.

NOTE: I also recommend scanning my page on Low Carb Diets and Heart Disease, where I discuss the recent evidence that Low Carb Diets can accelerate arterial plaque (atherosclerosis) in some men (when not losing weight) and cause heart damage after a heart attack.

So is it really all that bad?  Well, recent animal studies show that it may actually be much worse long term, at least for some men.  One researcher fed animals (rats) a 60% fat, 30% protein and 10% carbohydrate diet.  What they found was surprising when they took these animals through a heart attack and then bring them back again.  Basically, the low carb animals had fat in their heart, which lead to a larger heart attack, due to “due to ventricular arrhythmias and hemodynamic shock.”  [3] The researchers pointed that, after a heart attack, the all important left ventricular function was decreased.

Now this study did point out that there were no real differences prior to the heart attack.  However, this only shows that in the short term, men might not notice any issues on very low carb diets.  The results, at least in animals, clearly show that heart function is definitely being altered and, long term, may not be such a wise idea.  It also says that if you are one of the unlucky ones to have a heart attack, you may be at greatly increased levels of risk from a very low carb diet.

Furthermore, some studies show that low carb diets can increase inflammation and one study showed that increased fibrinogen levels.  Again, this would be particuarly dangerous in a heart attack scenario.  For details, see my page on Low Carb Diets and Inflammation. You can also find more about Low Carb Diets in my Summary Page on Diet and Nutrition.

HDL, LDL & Triglycerides Levels To Reverse Arterial Plaque.

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.

Testosterone Therapy: The Positive Cardiovascular Studies, 2015

Nevertheless, there is great reason for the TRT community to celebrate these findings, and I summarize the results and studies below for those who wish to dig into more detail.

CAUTION:  Always consult with your doctor when it comes to any medical condition including heart disease.  He or shoe knows your specific situation and medical background:  the studies just deal with averages and can have their own issues.

1. Men with Severe Heart Disease. This study looked at 755 senior men between the ages of 58 and 78 with very advance arterial plaque levels – many were diabetics, smokers, etc. – and split them up into three groups:  those who got no testosterone; those got a lower dose of testosterone; and those who got a higher dose of testosterone.  The latter group end up with testosterone > 742 ng/dl. I highly suggest that you look up the study and read it for yourself, but a quick summary is that the researchers measured a quantiy called MACE, Major Adverse Cardiovascular Events.  This will include things like a heart attack, stroke and probably angina.  What they found was the “the men who did not receive testosterone as part of their treatment were 80 percent more likely to suffer an adverse event, such as a heart attack, than those taking T.” [7][8]

2. Senior Men Receiving Injections. This study found that “older men who were treated with intramuscular testosterone did not appear to have an increased risk of MI [heart attack]. For men with high MI risk, testosterone use was modestly protective against MI.” [4] Injections, in particular, have been criticized – more on that below – as posing some additonal cardiovascular risk but notice that testosterone actually lowered the risk of heart attack in those who need it most.

3.  NORMALIZATION Greatly Improves Risk of Heart Attack, Stroke and Mortality.  This recent study in The European Heart Journal pointed out that the major component missing from the two negative CVD studies were normalization of testosterone levels, i.e. proof that the patients actually had their testosterone boosted significantly.  The authors of this study used a VERY large set of 83,000+ veterans data and found results that were so positive it has silenced virtually all TRT critics from what I have seen: [6]

a) A 47% reduction in all cause mortality!

b) An 18% reduction in heart attacks

c) A 30% reduction in strokes.

These are incredible numbers and, as I often point out, it is no wonder considering that testosterone lowers insulin levels and improves insulin sensitivity, something that is a major issue for most 45+ men in modern societies.  (See my pages on Testosterone and Diabetes and Testosterone and Metabolic Syndrome for more information.) Again, just because a man goes on TRT does not necessarily mean that anyone has proven that his testosterone has normalized.  He may not have been compliant and some delivery systems just do not work in some circumstances.

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

In my layman’s opinion, the research overall shows that testosterone therapy significantly improves cardiovascular outcomes in the average hypogonadal man placed on standard TRT.  This is actually remarkable considering that some rather lousy protocols are used out there, something that I highlight in my page on Potential Testosterone Injection Dangers. In addition, some men with clotting disorders may be at risk and you can read about this on my page called The Potential Risks of Testosterone Therapy. So talk to your doctor and do your own research as I always say, but it would appear that testosterone therapy still has a bright future ahead of it.

NOTE:  Before I go on, I want to be clear that I am not a doctor or a researcher but simply another guy out there enjoying the benefits of testosterone therapy.  That said, I am probably more interested in the subject that the great majority of physicians out there, simply because testosterone therapy has been such a life changer for me and greatly improved my health from all I can tell.  I also have a wife and three kids and certainly do not want to do anything reckless, and so I want to know the strengths and weaknesses of what I am doing.

I HEARD THERE WERE STUDIES SHOWING TRT INCREASES CVD RISK?  Within just a few months (Oct 2013 to Jan 2014) testosterone replacement therapy appeared to be on the ropes with two back-to-back studies showing increased cardiovascular risk for men on TRT. [1][2] These studies were controverisal and widely criticized in the TRT community however.  And one of the reasons is that, in general, testosterone therapy has done very well in the cardiovascular research, and so this was quite a shock.  In my opinion Dr. Morgentaler did an incredible job of showing the issues with these studies in two papers that you can read here and here. Although his discussion is not exactly an easy read, I see no point in rehashing it here, and I highly encourage you to read what he wrote. Below is a quick recap by Dr. Morgentaler of the key problems:

“However, methodological flaws and data errors invalidate both studies as credible evidence of risk. One showed reduced adverse events by half in T-treated men but reversed this result using an unproven statistical approach. The authors subsequently acknowledged serious data errors including nearly 10% contamination of the dataset by women. The second study mistakenly used the rate of T prescriptions written by healthcare providers to men with recent myocardial infarction (MI) as a proxy for the naturally occurring rate of MI. Numerous studies suggest T is beneficial, including decreased mortality in association with TTh…” [6]

Although one of our posters pointed out that Dr. Morgentaler has disclosed considerable financial ties to the testosterone manufacturers, Dr. Morgentaler’s position seemed completely vindicated by the above three ensuing major studies showing that testosterone therapy actually IMPROVES cardiovascular risk. [3] [7]

1) PLoS One. 2014 Jan 29;9(1):e85805, “Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men”

2) JAMA, 2013, November 6, 2013, 310(17), “Association of Testosterone Therapy With Mortality, Myocardial Infarction, and Stroke in Men With Low Testosterone Levels”

3) https://www.peaktestosterone.com/forum/index.php?topic=6369.0

4) Ann Pharmacother, 2014 Jul 2;48(9):1138-1144, “Risk of Myocardial Infarction in Older Men Receiving Testosterone Therapy”

5) Asian J Androl, 2015 Jan-Feb, 17(1):26-31, “Testosterone deficiency and cardiovascular mortality”

6) European Heart Journal, published August 6, 2015, “Normalization of testosterone level is associated with reduced incidence of myocardial infarction and mortality in men”

7) JACC, Apr 5 2016, 67(13), “CLINICAL EFFECTS OF TESTOSTERONE SUPPLEMENTATION AMONG HYPO-ANDROGENIC MEN WITH PREEXISTING SEVERE CORONARY ARTERY DISEASE: THE INTERMOUNTAIN HEART COLLABORATIVE STUDY”

8) https://www.medicaldaily.com/testosterone-shotsheart-attack-risk-coronary-artery-disease-381236

Aluminum and Your Brain-Peaktestosterone

For years scientists thought aluminum was a non-issue. There reasoning was based on the fact that only about a percent of any aluminum that you ingest makes its way into the bloodstream and then any that makes it into the bloodstream must pass the blood-brain barrier. In healthy individuals the blood-brain barrier is a formidable obstacle: only about .005% of any aluminum in the blood makes it into your brain. And so for years reseachers dismissed aluminum as a health-threat because these numbers just seemed too low.

Well, that was then and this is now. Ample research has since changed almost everyone s mind. First of all, substantial aluminum has been found in human brains, especially in subjects with Alzheimer s and dementia. The idea that the blood-brain barrier was a magical brain protector was shattered by this realization. Further research showed that, while Aluminum does not directly cause Alzheimer s, it can exacerbate any kind of dementia. The reason is that aluminum actually causes neuronal damage very similar to the mechanisms involved in Alzheimer s itself. You might say Aluminum is not a sibling but a look-alike cousin. For example, aluminum does the following, which those of you familiar at all with Alzheimer s will recognize right away

Scientists have even seen the damage that aluminum can do first hand: dialysis patients can receive excess aluminum and end up with aluminum-induced paroxysms and seizures. More frightening to the populace at large is the research showing much higher rates of dementia in individuals whose city water supply exceeds 200 micrograms/liter of aluminum! And, yes, quite a few cities do actually exceed this threshold.

The blood-barrier clearly wasn t protecting everyone and researchers also discovered that there are certain conditions where the blood-brain barrier can be compromised, such as during fever, invisible micro-strokes that are relatively common in middle aged and beyond and so on. Or perhaps just that minute amount that just naturally makes it into the brain is enough to do the damage. Either way, aluminum should clearly be one of our top concerns when it comes to protecting our brains..

So the bottom line is that it is NOT wise to rely on your blood-brain barrier to preserve your brain from the ravages of aluminum. Of course, don t cook with aluminum. Drinking from aluminum cans is supposedly safe because they coat with a kind of wax , but do you want to bet your mental faculties on it? “No brain, no life”, I always say.

Aluminum is not easy to avoid for many reasons: it is one of the most abundant elements on the earth s surface. Furthermore, they put it in many antacids and antiperspirants. It is also in black tea and grain-based foods, although in fairness none of these have been linked yet to dementia. Again, I would err on the side of caution in this case. You ve only got one life why not be semi-conscious while you re enjoying it?

NOTE:  If you sweat excessively, i.e. have hiperhydrosis, you may have been prescribed aluminum chloride hexahydrate, or Drysol, for the problem.  Please discuss with the doctor the possible future effect on the brain.

Cholesterol and Erectile Dysfunction - Peak Testosterone

150. That’s the magic number.  Keep your cholesterol below 150 all your life and you’ll never have heart disease. There is a likely corollary to that:  keep your cholesterol low to avoid erectile dysfunction.

The reason is simple:  your erections are very dependent on a healthy endothelium, the delicate lining of your veins and arteries that pumps out nitric oxide, and a healthy endothelium is dependent on low cholesterol.  As it turns out, high cholesterol tends to decrease the ability of the arteries to relax and you need them to relax for blood to flow into the penis.

One study of patients with cardiovascular disease and arteriosclerosis – and most people in modern, industrialized societies have significant arterial plaque buildup – found that Lovastatin (Mevacor) significantly improved endothelial function and arterial dilation. [1]  Of course, the significance of this is that Mevacor is a cholesterol-lowering statin medication.

This was verified with another statin, Lipitor, in a study on erectile dysfunction patients with high cholesterol and low morning erections and hardness factor. [2]  These middle-aged men had significantly improved erectile rigidity, a.k.a. hardness factor, after being on this cholesterol-lowering medication.

Even stronger evidence, however, was a study that found that men with total cholesterol over 240 mg/dl had 1.83 times the risk of erectile dysfunction and impotence.  In fact, they observed a dose-dependent rise in erectile dysfunction risk with increasing cholesterol. [3]  This means that the higher the cholesterol levels, in general the lower the erectile strength, adding more solid evidence that the research conclusions were on track.

Why is cholesterol so damaging to erections? If you read many of the popular health blogs, cholesterol supposedly has nothing to do with heart disease. Now I would have to agree that total cholesterol has nothing to do directly with heart disease. The reason is that it is really oxidized LDL that damages the endothelial wall. However, there is a decided relationship between total cholesterol and LDL that makes cholesterol a downstream indicator of potential problems. In fact, one study found that oxidized LDL slowed down certain kinds of vasodilation and triglycerides slowed down all kinds. [5] Remember: you want those arteries, including the ones in the penis, to be able to dilate and allow for increased blood flow.

So what is the best way to lower cholesterol?  Of course, the researchers in two of the studies above used pharmaceuticals, statins, to lower cholesterol.  However, is that really the best and most safe way?  Statins definitely have their issues and side effects, which I document in my link on The Danger of Statins.

What most men and doctors for that matter do not realize is that satured fat is the prime governor of cholesterol and LDL levels in men. This is why reducing saturated (and total) fat can send your cholesterol levels plummeting. I have known many men who could not get their cholesterol levels to singificantly budge and believed that their issue was genetic but were able to dramatically improve when they cut saturated fat levels. The most powerful example of this is a Low Fat Diet with which most men can achieve a total cholesterol level below 150. A Low Fat Diet is so powerful that, if done without cheating, can actually clear out your arteries. For more information, read my link on the Incredible Benefits of a Low Fat Diet and discuss with your doctor.  (Don’t do anything without discussing with your physician first if you have any medical condition or medications.)

The bottom line is that this is another as to how closely the heart and the penis are interrelated.  Heal one and you’ll likely heal the other.

REFERENCES:

1) N Engl J Med, 1995 Feb 23, 332(8):481-7, “Beneficial effects of cholesterol-lowering therapy on the coronary endothelium in patients with coronary artery disease”

2) The Journal of Urology, Jul 2004, 172(1):255-258, “IMPROVEMENT IN ERECTILE FUNCTION IN MEN WITH ORGANIC ERECTILE DYSFUNCTION BY CORRECTION OF ELEVATED CHOLESTEROL LEVELS: A CLINICAL OBSERVATION”

3) Am. J. Epidemiol, 1994, 140(10):930-937, “Total Cholesterol and High Density Lipoprotein Cholesterol as Important Predictors of Erectile Dysfunction”

4) European Urology, 2003, 44(3):355-359, “Erectile dysfunction is associated with a high prevalence of hyperlipidemia and coronary heart disease risk.”

5) Asian J Androl, 2000 Sep, 2: 161-166, “Hyperlipidemia and erectile dysfunction”

A Low Carb Diet Made This Man Sick - Peak Testosterone

I find Low Carb Diets just fascinating. To me it is remarkable that they are as popular as they are. I eat what I would call a high protein, medium carb, low fat diet and love it. I love fruit in particular, beer, dark chocolate, quinoa and a lot of things that have carbs.  I simply cannot imagine going with vegetables only. However, I recognize that Low Carb Diets are very popular with men, especially those losing weight. Low Carb Diets may even have some interesting applications, such as controlling certain types of cancer. [1]

That said, I have had concerns that some men – I’m not saying all – could hurt themselves with these types of diet.  And I have raised up some of the negative studywork in my links on Low Carb Diets and Inflammation and The Potential Dangers of Low Carb Diets. And, anecdotally, some men seem do seem to be getting hurt from these types of dietary regimens. Below is a horror story from the Peak Testosterone Forum members as to how a Low Carb Diet made him just plain sick. So, if you’re on a Low Fat Diet, and feel good, then no attack is intended.

But some of you could very well be experiencing some of the negative consequences of Low Carb Diets as this man did, including insulin resistance, inflammation and high cholesterol:

GUEST AUTHOR: DdR

Q. You mentioned that you got down to 10% bodyfat on a Low Carb Diet. That’ s quite impressive, of course, and so can you explain how you did that? In particular, can you give an overview of your diet?

A. Well, I say 10%, but it could’ve been 12%. I definitely had a six-pack. I lost three inches off my waist and could’ve worn size 30 pants no problem. I’m 5’11”, 35 years old, athletic build.

I achieved this by using a combination of the programs from Bulletproof Exec, Lean Gains, and Carb-Backloading. In essence I would wake up and drink a cup of Bulletproof Coffee with 10 grams of whey protein mixed in (prevents catabolism of the muscle). That would keep me satiated until 2 p.m., when I would have my first meal, which would consist of animal protein (let’s say tuna fish with mayonaise) and a vegetable (let’s say steamed broccoli with sauteed garlic). I would eschew all carbs. My second meal would echo the first meal, i.e., protein and vegetables, little carbs. I would eat nuts too and allow myself red wine.

On workout days (workout = heavy weightlifting) I would follow the same program, but after hitting the gym in the afternoon, I would slam carbs together with protein until bedtime. It didn’t really matter the amount of carbs, because I could only eat so much before getting sick. The theory is that carbs are being channelled towards the muscle cells to restore glycogen stores in lieu of going to fat cells.

Q. You mentioned that you were eating a lot of protein and fat? Was most of this coming from meat? Or were you also ingesting supplemental proteins and various oils?

A. Meat consisted of grass-fed beef, wild-caught salmon or other fish, pastured chicken, and eggs. Maybe tuna fish now and then. Whey protein every morning in my coffee. I also had salads quite a bit with EVOO and took cod-liver oil daily.

Q. You mentioned that you felt this diet led to some serious health issues. Can you describe those?

A. After a few months my cognition began declining, and in fact I started getting brain fog. My performance at work was slipping and I could barely tread above water.

I got blood work done. My cholesterol shot up by 70 points in three months. The other thing that was disturbing was that my inflammation marker (c-rp) was way above normal. This corroborated with how I was feeling, which was achy a lot. I was 34 and thought that this is what happens when you get older, but man I was shocked how quickly I was aging.

The thing that did it for me was that I started witnessing shortness of breath. Like I was about to pass out from shortness of breath. I first noticed it skiing (which I do a ton of and never had an issue), but then it began translating into normal everyday routines, like climbing stairs or riding a bike at a leisurely pace. When I would go to the gym and do squats and kettlebell swings, I would have to concentrate on breathing otherwise everything would go white.

I obviously was really concerned I had a heart defect, so I went to multiple specialists. Pissed away lots of money. They also said that I was normal. But I just felt awful and basically felt I couldn’t do strenuous activity anymore, otherwise I’d die. I thought that this was going to become my new life or non-strenuous activity.

Q. And you can’t think of anything else that might have caused these issues?

A. See answer above. PCP and cardiologist cleared me of any health problems. Once I ceased the above-described diet and starting ingesting normal foods, especially carbs, my shortness of breath went away. I had been suffering from insulin resistance since June of last year, but that has slowly been going away as well. I’ve noticed that my thinking the last few months has become much clearer.

Q. What made you finally pull out of that style of eating? And how did you know “it was time.”

A. Thinking that I was going to die. I’m not kidding. When you can’t even climb a flight of stairs without everything turning white and your heart’s pounding in your chest, you know something’s seriously wrong.

Q. How are you eating now and how improved are you? Some of the guys would probably be interested in knowing how long it took you to recover.

I eat a normal breakfast now, at least normal to me: a few eggs, lentils and some sauerkraut with tea. Or a smoothie with 40g Hi-Maize resistant starch, berries, flax seed, pea protein, and almond milk. I won’t hesitate to eat pancakes or Muesli.

I generally eat salads during lunch, but won’t hesitate to ingest some carbs, but clean carbs like quinoa, rice, legumes, or buckwheat. Dinner I usually let go and will eat pasta or a cooked potato. I’m eating fruit again! I love fruit. I eat a lot less meat and a lot more vegetables given that I’m basically substituting clean carbs for animal protein.

My bf% is now probably 16%. I don’t love what I see in the mirror, but my girlfriend doesn’t care, and frankly, I just want to feel good.

I still have not recovered 100%, even though I stopped this diet almost a year ago, although I’ve improved quite a bit. My cognition and memory have improved a lot, but I had to tackle the insulin resistance that had developed first. I believe my thyroid got screwed up from that diet because I’ve been suffering from libido, erection and insulin issues over the last year. I had a hemorrhoid for over eight months, which finally went away once I began jogging again and drinking pomegranate juice on a regular basis.

The biggest thing is the breathing. I think this diet really hammered my vascular system. I skied my butt off this past season w/o any issues. I’ve been climbing mountains the last few months, and no scary moments! I jog regularly for 30 minutes.

I’m still not great at the gym and do get dizzy when I do squats. It’s like I’ve still maintained my strength, but my lungs/vascular system is lagging behind, and I get close to passing out. I hesitate going to the gym sometimes now (like today!) because I’m fearful of passing out, even though it hasn’t happened (yet). I’m thinking of drinking beet juice before hitting the gym to ensure that I have adequate oxygen until this problem goes away.

Hope this helps everyone out there. I would really steer clear of low-carbing given what happened to me.

REFERENCES:

1)  Nutr Metab (Lond), 2011, 8:75, “Is there a role for carbohydrate restriction in the treatment and prevention of cancer?”

My sleep would be atrocious that night after carb backloading.

At any event, I put on muscle while simultaneously losing weight. It was stupidly simple to maintain that body-fat percentage as long as I got used to it.

Q. How did you feel on this diet in the beginning? Were you actually feeling good at the start of this program? And how long did you stay on this type of diet?

A. I felt fine in the beginning. I don’t want to say I felt great, but I felt normal. Energy levels were ok, but I would often suffer low blood-sugar levels and feel like utter crap. Didn’t notice any big difference from consuming BP coffee (unlike Joe Rogan, who said he “wanted to kick an alligator in the dick” after drinking BP coffee).

I stayed on the diet from August 2012 to May 2013.

Testosterone Right Now: Boosting Your Hormones Immediately

Need to boost your testosterone right now?  Well, there are proven ways to give yourself a nice jumpstart almost immediately.  Be forewarned that some of these can get you into trouble, so don’t go too crazy!  But if you just want to maximize your testosterone asap, then below are few interesting ways to do it:

NOTE: The most important ways to maintain and increase your testosterone are through lifestyle changes that I talk about on this site, such as Sleep, Sex, Guarding against Depression, Stress Protection, Long Term Strength/Weight Training and so on.

1. Attractive Woman.  A male can raise his testosterone simply by hanging around an attractive woman. [1] That’s right – that good-looking friend of yours can actually alter your hormones for the better.  Apparently, a little titillation can go a long ways, eh?  Be careful though:  the same study showed that it increased risk-taking as wellIn other words, you might also get stupid.

1) Social Psychological and Personality Science, Jan 2010, 1(1):57-64, “The Presence of an Attractive Woman Elevates Testosterone and Physical Risk Taking in Young Men”

2) Pychological Science, published Sep 21 2010, “Power Posing: Brief Nonverbal Displays Affect Neuroendocrine”

3) https://www.telegraph.co.uk/health/healthnews/6316522/Fast-cars-boost-mens-testosterone-levels-research.html

2.  Competition. We have coverd this extensively in another link on Competitive Testosterone Boosters, but studies show that even the anticipation of a competitive event can augment testosterone in the short term for males.  Competition (and especially winning) can do the same. Yes, sports of any kind can not only get us in shape but help us hormonally.  NOTE:  Losing can bring down your hormones, so be careful not to  create a pattern of defeat in your life.

3) Posture and Pose. This is a strange one, but you can give your testeosterone a boost right now if you simply adopt a “power pose” stance or posture. [2] The concept is that if you display dominance and power, it immediately signals the brain and your testosterone begins ramping up. This study showed an increase in testosterone of about a fifth or sixth and a drop in cortisol of about a fourth.  Not bad for something so simple, eh?  Just try not to scare the kids or the dog…

4) Fast Cars. One study monitored guys doing a little city driving. What they found was that when they put a fella in a Porsche, his testosterone immediately increased.  And when they put him in a beat up old Camry, his testosterone levels actually fell a little bit.  So next time the Little Woman suggests you drive the minivan, tell her that she might as well give you a groin kick…

Fast cars.  Beautiful women. Sports and games. Chest thumping. (I don’t know where the Rock n’ Roll fits in.)

Okay, some might say these are a little shallow.  But, hey, let them have the low testosterone, eh?  In the meantime, get busy and boost your testosterone now!

REFERENCES:

Why I Believe Plant Based and Vegetarian Diets win Eventually

REFERENCES:

1)  https://ajcn.nutrition.org/content/78/3/660S.full

Some of you aren’t going to like me saying this, but I sincerely believe that plant-based diets are going to take over the men’s health community eventually here in the U.S., a space traditionally dominated by Paleo and Low Carb.  And I believe it’s going to be sooner rather than later. I think I am somewhat unusual in the sense that I am plant-based (whole foods vegan) and yet have read a large body of Paleo and Low Carb writing and research.  In spite of that, I still think meat eating is going to dramatically decrease over the next 20 years and plant based eating will rise to ascendancy rapidly.

First of all, Low Carb Diets are already dying a fairly quick death for all the reasons I outline here:  The Best Summary of the Research-Backed Dangers of Low Carb Diets. That leaves the Americanized version of Paleo, and I think it, too, will rapidly die out and be replaced by the following three types of diets:

a) Vegan and Plant Based. These diets are 100% plant based.  Generally speaking, plant based means now someone who is vegan but eats only whole plant foods.

b) Vegetarians.  Vegetarians generally, eat 90+% plants and 10% a combination of eggs or dairy.

c) Flexitarian. If you feel that you have to have some meat, then there is a diet called flexitarian.  This simply means someone who eats 90+% plants and 10% meat, eggs or dairy.

I am sure that some if not most of you are very skeptical, but I think you’ll see why I say this when I explain Five Great Reasons to Go At Least 90+% Plant-Based:

1. Testosterone. Did you know that the best study that we have to date shows that vegetarians have testosterone equal to meat eaters and that vegans have the highest total testosterone? I discuss the study in detail in my page on Testosterone and Vegetarianism. Now vegans actually probably don’t have higher free testosterone, since their SHBG will tend to be a bit higher.  But the real point is that you can eat a TON of plants and no animals and have total testosterone at least equal to the meat eaters around you. Yes, it is a complete myth that plant foods lower testosterone, and there is no research whatsoever to support the ludicrous statements that I hear to the contrary.

2. Nitric Oxide and Blood Flow. Let me give you the #1 reason that diets with at least 90% plant are going to win with men:  plants are incredibly powerful boosters of nitric oxide and blood flow and animal foods and meat suck at it.  This is the reason I wrote my book The Peak Erectile Strength Diet. In my book – and at the time I wrote I was the only one who wrote about the subject as far as I know – I documented one reason after another that plant foods were such powerful aids in erectile strength. They are packed with nitrates, flavonoids, polyphenols, anti-inflammatories, antioxidants – the list goes on and on – and many other phytochemicals that protect your arteries from plaque and boost nitric oxide.

This is in direct contrast with animal foods which have no such ability whatsoever.  If you sit down and eat a steak or chicken, will it boost your blood flow and lower your blood pressure?  No way!  Quite the opposite.  This is a unique property of plant foods, and again you can read about it in my book.

CRITICAL POINT: So why is this so important?  Because guys are all about erections and plant foods can be a life saver in the bedroom, especially as you age. If you eat a ton of plant foods, you boost your nitric oxide AND you get to keep your testosterone.  Is this an unbeatable formula or what?

So what’s not to like?!  You basically get to have your cake and eat it too.

Again, men are short-changing themselves in the bedroom with low carb and certain Paleo Diets that load up on animal foods.  Yes, young guys can eat that way and have great erections because they have a lot of buffer and nice clean arteries.  Most middle-aged and senior men have no such “luxury.”

3. Gut Health. One of the things that just floors me is that men don’t stop and think about how much we look like an ape.  We are incredibly similar both internally and externally.  Nowhere is that more apparent than in our GI tract.  Our gut, in particular, is almost totally that of a herbivore.  It is long, twisting and convoluted.  This in direct contrast with the typical carnivore that has a short and straight gut.  It’s basically a pipe to shoot that stuff out as rapidly as possible.

Stop and think about why this is the case:  iff you eat a a large amount of meat, the contents of the bowel are going to be a rapidly putrifying, slowly moving, fatty blob.  This mass needs to “get in and get out” which is why a carnivore’s gut makes that so easy.

Plant eaters instead have a long twisting gut that requires a lot of fiber and bulk for obvious reasons.  What a disaster to shove a steaming pile of fat and meat into our poor gut, where it moves slowly and painfully through our herbivore-like GI tract!  No wonder Crohn’s, diverticulitis, IBS, colitis, etc. are at epidemic levels.  And no wonder our gut flora is a disaster.  One study after another has come out about the important of gut flora on health.  And high fiber, whole foods, plant-based diets are king in this area.

If you don’t have two easy, non runny and non-constipated bowel movements per day, then you need to get to a plant-based regimen.

4. Sustainability. I get amused with people who are worried about the fact that we have an aging population. I’m not being callous to demographic effects on the economy, but this is just the beginning!  There are now huge players in anti-aging, regenerative medicine and life extension that are going to revolutionize and extend both healthspan and lifespan very soon.  And I am not talking about supplements here:  I am talking CRISPR (gene editing), sterm cell therapies, nano technology and so on.

Already we already curing several types of blood cancer.  And the progress against cancer has been so impressive that it is not at all unreasonable to believe that cancer will be completely defeated in the next forty years.  As I write this, several of the nastiest genetic diseases have clinical trials underway to be eradicated with gene editing.  This research is going to rapidly accelerate.

So how does this fit  into an argument for plant foods?  Because as the population ages, there will simply be no way to feed men significant percentages of animal foods and products.  At some point we all have to admit that plant foods are much more sustainable.  Check out these stats as examples:

–Livestock produces more greenhouse gases than all cars, planes and trucks combined.

–To produce a pound of meat generally takes between 500 and 2000 gallons of water.  To produce a pound of most plant foods is between 30 and 200 gallons.

–“In the United States, more than 9 billion livestock are maintained to supply the animal protein consumed each year.” [1]

–“This livestock population on average outweighs the US human population by about 5 times.” [1]

–“At present, the US livestock population consumes more than 7 times as much grain as is consumed directly by the entire American population.” [1]

–“The amount of grains fed to US livestock is sufficient to feed about 840 million people who follow a plant-based diet.” [1]

I know lots of men on my forum who are into sustainable energy sources and get excited to hear about advances in solar power and other similar technologies. What they don’t realize is that shifting to a largely plant-based diet can have easily the same level of impact in achieving sustainability on our planet.

5. Supercultures. There are a handful of supercultures that have a unique combination of qualities:  they live without chronic disease (heart attack, autoimmune disorders, stroke or cancer) and also have extreme longevity.  These cultures typically have a high percentage of centenarians and men and women in their 90’s are usually very alert and mentally and physically active.  The Tarahumara of northern Mexico are a great example of this. John Robbins provides four other examples in his book, which I review here:  Healthy at 100. All of the supercultures have several things in common, but one of them are diets that are very high in and based upon plants.  This is powerful evidence in  my opinion that optimal performance and longevity is obtained with a 90+% plant-based diet.

So get busy and choose one of those diets and get started!  Solid testosterone, high nitric oxide, great gut health and maximum longevity. What’s not to like?

Priapism - Peak Testosterone

An uncontrolled, unstoppable erection may sound like a fantasy to most men, especially those in middle age and beyond that are struggling with erectile dysfunction.  However, any erection over a couple of hours is termed priapism and, besides being very painful, can result in permanent damage to the penis.  (Always go to the emergency room immediately if you cannot stop an erection!)

What causes priapism? Surprisingly, priapism is not completely understood.  However, there are many rather suprising triggers of priapism that many men m

1.Alcohol.  Heavy drinking was one of the most common associations with priapism. [1] Alcohol results in vasodilation – although if you have too much it can have the opposite vasoconstricting effect –  and the right dosage apparently can overstimulate.  Probably more importantly, alcohol affects the alpha adrenergic system – more about that below. [2]

2. Trazodone.  This antidepressant is estimated to cause 80% of drug-induced priapisms and can result in some rather severe cases. [3]  One particularly gruesome case resulted in amputation of the penis. [4] If you have been prescribed this drug, beware that “in approximately 33% of the cases reported, surgical intervention was required and, in a portion of these cases, permanent impairment of erectile function or impotence resulted.” [5]

2) Alcohol Clin Exp Res, 2009 Feb, 33(2):255-63, “A pilot trial of the alpha-1 adrenergic antagonist, prazosin, for alcohol dependence”

3) https://www.medscape.com/viewarticle/549253_6, “Counseling Patients About Sexual Issues: Drug-Induced Priapism”

4) J Clin Psychiatry, 2010, 12(2), “Penile Amputation After Trazodone-Induced Priapism: A Case Report”

5) https://www.mentalhealth.com/drug/p30-d03.html

6) International Journal of Impotence Research, 2005, 17:469–470, “Priapism caused by ‘All Nite Long'”

7) Eur Urol, 1986, 12(3):169-70, “Intracavernous injection of noradrenaline to interrupt erections during surgical interventions”

8) JOURNAL OF MEDICAL TOXICOLOGY, 5(4):223-225, “Refractory priapism associated with ingestion of yohimbe extract”

9) International Journal of Impotence Research, 2005, 17:293–294, “Unresolved priapism secondary to tamsulosin”

10) Br Med J, 1979 October 27, 2(6197):1039, “Prazosin and priapism”

11) https://www.dailymail.co.uk/news/article-2032629/Man-rare-disease-causing-agonising-erections-hours-robbed-father-knife-point-buy-painkillers.html

12) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3355694/

What causes such severe cases?  Trazodone is “thought to result from unopposed ?-adrenergic blockade; pharmacologic treatment consists of infusion of ?-adrenergic agonist drugs directly into the penis.” The significance is that noradrenaline actually blocks an erection from occurring.  In fact, surgeons have injected noradrenaline directly into the penis in order to bring down erections. [7]

One can think of nitric oxide as the stimulator of erections and, in a way, noradrenaline as the dampener. When you remove the brakes, the truck just keeps rolling down the hill  with nothing to stop it. Thus,  alpha adrenergic antagonists (alpha-adrenoceptor antagonists), which decrease noradrenaline levels, are very often the root cause of priapism.

Yohimbe (Yohimbine) is also common such preparations and can lead to priapism. [8] Why is that?  One compounnd in yohimbine is an alpha adrenergic antagonist.  One https://www.peaktestosterone.com/forum/index.php?topic=3.msg342#msg342 also mentioned another “formula” that resulted in the same.  Did it also have yohimbine in it?  Who knows?

Of course, the tragedy is that many men are taking these concoctions in the hopes of helping their sex lives only to find that they have potentially damaged themselves permanently.

4.  Alpha Blockers. Did you know that there are a whole class of drugs that are, by definition, alpha adrenoceptor antagonists?  And, yes, these can cause priapism.  Again, middle-aged and senior men are particularly vulnerable, because these are commonly prescribed for BPH (enlarged prostate).  One nasty case of this is mentioned in the literature, where a man’s priapism persisted even after shunt surgery on his penis. [9] Prazosin has also been linked to the same issue. [10]

5.  Cocaine and Prescription Narcotics. Cocaine is notorious for priapism and, again, the reason is related:  it depletes the body of noradrenaline. As noradrenaline (norepinephrine) levels fall, eventually the body loses its ability to shut off an erection in many cases.

This can happen with prescription narcotics (vicodin, percoset, oxycodone, etc.) as well.  One strange story out of the U.K. in late 2011 tells of a man who, due to a medical condition, supposedly experiened painful long-lasting erections and then robbed his own father at knife point to get money to buy pain killers. [11] We ask the question, “Could he not have been first addicted to pain killers which then led to his priapism?”

6. Pomegranate Juice and Viagra. There have been several case reports of priapism resulting from this combination. Pomegranate juice is not only a potent stimulator of nitric oxide but can alter liver function.  Those taking any PDE5 inhibitor (Cialis, Levitra, Stendra, etc.) should also use caution. [12]

REFERENCES:

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.

Varicocele Repair: Increasing Libido and Energy.

STEP 9:  For this reason I have included taking care of a varicocele as a step in my Peak Testosterone Program.  (For the other steps to the program, see my Home Page.) Of course, varicocele procedures aren’t going to help all men, but they will definitely significantly help a big percentage and will help with some of the symptoms that seem to plague us guys in modern societies, such as low libido, poor sleep, lack of energy and low levels of various hormones.  And, again, what is particularly remarkable is that some doctors will tell their patients that a varicocele procedure will not improve testosterone or their health in general, when, in fact, there are multiple studies that show just the opposite.

As an example, look at what this M.D. wrote about varicoceles:

“If a teenager or young man with a varicocele has a smaller than normal testicle on that side, there is an increased risk of infertility and many urologists consider this an indication to fix the varicocele surgically. Rarely, a varicocele may lower the testosterone level. In this instance, the testes are usually smaller than normal. Such a circumstance may decrease the libido. Evaluation of the serum free testosterone level can detect this.” [10]

1. Increased Testosterone. Will every man get an increase in testosterone?  Of course not.  Nevertheless, the studies show very powerfully that most men likely will:

a) Infertile Men.  One study showed that testosterone levels in infertile men increased from 319 to 409 ng/dl, a nice 28% increase on average.  The authors noted that “men with at least 1 firm testis preoperatively had a greater increase in serum testosterone.” [7]

b) Using Microsurgery. Another urologist did a larger study on any man with a varicocele and found that every age group had lower testosterone than their non-varicocele counterpart cohorts.  Furthermore, after varicocle surgery, 70 percent of the men experienced an increase in testosterone.  So much for the theory that repairing a varicole does not affect testosterone!

c)  Nice Increase. Yet another study showed that men got a boost of 110-146 ng/dl from varicocele repair.  This is not going to correct hypogonadism in anyone, but is an impressive increase nonetheless. [9]

2. Increased Sexual Activity.  One study on men with fertility issues found that couples had greatly increased intercourse rates post-varicocele: “the improvement of sexual activity was 50-75%, the pregnancy rate for their partners was 37% and increased plasma testosterone levels over a period of 3 years of follow-up after varicocele repair.” [5]

3. Increased Libido and Energy. Let me quote one urologist: “a varicocele repair can help increase testosterone, improving energy level, sex drive, and the ability to have an erection.” [6][10]

4. Greatly Improved Sleep.  Why would libido and energy improve?  One reason may be sleep.  Look at what Sam wrote, one of our regular posters:

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

“If you are a middle aged man and suffering from insomnia and low t make sure you don’t have a varicocele. While completely subjective and based entirely on my own personal experience, within 1 week of having my varicocele repaired I was sleeping through the night and haven’t had a bad nights sleep since. Coincidence?” [1] “I did and it had no impact on t levels but major improvements in sleep. Basically I went from waking up 3-5 times a night to sleeping through the night totally again.” [2]

5. Normalized Body Temperature.  Sam also noted something very interesting that indicates normalized thyroid function:

“So I was contemplating on how my average body temp went from an unstable but consistent 97.4ish to a steady 98.6 within a week of my varicocele procedure and it got me wondering if the body would down regulated your body temp if a varicocele was causing your gonads to operate at too high of a temperature. If so this could be a way for men to tell if they have a varicocele that is impacting testicular function.” [3]

6. Fertility. Correcting even a unilateral (one testicle) varicocele can make a very significant change in fertility.  For example, one study wrote, “Preoperatively, men with grade 3 varicocele had lower sperm counts and poorer fertility indexes compared to men with grades 1 and 2 varicocele. Sperm concentration improved significantly in men with grade 2 (33 +/- 5 million per cc preoperatively to 41 +/- 6 million postoperatively) and grade 3 (18 +/- 5 million preoperatively to 32 +/- 7 million postoperatively) varicocele after microsurgical ligation of the varicocele. Motility improved significantly in men with grade 3 varicocele.” [4]

1)  https://peaktestosterone.com/forum/index.php?topic=1675.0

2) https://peaktestosterone.com/forum/index.php?topic=1017.5;wap2

3) https://peaktestosterone.com/forum/index.php?topic=1386.0

4) J Urol, 1993 Apr, 149(4):769-71, “Relationship between varicocele size and response to varicocelectomy”

5) Systems Biology in Reproductive Medicine, 2003, 49(3), IMPROVEMENT OF SEXUAL ACTIVITY, PREGNANCY RATE, AND LOW PLASMA TESTOSTERONE AFTER BILATERAL VARICOCELECTOMY IN IMPOTENCE AND MALE INFERTILITY PATIENTS”

6) https://urologyaustin.com/urology-news/understanding-varicocele-identification-and-repair/

7) The J of Urol, 154(5):1752-1755, “The Effect of Varicocelectomy on Serum Testosterone Levels in Infertile Men with Varicoceles”

8) https://www.sciencedaily.com/releases/2011/06/110616142726.htm

9) https://www.doctoroz.com/blog/harry-fisch-md/hidden-testosterone-killer

10) https://en.allexperts.com/q/Urology-Male-issues-989/varicocele-loss-sexual-desire.htm

Clomid's Half Life and Time to Clear Out of Your System.

REFERENCES:

1)  British Journal of Clinical Pharmacology , May 1, 1989, 27(5), “Pharmacokinetics of intravenous clomiphene isomers”

2) https://www.peaktestosterone.com/forum/index.php?topic=8290.0

3) Reprod Biol Endocrinol, 2011; “Letrozole or clomiphene citrate as first line for anovulatory infertility: a debate”

4) Fertil Steril, 1999 Apr, 71(4):639-44, “Serum concentrations of enclomiphene and zuclomiphene across consecutive cycles of clomiphene citrate therapy in anovulatory infertile women”

Regardless of the reason, Clomid can take awhile to clear out of system and for any side effects to withdraw.  The reason for this has to do primarily with the half life of one of the isomers in Clomid.  Clomid is actually composed of two different drugs, enclomiphene and zuclomiphene.  The former actually has some anti-estrogenic effects and has been the subject of considerable press lately, because it is the sole active ingredient in Androxal.  You can read more about this in my page on Testosterone and Androxal if you are interested.  (It is still awaiting FDA approval as of this writing in Dec. of 2015.)

The other isomer is zuclomiphene and it is primarily responsible for Clomid’s estrogenic properties.  As such, this is the isomer that is most of interest when it comes to figuring out the time for Clomid to “clear out of your system.” And, unfortunately, zuclomiphene has the longest half life – significantly longer – and this is why estrogenic side effects can linger for quite awhile after quitting Clomid.  So what is the half life of these two isomers in Clomid?  This question was probably most definitely answered in a study on women. [1]

As you can see the zuclomiphene half life is 3-5 times longer than the enclomiphene. The authors point out that you will start out with more enclomiphene in your system, but,  somewhere between 1 and 7 days, zuclomiphene will take over.

How Long Does It Take For Clomid to Clear Out of Your System?

So how long does the zuclomiphen take to clear out of one’s system?  One of our senior posters (seppuku) had an interesting story that his testosterone was still boosted three weeks after just a few small (and low) doses of Clomid:

“A few years ago when I was going through the nhs system of blood tests and hopeless endos, I’d got hold of some clomid and had taken two 12.5mg doses during a week. I then got a letter from the hospital to see the endo in about three weeks. So of course I took no more clomid thinking it would be having no effect by then. He took a blood draw, and my usual level of around 290 – 340 had gone up to I think around 450ish. So the longer you can leave it the better, six weeks sounds reasonable.” [2]

So seppuku’s theory was that six weeks is about right for the time to clear it out of your system.  Is that correct?  Actually, that seems like a very reasonable number based on what I seen here:

NOTE: Most men can boost their testosterone nicely with Clomid, which is an indication that most men have tertiary hypogonadism, i.e. it is centered in the hypothalamus as opposed to the pituitary or testes. For more information, see my page on Clomid and Testosterone.

“Importantly, unlike clomiphene citrate, letrozole is devoid of any anti estrogenic peripheral action. Letrozole is also cleared from the circulation more rapidly due to a shorter half life (48 hours) as compared to clomiphene citrate which may take up to 2 months due to its prolonged half life (2 weeks).” [3][4]

Therefore, based on this study (on women), six weeks is not unreasonable, but it can be even longer – up to two months. And this is reasonable, because usually it takes about four to five half lives to be completely out of your system.  In the case of the second woman, this actually works out to be three months or more!  Practically speaking, I don’t think it usually takes that long.

What is a reasonable way to tell if it has cleared from your system?  Well, one way is to look at when you return to your testosterone levels, assuming you have a total testosterone read from before you started the Clomid.  By the way, in small percentage of men, Clomid can be a way to “reboot” to normal and healthy testosterone levels.  See my on Testosterone Restarts for more information.

LDL: How Do You Lower It Naturally? - Peak Testosterone

If you want to control or regress plaque, then in my opinion it is best to stick with the guidelines of the Plaque Regressers, who all require LDL to be below 80 mg/dl.  For more information, you can read my page on Anti-Plaque LDL Levels. Of course, getting below 80 naturally is not the easiest thing in the world, but dropping below 90 is not particularly hard.  My last read was in the upper 80’s for example.

So, to get yourself below 80, should you take a statin?  I don’t think that will be necessary, and the way to avoid doing that is from a combination of lifestyle choices and foods.  Let’s start with the Big Three Ways to Lower Your LDL:

2. Correct Hypothyroidism. Hypothyroidism will drive up LDL levels with a vengeance.   And correcting hypothyroidism with medication can lower LDL by an average of 12.8 mg/dl according to one study. [1] One study even suggested that high cholesterol couple with high normal TSH be considered for thyroid medications just to lower high cholesterol (and, therefore, LDL) levels. [2]

3. Plaque Reversing Diet. I recommend, as a starting point, choosing one of the diets offered up by the Three Plaque Reversers, Drs. Gould, Esselstyn and Davis. Here is quick overview of each and links to their book reviews. In my opinion, every guy over the age of 25 should have all three of these books and should have them just about memorized:

Read these books and choose one of the diets and you’ll see your LDL dropping in no time.  I do want to point out that none of these diets by themselves will probably get you below 80, especially if you are not losing weight.  And this is the reason that all three of the above physicians will use various supplements and/or statins in order to get a man in complaince.

So is there any way to avoid taking a statin then?  I believe so and the answer lies in the foods and supplements below, which can significantly lower cholesterol and LDL.

1. Tomato.  Researchers gave men and women 400 ml of tomato juice and 30 ml of ketchup daily and watched their cholesterol drop by 13%!  [5] Of course, this translated to a nice drop in LDL as well from an average of 94 to 84 mg/dl.  This is particularly important for me, because these were individuals with pretty good LDL levels and yet tomato products still dropped their LDL significantly.  In my case, I would like to drop my LDL by about 10 points and, of course, that is exactly what occurred in this study.

CAUTION:  Some men may be sensitive to consuming a lot of “nightshade” foods.

2. Oat Bran. Many men know that “oats lower cholesterol.”  Multiple studies actually show this, at least in men with high cholesterol.  One study found that giving men just 1 oz (28 g) of oat bran did the following:

“Blood lipid studies demonstrated significantly greater reductions in total cholesterol (average -2.2%) and LDL cholesterol (average -3.9%) in the oat-bran groups than in the wheat-cereal groups.” [3] That’s not bad for a small amount of the bran of one grain, eh? Larger amounts appear to yield even more impressive results.

Another study found that oat bran also decreased the LDL particle count, which is probably your most important lipid number.  Oat bran also lowered LDL particle size – also incredibly important – along with triglycerides and LDL!  Hard to beat that, eh? [10]

Bumping the amount up to 100 gram dropped cholesterol and LDL 13% and 14%, respectively. [6] Again, these were in men and women with high cholesterol, so it’s hard to know how much of a drop someone with lower LDL levels would experience.

It is important to not that this was out bran and not oatmeal.  Oatmeal can spike post-meal blood sugar in some sesnsitive individuals.

3. Raisins.  One study found that a cup of raisins every day dropped LDL-C by 3.5%. [7] The authors explained that there are many ways raisins probalby lower LDL:

“The addition of raisins to the diet may decrease CVD risk, as they contain dietary fiber to lower LDL-C, as well as a significant amount of polyphenols. Raisin polyphenols may interfere with cholesterol absorption, as shown with red wine polyphenols. Raisins and red wine are both derived from grapes; however, the drying process causes loss of polyphenols in raisins. Despite this, there is still a substantial amount of polyphenols on a per weight basis [13]. Raisin polyphenols can potentially decrease plasma TG by reducing apo E, as shown with lyophilized grape powder (LGP) supplementation in women. LGP also decreased VLDL particle secretion from the liver, possibly via MTP inhibition, which would contribute to reduced plasma TG and LDL-C ”

NOTE:  TG = triglycerides; LDL-C = the standard LDL number you are used to.

4. Strawberries. One study, admittedly in mostly women (with Metabolic Syndrome), found that 50 grams of freeze dried strawberries per day reduced LDL by about 12%. [8] This is an impressive drop, because it is the equivalent to about 3 cups of fresh strawberries.

5. Flaxseed.  Just 20 grams of flaxseed reduced LDL by about 4% in patients with high cholesterol. [9] Two recent studies also show that Flaxseed Fights Against Prostate Cancer and Flaxseed Helps Clear Out Your ARteries.. Not bad, eh/

6.  Garlic. Not only does garlic lower LDL, but it keeps it from being oxidized, giving it a double punch in the fight against atherosclerosis. [4] Garlic will also drop your blood pressure and, when combined with Vitamin C, really boost your arterial nitric oxide levels.  What’s not to like?!? (See my page on Garlic and Erectile Dysfunction for more information.)

PLANT-BASED FOODS. If you’ll notice, all of these LDL-lowering foods are plant-based.  I put some of the heavy hitters above, but keep in mind that many plant foods will lower LDL via their fiber, polyphenol and sterol content.

1)  The Journal of Clinical Endocrinology & Metabolism, 2001 Oct, 86(10), “TSH-Controlled l-Thyroxine Therapy Reduces Cholesterol Levels and Clinical Symptoms in Subclinical Hypothyroidism: A Double Blind, Placebo-Controlled Trial (Basel Thyroid Study)”

2) Eur J Endocrinol, Febr 1 1998 138 141-145, “High serum cholesterol levels in persons with ‘high-normal’ TSH levels: should one extend the definition of subclinical hypothyroidism?”

3) The Journal of Family Practice, 1991, 33(6):600-608, “Randomized, controlled, crossover trial of oat bran in hypercholesterolemic subjects.”

4) Am J Clin Nutr, Oct 1981, 34(10:10 2100-2103, “Effect of garlic on blood lipids in patients with coronary heart disease”

5) British Journal of Nutrition, Dec 2007, 98(06):1251-1258, “Tomato juice decreases LDL cholesterol levels and increases LDL resistance to oxidation”

6) Am J Clin Nutr, May 1981, 34(5):824-829, “Oat-bran intake selectively lowers serum low-density lipoprotein cholesterol concentrations of hypercholesterolemic men”

7) Lipids in Health and Disease, 2008, 7:14, “Raisins and additional walking have distinct effects on plasma lipids and inflammatory cytokines”

8) Nutrition Research, Jul 2010, 30(7):462 469, “Strawberries decrease atherosclerotic markers in subjects with metabolic syndrome”

9) Revista Medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi, 2005, 109(3):502-506, “Flaxseed supplementation in hyperlipidemic patients.”

10) Am J Clin Nutr, Aug 2002,76(2):51-358, “High-fiber oat cereal compared with wheat cereal consumption favorably alters LDL-cholesterol subclass and particle numbers in middle-aged and older men”

Alpha Blocker #2: Phentolamine (Vasoviril) - Peak Testosterone

Oral Phentolamine is another alpha-blocker which, unlike doxazosin, is marketed specifically as a treatment for erectile dysfunction and is, like Viagra, taken on demand . The trade name is Vasoviril. It has not been granted a licence in Europe or North America, but is approved in Brazil and Mexico.

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. Your sex life is at stake.

Phentolamine is a non-selective alpha-adrenergic blocker and thus is in the same general class as the well-known herb herbal erectile dysfunction remedy yohimbine.  The alpha-adrenergic receptors are used by noradrenaline and noradrenaline to put the brakes on erections.

NOTE:  You can find out more information about another alpha blocker by going to my page on Doxazosin and Erectile Dysfunction.

An August 2002 report in the International Journal of Impotence Research stated that, averaging two American trials, the mean change scores in the EF domain from baseline to the end of treatment in the parallel-design study were -2.3, 5.7 and 6.7 for the placebo, 40 mg, and 80 mg groups, respectively. So a healthy increase of 8 or 9 over a placebo. (The two trials were 28 Goldstein I, Carson C, Rosen R, Islam A. Vasomax for the treatment of male erectile dysfunction ; and Goldstein I. Oral phentolamine: an Alpha-1, Alpha-2 adrenergic antagonist for the treatment of erectile dysfunction.)

Oral Phentolamine is faster acting and shorter lasting than Viagra, and should be taken on an empty stomach. Users suggest it takes effect in about half an hour and it lasts about two to four hours. They also suggest Phentolamine works very well in combination with PDE5i. The cost is about twice that of Viagra.

My experience on the Peak Testosterone Forum is that alpha blockers are rarely used to treat erectile dysfunction.  However, some of the study work indicates that they can be very effective in many men.  For example, a German trial in 1998 reported that phentolamine helped 50% of men. And there are other reports it works synergistically with PDE5i.

A paper in 2001 from the Boston School of Medicine reviewed data on Vasomax (now Vasoviril) and stated that two large scale trials have found that Vasomax was associated with significant increases in the IIEF-EF scale. However these trials were conducted when Viagra was being developed and many men on the trials left to join the Viagra testing. And Viagra is generally regarded as more successful.

A 2002 Californian study reported that

Does It Increase Triglycerides? Not if Done Right.

I feel fantastic on a Low Fat Diet and I found recently that My Arteries Were Clear of Plaque, so I believe what I am doing is working. However, I keep reading over and over again that Low Fat Diets increase triglycerides and create a deadly “Pattern B” (small particle) lipid pattern.  Dr. Davis, the famed plaque-reversing clinician, constantly attacks Low Fat Diets with this point.

While I greatly respect Dr. Davis and don’t doubt him for a minute, this accusation has never made sense to me, because I have never had high triglycerides on a Low Fat Diet.  Yet I know that Dr. Davis is a very smart guy and has loads of practical field experience.  So why the discrepancy?

Well, my belief is that I have stayed in good territory, because I eat a Low Glycemic Low Fat Diet. For example, I eat a relatively low amount of grains – virtually no wheat or oats – and mostly fruit along with peas/lentils/chickpeas for carbohydrates. Paleo and low carb folks love to criticize fruit – well, at least many of them treat it like it was cheesecake – but the reality is the fruit is usually a low glycemic choice.  And I do not know any expert that would argue that peas/lentils/chickpeas are anything but healthy:  these are incredible superfoods and packed with “resistant starch” if you’ve been following the latest buzz on that subject.

So let me show you my last lipid numbers, so you can get an idea what a Low Fat Low Glycemic Diet will do for you.

Notice below that my LDL and triglycerides are actually very close to what Dr. Gould, another famous plaque-reversing researcher, has set in his guidelines.  (See my page on HDL, LDL and Triglyceride Levels for Plaque Reversal for more details.)  In fact, I am less than 10% higher that his thresholds, which may explain why I have doing been very well:  my latest blood pressure reads are actually below 110/70, which is excellent for a guy in his mid 50’s.

So I do NOT have high triglycerides by any stretch of the imagination even though I eat a lot of carbs compared to any low carb or Paleo peers.  And the reason is simple and was explained years ago by two low fat diet researchers named, coincidentally, Dr. Bernard:

1.  Dr. R. James Bernard. This Dr. Bernard has done more studies on Low Fat Diets than probably any man on the planet.  He worked extensively with Nathan Pritikin for example.  And he pointed out that the research showed that:

“The writers fail to recognize that a low-fat diet does not cause triglycerides to rise if the fat is replaced by unrefined, complex carbohydrates, naturally high in fiber, as reviewed by Anderson et al.” [1]

2.  Dr. Neal Barnard. This Dr. Bernard wrote a classic book, called “Dr. Barnard’s Program for Reversing Diabetes,” where he did just what the title of his book says with a Low Fat Diet.  This flies in the face of the Low Carb propaganda that claims that carbs accelerate diabetes and prediabetes.  In fact, the opposite is true:  you can eat a goodly amount of carbohydrates and actually reverse diabetes if you do it the right way.

What is “the right way?”  Well, Dr. Barnard showed that by only allowing his participants to eat only low glycemic carbohydrates. And it worked very well:  participants dropped their A1C by a full point from what I remember.  (You can read more about it in my page on Low Fat Diets and Diabetes.) This clearly shows that low fat diets do not have to send blood glucose and insulin out of control.  (High triglycides result from refined carbs and certain grains.)

By the way, Dr. R. James Bernard in the Circulation journal article above also pointed out that “Ornish et al reported regression of CAD on a 10% fat-calorie diet in spite of a rise in triglycerides.” [1] In other words, there is evidence that with a good low fat diet, even higher triclyerides can regress plaque.  I would err on the side of caution here though and follow Dr. Gould’s guidelines above, i.e. clamp down on your triglycerides.

CAUTION:  It is very important to not just assume you are regressing plaque because of your lipid numbers.  A number of things can trip you up, so get an IMT or Heart Scan and prove that your diet is working.  Neither require a doctor’s orders in most states. You should be able to get a Heart Scan, which does involved some radiation, for under $100.  And Lifeline – I have no affiliation – offers a CIMT for $70 as of this writing.

CONCLUSION:  This shows that the propoganda coming out of many Low Carb and Paleo gurus is simply not true:  all carbs are NOT created equal and you CAN eat a significant amount of carbs and have good triglyceride levels.  Again, you just have to go low glycemic.

One more pertinent question is if my triglycerides of 98 are good emough?  My personal opinion is that it probably is good enough, but that I should shoot to get it below 90 to match Dr. Gould’s guidelines.  Plus, I am a huge fan of the low fat-consuming Tarahumara, the famed ultramarathoners with no hypertension and incredible longevity. The Tarahumara are probably the healthiest people on the earth and their cholesterols is in the 120’s like mine and their triglycerides are 91. [3] Note that their numbers correspond almost exactly with Dr. Gould’s guidelines

Also, the night before I had had a 20 oz beer and I’m not a big guy, so this may have skewed the numbers a little negatively.  (Alcohol can raise triglycerides.)  In addition, I am relatively sedentary – I do exercise religiously an hour a day, but do sit a ridiculous amount as I basically have two jobs requiring me to be seated in front of a computer.

I think I can get my triglycerides below 90 simply by avoiding all alcohol – I am a one beer per night guy at most – and exercising more.  Of course, I could always take some niacin, but I would rather avoid megadosing a supplement if possible.

REFERENCES:

1)  Circulation, 1999; 100:1011-1015, “Correspondence: Very-Low-Fat Diets”

2) N Engl J Med. 1991 Dec 12;325(24):1704-8, “Changes in lipid and lipoprotein levels and body weight in Tarahumara Indians after consumption of an affluent diet”

How I Improved My PSA Score From 6.3 to 1.75 - Peak Testosterone

As some of you may know, my PSA shot up from about 1.4 ng/ml to a high of 6.3 in early December of 2013.  Yeah, Merry Christmas!  I was immediately forced off of HRT (testosterone therapy) for a month and ended up with a prostate biopsy.  Fortunately, they found Only Inflammation and No Cancer.

This was a sobering experience for me as I consider myself to be very healthy overall.  To this day, I still do not really know what caused the prostate inflammation.  However, I do have good news:  last week (4/25/2014) I found that my PSA was down to 2.0!  So it took about five months, but I almost have my PSA back down to my original baseline levels.  I had an interim read of 3.9 as well, even though my prostate was likely still inflamed from the biopsy, so I was showing improvement almost right away.

Of course, I’d like to have a baseline PSA less than 1.0 like some of the young guys on the Peak Testosterone Forum, but I’m on HRT, am sexually active – hallelujah! – and exercise every day. All of these will tend to raise PSA and so a PSA of 1.4 is not too unreasonable for a guy in his early 50’s in my opinion.

And, of course, I am very excited that I have reduced my PSA now by over three times in just a few months and thought I’d share – humbly of course – what I have done.  Before I go on, let me say thanks to Mike Shedlock who gave me the core ideas for a good deal of what you see below on the supplement side of things and who was a role model for all of us by dropping his PSA with an innovative nutraceutical solution. I cover all this in my link on A Cure For Prostate Cancer and am a regular reader of Mike Shedlock’s blog at Global Economic Analysis.

REFERENCES:

1)  Nutr Cancer, 2007, 58(1):35-42, “Relationship of dietary protein and soy isoflavones to serum IGF-1 and IGF binding proteins in the Prostate Cancer Lifestyle Trial”

2) https://www.med.nyu.edu/content?ChunkIID=21757

3) https://lpi.oregonstate.edu/infocenter/phytochemicals/i3c/

CAUTION: I want to caution anyone reading this with actual prostate cancer.  PC is a tricky disease and you have to be careful.  I highly recommend that you run anything that you are considering below by your urologist and a good oncologist.  (Most urologists are woefully ignorant on the underlying cancer mechanisms behind prostate cancer from what I have seen.)  And, of course, stay up on the latest research and share it with me!

NOTE:  Almost everything in my current regimen is anti-inflammatory.  Both prostatitis and prostate cancer are, in general improved by anti-inflammatory strategies, so this is a pretty safe bet in my opinion.  I should point out that the long term effects of supplements, especially megadosing are largely unknown.

NOTE: I am not anti-meat as you can see in my link on Low Fat Meats. However, some study work shows that veganism lowers IGF-1 to more natural cancer-protecting levels, so I am currently playing it safe.

NEWS FLASH: My latest PSA in mid late 2015 was 1.75.  I was very please with that, because this is almost to my old levels when I first started testosterone cypionate.  Lately, the only direct PSA-lowering strategies have been turmeric extract and flaxseed, along with my standard plant-based flexitarian diet, exercise routines and anti-aging supplement strategy.

As you can see,I took MISH’s PSA-lowering protocol as my starting point and simply did a few tweaks. Keep in mind, though, that he dropped his PSA dramatically and he had actual prostate cancer detected, so his results are particularly impressive.

Venous Leakage - Peak Testosterone

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Venous Leakage and Testosterone

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

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

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

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

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

REFERENCES:

Vegan Super Strength Trainer: Interview with Mike Mahler

Mike Mahler has trained many elite MMA fighter and throws around 105 pound kettleballs like we toss a bag of groceries on the counter. And, in fact, he’s become of the world’s foremost kettleball coaches and is known for his deep knowledge of practical strength training.

What is particularly unusual, though, is that Mike Mahler is a vegan and has been for years and years. This strong man has built his body and strength with nothing but plants, something that many people thought was impossible just a few years ago. When virtually all elite bodybuilders and athletes in power sports were gulping down hamburgers, whey and eggs, Mike had made a decision to leave all of that behind.

He had very few examples to go by at that time and was literally a pioneer in building muscle, mass and strength on a pure vegan diet.  And, if you’ve seen pictures of Mike, you know that it has worked and worked well.  Over time, he has shown the world that protein is protein, plant or not, when it comes to building mass.

Mike Mahler was a huge influence on my own life as I reached a point where I realized that my current Western-esque diet was killing me. At the time I had also discovered the incredible power of many plant foods to improve blood flow and nitric oxide output.  What stopped me from transititioning to these foods was the concern for losing muscle and, frankly, looking like one of skinny, emaciated guys that I associated with vegetarianism.  Reading Mike Mahler’s story made me realize that the idea that plant-based diets do not go with bodybuilding and strength was simply a myth.

Below is an interview with Mike that I think you’ll find very interesting.  He has great comments about kettleball training, veganism and even a hot, new testosterone supplement that may be coming out:

Q. I am sure that your diet today is different than when you first became a vegan? What have you learned along the way about ways to optimize a vegan diet for health and fitness?

A. (Yes it is. I make sure to have a lot of variety and avoid processed soy, wheat gluten, and fake meat products. Instead I focus on real vegetarian food such as nuts, seeds, legumes, fruits, and veggies. I get complete proteins by combining nuts and seeds with legumes. For example Lentils and pistachios, black beans and pumpkin seeds, navy bean and hempseeds. Such combinations equal a nice balance of protein, healthy fat, and low glycemic carbohydrates.)

Q. Your name is synonymous with Kettleball training. In your opinion are exercise programs such as kettleballs the best all-around form of exercise? Do you feel comfortable recommending a well-rounded kettleball program as one s only form of workout?

A. (The best overall workout program is the one the individual will actually use regularly. No one program or training tool is the best for everyone. That said, kettlebells are a very efficient training tool to build strength, flexibility, and endurance. You only need one or two kettlebells to get in great shape. They do not take up much space and are portable. You can train at home or take a kettlebell to the park or beach. The ballistic exercises such as cleans, swings, and snatches really work the posterior chain and when done in high repetitions or volume build incredible endurance and work capacity.

I do feel comfortable recommending kettlebells as the only tool for building everyday fitness. However there is no need to make such a choice. One can easily combine kettlebells with bodyweight training and other forms of exercise. If one wants to get super strong then barbells needed to be added as you cannot beat barbell squats and deadlifts. However, for everyday people that want to be fit, kettlebells can certainly be the focus.

Q. You find cardio boring and I feel the same way. Can you explain how you can get the same benefits of cardio from strength-based exercises such as kettleball?

A. By doing the ballistic exercises for time such as a ten minute set of kettlebell swings or snatches or doing circuit training workouts. Pick 5-7 KB exercises and do one after the other with very short breaks or no breaks for several rounds.

Q. One of my favorite topics is testosterone and you are known for being a hormonal expert. I know this is a broad question, but can you give us a few tidbits as to how to use your training and fitness techniques to optimize male hormone levels?

A. Training is important to build muscle and stay lean. The more muscle you have the more androgen receptors you have to pick up androgens such as testosterone. Keeping bodyfat low keeps aromatase enzymes low which are abundant in fat cells and convert testosterone into estrogen. High intensity exercise such as sprinting also increases levels of growth hormone which is important for building muscle, burning fat, and aging well.

Next restoration is very important so balancing adrenaline exercise with restoration exercise is important. Practice tai chi, chi kung, or meditation several times per week to lower the stress hormone cortisol and increase the ultimate stress management hormone DHEA. High levels of cortisol lowers testosterone so stress must be managed as well.

Q. A lot of middle-aged and senior men read my site. What advice would you give them when it comes to strength and/or weight training? In other words, should they be doing anything differently than what they did in their 20 s and 30 s?

A. Don’t waste time with isolation exercises such as curls and triceps pushdowns. Focus on compound exercises such as squats, deadlifts, bent over rows, military presses, and pull-ups. Avoid training to failure and use good form on every rep. Less volume and more recovery time become important as you get older so do not be afraid to take an extra rest day or cut off a set or two at workouts.

Q. What if someone really enjoys weights and wants to integrate kettleball training into his program? Are their advantages to doing this?

A. Kettbells are weights so that is the first thing you want to remember. Use kettlebells at the end of a regular workout as a finisher or on off days for active recovery. Ballistic KB drills are great after deadlifts and squats to really loosen up. Kettebells work very well as a supplement to any weight training regimen.

You can also replace many dumbbell exercises with kettlebells. For example, use kettlebells for presses instead of dumbbells.

Q. Many of the men coming to my site have Metabolic Syndrome, high blood pressure and/or various stages of cardiovascular disease. How can kettleballs benefit men in these categories and how can they best get started?

A. Focus on lowering inflammation. Take a food sensitivity test and eliminate all food that you score high sensitivity to. These are foods that cause a strong immune response to which will increase blood pressure. Get the test at lifeextension.org

With training focus on the kettlebell ballistic exercises such as swings and snatches for timed sets or high volume sets such as 10 sets of 10-20 reps with short breaks. Do this three times per week. Go for a walk every day and focus on deep breathing. Meditate daily as well and make sure you get deep sleep every night.

Q. You have written that one can put on muscle with .7-1.0 grams per lb (assuming you are not overweight). Now I m an ectomorph s ectomorph and have put on muscle at your recommended levels. But why do all the bodybuilding mags and sites promote at least double that figure? Surely, it s not just to sell protein powders?

A. One yes it is to sell protein powders as magazines have big bills to pay and it is the advertisers that pay it. Some people will need more protein than 1 gram per kilo. I know many that due great on 2 grams per kilo. However, 1 gram per kilo is a good starting point. Franco Columbu once told me that he and Arnold would eat one gram of protein per kilo and then added 30-40 grams on top of that when training hard. Sure they used steriods but that would be more of an argument to take more protein if it were beneficial due to the additional protein synthesis.

Q. How do you think a guy like Jack LaLanne was able to train at such intensity levels for so long day in and day out without overtraining? Was he just superhuman?

A. He actually had many health issues as a young man that led him to pursuing physical fitness. I think he had a very strong resolve and was dedicated to excellence. He made sure to sleep well every night, fueled up on high quality food and supplements, and really loved what he was doing in life. You cannot go wrong with that combination.

Q. From what I can tell, it is Paleo Diets that have taken the fitness, bodybuilding and strength sports by storm lately. Do you agree? And, if so, do you see any inroads being made by vegan and/or vegetarian athletes?

A. The Paleo Diet is very popular and many do well on it. One cannot argue with results so if one feels great on the paleo diet than more power to him or her.

A vegan diet is not necessarily the ideal fit for everyone but many are making it work very well. UFC fighters Mac Danzig and Nick Diaz thrive on a vegan diet and more and more athletes are trying out a vegan diet or something close to it and feeling great. As more athletes and training enthusiasts show it can be done well, more people will take a look and give it a shot.

Q. So what are you working on now? Any new favorite projects or products that you would like to share?

A. I recently released my book “Live Life Aggressively! What Self-Help Gurus Should Be Telling You” which is doing very well. 100% of the profit is going to help wounded soldiers and abandoned animals via two great organizations: Lifequest transitions and the Nevada SPCA .

I am working on a new testosterone boosting supplement that contains a south African herb called Bulbine Natalensis which has been shown to raise T by 347% and lower estrogen by 35%. It will be combined with a few other things that further free testosterone and also enhance insulin.

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:

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.

Semen Volume - Peak Testosterone

Do you have normal semen volume?  Researchers say it is usually between 2 and 6 ml. [11] with an average of 3 ml. (A teaspoon is 5 ml).  Keep in mind that you lose a little with aging as well, about .03 ml/year according to one study. [12] Semen volume has a lot to do with simple genetics and anatomy.  Very roughly half of the semen comes from the prostate, where it fills up the ejactulatory tubes upon stimulation.  The tubes are kind of like the missile tubes in a sub ready for launch. The PC muscles contract during orgasm and deliver the goods along with another batch of fluid from the seminal vesicles in the testes for the final explosive, potentially life-changing mixture.

However, some men notice their semen volume has gone down and become concerned. Of course, this can be from ejaculating too much and also from aging.  It can also be from retrograde ejaculation as I dicuss in my link on  Causes of Low Semen Volume. If it is indeed retrograde ejaculation, it needs to be handled a little differently and so I recommned that you read the above link.

However, in most other cases a man should be able to increase his semen volume a little and I discuss these below.  (It is always a good idea to talk to your doctor about it, especially if you are concerned about fertility.)

1.  Increased Libido. There’s a belief out there that libido is boosted greatly by the tank “filling up and needing emptying”.  I don’t know of any scientific evidence for that, but many men are convinced that this is the case.

2.  HRT (Hormone Replacement Therapy). I find that some men on testosterone therapy want to increase their semen volume, because they feel they have lost so much.  And they may have.  However, the reason is usually not so much the HRT as simply being hypgonadal, which is associated with decreased semen volume in men who have secondary hypogonadism. This condition works from dysfunction of the hypothalmus or pituitary and is characterized by low or low-normal LH (leutinizing hormone).

NOTE:  For non-HTR methods to raise your testosterone, see my pages How to Increase Your Testosterone Naturally and Common Causes of Low Testosterone for more information.

3.  Inadequacy.  For many men semen volume is a symbol of their identity as a male.

Regardless of the reason, I have some natural ways to increase semen volume that have a study or two behind them.  These are listed below:

HO HUM:  Of course, there is always the ultimate boring way to increase semen volume:  abstinence. Well, that’s a lot of fun, eh?  It is true that if you wait a few days between ejaculations, your semen volume will increase accordingly. However, I am not even going to include this as an option, because, unless you are going to join a monastery or switch careers to Arctic Explorer, this is probably not a good option for you.

1.  Maca. The herb from South American is synonymous with sexual passion and energy. And it is no wonder: it was used for ages by the ancestors of the Incas for increasing libido. Interestingly enough, this herb, which often served as food for the native peoples, also increased semen volume as well. I cover this in my link on The Superpowers of Maca.

2. Zinc. One study put young men on a controlled diet and varying levels of zinc supplementation .  Those with the least zinc had about a third less ejaculate than those with highest. [1] For more information, see my link on Zinc and ZMA.

NOTE #1:  If you are on HRT, there are no guarantees that any of these natural methods will increase your semen volume.  The studies are typically not done on males undergoing testosterone therapy obviously.

1) Am J Clin Nutr July 1992 vol. 56 no. 1 148-157, “Effects of dietary zinc depletion on seminal volume and zinc loss, serum testosterone concentrations, and sperm morphology in young men”

2) Biotechnology in Animal Husbandry, 2008, 24(3-4):139-146, “Effect of Tribulus terrestris extract on semen quality and serum total cholesterol content in White Plymouth Rock-mini cocks”

3) Hum. Reprod, 1999, 14(4):1028-1033, “Antioxidant treatment of patients with asthenozoospermia or moderate oligoasthenozoospermia with high-dose vitamin C and vitamin E: a randomized, placebo-controlled, double-blind study”

4) Animal Reproduction Science, Mar 2003, 76(1-2):99-111, “Effect of ascorbic acid and Vitamin E supplementation on semen quality and biochemical parameters of male rabbits”

5)  Urology, Oct 2000, 56(4):669, “Acquired hypogonadotropic hypogonadism presenting as decreased seminal volume”

6) Fertility and Sterility [1991, 56(2):319-324], “Subcutaneous gonadotropin therapy in male patients with hypogonadotropic hypogonadism.”

7) Fertility and Sterility, 1979, 32(5):556-561, “Male hyperprolactinemia:effects on fertility”

8) Systems Biology in Reproductive Med, 1993, 30(1):47-54, “Semen Analysis in Insulin-Dependent/Non-Insulin-Dependent Diabetic Men with/without Neuropathy”

9) BJU International, Feb 2006, 97(2):324 326, “Cigarette smoking is related to a decrease in semen volume in a population of fertile men”

10) Systems Biology in Reproductive Medicine, 1992, 29(2):177-183, “Blood Concentrations of Lead, Cadmium, Mercury, Zinc, and Copper and Human Semen Parameters”

11) “Speman in Male Sterility”, [Probe (1970): (IX), 4, 159], Vaze, V.H., M.S., F.C.P.S., Ambai Hospital, Kolhapur, India.

12) Hum. Reprod, 2003, 18(2):447-454, “The association of age and semen quality in healthy men”

13) http://www.nbcnews.com/id/5263250#.UXyUd7U4tPM, “Not just good, but good for you”, By Brian Alexander (msnbc.com contributor)

3.  Tribulis. Tribulis Terristris is what I call one of the Super Sexual Herbs. Admittedly, it has a spotty record in raising testosterone levels in men. However, this herb is known, among other things, for mimicking leutinizing hormone and, as such, it should not be surprising that it boosts semen volume in a couple of animal studies. [2]  Does it in humans?  Well, you may have to just try it to see if it works for you.  (Always check with your doctor first of course.)

4. Vitamin C and Vitamin E? One study showed that daily megadoses of Vitamins C and E on infertile men did not significantly improve semen volume. [3] However, the jury may still be out as a study on rabbit just a few years later showed an increase in ejaculate volume with the same two vitamins. So it may be dosage levels, times per day, etc. [4] Also, I always recommend mixed tocopherols if you take Vitamin E as taking just the traditional alpha tocopherol form will lower levels of the tocopherols (gamma and delta, which is not a good idea as these serve very different functions generally).

NEWS FLASH: There is some decent evidence that sperm acts as an antidepressant when absorbed through the vagina post-intercourse and can even lower her blood pressure when taken orally. [13]

5.  HCG.  Some of my might bristle a little that I would call this “natural”.  Well, HCG is natural in the sense that it is a placental hormone that the body is used to at some stage in its development.  It’s remarkably similar, as well, to leutinizing hormone and so the body responds extermely well to it. Its use is on the rise with men on HRT, who have some shrinkage of the testes.  HCG allows men to stay on testosterone therapy with no loss in volume.  (HCG can really ramp up estradiol production, so regular monitoring is required.  See my link on Testosterone and HCG for more information.)

6. Prolactin. High prolactin generally means lower testosterone and lower libido for us guys.  And, interestinly enough, one study shows that it can mean decreased semen volume as well. [7] If you feel you’re not squeezing out the juice like you used to, you might want to have your prolactin pulled as well,  For more information, see my link on Prolactin and Prolactinomas.

7. Retrograde Ejaculation. This condition occurs when some of the semen actually gets pushed into the bladder upon ejaculation. How would something this occur? Actually, it is surprisingly common, because there is a valve (sphincter) that normally keeps this from occurring. A number of things (surgery, drugs, local nerve damage, etc.) can lead to a state where this valve becomes overly relaxed and semen is allowed to flow down the wrong path. Men with this condition may notice that they literally have no ejaculate upon orgasming. If so, talk to your urologist.

8. Diabetes. Retrograde ejaculation (#5) can occur due to nerve dysfunction or damage, because proper signaling never reaches the sphincter valve. Of course, neuropathy is one of the hallmark symptoms of diabetes and so it is no wonder that this condition is so common. In fact, one study found that diabetic men actually had increased sperm output and sperm concentration but decreased semen volume and they speculated that this was due retrograde ejaculation. [8]

9. Smoking.  We all know smoking is bad for you, but if you’ve never quit given them up, keep in mind that they will likely reduce your semen volume as well. One study looked at fertile men and grouped them into non, mild, medium and heavy smokers.  What is interesting is that hormone levels (testosterone, LH and FSH) as well sperm motility (mobility) and density did not differ significantly among the groups.  The one characteristic that did differ was semen volume, which decreased with increasing levels of smoking. [9]

10. Cadmium.  High levels of cadmium were correlated with lower semen volume in one study. [10]

REFERENCES:

Are There Any Dangers in Eating very High-Nitrate Foods?

Eating high nitrate foods has made a nice difference for me. It has dropped my systolic blood pressure by about 10 points. I was getting quite a few readings that were 130-135/85-90, i.e. prehypertensive. Since I started eating lots – and I mean LOTS – of arugula, spinach, carrots and celery, my blood pressure is right at 120/80. And I make the argument in my link on How to Increase Your Nitric Oxide Naturally, that Mother Nature seems to have provided an alternate pathway for us to boost our nitric oxide levels with these high nitrate foods.

For a guy like myself who seems to have some amount of endothelial dysfunction from decades of a Western lifestyle, this is a huge help.  Young guys, who normally have very low levels of arteriosclerosis, are able to pump out ample nitric oxide through the normal pathway of their artery walls, but that’s often not the case for anyone 35+.

However, the question remains:  is it SAFE to eat high nitrate foods?  Is it safe for someone like myself to eat a lot of arugula and spinach and carrots?  Okay, now that might seem like a foolish question at first, but the problem is this little equation:

1) https://legacy.library.ucsf.edu/documentStore/w/t/i/wti86b00/Swti86b00.pdf, “Carcinogenic N-nitrosamines in the diet : occurrence, formation, mechanisms and carcinogenic potential”, German Cancer Research Center, Institute of Toxicology and Chemotherapy, Received 22 December 1989

2) Cancer Res, May 1 1994, 54:2390, “Intake of Fat, Meat, and Fiber in Relation to Risk of Colon Cancer in Men”

3) Cancer Epidemiol Biomarkers Prev October 2002 11; 1019, “Red Meat Intake, CYP2E1 Genetic Polymorphisms, and Colorectal Cancer Risk1”

4) https://www.sciencedaily.com/releases/2012/06/120620213215.htm

5) IARC Scientific Pub, 1978(19):443-460, “The intake of nitrate, nitrite and volatile N-nitrosamines and the occurrence of volatile N-nitrosamines in human urine and veal calves.”

6) https://lpi.oregonstate.edu/f-w00/nitrosamine.html

7) Gut, 2007; 56:1678-1684, Published Online First: 4 September 2007, “Fat transforms ascorbic acid from inhibiting to promoting acid-catalysed N-nitrosation”

Nitrosamines are compounds that have been implicated in many cancers.  If you’re a health reader, you’ll see them come up from time to time in various discussions.  For example, nitrosamines are suspected by many as being the primary carcinogen from smoking.  And, from what I have seen, nitrosamines do not play any positive role and have the potential to cause cancer.

Fuel has been added to the argument from the fact that processed and possibly red meats have been implicated in certain cancers, such as of the colon.  And, of course, the significance of that is that red and processed meats have nitrates and nitrites added to them:

“An elevated risk of colon cancer was associated with red meat intake…between high and low quintiles.  Men who ate beef, pork, or lamb as a main dish five or more times per week had a relative risk of 3.57 compared to men eating these foods less than once per month. The association with red meat was not confounded appreciably by other dietary factors, physical activity, body mass, alcohol intake, cigarette smoking, or aspirin use.” [2]

Nitrates added to meat and beer have been lowered over the years and so perhaps this risk has lessened.  For example, notice the reductions that were achieved in German beer:

“The dietary exposure to NDMA and other volatile N-nitrosamines has been calculated in a number of food surverys…Reductions in the use of nitrates and nitrites used for curing meats and modifcation of malting techniques in the brewing industry have resulted in significant reductions in the levels of N-nitroso compounds over the last 5 years. In West Germany, the daily NDMA exposure from beer of 0.74 ug/day in 1979/1980 has been reduced to 0.1 ug/day in 1987.” [1]

My point here is not to challenge eating meat, but rather to point out that the concern is very real and has been explored by a number of researchers.  One author stated that “these data provide additional support for the hypothesis that nitrosamines are carcinogenic to the rectum in humans and that RM [Red Meat] and, in particular, PMs [Processed Meats] are significant sources of exposure for these compounds.” [3]

A meat eater will often counter with the argument that if nitrates added to meat are carcinogenic, then the nitrates in high-nitrate plant foods are also likely carcinogenic as well.  And so this leads to the all-important question:

“Can nitrates in plant foods increase nitrosamine formation and, therefore, cancer risks?”

First of all, I don’t think anyone has a definitive answer.  That said, I do think there is good evidence that plant-based nitrates do NOT cause cancer even though I cannot prove it.  As always, though, I will caution you and say talk to your doctor and do your own research.

But let me explain why I don’t think this is much of an issue:

1. Lack of Study Evidence. As far as I know, there is NO evidence that high nitrate plant foods cause cancer.  Why are there numerous studies linking red and processed meats to increased colon cancer risks and none, for example, to spinach, lettuce, beets or other foods?

2. Spinach Probably Reduces Colon Cancer Risk. Spinach has been found to very likely REDUCE colon cancer risk, according to one study by the Linus Pauling Institute that found that “consumption of spinach can partially offset the damaging effects of the carcinogen. In tests with laboratory animals, it cut the incidence of colon tumors almost in half, from 58 percent to 32 percent.” [4] Many other plants reduce nitrosamine formation and so this may be another reason that plant-based nitrates have not been shown to have any negative health effects.

3. Lack of Epidemiological Evidence. Every population study that I have seen that looks at vegetable consumption and/or vegetarian diets shows equal or improved cancer risks.  Considering the fact that vegetarians eat a lot of greens and high nitrate foods, then why don’t we see them with more cancer issues?

4.  Questionable Increase in Nitrosamines.  Consuming nitrates does not seem to raise nitrosamines in the urine to dangerous levels according to one (older) study. [5]

My guess is that plants have many compounds

a) that are so effective at decreasing cancer risk that they overwhelm any effects from nitrosamines, or

b) actually reduce the conversion of nitrates and amines into nitrosamines.

Again, I certainly do not know that definitely and this is my conclusion from examining #1 – #4 above.

Nitrosamine Lowering Solutions

However, let’s say that you still feel like consuming large amounts of nitrates in plants is somewhat dangerous and you want to hedge your risks.  Are there any solutions?  Here are a couple of ideas:

1.  Avoid Simultaneously Consuming Medium and High Amine Foods. A compromise solution is  to avoid the other half of the equation, i.e. be careful not to eat medium or high amine foods at the same time you consume medium or high nitrate foods.  There are many lists of amines in food out there, so I am not going to attempt to reproduce that.  But, as an example, I would need to be careful about consuming tomatoes, sardines, almonds, peanuts and walnuts within a couple of hours of eating one of my higher nitrate meals.

2.  Low Fat Diet + Vitamin C.  Vitamin C can lower nitrosamine formation significantly.  In fact, the Linus Pauling Institute reports:

“About 1970 it was discovered that ascorbic acid inhibits nitrosamine formation. Consequently, the addition of 550 ppm of ascorbic acid is now required in the manufacture of cured meat in the U.S. Actually, most cured meat manufacturers add erythorbic acid (an isomer of ascorbic acid) rather than ascorbic acid. Although erythorbic acid has reduced vitamin C activity, it is as effective as ascorbic acid in inhibiting nitrosamine formation and is also cheaper than vitamin C.” [6]

However, one caution I have regarding this philosophy is that there is one study out there that shows that if you have low fat levels in your stomach and gut, you will get reduced nitrosamine formation from Vitamin C but if the presence of even medium amounts of fat, it can increase nitrosamine formation.  [8]To play it safe, you may want to eat lower fat combined with Vitamin C to make sure you get the full benefit.

REFERENCES:

Blueberries:Improve Erections and Reduce Erectile Dysfunction

I have for years been adding about a half cup of organic frozen blueberries into my nightly smoothies, and, in hindsight, that sounds like one of the smartest decisions I’ve ever made.  Why do I say that?  Because a recent study shows that blueberries were associated with reduced erectile dysfunction (along with red wine and citrus fruits). [1] The authors also noted that “a higher total fruit intake was associated with a 14 per cent reduction in the risk of erectile dysfunction. And that a combination of consuming flavonoid-rich foods with exercise can reduce the risk by 21 per cent.” Yes, it’s all about lifestyle when it comes to your heart and arteries. [2] My book, The Peak Erectile Strength Diet, covers many other foods and drinks that do the same.

1) ‘Dietary flavonoid intake and incidence of erectile dysfunction’, American Journal of Clinical Nutrition, on January 13, 2016.

2) https://medicalxpress.com/news/2016-01-blueberries-citrus-fruits-red-wine.html

3) J Acad Nutr Diet, 2015 Mar, 115(3):369-77, “Daily blueberry consumption improves blood pressure and arterial stiffness in postmenopausal women with pre- and stage 1-hypertension: a randomized, double-blind, placebo-controlled clinical trial”

4) Experimental Neurology, Dec 2005, 196(2):298 307, “Blueberry- and spirulina-enriched diets enhance striatal dopamine recovery and induce a rapid, transient microglia activation after injury of the rat nigrostriatal dopamine system”

5) Nutritional Neuroscience: An International Journal on Nutrition, Diet and Nervous System, 2006, 9(5-6), “Dietary supplementation with blueberry extract improves survival of transplanted dopamine neurons”

6) J Agric Food Chem, 2010 Apr 14, 58(7):3996-4000, “Blueberry supplementation improves memory in older adults”

7) J Med Food, 2005, 8:8-13, “Wild blueberry-rich diet affect the contractile machinery of the vascular smooth muscle in the Sprague-Dawley rat”

8) Nutrition, Metabolism & Cardiovascular Disease, 2012, 22:127-132, “The temportal effect of a wild blueberry (Vaccinium angustifolium)-enriched diet on vasomoter tone in the Sprague-Dawley rat”

So is the idea that blueberries could protect and possibly relieve erectile dysfunction without any biological plausability? Actually, it’s quite the opposite.  Below are Four Properties of Blueberries that Will Improve Hardness Factor and Decrease the Risk of Erectile Dysfunction:

1. Increased Nitric Oxide. I have dozens of ways to increase NO on this page:  Summary Page on How to Increase Nitric Oxide. Why do I give it so much coverage?  The reason is that nitric oxide is lowers blood pressure, increases blood flow and is an arterial anti-inflammatory. All of us men desperately need nitric oxide for the protections of our heart and penis. It turns out that blueberries are yet another plant food that boosts nitric oxide, at least according to a study on women that showed a huge 68% increase in nitric oxide levels. [3] Even better, these results were achieved with consumption of the equivalent of about a 1 cup of frozen blueberries each day. This is doable and berries are respected by almost every popular diet out there from Mediterranean to low fat to Paleo, so just do it!

NOTE:  Increased nitric oxide almost always means increased blood flow, including to the all-important pudendal and penile arteries.

2. Reduced Blood Pressure. The same study showed very significant drops in blood pressure, 7 and 5 mm, in systolic and disastolic blood pressures, repsectively. That drop in diastolic blood pressure is particularly significant, because many men with prehypertension find it hard to lower that one. Now it should be pointed out that this study examined post-menopausal women, and the reason is that they often struggle with high blood pressure.  This is shown by the fact that the average blood pressure levels were in the prehypertensive range.  Even, so, many men also struggle with prehypertension due to the high prevalence of prediabetes and insulin resistance, which are associated with higher blood pressure levels.

3. Lowered Arterial Stiffness. Again, the same study showed greatly decreased arterial stiffness as well in the blueberry treated group.  Obviously, stiff arteries are not going to help erections, and blueberries help in this category as well.

4. Improved Vasomotor Tone.  Arteries work through the relaxation and dilation of smooth muscle tissue. One of the issues that stress and aging can worsen is the noradrenaline-induced contraction of the arteries. Of course, this narrows arteries, decreases blood flow and is bad for erectile strength.  Blueberries have been found in a couple of animal studies to reduce that powerful contractile reaction, and thus improve the kind of stress responses that plaque us in modern societies. [7][8] This is the same pathway that alpha blockers work on but without the side effects!

5. Dopamine Protection and Possibly Stimulation. Dopamine is ground zero for libido. It also boosts mood and can help cure some types of depression.  One of the ways that TRT works is by boosting this key neurotransmitter, something I cover in my page on Testosterone and Dopamine. Blueberries at a minimum protection dopamine levels, and I’ll show evidence below that they actually boost them as well:

b) Reduced Depression. I do not know of a study that shows that blueberries actually increase dopamine levels.  However, if dopamine is increased, it will usefully help with depression, and one study on seniors and blueberry consumption shows improved depression. [6] The same study also showed improved memory!

REFERENCES:

Hair Loss Factors - 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”

Postprandial Glucose Levels: Affect T, Erections and Diabetes

What is the most important health test?  Right at the top of the list should probably be postprandial (post-meal) blood glucose levels, because this number affects erections and hormone levels for literally hours after the meal.  It also is a powerful predictor (like low SHBG) of your chances of developing diabetes.  The tragedy is that so few men know about this health marker or how to test for it.  Their erectile strength is weak; they feel lousy; they are suffering with fatigue; and yet they do not realize one simple and inexpensive test could help them troubleshoot a powerful root cause issue in many cases.  I know I see it all the time on Peak Testosterone Forum.

REFERENCES:

1)   Clinical Diabetes, Apr 2002, 20(2):71-76, “Is Postprandial Glucose Control Important? Is It Practical In Primary Care Settings?”

2) Diabetes, 1987 Jun,36(6):689-92, “Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry. Honolulu Heart Program”

3) Diabetes Metab, 2000 Sep, 26(4):282-6, “The DECODE study. Diabetes epidemiology: collaborative analysis of diagnostic criteria in Europe”

4) Diabetes Res Clin Pract, 1992 Aug, 17(2):111-23, “A comparison of the relationships of the glucose tolerance test and the glycated haemoglobin assay with diabetic vascular disease in the community. The Islington Diabetes Survey”

5) Clinical Diabetes, Oct 2004, 22(4):169-172, “Targeting Plasma Glucose: Preprandial Versus Postprandial”

6) Clinical Therapeutics, 2005, 27(Suppl 2):S42–S56, “Postprandial glucose regulation: New data and new implications”

7) Journal of Psychosomatic Research, Jul 2010, 69(1):33–41, “Fatigue in patients with diabetes: A review”

What most men do not realize is that what you put on your plate sends a huge wave of lipids and blood glucose through your arteries and arterioles. The latter is something you can easily track and monitor at home and on this page we go into why it is so important and how you can get a powerful sense as to whether or not you are on track or not.  Doctors will rarely pull or test this number unless you have already developed full-blown diabetes.  However, long before you reach this point, you will have likely suffered for years with prediabetes and the softer erections and altered hormone levels that this syndrome brings with it.

I will go into some of the mechanics on another page, but realize that Walmart, Amazon and other large retailers sell electronic monitors that will give you a reading in seconds.  You basically “lance” (prick) you finger, put a drop of blood on a test strip and insert the test strip into the monitor. However, first let’s go over some of the very critical research that shows just Why Postprandial Glucose Levels Are So Important and What Is the Best Target Level for us men:

NOTE: If you have already developed type II (adult onset) diabetes, the condition can often be reversed with diet and exercise.  See my pages on  Reversing Diabetes with a Low Fat Diet (Dr. Bernard) and Reversing Diabetes Using Dr. Whitaker’s Approach. You can also partially reverse diabetes often with HRT, something I discuss in my page on Testosterone and Diabetes.

Why Care About Postprandial Blood Glucose Levels?

Blood glucose levels may seem dry and unglamorous, but – trust me – they can hit you right where it counts:

1. Erections and Blood Flow. As insulin resistance mounts and insulin levels rise, endothelial dysfunction sets in and worsens.  What this means is that nitric oxide decreases and your arteries start to have difficulties in dilating, which in turn means that blood flow is decreased.  This will happen throughout your body, i.e. it will affect the arteries in your penis and can lead to erectile dysfunction and/or a decrease in hardness factor. Examples of this are studies in which diabetics are given insulin and endothelial function improves significantly [6]

2. Long Term Increase in Arterial Plaque.  The same study mentioned in #1 documented that Repaglinide, an anti-diabetic drug,” achieved regression of carotid atherosclerosis (intima-media thickness) in 52% of patients versus 18 % for glyburide over 1 year, although levels of HbAlc and CV risk factors were similar for both treatment groups.” [6]

3. Increase in Cardiovascular Mortality.  Elevated fasting insulin levels are known for microvessel damage and elevated postprandial glucose levels for macrovessel damage.  Basically, this means that those post-meal blood glucose waves can damage your arteries and, unfortunately, increases our risk of an early and untimely death.

4. Decreased Testosterone. One study found that giving a man a significant dose of glucose will lower his post-meal testosterone levels by 25%.  See my page Testosterone and Glucose for more information.

5. Fatigue. As you begin to lose your insulin sensitivity, fatigue is a common complaint.  Blood glucose is your primary fuel and, once insulin resistance sets in, your body is struggling with managing it.  Hypoglycemia can occur and result in alterations to the HPA axis.  Diabetics, in paricular can really struggle with energy according to this research commentary:

“Fatigue is a common and distressing complaint among people with diabetes and likely to hinder the ability to perform daily diabetes self-management tasks.” [7]

Why Is the Ideal Postprandial Blood Glucose Level?

1. Healthy Subjects Postprandial Blood Glucose Less Than 120 mg/dl (Possibly 140).  Researchers have pointed out that “in healthy, nondiabetic subjects, 2-hour postprandial blood glucose levels are usually <120 and rarely >140 mg/dl. Glucose levels peak at 1 h after the start of the meal and then return to preprandial levels within 2-3h.This rise and fall of postprandial glucose levels is mediated by the first-phase insulin response, in which large amounts of endogenous insulin are released, usually within 10 min, in response to nutrient intake. In individuals with type 2 diabetes, the first-phase insulin response is severely diminished or absent, resulting in persistently elevated postprandial glucose throughout most of the day.” [1]

2. Postprandial Well Below 157 mg/dl. The Honolulu Heart Study showed that those with postprandial glucose levels above 157 mg/dl had twice the risk of fatal coronary heart disease and, of course, heart disease is the #1 killer of men. [2] Of course, if 157 mg/dl causes this much death and destruction, one clearly wants to be well below that level! This corroborates well with #1 obviously.  Also, note that the researchers were looking at non-diabetics, so this is relevant for the great majority of men reading this.

3. Postprandial (Two Hour) Below 140 mg/dl. This the current recommendation of the American College of Endocrinology and the American Diabetic Association, both of which based this advice on the fact that the European DECODE study found the best mortality rates for those with postprandial glucose peaks below 140 mg/dl. [3] This is the number that I see most often quoted as the beginning of the “danger zone” for damage and future medical issues.

4. Starling’s Curve of the Pancreas. One powerful argument for maintaining glucose levels below 140 mg/dl is the fact that this is point at which the pancreas will no longer be able to produce enough insulin to control blood glucose levels.  Basically, this is the point “when the dam breaks.”  One author wrote that “normally, fasting glucose maintenance mostly depends on glucose production by the liver. In the progression of type 2 diabetes, insulin output is able to increase with the increasing glucose level until the FBG reaches about 140 mg/dl, at which point the β-cell insulin output cannot keep pace with the increased glucose load, and the fasting insulin concentration decreases. This is sometimes referred to as Starling’s Curve of the Pancreas. At this time, hepatic [liver] glucose production begins to increase because insufficient insulin is available for suppression.” [5]

CONCLUSION: Purchase a blood glucose monitor and make sure your blood sugar never gets over 140 after a meal.  And, ideally, it would never go over 120.  To understand the details as to how to do this, see my page on How to Test for Insulin Resistance.

NOTE: Several studies have confirmed that postprandial blood glucose is an independent predictor of heart disease, even when things like fasting blood glucose and A1C are taken into account.  In other words, it’s a Big Gun and should be monitored pretty regularly by every man on planet earth over the age of 25.  Furthermore, research supports that postprandial glucose peaks are actually a better predictor of insulin-related cardiovascular issues than fasting plasma blood glucose levels. [4]

Does It Increase Triglycerides? Not if Done Right.

I feel fantastic on a Low Fat Diet and I found recently that My Arteries Were Clear of Plaque, so I believe what I am doing is working. However, I keep reading over and over again that Low Fat Diets increase triglycerides and create a deadly “Pattern B” (small particle) lipid pattern.  Dr. Davis, the famed plaque-reversing clinician, constantly attacks Low Fat Diets with this point.

While I greatly respect Dr. Davis and don’t doubt him for a minute, this accusation has never made sense to me, because I have never had high triglycerides on a Low Fat Diet.  Yet I know that Dr. Davis is a very smart guy and has loads of practical field experience.  So why the discrepancy?

Well, my belief is that I have stayed in good territory, because I eat a Low Glycemic Low Fat Diet. For example, I eat a relatively low amount of grains – virtually no wheat or oats – and mostly fruit along with peas/lentils/chickpeas for carbohydrates. Paleo and low carb folks love to criticize fruit – well, at least many of them treat it like it was cheesecake – but the reality is the fruit is usually a low glycemic choice.  And I do not know any expert that would argue that peas/lentils/chickpeas are anything but healthy:  these are incredible superfoods and packed with “resistant starch” if you’ve been following the latest buzz on that subject.

So let me show you my last lipid numbers, so you can get an idea what a Low Fat Low Glycemic Diet will do for you.

Notice below that my LDL and triglycerides are actually very close to what Dr. Gould, another famous plaque-reversing researcher, has set in his guidelines.  (See my page on HDL, LDL and Triglyceride Levels for Plaque Reversal for more details.)  In fact, I am less than 10% higher that his thresholds, which may explain why I have doing been very well:  my latest blood pressure reads are actually below 110/70, which is excellent for a guy in his mid 50’s.

So I do NOT have high triglycerides by any stretch of the imagination even though I eat a lot of carbs compared to any low carb or Paleo peers.  And the reason is simple and was explained years ago by two low fat diet researchers named, coincidentally, Dr. Bernard:

1.  Dr. R. James Bernard. This Dr. Bernard has done more studies on Low Fat Diets than probably any man on the planet.  He worked extensively with Nathan Pritikin for example.  And he pointed out that the research showed that:

“The writers fail to recognize that a low-fat diet does not cause triglycerides to rise if the fat is replaced by unrefined, complex carbohydrates, naturally high in fiber, as reviewed by Anderson et al.” [1]

2.  Dr. Neal Barnard. This Dr. Bernard wrote a classic book, called “Dr. Barnard’s Program for Reversing Diabetes,” where he did just what the title of his book says with a Low Fat Diet.  This flies in the face of the Low Carb propaganda that claims that carbs accelerate diabetes and prediabetes.  In fact, the opposite is true:  you can eat a goodly amount of carbohydrates and actually reverse diabetes if you do it the right way.

What is “the right way?”  Well, Dr. Barnard showed that by only allowing his participants to eat only low glycemic carbohydrates. And it worked very well:  participants dropped their A1C by a full point from what I remember.  (You can read more about it in my page on Low Fat Diets and Diabetes.) This clearly shows that low fat diets do not have to send blood glucose and insulin out of control.  (High triglycides result from refined carbs and certain grains.)

By the way, Dr. R. James Bernard in the Circulation journal article above also pointed out that “Ornish et al reported regression of CAD on a 10% fat-calorie diet in spite of a rise in triglycerides.” [1] In other words, there is evidence that with a good low fat diet, even higher triclyerides can regress plaque.  I would err on the side of caution here though and follow Dr. Gould’s guidelines above, i.e. clamp down on your triglycerides.

CAUTION:  It is very important to not just assume you are regressing plaque because of your lipid numbers.  A number of things can trip you up, so get an IMT or Heart Scan and prove that your diet is working.  Neither require a doctor’s orders in most states. You should be able to get a Heart Scan, which does involved some radiation, for under $100.  And Lifeline – I have no affiliation – offers a CIMT for $70 as of this writing.

CONCLUSION:  This shows that the propoganda coming out of many Low Carb and Paleo gurus is simply not true:  all carbs are NOT created equal and you CAN eat a significant amount of carbs and have good triglyceride levels.  Again, you just have to go low glycemic.

One more pertinent question is if my triglycerides of 98 are good emough?  My personal opinion is that it probably is good enough, but that I should shoot to get it below 90 to match Dr. Gould’s guidelines.  Plus, I am a huge fan of the low fat-consuming Tarahumara, the famed ultramarathoners with no hypertension and incredible longevity. The Tarahumara are probably the healthiest people on the earth and their cholesterols is in the 120’s like mine and their triglycerides are 91. [3] Note that their numbers correspond almost exactly with Dr. Gould’s guidelines

Also, the night before I had had a 20 oz beer and I’m not a big guy, so this may have skewed the numbers a little negatively.  (Alcohol can raise triglycerides.)  In addition, I am relatively sedentary – I do exercise religiously an hour a day, but do sit a ridiculous amount as I basically have two jobs requiring me to be seated in front of a computer.

I think I can get my triglycerides below 90 simply by avoiding all alcohol – I am a one beer per night guy at most – and exercising more.  Of course, I could always take some niacin, but I would rather avoid megadosing a supplement if possible.

REFERENCES:

1)  Circulation, 1999; 100:1011-1015, “Correspondence: Very-Low-Fat Diets”

2) N Engl J Med. 1991 Dec 12;325(24):1704-8, “Changes in lipid and lipoprotein levels and body weight in Tarahumara Indians after consumption of an affluent diet”

Propecia and Depression - Peak Testosterone

What is the primary sex organ, the penis or the testes?  It’s a trick question, because the answer is ‘neither.’  The answer is that the center of your sex life is the brain.  Just ask any high prolactin man and he’ll tell you.  High prolactin lowers dopamine and that is a huge sex life killer.

So what does that have to do with Propecia (Proscar or finasteride)?  As I’ve discussed on other pages, research has shown that Propecia has an abnormally high rate of long term / permanent sexual side effects.  I even have reason to believe that this is what brought my own health spiraling downhill about fifteen years ago, something I discuss in my page Did Propecia Take Out My Health?

For a long time it was assumed that the issue to be hormonal, i.e. decreased testosterone or DHT (dihydrotesterone).  However, the research has not really backed this up. So researchers began looking elsewhere and it appears that the answer likely lies in the brain.  Look at the bullets points from the research abstract that looked at former Propecia users when compared to controls:

REFERENCES:

1) J Clin Psychiatry, 2012 Sep, 73(9):1220-3, “Depressive symptoms and suicidal thoughts among former users of finasteride with persistent sexual side effects”

2) BMC Clin Pharmacol, 2006, “Finasteride induced depression: a prospective study”

However, before I do that, let me just briefly discuss a 2012 study and shows this is a huge clinical concern.  This study showed overwhelming negative and long-lasting psychological side effects in former Propecia (finasteride) users, i.e. men who had not taken Propecia for at least three months: [1]

“Rates of depressive symptoms were significantly higher in the former finasteride users (75%; 46/61) as compared to the controls (10%; 3/29)”.

“Moderate or severe depressive symptoms were present in 64% (39/61) of the finasteride group and 0% of the controls.”

” Suicidal thoughts were present in 44% (27/61) of the former finasteride users and in 3% (1/29) of the controls.”

These numbers are staggering.  Propecia increases rates of depression by 75%!  And the lion’s share of these results in severe depression.  And suicidal tendencies are increase by 2700% and includes almost half of the former Propecia users!

Now I’ll ask an obvious question:  what do you think this will do to your sex life?  Well, of course it will be a sex life killer for many men. Depression is brutally hard on the (penile) arteries and the brain and thus delivers a one-two punch to your bedroom endeavors, something I discuss in my page on Depression and Erectile Dysfunction.

But all of this leads to an obvious question;  if finasteride is not changing testosterone or DHT much, just what is it changing?  It turns out that blocking 5-alpha-reductase – the enzyme that Propecia acts upon – also lower allopregnenalone and this, in turn, lowers GABA levels. GABA is critical neurotransmiter that, along with sertonin, is your “peace and tranquility” neurotransmitter.  If one lowers GABA much, you end up anxious and depressed.

A 2006 study explains the entire pathway that is disrupted by Propecia:

“5alpha-reductase is a critical enzyme in the conversion of several steroids such as testosterone, progesterone, aldosterone and corticosterone in the brain. This enzyme converts testosterone to the most natural potent androgen DHT, and also it acts an important role in conversion of progesterone to dihhydroprogesterone (DHP). DHP is further converted to allopregnanolone (5alpha, 3alpha-tetrahydroprogesterone) by 3alpha-HSD. Allopregnanolone is a modulator of gamma amino butyric acid type A receptor (GABA-A), and increases chloride conductance. This neurosteroid has been found to exert anti-convulsant, anesthetic and anxiolytic effects. Moreover, change in the levels of allopregnanolone is found to be associated with depressive disorders.” [2]

Of course, there is still a lot that we don’t know.  Is GABA permanently lowered?  Is allopregnanalone permanently decreased?  Or is there perhaps some other reason not yet discovered?  I don’t know the answer to those questions, but I can tell you that that is one of the riskiest of the more common medications out there in my opinion.

Cosmetic Surgery for Males - Peak Testosterone

In my link on Skin and Appearance, I tell you about how to dramatically improve your appearance and decrease wrinkles using non-surgical methods, i.e. lifestyle and supplement-related solutions.  However, for some of you middle-aged and beyond guys out there, this may not be good enough for you.

You may have extensive skin issues from smoking damage or sun exposure.  Or maybe you are entering the market again and just want to look as good as possible.  You may even want to Date Someone Younger.

Any of these reasons, and a dozen more that we could name, may require you to consider surgical alternatives.  Below I have compiled a list of procedures that are tailor-made for males.  It is a complete myth that cosmetic surgery and plastic surgery are for females only.

Yes, we’ve probably all known a female or two that have been obsessed with the subject. You may even know a female or two that have over-cupped themselves to the point of the absurd.  Well, I’m not talking about anything weird here:  I’m just talking about wrinkle-reduction so that you look and feel your best for whatever reason.  Cosmetic surgery is about looking good and us males should want to look and feel just as good as the females in our lives.

Besides surgery, cosmetic or not, is science.  Philosophically, what is the difference between taking Vitamin C or Alpha-lipoic acid to look and feel youger than using surgery?  Obviously, one can go to an extreme here – think Michael Jackson – but the great majority of guys are not going to spend their money on cosmetic surgery unless it’s really necessary.  If you’ve got a lot of sun damage, your much more likely to consider foregoing a new set of clubs or that trip to Cabo in order to get a new face.

CAUTION:  The only cosmetic surgery I caution you on is bariatric, or weight loss surgeries such as liposuction. These are the most common cosmetic surgery procedure for males by the way.  In 2007 almost 60,000 guys had one!  So why do I caution against it?  Liposuction, or other weight loss procedures, can bypass your investigation into the root cause of your overweight condition if you have one. Peak Testosterone readers know that extra fat can be result from low testosterone, low growth hormone, overeating, underexercising, insulin resistance, an underactive thyroid or some combination of the above.  These are all deadly and you need to know exactly what has caused you to put on those extra pounds.  In addition, liposuction does not lead to any reductions in cardiac risk factors. This has surprised researchers, because the fat tissue is removed and yet heart outcomes do not change. [6] However, losing weight the “old fashioned way”, i.e. gradually with diet and/or exercise, improves EVERY cardiovascular risk factor.

In addition, bariatric surgeries actually carry significant risks.  A recent study [1] found that “about 4% had at least one serious complication (a life-threatening blood clot, the need for more procedures related to the weight loss surgery, or death)”. [2] That’s a 1/25 chance of a near death experience!  Again, talk with you doctor, but wouldn’t it be better to lose weight through exercise and proper diet with little to no risk of death?  Regardless, realize that being Overweight is Deadly and it is literally life and death to defeat this issue in your life.

Below is a list of great cosmetic surgeries for guys, depending, of course, on your situation.  I have also documented How Common Cosmetic Surgery is For Males.

1) Thermage. Thermage is a “monopolar radiofrequency” procedure.  It essentially cooks your skin so that the skin rebuilds.  Thermage for about two thirds of individuals does something magical:  it actually can reduce facial and neck sag.  The downtime is minimal, a couple of days on average although it can be longer, and the cost is in the medium range (~ $1,500).  Again, most people get younger looking skin with less sagging but not dramatically so.  CAUTIONS:  Thermage can “boil away” subcutaneous fat and it can leave small burns that are slow to heal.  Talk to your doctor about risks.

2) Bipolar Radiofrequency Plus Pulsed Light. Bipolar radiofrequency does not heat the skin as deeply as Thermage but when combined with Pulsed Light does achieve good results. Again, this can actually decrease skin sagging on the face and neck, although results are generally somewhat less than with Thermage. CAUTIONS:  Side effects can still take place but are generally less than Thermage.  Repeated treatments are usually require.

2) Dermal Fillers. This involves injecting substances into a wrinkle to reduce the appearance of the wrinkle, kind of autmotive putty for the face one might say.  The classic use of dermal fillers is on the nasolabial fold, i.e the lines beside your mouth.  The beauty of dermal fillers is that results last a long time, e.g. 18-24 months, and downtime is minimal.

3) Eyelid Surgery or Blepharoplasty. The eyes are the most revealing aspect of your body.  Women stare into them longingly – well, hopefully – and few can argue that they are the “window to the soul”.  They also reveal your age better than any other part of the body.  This is because the skin is very thin and easily damaged from the sun, lack of sleep and so on.  The eyes instantly flash whether you are tired or well-rested. Blepharoplasty can remove the excess skin from upper and lower eyelids and remove the bags from the lower lids and, if done well, take ten years off your appearance in a matter of a few hours.  You may want to read this link which has many reviews of those who have undergone the procedure.

4)  Microdermabrasion. This one may be worth a try. It is, after all, the #1 procedure for Hollywood-types.  Some stars have this procedure done every two weeks (or even more frequently) while filming. Lighting directors apparently go ga ga over the smooth finish that it gives skin. The important thing for guys to know is that it is sometimes called the “lunchtime peel”, because there is almost no downtime. Better yet, the cost is low:  just a few hundred dollars per session normally. It consists essentially rubbing a sandy material over the skin of your face in order to cause mild skin damage which then forces regeneration of new, improved skin.  Unfortunately, the results are often not spectacular, but  if you are one of the lucky individuals that respond well to microdermabrasion, it is an excellent alternative, especially for the price.  CAUTION: It is uncommon but you should know that a few individuals respond with excess tissue inflammation and can come out looking a little worse, i.e. with increased wrinking in certain areas.

In addition, sagging on upper and lower eyelids is extemely common.  And, unfortunately, once skin has sagged in a major way in the eye area, there is no good non-surgical way to re-firm it.  (Thermage can do some firming in the eye area for some people but it generally not going to do a major improvement.)  This is where an “eye lift” or blepharoplasty can come into play.  It will take you out of commission for awhile, but there really is no substitute.

5) Peels, Laser Resurfacing and Face Lifts. These are much more invasive procedures with a more significant list of side effects.  Of course, if you have significant skin damage or sag, then you may want to consider these.

6) Botox. The above procedures, for the most part, will only be partially successful on “motion wrinkles and lines”.  These lines, such as crows feet and glabellar lines (between the eyebrows), are caused by the expressions you make.  Botox works by injecting a Botulin toxin into the muscle area involved, which “deadens the muscle” that causes the wrinkling.  It works remarkably in many people and seems to actually allow the body to heal the wrinkles in many cases. Botox treatments generally last about four months and cost $300-400 per treatment. MONEY SAVER: New research shows that after you are a veteran, i.e. have had Botox for two years, you can go to treatments every six months (instead of the usual three) and still have reduced facial wrinkles. [7]

CAUTION 1: One should be aware that researchers recently found, to their surprise, that a minute amount of the Botulin toxin did actually migrate down the nerve.  Most doctors do not believe the small amounts involved will cause any kind of permanent issue, but no one knows for sure of course.

CAUTION 2:  Botox, if done incorrectly, can actually cause “new wrinkles” and can lead to ptosis (sagging).

CAUTION 3:  One recent study found that Botox can actually lead to decreased emotional responsiveness. [5] The reason is simple:  your facial expressions actually provide feedback that increases and validates your emotions.  Without facial expressiveness, emotional responses are blunted and dampened.  For this reason, still other research indicates that treating crows feet with Botox can increase feeling of depression due to the loss of neural feedback. [8]

CAUTION 4:  2009 study found that Botox results in an immune response, at least in mice. The long term consequences of this immune response have not been studied. [4]

CAUTION 5:  Some individuals actually become Botox resistant over time.

CAUTION: Watch out for the new GFX procedure to handle facial wrinking, especially in the area between the brows.  It has been approved for “overactive muscles” by the FDA but has not yet been approved for cosmetic purposes yet.  And that may be with good reason:  it works via the same radiofriequency used to Thermage, except in this case it’s used to actually temporarily stun the local nerve. This produces a Botox-like effect, except that in the case of GFX, one does not know for sure if nerve function will be fully restored.  In other words, if you don’t like the results, it may be too late.

7) REX. There is another very new procedure called REX, or Relaxed Expressions Toxin-Free RF Treatment, that works by inserting a small needle and using radio frequency waves (kind of like Thermage) to deaden nerve function, essentially accomplishing the same thing as Botox, but without using any nerve toxins.  It is first being pushed for glabellar lines between the eyebrows, but its proponents say it can be used for crow’s feet and even forehead lines.  Its practitioners claim that results are better and more natural.  CAUTIONS:  Results last for a year or more, which is both good and bad.  If you like the results, its great.  If you don’t like the results for some reason, you’re going to be waiting for awhile.  This is still not FDA approved and no one knows long term effects.

8) Dysport. This is a brand new replacement for Botox and the results look promising. One recent study showed legitimate wrinkle reduction for frown (or motion) facial lines in 85% of participants. [3] Results appear to initiate and last in roughly the same time frame as traditional Botox.  (Dysport is, like Botox, a botulinum neurotoxin type A.)  Hopefully, this will drive down costs due to competitive pressures. (There are also a couple of other Botox competitors coming down the pike as well.)

9.  Hyaluronic Acid Fillers. These, as the name implies, reduce wrinkles by “filling in the valleys”.  However, hyaluronic acid is a natural is a natural substance of skin and WebMD reports that there is some evidence that it actually promotes collagen formation. Collagen formation is the “backbone” of your skin and almost anything that promotes the protection or renewing of it is a good thing for your appearance.  In other words, repeated injections of hyaluronic acid may very well help your body actually reduce its own wrinkles. Costs vary depending on the amount of filler used and are typically in the $400 to $1000 range with one treatment lasting, in general, for 6 to 12 months. Common brands are Juvederm, Restylane and Captique. Results in the brow area are excellent and can last up to two years in many cases.  CAUTION: You want to get someone with good experience (and board-certified) because, if done incorrectly, you can get tiny mini-bumps on the skin.

10. Fraxel Laser. Traditional ablative laser treatments were effective but fraught with side effects:  the problem being that these older lasers heated both the top and deeper layers of the skin.  The Fraxel Laser changed all that by  heating only the deeper layers of the skin which allowed for decreased side effects and downtime.  However, there is generally downtime of several days to a week as the patient has an actual “sunburned” look during that time period. If you get treated on a Friday, for example, you might be ready by Monday. The good news is that the new skin that emerges is usually well worth the wait:  wrinkling, blotching, age spots, pigment spots and other skin problems are usually substantially improved.  If you want a new face to jump start your career or a relationship, Fraxel laser is definitely worth considering. It is one of the few treatments that is accepted as getting rid of fine lines around the eyes. Keep in mind, though, that it is quite expensive:  about a grand per treatment and 3-5 treatments are usually recommended over the course of about a month.  If you truly want a new face, though, the cost and inconvenience may well be worth it.

11) Tri-Luma. One of the most popular and successful treatments for skin discolorations is prescription-only Tri-Luma.  If you have melasma and/or age spots on your face, you may want to talk to your dermatologist about Tri-Luma.  It does have a fair number of side effects, but for the most part, are what you might expect, including peeling, dryness, redness and so on. In a small minority of people, it can create a bluish tint and, of course, should be discontinued immediately.

12) Liquid Face Lift. If you’ve got the money, then this procedure gives you the power to take ten years off your face in one afternoon. There is also minimal downtime, lengthy persistence and possible collagen-boosting properties as well.  For more details, see this link on the Liquid Face Lift.

NOTE:  Read here about the Most Common Cosmetic Surgery and Procedure for Guys.

REFERENCES:

Thanks to SmartSkinCare and Dr. Todorov for much of the above information.

1) Flum, D. NEJM, Jul 30 2009, 361:445-454; Robinson, M., NEJM, Jul 30 2009; 361:520-521

2) https://www.medicinenet.com/script/main/art.asp?articlekey=104221

3) UT Southwestern Medical Center (2009, August 3). Dysport Deemed Safe, Effective Anti-wrinkle Treatment, Plastic Surgeons Say. ScienceDaily. Retrieved August 4, 2009, from Science Daily Dysport coverage .

4) Aesthetic Surgery Jour, Sep 2009, 29(5):414-418, “Type A Botulinum Toxin Induced Antibody Production: A Murine Model of Antibody Response”

5) Emotion, 2010 Jun, 10(3):433-40, “The effects of BOTOX injections on emotional experience”

6) Obesity, 2008, 16(12):2648 2651, “Long-term Effects of Large-volume Liposuction on Metabolic Risk Factors for Coronary Heart Disease”

7) https://www.sciencedaily.com/releases/2010/04/100426141504.htm

8) https://medicalxpress.com/news/2013-04-laughter-lines-patients-depressed.html

Cocaine, Heroin and Erectile Dysfunction - Peak Testosterone

It will probably not surpise most of you that most drugs are very hard on your penis considering how hard they are on your body.  Well, consider your suspicions confirmed.  Most guys using recreational drugs do not wake up in the morning saying, “Today, I’m going to trade a half hour of pleasure for my sex life.”  But that is exactly what most recreational drug users aren doing without even realizing it.  It may take a week or two or  may take a year or two, but almost always one of the first things to go out the window are the ol’ erections.

1)  Drug and Alcohol Dependencies, Apr 1 2008, p. 12-18

2) Med J Australia, 2002, 177(5):260-262

3)  Cardiology, 88(3):191

4) NEJM, Apr 24 1975, 292:882-887

5) J of Postgraduate Med, 2006, 52(1):51-56

Let’s start with the opiates, such as heroin, methadone and so on.  All of these are very hard on male erectile strength, sabotaging it in many different ways.  Some of these drugs should be called Erection Killer, Anti-Viagra, Castratanol or something similar.  One study  looked at heroin addicts in treatment with methadone or buprenorphine and found that almost half reported erectile dysfunction, 24% saying mild to moderate and 18% severe. [1]  Of course, that assumes that you survive: cocaine also is a fantastic clot builder and artery spasmer and heart attacks are not

NOTE:  Don’t think you are immune if you’re abusing prescription drugs.  The DEA estimates that in America there are “nearly 7 million Americans are abusing prescription drugs more than the number who are abusing cocaine, heroin, hallucinogens, Ecstasy, and inhalants, combined”. Furthermore, the problem is bound to get worse as one recent study in the Journal of Adolescent Health found that one in five adolescents lends or borrows prescription drugs.  Prescription drugs are just as powerful and damaging as those on the street.

But how does cocaine lead to erectile dysfunction?  One journal points out that it basically greatly accelerates the aging of the arteries, leading to accelerated plaques and calcification. [2]  Another study found that chronic cocaine use lead to chronically elevated CRP levels, which good Peak Testosterone readers know is one of the leading risk factors for heart disease. [3]  Methadone and heroin destroy just about every marker of gonad function that researchers can think of.  It lowered ejaculatory volume, seminal vesicular and prostatic secretions by over half! [4] Those Nirvana lyrics “Half the Man I Used to Be” really apply here. But the nightmare doesn’t stop there:  baseline testosterone levels were 43% lower in methadone users for example.  Interestingly enough, methadone (a controlled substance given at clinics) produces the worst results in all markers, but heroin is not far behind.

Next we will cover marijuana.  This supposedly benign plant that everyone wants to use for medicinal purposes should be called The Great Sterilizer. Please read this link on How Marijuana Can Destroy Your Hormones, Fertility and Lead to Impotence.

REFERENCES:

Stories of Low Testosterone from Posters and Emails

Every man has his own story about testosterone and what it can do to his life. I find that theses stories tend to run in themes and these common themes may help some of you out there struggling with low T.

Low testosterone can be a huge struggle for a man, making career, relationships, fitness and mental health very, very difficult. And most men go at it alone often with little or no help from their physicians. They are reluctant to talk about the issue with their spouses, their sex life goes downhill and on and on. If any of these apply, read any story below and you’ll see that you are not alone. Finally, consider joining the Peak Testosterone Forum and getting involved.

1. Ignored Hypogonadism.  I cannot tell you the number of physician horror stories that I have encountered where the doctor simply ignored the patient’s hypogonadism (clinically low testosterone).  The threshold for hypogonadism is outdated and abyssmally low by almost any standards and most labs put it in the 250-280 ng/dl range.

Look at this poor guy below, who was in his late 20’s, and had testosterone that was clearly hypogonadal.  In fact, his testosterone was arguably about a third of what it should have been and he had classic low testosterone symptoms to boot.  He actually had to demand a testosterone reading in the first place and then his doctor ignored the reading and told him he was okay!

“I was irritable, experiencing E.D., no muscle growth (after two years in the gym), almost no body hair, fatigue, etc. So I went into my Primary Care Dr. and insisted on getting my levels checked. He dismissed it and said that he felt my levels probably were low, but didn’t think I should get them checked. I urged him to however, and in the end he did. On September 26th 2011, at 4:55 pm, my T levels came back as…

Free Testosterone: 44.8 Range: 35.00-155.00

Total Testosterone: 283 Range: 250-1100

Having checked the ranges for my age and found my levels to be very low, I naturally was disturbed. Yet my Dr. assured me nothing needed to be done, as they were ‘normal’ results.”

2. Misread and Misinterpreted Testosterone Readings.

I also sometimes get emails and forum postings from men whose physicians seem to have no idea what hypogonadal testosterone even is.  In fact, they seem to – and who knows if it is deliberate? – ignore the reference ranges on the lab results.  As mentioned above, all hypogonadal thresholds are 250-280 from what I have seen and yet notice what this man’s doctor says to him:

“Hi all – first post…So, here’s my deal: i’m a young, fit/slim 43 – i stay fit, run, mountain bike (alot in summer), lift weights (though not a ton). Snowboard as well. Overall, a pretty darn good diet, but not perfect. i definitely try to eat well overall. I wasn’t feeling low energy, or exhibiting most other signs of low test, but i just know my libido is not “great.” it’s ok, not great. And, over the early spring, i def had a bit of a “staying hard’ issue. went to my primary care in May last year, and had him to a test check. Came back 194 ng/dL….”yikes” i thought! isn’t that low? my doc kinda blew it off, and said “yeah it’s normal…low normal..” pat pat, send me on my way.”

Inflexible Diagnosis. Some doctors simply will not treat a man with HRT (Hormone Replacement Therapy no matter how bad his low testosterone symptoms if he is above the hypgogonadal threshold. Read this story below from a senior man who was clearly miserable with low T and yet his doctor told him he was just find since he had one reading above 280 ng/dl:

“I’m facing at least 90 % of the symptoms you placed on your pages.Age 60, and fed up with them totally. No diabetes , no MS no cancer, no stomach ulcer – perfect prostate , great liver. and kidney [uncomplicated hear attack 18 years ago.

All this make me happy -Thanx God for it ! nevertheless on the other hand the legitimate question arises : why I feel so sick weak [ insomnia , foggy mind, and all tis you know so well] while my results are so great !!!

I [I? He didin’t have such idea] asked my dr about testosterone test in 2010 [TEST RESULT :12.7 no idea what does it mean my GP told me that is absolutely OK]”.

What these doctors do not realize is that all of this affects how a man thinks about himself and, just as important, his relationship with his wife or significant other.  Look at these stories:

“1) Sometime in my mid 30s I began to notice some difficulty achieving or maintaining a firm erection. But it wasn’t consistently difficult. At age 37 I had a terrible experience with the woman of my dreams (at the time,) in which I could not perform.”

“2) I should mention to you guys that before I actually got a physician to help me I had lost my job, the woman I was seeing dumped me”

By now you may wondering if I ever get any good stories? Of course, and one of my favorite was the story of this man, who wrote, after going on T therapy, about how his sexual function was completely restored and then some:

In early April I received 12 pellets and that was when I really saw a marked uptick in libido as evidenced by the increase in desire to have sex. Now at 51, I’m averaging between 3 and 4 times a week! Probably similar to what I was experiencing in my 20’s and 30’s!

After the pellets really started kicking in, I was on a personal marathon to see how many times a week I could have sex at 51 years old. This wasn’t on purpose but that’s exactly what I was doing. Now after a full year and I’m no longer fearful that my increased libido is temporary I’ve settled down to twice per week.

Are Multivitamins: Brain Food or a Waste of Money?

Mulivitamins have been disappointing to say the least. There is little evidence, for example, that they protect men from the big killers of heart disease and cancer.  The latest slap in the face was a huge study of 162,000 women in the Archives of Internal Medicne that found no correlation between taking a multivitamin and heart disease, cancer or total mortality. [1]   Actually, some large studies have shown cardiovascular benefits, [7] but this is controversial at best.

Because of studies such as these, many of those in the traditional medical establishment like to slam taking multivitamins as complete waste of money.  However, I feel these criticisms are overstated, because there are several areas where multivitamins may excel for us guys.  One surprising area where the evidence for multivitamins looks good is the brain.

The reasons for this are many, but suffice it to say that the brain is a huge nutrient and energy hog.  It requires, among other things, lots of the B vitamins. Plus, as people age, they often lose GI acidity and the ability to digest certain vitamins, including the B vitamins, and minerals.  A good multivitamin, therefore, looks like a good insurance policy for you grey matter.

There is another key area where a multivitamin may help:  immunity. One study has found that a multivitamin with around a 100% of the RDA in minerals as well as vitamins can protect against colds and flus.  Several studies have shown that in seniors, whose vitamin and mineral digestion has often declined, a multivitamin/mineral supplementation can help prevent infections. [4]  This was backed up by a recent study that showed that even those in the 50-65 age range can get an immune boost as well. [5][6]

NOTE:  Many cheap multivitamins have fillers such as Calcium that actually slows or halts the absorption of much of what is in the multivitamin!  In addition, some of the standard multivitamins are highly compressed, which is why you could load it as a round if they put a little powder in it, and thus do not dissolve fully.

Multivitamin Cautions

CAUTION #1: There is some caution in order when it comes to multivitamins.  For exammple, folic acid plays a pivotal role in the synthesis and repair of DNA, which is why it’s recommended for pregnant women. However, it appears it can stimulate certain cancers in both men and women and there is also some evidence that the folic acid added to vitamin supplements is much more potent than the folate found in food. The bottom line:  be careful not to consume fortified breads and cereals in addition to a multivitamin.

CAUTION #2:  There is also evidence that too much selenium can raise cholesterol. [8] Men need to be careful here, because cholesterol is a risk factor for heart disease and endothelial dysufunction, which will translate to poor erections eventually.  The study above showed that those with the highest selenium had 8% higher cholesterol and over half of those in this category were taking multivitamins. [9]

REFERENCES:1) Arch Intern Med. 2009;169(3):294-304, “Multivitamin Use and Risk of Cancer and Cardiovascular Disease in the Women’s Health Initiative Cohorts”

2) Personality and Individual Differences, 1991, 12(4):351-362; Personality and Individual Differences, 1991, 12(4):363-365

3) Am J Clin Nutr, 1997 Jan;65(1):20-9

4) https://www.crnusa.org/benpdfs/CRN009benefits_elderly.pdf

5) Chandra RK. Influence of malnutrient supplement on immune responses and infection-related illness in 50-65 year old individuals. Nutr Res 2002;22:5-11

6) https://www.quantumhealth.com/news/MULTIBOOST.htm

7) Am J Clin Nutr, 2010 Nov, 92(5):1251-6, “Multivitamin use and the risk of myocardial infarction: a population-based cohort of Swedish women”

8) American Journal of Clinical Nutrition, Aug 2008, 88(2):416-423, “Serum selenium and serum lipids in US adults”

9) https://www.wsmv.com/health/21604674/detail.html

Brain and Excitotoxins - Peak Testosterone

REFERENCES:

1) Eur J Oncol, 2005, (10)(2):00-00

2) Neuroendocrinology, 1978, 26:220-228; 1986, 42:158-166; 1980, 30:280-284

3) American Society of Nephrology (2009, November 2). Diets High In Sodium And Artificially Sweetened Soda Linked To Kidney Function Decline. ScienceDaily. Retrieved November 2, 2009, from https://www.sciencedaily.com /releases/2009/11/091101132543.htm

4) Neurology, 2009, 73:920-927, “Kidney function is associated with the rate of cognitive decline in the elderly”

5https://esciencenews.com/articles/2009/11/05/small.increases.phosphorus. mean.higher.risk.heart.disease

6)https://esciencenews.com/articles/2009/11/05/kidney.function.decline. increases.risk.heart.failure.and.premature.death

Sound unbelievable?  Well, here is a partial list of the hormonal vampires:

All of these ingredients have several things in common:  they are used in the food industry as “flavor enhancers” but are under the covers what biologists call excitotoxins and contain either aspartate or glutamate.  Glutamate is the most studied of the two compounds, but aspartate is definitely glutamate’s evil little sibling.

Together these two have something in common:  when ingested, they love to destroy neurons.  And, just as bad, when they destroy neurons in the right places, they can take out your entire hormonal cascade, including testosterone.

Animal studies, and not at overly high doses by the way, have shown that when pregnant mothers are fed glutamate the offspring is born normally but then during puberty a host of reproductive issues surface including shrunken testes. In other words, these molecules would better be called eunuch-o-toxins.

Interestingly, these key molecules are actually used by your brain for energy and as a type of neurotransmitter. In fact, they are involved in the switching mechanism of your neurons and are called excitotoxins because they literally overexcite the neurons to death if ingested in even relatively small quantities.  Neurons that receive too much glutamate or aspartate allow a flood of calcium – calcium is used for turning neurons on and off – into the cell.  The neurons under these conditions become swollen and damaged and eventually die.  So a little glutamate and aspartate is essential for the brain but too much is neuronal death.  Yes, your cells can literally get overexcited to death.

Furthermore, animals that are fed relatively low levels of glutamate can actually develop too many synaptic connections.  The brain becomes literally miswired.  In fact, studies show animals on glutamate become hyper and unable to perform normal tests of intelligence (for animals of course). This, of course, is because their brains are slowly getting mangled.  It is like taking a race horse or an elite bodybuilder and forcing him to work out until the muscles are literally shredded irreparably.

The tragedy is that many otherwise health-conscious people think that MSG, or monosodium glutamate, is only a health problem because it contains extra sodium or causes allergic-type reactions in sensitive people.  And probably an even greater tragedy is that many people, trying to be healthy by drinking diet sodas, are soaking their hypothalmuses (and in some cases brains) with excitotoxins. (Aspartame is so named because of the aspartate in its chemical composition which is released upon digestion in the stomach.)

So what do the studies show?  One animal study in a prestigious European journal already found “a statistically significant, dose-related increase in lymphomas and leukaemias in females” at about the equivalent level of three diet sodas per day. [1] This study was conducted on 1,800 rats and the control animals had no lymphomas.  In contrast, the animals aspartame had 10 malignant gliomas, 1 medulloblastoma and 1 malignant meningioma.  Yet somehow pro-aspartame proponents argue that this is not statistically significant!

Before I go on, I need to mention that, while I had read some basic information about excitotoxins, the book that really opened my eyes was Russell Blaylock’s The Taste That Kills. I cannot possibly do justice to this book in just one web page, but keep in mind that the author is a neurosurgeon and has packed this book with studes and references.

So why, you might ask, would the FDA allow these excitotoxins into our food supply?  Well, here is the FDA’s (extremely weak) argument:  the brain is protected by the blood-brain barrier which does not allow the passage of either glutamate or aspartate into your precious grey matter.  This is deadly and foolish thinking, because there are parts of your brain completely unprotected by the blood-brain barrier. Secondly, the blood brain barrier is not perfect and will under certain circumstances allow passage of glutamate and aspartate sized molecules directly into the brain.

But let’s focus on the problem that is going to be an issue for almost everyone.  There is a very key region of the brain where MSG and aspartate can march in and rape and pillage during their stay: the hypothalamus. This region of the brain essentially couples the nervous system and the endocrine system together. The hypothalamus pumps many key “factors” into the pituitary and the pituitary in turn controls your many of the hormones that you hold most dear as a male, including leutinizing hormone, i.e. LH, follicle-stimulating hormone, i.e. FSH, and growth hormone, i.e. GH.  And I should mention that testosterone is strongly effected by leutinizing hormone and, to a lesser extent, growth hormone.

Thus, it would stand to reason that damage to the hypothalamus from glutamate (and aspartate) could negatively effect all these key hormones effecting masculinity and fertility.  And that is exactly what the animal studies have found.  Growth hormone, leutinizing hormone, prolactin and several other hormones are all hit by the ravages of glutamate [2] resulting in animals that are so damaged that they obese with decreased fertility and often shrunken testes and pituitaries.

Do you know the foods and drinks that boost Nitric Oxide and repair the veins and artieries to your penis?  Then check out the Peak Erectile Strength Diet Program where I show you how to dramatically improve your erectile strength.

By the way, I should mention that these changes do not necessarily show up right away.  They often show up only when the animal goes through puberty.  In other words, the excitotoxin damage can sit their dormant for years, relatively unnoticed, yet hitting your body years later like a freight train.  How many middle aged guys out there have wondered why their testosterone has vaporized in middle age seemingly inexplicably due to the ravages of MSG ingestion during their formative years?  We will never know the answer to that question and, more importantly, nor should we have had to.

NOTE:  Do you feel like crap and don’t know why?  You may have Excitotoxin Syndrome.  If so, please read about it here.

Regardless, the damage to us middle aged and beyond guys from glutamate and aspartate is probably rather extensive.  Throughout the 60’s, many manufacturers laced baby food with glutamate! (And you older guys wonder why you’ve been having problems, eh?) In addition, many women probably at more glutamate at meals during the very vulnerable first trimester when our entire brain is much more exposed to all that our moms ate and drank.  Again, animal studies show horrific brain damage from just these situations.

Okay, you can’t the past – we all know that.  But how do you protect yourself from excitotoxins from this point forward?  First of all, do NOT ever consume any of the items on the list at the top of this link.  That’s a no-brainer – no pun intended.  In fact, I strongly recommend that you do not consume these even in minute amounts.

You also must be extremely careful when it comes to packaged foods (and eating out).  Somehow the food manufacturers got the FDA to not only allow MSG but to allow it in many foods without being labeled.  Monosodium glutamate can be added to your food under labels like “spices”, “natural flavorings” and so on in many cases without actually labelling it glutamate or anything similar. You also get substantail amounts of MSG generally in “sodium casseinate”, “autolyzed yeast extract” and “maltodextrin”. So beware! The only way to really protect yourself is to buy foods packaged without absolutely no ambiguous or vague entries whatsoever.

NOTE:  I have documented some of the Fast Food Chains and Restaurants that Pack their Foods with MSG.

Remember that you probably have considerable damage to your hypothalamus and possibly other regions of your brain from the past decades of your life.  Many neurological diseases are based on a critical threshold being passed.  For example, in the case of Parkinson’s, one can have 50, 60 or even 70% of the cells in a certain area of the brain destroyed without any symptoms showing up.  But once we you pass the 80% threshold, that is when the devastating symptoms of Parkinson’s manifest themselves.

There are probably many areas of your brain where you probably at the 50% point.  The last think you want to do is anything that may take you down the home stretch to neurological disease and possibly dementia.  Remember:  your brain and your hypothalamus in particular sit vulnerable and exposed like a little child.  You are the only one that can protect them.  I highly recommend that you read my link on the Brain as well for other critical ways to protect yourself.

NEWS FLASH: Researchers have just linked kidney decline to diet drink consumption. [3] Aspartame, the artificial sweetener in most diet drinks such as Diet Coke and Diet Pepsi, breaks down into formaldehyde. Formaldehyde can accumulate in the kidneys and other organs and cause damage. This can potentially have far-reaching consequences as kidney decline has been linked with cognitive decline and loss of memory in seniors. [4]  Kidney decline has also been linked to an increase in phosphorous [5] and ensuing heart disease. [6]

The bottom line:  preserve what you got!  “Your grey matter is all that matters”.

Cosmetic Procedures: Total Privacy and Secrecy.

A lot of us males want to look younger and better, but we don’t want a soul on planet earth to know about it.  Okay, maybe the wife or girlfriend can know a little something – she might find it attractive – but not much.  We would like easy, quiet ways to knock the years off of our appearance without obsessing over it like many of the females around us.

Well, guys, you can accomplish all those goals.  You can knock years, even decades in some cases, in complete privacy.  Some of the techniques below can be done without a soul on planet earth knowing about it.  Some of them require one or maybe two to know about it.  Take a look and start looking better in just a few weeks.

Remember:  appearance – we hate to admit of course – is better for your relationships and your career.

3.  Retin-A (Forehead Wrinkles).  Retin-A is a proven wrinkle fighter.  It is prescription only, but the nice thing is that once you have the tube, you can discreetly apply it at night without anyone knowing. (It’s best to keep it in the refrigerator, but of course that opens up the possibility that someone unwanted may see it.) See this link on the Skin for more information.

4.  Botox (Nasolabial/Crowsfeet). Botox is generally a no downtime procedure.  Many people go back to work after receiving treatement and the treatment itself is very short as well making it very unlikely that anyone will ever know you had a treatment.  (It is possible to have bruising or small needle marks, but these are uncommon issues.)  Please see the section on Botox in this link for cautions and side effects regarding Botox. CAUTION: Some research indicates that treating crows feet with Botox can increase feeling of depression due to the loss of neural feedback. [2] For other cautions, see my link on Cosmetic Surgery for Males.

5. Dysport. Dysport is the “New Botox”.  I just passed a sign that was advertising Dysport at $4/unit and Botox at $10/unit.  Dysport, however, takes 2.5-3 times as many units per treatment as Botox, so the cost is roughly the same.

6. Hyaluronic Fillers such as Restylane (Throughout Face).  Same as Botox.

7.  Microdermabrasion   Microdermabrasion is called the “lunchtime peel” for good reason:  it has little to no downtime.

There you have it: six treatment plans that will very likely take about twenty years off of your face. They are all fast and easy and secrecy and privacy are virtually assured.  With even a little discretion, you can keep this a secret for decades.

We think that your biggest issue is going to be all those annoying clerks and cashiers carding you again.

REFERENCES:

1) J Cosmet Laser Ther, 2005 Dec, 7(3-4):196-200, “A study to determine the efficacy of combination LED light therapy (633 nm and 830 nm) in facial skin rejuvenation”

2) https://medicalxpress.com/news/2013-04-laughter-lines-patients-depressed.html

2.  Do It Yourself. Use Dr. Todorov’s SmartSkinCare Info Packs.  His Info Packs tell you how to make your own Vitamin C and other topical solutions that have a proven track record in diminishing wrinkles. You can purchase and make all of his products with not a soul on planet earth knowing about it.

3.  OmniLux New-U LED System. LED light treatments have been done for several years now in doctor’s offices (a.k.a. Gentlewaves) and were approved by the FDA for the sensitive areas around the eye.  The reason is that LED treatments are gentle and have “no pain, side effects or downtime”.  However, you can now by the above system for over the counter home use and is sold as the OmniLux New-U.  The beauty of this is that no one ever needs to know.  These systems works through the application of infrared and red light to the skin which then stimulates collagen production.  This is beautiful, because the eyes are very difficult to treat effectively without injuring and inflaming the thin skin around the eye socket.  Yet it is critical if you want to shave years off your appearance as studies reveal that people look at the eyes to discern the age of someone they meet.  The eyes are the “window to the soul” and to your biological age as well. The general consensus is that LED treatments tend to work well to remove fine lines and wrinkes in the eye and some surrounding areas. There are a couple of studies showing its effectiveness. [2] .

CoQ10 and Your Sex Life - Peak Testosterone

Can CoQ10 improve your sex life?  I’m not big on supplements, but the evidence looks strong that it can do just that.  In fact, I would throw CoQ10 into the same category as the Super Sexual Herbs that I have written about, i.e. a supplement that seems to help bedroom performance in a lot of subtle but important ways.

Here is a list of 8 ways that CoQ10 can help you when it’s showtime:

1.  Blood Flow. In patients with a certain heart-related issues, left ventricular dysfunction, CoQ10 improved blood flow. [1] This has been verified in other patient subgroups as well, including statin-treated diabetics [2].  Most importantly, CoQ10 improved FMD (Flow Mediated Dilation) in men with endothelial dysfunction. [3] A significant percentage of middle-aged men in modern, industrialized societies have endothelial dysfunction and it is the root cause of most erectile dysfunction. In other words, CoQ10 will very likely help the men who need it most.

2.  High Blood Pressure (Hypertension). One of the biggest risk factors for sexual issues in males is high blood pressure. One meta-analysis, which is a study of many studies, found that CoQ10 was significantly reduced high blood pressure. [4] The abstract specifically states that “we conclude that coenzyme Q10 has the potential in hypertensive patients to lower systolic blood pressure by up to 17 mm Hg and diastolic blood pressure by up to 10 mm Hg without significant side effects.” These are impressive results that mean not only will CoQ10 likely give your sex life an immediate erection-boosting increase in blood flow, but it will protect your erections in the long term as well.

NOTE:  Remember that most of the evidence for CoQ10 is not in young, healthy patients, but rather with those with issues of aging and a modern lifestyle.

1) Atherosclerosis, 2011 Jun, 216(2):395-401. Epub 2011 Feb 17, “Reversal of mitochondrial dysfunction by coenzyme Q10 supplement improves endothelial function in patients with ischaemic left ventricular systolic dysfunction: a randomized controlled trial”

2) Diabetes Care, 2009 May, 32(5):810-2, Epub 2009 Feb 19, “Coenzyme Q10 improves endothelial dysfunction in statin-treated type 2 diabetic patients”

3) Int J Cardiolm 2005 Feb 28, 98(3):413-9, “Influence of coenzyme Q(10) and cerivastatin on the flow-mediated vasodilation of the brachial artery: results of the ENDOTACT study”

4) J Hum Hypertens. 2007 Apr;21(4):297-306. Epub 2007 Feb 8. “Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials”

5) https://www.lef.org/magazine/mag2007/nov2007_itn_01.htm

6) Mitochondrion 2007, 7(suppl 1):S154 S167, “Coenzyme Q10 in cardiovascular disease”

7) J Pharmacol Sci. 2008 Jun;107(2):128-37, “Beneficial effect of coenzyme Q10 on increased oxidative and nitrative stress and inflammation and individual metabolic components developing in a rat model of metabolic syndrome”

8) Fertility and Sterility, Jan 2004, 81(1):93-98, “Coenzyme q10 supplementation in infertile men with idiopathic asthenozoospermia: an open, uncontrolled pilot study”

9) Molecular Aspects of Medicine, 1997, 18(1):213-219, “The effect of coenzyme Q10 on sperm motility and function”

10) Food Consumer Article

3.  Nitric Oxide Protection. One way that CoQ10 does its magic is by protecting your precious nitric oxide from oxidation. [5] This makes CoQ10 likely a synergistic supplement that will enhance other erectile supplements (and medications), because it helps to preserve and protect nitric oxide through a different metabolic pathway. [6]

4. Metabolic Syndrome. Another huge risk factor for erectile dysfunction (and a lot of other nasty conditions) is Metabolic Syndrome.  In lab animals, CoQ10 improves many of the major risk factors for Metabolic Syndrome. [7] Furthermore, the improvements were dose-dependent, i.e. the more CoQ10, the less certain key signs of Metabolic Syndrome, specifically inflammation and free radical damage. Even more remarkable was the fact that CoQ10 was able to prevent the typical rise in insulin levels (from insulin resistance) that normally accompanies this condition.

NOTE:  CoQ10 can be expensive in health food stores, but is very reasonably priced on Amazon: Swanson Coq10 100 100 mg Softgels. CoQ10 is poorly absorbed and must be taken with a little fat and ideally a little Vitamin E as well. (Always talk to your doc first and see Caution below.)

6. Libido Protection. Dopamine could be termed the “Sex Neurotransmitter.”  As I point out in my link on Natural Dopamine Increasers, CoQ10 is also famed for preserving brain dopamine and thus may help with sexual desire and libido.

7.  Fertility. Several studies have shown that CoQ10 improves sperm factors and fertility. [8][9]

8. Wrinkle Reduction. Topical CoQ10 can also reduce wrinkles if done in the right proportions.  There are various Do It Yourself formulations out there, including the Info Packs at Smart Skin Care. What does that have to do with sex?  We all know that half of performance is self-confidence and looking better can help dramatically.  See my link on Wrinkle Reduction for Men for other ideas as well.

CAUTION: The only caution that I know of with CoQ10 is that one study showed that women with the highest levels of CoQ10 had an increased risk of breast cancer. [10] This contradicts the work of other researchers, though, who have used CoQ10 to treat cancer. See my link on Alternative Cancer Treatments for more details.

REFERENCES:

Low Testosterone Cause Bone Loss(Osteopenia or Osteoporosis)

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 our forum posters 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 this research summary 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://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

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.

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.

Vegetarianism and Reducing Inflammation - Peak Testosterone

REFERENCES:

1)   Nutrition, Oct 2004, 20(10):863-866, “Effects of a long-term vegetarian diet on biomarkers of antioxidant status and cardiovascular disease risk”

2) European Journal of Clinical Nutrition, 2008, 62:138 144, “Total cardiovascular risk profile of Taiwanese vegetarians”

3) Bratisl Lek Listy, 2005, 106(11):345-347, “C Reactive Protein and Nutrition”

A number of key studies show that vegetarians enjoy improved longevity, i.e. experience significantly decreased death rates, especially in the area of ischemic (blood flow-related) heart disease.  This is something I cover in my page on Vegetarian Longevity. NOTE: It is worth nothing that Vegetarians Enjoy Equal or Superior Testosterone Levels according to one study.

So what confers these health benefits in the cardiovascular arena to plant-based diets?  Vegetarian diets, in general, have many advantages in this area:

1. Lowered blood pressure.

2. Increased antioxidant status.

3. Decreased inflammation

I want to focus here on #3, i.e.decreased inflammation. All men everywhere should have a laser-focus on controlling their inflammation levels and the reason is simple:  inflammation appears to the root of most chronic illness in Western societies, including cardiovascular disease, autoimmune disease, cancer and dementia/Alzheimers. (Insulin insensitivity would be a close second.)

NOTE:  For more information, see these links on Controlling Inflammation.

Below I want to outline how vegetarians have been shown in a number of key studies to have lower inflammation levels than the general populace and meat-eaters:

  1. Sex-Matched Long Term Vegetarians.  This study concluded that “a long-term vegetarian diet is associated with markedly higher fasting plasma AA concentrations and lower concentrations of TAG, UA, and hsCRP. Long-term vegetarians have a better antioxidant status and coronary heart disease risk profile than do apparently healthy omnivores.”   Notice the decreased hsCRP levels, a key marker of the body’s overall inflammation levels.  hsCRP stands for “highly sensitive C-Reactive Protein.

2.  Taiwanese Study.  This study noted that “”Taiwanese vegetarians have lower total cholesterol, LDL-C and hs-CRP levels, and higher homocysteine levels than omnivores.”

3.  Slovakian Study. This study showed dramatically reduced hsCRP levels. Authors praised the increase fruit and vegetable consumption of vegetarians as a likely reason for cardiovascular improvements.  The difference in CRP scores was remarkable:  .72 mg/l in vegetarians versus 1.62 in meat-eaters.

All evidence shows that one of the big benefits from a vegetarian, plant-based lifestyle is greatly reduced inflammation levels.  Again, the important of this cannot be overestimated.  Keep in mind that inflammation is the primary component that damages your arteries, leading to decreased nitric oxide output, weakened erections and increased arterial plaque.

Chromosome and Telomere Killer - Peak Testosterone

Immortality.  Is it within our reach?  Can science dramatically extend human lifespan?

One of the first barriers that must be overcome for this to happen is to surpass the infamous Hayflick Limit, which is a practical limit on the number of divisions that a cell can undergo until it becomes a weak and doddering “senior citizen”, a.k.a senescent. Senescent white blood cells, for example, double one’s risk of cancer according to one study. [3] Still another study showed that bone loss [5] and fertility are correlated with telomere length. Other examples abound.

The reason for the notoriety of the Hayflick limit is that most cells, as they divide, lose just a little DNA off the end of their chromosomes, which is named a telomere.  Stem cells, though, overcome this shortening and, because of it, are cells that are practically immortal.  How do stem cells achieve the fountain of youth?  They do it, it turns out, through telomerase, an enzyme that essentially replaces the missing DNA on the end of the gene. In other words, increasing telomerase levels makes it theoretically possible that one’s cells never shorten and reach “old age”.

As you might expect, there has been considerable research on telomerase and the summary is this:  natural increases in telomerase have shown considerable promise, whereas artificial increases in telomerase have led to increases in cancer rates.  For example, one study used cancer resistant mice and then gave them extra telomerase and, indeed, the lifespan of the mice was increased. [1]  In other words, if you can limit cancer, you can likely increase lifespan.

This could perhaps be accomplished through some of the lifestyle changes that I recommend in my Cancer Prevention link. In other words, a lifestyle that both reduces cancer risk and increases telomerase may be ideal.  This is indicated in a study of very old Jews, average age 97, that showed that these centennarians had significantly longer telomeres. [2]

NEWS FLASH:  A groundbreaking 2010 study in the journal Nature reported some potentially incredible telomerase-related news.  Scientists created mice that aged very quickly by developing a line with low levels of telomerase. What was exciting was that when these mice had their telomerase reactivated through a clever chemical process, the mice regained their fertility and brain function and all without cancer. [15]  Of course, this is just an initial animal study, but it is a very promising first step.

So how can we increase telomerase in a (very likely) safe way in order to keep our telomeres nice and long, the way nature intended them?  Here are some of the key strategies from the latest research, which, you may notice, match many of the healthy strategies for your heart, brain and skin:

1)  Fish Oil.  Fish oil reduces oxidation of certain key metabolic processes and this is likely the reason that those with the highest levels of omega-3’s have the longest telomeres. [4]

2) Ornish Diet.  As we have mentioned elsewhere, the Low Fat (Ornish) Diet slows down telomere shortening.  And, of course, a Low Fat (Ornish) Diet will actually clear the plaque right out of your veins,  decrease erection-killing blood pressure as well and increase your telomerase activity. [16]

3) Sitting. The difference in telomere lengths between the most active and least was equivalent to about ten years of aging according to one study. [7] Sitting isn’t just hard on your bod – it’s hard on your chromosomes.

4) Exercise. Exercise may be king when it comes to slowing down telomere aging.  Older runners have telomeres 75% less aged than their sedentary counterparts. [8]  Research has shown that exercise activates telomerase.

5) Vitamin D.  Lower vitamin D levels are associated with shorter telomeres, at least in women. [9]

6) Stress and Cortisol. A number of studies have shown that stress shortens telomeres.  For example, one small study showed that women sexually abused as children had shortened telomeres, i.e. not only were they scarred emotionally but on the cellular level as well. [10]  The reason appears to be tied to the stress hormone cortisol, which has been shown to reduce telomerase activity. [13] A further verification of this was recently found in a study of women with chronic anxiety, who were found to have shorter telomere lengths. [17]

7) CAUTION:  Green Tea and Curry/Turmeric/Cursumin. Green Tea is a little scary.  The key ingredient in green tea, EGCG, has been found to be a powerful telomerase inhibitor. And, in some cases, this likely gives green tea its anti-cancer properties.  However, do you want cancer protection simply because your chromosomes have been shortened to senescence? [6] Turmeric has the same property and therefore I am cautious about using this as well, even though I love curry! [18]

8) Smoking. Smoking attacks just about every system in your body so why not your chromosomes as well, eh? [11]  This was verified in a study that showed that telomere length was actually affected in a dose-dependent manner, i.e. the more pack-years the person had smoked, the shorter their telomeres. [12]

9) Overweight. That spare tire around your middle likely accelerates aging according to one study (of women), which found that the more the weight and the higher the BMI, the shorter the telomeres. [14]

REFERENCES:

1) Cell, Nov 2008, 14;135(4):609-22, “Telomerase reverse transcriptase delays aging in cancer-resistant mice”

2)  https://www.eurekalert.org/pub_releases/2009-11/aeco-ltt111109.php

3) JAMA, Jul 7 2010, 304:69 – 75, “Telomere Length and Risk of Incident Cancer and Cancer Mortality

4) Journal of the American4) Journal of the American Medical Association, 2010, 303(3):250-257, Association of Marine Omega-3 Fatty Acid Levels With Telomeric Aging in Patients With Coronary Heart Disease

5) Mech Ageing Dev, 2005 Oct, 126(10):1115-22, “Telomere length versus hormonal and bone mineral status in6) Biochem Biophys Res Commun, 1998 Aug 19, 249(2):391-6, “Telomerase inhibition, telomere shortening, and senescence of cancer cells by tea catechin”

7) Arch Intern Med, 2008, 168[2]:154-158, https://pubs.ama-assn.org/media/2008a/0128.dtl

8) https://well.blogs.nytimes.com/2010/01/27/ phys-ed-how-exercising-keeps-your-cells-young/

9) The American Journal of Clinical Nutrition 86 (5):1420 5, “Higher serum vitamin D concentrations are associated with longer leukocyte telomere length in women”.

10) Biol Psychiatry, 2010 Mar 15, 67(6):531-4, Epub 2009 Oct 14, “Childhood maltreatment and telomere shortening: preliminary support for an effect of early stress on cellular aging”

11) Lancet, 2005, 366:662 664, “Obesity, cigarette smoking, and telomere length in women”

12) European Respiratory Journal, Mar 1 2006, 27(3):525-528, “Telomere shortening in smokers with and without COPD”

13) Brain, Behavior, and Immunity, May 2008, 22(4):600-605, “Reduced telomerase activity in human T lymphocytes exposed to cortisol”

14) Cancer Epidemiology, Biomarkers & Prevention, Mar 2009, 18:816, “Obesity and Weight Gain in Adulthood and Telomere Length”

15) Nature, 2010, Received 08 May 2010, Accepted 26 October 2010, Published online 28 November 2010, “Telomerase reactivation reverses tissue degeneration in aged telomerase-deficient mice”

16) The Lancet Oncology, 9(11):1048-1057, “Increased telomerase activity and comprehensive lifestyle changes: a pilot study”

17) PLoS ONE, 2012, 7(7):e40516. “High Phobic Anxiety Is Related to Lower Leukocyte Telomere Length in Women”

18) Cancer Letters, 8 Oct 2002, 184(1):1-6, “Curcumin inhibits telomerase activity through human telomerase reverse transcritpase in MCF-7 breast cancer cell line”

Testosterone Labs for Self-Testing - Peak Testosterone

1) https://store.zrtlab.com/index.php?option=com_content&view=article&id=106&Itemid=612

2) https://www.peaktestosterone.com/forum/index.php?topic=1250.15

3) https://www.saveonlabs.com/Dr-Mark-Hyman-Saveonlabs-com-s/1889.htm

4) https://www.saveonlabs.com/product-p/30740.htm

5) https://www.peaktestosterone.com/forum/index.php?topic=571.0

6) https://www.peaktestosterone.com/forum/index.php?topic=456.30

7) https://www.peaktestosterone.com/forum/index.php?topic=1453.0

8) https://www.peaktestosterone.com/forum/index.php?topic=1431.0

Pull Your Testosterone. The first step in evaluating your testosterone status should start with pulling your total testosterone.  In my opinion, evey guy should just pull this number periodically, symptoms or not, in order to have a good baseline.  As you’ll see below, it’s about $25 now here in the U.S.  It is fast, cheap and very important to your health.

One of the things that I have discovered as I have begun to research and monitor my own health is that my physicians – God love ’em – do not always test everything they should test nor monitor as frequently as is necessary. This is nothing against them, of course, as they have limited time and are under obligation to insurance companies and fellow physicians to minimize costs as much as reasonably possible. I know that in my own life I was low testosterone for years before I convinced my PCP to finally pull my T.  And it was years after that that anyone pulled my prolactin, estradiol and TSH. These all should have been looked at, but it simply never happened. And I could have probably avoided a great deal of heartache and suffering if I had simply had done these tests myself and shown them the results.

I am NOT suggesting that you become your own doctor, but in the U.S. and many other countries, there is considerable medical freedom and one has the right to monitor one’s health.  Think of this: your body and mind are an incredibly complex and highly tuned machine. It makes a combustion engine look like a play toy. Does your doctor really have the time to see if you need a tune up? 99% of the time your doctor is too busy just trying to keep patients alive and semi-functional.

This is the reason that I compiled a list of testosterone labs that pull various hormones for men based on Peak Testosterone Forum posts that I have received over the years. I have also included some commentary about what some of these specialize in and what they can and can/cannot be used for. I am NOT suggesting that you become your own doctor, but in the U.S. and many other countries, there is considerable medical freedom and one has the right to monitor one’s health.

NOTE: There are four states that will not let you pull your own labs. Yes, you read that right.  Even if you PAY CASH, you cannot pull your own labs.  Now please tell me that America is a free country when many of its citizens cannot even monitor their OWN health when they pay for service with their OWN money.

Think of this: your body and mind is an incredibly complex and highly tuned machine. It makes a combustion engine look like a play toy. Does your doctor really have the time to see if you need a tune up? 99% of the time your doctor is too busy just trying to keep patients alive and semi-functional? Consider my situation:

–I have never had homocysteine pulled by any doctor.

–I have had ferritin pulled only once.

–I have never had any thyroid hormones pulled except TSH and total T4.

–I have had CRP pulled maybe twice.

–I never had LH, FSH or prolactin pulled in my hypogonadal days.

Is my situation unusual? Certainly not. There just aren’t the financial and time resources available for decent testing in the great majority of insurance-backed systems. The bottom line is that you are probably going to have to do some yourself, or perhaps find a doctor or naturopath on a cash basis that can help you do the same.

For all these reasons I compiled a list of testosterone labs that pull various hormones for men based on Peak Testosterone Forum posts that I have received over the years. I have also included some commentary about what some of these specialize in and what they can/cannot be used for. Almost all of these labs are U.S. only, but there are a couple of exceptions as you will see:

CAUTION:I do not have any personal knowledge or affiliation with any of these labs. You must do your own research, i.e. “caveat emptor”.

1. DiscountedLabs.com.  If you are looking for the best prices for self-testing with the biggest, most respected lab (Lab Corp) in the country, then Discounted Labs is a good starting point. Nelson Vergel started Discounted Labs, and many of you will recognized his name as one of the most established names in the TRT/HRT community. He sent me an email where he promised to beat anyone else’s prices, and it sure seems to be the case! NOTE:  I have used Discounted Labs and had a good experience. Again, one big advantage is that the use Lab Corp, which is the largest lab here in the U.S. (NOTE: Discounted Labs is a site sponsor.)

2 Health Tests Direct.  I first found out about this lab company, because one of our longtime posters used them with great success.  They were unique for a long time, because they offered not only LabCorp pricing but also Sonora Quest. NOTE:  I have used them and had a good experience.

3.  Life Extension Foundation. One of the older and more respected supplement companies, LEF is known for its in depth articles and good support staff.  One very interesting thing that you can get, through them, a wide variety of lab panels at some of the big labs.  They have for example an Inflammation Panel and a Cardiac Panel that I have wanted to get myself that includes many of the key heart disease risk factors such as “Chemistry Profile (Complete metabolic panel with lipids) Complete Blood Count (CBC), C-Reactive Protein (high sensitivity), Fibrinogen, Homocysteine Vitamin D 25-OH.”  They also have some more specific blood draws for things like CoQ10, anemia and cortisol. The prices are quite reasonable and, of course, it’s nice to deal with a well-established company. NOTE:  I have used them and had a good experience.

One of the panels many men would be interested in is the Male Panel, which includes the “Chemistry panel (complete metabolic panel with lipids), CBC, DHEA-S, DHT, Estradiol, PSA, Pregnenolone, Total and Free Testosterone, Sex Hormone Binding Globulin (SHBG), TSH, Free T3.”  So in one shot you’ve got a lot of questions answered dealing with male hormones, especially the ones that can directly impact your sexual health.  The cost as of this writing was about $224 for members and $399 for nonmembers where a one year membership cost $75.

NOTE: You’ll want to check out that the above test uses the correct estradiol test for males. If you happen to be low estradiol, then the standard test will often not give you correct results based on what I have seen. Talk to the lab and make sure you are getting the correct test.

Also, they use LabCorp, which is I believe the biggest general lab in the U.S. and most states are available to LEF members.  For general information, see these https://www.lifeextension.com/ and https://www.lifeextension.com/.

NOTE: I have purchased a number of items from LEF with good success and been quite impressed with their support staff.  However, I have never ordered lab work through them.

4.  ZRT Labs. This is another reasonably priced lab.  The offer both saliva and blood spot testing. One of our senior posters used them several times to examine some standard male hormones as well as adrenal and thyroid function. One intriguing panel is called the Female/Male Saliva Profile I and includes the following: “five (5) tests: Estradiol (E2), Progesterone (Pg), Testosterone (T), DHEA-S, and morning Cortisol (C1)” for $170 as of this writing. [1] Blood spot testing tends to be a little more but is still (relatively) inexpensive.

6. (U.K. Testing) Private Blood Tests.  U.K. guys, from what I have seen on the Peak Testosterone Forum, have a notoriously difficult time getting treatment and testing.   “I’ve found a useful website here in the UK, www.privatebloodtests.co.uk , this allows you to run bloods at a local hospital without going through your GP, which is useful for tracking things like Clomid.” [5] Again, I do not know anything about them, other than what was mentioned in this post, so do your own research.

7.  (U.K. Testing) Blood Tests London. One of our posters also recommended bloodtestslondon.com.  His comments were that “the prices were very competitive, and they turned my thyroid blood work around in less than 1 working day. If any of the blood results are out of range then they get a doctor to comment on them (included in the price).” Again, I do not know anything about them, so do your own research.

8.  PrivateMDLabs.  This lab, according to one of our veteran posters, uses blood draws through LabCorp.  This one has been used by a couple of men and the only negative comment was that “they have a male panel that is not as comprehensive as I’d like, but includes some things that are worth monitoring.” [7]

9.  Genova.  One of our posters that has been around awhile used Genova labs for a metabolic and digestive panel. [8] One of the established Paleo media personalities has used them.

10.  Rhein Labs. This lab specializes in testosterone and estrogen-related metabolites and can really help you diagnose the root cause of your hormonal issues.  Check out https://www.peaktestosterone.com/forum/index.php?topic=3311.0 for sample results and costs from one of the senior posters on the Peak Testosterone Forum.

11.  Direct Labs.  I have used this lab for hair testing.  However, they have many other tests available as well.

REFERENCES:

Zinc Dangers (Neurotoxic, Prediabetes, Cancer, etc )

The recent research is particularly disturbing, because correcting low levels of zinc can double a guy’s testosterone: see my on Zinc Deficiencies and Low Testosterone. Furthermore, some studies show zinc supplementation can increase the average, healthy male’s testosterone a bit, although not all. Because of all of this coverage in the health press, a significant percentage of men are taking rather high doses of zinc – sometimes 3 + times the RDA for example – on a daily basis. Below I will show you why this may not be a good idea.

Before I cover some of the dangers of zinc, I do want to say that it would be very easy for a man to become zinc deficient for many reasons:

a) poor absorption due to GI disorders, which are incredibly common

b) poorly done vegetarian and vegan diets.  (I eat an almost entirely plant-based diet, so this is not a criticism of anyone out there.)

c) caffeine, tannins, tea/coffee, iron, etc. can slow zinc absorption

d) a man loses about 5 mg of zinc when he ejaculates.

Here are some of the (potential) risks that have recently been uncovered regarding zinc. (Thanks to the guys on Peak Testosterone Forum who pointed out some of these studies – seppuku!)

1. Possible Increased Prostate Cancer Risk.  Some researchers believe that too much zinc could fuel prostate cancer:

“The high concentration of zinc in the prostate suggests that zinc may play a role in prostate health. We examined the association between supplemental zinc intake and prostate cancer risk among 46 974 U.S. men participating in the Health Professionals Follow-Up Study…Although we cannot rule out residual confounding by supplemental calcium intake or some unmeasured correlate of zinc supplement use, our findings, that chronic zinc oversupply may play a role in prostate carcinogenesis, warrant further investigation.” [6]

Men on HRT should particularly take notice, because, if one’s PSA rises, the doctor or clinic will likely immediately take you off of HRT.  So that will be adding insult to injury…

MEN ON HRT: Some of you are taking lots of zinc in order to control your estradiol levels. For all the reasons on here, that may not be such a good idea.

2. Prediabetes and Metabolic Syndrome. Suppversity has a great article on how an animal study shows that zinc induces Metabolic Syndrome. [1] For those who don’t know, Metabolic Syndrome is the suite of symptoms that is a plaque in Western socieities, characterized by prediabetes (insulin resistance), high triglycerides and high blood pressure.  It’s very hard on arteries and hormones and leads to a host of chronic diseases.  The last thing you want to do is to push the pedal on this one.  Also, the article calculated the human equivalent and 30 mg, according to this calculation, could potentially cause trouble.

“Can you think of any reason why 50mg of zinc absolutely kills my libido i read it should do the opposite. Any theory? Copper deficiency…. low estrogen?” [2]

4 Dementia.  Few guys know that zinc is neurotoxic and probably at pretty low levels.  No one knows exactly what that level is, but why take a chance, eh?  As an example as to just how this level probably is, consider this statement from one set of researchers:

“Increasing evidence has suggested that zinc (Zn) is central to ischemia-induced neuronal death and, finally, to the pathogenesis of VD [Vascular-Type Dementia].” [5]

In other words, they believe that even the relatively low levels of zinc in the standard Western Diet may be playing a role in many of the dementias that we see in our seniors.  Now imagine a guy taking 3+ times the RDA of zinc.

5. Nasty Lipid Changes. The common supplemental amount that bodybuilders and health nuts take here in the U.S. is 50 mg.  I believe that is what is in the standard ZMA supplement that many men take for example.  A study out of China showed that giving just 40 mg per day to healthy males showed that “total cholesterol (TC), triglyceride (TG), Low density lipoprotein cholesterol (LDL-C) and apolipoprotein B100 (ApoB100) increased significantly, high density lipoprotein cholesterol (HLD-C) and apolipoprotein A1 (ApoA1) decreased after supplementation..” [3] This is ugly and could lead to increased arterial plaque and, yes, that can eventually affect you in the bedroom.

6. Lowered Iron Absorption. Too much zinc can slow down iron absorption. [4] Now this effect may actually help some guys who are eating red meat and getting too much heme iron in their diet.  For still other men, though, decreasing iron levels could be an issue.  Examples of this are men with undiagnosed hypothyroidism and gut issues, who end up with low iron stores.  For example, on the Peak Testosterone Forum, we have had several posters with low ferritin levels.

NOTE:  Zinc will also lower copper absorption.  Overly high levels of copper from pipes is a probably a huge problem and so this may be an advantage.  (Copper has been implicated in Parkinson’s Disease for example.)

7. Lowered Magnesium Levels. Some experts say that taking supplemental zinc can lower magnesium levels – never a good idea. [7] Magnesium plays a huge role in arterial health, testosterone and serotonin production and blood glucose / insulin control (just for starters).

1)  https://suppversity.blogspot.co.uk/2012/06/zinc-15mg-are-plenty-after-120-days.html?m=1

2) https://www.peaktestosterone.com/forum/index.php?topic=4090.0

3) Wei Sheng Yan Jiu, 2004 Nov, 33(6):727-31, “Effects of high level Zn intake on metabolism in man”

4) Pediatric Research, 2006, 60:636 636, “Inhibition of Iron Absorption by Zinc: Effect of Physiological and Pharmacological Doses: TL015”

5) Int J Mol Sci, Nov 2013, “The Molecular Mechanisms of Zinc Neurotoxicity and the Pathogenesis of Vascular Type Senile Dementia”

6) J Natl Cancer Ins, 2003 Jul 2, 95(13):1004-7, “Zinc supplement use and risk of prostate cancer”

7) https://www.thedcasite.com/zinc_magnesium_levels.html

LDL- Predictor of Arterial Plaque,Heart Disease-Not Regular LDL

I have written a little about this before, but a Peak Testosterone Forum member asked the following, and I realized that I had not done enough to show the extreme importance of LDL-P in predicting arterial plaque and heart disease in general:

“Thanks for the response and the info, bud! I really appreciate it. Sorry that it took so long to respond, I have been traveling and also been swamped with work. With regards to LDL-P, I don’t know if a specific study that states that LDL-P (regardless of composition of sizes) is the best indicator of CVD risk. I’m not saying that it doesn’t exist, I just dont know if it does. That would be pretty compelling.” [1]

To answer this poster’s question, I would say that not only is there evidence LDL-P is the best predictor of future heart disease, but there is abundant evidence that it is so.  Here are Five Powerful Examples from the Research (and there are many more):

Therefore, it is prudent to work on every 100 points of LDL-P that you can.  Keep working on it and bring it down. CAUTION: There is a small percentage of men with extremely low cholesterol and lipid numbers.  These men do not need to bring their numbers down and may even need to try to boost them.

This same study in the journal Atherosclerosis basically showed the LDL-P blew away LDL-C as far a predicting heart events:

“Particularly in patients whose LDL-P and LDL-c levels are discordant, LDL-P seems to better predict cardiovascular (CV) events than LDL-C levels [6-8]. Several expert panels and guidelines already advocate the use of LDL-P as target of therapy in certain at-risk patients. This report aimed to provide real world evidence that confirms that clinical management aided by LDL-P.” [3]

BUT WHY?  Why is LDL-P so important and clearly so much more predictive than LDL-C?  Because LDL-P essentially measure the concentration of LDL particles in your plasma and it is the concentration of LDL that determines if it will be pushed into your artery walls.

2. Arterial Plaque (via IMT) in Healthy Men.  Many studies show that LDL-P is associated strongly with the buildup of arterial plaque, the Great Bedroom Killer. One way to measure plaque is via an IMT, an ultrasound that measures the thickness of your carotid (neck) artery, i.e. plaque buildup.  Researchers in one study found that LDL-P was a powerful and independent predictor of IMT:

“In a community-based sample of Japanese men, free of clinical CVD, LDL-P was a robust marker for subclinical atherosclerosis, independent of LDL-C and other lipid measures. Associations of LDL-C and other lipid measures with either cIMT or CAC were generally not independent of LDL-P.” [6]

Again, notice that they said that, while LDL-C cannot be entirely ignored, LDL-P was the more powerful and independent predictor.

3. Framingham Offspring Study.  Researchers examined this set of data and concluded that “in a large community-based sample, LDL-P was a more sensitive indicator of low CVD risk than either LDL-C or non-HDL-C, suggesting a potential clinical role for LDL-P as a goal of LDL management.” [2] And the event rate was much improved over other CVD markers examined as well:

“Subjects with a low level of LDL-P (<25th percentile) had a lower CVD event rate (59 events per 1000 person-years) than those with an equivalently low level of LDL-C or non-HDL-C (81 and 74 events per 1000 person-years, respectively).”

4. PLAC-I Trial (Statin Treated Men).  In this study, the authors found that “within treatment groups, CAD progression was strongly associated with total LDL-P, after adjusting for other lipid levels, and a small LDL-P level of over 30 mg/dl was associated with a ninefold increased risk in CAD progression.” [5] In other words, it doesn’t matter whether you are on statins or off, LDL-P is the big gun. And notice that your heart disease risk goes up exponentially if you have a high small particle count number.

5. Quebec Cardiovascular Study.  Again, researchers emphasized the critical importance of apo B, which is an alternative and parallel lipid measurement:  “The results of this prospective study confirm the importance of both elevated plasma cholesterol and decreased high-density lipoprotein cholesterol levels as risk factors for ischemic heart disease. They also emphasize the high prevalence of an elevated apo B dyslipidemic state in ischemic heart disease.” [4] NOTE:  ApoB is also less expensive to pull than LDL-P and gives the same information.  However, the only disadvantage is that thresholds for plaque control and reversal do not seem to be as well-researched.  See my pages on Penile Arterial Plaque Regression for more information.

CAUTION: There are many other important predictors of heart disease and events, including CRP, Lp(a), fibrinogen, blood pressure, etc.  So do NOT monitor your heart disease risk with just one number.  That said, it’s hard to beat LDL-P as the biggest cardiovascular market now and many notable high fat, Paleo and Low Carb bloggers have discussed this.

1) https://www.peaktestosterone.com/forum/index.php?topic=9550.0

2) J Clin Lipidol, 2007 Dec 1, 1(6):583 592, “LDL Particle Number and Risk of Future Cardiovascular Disease in the Framingham Offspring Study Implications for LDL Management”

3) Atherosclerosis, 2014 Aug, 235(2):585-91, “Cardiovascular risk in patients achieving low-density lipoprotein cholesterol and particle targets”

4) Am J Cardiol, 1995 Jun 15, 75(17):1189-95, “Prevalence of dyslipidemic phenotypes in ischemic heart disease (prospective results from the Qu bec Cardiovascular Study)”

5) https://www.medscape.com/viewarticle/712122_3

6) J of Clin Lipidology, “Associations of serum LDL particle concentration with carotid intima-media thickness and coronary artery calcification”

Saturated Fat: Does It Raise Cholesterol? - Peak Testosterone

Now the difference from lowest to highest is not really that great, right? This is true and, furthermore, the amount of saturated fat in butter and coconut oil greatly exceeds that of safflower oil, so, if saturated fat were a big driver of cholesterol, you would expect a much greater difference.  This is the point of the authors I mentioned above:  saturated fat should not be demonized, because it simply does not change cholesterol that much even in very large quantities.  Now I respectfully disagree with that – remember I’m all about maximizing erectile strength – and I’ll discuss why below.  But, for now, I concede the point that saturated fat does not make a massive difference in most of the typical, high cholesterol Americans out there.

Before we leave this study, let’s look at the numbers that really count:  LDL.  LDL is the “bad cholesterol” and both small and large particles can lead to arteriosclerosis.  So let’s look at what happened in the above study to LDL levels:

In this case, the type of oil used makes a bit more of a difference – 16% from lowest to highest.  And please keep reading:  I make an important point regarding LDL below.

NOTE:  Yes, I know that coconut oil has some great properties.  For example, did you know that, while coconut oil will raise LDL some, it bumps by HDL more proportionately according to some research? [3] The reason is that it is a rich source of lauric acid. In fact, some very heart healthy cultures based their diet off of coconut oil and fish. See my page on The Diet of the Tokeluau and Pukapuka. There is also an older study that shows that beef fat does not have nearly the negative impact on lipids as one might think. [4] All I can say, though, is please keep reading.

2. Normal Cholesterol. There was a theory that a certain genotype (E4 or APOE4) responded much more strongly to saturated fat than the general population.  One study looked at all the different genetic variations in those with normal cholesterol levels and came to this conclusion: [5]

“Relative to the average American diet, both the Step 1 and Low-Sat diets significantly reduced total cholesterol, LDL cholesterol, and HDL cholesterol in all three apoE genotype groups. No evidence of a significant diet by genotype interaction, however, could be identified for any of the measured lipid and lipoprotein end points.”

Basically, this study showed that that everyone (with normal cholesterol) responds to saturated fat.

3. Mildly High Cholesterol. Another study a year later again looked at these same genotypes, but this time in those with “mildly high cholesterol.”  What they found was somewhat similar:  all genotypes were responsive but the most responsive was the Apo E4 group. [6] What they did was create a diet with about half of the saturated fat of the original diet and it dropped total cholesterol and LDL levels about 15% and 9%, respectively in the E4 group.  Again, other groups dropped but not as much.

So the bottom line is that there is lots of evidence that reducing saturated fat will reduce your cholesterol levels, but the magnitude of the reduction may be determined by your genotype.  The above experts are right in the sense that much of the population does not experience a huge drop.

However, their emphasis of this point I think is a huge mistake.  First of all, those with the E4 genotype are probably put at risk.  But the other point is this:  those of us on Low Fat Diets realize that lowering BOTH saturated and total fat will usually dramatically lower total cholesterol and LDL.  The Tarahumara Indians – arguably the healthiest culture on planet earth – have cholesterol levels below 130.  My last reading was also below 130. And the solid majority of people that go on a Low Fat Diet can get their cholesterol below 150.

NOTE:  Some studies show that dropping total fat does just as much to lower cholesterol as lowering saturated fat. [8]

So, in my opinion, these health writers are implying that you can’t really significantly lower your total cholesterol.  Well, this just simply is not the case and, again, it is common knowledge in the Low Fat community that cholesterol can be lowered easily and quickly.  And, by the way, it’s not just by reducing fat in the diet that cholesterol can be lowered:  many foods do the same as does losing weight. (You’ll lose about a point in cholesterol for every pound you lose.) You don’t have to blame bad genetics on your high cholesterol:  it’s almost always possible to get it down into a safe zone with just lifestyle changes.

Now on this page I am not going to get into the cholesterol controversy.  I’ve written about that on other pages.  And, to be honest, I don’t think total cholesterol matters that much anyway.  The number that really counts is LDL, or the “bad” cholesterol.  If you care about keeping your arteries clean and clear, then you should care about LDL.  All the researchers and clinicians that I know of that regress plaque and reverse heart disease pay attention to LDL.  See my page on LDL Thresholds to Arrest or Reverse Heart Disease.

Wonder why the American Diet kills your arteries very slowly over decades and not months?  Well, the studies above show that high saturated fat tweaks up your LDL just enough to help contribute to arterial plaque buildup but very slowly. Pretty insidious, eh?  Almost diabolical some would say.  Instead of killing you overnight, saturated fat may be a factor (along with inflammation) that kills you very gently and slowly – molecule by molecule. The typical pattern is that the penile arteries fill up with plaque first, because they are smaller, and the cardiac and neck arteries follow about five years later, leading to a major event like heart attack, stroke or angina.  See my page on the The Dangers of Erectile Dysfunction for the research in this regard.

REBUTTAL? Yes, there are a couple of large epidemiological studies that show that saturated fat really doesn’t matter.  And this is more or less what one would expect based on the above cholesterol/LDL numbers.  Of course, there are many factors that contribute to arteriosclerosis and arterial hardening of the arteries, but the biggest is LDL and saturated fat has a pretty small impact in that area.  However, I don’t drink decaffeinated coffee either.  Decaff coffee actually increases LDL a little – very similar to saturated fat – for reasons that are poorly understood.  I play it safe and avoid decaff coffee, though, as I don’t need that extra boost to my LDL.

And, if you don’t think total cholesterol matters, I’d ask you to consider the APOE4 genetic group that I mentioned above.  Their skewed lipid profiles put them at risk for “atherosclerosis, Alzheimer’s disease, impaired cognitive function, reduced hippocampal volume, HIV, faster disease progression in multiple sclerosis, unfavorable outcome after traumatic brain injury, ischemic cerebrovascular disease, sleep apnea, accelerated telomere shortening and reduced neurite outgrowth.” [7] The lesson to be learned is that it does not pay to ignore your LDL numbers.

And there are other reason to be cautious about satured fat as well:

NOTE:  To be clear, if you’ve read my page on Low Fat Meats, then you know that I have no issue with a range fed, humanely treated animals sources of protein.

REFERENCES:

1) J of Lipid Res, Aug 1995, 36:1787-1795, “Effects of coconut oil, butter, and safflower oil on lipids and lipoproteins in persons with moderately elevated cholesterol levels”

2) https://culinaryarts.about.com/od/culinaryreference/a/fattable.htm

3) Am J Clin Nutr, 2003 May, 77(5):1146-55, “Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials”

4) Am J Clin Nutr, Aug 1985, 42(2):190-197, “Plasma lipid and lipoprotein response of humans to beef fat, coconut oil and safflower oil”

5) Arterioscler Thromb Vasc Biol, 1997 Nov, 17(11):2914-23, “ApoE genotype does not predict lipid response to changes in dietary saturated fatty acids in a heterogeneous normolipidemic population. The DELTA Research Group. Dietary Effects on Lipoproteins and Thrombogenic Activity”

6) Am J Clin Nutr, 1998, 68:1215 22, “Effect of apolipoprotein E polymorphism on serum lipid response to the separate modification of dietary fat and dietary cholesterol”

7) https://en.wikipedia.org/wiki/Apolipoprotein_E

8) Br Med J. Mar 2, 1963, 1(5330):571 576, “Diet and Plasma Cholesterol in 99 Bank Men”

Saturated Fat and Cholesterol Conclusions

Testosterone and Pain: Can Hurt In Some Cases?

Have you ever known someone addicted to prescription pain medications?  I have known a few, and it is ugly.  It completely changes their personality and I don’t mean for the better.  They usually struggle holding a job, develop medical issues and become toxic to their family and friends.  The tragic thing is that there is no signs of this epidemic abating anytime soon.  Consider a couple of U.S. statistics showing the inundation and permeation of society with these medications.:

–Over 200 million opiate prescriptions are written every year.  That’s over a billion pills in one year!

–There are at least 2 million people addicted or abusing painkillers each year.

When I talk about painkillers, which include such household names as oxycodone, hydrocodone, codeine, morphine, fentanyl, methadone, Demerol, Dilatid, and Oxycontin, I am referring on this page to the opiates.  These are in the same class of compounds as heroin and cocaine and bind to the same receptor.  The other more “mild” painkillers have their own problems.  NSAIDs are notorious for ripping up the GI tract, and Tylenol lowers glutathione levels, always a bad idea.

Do Painkillers Lower Testosterone?

Many men addicted to painkillers do not realize that many studies now show that these medications will lower testosterone if you use them long enough:  How does this occur?  It induces a sort of partial secondary hypogonadism, i.e. negatively impacts the HP part of the HPT axis by suppressing the hypothalamus’ secretion of gonadotropin-releasing hormone.

1.  A 2016 study showed greatly increased odds of low testosterone for men on painkillers.  The biggest drops in testosterone, 27% and 38%, were seen in senior aged men between the ages of 60 and 70 and 70+, respectively. [3]

2. A 2009 study attempted to deal more with the legitimate use of those using opiod painkillers and noted that the endocrine system should be monitored when these medications have to be used. [4] As you will see below, it would be hard to patch all the holes however.

3. A 2015 study showed the growing prevalence and recognition of this and coined the term OPIAD, “Opiate Induced Androgen Deficiency.”

3.  Another 2009 study noted that painkillers negatively impacted virtually all the major hormones that we men hold dear for sexual and cognitive performance,  body composition and muscle gains:

“Sustained-action opioids used on a daily basis for more than a month have a number of adverse effects on human endocrine function.5-14 For example, opioids decrease levels of the gonadal sex hormones, growth hormone, cortisol, and dehydroepiandrosterone sulfate (DHEAS).6,9 Opioids also blunt the cortisol response to corticotropin.” [5]

NOTE:  I cover other nasty issues in my page on illegal drugs here:  Cocaine, Heroin and Erectile Dysfunction. On there I discuss a study that shows methodone users having testosterone 43% less than controls.

Notice that your hormones start going downhill after just one month. This is how quickly painkillers do their damage on the brain, and their effect is all encompassing.  If you’ve ever been around someone addicted to these medications, you know that they can create aggressiveness, irritability, withdrawal, depression and anxiety, etc.  And it’s no wonder considering that their hormones are all under seige!

What About Pain Associated with TRT (Testosterone Replacement Therapy)?

TRT (testosterone replacement therapy) should be a health-benefitting, bedroom-boosting change for a hypogonadal man.  I know it has been a life-saver for me.  However, occasionally on the Peak Testosterone Forum I will get a complaint that TRT actually causes pain or discomfort.  Below I outline the kinds of pain-related issues that men can run into with exogenous testosterone:

1.  Back and Joint Pain (Part I). This is actually fairly common in men starting on HRT.  And the reason is simple:  men feel better (on well done) testosterone therapy and start working out more often and harder.  It is very easy to overdo it. Libido is up usually and so you want to impress the every female within a five mail radius and so you’re adding a few extra plates on the bar without even thinking about it.

Of course, the solution here is to ramp up your workouts S-L-O-W-L-Y and gradually.  You don’t have to be ready for the Olympics in two weeks, so just scale back a little and enjoy your newfound recovery and recuperative powers.

2.  Back and Joint Pain (Part II). There are can be a potentially more serious problem causing this kind of pain:  low estradiol.  Some men are very sensitive to Arimidex (and other aromatase inhibitors) and find their estradiol levels plummeting after using them.  When estradiol levels fall below about 12 pg/ml, joints can start hurting and aching.  And, unfortunately it usually takes a couple weeks for estradiol levels to climb back up to their steady state, baseline level.  This can even take longer a little longer if a Suicide Inhibitor was used.

3. Testicular Pain. When receiving exogenous testosterone, i.e. standard HRT, the testes actually shut down partially. Basically, the body begins to rely on the new source of testosterone and signals the testes that it can shut down (partially). This “shutting down” can actually cause some men some testicular discomfort. Look at what this poster wrote:

“I am on testosterone, so this does not apply to your situation. But, I had some cramping and electrical jolt feelings down there about 3 weeks after starting cream. My doc at the time said it was because they were stopping production and shutting down. Maybe any change in T production, whether up or down, causes some sensation.” [1]

By the way, this same man got rid of this pain by adding HCG to his regimen.  HCG stimulates the testes, assuming you are not primary hypogonadal, to begin some testosterone production.  For this reason, men on HRT often add HCG to their regimen in order to increase their testicular volume.  Look at what this man wrote about how HCG got rid of his pain:

“They said that part of shutting down/catabolism of the testicles could be intense pain and that HCG would help in this area. They sent me a couple of vials of HCG, I did my research, and gave it a shot for a few weeks. Lo and behold, after my 2nd injection, my pain was down by 50%. By my 3rd shot it was gone altogether.” [2]

However, I should add that HCG itself can sometimes cause some pain due to the testes growth.  Discuss with your doctor of course.

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

4.  Nipple Pain. It is possible for a man to start on HRT and experience nipple sensitivity, even pain.  This is quite common with steroid users, who go ultra-high with testosterone.  And it does happen from time to time with men on standard HRT as well.  The solution can usually be solved with Arimidex (anastrazole), which lowers estradiol.  Other AIs or SERMs may be employed, such as letrazole or tamoxifen, although this is uncommon from what I have seen.  Losing weight will likely help and/or zinc.

5. Deliver Method Pain. Many of the “delivery systems” can cause pain in certain cases. For example, it is possible to end up with the following:

a) an abscess or ulcer with injections

b) severe local rash with patches

c)  infections with pellets

Based on what I have seen, a) is very uncommon, b) is quite common and causes almost everyone to quit patches and c) is quite common but many urologists successfully avoid these potential infections by giving antibiotics the day before the procedure.  Again, talk to your doctor about his or her experience with these type of risks.

CAUTION: If you go on Arimidex or another aromatase inhibitor, be sure to monitor your estradiol with the lab’s most sensitive test.  Some men are very sensitive to AI’s and their estradiol levels will go down to the basement.  You need these very accurate tests to properly detect the numbers involved.

REFERENCES:

1)  https://peaktestosterone.com/forum/index.php?topic=1705.0

2) https://peaktestosterone.com/forum/index.php?topic=2021.0

3) Pain Medicine, Dec 2015, 16(12):2235 2242, “Effect of Opioids on Testosterone Levels: Cross-Sectional Study using NHANES”

4) Clin J Pain, 2009 Feb, 25(2):170-5, “The impact of opioids on the endocrine system”

5) The Journal of the American Osteopathic Association, Jan 2009, 109:20-25, “Opioid-Induced Endocrinopathy”

6) https://www.sciencedaily.com/releases/2013/06/130617142047.htm

8) NEJM, 1975, 292:882-887, “Function of the Male Sex Organs in Heroin and Methadone Users”

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:

Painkillers are Sex Life Killers

An uncontrolled, unstoppable erection may sound like a fantasy to most men, especially those in middle age and beyond that are struggling with erectile dysfunction.  However, any erection over a couple of hours is termed priapism and, besides being very painful, can result in permanent damage to the penis.  (Always go to the emergency room immediately if you cannot stop an erection!)

What causes priapism? Surprisingly, priapism is not completely understood.  However, there are many rather suprising triggers of priapism that many men m

1.  Alcohol.  Heavy drinking was one of the most common associations with priapism. [1] Alcohol results in vasodilation – although if you have too much it can have the opposite vasoconstricting effect –  and the right dosage apparently can overstimulate.  Probably more importantly, alcohol affects the alpha adrenergic system – more about that below. [2]

2. Trazodone.  This antidepressant is estimated to cause 80% of drug-induced priapisms and can result in some rather severe cases. [3]  One particularly gruesome case resulted in amputation of the penis. [4] If you have been prescribed this drug, beware that “in approximately 33% of the cases reported, surgical intervention was required and, in a portion of these cases, permanent impairment of erectile function or impotence resulted.” [5]

2) Alcohol Clin Exp Res, 2009 Feb, 33(2):255-63, “A pilot trial of the alpha-1 adrenergic antagonist, prazosin, for alcohol dependence”

3) https://www.medscape.com/viewarticle/549253_6, “Counseling Patients About Sexual Issues: Drug-Induced Priapism”

4) J Clin Psychiatry, 2010, 12(2), “Penile Amputation After Trazodone-Induced Priapism: A Case Report”

5) https://www.mentalhealth.com/drug/p30-d03.html

6) International Journal of Impotence Research, 2005, 17:469–470, “Priapism caused by ‘All Nite Long'”

7) Eur Urol, 1986, 12(3):169-70, “Intracavernous injection of noradrenaline to interrupt erections during surgical interventions”

8) JOURNAL OF MEDICAL TOXICOLOGY, 5(4):223-225, “Refractory priapism associated with ingestion of yohimbe extract”

9) International Journal of Impotence Research, 2005, 17:293–294, “Unresolved priapism secondary to tamsulosin”

10) Br Med J, 1979 October 27, 2(6197):1039, “Prazosin and priapism”

11) https://www.dailymail.co.uk/news/article-2032629/Man-rare-disease-causing-agonising-erections-hours-robbed-father-knife-point-buy-painkillers.html

12) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3355694/

What causes such severe cases?  Trazodone is “thought to result from unopposed ?-adrenergic blockade; pharmacologic treatment consists of infusion of ?-adrenergic agonist drugs directly into the penis.” The significance is that noradrenaline actually blocks an erection from occurring.  In fact, surgeons have injected noradrenaline directly into the penis in order to bring down erections. [7]

One can think of nitric oxide as the stimulator of erections and, in a way, noradrenaline as the dampener. When you remove the brakes, the truck just keeps rolling down the hill  with nothing to stop it. Thus,  alpha adrenergic antagonists (alpha-adrenoceptor antagonists), which decrease noradrenaline levels, are very often the root cause of priapism.

Yohimbe (Yohimbine) is also common such preparations and can lead to priapism. [8] Why is that?  One compounnd in yohimbine is an alpha adrenergic antagonist.  One poster on our forum also mentioned another “formula” that resulted in the same.  Did it also have yohimbine in it?  Who knows?

Of course, the tragedy is that many men are taking these concoctions in the hopes of helping their sex lives only to find that they have potentially damaged themselves permanently.

4.  Alpha Blockers. Did you know that there are a whole class of drugs that are, by definition, alpha adrenoceptor antagonists?  And, yes, these can cause priapism.  Again, middle-aged and senior men are particularly vulnerable, because these are commonly prescribed for BPH (enlarged prostate).  One nasty case of this is mentioned in the literature, where a man’s priapism persisted even after shunt surgery on his penis. [9] Prazosin has also been linked to the same issue. [10]

5.  Cocaine and Prescription Narcotics. Cocaine is notorious for priapism and, again, the reason is related:  it depletes the body of noradrenaline. As noradrenaline (norepinephrine) levels fall, eventually the body loses its ability to shut off an erection in many cases.

This can happen with prescription narcotics (vicodin, percoset, oxycodone, etc.) as well.  One strange story out of the U.K. in late 2011 tells of a man who, due to a medical condition, supposedly experiened painful long-lasting erections and then robbed his own father at knife point to get money to buy pain killers. [11] We ask the question, “Could he not have been first addicted to pain killers which then led to his priapism?”

6. Pomegranate Juice and Viagra. There have been several case reports of priapism resulting from this combination. Pomegranate juice is not only a potent stimulator of nitric oxide but can alter liver function.  Those taking any PDE5 inhibitor (Cialis, Levitra, Stendra, etc.) should also use caution. [12]

REFERENCES:

Estrogen, Dangers - Peak Testosterone

Much of this site focuses on ways to increase testosterone. But this emphasis on testosterone can be somewhat misleading for some men, because it implies that testosterone is the only hormone in any of the problems they might be experiencing. In reality, there is another major player, especially for overweight, middle-aged and steroid-using guys.

In fact, it is interesting that some middle aged and beyond males have normal testosterone yet they have most of the symptoms of andropause or low testosterone. How can this happen?  Because, more often than not, males with normal testosterone and andropause symptoms have overly high estrogen levels.  The reason is simply that it is the ratio of testosterone to estrogen that is ultra-critical for us guys and so increased estrogen can be just as physiologically negative for us as low testosterone.

It may surprise you to know that testosterone and estrogen are actually chemically very similar: they differ by only a carbonyl and a methyl group.  But, oh, what a difference a subtle chemical alteration can make!  Testosterone is responsible in us guys for a bigger larynx, thicker hair shafts, larger organs, augmented bone density and other traits that differentiate us from members of the fairer sex.  In contrast, estrogen in females leads to breast development and enlargement, less body hair and a more nurturing attitude.

The problem for us males is that increasing estrogen can lead to decreased libido and erectile strength. In other words, too much estrogen can literally turn you into a girly man and take your sexual legs right out from under you.  As you may know, estrogens are even associated with the “man boobs” that you see many overweight, middle aged guys struggling with. Yes, you have got to get estrogen under control!

So why do estrogen levels increase with age?  Researchers have observed is that, in general, adipose fat levels increase with aging while muscle mass decreases.  [2] As we have mentioned elsewhere, this increase in fat tissue results in increasing tissue levels of aromatase which converts testosterone to estrogen.  In fact, this conversion of testosterone is the only reason we males have any estrogen.  But this increased conversion to estrogen leaves us with less testosterone which decrease our muscle mass which makes it easier for us to gain weight and on and on the cycle goes.

NOTE: This is yet another reason why exercise is even more critical as we age: it preserves (or even builds) muscle mass and burns off fat at the same time.

So notice that one of the ugly facts of middle age is this rise of aromatase leads to a simultaneous decrease in testosterone and increase in estrogen.  The sword cuts both ways one might say.  Woe is us because we are simultaneously stripped of our primary male hormone and injected with the primary female hormone. And that means both numerator and denominator move in the wrong direction in the all important ratio of testosterone/estrogen.

This, by the way, leads to a perilous tissue accumulation of estrogen.  Researcher have discovered this in the prostate. [12] In fact, that same study concluded that “the prostatic accumulation of DHT, estradiol, and estrone is in part intimately correlated with aging”.  Estradiol and estrone are two forms of estrogen, neither of which do you want accumulating in your tissues. In other words, male menopause or andropause is as much about estrogen as it is about testosterone.

I should mention, though, that some estrogen is essential for bone health. In fact, one of the major issues that low testosterone males can have is also having low estrogen (since estrogen is made from testosterone). Low estrogen, at least in the long term, will actually lead to osteoporosis which is yet another reason to keep your testosterone up through HRT (Hormone Replacement Therapy).

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.

Estrogen: Side Effects

That said, we males only need small and youthful amounts of estrogen for optimum health. The overabundance of estrogen in middle and old age is simply a bad dream. Here are just a few of the nasty things estrogen can do to us:

So how can you keep the female hormone in check?  Read my links on How to Control Estrogen. You should also ehck out How to Increase Your Estrogen (Estradiol) Levels as well for some of the good, bad and ugly things that can increase T and E2.

REFERENCES:

2) Medical Hypotheses, Jun 2001, 56(6):702-708, “Aromatase, adiposity, aging and disease. The hypogonadal-metabolic-atherogenic-disease and aging connection”

12) J Clin Endocrin Metab, 1993, 77: 375-381, “Effect of aging on endogenous levels of 5-alpha-dihydrotestosterone, testosterone, estradiol and estrone in epithelium and stroma of normal and hyperplastic human prostate”

Arimidex and Estrogen - Peak Testosterone

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://peaktestosterone.com/forum/index.php?topic=295.msg2616#msg2616

2) https://peaktestosterone.com/forum/index.php?topic=433.msg4718#msg4718

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

4) https://hrt-rx.com/2012/06/05/ arimidex-vs-femara-for-increasing-testosterone-in-men-hrt/

5) Fertility and Sterility, Jul 2012, 98(1):48-51, “Changes in hormonal profile and seminal parameters with use of aromatase inhibitors in management of infertile men with low testosterone to estradiol ratios”

6) Molecular and Cellular Endocrinology, 16 May 2006, 250(1-2):2-7, “Hormonal approaches to male contraception: Approaching reality”

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

8) J Sex Med, 2012 Jun, 9(6):1681-96, “Estrogens in Men: Clinical Implications for Sexual Function and the Treatment of Testosterone Deficiency”

9) J Urol, 2013 Feb, 189(2):647-50, “Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy”

Some of the more forward thinking doctors are now prescribing Arimidex in conjunction with HCG.  HCG, of course, stimulates the testes to produce testosterone and is used primarily to avoid testicular shrinkage, but it can also cause estradiol problems downstream.  One of the more famous “internet hormone doctors” is Dr. Eugene Shippen and one of our Peak Testosterone posters went to him.  Dr. Shippen’s overall protocol for this man, whose testosterone was 296 ng/dl, was as follows:

“He sent back a letter and a prescription for Clomid. (for 7 day stimulation test) My results showed I had Secondary Hypogonadism. My T had risen to 541, My E2=47, and DHEA was below the bottom of normal and D3 was low. On May 30th I went to Pa. to meet with him, he spent over 2 hours going over all my test results and did a physical that included a prostate check. He order[ed] the following meds: HGC, Arimidex, and 25mg DHEA oral supplement. I must have a followup blood test in 3 weeks for T, E2, and DHEA-S. Then in 6 weeks a full blood workup for Endocrine testing. He wants me to take D3 4000mg daily and drink Pomergranate juice plus Vit. C 1000mg.” [1]

Of course, in this case Arimidex was used in conjunction with HCG, but it is also often used by itself. Look at what one of the men on the Peak Testosterone Forum experienced:

“Having said that, Arimidex has done wonders for me in the 2 months i’ve been taking it, and my E2 was only 48 after a few months on hcg. the doc prescribed me 0.5mg ED, which is higher than what most people I read about on msg boards take. I tried that at first, felt nothing for about 10 days, then all of a sudden I started waking up with the biggest erections I had experienced in many years. and libido came back and now I think about sex all the time. just the hcg alone wasnt doing it for me even though it did raise my T levels. i have now cut back to 0.5mg EOD, which is still higher than most people seem to take, but it seems to be working for me. I read a comment on another more steroid oriented forum where a guy was saying to calibrate the Arimidex dosage based on morning wood, because if it gets too low you wont have it, but if it’s just right it will be huge and powerful.” [2]

NOTE:  Arimidex is not the only way to clinically lower estradiol.  There are other aromatase inhibitors, such as letrozole (Femara), for example.  There are also irreversible aromatase inhibitors.  See my page Suicide Inhibitors for some background information.

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

Arimidex also has a big advantage for younger men wanting to possibly have kids: it does a much job at preserving fertility than traditional testosterone therapy.  Classic HRT (Hormone Replacement Therapy) will generally significantly decrease fertility, making childbearing difficult to impossible.  In fact, the new 6-week testosterone therapy injectable, Nebido, is actually being used as a quasi-contraceptive by some men.  And there is considerable research going on to find the best way to use HRT to achive a reliable male contraceptive. One research summary even wrote that “current hormonal combinations completely suppress spermatogenesis without severe side-effects in 80 90% of men, with significant suppression in the remainder of individuals. Recent trials with newer, long-acting forms of testosterone combined with progestogens have yielded promising results and may soon result in the marketing of a safe, reversible and effective hormonal contraceptive for men..” [6]

The aromatase inhibitors (AI’s) can sometimes bypass that concern.  (Confirm with your doctor, of course.)  In fact, Arimidex will actually improve some fertility parameters.  One recent study looked at Arimidex and found that, besides delivering a nice boost in testosterone, FSH was largely unchanged and sperm density was increased by 78%. [4][5] For these reasons, fertility doctors will sometimes use Arimidex to treat male fertility issues.  For example, you might be started on Clomid for a few months and, if your testosterone is too high, Arimidex (anastrozole) may be prescribed in combination.  Or some men are started with both immediately and then monitored.  Again, I’m not a big fan of Arimidex due to the above four concerns, but some physicians do make use of it.

These types of fertility treatments for men are much more common than generally realized:  male fertility is probably impacting up to a fourth of all troubled pregnancies. Fertility doctors also tend to be much more cutting edge when it comes to boosting testosterone than many traditional doctors, such as urologists, endocrinologists and primary care physicians. Why? Fertility specialists have been treating men for over a decade with alternative treatments and are interested in preserving libido, which requires good testosterone levels, along with boosting sperm parameters. Thus, they have on average built up a lot more experience than most other specialities.

However, I should point out that some physicians are now using low dose HCG in conjunction with testosterone therapy in order to maintain fertility.  For those interested, see a fertility specialist familiar with Dr. Lipschultz’s work.  [9]

Arimidex and Testosterone Therapy

Arimidex (anastrozole) is also quite commonly used in men who are on testosterone therapy (HRT or TRT).  The reason is that 80% of a man’s estradiol comes from the conversion of testosterone into estradiol in the fat tissue through the aromatase enzyme.  The more weight that a man has gained, the higher the estradiol levels that he will have on average.  Furthermore, some TRT providers push men to very beefy levels of testosterone, say 1000-1200 ng/dl, which may be above the man’s natural set points.

When I first started cypionate injections at an HRT clinic, they put me on low Arimidex just a couple of months later. This really surprised me, because I really did not want to have to “medicate my TRT.”  The argued that the dose was very low compared to, say, a cancer patient, and it has no real side effects when done properly, i.e. estradiol is not sent overly low.

So for a few months I took .5 mg twice a week.  I then pushed them to let me lower it to .25 mg twice per week.  Both of these doses are pretty common for men on testosterone, and I see it quite often on the Peak Testosterone Forum. But I did everything in my power to get off of Arimidex and used a threefold approach to actually accomplish the task:

This allowed me to get off of Arimidex completely.  My testosterone levels are still very solid and in the 700-800 ng/dl range.  And in my opinion almost every guy on TRT should endeavor to do the same, because this will generally be more physiological, or natural.  Plus, the cautions and risks cited above for Arimidex Monotherapy also apply here as well.

Of course, Arimidex is often used by steroid users to decrease over-aromatization from driving their testosterone into supraphysiological zones, i.e. way above normal, which in turn leads to elevated estradiol.  They aslo use it post-cycle period when they are desperately trying to get their testosterone jumpstarted – sometimes unsucccessfully I might add. As strange and annoying as this is, steroid users and fertility doctors were some of the early pioneers of Armidex usage.

CAUTIONS: However, Arimidex is not something that should be used unless it is under a doctor’s supervision, primarily because estradiol, the E2 estrogen, needs to be monitored.  One of the problem’s with Arimidex is that one can easily push estrogen levels too low.  In the short term this can lead to joint pain.  Scientists are not sure why, but, when estrogen gets too low on Armidex, the joints can begin to be very painful.

Even more dangerous, though, would be long term damage fromm overly low estrogen levels.  Low E2 will eventually lead to bone mass loss, i.e. osteopenia and ultimately osteoporosis.  See my link on Why Men Need Estrogen for more details.

Arimidex can also negatively effect libido.  The thinking is that if estradiol gets driven too low that sex drive goes with it.  Again, estrogen in males has a fairly tight therapeutic range with too much or little decreasing sexual desire. (It can also send libido thorugh the roof!)

DHEA Replacement Therapy - Peak Testosterone

How many times have you had DHEA pulled by your physician?  Probably never.  That should be no surprise, considering that the great majority of physicians do not believe in DHEA Replacement Therapy.  However, in my opinion DRT (DHEA Replacement Therapy) should be almost as common as TRT (Testosterone Replacement Therapy). (I made up DRT, but I think it’s a good acronym.)  The reason is simple:  it is quite common for men to be very low in DHEA.  What is the difference between this and hypogonadism in men?

In addition, there are very powerful arguments for DHEA Replacement Therapy:  hormones that are good candidates for replacement are ones that commonly decrease with aging.  DHEA definitely fits in this category and, in fact, drops more as a percentage than any other hormone.  If you check out my page on DHEA Levels in Men by Age, you will see just how dramatically levels fall from the age of 30-40 to 80.

And, as is so often the case with these kind of hormonal drops with aging, low levels have been linked to a great many chronic disease conditions. So are we really supposed to believe that low DHEA levels are good for you? Isn’t it more logical to believe that this is just an unfortunate (but correctable) part of aging, such as is encountered with collapsing levels of testosterone, SOD, CoQ10, etc.?

And I would argue that we should handle DHEA in a manner very similar to testosterone:

WHY DON’T DOCTORS TREAT LOW DHEA? DHEA is not even on the radar of most physicians.  They are so busy with acute care that they cannot possibly test your for  DHEA.  If they do, DHEA has a huge lab range and, if you fall in that range, 99% of physicians will ignore the result – case closed.  Doctors are just now being trained in the most rudimentary knowledge regarding testosterone. Expecting them to understand the pros and cons of DHEA is just unrealistic at this point.  Most of them will hand you some Cialis or Prozac and send you on your way.

This is very unfortunate, because they are completely ignoring a flood of pro-DHEA research that has come out in the last ten years.  For example, there are risks with being deficient: The Risks of Low DHEA. I cover the many huge benefits of DHEA for men here. But let me give you a few teasers points and, again, these only apply to men that are low in DHEA (as measured by DHEA-S):

1. Nitric Oxide.  Men, take note:  DHEA stimulates nitric oxide production and has a receptor in endothelial (arterial lining) tissue, something I discuss in page on the The Benefits of DHEA. DHEA also generally boosts free testosterone (but not total) in men.  See my page on Testosterone and DHEA for more information.

So DHEA clearly seems appropriate from the aging standpoint, but, of course, the real test is whether or not DHEA Replacement Therapy has done well in the studies.  The answer is ‘yes,’ of course, and I document some key examples below.  I also want to mention that DHEA  got rid of my lifelong anxiety, something I discuss in my page on DHEA and Pregnenolone.

2. Lowers Inflammatory Cytokines. Cytokines are the inflammatory messengers associated with a host of chronic disease:  cancer, heart disease, autoimmune disease and Alzheimers.  The most potent and well-known cytokines are IL-6 and TNF alpha. A recent study gave a group of seniors between the ages of 65 and 75 50 mg of DHEA daily and observed that “there were significant decreases in the plasma concentrations of TNFa and IL-6 in response to 1 year of DHEA replacement.” [6]

3. Improved Insulin Resistance. One of the struggles for many of middle and senior age is an increase in insulin resistance.  The same study above found that “it was evident on evaluation of the data, that improvements in glucose tolerance in response to DHEA occurred only in those participants who had abnormal glucose tolerance. We, therefore, did a separate analysis on the glucose tolerance data of the participants who had abnormal glucose tolerance initially. The improvements in glucose tolerance and AUC after one year of DHEA replacement was considerably greater when the results are not diluted by the values obtained on the participants with normal glucose tolerance.” [6] A 2007 study found that DHEA helped lower advanced glycemic end produts and oxidative stress in diabetic patients, and it’s no wonder of course. [3]

4. Lowered Body Fat.  DHEA supplementation was found in one study to lower BOTH kinds of body fat: subcutaneous and visceral (belly or stomach). [4] This same study found that insulin sensitivity was improved as well and also included only senior patients (between the ages of 65 and 78).

You’re right – it doesn’t get much better than that!  Inflammation, insulin resistance and weight gain our biggest enemies as men age and DHEA is clearly a powerful weapon in our arsenal against all three of them.

REFERENCES:

1)  N Engl J Med, 2006; 355:1647-1659, “DHEA in Elderly Women and DHEA or Testosterone in Elderly Men”

2) New England Journal of Medicine, 1986, 315:1519-1524, “A prospective study of dehydroepiandrosterone sulfate, mortality and cardiovascular disease”

3) Diabetes Care, Nov 2007, 30(11):2922-2927, “Dehydroepiandrosterone Administration Counteracts Oxidative Imbalance and Advanced Glycation End Product Formation in Type 2 Diabetic Patients”

4) JAMA, Nov 10 2004, 292(18), “Effect of DHEA on Abdominal Fat and Insulin Action in Elderly Women and Men”

6) Aging (Albany NY), 2011 May, 3(5):533 542, “Dehydroepiandrosterone (DHEA) replacement decreases insulin resistance and lowers inflammatory cytokines in aging humans”

a) Test to see if ayou are “deficient” or very low in DHEA, actually DHEA-S in this case.

NOTE:  Testing is inexpensive and you do not need a doctor’s orders with these labs:  Cheap Men’s Lab Testing. It is always better to work with a doctor, naturopath or Life Extension Foundation when it comes to hormones in my opinion.

b) Treat if and only if you are low on the range or below the lab’s range.

c) Raise DHEA-S levels to physiological levels – perhaps upper mid in the lab range – using low dose DHEA, usually 15-50 mg/day.

d) Monitor symptoms and DHEA-S levels afterward.  (Occasional side effects are poor sleep, increased estradiol or PSA, etc.)

Again, this is exactly what any decent physician does with with testosterone and there is no reason to divert from this procedure with DHEA either.  I would add that my experience to date with DHEA has been excellent.  DHEA Replacement Therapy got rid of my lifelong struggle with anxiety. TRT got rid of about half of it and the addition of DHEA the other 50%, and you can read about it here if you are interested:  Lee Myer’s Experience with DHEA and Pregnenolone.

:Interview with Dr. Barnard's , Joseph Gonzales.

One of the most well-known of all the Low Fat experts is Dr. Neal Barnard. I recently contacted his organization and asked them some of the questions that I get asked on The Peak Testosterone Forum from time to time. Dr. Barnard’s dietician, Joseph Gonzales, was nice enough to answer us and his very interesting and timely responses are included below. One of the huge assumptions of the Cholesterol-Doesn’t-Matter Movement is that cholesterol is good for the brain. Below you’ll read a study that should make any such person pause and reflect. You don’t need to consume a bunch of saturated fat – wild game generally has relatively little by the way! – to artificially ramp up your cholesterol production and Mr. Gonzales explain just why below.

Q1. I want to start by asking about PCRM, the Physicians Committee for Responsible Medicine. Can you give everyone a brief introduction as to what you and your organization are all about and hope to achieve?

A. Our nonprofit organization, founded by clinical researcher Neal Barnard, M.D., in 1982, advocates for preventive medicine, advanced research methods, and encourages higher standards for ethics and effectiveness in research. Endless research shows that low-fat, plant-based diets can prevent and reverse chronic diseases, including diabetes, heart disease, and cancer. Throughout our clinical research at the Physicians Committee, we ve helped hundreds of people transform their lives by making simple dietary changes.

To this effect, the Physicians Committee created the Power Plate, a visual tool to show consumers how to follow a healthful plant-based diet. A year later, the USDA launched My Plate, which bears a striking resemblance to the four food groups on PCRM s Power Plate: vegetables, whole grains, fruits, and legumes. We re happy to provide resources that influence federal legislation, shape dietary guidelines, and provide people with information that can save their lives.

Q2. Power Foods for the Brain is very timely, because a common claim that I receive on the forum and in emails is that a Low Fat Diet is hard on the brain because the brain is “the largest repository of cholesterol”. Can you give us a quick synopsis as to why a Low Fat is actually incredibly GOOD for the brain?

A. Studies show that diets high in saturated fats can more than double your risk for Alzheimer s disease. In the American diet, the biggest source of saturated fat is from dairy products cheese, ice cream, butter, and milk. Meats chicken, sausage, burgers, and roast beef are a close second.

Researchers from the Chicago Health and Aging Project find that over a four-year period, people who got around 25 grams of saturated fat each day had at least twice the risk of developing Alzheimer s disease compared with those who got only about half that much.

Saturated and trans fats cause your body to make more cholesterol, which, in turn, clogs your arteries and limits blood flow to your brain, putting you at risk for stroke.

Cholesterol also increases the production of beta-amyloid and plays a role in the formation of beta-amyloid plaques in your brain, which can lead to Alzheimer s disease. People who carry the APOE4 gene absorb cholesterol more easily from their digestive tracks compared with people who do not have this allele. As a result, APOE4 carriers tend to have a higher risk of both heart disease and stroke. The good news? Genes do not determine our destiny; they merely act as committees and suggest orders.

Q3.  Of course, a low glycemic Low Fat Diet can largely or completely reverse both (adult onset type II) diabetes and heart disease as your book describes in great detail. What other chronic disease conditions does a Low Fat Diet target extremely well?

A. A low-fat, plant-based diet is shown to alleviate chronic pain, including arthritis and migraines; prevent certain forms of cancer, especially colorectal and breast cancers; and can stave of Alzheimer s disease and dementia.

NOTE: My wife battled with migraines and got rid of them when she went to lowish fat, raw foods type diet.

We continue to hear about people who improve all other aspects of their life ranging from curing allergies to reversing Crohn s disease by making simple dietary changes. One of my favorite stories is from Randy Hale, an Oklahoma man, who thought a low-fat vegan diet was a bacon diet. He overhead a PBS interview about Dr. Barnard s 21-Day Kickstart program and decided to give it a try. He soon found no meat was allowed but went all out for 21 days. For three weeks he ate a diet rich in vegetables, fruits, whole grains, spices, and legumes. It s been a year and Randy hasn t looked back since. The result? He lost more than 40 pounds in six months, reversed type 2 diabetes, went off all medications, and has influenced several residents in Oklahoma City to test-drive a healthful plant-based diet. Randy no longer worries about living long enough to enjoy the company of his children; he now hikes 100 miles each month and can easily keep up with his energetic granddaughter.

Q4. One of the big objections to whole grains that I hear is that some of the most accessible and familiar grains (wheat, corn and soy) are heavily GMO’d. I avoid the issue by eating a lot of quinoa, beans and fruit/vegetable smoothies. Do you feel these GMO concerns are overblown? And, if not, how do you recommend men interested in Low Fat living circumvent this issue?

A. There remains a lot of controversy about GMO s but research consistently shows the health benefits of simple plant-based foods, including whole grains. I advise complex carbohydrates and prefer ancient grains, including brown rice, oats, barley, quinoa, spelt, and whole-wheat linguine. I start my day with a big bowl of oatmeal and top it with berries, a handful of nuts, and serve it with a green smoothie. Complex carbohydrates provide nourishment and certain grains, including oats and barley, provide soluble fiber, which lowers cholesterol levels.

About one in ten people do have a gluten sensitivity. If you suspect you fall into this category, eliminate wheat from your diet for three weeks and see if you notice a difference.

Q5. Would you like to fill us in on any new recent studies, projects or books? And do you have a home site where men can keep track of your latest advice and recommendations?

A. You can follow the advice of some of the best athletes in the world NBA champion John Salley, ultra marathoner Scott Jurek, and Ironman Brendan Brazier at 21 Day Kick Start, a free online program that goes live the first day of each month. We have a community forum where you can get direct feedback from our team of registered dietitians. You can also download healthful meal plans, find restaurants in your area, and liaise with fellow Kickstart participants. Better yet? You can create your own success story, whether you re aiming to build muscle or shed a few pounds.

You can follow the latest research at Dr. Bernard’s Web Site and access additional nutrition information at Nutrition MD.

Berberine: How It Helped Me Lower My A1C Below 5.0 - Peak Testosterone

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

PSA: What Does It All Mean? - Peak Testosterone

Well, it’s time to get personal I suppose.  I just had my PSA reading and, in case you were wondering, the reading was 0.8 ng/ml. Now, since the standard threshold for prostate cancer is 4.0 ng/ml, I’m completely and utterly out of the woods, right?  After all, my PSA is about a fifth of what it should be, eh?

Actually, nothing could be further from the truth and this is important because I should in no way take a decent PSA reading as a reason to discontinue standard Prostate Cancer Preventative Measures. For one thing, I spent decades as a good American eating buckets of red meat, dairy and heterocyclic amines, all of which are infamous for promoting cancer “down under”.  [1] (Actually, the data linking hetercyclic amines and prostate cancer is now considered questionable.)  Faithfully, every day all a human being reasonably could to maximize their prostate cancer risk and so, unfortunately, I will need to be ever cautious.

Besides that, the actual PSA reading is increasingly controversial with regard to its accuracy in predicting prostate cancer.  Unfortunately, it is quite correlated with a number of unrelated conditions including BPH, infections and even testosterone levels.  However, it is still important to get a PSA reading, because even a very small increase in PSA could indicate prostate cancer. This is why it is still very important to get your PSA checked and establish a baseline.  In fact, one paper points out that an increase as small as 0.2 ng/ml often indicates prostate cancer. [2]  Also, this same paper points out that the median PSA reading for men in the 50’s in 0.7 and guys in their 40’s 0.6, so my readings were nothing to brag about in the first place.

The bottom line is that you’re going to see me eating my broccoli and tomatoes for a lot of years to come.

REFERENCES:

1) CANCER CAUSES AND CONTROL, 2001, 12(6):557-567, “A prospective study on intake of animal products and risk of prostate cancer”

2) https://urology.jhu.edu/newsletter/prostate_cancer820.php

Compounding Pharmacies and 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?

1) Potentially Enjoy the Freedom of Paying Cash. Many men do not have the option of insurance or would just like the convenience and control of running their own TRT (in conjunction with a good physician of course).  Well, you can afford to do this with compounded products!  If you don’t mind paying cash, you can a) pick and choose an expert TRT physician, b) and stop worrying about prior auths, changing formularies, delays in getting refills, etc. and c) control your target level (wth your doc), something that is more difficult with a product like Androgel.

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!

REFERENCES:

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/ingredients/703207-ISOPROPYL_PALMITATE/

Cyclo Bolan: Testosterone Destroyer - Peak Testosterone

REFERENCES:

1) Digestive Diseases and Sciences, May 2009, 54(5):1144-6 Severe Cholestasis and Renal Failure Associated with the Use of the Designer Steroid Superdrol (Methasteron): A Case Report and Literature Review

2) American Journal of Gastroenterology, 2006, 101(11):2659-2662, “Cholestatic Jaundice and IgA Nephropathy Induced by OTC Muscle Building Agent Superdrol

“hi, read and printed out many of the articles from your site. Found it by accident when researching gynecomastia. I’m afraid I may have a mild form of it since I took a weight lifting supplement a year ago which wiped out my testosterone and HDL, while it skyrocketed my cholesterol and LDL. I read somewhere that when testosterone production halts, estrogen steps up to the plate.”

“Well your site was very informative and answered many questions. I suspect ALL of my health problems are directly or indirectly related, such as hair loss, low energy, low libido, etc. But it wasn’t until I noticed mild gynecomastia that I’ve become greatly concerned.”

“Do you have a program to reduce gynecomastia? There were some sites that said it is irreversable since scarring occurs after 12 months. Also there are many name brand supplements and foods – do you have a do and don’t list or are there any brand names you recommend in particular?”

This reader was quite casual about it all, which is unusual. Generally, young steroid users are very panicked. (From what I have seen, steroid users are almost always young, say, less than 35.) Notice the many nasty side effects that he noticed after taking this supplement:  “hair loss, low energy, low libido.”

What he doesn’t know is that he got off “lucky.”  Cyclo Bolan is composed of two steroids, halodrol and superdrol, both of which have heavy side effects. This reader didn’t know it, but he got off “lucky.”  Both superdrol and halodrol are very hard on the liver and many studies in the journals have reported the same. [1][2]  Testosterone can often be restored by a good doctor but you only have one liver. And on Cycle Bolan in just a few weeks you can find that your cholesterol has gone through the roof and you’re peeing brown urine and have jaundiced (yellowed) eyes and skin.  Oy vay!

Also, this young man was not exaggerating when he said that his testosterone was “wiped out.”  If you read what he wrote back below, you can see that he had a reading of 11 – yes, 11! – after taking this supplement. That is one of the lowest readings I have ever had reported:

“The supplement was Cyclo Bolan by Infinite Labs. it was banned by the FDA. Yes, I got blood tested today. My doctor says that it should be reversable so I’m hopeful. she also mentioned putting in Chrysin into a transdermal testosterone cream.”

“I know your article said that chrysin doesn’t work but did you mean oral adminstration only?…My testosterone dropped to 11 last year and has since returned back up to 340’s. But that was in March. My doc seems to think it could have dropped again since then.”

Is it a given that he will get his testosterone back?  Usually doctors can jumpstart testosterone in steroid users, but that is not a certainty.  Sometimes T levels are permanently damaged.

In any event, I wanted to pass along the dangers of this supplement as a warning.  Steroids are dangerous for professional athletes, but they are at least generally under experienced clinical supervision and monitoring.  I believe the original Cyclo Bolan was discontinued and Infitine Labs sells a similarly named product that is based on Tribulis. However, I would not touch anything from that supplement manufacturer as they clearly have no interest in your health.  Superdrol and halodrol are still widely available, though, and I advise everyone to stay completely away from either.

Yes, a lot of those mammoth, muscle bound young guys in the gym are risking life and limb and liver. I never heard back from this reader:  I hope everything came out well for him.  He told me that I could pass this information along, by the way, to maybe help out some other men out there.

Fast Food and Excitotoxins - Peak Testosterone

I don’t get scared very easily, but when I got the “allergy menu” from a waitress at a Denny’s, I wanted to hide under my mattress and never eat out again.  The “allergy menu” was a list that Denny provides of menu items that contain various things that cause allergies.  Of course, Denny’s is living back in the 80’s with an outdated viewpoint that the only issue that MSG, or monosodium glutamate, causes is allergies, which is why it is on its allergy menu.

Of course, this is a naive way to look at things and God only know how many hypothalmuses their policies have whacked.  Look at the items below and think of some poor mother unwittingly feeding her one or two year old a good dose of neuron killing excitotoxins, thinking that she is doing the opposite and treating her family to a nice, down home meal [1]:

Marinara sauce, sausage links (breakfast), chicken noodle soup, clam chowder soup, vegetable beef soup, country fried steak, croutons, caesar dressing, fat free ranch dressing, regular ranch dressing, brown gravy, turkey gravy and mozzeralla cheese sticks.

And what a potential: you go in to order something that you think is healthy, like a salad or pasta with marinara sauce, only to get a nice dose of brain busting excitotoxins heaped onto your plate. This is the picture of irresponsibility that plagues the food industry. Simply to add a little flavor enhancement, they will put our craniums at risk!

By the way, it is not just Denny’s:  most of the fast food and restaurant chains do the same thing.  It is a crapshoot as to whether or not you can avoid MSG.  Another example is Burger King. I have often ordered a Veggie Burger thinking that I am partaking of something semi-health only to find out that it is laden with monosodium glutamate. In fact, Burger King apparently goes to great lengths to load these patties with almost every form imaginable of MSG including “Textured Vegetable Protein (TVP), Calcium Caseinate, Hydrolyzed Corn, Soy, and Wheat Protein, Autolyzed Yeast Extract, Natural Flavors”! [2] I should have known better than to trust my health to a fast food corporation, but at least I won’t make the same mistake again.

Other Burger Kind items that include monosodium glutamate are “BREADED ORIGINAL CHICKEN PATTY (Fried), SPICY CHICK N CRISP PATTY, Breaded TENDERCRISP Chicken Filet (Fried Whole Muscle Breast), CHICKEN FRIES (Fried), Crown Shaped CHICKEN TENDERS (Fried),GE (Fried), TENDERGRILL CHICKEN FILET, GARLIC PARMESAN CROUTONS – SALAD TOPPINGS, LOADED POTATO Topping (for Steakhouse Burger), SMOKY CHEESE SAUCE, BISCUIT, CROISSANT”. [2]

And you wonder why you have low testosterone and erectile dysfunction?  Welcome to the world of food engineered excitotoxins!

NOTE:  Do you feel like crap and don’t know why?  You may have Excitotoxin Syndrome.  If so, please read about it here.

REFERENCES:

1) Denny’s Allergens and Sulfites Nutrtional Information sheet, received in the store 5/26/2009.

2)

Processed Foods and Flavors: Healthy Foods Turned Toxic .

I’m almost to the point where I make all of my own food.  Why?  Masochism?  Paranoia?

I’ll let you be the judge, but the more I see the less I feel I can trust anyone in the food industry.   An excellent example of this is actually not fast food and mac and cheese, but ingredients that seem to target the health-conscious.  Below I’ve listed some examples of foods that should be healthy, but, unfortunately for those seeking to optimize their health and well-being, these foods have actually been perverted and corrupted into Frankenfoods.

Furthermore, if you consider how these foods are advertised and labelled, you can’t help to wonder if there’s not a little bit of camouflaging going on. Examples abound, but here are a few notable ones:

1) Yeast. Nutritional yeast and even brewer s yeast are very healthy foods known for being high in B vitamins. What does the food industry do with yeast? They place it into concentrated salt solutions that dry and shrivel the yeast cells and heat what remains at high temperatures. Why on earth would they do this to this otherwise healthy good? The answer is to create a monstrosity called “autolyzed yeast extract”, Autolyzed yeast extract which is rife with not just one of the major excitotoxins, but both:  monosodium glutamate and aspartate.  Concentration levels are very high, usually in the 10-20% range by weight. This is particularly dangerous for children, but even adults can get themselves in trouble as well.  If you buy processed foods, you’ll see this over and over again.  Read my link the Danger of Excitotoxins for what this does to your poor hypothalamus.

2) Soy. Soy is considered by many to be one of the supremely healthy foods and is a staple of many vegetarian and vegan diets. Soy is admittedly controversial, but it definitely has numerous studies showing cardiovascular benefits, anticancer properties and even nitric oxide stimulation. Regardless of your feelings about soy, and I am very cautious because it may shrink the brain in males, consider what the food industry does with this food. In order to extract the oils from soy during processing, hexane is used. Hexane is a nasty industrial toxin with carcinogenic properties and contamination of soy products has been widely reported of late. Bon appetit…

3) Whey. Whey is the king of proteins used by bodybuilders and athletes the world over. It boosts immunity, increases glutathione and has an excellent amino acid profile. But is it really all goodness and light? Not once the food goons get done with it! For reasons unknown, whey is almost always processed with a process called hydrolyzation, i.e. heating at high temperatures. (For more details, see my link on Whey and Excitotoxins.)

This leaves the consumer with a toxic mixture of excitotoxins, including abundant free glutamine and aspartates. Furthermore, it also insures the anhilation of its glutathione boosting properties. Again, I cannot imagine why anyone would even conceive of doing this, yet most bodybuilders have no idea that, in their efforts to improve their health and muscle mass, they may be taking out their neurons.  This isn’t just an issue for the muscle heads by the way:  hydrolyzed whey, soy and vegetable proteins are put in many processed foods, leaving the public vulnerable to excitotoxin exposure.

4) Toothpaste. Okay, this isn t a food, but health-minded people put this in their mouth several times a day and some is swallowed and aborbed. Many health-conscious people know that gum disease is associated with cardiovascular disease due to increased inflammation levels. So we all break out our toothpaste and begin the war against all that is orally evil never suspecting that the cure is likely worse than the disease.

Yes, indeed, toothpaste is full of questionable and even downright toxic ingredients. Let s look at some of the ingredients in Colgate Total Plus Whitening Toothpaste as of 3/17/2011. We ll start with Triclosan. This is the potentially dangerous pesticide that I cover in my links on The Dangers of Antimicrobial Soaps and Toothpaste Dangers. CAUTION:  Be cautious about using baking soda as an alternative toothpaste:  some experts believe it can damage enamel over time.

REFERENCES:

1) https://www.ccohs.ca/headlines/text186.html

Aphrodisiacs: Male Libido Supplements - Peak Testosterone

Or maybe you’re a male who just wants to enhance your sexual desire using some scientifically-backed male libido supplements?  Well, we have good news:  there are several legitimate, scientifically-verified such supplements that seem to work quite well on the male brain.. Yes, it’s Christmas at Peak Testosterone.

However, one should keep in mind that there are several medical conditions that can cause waning libido, almost all of which should be checked by a doctor.  For example, no male libido supplement on planet earth can help stimulate you if you are low in testosterone.  Testosterone is simply too intimately tied to male libido.  Read this link on Low Testosterone Symptoms if you think that might be an issue.  Lack of sleep, depressed immunity, depression, stress, relationship issues and many other things can do the same.

1)  Maca.  We have already covered Maca’s sperm and erection enhancing properties in our discussion of Maca and in our Erection Supplementation Guide. But what you may not know is that Maca has had a reputation for centuries among Peruvians for its libido-increasing powers among male tribal members.  And animal studies bear out the ancient wisdom. [1]

In fact, one animal study turned rats into rabbits.  Don’t believe me?  It all started when researchers studied rats and put one male rat in with two virgin female rats.  Rat heaven, eh?  Researchers were astonished to find that each male rat entered, i.e. penetrated the female rats over fifty times in a three hour period! [2] When is the last time you did that, mate?  This greatly exceeded the number of penetrations performed by the Maca-less rats. Those rats just couldn’t get enough.

2) Muira Puama. Maca comes from Peru. Muira Puama comes from the same continent in Brazil. Most of the studies on Muira Puama’s aphrodisiac qualities have been done by a Frenchman. But, then, who better to study an aphrodisiac than a Frenchman, right?  One of his studies on human subject showed that about 2/3 of low libido participants were helped by taking Muira Puama. [3]

3) Tribulis Terristris. Tribulis is tremendulis and fantabulis. We have covered this herb elsewhere, including How to Improve Testosterone and Super Sexual Herbs, but made scarce mention of the fact that Tribulis Terristris also has evidence of being a decent male libido supplement at least in animals. [4] It seems to work this magic by increasing DHEA and Nitric Oxide.

4) Ginseng. Korean Ginseng was shown in one study to improve erectile strength and function in a number of ways, including boosting the beloved Nitric Oxide. [5]  This same study found that Ginseng boosted libido and other animal studies have implied that sexual desire is enhanced by this herb as well.

5) A specific extract of the food and spice Fenugreek has been shown to be a significant libido and orgasm booster.  For more information, see my link on The Benefits of Fenugreek. (There are a couple of Cautions with this herb as well.)

CAUTION 2: One male libido supplement that gets some press is Damiana.  However, it’s powers are poorly documented and debatable in males anyway.  In addition, it has been shown to be estrogenic, the last thing most of us guys need. [6]

CAUTION 3:  Some pills are what I would call an anti-aphrodisiac. Beta blockers (for high blood pressure/arrythmias) are notorious libido reducers.  Cimetidine (Tagamet) for stomach acid is another interesting case, because it can actually cross the blood-brain barrier and somehow interferes with sexual desire in many patients. [7] Dopamine is, in general, associated with an increased sex drive and seratonin with the opposite.  For this reason, almost all common antidepressants can lead to a loss of libido. In fact, the research shows that a great many of the antidepressants lead to loss of libido, erectile dysfunction and delayed orgasm. [8]

1) J Ethnobiology, 1981, 1:208-212

2) Urology, Apr 2000, Qun Yi Zheng

3)  Ethnopharmacology, Mar 1995, Male Sexual Asthenia – Interest in a Traditional Plant Derived Medication

4) Ann Acad Med (Singapore), Jan 2000, 29(1):22-26

5) Int J Impot Res,Sep 1995,7(3):181-6, “Clinical efficacy of Korean red ginseng for erectile dysfunction”

6) Journal of Ethnopharmacology. 120:387-393, “Anti-Aromatase Activity of the Constituents from Damiana (Turnera diffusa)”

7) Can Med Assoc J, Aug 18 1979, 121(4):404 405, “Diminished libido with cimetedine therapy”

8) Indian Journal of Medical Sciences, 2001, 55(3):139-148, “Antidepressants induced sexual dysfunctions”

Viagra Failure - Peak Testosterone

Viagra. Cialis.  Levitra.  These are a miracle in a bottle, right?  Well, not for a huge percentage – around a third – of middle-aged and beyond men. These drugs fail and fail miserably for them – they simply do not work.  (And sometimes failure occurs with these PDE5 Inhibitors due to nasty side effects including headaches and hearing, vision and stomach disturbances.)

I have already documented many reasons for their lack of effectiveness in my link on Why Viagra Doesn’t Work.  However, I want to cover another important reason for Viagra failure here:  lack of baseline nitric oxide production in men that are 40+.

This point was emphasized in a Recent Interview with Nathan Bryan, one of the world’s foremost experts on nitric oxide. In this interview, Dr. Bryan explained how PDE5 Inhibitors work, which is by inhibiting the activity of an enzyme that breaks down nitric oxide. In other words, and as I have explained often on this site, Viagra and other similar drugs do not actually directly increase NO, they merely allow it to stay in your system longer.  This is only effective if you have sufficient baseline nitric oxide production in the first place. As Dr. Bryan put it, “Without production of NO, this pathway does not and cannot work. In fact, this is why Viagra and Cialis do not work in 100% of the population.”

And Dr. Bryan himself has pointed out that most 40-year-old men will only produce half of the nitric oxide that they did when they were 20. [1] This is a drastic reduction! It’s a wonder us old timers can even have an erection, eh?

Now imagine what happens when a man has “endothelial dysfunction.”  His arteries and veins have been damaged, inflamed and coated with extra plaque after years of lifestyle abuse.  His nitric oxide is will be in even worse shape. The reduction in blood flow will affect almost every system in his body, including those affect his sex life. And for him taking Viagra, Cialis or Levitra is doomed to failure.

So is there any hope?  Are there any natural ways to boost nitric oxide for a man with nitric oxide insufficiency?

Yes! I hope that you’ve already found many of these ways as you’ve searched around my site, but let me summarize some of the key ways that you can get your nitric oxide levels back in shape:

1.  Diet.  One of the ways you can increase baseline nitric oxide production is through consumption of nitrates.  I discuss many of these in my book on book Peak Erectile Strength Diet, but spinach and beetroot juice are classic examples. Nitrates are converted to nitrites by bacteria on your tongue and to NO in your stomach and gut.  In addition, many of these foods will also enhance and protect your nitric oxide, thus effectively raising nitric oxide levels farther downstream.

CAUTION:  Avoid amines when consuming nitrates in the diet. Certain cheeses and meats may combine with nitrates and create carcinogenic compounds called nitrosamines.  In addition, avoid consuming supplemental Vitamin C with any fat in the stomach for a similar reason.

2.  Neo40.  This new supplement works via not allowing supplying baseline nitrates, but also by adding an enzyme that helps the body convert the nitrates more easily to nitric oxide. [1]

NOTE:  You can boost the power of all of these through exercise.  Exercise is a potent booster of nitric oxide and researchers believe it works primarily by increasing the bioavailability of the same enzyme that Viagra works on. So then does it really increase baseline nitric oxide production?  Well, exercise gets you to the same point through a different route:  it increases the number of new capillaries and veins throughout the body, a fact I cover in my link on Exercise and Erectile Dysfunction.  This has a similar net effect as #1 and #2 above – more blood flow to more tissues.  See my link on Sexercise for a dozen other reasons to exercise as well.

REFERENCES:

1) https://findarticles.com/p/articles/mi_7396/is_334/ai_n57416886/pg_4/ ?tag=content;col1

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.

Aromatase Inhibitors While on HRT (TRT) - Peak Testosterone

Before we go into this, let’s discuss just what an aromatase inhibitor does.  Aromatase is the enzyme that converts testosterone into estradiol is us men.  As it turns out, both aging and the weight gain that accompanies aging leads to greater conversion of our testosterone into estradiol, the “bad estrogen”, that is responsible for so many well-known issues in men, including (often) prostate issues, gynocomastia and erectile/libido/hormonal problems.  Aromatase is in fat cells and as our fat cells expand from a sedentary lifestyle and/or overeating, we men can easily end up with too much aromatase.

NOTE: Aromatase is also involved in the creation of estrone via conversion from androstendione.

This is where the aromatase inhibitors come in. They work by binding to aromatase, thus taking it “out of commission”.  So why would so many men be on AI’s (aromatase inhibitors)? First of all, a few men on the Forum have tried aromatase inhibitors for medical reasons.  For example, estradiol can play a major role in gynocomastia.  An aromatase inhibitor such as  Arimidex (anastrozole) – occasionally letrozole is used – is used quite commonly to prevent or reverse gyno.  (Tomoxifen, which is a SERM, is also used and actually goes after prolactin and probably estrogen receptors in your chest/breast tissue.)

These usages of AI’s are relatively uncommon. However, it is Arimidex’s usage in HRT (testosterone therapy) that has now become increasingly common.  From what I have seen, if a man goes over a total testosterone of about 600 ng/dl, he will very likely need an aromatase inhibitor.  In fact, one of the biggest reasons that I see for issues with HRT is when doctors do not treat the elevated estradiol levels that can occur boosting a man’s testosterone.  The symptoms are very similar to those for low testosterone:  mood crashes, loss of libido, erectile dysfunction and so on.

That said, many doctors do know about the importance of managing estradiol with testosterone replacement and will give their patients Arimidex.  The dosage is usually very low – .5 to 1.0 mg/ week split it into two – compared to that given to prostate or breat cancer patients.  Many men are now going to HRT clinics as well and these almost universally prescribe Arimidex, because  testosterone levels are typically pushed into the 800-1200 range (peak).  The purpose of the Arimidex is to get men into the 20-30 pg/ml range.  And there have been literally dozens of men on Arimidex on the forum following this or a similar protocol.

It should be pointed out though that men can easily get over high estradiol levels from the following situations as well:

2.  Being on Clomid to boost testosterone (and preserve testicular function and fertility) or get off of HRT.

3.  Being on HCG Monotherapy.  (See my page on HCG Monotherapy for more information.)

So, if you put all these cases together, many more men may be using an aromatase inhibitor than you might think, especially as  testosterone therapies, both standard and alternative, have grown and expanded in popularity over the last decade.  And almost all of them are using Arimidex.

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

Why, then, the Arimidex obsession?  Well, first of all, it is now quite reasonably priced after going generic a couple of years ago.  And it has broad application and relatively few side effects if a) used at a lower dosage and b) plasma estradiol levels are regularly monitored and managed.

NOTE:  Arimidex is very powerful and higher dosages (1 mg/day) will lower “estradiol by approximately 70% within 24 hours and by approximately 80% after 14 days of daily dosing.” [1] Other studies have shown that you can get even greater reduction in estradiol levels however. [2]

However, there are definitely other aromatase inhibitor options out there and a couple of them may be more applicable, i.e. discuss with your doctor if appropriate:

1.  Letrozole (Femara). One study (in women) showed that Arimidex could achieve almost total suppression of estradiol levels but was still detectable.  However, letrozole was even more powerful and could achieve total suppression of estradiol to where it could not even be detected! [2]  Now you have to be careful in going too low with estradiol as it can actually be dangerous and lead to osteoporosis, mood and erectile issues, etc., something I document in my link on “Do Men Need Estrogen?”.

However, in some cases, that slight extra horsepower from letrozole can help with gynocomastia, at least according to the “common knowledge” on the steroid forums. The general feedback is that anastrozole can prevent gyno usually, but letrozole can actually reverse it (in some cases).  Discuss with your physician of course as letrozole has a repulation for more side effects.

2.  Suicide Inhibitors (such as Aromasin). These “type I” type of aromaste inhibitors do their work using a little different technique:  they actually bind to the aromatase enzyme and permanently and irreversibly take it out of commission.  This may seem really ugly, but the body rebuilds those enzymes after a few weeks usually.  These type of inhibitors are popular in the steroid community and men that are doing HRT on their own (which I don’t advise).  However, I have not seen many HRT clinics, urologists, endos or PCPs. using them.

One study on young men showed that 25 and 50 mg dosages both reduced plasma estradiol levels by about a third in 14 days, which is not a bad reduction. [3] I cover these types of aromatase inhibitors in more detail in my link on Suicide Inhibitors.

SIDE EFFECTS: Side effects are minimal on these drugs assuming that estradiol levels are kept in a safe range. Most of the nasty side effects come from men and women who have greatly suppressed their estradiol due to cancer treatment. However, it should be pointed out that Arimidex, for example, affects liver enzymes and may also raise inflammatory cytokines.  I hope to do a page on this soon.

REFERENCES:

1)   https://www.rxlist.com/arimidex-drug/clinical-pharmacology.htm

2) Journal of Clinical Oncology, Feb 1 2002, 20(3):751-757, “Influence of Letrozole and Anastrozole on Total Body Aromatization and Plasma Estrogen Levels in Postmenopausal Breast Cancer Patients Evaluated in a Randomized, Cross-Over Study”

3) The Journal of Clinical Endocrinology & Metabolism, Dec 1 2003 88(12):5951-5956, “Pharmacokinetics and Dose Finding of a Potent Aromatase Inhibitor, Aromasin (Exemestane), in Young Males”

Alcohol: Friend or Foe? - Peak Testosterone

Alcohol – is it good for you or bad for you?  Does it protect your heart or endanger it?  Well, the answer to those questions require more than just a simple “yes” or “no”.  The overwhelming consensus is that alcohol, one or two drinks per day, is heart-protective. And since heart disease is the number one killer of us males, this has often put alcohol center stage as a healthy addition to a fit lifestyle.

How does it do its cardiovascular magic?  Alcohol, again in doses of one or two drinks per day, raises HDL levels, [1] which is cardioprotective and can even stimulate erection-producing Nitric Oxide. It also seems to stabilize arterial plaques and somewhat reduce their formation as well. [15] Alcohol, in moderation of course, also thins the blood and reduces clotting and, of course, it is clotting that can contribute to MI’s (heart attacks). This also helps explain how several studies have also found that moderate alchohol consumption reduces the risk for stroke which are the results of clots. [8][9]

Alcohol has also other good properties as well.  Red wine, for example, has been found to be significantly protective of Prostate Cancer. A 2010 study found that moderate drinking was able to significantly protect the brain. [12]  Other cross-gender studies have shown the same thing. [13] [14]

So moderate alcohol consumption is a no-brainer, right?  As is often the case, the story is much more complex. Alcohol produces toxins and carcinogens, increases the risk for certain cancers and lowers levels of many critical nutrients and antioxidants.

The truth is that there is an alternative:  a Low Fat Diet.  A Low Fat Diet, such as the Ornish Diet, is so heart protective that it actually reverses arterial plaque. As I have pointed out, cultures and people that have maintained cholesterol below 150 for a substantial portion of their life have virtually no heart disease. In addition, Low Fat Diet also looks very protective against prostate cancer as well.

REFERENCES:

1) Diabetologia, Oct 2004,(47)10:1760-1767(8)

2) Eur J Cancer Prev,Feb 2006,15(1):69-73

3) Ann Intern Med,Apr 2004,20;140(8):603-13

4) Hypertension. 2005;45:851-852

5) Alcohol, Jan 2001,23(1):35-9

6) Alcoholism: Clinical and Experimental Research, Published Online: 23 Oct 2009, “Alcohol Stimulates Activation of Snail, Epidermal Growth Factor Receptor Signaling, and Biomarkers of Epithelial Mesenchymal Transition in Colon and Breast Cancer Cells”

7) Cancer Epidemiology, Biomarkers and Prevention, Dec 2003, 12:1540-1543, “Risk of Basal Cell Carcinoma in Relation to Alcohol Intake and Smoking”

8) NEJM, 319:267-273, Aug 4 1988, “A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women”

9) JAMA, Feb 5 2003, 289(5):579-588, “Alcohol Consumption and Risk of Stroke”

10) Nucleic Acids Res, 2005, 33(11):3513-20, “Polyamines stimulate the formation of mutagenic 1,N2-propanodeoxyguanosine adducts from acetaldehyde”

11) Alcohol and Alcoholism, 21(1):81-84, “ALCOHOL ENHANCES VITAMIN C EXCRETION IN THE URINE”

12) N Engl J Med 2005; 352:245-253, “Effects of Moderate Alcohol Consumption on Cognitive Function in Women”

13) Age and Ageing, 2007, 36(3):256-261, “Moderate alcohol consumption in older adults is associated with better cognition and well-being than abstinence”

14) British Medical Journal, 2004, 329:538-539, “Daily Alcohol in Your 40 s Increases Risk of Mild Cognitive Impairment” (NOTE: Authors found that moderate drinking improved cognition and more than that lowered it.)

15) American Journal of Epidemiology, 2005, 162(4):391-392, “ALCOHOL CONSUMPTION, BINGE DRINKING, AND EARLY CORONARY CALCIFICATION: FINDINGS FROM THE CORONARY ARTERY RISK DEVELOPMENT IN YOUNG ADULTS (CARDIA) STUDY”

16) Cancer Detection and Prevention, 2009, 32(5):352-362, “Lifetime consumption of alcoholic beverages and risk of 13 types of cancer in men: Results from a case control study in Montreal”

HANGOVER:  What about if you go overboard and drink more than 1-2 drinks?  It turns out that there is some research showing which foods are actual Legitimate Hangover Aids and Cures

Blood Pressure. Alcohol, at least beyond some threshhold which is probably around three drinks for most individuals, increases blood pressure. [4] Again, this is not an issue for moderate drinkers.

Glutathione and Vitamin C. Two of the body’s key antioxidants are glutathione and Vitamin C.  Alcohol consumption lowers levels of both of these key protective agents. In the case of glutathione, this occurs because it binds to carcinogens and toxins produced by alcohol in order to protect the body. Alcohol also leads to increased urinary excretion of Vitamin C. [11]

Improving Your Fertility Naturally - Peak Testosterone

I occasionally get letters asking how to increase male fertility so I felt it was time to cover some of the basics.  But, first and foremost, let me congratulate you because “it’s time to party!”  That’s right – did you know that the average couple takes 104 times in six months to get pregnant and has sex four times per week! [28] Okay, you’re going to pay the price for the next 18 years, but it’s going to be the best half year of your life in the meantime!  One in ten women said they literally jumped their man as he walked in the door and another one in ten said they called him home from work for a little love making. Get busy and populate!

Now, in spite of the fact you’d like that to probably last forever, you’ve got to do your part and maximize your chances for a pregnancy.  The drive to have children is incredibly deep for women and you could have a frustrated or even depressed woman on your hands otherwise.  And, in spite of what a lot of guys think, often infertility issues have to do with the male not the females.  A lot of guys think, “Look! Sperm came out – it can’t be my problem.”  However, it has been recently estimated that the male plays a role in a quarter to a half of all couples with fertility problems. [4]

So my purpose is to show you males how to give it “your best shot” and optimize the probability of pregnancy from the man’s side.  Below are the key ways that researchers have found to help you do just that:

CAUTION:  Always check with your doctor before taking a supplement.  It is his or her job to know the latest research on fertility.

1) Zinc. Low levels of zinc can lead to a reduction in male fertility.  Let me quote from one journal article:  “Studies have demonstrated that zinc therapy results in significant improvement in sperm quality with increases in sperm density, progressive motility and improved conception and pregnancy outcome.” [1]

2) Saturated Fat.  A few recent studies have found that diets high in saturated fat dietary lead to significantly decreased fertility and a tremendous difference in sperm quality. [30]  One of the studies found a dose dependent response to saturated fat in the diet, i.e. the more saturated fat, the less the fertility.  In this study, the effect of high levels of saturated fat in the diet was so powerful that the researchers basically speculated that this may explain the decreases in fertility that we have been seeing in many countries around the globe: [38]

“Our findings are of potentially great public interest, because changes in diet over the past decades may be part of the explanation for the recently reported high frequency of subnormal human sperm counts. A reduction in saturated fat intake may be beneficial for both general and reproductive health.”

3) Fruits and Vegetables. Since they help with almost every other physiological function, is it any wonder that fruits and vegetables also improve sperm quality?  [13] And I don’t know about you, but I want to be a quality guy. And remember:  it’s much better to guy organic more than likely – see #4:

TRIVIA: Did you know that your fertility could have been affected by your mother’s beef consumption during pregnancy?  Read this link on The Importance of the Prenatal Lifestyle.

4) Pesticides. Harvard University recently uncovered evidence that pesticides in fruit and vegetables can actually affect sperm counts and fertility. [40] Okay, I doubt you’re picking yourself up off the floor with that bit of news, but it is nice when science confirms common sense, eh?  Basically, they took a group of men and controlled for various known fertility factors and still found an association based on pesticide consumption.  Now, admittedly, it involved a lot of assumptions, but it would help explain why sperm counts are so decreased in the last few decades.  Again, buy organic if at all possible.

5) Heat. You probably already heard this from the doctor, but heat and sperm do not go together. You might want to consider boxers and, whatever you do, do not set the laptop you know where!  Even pants that are too snug can do a number on the little guys.  So remember:  keep the spring breezes blowing down there.

6) Scrotal Fat. This is an expression for fat in the area of the scrotum (nuts, huevos, balls, etc.).  The problem is that fat in this area acts like a nice, warm winter blanket and elevates temperatures of your little swimmers.  And as you probably know, this kills and immobilizes sperm.  One study found that five out of six infertile males had high scrotal fat. [7] Yet another study found that lipectomy, a surgical fat-removing procedure, greatly increased sperm count, motility and pregnancy rates. [8]  So what generally causes increased scrotal fat?  You guessed it – being overweight.

7) Overweight. If you have a gut around your waste, you should be aware that it is associated with decreased male fertility. Now I have to be careful here:  I do not want to make anyone feel guilty about not having children simply because they have some extra pounds.  But, on the other hand, I have to tell you the truth and the truth is that a spare tire can lower your odds for pregnancy.  Increased BMI (Body Mass Index) in particular has been associated with male infertility.  One study found, for example, that men with fertility issues were three times as likely to be overweight with a high BMI (BMI > 30). [5]  Many studies have confirmed this same finding. One study in particular went into great detail and found in 81 infertile men that total sperm count, sperm motility and semen volume were all negatively correlated with various combinations of waist circumference, hip circumference and BMI. [6] Why are those extra pounds such an issue in pregnancy?  Three simple reasons:  1) decreased testosterone, 2) oxidative stress (which can damage sperm DNA amoung other things) and 3) increased temperatures in the scrotum (from fat in the area of the scrotum and from a sedentary lifestyle).  Being overweight also can lower follicle-stimulating hormone, FSH, and luteinizing hormone, LH, in overweight men as well, another risk factor.

WARNINGS: 1) If you don’t know: Chlamydia is a bacterial STD that is often symptomless. In females, it can potentially result in loss of fertility due to damage to the end of the fallopian tubes and lead to increased likelihood of tubal pregnancies. The solution? Have her get tested yearly with a simple swab or urine test if applicable. 2) Also, read the discussion below for how Viagra and other PDE5 inhibitors may affect fertility! 3) In addition, I would recommend reading this link on Excitotoxins and Your Child: these have the potential to be much more deadly to your childs testosterone and fertility than even pesticides.

8) Stress. We have told you many of the evils associated with Stress and Cortisol: it destroys your brain, your arteries and your testosterone.  And you can probably guess where I’m going next:  it can also cause fertility issues.  This is probably because stress lowers testosterone.  In fact, scientists have found out how stress lowers your testosterone:  through a tricky little enzyme called 11 HSD-1led 11 HSD-1. [3] Your body produces most of its testosterone in the “Leydig Cells” and this enzyme keeps cortisol, the primary stress hormone, from pushing down your testosterone.  It literally puts the brakes on cortisol from destroying your testosterone.  However, in times of stress, there is simply too much coristol versus 11 HSD-1 and this leads to a decrease in your testosterone production.  Of course, anything that lowers testosterone is bad for fertility.

In addition, researchers at Berkeley found that cortisol from the adrenals lowers GnRH, thus lowering testosterone and estrogen, and boosts GnIH, which hammers fertility. [36] So to have a kid you gotta relax!  See my links on Stress Management, The Relaxation Response, Secular Meditation and PMR for some good ideas on how to do just that.

9) Excitotoxins.  These nasty chemicals, found in many items in your supermarket, can kill your fertility.  Be informed and read this section on Excitotoxins.  These are also a tremendous risk to your children as well.

10) CoQ10. CoQ10 is more than just an antioxidant:  it is also involved in energy production.  And, apprently, they give energy to your little swimmers as well.  Research shows that in men with male fertility issues, i.e. low male-factor fertility rates, that 60 mg/day of CoQ10 increased sperm motility and fertilization rates significantly. [9]  Another study showed CoQ10 correlated not just with sperm motility but also with sperm count as well.  [10]

11) HRT/Androgel/Testim/Testosterone.  CAUTION: Take care with testosterone if you are trying to get your woman pregnant. (You really need to take care if you are trying to get someone else’s woman pregnant for completely different reasons.)  Supplemental testosterone of any form can lower Leutinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) levels and lead to lower sperm counts and fertility.  This requires a urologist or endocrinologist that specializes in this area and is willing to carefully monitor you.

12) Varicoceles. These are basically varicose veins in the testicle area.  Some studies have shown that they can decrease fertility and others have shown the opposite. However, WebMD’s is unambiguous and states that varicoceles “affect 10% to 15% of men and can interfere with sperm function.” [15] The same article goes on to report a new minimally invasive procedure that uses a small catheter with great success.  This procedure was found to significantly improve sperm activity and counts and, in addition, 26% of the couples tested were pregnant six months later. Again, a specialist is recommended if you have this kind of issue. Varicoceles, and the ensuing loss of blood supply to the testicle, can effect all the hormonal output of the affected testicle.  One study showed that varicocele surgery boosted testosterone an average of 28% in a test group of 53 infertile males. [19]

13) Soy. Watch the soy. In a recent study men who had a half serving or more of soy had decreased sperm concentrations to the tune of 41 million less sperm per ml, which sounds like a lot to us. No other sperm parameters were affected, such as motility or quality or semen volume. [11] But the bottom line is that soy gives you less sperm which could impact fertility rates.

14) L-Arginine.  A deficiency in L-Arginine can lead to a low sperm count. Several researchers have used it successfully in his practice to improve fertility and sperm counts (in one case 4 g orally daily).

15) Vitamin E.  Sperm actually store Vitamin E and animal studies have shown that it increases sperm motility [17] and viability (in adverse, post-thaw conditions). [18]

16) Marijuana or Cannabis. Please tell us you are not a regular cannabis user.  Besides problems with fertility, marijuana can effect hormones and erectile strength.  Please read this link on How Marijuana Can Destroy Your Hormones, Fertility and Lead to Impotence.

17) Viagra. There is a laboratory study that shows that Viagra negatively impacts sperm.  Again, this in the laboratory only and has not been shown in vivo. The researchers found that Viagra actually overstimulated the sperm by affecting something called the “acrosome reaction”, which is a critical process whereby sperm releases enzymes to makes its way into the egg for fertilization.  This seems to be primarily by ushering more calcium into the cell and also changing the energy levels of the sperm, causing the sperm to be overly active.  Again, this is something to consider as many guys take Viagra in order to increase fertility.  (Pfizer has gone on record stating that there is no effect on fertility.  And if you can’t trust a huge pharmaceutical giant, who can you trust?)

However, it should be mentioned that a more recent study on actual human subjects showed that Viagra did actually increase sperm motility by about 30%. [23] Cialis, on the other hand, decrease sperm motility in the same study by about 25%.

18) Ejaculate.  As you know I often point out How Sex is Good for Erectile Dysfunction and Sex is Good for Hormones, but that’s not the end of the story:  it looks like sex is also good for sperm!  Probably because the little guys spend less time in storage, sperm shows higher quality and less DNA damage.  (Heat, oxidative damage and other factors can damage sperm as they sit in the male body.) In one recent study males with fertility problems were asked to ejaculate once per day and that signficantly helped reduce DNA damage. [14]

19) CoQ10. A 2004 study found that CoQ10 improved both sperm counts and motility. [16]  Participants were males aged 25-39 who took a rather hefty 200 mg/day dose for six months.

20) Phthalates.  Avoid these bad boys like a plague. These softeners of plastic are linked to lowered sperm quality [20] and DNA damage [21]. For more information, see this link on Common Chemicals That Lower Testosterone.

21) Chlamydia. Get screened for this STD:  a recent study linked it to infertility in both men and women. [22]

22) Bisphenol-A (BPA). This xenoestrogen is prevalent in plastics and foods and causes a host of health issues, including increased sterility in males. See this link on on Bisphenol-A for more details.

23) Chronic Non-Moderate Alcohol Consumption. Chronic and non-moderate alcohol consumption is strongly associated with lowered testosterone in animal studies.  Interestingly enough, lowered testosterone is usually followed by a protective feedback loop where LH (Leutinizing Hormone) and FSH (Follicle Stimulating Hormone) are increased.  Unfortunately, in these case alcohol actually lowers all three:  testosterone, LH and FSH in unison, which will of course lead to decreased fertility. [24]

24) Soda. Scientists have found a correlation between coke consumption and lousy sperm counts. [25] It could be because the Sugar Lowers Testosterone or some other factor that we do not yet understand. At this point, it could also just be the lifestyle of soda drinkers. Regardless, drinking a lot of coke is probably not a good idea if you are trying for children.

25) Panax (Korean) Ginseng. One study on rats showed increased sperm count and motility from Ginseng. [26]  This was verified in a (small) study on male subjects as well. [27]

26) Avoid Cell Phones? One recent study shows that cell phone usage may lower male fertility levels. [29] Researchers have not yet isolated an underlying cause, but a likely culprit is alterations in the brain’s pituitary output since the men had lowered levels of Luteinizing Hormone.

27) Pomegranate. Fruits and vegetables, in general, improve fertility.  So it is not too surprising that one animal study shows the pomegranate increases sperm quality. [39] (It also can help with erectile function – see my page on Pomegranate Juice and Erectile Benefits.

28) Elevated Prolactin. A very common cause of inferility in men can be elevated prolactin levels. [31] For some additional information, see this link on Testosterone, Prolactin and Prolactinomas.

29) Tongkat Ali (Eurycoma Longfolia). This herb has been shown in a number of animal studies to greatly improve male fertility.  One study on rats found that not only was only plasma testosterone increased but testosterone in the testes as well and sperm counts, motility and morphology were all improved. [32] Another side benefit of Tongkat Ali is that it also is tied to improved libido in a number of animal studies. [33][34]

30) Triglycerides and VLDL. Elevated triglycerides are a risk factor for heart disease and erectile dysfunction, so why not infertility as well, eh? That is what one study found. Not surprisingly, researchers also found VLDL (small dense “bad cholesterol” particles) were also a significant risk factor. Of course, the reason is that these are a sign of the Metabolic Syndrome and Insulin Resistance. [35] This is a big subject, but elevated triglycerides are generally related to too many refined carbohydrates in the diet.  And both VLDL and triglycerides follow around individuals eating high glycemic load carbohydrates like an attack dog, clogging arteries and, apparently, damaging sperm parameters as well.

31) Progesterone. 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. [37] You can get your levels checked at one of these Man Friendly Labs.

REFERENCES:

1)  J of Andrology, Feb 2000, 21(1):53-57

2) Indian J Physiol Pharmacol, 1987, 31:30-34; Eur J Obstet Gynecol Reprod Biol, 1998, 79:179-184; Andrologia, 1988, 20:21-22

3) J Androl, 1997, 18:475-479

4) Campbell’s Urology, M Sigman and J Jarow, 2002, p. 1475-1531

5) WHO Laboratory Manual for the Examination of Human Semen and Sperm Cervical Interaction, 1999

6) Andrologia, 2005, 37(5):155-159

7) Br J Urol, 1981, 53(1):50-54

8) Br J Urol, 1981, 53(1):55-61

9) Molecular Aspects of Medicine, 1997, 18(1):213-219

10) Journal of Andrology, 1994, 15(6):591-594

11) Jorge E. Chavarro, Thomas L. Toth3, Sonita M. Sadio4 and Russ Hauser, Hum. Reproduction,. advance access published online on July 23, 2008, Soy food and isoflavone intake in relation to semen quality parameters among men from an infertility clinic

12) Hendler, M.D., Ph.D., Sheldon Saul, The Doctor’s Vitamin and Mineral Encyclopedia, 1990, p. 209-215;  Quillin, Ph.D., R.D., Patrick, Healing Nutrients, 1989, p. 274, 368

13) Fertility and Sterility, Still online published only, “A low intake of antioxidant nutrients is associated with poor semen quality in patients attending fertility clinics”; Jaime Mendiola, Ph.D.ab, Alberto M. Torres-Cantero, M.D., Dr.P.H.bc, Jes s Vioque, M.D., Ph.D.cd, Jos M. Moreno-Grau, Ph.D.e, Jorge Ten, Ph.D.a, Manuela Roca, M.D., Ph.D.b, Stella Moreno-Grau, Ph.D.e, Rafael Bernabeu, M.D., Ph.D.

14) Dr. David Greening, Jun 2009, presented at the 25th annual meeting of the European Society of Human Reproduction and Embryology in Amsterdam.

15) WebMD The Magazine, Nov/Dec 2008,  p. 14.

16) Fertil Steril, 2004, 81:93-98

17) J Androl, 1996 Sep-Oct, 17(5):530-7, “Lipid peroxidation and human sperm motility: protective role of vitamin E”

18) Arch Androl, 1994 Jul-Aug, 33(1):11-5, “Effect of natural antioxidants tocopherol and ascorbic acids in maintenance of sperm activity during freeze-thaw process”

19) The J of Urol, 154(5):1752-1755, “The Effect of Varicocelectomy on Serum Testosterone Levels in Infertile Men with Varicoceles”

20) Epidemiology, 2003, 14:269-277, “Phthalate Exposure and Human Semen Parameters”

21) Environ Health Perspect, 2003, 111:1164-1169, “The Relationship between Environmental Exposures to Phthalates and DNA Damage in Human Sperm Using the Neutral Comet Assay”

22) Human Reproduction, 19(5):1121-1126.”Demonstration of Chlamydia trachomatis IgG antibodies in the male partner of the infertile couple is correlated with a reduced likelihood of achieving pregnancy”

23) Fertility and Sterility, 88(4):860-865, “Alterations in sperm motility after acute oral administration of sildenafil or tadalafil in young, infertile men”

24) Natl Inst on Alcohol Abuse and Alcoholism, “Alcohol and the Male Reproductive System”, Mary Ann Emanuele, M.D., and Nicholas Emanuele, M.D.

25) American Journal of Epidemiology, 2010, originally published online on March 25, 2010 ,171(8):883-891, “Caffeine Intake and Semen Quality in a Population of 2,554 Young Danish Men”

26) Fertility and Sterility, Oct 2007, 88(4):1000-1002, “Korean ginseng induces spermatogenesis in rats through the activation of cAMP-responsive element modulator (CREM)”

27) Panminerva-Med, 1996 Dec, 38(4): 249-54, “Effects of Panax Ginseng C.A. Meyer saponins on male fertility”

28) Dailymail.co.uk, DAILY MAIL REPORTER, Last updated at 12:31 PM on 16th August 2010, “104th time lucky: Average couple has sex more than 100 times before falling pregnant”

29) ScienceDaily, 19 May 2011. Web. 23 May 2011, Queen’s University, “Cell phone use may reduce male fertility, Austrian-Canadian study suggests.”

30) Hum Reprod, 2012, 27(4), “Dietary fat and semen quality among men attending a fertility clinic”

31) Rev Fr Gynecol Obstet, 1977 Oct, 72(10):631-40, 641-4, “[Investigation of the gonadotrophins and prolactin in sterile men (the LH-RH + TRH test) (author’s transl)]”

32) Natural Product Communications, 2009, 4(10):1331-1336, “The effect of Eurycoma longifolia on sperm quality of male rats”

33) Fundam Clin Pharmacol, 2002 Dec, 16(6):479-83, “Effect of Eurycoma longifolia Jack on orientation activities in middle-aged male rats”

34) J Basic Clin Physiol Pharmacol, 2003, 14(3):301-8, “Eurycoma longifolia Jack enhances sexual motivation in middle-aged male mice”

35) Systems Biology in Reproductive Medicine, “Correlation of Seminal Parameters with Serum Lipid Profile and Sex Hormones”

36) https://www.berkeley.edu/news/media/releases/2009/06/15_stress.shtml

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

38) Am J Clin Nutr, Feb 2013, 97(2):411-418, “High dietary intake of saturated fat is associated with reduced semen quality among 701 young Danish men from the general population”

39) Clin Nutr, 2008 Apr, 27(2):289-96, “Effects of pomegranate juice consumption on sperm quality, spermatogenic cell density, antioxidant activity and testosterone level in male rats”

40) Hum. Reprod, 2015, First published online: March 30, 2015, “Fruit and vegetable intake and their pesticide residues in relation to semen quality among men from a fertility clinic”

Permanent and Irreversible Aromatase Inhibitors - Peak Testosterone

Many men know what an aromatase inhibitor is since Arimidex (anastrazole) is now used in so many HRT and fertility clinics. Or, if you’ve been around athletes or bodybuilders, the subject has very likely come up at one time or another. What most men don’t know is that there is a whole new class of aromatase inhibitors called “suicide inhibitors”, “permanent aromatase inhibitors” or “irreversible aromatase inhibitors”. One of the most famous of these is an FDA-banned compound called 6-OXO that took the bodybuilding world by storm about ten years ago and was subsequently banned in May of 2009.

The FDA’s Warning Letter sounded particularly ominous and stated that “the condemned Formadrol Extreme XL contained ATD and 3,6,17-androstenetrione (also known as “6-OXO”). Both of these substances are steroids that inhibit the activity of the enzyme aromatase and may be found in dietary supplements promoted to boost testosterone levels..” [1] Earlier in the letter it stated the FDA’s reasoning which was that “based on laboratory tests, the FDA determined that the products contain one or more unapproved food additives and/or new dietary ingredients for which there is inadequate information to assure that the ingredients do not present a significant or unreasonable risk of illness or injury.”

6-OXO is a very powerful suicide inhibitor and the FDA had a point:  why did the manufacturer not have to prove safety like other AI’s that have gone through clinical trials?  In fact, there is an actual suicide inhibitor that has received FDA approval for the treatment of breast cancer called Aromasin or Exemestane. (Aromasin is already significantly used in the steroid community even though it is relatively new.)

So what are the properties of these new AIs?  Are they really permanent and irreversible?

Here are a few facts about them:

So how dangerous are these drugs? Well, keep one thing in mind: they are fairly extensively used by the steroid community as I mentioned and have been used by women, of course, for breast cancer treatment.   So, generally speaking, they should be safe for short term use.  However, there are a few important things to keep in mind in my opinion:

1.  Permanent Means Permanent? We had one board member who seemed to have had permanent damage from taking a product with suicide inhibitors.  His symptoms of low testosterone starte appearing after he took a testosterone supplement called Arime Stage 5 PCT.  This appears to have several suicide inhibitors.  One them was Androst 5 and, based on the ingredient label naming, there were a couple more in their as well. [5] Almost 3 months later, this 22-year-old still had estradiol of 6 pg/ml!  This is a very low and dangerous level of estradiol and can lead to many issues including bone loss, as I document in my link Do Men Need Estrogen?

Now this may be a bad lab read.  This man have had some other medical issue that was pushing down his estradiol.  But it is very coincidental that immediately after he took this supplement he felt terrible and then his estradiol was in the basement.

2.  Permanent Means Semi-Permanent?. There have been reports of people experiencing multi-month side effects.  For example, check out this study of one woman’s case of hypothyroidism that may have been induced by Aromasin (Exemestane):  “We believe that the increasing fatigue and weakness in our patient might have been associated either with subclinical hypothyroidism or with administration of exemestane (a known adverse effect of the drug) or both. Further studies are required to investigate how exemestane influences thyroid function.” [7]

3. Untested Supplements. Labs are pumping out these AI’s and they are showing up in testosterone and AI-esque supplements.  I mentioned a couple above and Arimistane and 6 Bromo are also quie well known.  There are a dozen smaller permanent AIs as well.

Th problem with all of them is that of the users of these are young bodybuilders and athletes who often do not understand what they taking.  And the supplement in this case is certainly not going to say, “This is an irreversible suicide inhibitor that is untested and experimental”.

In fact, here is what one of the ads reads: “ArimePCT Stage 5 by EPG was created to suppress estrogen levels while you increase testosterone levels. ArimePCT Stage 5 helps restore your hormonal balance and prevent muscle loss after any testosterone boosting anabolic cycle.” This is just too muich temptation for some guys to resist.

So what’s the harm?  Think how powerul these drugs are.  They can deactivate one of the most important enzymes in your body.  Do they afffect other enzymes?  Well, no one knows, because there has been no testing done.  For example, Canadian authories reported that one popular supplement containing 6-OXO and a steroid named 1-AT likely caused seizures and clotting in one man. [7] This could be a life-changing event for someone needless to say.  Again, these are very synthetic and unnatural compounds and, based on virtually every other pharmaceutical that we know of, they will have some kind of negative impact on health. So, as always, I cannot think of any good reason to try an untested supplement.

In addition, some men will use one of these supplement inhibitors and push their estradiol too low.  This can cause many side effects from loss of libido to erectile dysfunction and so on.

NOTE:  There is another suicide inhibitor out there that is a legitimate pharmaceutical called Teslac (Testolactone). It is a different animal and is actually structurally similar to progesterone rather androstenedion. Nevertheless, it appears to be an irreversible and permanent aromatase inhibitor and I see steroid men discussing it from time to time, because its estrogen lowering effects are quite powerful. [4]

REFERENCES:

1)   https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2009/ucm152358.htm

2) J Clin Endocrinol Metab, 2003 Dec, 88(12):5951-6, “Pharmacokinetics and dose finding of a potent aromatase inhibitor, aromasin (exemestane), in young males”

3) J Clin Pharmacol, 2005 March; 59(3): 355 364, “A predictive model for exemestane pharmacokinetics/pharmacodynamics incorporating the effect of food and formulation”

4) https://peaktestosterone.com/forum/index.php?topic=1636.0

5) Biol Pharm Bull, 1997 May ,20(5):490-5, “Aromatase inactivation by a suicide substrate, androst-5-ene-4,7,17-trione: the 5beta,6beta-epoxy-19-oxo derivative, as a possible reactive electrophile irreversibly binding to the active site”

6) https://www.cumberlandnewsnow.com/Living/2008-06-19/article-390626/ Health-Canada-warns-diet-supplement-can-lead-to-seizures,-blood-clots/1

7) Clin Drug Investig. 2008;28(10):669-71, “Exemestane-induced subclinical hypothyroidism : a case report”

1. They do indeed permanently and irreversibly bind to the aromatase enzyme.  However, don’t panic if you’ve taken one of these – I’ll explain more below.

2.  This permanent binding can cause a very significant decrease in the estrogens.  According to one study in young males, Aromasin decreased estradiol by about a third. [2]  6-OXO was shown to significantly increase testosterone as I discuss in my link on How to Increase Your Testosterone Naturally. (See no. 6.)

3. There are actually two types of aromatase inhbitors. Type I is the irreversible kind, such as Aromasin and 6-OXO, and type II are the classic AI’s such as Arimidex and letrozole.

4.  Aromasin and 6-OXO are both structurally similar to androstenedione and, therefore, are considered steroids. [3] (You may recall that andro was used by slugger Mark McGwire in the 90’s.)  The reason for their classification as a steroid is subtle.  If you’ll recall androstenedione is intermediate in the pathway from pregenenolone to testosterone/estradiol.  In fact, it can directly convery to estradiol by acquiring and permanetly binding to the aromatase enzyme. Basically, Aromasin and 6-OXO are slighly modified copies.

5.  Although many of your enzymes are permanently inactivated through a suicide inhibitor, it should not mean that your estradiol is permently lowered.  The reason is that your body will begin to manufacture new aromatase enzymes after a few weeks.  I have read, in non-authority sites,  that it generally takes between one to three weeks to recover.

Clomid: Preserve Your Fertility While Raising Your Testosterone

REFERENCES:

1) J Sex Med, 2005 Sep, 2(5):716-21, “Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism”

2) Fertility and Sterility, Jan 2003, 79(1):203-205, “Use of clomiphene citrate to reverse premature andropause secondary to steroid abuse”

3) https://www.peaktestosterone.com/forum/index.php?topic=229.msg2032#msg2032

What is a SERM?  It means that it will in some tissues act as an estrogen and in others block estrogen. However, the bottom line is that in males it generally works its hormonal magic by blocking or inhibiting estrogen at the hypothalamus which, in turn, stimulates GnRH and, further downstream, LH (leutinizing hormone) in the pituitary.  Males can see their low testosterone levels double or more, especially in the case of secondary hypogonadism.

Some decent research and years of clinical practice have born this out. For example, one study put 36 men with average total testosterone of 248 ng/dl on 25 mg/day of Clomid and after 4-6 weeks the men’s average testosterone was a much improved 610 ng/dl. [1] This is a nice boost indeed, especially for what is considered a relatively low dose of Clomid.  The authors also point out that the all-important testosterone to estrogen ratio was raised from 8.7 to 14.2.

We have had a couple of Peak Testosterone Forum member who were enthusiastic Clomid users.  Look at what this guy wrote:

“Yep, seems like I ‘passed’ the Clomid challenge. February I had a reading of total T at 270 ng/dl. Today’s results, after 5 1/2 weeks on Clomid: 627 ng/dl!! Wow, so that was really good news…” [3]

Clomid also has certain advantages over standard testosterone therapy.  HRT requires shots or topicals that require time and potential risks.  It’s nice just to take a simple pill, as is the case with Clomid. And the good news is that Clomid seems to generally raise testosterone in the younger men who try it, which is still more evidence that the great majority of men have secondary hypogonadism.  Also, it is worth pointing out that a significant percentage of men have what I would call an “HRT-like” experience from Clomid, i.e. it improves libido and erectile strength and they feel better as well.

However, many have th opposite experience where their testosterone increases but they get no increase in libido.  We have had men shoot up into the 800’s  or higher on Clomid and yet have absolutely no increase in sexual desire.  This shows just how Clomid can negatively impact the male brain due to its sometimes estrogenic qualities.  And there is simply no way to know if you will be one of the lucky or unlucky ones.

So how safe is this convenient Clomid? In the short term, Clomid seems quite safe it can have side effects such as visual disturbances and headaches that should be discussed with your doctor – and that is one reason that some doctors are increasingly prescribing it for hypogonadism. Clomid has been taken for years by males as a fertility treatment due to its testes-stimulating powers. So it has a reasonable track record considering that it has been out for awhile.

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

One other crowd that has used Clomid for an extended period of time are steroid users and certain athletes.  Steroid men will use Clomid to get their testosterone back, a common issue with steroid abuse. It is commonly used upon completion of a steroid cycle to “jump start” testosterone.  Often testosterone will collapse after steroid use and Clomid is the only thing that will bring back testosterone and estrogen within normal physiological ranges.  This was documented when one study discussed Clomid’s effective use to do just this with a “steroid abuser”. [2]

The bottom line is that Clomid has been used extensively by many men off label and even non-legal users and all have found it to be reasonably well-tolerated with low side effects for short term use as long as low doses are used and certain procedures are followed. I discuss some of the side effects below, and, of course, you should talk to your doctor first before going on Clomid and discuss risks/rewards. NOTE: Clomid does not always work. If you are primary hypogonadal, for example, Clomid will do nothing for you. And the same is true if you have pituitary damage..

CAUTION: Many men now want to use Clomid long term.  Talk to your doctor, but I think this is unwise for a variety of reasons that I go into detail about in my link on Your Risks with Long Term Clomid Usage.  Below I give a quick summary, though, of the issues involved:

1) Vision. A surprisingly common side effect of Clomid is blurred vision and some would add floaters.  However, one important point is that this risk is greatly reduced with low dose Clomid. By low dose, I mean 12.5 mg MWF or maybe 25 mg MWF at the most. Now you have to talk to your doctor about risks, but the general advice that I have seen is that one must quit Clomid and call your doctor’s office immediately if you experience any visual disturbances.

2) Moodiness and Estrogen. Clomid is actually estrogenic in some cases and  moodiness and mood swings are fairly commonly reported.  The bottom line is that Clomid’s effects are poorly understood and likely vary from individual to individual.

3) No Increase In Libido. Many men will see their testosterone double or even triple on Clomid. With that kind of increase in testosterone, you would expect a nice boost in libido. However, this often does not happen, and the reason is that the estrogenic effects of Clomid probably outweight the increase in testosterone in these men. Unfortunately, you just don’t know if you’re one of the lucky ones until you try.

4) Thyroid.  Some of Clomid’s common side effects match up quite well with those encountered during various thyroid issues.  This has some wondering if Clomid does subtely affect thyroid function in some way.

5) Nausea or Headache. These are fairly common side effects with Clomid. Again, your doctor should be called immediately if this is an issue.

6) Clomid. Clomid raises SHBG enough to where it could be an issue for some men with high SHBG. As SHBG rises, the percentage of free testosterone can fall. Ideally, you want this range to be 1.5-2.5 percent of total testosterone. See this link on High SHBG for more information.

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.

Crash Dieting: Why It Does Not Work - Peaktestosterone

I’m going to give you a simple reasons that crash dieting (less than about 1200 calories per day) does not work in the long term:  hormones. We’ve all known many people who have rapidly dropped the pounds only to quickly regain the same weight again. Dieting is painful and we all want to see results quickly, i.e. an immediate reward for our pain, so crash dieting is a natural for many people. Unfortunately, crash dieting negatively affects several key hormones and can sabotage your long term efforts.

Below I am going to cover three of those hormones below:

1.  Thyroid. Imagine this:  you try to shed the pounds by rapidly dropping calories and your body resets its baseline metabolism making it much more difficult for you to lose weight.  Well, you don’t have to imagine it:  this is exactly what the body does according to one study on obese subjects. [1] Dramatic calorie reduction resulted in significant alterations in thyroid function, particularly decreases in T3 output. The researchers tried to compensate by restoring T3 but still baseline metabolism could not be fully restored. Some experts believe that crash dieting negatively alter your baseline metabolism long term.

Rapid weight loss also negatively alters most of the key appetite hormones as I outline in my link on Hormones and Your Appetite.  This requires crash dieters to display almost superhuman will power and can easily lead to rebound eating.

By the way, one area of anti-aging research is caloric restriction.  Reducting calories by about 30 percent extends maximum lifespan in mice and many animals. (It doesn’t seem to work as well in humans.)  How does caloric restriction do its magic in animals?  Researchers believe it may work in mice by “feminizing” them. In fact, here is the title of one article:  “Short-Term Calorie Restriction in Male Mice Feminizes Gene Expression and Alters Key Regulators of Conserved Aging Regulatory Pathways.”

Again, I ask if crash dieting really how you want to lose weight?

CAUTION:  Rapid weight loss may be desireable for some very obese individuals:  discuss with your doctor.

REFERENCES:

1) Metabolism, 1986 Apr, 35(4):289-91, “Decrease in resting metabolic rate during rapid weight loss is reversed by low dose thyroid hormone treatment”

2) The Journal of Clinical Endocrinology & Metabolism, Jun 1 1989, 68(6):1013-1018, “Fasting Alters Pulsatile and Rhythmic Cortisol Release in Normal Man”

2.  Testosterone. Significant drops in calories lead to significant drops in testosterone.  Over time this can lead to muscle loss, which is never good for weight loss, self-image or your general health.  See my link on Losing Weight the Right Way for more information.

3.  Cortisol. Researchers have found in several studies that crash dieting scenarios and/or fasting lead to increased cortisol output. [2] Cortisol dampens testosterone, depletes muscle and can increase visceral (belly) fat.  Again, none of this is good for weight loss, self-image or your general health in the long term.  See my link on Visceral Fat for more information on the cortisol-visceral fat connection.  CAUTION:  Crash dieting is also associated with arrythmias likely for this same reason.

Cholesterol and Erectile Dysfunction - Peak Testosterone

150. That’s the magic number.  Keep your cholesterol below 150 all your life and you’ll never have heart disease. There is a likely corollary to that:  keep your cholesterol low to avoid erectile dysfunction.

The reason is simple:  your erections are very dependent on a healthy endothelium, the delicate lining of your veins and arteries that pumps out nitric oxide, and a healthy endothelium is dependent on low cholesterol.  As it turns out, high cholesterol tends to decrease the ability of the arteries to relax and you need them to relax for blood to flow into the penis.

One study of patients with cardiovascular disease and arteriosclerosis – and most people in modern, industrialized societies have significant arterial plaque buildup – found that Lovastatin (Mevacor) significantly improved endothelial function and arterial dilation. [1]  Of course, the significance of this is that Mevacor is a cholesterol-lowering statin medication.

This was verified with another statin, Lipitor, in a study on erectile dysfunction patients with high cholesterol and low morning erections and hardness factor. [2]  These middle-aged men had significantly improved erectile rigidity, a.k.a. hardness factor, after being on this cholesterol-lowering medication.

Even stronger evidence, however, was a study that found that men with total cholesterol over 240 mg/dl had 1.83 times the risk of erectile dysfunction and impotence.  In fact, they observed a dose-dependent rise in erectile dysfunction risk with increasing cholesterol. [3]  This means that the higher the cholesterol levels, in general the lower the erectile strength, adding more solid evidence that the research conclusions were on track.

Why is cholesterol so damaging to erections? If you read many of the popular health blogs, cholesterol supposedly has nothing to do with heart disease. Now I would have to agree that total cholesterol has nothing to do directly with heart disease. The reason is that it is really oxidized LDL that damages the endothelial wall. However, there is a decided relationship between total cholesterol and LDL that makes cholesterol a downstream indicator of potential problems. In fact, one study found that oxidized LDL slowed down certain kinds of vasodilation and triglycerides slowed down all kinds. [5] Remember: you want those arteries, including the ones in the penis, to be able to dilate and allow for increased blood flow.

So what is the best way to lower cholesterol?  Of course, the researchers in two of the studies above used pharmaceuticals, statins, to lower cholesterol.  However, is that really the best and most safe way?  Statins definitely have their issues and side effects, which I document in my link on The Danger of Statins.

What most men and doctors for that matter do not realize is that satured fat is the prime governor of cholesterol and LDL levels in men. This is why reducing saturated (and total) fat can send your cholesterol levels plummeting. I have known many men who could not get their cholesterol levels to singificantly budge and believed that their issue was genetic but were able to dramatically improve when they cut saturated fat levels. The most powerful example of this is a Low Fat Diet with which most men can achieve a total cholesterol level below 150. A Low Fat Diet is so powerful that, if done without cheating, can actually clear out your arteries. For more information, read my link on the Incredible Benefits of a Low Fat Diet and discuss with your doctor.  (Don’t do anything without discussing with your physician first if you have any medical condition or medications.)

The bottom line is that this is another as to how closely the heart and the penis are interrelated.  Heal one and you’ll likely heal the other.

REFERENCES:

1) N Engl J Med, 1995 Feb 23, 332(8):481-7, “Beneficial effects of cholesterol-lowering therapy on the coronary endothelium in patients with coronary artery disease”

2) The Journal of Urology, Jul 2004, 172(1):255-258, “IMPROVEMENT IN ERECTILE FUNCTION IN MEN WITH ORGANIC ERECTILE DYSFUNCTION BY CORRECTION OF ELEVATED CHOLESTEROL LEVELS: A CLINICAL OBSERVATION”

3) Am. J. Epidemiol, 1994, 140(10):930-937, “Total Cholesterol and High Density Lipoprotein Cholesterol as Important Predictors of Erectile Dysfunction”

4) European Urology, 2003, 44(3):355-359, “Erectile dysfunction is associated with a high prevalence of hyperlipidemia and coronary heart disease risk.”

5) Asian J Androl, 2000 Sep, 2: 161-166, “Hyperlipidemia and erectile dysfunction”

Homocsysteine-Avoiding Erectile Dysfunction and Heart Disease

I recently (Feb of 2016) pulled my homocysteine for many reasons including the following:

a) No doctor had ever pulled it for me as far as I know, even though there is a mountain of research behind its importance

b) Recent research shows it is a risk factor for erectile dysfunction since it lowers nitric oxide and accelerates plaque in the arteries, something I cover in my page on Homocysteine and Erectile Dysfunction.

My results, which was 11.3 umol/l, fall into what might be termed a “grey area”  However, before I discuss my own results, let’s look at Three Different Ways to Set Your Target Homeocysteine Level:

1) Metabolism, 2006 Dec;55(12):1564-8, “Hyperhomocysteinemia: a novel risk factor for erectile dysfunction”

2) Circulation, May 17, 2005 vol. 111 no. 19 e289-e293, “Homocysteine and MTHFR Mutations: Relation to Thrombosis and Coronary Artery Disease”

3) Indian J Chest Dis Allied Sci. 2008 Jan-Mar;50(1):39-48, “Homocysteine, Folic Acid and Coronary Artery Disease: Possible Impact on Prognosis and Therapy”

4) Circulation Research, 2006; 99: 565-566, “Homocysteine and Cardiovascular Disease Is HDL the Link?”

5) https://www.hormonesmatter.com/hidden-heart-disease-risk-factor-high-homocysteine/

6) Life Extension Foundation, “When Homocysteine Levels Won’t Come Down,” by William Faloon

1. 12 umol/l to Avoid Erectile Dysfunction. A recent study look at non-diabetic patients with erectile dysfunciton and normal control subjects.  This is a very important study in my opinion, because it matches what I often see on The Peak Testosterone Forum, i.e. men that appear to have no major chronic disease but can’t figure out why they are experiencing erectile dysfunction.  What this study shows is that these seemingly healthy guys have higher homocysteine levels on average:  10.7 versus 16.4 umol.  In fact, if you look at the data for this study, you’ll see that average lipid numbers were not that different for the two groups  What really stood out most were varying homocysteine levels.

The researchers stated that “the reference range for Hsys concentrations has been proposed to be between 5 and 15 umol/L. Based on these data, we speculate that Hcys levels greater than 12.1 umol/L increase the risk of ED. Based on our results, the chance of developing ED is 80% in the cutoff point of patients with hyperhomocysteinemia.” [1]

They also stated that men with elevated homocysteine had three times the risk of developing erectile dysfunction!

2.  12 umol/l to Avoid Heart Disease. Many commentators have noted that at about 12 umol/l, your risk of heart disease and cardiovascuclar issues go up.  Here are a couple of examples:

“Plasma Hcy levels above 12-15 umol/l in the fasting state and above 40-50 umol/l after methionine loading is probably associated with increased risk of atherothrombotic disease.” [3]

“The Tuft research team concluded that people with homocysteine levels greater than 11.4 mol/L have a significant risk of having a heart attack. These findings were published in the February 2, 1995 edition of the New England Journal of Medicine.” [5]

NOTE: Elevated homocsysteine is associated with many other conditions as well, including “coronary artery disease (atherosclerosis), heart attack, stroke, peripheral arterial disease, venous thrombosis, deep vein thrombosis, pulmonary embolism, dementia.” [2] If you find your homocysteine is above range, say 15 umol/l, discuss with your physician.

IS YOUR HDL LOW? My HDL has always been on the low side.  I have read research that explains that some men just have low HDL and these men cannot improve their HDL via exercise like most men.  One interesting explanation is that elevated homocysteine actually lowers HDL. [4] Now my homocysteine is not that high, but the commentary listed in reference #4 caught my eye, and I would guess that it is applicable to some of you reading this.  Please see the reference for more information.

3.  ~8 umol/l (William Faloon, President of Life Extension Foundation). William Falloon has an interesting discussion where he talks about how taking ibuprofen gave him early stage kidney disease and elevated homocysteine. [6] In the course of that article, he talks about aggressively targeting 8 umol/l:

“That meant my homocysteine reading should have been below 8 mol/L, whereas in fact it was a startlingly high 15.6. The only reason my homocysteine could be this high, I argued, was a failure of my kidneys to remove and neutralize the excess homocysteine.” [6]

I was not able to find evidence that you have to be at levels this low, but it does seem prudent not to come anywhere near the 11.4-12.1 umol/l levels mentioned above.

MY PLAN OF ACTION:  I would like to pull my homocysteine levels down about 10-20% to avoid coming anywhere near the above.  To do this, I will probably consume more of the nutritional brewer’s yeast that I consume, which is loaded with B vitamins.  It’s nasty stuff, but should help pull down my homocysteine levels. If it does not, then I may need to supplement B vitamins.  (I do not recommend using synthetic folic acid, an unnatural form found in many of the cheaper multivitamins and formulations out there.  It persists for a long time in the body.)  I also will do a fasting homocysteine test, since methionine can raise homocysteine and I consume a fair amount of protein (for muscle building purposes).  Many other things can elevate homocysteine levels from kidney disease to MTHFR, so do your research and discuss with knowledgeable physicians if this is an issue for you.

REFERENCES:

Growth Hormone Therapy Dangers - Peak Testosterone

One theory of aging is that we simply need to replace our collapsing hormones to youthful levels and then weight management, mood, memory, erectile function and all over things good will return with a vengeance. Of course, the reality is much more complex and replacement with HGH is one of those. HGH (Human Growth Hormone) is one of the few hormones that has really struggled in the research as I will show below.  Here are Five Great Reason to Think Twice about HGH (Growth Hormone) Therapy and possibly even consider it dangerous for some men:

1.  Increase in IGF-1. If you’re young, increasing IGF-1 may not be a significant risk.  However, as we age and accumulate DNA, estradiol increases, enzyme activity slows down, etc., cancer becomes much more of a risk and a concern.  A little less than half of all men will get cancer statistically and IGF-1 has been found to play a significant role in many of the common epithelial ones.  What does this half to do with HGH therapy?  Well, giving a man exogenous growth hormone will increase his levels of IGF-1.  For example, one study on the subject found that the IGF-1 levels of the men tripled when given HGH. [1]

As some of you know, this is probably going to be good for building muscle (hypertrophy).  However, rememember that the “GF” in IGF-1 stands for “growth factor” and it has the potential to supercharge cancer cells according to a lot of research.  In fact, lower IGF-1 levels are one of the most powerful anti-aging markers and this has been verifed in many species.  One of the other reasons for this is that increasing IGF-1 levels is associated with increased risk for diabetes, something we will discuss below.

NEWS FLASH: IGF-1 on the scalp may be a cure for baldness according to a recent study on mice. [3] As far as I know, it is not available yet as a treatment in men.

2. Increase in Lp(a). One of the biggest risk factors for atherosclerosis (arterial plaque) is Lp(a).  Lp(a) is also very hard on endothelial function, i.e. blood flow and thus can directly impact your bedroom performance.  (See my reviews on the plaque reversers:  Track Your Plaque and Heal Your Heart. And , interestingly enough, HGH therapy increases Lp(a) and IGF-1 decreases Lp(a). [4] This will likely not bode well for your arteries.

3. Incresased Risk of Diabetes. As I mentioned above, increasing IGF-1 levels increases the risk for adult onset diabetes.  This is probably the reason that HGH Therapy increases the risk for diabetes according to one study of senior overweight men. [5]

4. Possible Increased Rates of Death and Dying. European researchers look at the long term mortality rates of children who had received recombinant human growth hormone (rGH) in childhood.  They found that the rate of death was significantly increased in certain key areas and this was especially true for those who received higher dosages, thus indicating some “dose dependent” action. The authors concluded that “bone tumor-related mortality was increased. An increase in mortality due to diseases of the circulatory system or subarachnoid or intracerebral hemorrhage was observed.” [6]

5. Nasty Side Effects.  One of the studies above found that “persons treated with GH were significantly more likely to experience soft tissue edema, arthralgias, carpal tunnel syndrome, and gynecomastia.”

CONCLUSION:  HGH is devil and angel at the same time.  On the one hand, it has some very impressive benefits:  it decreases fat levels and can boost muscle a bit.  It also can lower cholesterol levels and increase skin thickness. At the same time, though, it appears to put you in harm’s way for diabetes, hemorrhages and possibly atherosclerosis and cancer.  There are other more natural ways to boost your growth hormone, something I cover in my page on Lifestyle Methods to Increase Human Growth Hormone and Sleep and Growth Hormone.

REFERENCES:

1)  NEJM, Jul 5 1993, 323(1), “Effects of human growth hormone in men over 60 years old”

2) Mechanisms of Ageing and Development, Feb 2005, 126(2):305-307, “Do deficiencies in growth hormone and insulin-like growth factor-1 (IGF-1) shorten or prolong longevity?”

3) Growth Hormone and IGF Research, Apr–Jun 2014, 24(2-3):89–94, “Exogenous IGF-1 promotes hair growth by stimulating cell proliferation and down regulating TGF-β1 in C57BL/6 mice in vivo”

4) Eur J Endocrinol, 1997 Apr, 136(4):377-81, “Growth hormone increases and insulin-like growth factor-I decreases circulating lipoprotein(a)”

5) Ann Intern Med, 2007 Jan 16, 146(2):104-15, “Systematic review: the safety and efficacy of growth hormone in the healthy elderly”

6) J Clin Endocrinol Metab, 2012 Feb, 97(2):416-25, “Long-term mortality after recombinant growth hormone treatment for isolated growth hormone deficiency or childhood short stature: preliminary report of the French SAGhE study.

Quinoa and Testosterone - Peak Testosterone

There aren’t any studies out yet proving that quinoa boosts testosterone or increases erectile strength, but I think it’s just a matter of time.  This food is a bedroom powerhouse and you can thank the Incan Love gods for it:  quinoa comes from the Andes just like Maca and should be a staple of every male concerned with his hormones and erections.

Quinoa is actually not really a true grain and is closer to spinach and tumbleweeds in origin. All we know is that quinoa has many properties that will likely help increase your muscle mass, hormones and bedroom prowess.

Think I’m exagerrating?  Here are some great reasons to consider quinoa one of your best bedroom buddies:

1.  Ecdysteroids.  Some bodybuilders take ecdysteroids for muscle building.  Well, the amount of ecdysteroids in quinoa is comparable. [1]

2. Protein Quality.  Plant protein is notorious for a lower “usability”.  Almost always it is lower in one of the key amino acids such as lysine (in the case of rice) making it not as bioavailable as animals proteins.  Quinoa is a rare exception:  it’s protein is ready to go.

1) https://www.ergo-log.com/quinoa.html

2) https://www.whfoods.com/genpage.php?dbid=142&tname=foodspice

3.  Zinc. Move over oysters.  One cup of quinoa has about a third of your daily zinc and abundant copper as well. A zinc deficiency can lower testosterone and zinc is also an aromatase inhibitor.  Nice!  Or you can always do what everyone else does and take Zinc Supplements that lead to arterial inflammtion and/or excitotoxin damage.

5. SOD. Quinoa is packed with manganese and, as mentioned above, copper, both cofactors in building your body’s superantioxidant SOD.  SOD protects mitochondria like nothing else and mitochondrial damage is a key cause of andropause.

6. Arginine and Glutamic Acid. One cup of quinoa has 22 grams of protein, which is high for a plant, and – oo la la – about 1.7 grams of L-Arginine and about 3 grams of Glutamic Acid (not to be confused with the excitotoxin). Both of these bad boys can optimize or boost nitric oxide and lower blood pressure.  That means more blood flow and better erections.

REFERENCES:

Erectile Dysfunction - Secondary Supplements -

Hopefully, you’ve already my Top Five Erectile Supplements with solid research and few side effects.  These top five can heal about two thirds to three fourths of guys with erectile dysfunction according to the studies.  However, there are a number of other very helpful supplements that can improve erectile strength directly and/or indirectly that I wanted to include as well:

Don’t forget to read my links on the following, all of which can be just as helpful as supplementation:  Erectile Repair Guide, Kegels, the https://www.peaktestosterone.com/ and Exercise.  Always get to the root of your problem  or eventually heart and arterial disorders will stop your sex life dead in its tracks.

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.

4) CoQ10.  A study from Germany showed that men with sub par endothelial function were helped by taking CoQ10.  That should translate to improved erectile dysfunction. What they found was that blood flow was increased to arm vessels simply by increasing this one nutrient. [7] This was verified by one recent European study showed something similar:  taking 300 mg/day of CoQ10 helped endothelial function by relaxing veins – yes, that means more blood flow throughout the body including the penis – and increasing the body’s key antioxidant SOD (which protects your incredibly valuable Nitric Oxide). . [8] So, yes, even a run-of-the-mill, non-exotic supplement like CoQ10 can improve erectile dysfunction and impotence.

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.

REFERENCES:

4) Phytotherapy Research 2002,16:1-5; Nutrition Research,2001,21:1251-1260;Nutrition Research, 2003,23: 1189-1198;Life Sciences,2004,74:855-862

5) J Urol 2002; 168:2070-3

6) Asian J Androl 2007;9(2):241-4

7) Intl Journ Cardio 2005 Feb 28, 98(3):413-9

8) Eur Heart Journ 2007 28(18):2249-2255

9) Urology 2004 Apr,63(4):641-646

10) Curr Med Res Opin, 2004 Sep,20(9):1377-1384

11) Amer Jour Clin Nutr, 2007 Sep,86(3):610-7

12) Amer Jour Cardio,2007 Aug 1,100(3):455-8

13) Am Jour Clin Nutr, Apr 2007, 85(4):1068-74

15) J Cardiovasc Pharmacol,1998,32:509-515

16) Hum Psychopharmacol,2002,17:279-284

17) Gen Pharmacol,1982,13:169-171;Gen Pharmacol,1982,13:225-230;Gen Pharmacol,1983,14:277-280

18) J Clin 17) Gen Pharmacol,1982,13:169-171;Gen Pharmacol,1982,13:225-230;Gen Pharmacol,1983,14:277-280

18) J Clin Endocrinol Metab,1991,73:4-7

19) Eur J Clin Nutr, 2008 Dec, 62(12):1426-31, Epub 2007, “Fish oil supplementation improves large arterial elasticity in overweight hypertensive patients”, Wang, et. al.

20) Journal of Andrology, Sep/Oct 2008,(29):5

21) JAMA,2007,297:2351-2359932-40

24) Circulation, 1998 Jun 9, 97(22):2222-9

25) Intl J Impotence Res, 2008, 20:173-180

24) Circulation, 1998 Jun 9, 97(22):2222-9

225) Intl J Impotence Res, 2008, 20:173-180

26) Eur J Clin Nutr, 2008 Dec, 62(12):1426-31, Epub 2007, “Fish oil supplementa26) Eur J Clin Nutr, 2008 Dec, 62(12):1426-31, Epub 2007, “Fish oil supplementation improves large arterial elasticity in overweight hypertensive patients”, Wang, et. al.

27) Journal of Chromatography A, 17 June 2005, 1078(1-2):196-200, “Determination of citrulline in watermelon rind”

28) Brit J Sports Med, Oct 2003, 37: 464–70. “The Ergogenic Effects of Eurycoma Longifolia Jack: A Pilot Study”

29) https://www.nytimes.com/2013/04/08/health/study-points-to-new-culprit-in-heart-disease.html?exprod=myyahoo&_r=0

Growth Hormone and Sleep - Peak Testosterone

Most guys know that growth hormone burns fat and increases lean muscle mass.  However, not as many know growth hormone is very dependent on sleep. Growth hormone is one of your truest friends:  it directly and positively effects the brain and “mental agility” as one set of researchers put it. [6] Really Human Growth Hormone’s capabilites goes beyond this and it is now recognized as directly improving learning and memory. [7] Yes, you can rebuild your brain even in middle age and beyond if you let your body squeeze out this precious hormone while you’re snoozing. (For other ways way to churn out Growth Hormone, read this link on How to Boost Growth Hormone Naturally and  Interval Training.)

And, just as with testosterone, sleep deprivation leads to no normal nocturnal Growth Hormone surge. Zip. Nada. It’s this simple:  if you deny yourself sleep, you get a drastically blunted Growth Hormone response.  One set of researchers summarized that “the nocturnal Growth Hormone surge is largely sleep-dependent.” [8] That’s pretty clear language for scientific researchers:  if you want Growth Hormone rebuilding your body and mind, you must have lengthy, quality sleep.

You might be saying, “Well, that only applies to those fools who engage in total sleep deprivation”.  Au contraire!  One study found, as is the case with testosterone, an almost linear relationship between Growth Hormone and slow-wave sleep. [9] This kind of deep sleep becomes progressively more difficult as we age:  sometimes we just plain have to work at it. The linearity that the researchers discovered means on a practical level that the more you sleep, the more Growth Hormone you ll have and the more sleep you lose, the less Growth Hormone you ll have, all other things being equal.

Optimizing Growth Hormone is often a concern of many dads who want their child to be as tall as possible, since Growth Hormone governs height for those of us with kids.  Of course, height is mostly a function of heredity, but I tell them that the safest way to optimize Growth Hormone is through sleep.  There is no study that I know that correlates height and sleep, but it is likely somewhat of a factor in the growth and development of your kids.

By the way, did I mention that Growth Hormone even stimulates additional testosterone production?  Growth Hormone creates a cascade of increasing IGF-1, FSH (Follicle Stimulating Hormone), LH (Leutinizing Hormone), which ultimately leads to increases in testosterone (and estrogen but proportionally of course).  The increases may not be huge but every little bit helps!

So the bottom line is that optimization and maximization of your growth hormone output requires you to just be disciplined and put your head down on that pillow.

NOTE:  For more information , see my links on sleep, see my pages on Sleep and Testosterone, Rebuild Your Brain Through Sleep, Sleep and Strong Erections and Natural Sleep Aids.

REFERENCES:

6) Rev Endocr Metab Disord,Dec 2006,7(4):225-35

7) Cardiovasc Res,Apr 2002,54(1):25-35

8) J Psychiatry Neurosci,July 1991,16(2):96 102

HCG Dosages for HRT and Monotherapy - Peak Testosterone

HCG had become a significant play in the testosterone therapy world and with good reason:  it keeps a man from losing testicular volume when on standard HRT (TRT) and be used by itself as HCG Monotherapy to maintain testicular function. Although HCG is a leutinizing hormone (LH) “mimic” and thus bypasses the pituitary and hypothalamuas, it at least keeps your testes in the game. In addition, HCG can preserve one’s fertility, both as a monotherapy and even with HRT in many cases.  So for men still trying to have kids, it’s a nice option.  (Sometimes HMG has to be added in as well.   See my page on HCG Monotherapy for more deetails.) As of this writing, a  Peak Testosterone Forum Poll showed that over 10% of the men on any kind of HRT were on an HCG Monotherapy program.

So one obvious question is dosage for all these uses of HCG.  (Sorry ladies – I am only talking about dosages for men here.) Unfortunately, I see HUGE variability in dosing on the Peak Testosterone Forum. Keep in mind that probably 95% of the men on the forum are under a doctor’s care, so there is a big difference in opinion among docs about how much HCG should be given.  Let’s look at the basic ways that HCG is currently being used by men and some common dosages.  (Always discuss safety with your doctor.  I’m just letting you know what I am seeing “on the street.”)

CAUTION:  I would argue against some of the higher doses of HCG, especially for older men, due to the fact that HCG is highly stimulatory and has a much longer half life than it’s analog LH (luteinizing hormone).  You can read about my reasoning in my page The Potential Dangers of Too Much HCG?

1.  HCG Monotherapy.  Dosages on this are all over the map. Let me give just some of the examples that I have seen recently:

a)  250 IU Every other Day.  This low dosage (for monotherapy) boosted one of our regulars (electrify) up to a T level of 460 ng/dl.  Most guys seem to target testosterone levels higher than this.  However, his estradiol apparently shot up a bit more and he was even taking some Arimidex, an aromatase inhibitor that lowers estradiol. levels.

b) 500 IU Three Times Per Week (Dr. Shippen).  One of the “HRT doctors” that I have the most respect for is Dr. Shippen.  He is known for being thorough and also showing great concern for the long term health of his patients.  One of our forum members wrote the following:

“Actually, the starting dose is 500iu 3x/wk. In fact, he wrote that on a prescription slip when he corresponded with me initially. The text of his HCG challenge then states basically that mid-level responders can go up in dosage accordingly. He is reasonable with this and conservative, thus, the idea is to go up just enough to get to a good testosterone level. Of course, if someone responded well to such a low dose such as 250, that could be a workable dose.” [5]

Of course, you need to call Dr. Shippen’s office to find the official version.  (I have no affiliation.)

c) 700 IU Three Times Per Week.  One of our senior forum members was on HCG Monotherapy for awhile and Dr. Shippen reportedly put him on 700 IU three times a week.  He described his experience as follows:

“HCG use, I’ve been all over the map with dosages. I initially saw a very well renowned urology practice with a national reputation. They had the brilliant idea of prescribing the massive dose of 1,500iu/3x/week. Even back then I knew about HCG dosages and only did this for a week or so before I lowered it on my own. I then saw Dr Shippen, and he continued me on his own compounded brand of HCG at doses he wanted me to titrate (starting at 700iu/3x/week).” [2]

Notice that he and apparently Dr. Shippen considered the 1,500 IU to be too high of a dose and cut it back to 700 IU.  Yet another member wrote that Dr. Shippen likes 500-700 IU per week and rarely if ever over that.  This same member (JustAskin) stated that, when he went over 500 IU three times per week, his testosterone would actually drop.  This supports the theory that an overly high HCG dosage can actually desensitize receptors or downgrade the Leydig cells themselves somehow.

d) 1000-2000 IU 2-3 Times Per Week.  Quite a few experts warn against going too high with HCG as they feel it can lead to desensitization or perhaps even actual damage of the Leydig cells.  However, it is a controverial topic as I’ll show below and I have the subject argued both ways.  For example, there are some endocrinological guidelines that recommend 1,000 – 2,000 IU 2 -3 times per week.  This is a massive dose from what I have read, but I have seen guys on the forum doing this much.

“I just visited a hormone replacement clinic, and upon conversation I am trying HCG with arimidex. Doctor said that he starts people with 1,000 IUs two to three times a week. This is based on a 2002 American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Evaluation And Treatment of Hypogonadism in Adult Male Patients. In this document in the section on Gonadotropin Therapy for Induction of Spermatogenesis they actually recommend 1000 to 2000 IUs two to three times a week. I also know that Dr. Crisler recommends no more than 500 IUs on a single day for the danger of desensitizing lh receptors. I told this to doctor and we agreed to start with 500 IUs per shot twice a week. Is that reasonable/normal?.”   [3]

However, if you read the actual paper, it may be indicating that this is not intended as a long term protocol and calls it an “initial regimen:”

The actual quote form the paper he cited was “It is known that HCG binds to leydig cell LH receptors and stimulates the production of testosterone. Peripubertal boys with hypogonadotropic hypogonadism and delayed puberty can be treated with hCG instead of testosterone to induce pubertal development. The initial regimen of hCG is usually 1,000 to 2,000 IU administered intramuscularly two to three times a week.” [1]

HIGH DOSES OF HCG GREATLY RAISE ESTRADIOL LEVELS:  Does this mean that this high doses are safe?  Well, that’s one you’ll to discuss with your doctor, but personally I don’t think so.  And it’s somewhat of a moot point, because going over about 700 or 1000 IU really sends the estradiol skyrocketing generally.  For example, look at the story of this man:

“I took 16 2000iu hcg injections a few years back. I believe it was every other day injections into my ass cheek (I say this because next time I am going to do sub q into my stomach) – my test levels rose to 800s – my strength in the gym shot WAY up (my bench press max doubled within a week and I was able to see my abs) – it did NOT improve my sex drive at all though – I believe hcg converts into estradiol at a high rate so any chance at having increased sex drive was removed..” [4]

SUMMARY:  The most common and cautious dosages on the forum seem to be 500-1,000 IU three times per week.  HCG seems to stimulate estradiol levels more than standard HRT and thus might be a good option for men with low estradiol.  However, for those with normal aromatase conversion, these higher estradiol levels often cause somewhat reduced libido and less than spectacular results when compared with standard HRT.  Furthermore, Arimidex seems to be of limited value and libido is often, therefore, not raised as much on HCG Monotherapy.  Advantages include better fertility parameters (generally) and increased testicular volume (generally).

CAUTION:  Some men are concerned that long term use of HCG will atrophy the pituitary.  This is because HCG bypasses the pituitary and jumpstarts the testes directly. Studies are lacking, so discuss with your doctor.

2.  HCG with Intramuscular Weekly Testosterone Cypionate.  One very common practice at HRT clinics and with anti-aging physicians is to simultaneously adminster HRT (testosterone therapy) and low dose HCG.  This is done most often with testosterone cypionate injections. For example, when I was at an HRT clinic, I was taking between 120 and 150 mg of cypionate once per week and 250 IU of HCG twice per week.  The timing of the HCG injections was meant to be at the low point, or trough days, and so I injected 250 IU on the day before my cypionate injection and 250 IU the day of.

Their are several common reasons for adding low doseHCG to one’s HRT regimen, which I have outlined below.

NOTE:  Some men need to go up to 500 IU twice per week to experience any increase in testicular volume.

REFERENCES:

1)   AACE Hypogonadism Guidelines, Endocr Pract. 2002;8(No. 6) 451, “AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE EVALUATION AND TREATMENT OF HYPOGONADISM IN ADULT MALE PATIENTS 2002 UPDATE”

2) https://www.peaktestosterone.com/forum/index.php?topic=5046.msg41983#msg41983

3) https://www.peaktestosterone.com/forum/index.php?topic=1652.0

4) https://www.peaktestosterone.com/forum/index.php?topic=2650.0

5) https://www.peaktestosterone.com/forum/index.php?topic=2233.0

Aluminum: Good for Your Car, Bad For Your Brain - Peak Testosterone

For years scientists thought aluminum was a non-issue. There reasoning was based on the fact that only about a percent of any aluminum that you ingest makes its way into the bloodstream and then any that makes it into the bloodstream must pass the blood-brain barrier. In healthy individuals the blood-brain barrier is a formidable obstacle: only about .005% of any aluminum in the blood makes it into your brain. And so for years reseachers dismissed aluminum as a health-threat because these numbers just seemed too low.

Well, that was then and this is now. Ample research has since changed almost everyone s mind. First of all, substantial aluminum has been found in human brains, especially in subjects with Alzheimer s and dementia. The idea that the blood-brain barrier was a magical brain protector was shattered by this realization. Further research showed that, while Aluminum does not directly cause Alzheimer s, it can exacerbate any kind of dementia. The reason is that aluminum actually causes neuronal damage very similar to the mechanisms involved in Alzheimer s itself. You might say Aluminum is not a sibling but a look-alike cousin. For example, aluminum does the following, which those of you familiar at all with Alzheimer s will recognize right away

Scientists have even seen the damage that aluminum can do first hand: dialysis patients can receive excess aluminum and end up with aluminum-induced paroxysms and seizures. More frightening to the populace at large is the research showing much higher rates of dementia in individuals whose city water supply exceeds 200 micrograms/liter of aluminum! And, yes, quite a few cities do actually exceed this threshold.

The blood-barrier clearly wasn t protecting everyone and researchers also discovered that there are certain conditions where the blood-brain barrier can be compromised, such as during fever, invisible micro-strokes that are relatively common in middle aged and beyond and so on. Or perhaps just that minute amount that just naturally makes it into the brain is enough to do the damage. Either way, aluminum should clearly be one of our top concerns when it comes to protecting our brains..

So the bottom line is that it is NOT wise to rely on your blood-brain barrier to preserve your brain from the ravages of aluminum. Of course, don t cook with aluminum. Drinking from aluminum cans is supposedly safe because they coat with a kind of wax , but do you want to bet your mental faculties on it? “No brain, no life”, I always say.

Aluminum is not easy to avoid for many reasons: it is one of the most abundant elements on the earth s surface. Furthermore, they put it in many antacids and antiperspirants. It is also in black tea and grain-based foods, although in fairness none of these have been linked yet to dementia. Again, I would err on the side of caution in this case. You ve only got one life why not be semi-conscious while you re enjoying it?

NOTE:  If you sweat excessively, i.e. have hiperhydrosis, you may have been prescribed aluminum chloride hexahydrate, or Drysol, for the problem.  Please discuss with the doctor the possible future effect on the brain.