MODULE #8 - Lesson 3

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MODULE #8 - Lesson 3 21st Century Man: Testosterone and Andropause

Module 8 - Lesson 3 21st Century Man: Testosterone and Andropause Testosterone and andropause are 2 pressing issues for men in the 21st century. In today s lesson we re going to talk about both and how they relate to you. This actually applies to women as well. What We ll Be Covering Today What we ll cover today: what testosterone is and how it s produced; what happens to testosterone (T), what happens to T as we age; five common ways T levels become affected; how to boost your T levels naturally; and more. 2

What is Testosterone? Testosterone is a steroid hormone from the androgen group. These are anabolic hormones, they build up growth and they lead to masculinizing effects in both men and women. Testosterone regulates libido, energy, immune function, muscle development, and bone health. Typical levels in males range from about 230 to 1000 ng/dl and in females 28 to 80 ng/dl. I just want to again dispel a myth will cause women to get bulky. We know that testosterone is actually increased with resistance training but the reason that men are able to build muscle is because they have so much more testosterone than females so there is a very little chance that you will bulk up like the picture. If you re a woman, you can lift weights. You re not going to turn into Schwarzenegger. That s a different topic. Those are the blood levels you re basically looking at. We re talking about total cholesterol numbers here. We ll look at the difference in just a second. Those are total cholesterol levels. How is it Made? In males the Leydig cells, found in the testes, synthesize testosterone. In females, the ovaries and adrenal glands synthesize a much smaller amount of testosterone, as we just saw. Testosterone secretion is controlled by gonadotropin-releasing hormone (GnRH), which is released by the hypothalamus, and it occurs in pulses. These pulses then stimulate the pituitary gland to secrete LH, which is called luteinizing hormone. We ve seen this mechanism of action take place with the adrenal glands and the secretion of cortisol and other adrenal hormones, so everything starts in the brain and kind of works its way down. Like with these other hormones, testosterone also has a negative feedback loop, which we ll look at in a moment. 3

Once the pituitary secretes luteinizing hormone, this causes an enzymatic conversion of cholesterol into testosterone in the Leydig cells. Cholesterol is essential to testosterone, as well as all the other sex hormones, and I ll show you a slide which will show that. On the top left we have cholesterol and from cholesterol, every other sex hormone is created: progesterone, testosterone; estradiol, which is pretty much estrogen; cortisone; aldosterone. They all come from cholesterol. Cholesterol is essential, it s paramount to your health and specifically with respect to testosterone as well. This is the negative feedback loop that occurs in the male human body. We have the hypothalamus in the brain, which signals to the pituitary gland to release luteinizing hormone (LH), which then sends a signal to the testes 4

to convert cholesterol and the testosterone. When the body has enough testosterone, it sends a message back to the brain saying, Okay, We don t need to produce any more LH. We have enough testosterone. It kind of shuts down that mechanism. Here s the dilemma when we start looking at testosterone supplementation. For instance, if we have too much testosterone coming in, let s say you re a supplementing with testosterone, if the body thinks there s too much testosterone it stops production at the source, which is in the brain, or it will convert the excess to something else, such as estradiol or DHT. We ll look at these in a second. If you have too much testosterone it sends the message Do not produce any more testosterone. The problem with that is if you stop supplementing with testosterone, all of a sudden your body now has very low levels of testosterone that it s creating for itself. Testosterone supplementation side effects can include testicular atrophy, because if the testicles are not needed to produce testosterone then they can shrink in size. 5

If you don t use it, you will lose it. If you don t stress your bones, your bones won t need to hold on to your minerals. Therefore, if you go to space for a week, you re going to lose a lot of bone-mineral density. It s the same thing that s happening here. A lot of times men who supplement with testosterone because they want to pack on muscle can develop man boobs because the excess testosterone gets converted to estrogen. There s also some speculation that it increases cardiovascular disease if you have too much testosterone, whereas some studies actually show that low testosterone increases the risk of cardiovascular disease. That one is kind of up in the air. Two of the big ones are really testicular atrophy, man boobs. For women who are supplementing with testosterone, for instance, in the world of fitness competitions, they ll start getting facial hair, masculinization of the jaw, and all that kind of stuff; a very distinctive look that occurs with increasing testosterone intake. At high levels, testosterone supplementation is not a good thing to do. We re going to look at ways to actually naturally increase your testosterone, but before we even get there, we have to understand how testosterone is affected. 6

First we need to understand the physiology of how testosterone is created. When you understand the fundamentals, the physiology of what s happening inside your body, the decisions you make are a lot easier. In this flowchart we have the pituitary, the testes, and then within there, we have cholesterol, pregnenolone, which is the first hormone the pituitary signals to the testes via LH to convert cholesterol into testosterone. Testosterone s down here. In order to get to testosterone, it has to go through a couple different pathways. Cholesterol is first converted into pregnenolone, which we saw in the adrenal lesson. It s the first building block after cholesterol in all these different hormones. Pregnenolone can go two ways. It can be converted to progesterone and from there, cortisol can be created or aldosterone can be created. Aldosterone, we saw, was related to the sodium-potassium regulation, water retention. Cortisol, obviously, is a stress hormone. Pregnenolone can also lead to DHEA, which can then be converted to androstenedione. Androstenedione can be converted into estrone, a type of estrogen, or it can go directly into testosterone, and testosterone can be converted into estradiol or DHT. 7

First of all, there are two types of testosterone, we have free testosterone, which is the active form of testosterone. If you have free-flowing testosterone, it can exert its effects in different receptor sites in your body. Only 2% of all of your testosterone is free testosterone. The other 98%is inactive and is bound to what s called the sex hormone binding globulin. We have two forms of the active form, which is free inactive form, whereby the testosterone is bound to this protein carrier pretty much. This is the pathway of testosterone creation. As I mentioned, it can go to DHT as well or estradiol, which is a type of estrogen. Common Misconception There s a common misconception that as we age T levels decrease. The reality is that they do decrease a little bit but not dramatically. What actually does happen is that the levels of the sex hormone binding globulin do increase with age, which means that there s less free testosterone available. These two graphs here show, we have total testosterone and free testosterone, the top one showing that after about 30 years old things start to decline. We see this decline in total testosterone. At the same time we also see this slight decrease in free testosterone. Now, is it because free testosterone itself is declining and that s the reason why testosterone is declining? Well, not really. It s mainly because of the sex hormone binding globulin, which is binding up more of the free testosterone, which means that there s less free testosterone available. Yes, this graph will decrease, because more of it s being bound by this protein carrier. The other thing is that estrogen and this can come about through blood sugar irregularities, soy foods, etc., in men increases sex hormone binding globulin. If you have a huge estrogen load coming in through different sources, that s going to increase the amount of free testosterone, which is now going to bind to sex hormone binding globulin, which means that there s going to be less testosterone available to exert its androgenic effects within different cells, within the muscles, for instance. 8

Here s another chart that shows declines in total testosterone, free testosterone. Big declines there but look at this: huge increase in SHBG, which is the sex hormone binding globulin. There s a huge increase as we age of this binding protein, and that is binding up a lot of this free testosterone. You can have theoretically high levels of testosterone, but it depends on the level of how much of that is free versus how much of it is bound and different ratios of estrogen and testosterone to really understand whether you have a low testosterone or if you re just exhibiting low-testosterone symptoms as a result of some of these mechanisms. 9

Symptoms of Low Testosterone Symptoms of low testosterone include low energy, fatigue, and lethargy, kind of like a loss of mojo; decreased strength and work capacity; low sexual desire; lack of sexual responsiveness, weaker orgasms or difficulty achieving orgasm; loss of lean body mass, including muscle and bone density, along with an increase of body fat; and perhaps an increase of cardiovascular risk, including poor blood lipid profile, higher blood pressure, and so forth. Again, that s not clear, cut, and dry in the literature yet. 5 Common Ways Testosterone Levels Are Affected Let s look at five common ways testosterone levels are affected. Let s say you notice some symptoms so you go to your doctor, you have your testosterone checked, the testosterone test may come back somewhat normal or even, in some cases, elevated, but there could be other things going on, and we ll look at five of the common ways that testosterone levels are affected. These are very, very common. 10

Same breakdown as we looked at earlier. The first one we re going to look at is stress. Stress is huge and the reason for that is because of high cortisol levels. First of all, what cortisol does is it literally shuts down LH, so the pituitary gland no longer even communicates to the testes to convert cholesterol into pregnenolone, so that s the first thing. If that s happening, if there s a problem at the pituitary level and we stat addressing these other things, we re fighting the wrong battle. We have this shut off LH so the communication between the pituitary, the brain, and the testicles has really been severed. The second thing that happens with stress is that as a result of this cortisol elevation, this pathway tends to be preferred. This is known as the pregnenolone steal, because it s essentially stealing, if you will, kind of favoring this conversion. Cholesterol to pregnenolone to progesterone, down to cortisol. Cortisol is the ultimate by-product, because the body says, Hey, you know what? We re going to shut off the reproductive side of things. We don t need testosterone for reproduction right now. We need to survive. Survival is first, as we ve seen. In periods of stress, the body will shunt away from the reproductive side and it will focus on this cortisol production through this pregnenolone-steal pathway. That s the first way that stress impacts testosterone levels. If this pathway s being preferred, then we re not going to very low amounts of testosterone, being produced. If you go to your doctor and you have your testosterone checked and you have low levels of testosterone, well, this could be one of the reasons. 11

The second way we can affect our testosterone levels, is through bloodsugar imbalances, and specifically through the impact of insulin. Here, when we have high levels of insulin, what happens is, we get this other pathway which tends to be favored. Here we have pregnenolone, which is converted to progesterone, which can then be converted to androstenedione, but instead of being converted into testosterone, it tends to favor its conversion to estrone, which is a precursor, to estrogen. We re shunting away from producing testosterone and moving toward producing more estrogen because of high levels of insulin in the blood. This goes back to, obviously, what we eat. The other thing to remember is that androstenedione is five times weaker than testosterone, but it competes with testosterone on testosterone binding sites throughout the body. Therefore, you have low-testosterone symptoms because you have more androstenedione binding to testosterone receptor sites. Let s say you have a blood test done, and the blood test comes back saying your levels of testosterone are normal but you re exhibiting these symptoms. You might have high levels of androstenedione because of high levels of insulin, and because androstenedione is five times weaker but competes with testosterone for binding sites so testosterone is not going to be exhibiting its effect throughout the body. 12

The other thing androstenedione is converted into estrone, which is essentially an estrogen, and that leads to an altered estrogen-to-testosterone ratio. It s the ratio; it s not the absolute numbers, for instance, as we mentioned in the mineral section in Module 4. It s the ratio that s so important. If we have an altered estrogen-to-testosterone ratio, this can lead to low testosterone symptoms. The other thing is that too much estrogen increases sex hormone binding globulin, which we mentioned earlier. This is the second way that our testosterone levels can be affected. Even if the levels themselves on a blood test are not affected, symptoms can be exhibited based on this pathway; but also, this can directly impact the amount of testosterone that s being produced or not being produced. This is all going back to blood-sugar imbalances. The third way that we can affect testosterone production is by impaired liver detoxification. We ve mentioned how important liver detox is, the importance o the liver, the health of it. The half-life of testosterone is seven minutes, which means that it takes seven minutes for testosterone to be metabolized in half and then another seven minutes from there, in half, and in half and in half. They use this a lot with radiation. 13

The half-life of estrogen is several hours, so this presents us with an issue because this now upsets the estrogen-to-testosterone ratio again and even more so if the liver cannot clear out excess estrogen, because, again, the liver s going to filter all of this stuff. If the liver is unable to clear out this excess estrogen, well, we re going to have low-testosterone symptoms, even if there s enough testosterone in the body. Dihydrotestosterone (DHT) is ten times stronger than testosterone, and this leads to, like insulin resistance, we re going to get a testosterone receptor resistance to testosterone, because what s happening is that if testosterone is being converted to DHT due to the upregulation of an enzyme called 5-delta desaturase, if this enzyme is upregulated instead of having free-floating testosterone throughout the blood, it s converted to DHT. Now we have a molecule that s ten times stronger than natural free-floating testosterone, and that s going to overstimulate the receptors throughout your body, and, like with insulin we develop insulin resistance, with leptin we develop leptin resistance. The same thing happens here. Again, this upregulation of the enzyme 5-delta desaturase leads more testosterone converted to DHT, and that can lead to testosterone resistance. T isn t working at the cellular level, because those receptors are no longer sensitive to it. 14

And the fifth way that we can affect our testosterone levels is dietary deficiency. Three of the common ones are zinc. You ve probably heard of zinc being an important precursor for testosterone, which is definitely true, but it s interesting that if you already have adequate levels of zinc in your body taking extra zinc won t make a difference. Also, because it s so dependent on having good stomach acid to be absorbed, having an underactive stomach is going to impair your ability to absorb zinc. Taking the steps to make sure your stomach s producing enough hydrochloric acid and you re digesting things properly or else zinc is not going to be absorbed. Omega-3s definitely have a preference here for all of this stuff and for improving those pathways. B6 kind of indirectly because it impacts estrogen metabolism, so it s able to kind of speed up estrogen metabolism, which is obviously going to help rectify the estrogen-to testosterone ratio in the body. Those are five common ways that we affect our testosterone levels without really directly talking about testosterone itself. There are things that we re doing that are affecting the ultimate end result. 15

Causes of Low T Symptoms These causes of low T symptoms: decreased liver detoxification; poor gastrointestinal health; altered adrenal function, if we have too much cortisol pumping out; blood sugar and insulin issues; altered enzyme activity; comprised pituitary function. These are all causes of low-testosterone symptoms. Andropause is to men what menopause is to women. It s a drop in androgens or testosterone, which leads to low-testosterone symptoms. If you re a man who s dealing with andropause the solution is not I need more testosterone. The solution might be rectifying the health of your liver, stomach digestion, and improve GI health. We need to support our adrenals to reduce stress. We need to manage our blood sugar. If we go to our doctor they re just going to say, You have low testosterone levels. I guess we ll just give you some testosterone, and they ll give you AndroGel or something like that without dealing with these initial issues. 16

Testosterone Replacement Therapy What about testosterone-replacement therapy? This is a picture of Dr. Jeffry Life, who, I believe, in this picture is about 65 years old. He s a big proponent of TRT. He actually left this medical practice and devoted the rest of his life to getting this message out about the importance of testosterone for older men. Just to show you how this has grown the last couple of years, the number of testosterone prescriptions in the U.S. alone has tripled with sales now close to $400 million a year. That s still dwarfed by Lipitor and a lot of the other big pharmaceuticals, but we ll see this number continue to rise especially with anti-aging clinics like Cenegenics, 20,000 patients, 2,000 physicians working with them. There s definitely more movement into this area. Here s my take on all of this, whether we re talking about menopause, andropause, or doing anything with hormones inside the body. Don t mess with physiology. Obviously, you re not going to hear this from your doctor, but our bodies have worked as they have for the last several thousand years, and that s not to say that we can t improve things. There re definitely ways that we can improve our health. I definitely believe that we can increase our lifespan but maybe it s my naïveté or lack of information that we have currently, but when we start messing with nature, we don t know the repercussions. It s like the Jurassic Park thing, where you think we can re-create the Jurassic time all over again in the modern world. We can t play God. We don t know how things will turn out. I m not going to say that you must avoid TRT at all costs. If that s something you want to look into, then, by all means, discuss this with your doctor. Understand that most doctors don t have a specialty in this area, so do due diligence to 17

find one who does, and then, with an understanding of some of the stuff we re talking about in this lesson, you can make a better decision, and perhaps TRT is for you. I m not too sure. You ll have to try it out and see if it gives you the results you re looking for. TRT Side Effects Nonetheless, I want to show you some ways that we can boost testosterone levels naturally. A couple side effects of TRT in younger men, it shrinks the testes and, in all men, drops the sperm count, it really depends on the different program you re following, so if you have too high of a dosage, it s going to shut down the testes functions. They ll be able to shrink in size because they don t need to be used as much. There is some interesting research showing that testosterone doesn t necessarily initiate prostate cancer, but since prostate cancer cells require testosterone to grow, supplemental testosterone can be problematic. If you already have inklings of prostate cancer, you definitely don t want to be supplementing with high levels of testosterone, because that can further the growth of those prostate cancer cells. Boosting T Naturally Let s look at some ways to boost testosterone naturally. We re going to talk about sex, exercise, fat loss, diet and supplementation, and stress management. If you focus on these five before looking at the replacement-therapy side of things, I guarantee you d exhibit some really, really good symptoms. Sex Here s what it comes down to. Some research hints at the use-it-or-lose-it feedback loop. Testosterone levels increase with sexual stimulation and activity and decline after long periods of celibacy, so enjoy lots of safe sex, assuming you re of age and the other partner s of consent. That s needless to say. 18

Exercise Let s talk about exercise. The stimulation of the beta-adrenergic receptors, which is anything that s going to cause a surge in epinephrine or adrenaline encourages testosterone synthesis and a release in a dose-dependent fashion. So, the more stimulation, the more synthesis. Essentially, this is relative to the intensity of exercise, which means, the harder you train the more testosterone you will get. In the last lesson we talked about the importance of intensity. Again, this is it with respect to testosterone. You cannot be gliding nice and easy on the elliptical for an hour. You need to be lifting heavy; you need to be increasing the intensity of your workouts, because, at the same time, extended bouts of endurance exercise seem to suppress testosterone, so you don t want to be going for three-hour runs every day of the week. Moderate- to high-intensity exercise increases plasma concentrations of testosterone, however, more so in men than in women. So, once again, women, if you re engaging in heavy lifting, high-intensity exercise, it doesn t lead to as great an increase in testosterone as it does in men. Women tend to respond to intense exercise with very small and/or delayed testosterone increases or even no testosterone increases at all. There s very little synthesis of testosterone or increase in testosterone as a result of intense exercise in women. In men, definitely. 19

Strength vs. Hypertrophy Workout I want to show you a couple studies, the first one is from the International Journal of Sports Medicine in 1991, and they compared a power-lifting type of workout consisting of three sets of five reps, with three minutes rest between sets versus a body building type of workout consisting of three sets of ten reps, with one minute rest between sets. That s the typical protocol: strength and power, lots of rest, low reps, and muscle-building. We re looking at higher volume, so about ten reps, the minimal rest, really taxing the muscles. T levels were increased for 15 minutes following exercise and the body building workout led to a 67% increase, and that was superior to the power-lifting workout, which led to a 32%. Both increase T levels; it s seen that the body building workout increased it even more so, and we can kind of figure that to happen, although the more intense you work out, the greater the testosterone level increase as well. Sometimes, depending on the nature of the workout structure, that can obviously change things. Body builders don t typically have higher testosterone levels than the average person. Many studies have shown that because of their intense of training and the fact that they burn more calories than they intake or it stays around par. This actually creates more of a stress on the adrenal system, and when there s more cortisol secreted, it depresses T levels. You d think body builders would have higher levels of T. Testosterone levels vary dramatically throughout the day. We re talking about a huge discrepancy very high levels. The one thing I forgot to include in this presentation is that testosterone levels seem to be highest in the summer and early fall. Some speculate it has something to do with sunlight and vitamin D levels. Essentially, the higher the vitamin D you have, the higher the testosterone levels. 20

In summer and early fall, we obviously have the most sunlight. When we re getting more sunlight, we re getting more vitamin D, and, therefore, we re getting higher levels of testosterone. That s something else to consider before setting into hibernation mode for the winter. Get some sunlight. Long Distance Running Long-distance running. A study in the European Journal of Applied Physiology in 96 looked at T levels in elite distance runners versus sedentary men. At rest, sedentary men had 54% more total and free testosterone floating around their blood than the runners did. In general, most volume-training athletes have lower levels of testosterone. This comes back to the elevated stress on the body, leading to higher levels of cortisol. What s interesting is that the volume threshold seems to be at about eight hours. So if you re doing more than eight hours of exercise per week, then you re probably compromising your testosterone levels. That s why the exercise programs I put together rarely exceed five hours a week. That s not the only reason overtraining is also an issue. This study just goes to show, again, that more is not necessarily better. 21

This is what they did. On the left here, we have running, intensity, and duration. They had a couple of protocols. They had 80% max heart rate for 120 minutes, two hours; 80% of max heart rate for 20 minutes; 50% of max heart rate for 120 minutes; and 50% max heart rate for 20 minutes. The sedentary and elite runners, we had a big increase at the 120 mark for 80% max heart rate, and we had a slightly lower increase still at the same heart rate, same intensity, for a lower duration: 31% and 62% respectively. The elite runners had a greater response in testosterone levels in general, but look at this: 50% of maximum heart rate, whether it was 20 or 120 minutes, did nothing in terms of boosting testosterone levels. So, intensity is the key 80% max rate the longer the duration, naturally increase the intensity as you go, led to a greater increase. Fat Loss Since adipose tissue, fat tissue, increases estrogen output due to enzyme aromatase, which converts testosterone into estrogen, losing fat is essential to reestablishing healthy estrogen-testosterone ratios and free testosterone in the blood. This picture shows it pretty clearly. If you have decent levels of testosterone and you have high levels of fat, well, with those high levels of fat, you re going to have more aromatase converting testosterone into estrogen. If you have more fat, you ll have more estrogen in the body will skew your ratio. Getting rid of unnecessary fat tissue is critical, especially when we re talking about testosterone. 22

Testosterone Diet & Supplementation Eat a whole-foods diet. Increase intake of healthy fats: olive oil, coconut oil, EFAs, avocado, grass-fed meat or eggs. Again, we want to get some saturated fat in; we want to get good monounsaturated and good unsaturated fats in, and we want to get our bodies starting to use cholesterol more efficiently. Healthy fats are really critical to healthy testosterone function. Increase caloric intake slightly. More calories in tends to increase the conversion of cholesterol to testosterone. This doesn t mean over consume and create more fat. If you are strength training, which is very important to understand, you want to increase your calories, because a very-low-calorie diet is going to impair testosterone production. You want to eat more zinc-rich foods, oysters, pumpkin seeds, and so forth and ensure you have enough hydrochloric acid in your stomach. If you need to, take an HCL supplement in conjunction with your foods. Reduce sugar intake, which includes alcohol, and reduce high levels of estrogen, soy and xenoestrogens and so forth. We ve seen that sugar wreaks havoc on this whole testosterone pathway. It does so directly through insulin, and it also does so indirectly by stressing adrenal glands even more, so you need to reduce the sugar, you need to reduce the alcohol consumption. Estrogen and Supplements In general, we want to avoid highly estrogenic foods because we don t want more estrogen in the body. That estrogen-to-testosterone ratio needs to be in balance. For instance, hops are high in estradiol, so avoid beer made form hops and avoid beer in general. Soy foods, soy milk, tofu, avoid unless it s fermented and then only in moderation. Soy products tend to be processed garbage. It s going to dramatically increase the estrogen load in your body, which is going to shift that ratio. 23

Tap water is loaded with xenoestrogens from drugs, for instance, birth control pills that have been flushed down the toilets, all sorts of things like that. Even women on birth control pills pee after, there s residue of those birth control pills in the water. We re talking about very minute amounts, but over a decade or two or more, those levels can add up in the body. Xenoestrogens, these are kind of known as fake estrogens. Tap water, not a great option. Well, neither is bottled water depending on the quality of the plastic. If you have a bottle of water sitting in the sun, that s going to increase its chemical reaction, which is going to leech xenoestrogens into the water itself. Now you re drinking what you thought was good bottled water but actually has higher levels of xenoestrogens. Try to drink filtered water from home when possible. If you have to get bottled water, make sure it s a dark, solid bottle, no flexible plastics, none of that stuff. Helpful supplements. Pine pollen is the male sperm of trees. This is how trees reproduce, and it s the highest plant source of testosterone. Because of that, it should be taken as a tincture and in very small doses. You definitely want to consult with an herbalist or naturopathic doctor before doing this, because pine pollen can be pretty dramatic in terms of its effects. It s literally just injecting testosterone into your body, so less than about an ounce daily is generally recommended. Tribulus essentially allows the testes to function more efficiently. The typical dosage is about 200 mg three times per day. Again, all of these supplements you want to verify first with an herbalist or a naturopathic doctor. Asian ginseng is helpful for regulating testosterone levels. It should not be mixed with antidepressants, so if you re on an antidepressant do not take it. Nettle root interferes with the testosterone binding to sex hormone binding globulin. That s a good thing as well because we don t free testosterone binding. Those are four pretty powerful supplements with respect to boosting and regulating testosterone levels. 24

Stress Management And then stress management. Adrenal disruption is not good for testosterone levels because high levels of cortisol suppresses testosterone production. You need to manage your stress. Yoga, meditation, whatever you want you need to get it handled. And along those lines, adequate, restful sleep is also necessary, so making sure you re going to sleep at about the same time every night, waking up at the same time every morning that was kind of my rule of thumb, the best thing to do to improve your sleep and then obviously making sure that you re sleeping throughout the night. Summing Up Let s sum all of this up. To maximize testosterone levels for muscle growth, recovery, and health we want to engage in regular, intense exercise. Don t severely restrict calories to more than 20% base needs. If you re looking to lose weight, in that 10 to 15% is probably the safest way to do so. Make sure you re consuming enough micro- and macronutrients by eating a whole-foods diet and make sure you are getting healthy fats. Engage in safe, regular sexual activity. Avoid medications and drugs as much as possible. If you re on some, check with your doctor first, because, again, all these medications and drugs tend to increase the estrogen load in the body. And get adequate sleep, seven to nine hours per night in general for most people. And control stress and anxiety levels. We ve taken a situation in men which is becoming problematic, but the solutions are not rocket science. When we find the root cause of some of these problems and then rectify them we will see results. We can t just say, Okay, I ve got low testosterone. I need to supplement with testosterone, because it s not necessarily what s going on by itself. The goal should be to reestablish a more youthful balance of hormones in your body by doing two things: increasing the free testosterone influence and diminishing the estrogen and sex hormone binding globulin influence or increasing the testosterone-to-estrogen ratio for optimal health and function. 25

We want to reduce the estrogen load, increase the testosterone influence within healthy means. We re not supplementing with black market testosterone. We re doing things naturally, if possible. And then if not, we can look at those replacement therapies if needed. But, again, you want to get this stuff checked out. Get Tested A good male-hormone panel will include: total and free cholesterol; the estrogens estrone, estradiol, estriol; androstenedione; sex hormone binding globulin; DHTA, DHT; luteinizing hormone; and possibly an adrenal salivary panel to assess cortisol levels. Ideally you want to be looking at all of these things. Your doctor, a naturopathic doctor, can give you a really good understanding of what all this stuff means for you. Most naturopaths can run salivary, blood, and/or urine tests for these different hormones, so if you want to get tested, try to get these tested out. Again, if you re going to your doctor and you re just getting a total testosterone level measure, that s not going to give you much. You don t know how much of that total testosterone is free, you don t know how much of that is bound to SHBG, and so you want to get this stuff measured. Ideally, you want to measure this over time, especially if you re starting to put stuff into practice. Sooner than later, you want to see how that s going to impact these levels as you do so over the coming months. 26

Coming in Lesson 4 So, that is Lesson 3. Hopefully it s made sense for you. Coming next in Lesson 4, we re going to be talking about the role of estrogen in the body, estrogen dominance, and menopause. We ll be shifting from a predominantly male focused topic to a predominantly female focused topic although there will be important things men should know too. It s really important to understand how hormones impact our physiology, because they are messengers telling our cells and organs and systems different things, and we need to understand that. That s coming your way in Lesson 4. I hope you ve enjoyed this lesson, and we ll see you then. 27