Thank you everybody for making it to my seminar on male menopause on Tuesday the 17th. As promised I've put together the notes from the class here for your reference.
First, we covered the basic cause of male menopause. As we age the Leydig cells in the testes make less and less testosterone. The result is that as men age they start to demonstrate symptoms associated with a decrease in male testosterone activity. To make matters worse the numbers of Sex Hormone Binding Globulins (SHBG) also increases with age. The SHBGs bind to testosterone in our blood stream and make it inactive. Only after it cleaves off of this carrier protein is it able to perform all the manly binding and stimulating that testosterone is responsible for in our bodies.
So we end up with this double whammy of lower testosterone and less of that testosterone able to be active in our blood. How does this show up in terms of symptoms? Well, I'm glad you asked. There are a lot of important things that testosterone does in our bodies, and the problems presenting when testosterone get low run the gamut from emotional, to physical to everywhere in between. Lower energy, and decreased muscle mass are the main physical manifestations. The mental manifestations include slower cognition, poor memory, and less focus. The emotional changes can include depression, anxiety, and a less competitive attitude. A lot more men out there these days are making use of testosterone replacement therapies than had in previous decades. The increase is likely due to a number of factors which we'll get into deeper below.
But first, what can be done about this? Well, as I covered in the class there are three main areas that we can work with to influence hormone production and synthesis: diet, lifestyle, and supplements.
When we look at diet, first we want to think about where our hormones come from. Here's a brutally oversimplified figure depicting hormone synthesis: (for the whole enchilada check out this great chart).
So we start with cholesterol. That requires that our diet is sufficient in healthy fats to make this all-important hormone precursor. The cholesterol gets converted to pregnenolone, and then from there takes a stroll down different paths to arrive at its final product like a sex hormone or a stress hormone. But the important part for now is that all of these hormones begin as cholesterol.
The first step to establishing healthy testosterone levels then is to ensure that healthy fats are coming in. This has played out in the work of a California nutritionist named Kim Schuette, recently featured as a speaker in the Real Food Summit. Kim has done some amazing work on patients with erectile dysfunction. The amazing part is that she did this through dietary changes. This involved a diet structured around traditional fats like butter from pastured cows (pastured means cows raised eating grass rather than grains), cod liver oil (which you can pick up here) and the elimination of grains and processed food. Not a bad gig being able to reverse erectile dysfunction through diet alone. Kinda speaks about how far we've come from a healthy natural diet. The troubling thing about all this is that these poor guys were actually told by the authorities that they were on the best diet possible. They were told by the powers that be, including the USDA and the Surgeon General, that saturated fats and cholesterol in our diets were causing heart attacks and strokes and that we need to eat little or no saturated fat to be healthy. Take a look at my establishing accurate cardiovascular risk post to get the whole picture on this issue, but there is a lot more going on than fats, and outlawing an entire macronutrient type from our diet is dangerous for our health, and kinda not smart. So the message is: eat healthy fats including: grass fed beef, pastured eggs, cold water fish, cod liver oil, coconut oil, and butter and milk from pastured cows.
Other ways we can tweak our diets to get the best results in terms of testosterone levels? Well, the next thing to think about is the aromatase inhibitor. This is where my earlier picture of hormone synthesis shows itself to be woefully inadequate. Here's a better illustration: (note the aromatase between testosterone and estrogen.)
Aromatase is an enzyme that converts testosterone into estrogen. It makes sense then that if this enzyme is really active then there will be more estrogen and less testosterone in your blood. So you can inhibit this enzyme and end up with the opposite scenario in place. Luckily, there are several things in our environments, and in our diets that do exactly that.
Here's are the main foods we talked about: the brassicas (cabbage, kale, chard, brussel sprouts), red wine and olive oil, and oysters. Also white button mushrooms contain phenols that effectively inhibit the aromatase enzyme. These are general guidelines, there are other foods that have this same effect, but these were the foods that I found the best support for their activity.
These are foods to eat, are there also foods to avoid? Yes. There are a number of foods that have phytoestrogens in them. These are chemicals that look similar enough to estrogen that they actually stimulate estrogen receptors in the body and result in the effects that having more estrogen would cause. A few of these foods are: soy products, yams, flax seeds, oats, beans, lentils, and whole grains. Obviously a lot of these are healthy foods and entirely eliminating them from your diet may not be necessary. Rather, if you are struggling with testosterone issues, don't make these foods main staples in your diet. Instead make them periodic parts of your rounded diet (that is also rich in healthy sources of healthy fats.)
There are also estrogen-like chemicals in some not so nice places. These are mainly the result of industrial processing, or artificial ingredients added as stabilizers, emulsifiers, and preservatives to cosmetics, foods supplements, and even some foods. Whenever choosing lotions, sunscreen cosmetics or supplements make sure that there are no pthalates, parabens, or BPAs present in these items. Parabens are mainly found in cosmetics, lotions, and soaps. The pthalates are found in these same products as well as often being incorporated into the outer coating on supplements, vitamins and prescription medications. Everybody is probably familiar with BPA aka Bisphenol-A by now. This is a plasticizer that is often used with food packaging. It is ubiquitous in the food world: soup cans, juice cans, soda cans, water bottles, plastic packaging, clamshells, even baby bottles used to contain BPA. This is most easily avoided by eating real food. The more a food is processed the more packaging it will have around it, the more likely it is that BPA is in the packaging and in the food. Eat foods that don't require as much packaging, like fresh fruits and vegetables, meats, eggs, cheese, and if you eat beans get them as dried beans and soak them rather than buying a can of them. Buy the ingredients and make the soup rather than buying a can of soup. There was a study fairly recently at Harvard where they subjected students in the cafeteria to either canned soup or homemade soup for a week and checked the BPA levels in the 2 sets of subject, those fed the canned soup had over 1,000% higher levels of BPA (yes that was 3 zeros, one thousand percent higher). The BPA absolutely makes it into our bodies, and it absolutely causes endocrine disruption.
That pretty much wraps up the diet section. Next lets talk about lifestyle. In order to maintain a healthy testosterone levels the most important thing in terms of lifestyle is to chill out. Here's that diagram again:
Notice that cortisol sits at the end of a different pathway than testosterone? That's important. Cortisol is the body's main stress hormone and anytime we are under a great deal of stress our production of Cortisol gets ramped up. Pregnenolone is the raw material that gets used to make both of these hormones. The more that goes to making cortisol, the less is available to make testosterone. We end up making a lot less testosterone. So when we get heavily stressed we see our testosterone levels plummet. Now in the short term, such as with acute stress like a physical danger, that type of stress stimulus can be a good thing and can actually result in higher levels of testosterone down the road. It is the type of chronic stress that is more common in our culture that is the real problem. When stress occurs in short bursts with an obvious end, that stress becomes a force that makes us stronger and teaches us new things. Because it is so short lived it doesn't significantly influence our sex hormone synthesis. When we have the kind of stress that comes from a job we don't like or from financial woes, or relationships, we end up with stress that endures for much longer than intended. Testosterone levels are effected. So a great step to take in order to improve testosterone levels is to find some type of a relaxation routine you can fit into your day, and stick to it regularly. A great example would be finding 15 minutes in the morning and sitting comfortably and trying to do nothing. Deep breathing is an instant and easily available activity that has been found to lower cortisol levels. Whatever you are into, use that as a means to reduce your chronic stress level. Other important steps you can take to lower your cortisol levels are: get adequate sleep, get sufficient micronutrients (an unhealthy diet is a source of chronic inflammation and that inflammation results in higher cortisol levels), avoid excessive training (don't forget to take rest days), reduce inflammation in general (Reduce your exposure to the constant sources of low level inflammation. A good example is the ridiculously uncomfortable high heels that women feel they need to wear. The constant friction and discomfort, besides being a mental stressor, are also a source of physical inflammation, resulting in higher cortisol levels as well.)
Strength resistance training is another important step to take in order to increase testosterone levels. Numerous studies have found that resistance strength training increases the testosterone levels in men and women, as well as decreases the cortisol levels in as short as 4 weeks.
Taking part in competitive play can also boost testosterone levels. One study confirm this by pitting subjects against one another in a number game where they compete for time. The winning participant had higher recorded testosterone levels after the game. The degree to which losing a competitive game might decrease testosterone levels isn't clear. This study also found that when the game was preceded by a visualization exercise that involved seeing oneself win the game, that the testosterone levels were increased more significantly. The take home message is to set goals that you can attain, visualize succeeding in attaining them and then go do it.
We also talked about supplements that can be taken to increase testosterone levels.
Healthy Fats: Get on some healthy fats: fish oil, or cod liver oil (I'd recommend fermented cod liver oil from green pastures). Look for about 1,000 mg of fish oil per day. Pastured butter and dairy are other good options.
Vitamin D3: Vitamin D supplementation (in those that truly are deficient) is likely to increase testosterone levels. Ensure through blood testing that indeed your levels are low before supplementing. There are Vitamin D receptors on many of our organs and tissues and the reproductive tissues are no exception. I recommend 1,000-4,000 iu per day until blood levels of vitamin D3 have reached optimal level.
Natural Aromatase Inhibitors: There are a number of supplements that have been found to, or are suspected to inhibit the aromatase enzyme, thereby slowing the conversion of testosterone to estrogen. One of these is Chrysin. Make sure that you get a supplement that pairs it with Piperine in order to enhance the absorption. Look for a dosage around 2gms per day. Another aromatase inhibitor is grape seed extract. It also is a potent antioxidant and has been found to have some great anti-cancer actions. So not a bad one to add to the cabinet. Look for about 50-200mg/day.
Chines Herbs: There are a number of Chinese Herbs that have been shown to increase testosterone levels. The three that we talked about are: Bai Ji Li, Yin Yang Huo, and Wu Jia Pi. These are all herbs that are considered to be of a warm temperature energetically, and have particular affinity to the organ systems kidney and liver in Chinese Medicine. This indicates that these herbs would be beneficial for treatment of the symptoms associated with low testosterone levels. Studies examining the effect these herbs have on testosterone levels later showed that indeed these herbs do increase testosterone levels in subjects. It is best to get these herbs the way they are prescribed in traditional chinese medicine, that is paired with approriate balancing herbs, within a carefully crafted herbal formula. When Chinese Herbs are prescribed by a trained Chinese Herbalist they rarely are given without taking part in a complete formula of several herbs. This ensures that any possible side effects are avoided, absorption is optimized and the effects of the formula are balanced and comfortable for the patient. Seek out a knowledgeable practitioner for your herbs. In this way you can also be sure that you are receiving a quality product that is free of toxins, heavy metals, and adulterants.
So that's pretty much all we covered: get your diet right, chill the heck out on a daily basis, look for some good supplements and utilize some mental visualization exercises. Thanks again everybody that made it out for it.
