Natural Testosterone Support · 2019. 12. 20. · avoid prescription drug therapy, unless as a last...

44
Natural Testosterone Support Professional Methods Dr. Casey Greene in collaboration with

Transcript of Natural Testosterone Support · 2019. 12. 20. · avoid prescription drug therapy, unless as a last...

Page 1: Natural Testosterone Support · 2019. 12. 20. · avoid prescription drug therapy, unless as a last line option under supervised medical care. While testosterone replacement therapy

Natural Testosterone SupportProfessional Methods

Dr. Casey Greene in collaboration with

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Welcome from Nexus Health Partnership!

First off, we at NexusHealthPartnership.com would like to congratulate you on finding this rare resource. Influenced by the research of our team of experts, the information in this ebook will help guide you in naturally optimizing your testosterone and related hormone levels. While any doctor can write you a prescription for testosterone and call it a day, a far better approach is to look for and figure out the underlying cause. While simply taking testosterone will improve several symptoms quickly, it does not address the hundreds or even thousands of underlying problems in the body causing testosterone deficiency in the first place. Wouldn’t you rather be in optimal male form naturally than dependant on a weekly needle? If you ever come off the injections, you’ll be in worse shape than ever without a professionally designed program to wean you off. Even then it’s still questionable.

The information in this book was quite difficult to obtain. It required decades of intense work with leading professionals and experts in the areas of male testosterone optimization and nutrition to assemble. We at NexusHealthPartnership.com hope that you find the information to be as invaluable as we have for both ourselves and our clients.

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About Us

Who are we, and why should you care to know our opinion on the topic of natural testosterone support?

Nexus Health Partnership is a team of trained professionals who specialize in nutrition, fitness, and functional medicine. Unlike most areas of modern medicine, functional medicine focuses on finding the root cause of a given health problem, and testosterone deficiency in men should be no different in approach. Our professionals have worked with hundreds of leading physicians, pharmacists, nutritionists, and exercise physiologists specializing in the areas of male hormone optimization, body composition, and nutrition while seeing the results in thousands of patients and clients. After years of observing vast numbers of men going on testosterone therapy both medically and illegally for a boost, we decided there had to be a better, more natural, and sustainable way. Well there is, and we’re here to tell you about it!

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Natural Testosterone Optimization E-Book iv

How to Use This BookFirst off, this book is not intended to teach you how to use testosterone replacement therapy. This book is intended to offer best-practice methods used by leading healthcare professionals to maximize natural male testosterone levels while optimizing related hormones. These methods are preferred for addressing the root causes of male testosterone deficiency and related hormone imbalances while attempting to avoid prescription drug therapy, unless as a last line option under supervised medical care. While testosterone replacement therapy can certainly be useful in the right candidate, most men can optimize their testosterone levels naturally. Doing so can also improve related symptoms such as low energy, low sex drive, erectile dysfunction, less muscle mass, poor mood, and lack of motivation by utilizing the methods within this book. Prescription, and especially illegal use of anabolic steroids, can have serious negative consequences when not used properly or not needed in the first place.

This book is organized by given types of health problems that lead to suboptimal male testosterone levels. It will educate you on how to use leading professional nutritional strategies, supplements, and lifestyle changes to correct testosterone deficiency. Based on your health status, diet, and other lifestyle habits, you might benefit from utilizing one, several, or even all of the suggested strategies to optimize your natural testosterone levels.

There is no one magic pill to correct any and all possible causes of testosterone deficiency. Even if there was, all the ingredients couldn’t even fit in a single capsule that could be swallowed without choking. For example, the amount of magnesium alone many men need to take could require several capsules daily without even getting into other ingredients used for other purposes. Plus, different people need unique nutrients or lifestyle changes to address their specific underlying problems, which is why there is no single solution. Some men would benefit from certain supplements or changes, while others might be best to not take certain ingredients. This is why a customized regimen is the best approach for you, not an all-inclusive magic pill that some skilled marketer has conceived.

“There is no

one magic pill...”

Note: The statements in this book have not been evaluated by the U.S. Food and Drug Administration (FDA), and are intended for informational purposes only.

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Natural Testosterone Optimization E-Book v

Table of Contents

1 BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 PRIMARY CAUSES OF LOW TESTOSTERONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

2.1 Nutritional Deficiencies Related to Low T . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

• Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

• Vitamins D & K2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

• Magnesium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

• Zinc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

• Vitamins A, E, & Selenium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

• Protein . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

• Summary of Nutritional Deficiencies Linked to Low T . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

2.2 Testosterone Metabolites, Carriers, & Estrogen Metabolism . . . . . . . . . . . . . . . . . . . 17

• Metabolites/Carriers & Causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

• Metabolites/Carriers & Side Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

• Metabolites/Carriers - What Raises & Lowers Them . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

• Summary of Testosterone Metabolites, Carriers, & Estrogen Metabolism . . . . . . . . . . . . . . . . . 20

2.3 Chronic Stress & Elevated Cortisol Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

• Background on Testosterone to Cortisol Ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

• What to Do About It . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

• Chart - Nutrients/Herbal(s) & What They Do Related to Stress . . . . . . . . . . . . . . . . . . . . . . . . . . 23

• Summary of Chronic Stress & Elevated Cortisol Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

2.4 Obesity, Cardiometabolic Disease & Chronic Inflammation . . . . . . . . . . . . . . . . . . . . 25

• Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

• Chart - Recommendations to Prevent and/or Reverse Cardiometabolic Diseases . . . . . . . . . 28

• Summary of Obesity, Cardiometabolic Disease & Chronic Inflammation . . . . . . . . . . . . . . . . . . 29

3 CLOSING NOTES ON TESTOSTERONE DEFICIENCY . . . . . . . . . . . . . . . . . . . . . . . 30

4 DISCLAIMERS AND NOTICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

5 INDEX OF SUPPLEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

6 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

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Natural Testosterone Optimization E-Book 1

1 Background Information

What is the advantage of getting your natural testosterone levels back versus going to the doctor and getting an injectable or gel medication to do it for you? Well, for starters, there are certainly side effects associated with taking supplemental testosterone medications. These can include, but are not limited to, suppression of natural testosterone production, decreased or fluctuating sexual function, increased estrogen levels, hair loss, increased water retention, changes in mood, oily skin, acne, increased hematocrit or blood thickness, changes to prostate and urinary function, and too many more to list here. Now, before you assume I’m against medical testosterone replacement therapy, let me assure you that it can be a very valuable medical therapy in the right patient under supervision by a qualified and experienced healthcare practitioner. I will say that a physician experienced in testosterone replacement therapy should be able to help you avoid most of the listed side effects while providing many medical benefits. But shouldn’t fixing the root of the problem always come first? Wouldn’t you rather not be dependent on medications to maintain your testosterone levels? Plus, what if fixing all these underlying problems actually helps you to feel better than the medications could? Well, I’m here to tell you they can, and probably will!

Let’s look at what low T might look like in a

nutshell, although you’d of course have to see

your local doctor for diagnosis.

“...what if fixing all these

underlying problems actually

helps you to feel better than the

medications could?”

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Natural Testosterone Optimization E-Book 2

Symptoms of Low T

Low libido, erectile dysfunction, depression, fatigue, mental impairment, insulin resistance,

obesity, type 2 diabetes, hypertension, decreased muscle mass, poor cholesterol profile,

lowered bone density, high blood pressure, body hair loss, increased rate of injury, slower

recovery, as well as decreased desire and capacity for physical activity are among the

leading symptoms of low T.1

Basic Diagnosis

(varies somewhat by treatment guideline):1

• Presents multiple and significant symptoms from above

• Serum total testosterone level below 300 ng/dL in early morning (confirmed twice)

• Additional testing as needed: free T, SHBG, estradiol, LH, FSH, etc.

This book is focused on optimizing natural T levels based on the following

4 primary categories:

PRIMARY REASONS FOR LOW T BASIC DESCRIPTION

Nutritional Deficiencies• Vitamin D, Magnesium, Zinc, Vitamin A, Vitamin E,

Selenium, Protein, Fats, Cholesterol

Testosterone Metabolites,

Carriers, & Estrogen Metabolism

• Aromatase = T to Estrogen

• 5-AR = T to DHT = Hair loss, prostate/urinary

problems

• SHBG = Less free testosterone

Chronic Stress • Stress = Cortisol = Lower T

Obesity & Related

Cardiometabolic Diseases

• Obesity & most related chronic diseases such as

insulin resistance, type 2 diabetes and heart disease

are highly correlated with low T

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Natural Testosterone Optimization E-Book 3

2 Primary Causes of Low Testosterone

2.1 Nutritional Deficiencies Related to Low T

BackgroundWhile we, on average, get no shortage of calories in our American diets, we can often be low in various nutrients critical to optimal testosterone production and function. This is thanks to the many processed foods we consume, as well as lack of variation in our dietary

choices. A well-rounded diet rich in whole foods with a wide array of colors is, of course, a

recommended starting point. Below are the primary, individual vitamin or mineral deficiencies

scientifically linked to lowered testosterone levels. It’s not a coincidence these are also some of

the most common dietary deficiencies, which is why

testosterone levels can be optimized through an

increased intake of these nutrients if deficient.

“...While we on average get

no shortage of calories in our

American diets, we can often

be low in various nutrients...”

EMPTYCALORIES

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Natural Testosterone Optimization E-Book 4

Vitamins D & K2

Background

Vitamin D is not only the primary nutrient deficiency in the U.S., but it is also the primary

nutrient deficiency highly linked by science to testosterone deficiency. The male sexual

reproductive organs are a major target tissue for vitamin D, which actually acts as both a

hormone and gene regulator.2 Vitamin D’s gene regulation leads to lowered inflammatory

markers and increased testosterone synthesis.3 Vitamin D is primarily made by the body

utilizing cholesterol after exposure to sunlight, but a small amount is also obtained in the diet.

Since American culture typically encourages less of both sunlight and

cholesterol nowadays, vitamin D deficiency is on an epidemic level.

Optimal Levels

Most patients I’ve seen in testing 25-hydroxy-vitamin D serum levels range from 20-

35ng/mL. Labs typically mark a deficiency at less than 20ng/mL. However, studies are

increasingly showing, and experts are noticing, reduction in rates of many chronic diseases

when 25-hydroxy-vitamin D levels are in a more optimal range of 50-80ng/mL. This would

certainly be the case with reversing testosterone deficiency. Understanding the difference

between being in the “normal lab range” and being at an optimal level is critical. Normal lab

ranges reference a huge pool of patients both healthy and unhealthy, so all parts of those

ranges are not necessarily desirable.

Dosing

The old 400 IU daily vitamin D doses will not budge your serum vitamin D levels, and are

quite frankly not very different from a placebo. If your vitamin D levels are anywhere near the

“Since American culture typically

encourages less of both sunlight and

cholesterol nowadays, vitamin D

deficiency is on an

epidemic level.”

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Natural Testosterone Optimization E-Book 5

bottom of the lab range, then doses between 5,000-10,000 IU daily will have to be used at

least for a limited period of time. Depending on various factors, including seasons (summer

versus winter) you will need to maintain these doses for anywhere from 3-12 months to get

your levels near the optimal range. Most people will need to start at vitamin D 5,000 IU

daily to make a significant impact, along with vitamin K2. Vitamin K2 in MK7 form is added

for reasons that go beyond the scope of this book. In a nutshell, it has more to do with

calcium and vascular health, although that does tend to greatly support both optimal erectile

function and mental function as overall blood flow is improved. People on vitamin K inhibiting

blood thinners should speak with their healthcare provider before taking any supplements

containing vitamin K.

Clinical Studies

One study of 200 healthy males had subjects take either 3,332 IU vitamin D daily or

placebo for 1 year. Compared to the starting values, they saw a significant increase in

total testosterone, bioactive testosterone, free testosterone, and 25-hydroxy-vitamin D

blood serum levels. Not only was total testosterone increased 25%, but free, or useable,

testosterone increased by 20% as well, meaning the entire testosterone profile improved

significantly. The placebo group saw no change.2

Another study showed that men with sufficient 25-hydroxy-vitamin D blood levels, again

only sufficient and not even optimal, had significantly higher levels of testosterone and

significantly lower sex hormone binding globulin (SHBG) levels. It also showed a high

association with changing testosterone levels in comparison to seasonal changes. In other

words, winter months with less sunshine and vitamin D correlated to less testosterone.3,4 As

a side note to be covered more in depth later, higher SHBG levels means more testosterone

is bound up, and therefore not free to act. While some SHBG is necessary, we generally want

less to optimize testosterone’s ability to do its job.

Total Testosterone 1 Year

1 Year

VITAMIN D GROUP

PLACEBO GROUP

VITAMIN D GROUP

PLACEBO GROUP

25% INCREASE

NO CHANGE

20% INCREASE

NO CHANGE

Free Testosterone

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Natural Testosterone Optimization E-Book 6

Vitamin D Summary

For these reasons, vitamin D is often the first place we look in optimizing male

testosterone levels naturally.

• Vitamin D 5,000 IU + K2 (MK7) 180 mcg Capsules - Take 1 capsule by mouth daily

• Vitamin D 5,000 IU - Taking 1 additional capsule daily (total 10,000 IU daily) might

be beneficial for those with very suboptimal 25-hydroxy-vitamin D levels, or during

winter months with limited sun exposure. Consult your healthcare provider for advice.

Note: If on vitamin K inhibiting blood thinners (ex: warfarin), consult your healthcare provider before

taking any supplements containing vitamin K.

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Natural Testosterone Optimization E-Book 7

Magnesium

Background

While vitamin D is the most common vitamin

deficiency, magnesium is easily the most

common mineral deficiency, with between half

to three-quarters of Americans being deficient

per NHANES data.5,6,7 To make it worse, that rate

is only based on the government recommended

daily intake, but not on optimal levels. And

that’s a shame, because it is critical in over 300

enzymatic reactions within the body, and it even

positively alters gene expression. Magnesium

deficiency has an alarmingly large association

with cardiometabolic health problems including

heart disease, obesity, insulin resistance, high

cholesterol, and even type 2 diabetes.8

What does this have to do with testosterone deficiency? Well, did you know that

testosterone deficiency is more highly associated with this cardiometabolic set of chronic

diseases than with aging itself?9 So, maximally reversing or preventing these diseases is

critical to reversing or preventing testosterone deficiency, and magnesium deficiency is

highly linked to this set of cardiometabolic diseases.10-14 But that’s not all, as magnesium

deficiency is specifically correlated with dysregulation of the HPA hormone axis regulating

testosterone output.15 I’ve even heard experts in the field state that long-term severe

magnesium deficiency is equatable to castration. Now, that may be a bit extreme,

but you get the point.

How Do I Know if My Magnesium Levels are Low?

Modern medical practice typically tests only serum magnesium levels, which are typically

only out of range when acutely ill with severe electrolyte imbalance. A red blood cell (RBC)

magnesium test is the best method to test actual body stores of magnesium. Various lab

ranges go from 3.5-6.8mg/dL, but experts in this area recommend an optimal level of

6-6.5mg/dL, or even up to 7.2mg/dL. The average American patient initially tests between

3-4mg/dL. Many functional or integrative-based medical clinics can order this type of test,

or you can order it yourself through various labs for informational purposes. Whether or not

you wish to go through testing, basic magnesium supplementation will very likely benefit

you in many ways, especially testosterone optimization. Ample intake through diet alone is

difficult based on nutrient depletion in farming soil after decades of mass farming.6,7

“...magnesium is easily the

most common mineral

deficiency found...”

75%DEFICIENT

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Natural Testosterone Optimization E-Book 8

What Kind of Magnesium to Take?

Generally, chelated magnesium supplements

absorb far better orally than typical cheaper

salt forms such as magnesium oxide.5 Most

magnesium supplements found at your nearby

store will do nothing but cause some quick,

onset diarrhea. They’re good for treating

constipation but terrible for building up body

stores of magnesium.

Chelated, or reacted, magnesiums attach

magnesium to an amino acid that has

enhanced absorption both in the gut, as well

as to particular parts of the body afterwards

pending the amino acid’s nature. Common

magnesium chelates include magnesium glycinate, magnesium malate, magnesium citrate,

and magnesium threonate. For most people, doing general supplementation with magnesium

to get their magnesium levels up, taking a mixture of magnesium chelates in one supplement

is best. More specifically, additional uses of magnesium are better matched with particular

magnesium chelates, often as an add-on to the primary mixed chelate used. For example,

anxiety, sleep, and mood support are best matched with magnesium threonate, as threonate

best crosses the blood brain barrier to increase magnesium levels in the brain.5

Topical magnesium supplementation can also be very helpful, especially in those with a very

limited tolerance to oral magnesium.

How Much Magnesium to Take?

The recommended daily allowance for males is roughly 400mg elemental magnesium daily

depending on age.5 Elemental means the magnesium weight when not including the attached

amino acid or salt. This is really a baseline amount though, which depends on your RBC

magnesium levels, your diet, and your body’s usage level of magnesium. It is much higher

in athletes, for example. Many patients working with a functional medicine practitioner may

have to go on a much higher or more frequent doses of magnesium for 6-12 months to get

RBC levels to an optimal state. In fact, supplementation often makes symptoms of magnesium

deficiency worse in the very beginning, as the body will reserve magnesium to its most critical

uses while deficient. Then, upon getting ample amounts, it will rev up many of those 300+

enzymatic reactions and gene regulatory processes. This can cause levels to stay depleted

for several months in the beginning, but they will start to increase eventually, and then require

lower maintenance levels of supplementation afterwards.8

“Chelated magnesiums

attach magnesium to

an amino acid that has

enhanced absorption...”

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Natural Testosterone Optimization E-Book 9

It would be extremely difficult to take a harmful amount of oral magnesium at once, as very

high amounts will likely cause diarrhea, and therefore release of the excess. If experiencing

this problem, simply back off the dose by roughly two-thirds. Also avoid taking too much

with calcium-containing foods and/or supplements, as they compete for absorption

in higher amounts.5

Magnesium Summary

In summary, it’s important to get your magnesium levels up to support not only higher

testosterone levels, but reduce obesity, insulin resistance, and support against related

cardiometabolic conditions.8,10-14

• Reacted Magnesium (magnesium malate, magnesium citrate, magnesium lysinate

glycinate chelate) Capsules - Take 2-4 capsules daily as a base dose. Consult with a

functional medicine practitioner before taking higher doses.

• Magnesium Threonate - Take 3 capsules by mouth at bedtime if needing additional

magnesium specifically for anxiety, sleep, or mood support.

• Topical Magnesium Oil - Apply to shoulders and/or upper back 1-2 times daily as

either additional or alternative way to get magnesium. If you sense irritation due to

skin sensitivity within an hour afterwards, be sure to always wash off 10-15 minutes

after application.

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Natural Testosterone Optimization E-Book 10

Zinc

Background

Zinc, which powers over 300 enzymes and affects gene

transcription,5 is arguably the most powerful mineral

we know of related to overall testosterone support in

men. It is involved in not only testosterone production,

but is also an aromatase inhibitor to lower estrogen

conversion, and even helps with detoxification of

various toxins to the testicles, such as cadmium. It even

has vast scientific evidence for immune support and

optimization.16-22 Zinc is also another common mineral

deficiency, or at least is typically not at optimal levels.5

Oysters, which are not a daily or weekly staple in most

people’s diets, are the dietary food highest in zinc. Red

meat and poultry provide most of the zinc in the typical

American diet. Zinc supplementation for men needing

testosterone optimization can often be useful. Athletes

lose a lot of zinc through sweating and, therefore,

might require more.

How Do I Know if My Zinc Levels are Low?

A zinc challenge test uses taste and is a simple, low

cost test that can even be done at home. Just like

with magnesium, a red blood cell test is a better

blood test to indicate body stores than a serum blood

test. However, this test is typically not necessary for

normal supplementation.

What Kind of Zinc Should I Take?

If supplementing, I usually recommend getting zinc through a high-quality multivitamin/

mineral supplement first. Although, taking an additional zinc supplement for 3-6 months

can help give a boost when initially optimizing testosterone levels in some men. In men

with severe zinc and/or testosterone deficiency, or not wanting a multivitamin/mineral, I will

suggest a standalone zinc supplement on an ongoing basis as well. Be careful with over-

supplementation though. Daily doses over 40mg, while shown safe by many studies,16-18 are

not advised without the supervision of a medical practitioner. Zinc supplementation can

“...arguably the

most powerful

mineral we know of

related to overall

testosterone...”

INC

RE

AS

ES

TE

STO

ST

ER

ON

ED

EC

RE

AS

ES

ES

TR

OG

EN

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Natural Testosterone Optimization E-Book 11

deplete copper stores so low-dose copper supplementation should be added as well,5 either

in a multivitamin/mineral or with the zinc supplement. Too much zinc for extended periods

can have side effects including gastrointestinal upset, copper deficiency, and affect

taste reception.5

The form of zinc is very important for absorption, which goes back to the old “you get what

you pay for” premise. Zinc bisglycinate chelate or zinc mono-L-methionine are generally the

preferred forms of zinc to maximize absorption. Minerals generally absorb far better when

chelated to particular amino acids.5 Most supplement brands on the market use zinc oxide

or some other cheap form with very poor absorption and, in short, are a waste of money.

Zinc Summary

In summary, zinc is absolutely critical to healthy testosterone production, as well as

reducing the conversion of testosterone to estrogen by the aromatase enzyme. It even

helps in various detox pathways that directly support the health of the testes, and therefore,

testosterone production.16-22

• Multivitamin/mineral containing Zinc bisglycinate - Approximately 10mg

elemental zinc daily

• Zinc Chelate Supplement - 10-60mg of elemental zinc daily pending formulation

*Consult a healthcare provider before supplementing more than 40mg elemental zinc daily.

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Natural Testosterone Optimization E-Book 12

Vitamin A, Selenium, Vitamin E

Background

Studies indicate vitamin A is favorably related to androgen and sperm production, as it

supports both testosterone production and androgen receptor sensitivity. Doses as high as

10,000 U daily to twice daily for 6 weeks have been studied with great results. Vitamin A

regulates germ cell differentiation to support testicular tissues involved in testosterone and

sperm production.23,24

Selenium is also favorable to testosterone and sperm production,23 and even supports

detox of cadmium and other testicular tissue toxins by assisting superoxide dismutase and

glutathione peroxidase to reduce oxidative damage and endocrine disorders.25 Cadmium is

very toxic to testicular cells that produce testosterone and sperm. It is primarily absorbed

through tobacco smoke, occupational exposure, nickel-cadmium batteries, and certain

contaminated fish.

Vitamin E protects testicular cells against cellular damage through antioxidant activity, and

increases sperm motility.23

Testing for vitamin A, vitamin E, and selenium levels is generally not needed or

recommended. We should just make sure we have adequate dietary intake and add

in a high-quality multivitamin/mineral as needed to make sure that intake is

adequate as recommended.

Summary

Multivitamin/mineral containing:

• Vitamin A: (natural mixed carotenoids) - 5,000-10,000 IU daily

• Selenium: 100-200mcg daily

• Vitamin E: (d-alpha tocopherols) 50-100 IU daily

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Natural Testosterone Optimization E-Book 13

Protein

BackgroundWhile most people assume that higher protein intake is mainly for packing on muscle mass, many studies have now shown that it is quite beneficial in supporting fat loss and maintenance of metabolism when dieting.26-35 If you’ve caught on to the theme by now, you realize that everything you can do to lower body fat and build more muscle naturally will improve metabolism. It can also lower aromatase-based conversion of testosterone to estrogen within fat cells, lower chronic inflammation, and improve a whole slew of cardiometabolic health problems.36-38,40 Studies show that higher protein intake specifically decreases SHBG. And remember, this is the mean little molecule that likes to keep our testosterone stores bound up in the blood where they can’t help us out.39 All of these factors related to low protein intake come together to worsen testosterone deficiency!

How much daily protein do I need? This might depend on various factors per research, including your gender, age, activity level, body composition, diet (ketogenic diets for example cannot exceed certain protein thresholds and maintain ketosis). Protein requirements are lowest in those that are sedentary and/or obese and increase as a person is leaner, older, more active, and especially when attempting to lose fat and/or gain muscle. See the basic breakdown below based on several leading studies:26-35

Optimal Daily Protein Intake Ranges Table

• Use lower to middle range if: inactive + obese

• Use middle to upper range if: active + obese or lean, lean, elderly

Hint: Seem too complicated? 1 gm/lb will easily suffice for most people not doing intensive exercise multiple times daily.

Data is compiled from a combination of leading studies and meta-analysis to give a broad range of leading scientific and expert opinion on the topic of protein intake.26-35

500 gm

50 gm

100 gm

150 gm

200 gm

250 gm

300 gm

350 gm

400 gm

450 gm

300 LBS.250 LBS.200 LBS.150 LBS.100 LBS.

Body Weight

Daily

Pro

tein

In

take

(Re

co

mm

en

de

d R

an

ge

s)

Goal - Fat Loss

DAILY RANGE0.5–1.5 gm/lb

Goal - Muscle Gain

DAILY RANGE0.8–1.5 gm/lb

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Natural Testosterone Optimization E-Book 14

What Kind of Protein Should I Take?

PROTEIN TYPE ADVANTAGES DISADVANTAGES

Whey Protein

• Best post-workout

• Fast digesting for post-

workout

• Blends very easily

• Largest stimulus to muscle

synthesis

• Likely not best alone outside

of workout window

• Fast digesting, which limits

digestible amount and

nitrogen balance over time

• Not as good for meal

replacement

• Dairy sensitivities

Casein Protein

• Sustained release effect

• Better for meal replacement

• Better as an appetite

suppressant

• Can make protein puddings

with thicker texture

• Not as optimal post-workout

• Lower insulin response and

speed of recovery post-

workout compared to whey

alone

• Dairy sensitivities

• Doesn’t blend as easily

Whey + Casein

Protein Blend

• Combines immediate and

sustained release proteins

• Better for meal replacement

• Better appetite suppressant

• Might slightly lower insulin

response and speed of

recovery post-workout

compared to whey alone

• Dairy sensitivities

Various Plant Proteins

(pea, rice, hemp,

mushroom, etc.)

• Avoids dairy sensitivities in

susceptible individuals

• Incomplete amino acid

profiles unless combined

intelligently

Hint: We normally recommend a blend protein as most people’s primary way to supplement protein,

as more can be absorbed over time while better controlling appetite. This would be a high-quality

whey+casein blend, or a plant protein blend in those avoiding dairy. Whey protein is best as an

additional protein supplement to be used specifically after workouts since it most rapidly lowers

cortisol levels and raises insulin levels.

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Natural Testosterone Optimization E-Book 15

Summary of Nutritional Deficiencies Linked to Low T

Have you noticed a theme here in the particular vitamins related to testosterone deficiency?

They include all of the fat soluble vitamins! Vitamin A, Vitamin D, Vitamin E, and Vitamin K.

It should become apparent rather quickly here that eating a diet specifically aimed for “low-fat”

will essentially murder your testosterone levels! The entire low-fat movement was started by Dr.

Ansel Keys many decades ago. However, in recent years his 7 Countries Study and other research

has been largely torn to shreds by many expert researchers in nutrition, possibly the most notable

being Gary Taubes.41 The topic is too loaded to get deep into in this book, but just know that fats

and cholesterol are not likely as evil as they’ve been made out to be over the past several decades.

While carbohydrates are not inherently evil either, their highly processed varieties (ex: sugar and

other processed grains) likely play a more primary role in the development of obesity and related

cardiometabolic diseases.41,42 Remember how we said those same cardiometabolic diseases were

even more linked to testosterone deficiency than aging itself?

Recommendations in Summary

Avoid a low-fat diet, at least as a portion of overall

calories. Make sure to consume healthy fats regularly,

which even includes naturally raised animal fats such

as grass-fed beef and dairy, pasture-raised eggs and

poultry, and wild-caught fish. Some fats are required

to get, as well as properly deliver and absorb, the fat-

soluble vitamins A, D, E and K. Only excessive omega 6

fats and artificial trans fats are still strongly associated

with inflammation and cardiometabolic disease.41,42,43

Even omega 6 fats are not inherently bad, but

Americans tend to get up to 25 times more omega

6 fats in our diets than omega 3s due to processed

vegetable oils being in virtually every processed food

available. This triggers excessive chronic inflammation

leading to insulin resistance, obesity, as well as a slew

of other cardiometabolic diseases.42 The best ratio of

omega 6 to omega 3 would be between 1:1 and 1:4 as

we had available before processed foods, or at least

as close as possible. A later section discusses omega

3 fish oil supplements to help address this as well.

Get optimal protein intake. Remember 1gm/lb of high quality protein (complete essential amino acid profile) is a good rule of thumb.

“‘low-fat’ will

essentially murder

your testosterone

levels...consume

healthy fats

regularly...”

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Supplements Summary Table

SUPPLEMENT OVERVIEW

Vitamin D

• Vitamin D 5,000 IU + K2 (MK7) 180 mcg Capsules - Take 1

capsule by mouth daily

• Vitamin D 5,000 IU - Taking 1 additional capsule daily (total

10,000 IU daily) might be beneficial in those with very

suboptimal 25-hydroxy-vitamin D levels, or during winter

months with limited sun exposure. Consult your healthcare

provider for advice.

Magnesium

• Reacted Magnesium (magnesium malate, magnesium citrate,

magnesium lysinate glycinate chelate) Capsules - Take 2-4

capsules daily as a base dose. Consult with a functional medicine

practitioner before taking higher doses.

• Magnesium Threonate - Take 3 capsules by mouth at bedtime if

needing additional magnesium specifically for anxiety, sleep,

or mood support.

• Topical Magnesium Oil - Apply to shoulders and/or upper back

1-2 times daily as either additional or alternative way to get

magnesium. If you sense irritation due to skin sensitivity within

an hour afterwards, be sure to always wash off 10-15 minutes

after application.

Zinc*

• Multivitamin/mineral containing zinc bisglycinate -

Approximately 10mg elemental zinc daily

• Zinc Chelate Supplement - 10-60mg of elemental

zinc daily pending formulation

*Consult a healthcare provider before supplementing more than

40mg elemental zinc daily

Vitamins A, E, &

Selenium

• Multivitamin/mineral containing:

• Vitamin A: (natural mixed carotenoids) 5,000-10,000 IU daily

• Selenium: 100-200mcg daily

• Vitamin E: (d-alpha tocopherols) 50-100 IU daily

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2.2 Testosterone Metabolites, Carriers, & Estrogen Metabolism

Much of having optimal natural testosterone levels comes not only from simply putting more testosterone in, but in making sure all the other metabolite pathways are optimized. For example, it might sound great to simply inject a massive amount of testosterone into the body, thereby achieving the highest levels of manliness immediately, right?

Wrong! The body likes to maintain the status quo, so it will heavily convert what it sees as excess testosterone into the following metabolites:

Metabolites/Carriers & Causes

METABOLITE/CARRIER CAUSE

Estradiol

(E2 form of estrogen)• Aromatase enzyme

Dihydrotestosterone (DHT) • 5-α-reductase enzyme

Sex Hormone Binding

Globulin (SHBG)

• More T needs more carrier proteins• Higher estrogen levels• Low vitamin D levels• Low protein intake

Not only does this mean less testosterone activity in the body, it means nasty side effects of these metabolites when in excess, which include:

Metabolites/Carriers & Side Effects

METABOLITE/CARRIER SIDE EFFECTS

E2

• Hypothalamic suppression of testosterone production, water retention, gynecomastia (man boobs), emotional disturbances, sexual dysfunction, increased body fat, less muscle, increased heart disease and type 2 diabetes risk, increases DHT receptors in prostate, increased SHBG binding up more T44

DHT• Alopecia (male pattern baldness), urinary issues, enlarged

prostate, oily skin, acne45-48

SHBG • Significantly less testosterone-based activity

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Natural Testosterone Optimization E-Book 18

These metabolites are not all bad. For example, estrogen is required in small amounts in men for many functions, and you certainly wouldn’t want to see your cholesterol profile or bone density if you wiped out all of your estrogens! DHT is essential in moderation for healthy sexual function, and SHBG is necessary in moderation to control the actual usage of free testosterone reserves. We simply want to make sure that all of these metabolites are in check. They should be doing their respective jobs, but not in overtime by any means!

So what do we do about this? Well, if you have symptoms of one of these metabolites in excess, or your doctor has told you after lab testing that you have high amounts of one or all of these, we can potentially get them under control by several natural means.

Metabolites/Carriers - What Raises & Lowers Them

METABOLITE/

CARRIER PROTEINWHAT RAISES IT? WHAT LOWERS IT?

E2

• Excess body fat = excess

aromatase13

• Excessively high testosterone

levels (i.e.; steroid abuse)

• Poor estrogen metabolism (i.e.;

limited vegetable/fruit intake =

limited CDG, DIM & I3C)60-69

• Lowering body fat13

• Stinging nettle root49-51

• Pygeum Bark Extract57-59

• Zinc70

• Indole-3-Carbinol (I3C)63-65

• Diindolylmethane (DIM)60-62

• Calcium d-Glucarate (CDG)66-69

• Flax seed lignins• Fiber• Resveratrol• Green tea118

DHT

• Excessively high testosterone

levels (i.e.; steroid abuse)

• Genetic tendency

• Lower excess estrogens• Lowering body fat• Stinging nettle root49-51

• Saw palmetto53-57

• Pygeum bark extract57-59

• Zinc22

SHBG

• Excessively high testosterone

levels (i.e.; steroid abuse)

• High estrogen levels

• Obesity70

• Low fat diets

• Low protein diets39

• Exercise73

• Protein39

• Healthy fats• Stinging nettle root49-51

• Omega 3s (EPA/DHA)71

• Vitamin D• Lowering excess estrogens• Lowering body fat70

Notice we’ve now come across both vitamin D and zinc yet again? These two characters are

quite the powerhouses when it comes to optimizing testosterone, and by multiple methods!

Exercising and lowering body fat also contribute by yet another method to optimize

testosterone, as do high protein diets alongside adequate healthy fat intake.

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Natural Testosterone Optimization E-Book 19

Herbals come in strong here assuming the right high-quality extracts in the right amounts

are used according to scientific evidence. Stinging nettle root wins the gold here as it

actually optimizes all three metabolite pathways! Stinging nettle root lowers aromatase

activity to lower estrogen conversion, lowers 5-alpha-reductase activity to lower DHT

conversion, and lowers SHBG levels!49-52 Saw palmetto is a rock star at keeping DHT levels

at bay, as well as supporting both prostate and sexual health.53-57 Saw palmetto combined

with stinging nettle root has been shown to have a synergistic effect on testosterone

optimization, prostate and sexual health according to studies.57 Pygeum bark extract has

also been shown by studies to support normal prostate size and function57-59, as well as work

synergistically with stinging nettle root to block aromatase activity, which again increases

testosterone levels and lowers estrogen levels.57

If you are concerned with one or more of the problems mentioned above, then a high-

quality combination herbal supplement developed according to clinical study data and

made with high-quality and potent extracts could be of great benefit to your overall

testosterone levels. Quality is key when it comes to herbal formulations, as what you

actually get can vary vastly from product to product. The dose is critical here, as too

little doesn’t have the desired effects, but too much can also cause side effects such as

sexual dysfunction. As a pharmacist, I see the overpowering side effects of prescription

pharmaceuticals such as finasteride all the time, especially sexual dysfunction. Sure, it helps

prostate function and slows hair loss, but is significant sexual dysfunction worth it? Poorly

formulated herbals can have the same negative overpowering effects. A more natural

method consisting of well-studied and moderate dosing of high-quality herbal extracts is

often more suitable in most men based on extensive clinical experience.

Alternatively, if your intake of fruits and vegetables is about as rare as a winning lottery

ticket, then you likely have a problem with estrogen metabolism. And while we certainly

like to focus on getting more testosterone in, we also need to make sure we eliminate any

excess estrogens that are made for overall hormonal balance. Don’t forget that estrogens

are always made from either testosterone or androstenedione, so as we use various

methods to increase our testosterone levels it becomes more and more critical to

make sure that the inevitable increase in estrogens is kept at bay through optimal

estrogen metabolism.

“Turns out your mother knew

what she was talking about

when she told you to eat

your veggies!”

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Natural Testosterone Optimization E-Book 20

Cruciferous vegetables, such as broccoli, brussel sprouts, and cabbage play a huge role in

aiding proper estrogen metabolism and detoxification. Turns out your mother knew what

she was talking about when she told you to eat your veggies! Maybe she didn’t know about

this specific reason, but we’ll still give her credit! Why the benefit? Cruciferous veggies

contain glucosinolates, which go on to form substances such as indole-3-carbinole (I3C) and

diindolylmethane (DIM) through the chewing and digestive processes. These compounds

are absolutely critical in proper estrogen metabolism in both men and women.60-66 This also

plays a huge role in prostate, breast, and intestinal health, as excess estrogens can have

increased risks of cancer in these regions.60-62 Calcium-D-glucarate is another compound

found in various fruits and vegetables that supports detoxification of estrogen and other

toxins by inhibiting beta-glucuronidase, an enzyme found in some gut bacteria that

interferes with optimal estrogen metabolism.67-69

While eating a well-rounded diet full of a very colorful array of fruits and vegetables is of

course a top recommendation for this and many other facets of health, we realize that this

might not be a practical approach for many of us. In this case, studies show a supplement

containing high-quality I3C, DIM, and CDG in proper dosing can help with this estrogen

metabolism dilemma.60-69

Summary

Just as important as making more testosterone is controlling its various metabolites

like estrogen and DHT, lowering strong binding proteins like SHBG, and enhancing the

metabolism and detoxification of estrogen pathways. Controlling for these factors can

not only increase your testosterone levels, but also your free testosterone. It will also help

prevent hair loss, improve your prostate and urinary function, maximize sexual function, and

improve many other aspects of your health.

Recommendations in Summary

Lower body fat = lower aromatase enzyme = lower estrogen levels

• High protein diet + a well designed exercise program

Herbals - Stinging nettle root, saw palmetto extract, pygeum bark extract

• Lower testosterone conversion to estrogen

• Lower testosterone conversion to DHT

• Lower SHBG levels to free up more T

• Improve prostate and sexual health

• Reduce hair loss

Phytonutrients - I3C, DIM, CDG

• Improve estrogen metabolism

• Improve support against various health risk associated with excess estrogens

• Lower risk of various cancers such as breast, prostate, and intestinal

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2.3 Chronic Stress & Elevated Cortisol Levels

Background on Testosterone to Cortisol Ratio

Not to stress you out, but your stress levels could be one of the primary factors throwing

off your testosterone levels!74-76 We’ve all heard our grandfathers state that back in their day

it was uphill both ways while barefoot in the snow, right? Well, physical labor was certainly

more of a factor in the average guy’s life many decades ago. However, many would argue that

mental stress, especially from a chronic standpoint, is on average greater nowadays. We have

infinite amounts of information at our fingertips at a moment’s notice thanks to technology.

Think about it — we’re continually bombarded with everything from the constant expectation

to respond to work emails to negative news from around the globe or our own household.

And with the world population ever increasing, and information more readily available, the

workforce is infinitely more competitive than it was decades ago. Talk about stressful!

Stress equals elevated cortisol levels, which

is good, as nature intended for brief periods

to adapt to acutely stressful events — as long

as they can swiftly return to normal. A great

example would be your primitive ancestors

being attacked by a wild animal. The body would

activate the fight or flight response, thereby

elevating cortisol, adrenaline, blood sugar levels,

and other adaptive factors. Your ancestor would

briefly be given the enhanced physical ability to

survive this encounter. Then, once it’s over, stress

levels and corresponding chemical responses

would go back to normal as intended.

But what if your life is chronically stressful

with no end in sight? I’m guessing many of

you reading this are saying, “That’s me,” right?

Whether it’s work, family, relationships, your

impossible to-do list, finances, lack of sleep,

caffeine abuse to continue functioning, or any

number of problems you’re dealing with, your

adrenal glands are likely working overtime

pumping out the stress hormone cortisol in

an attempt to adapt. In this case, chances are

that your testosterone to cortisol ratio is not

looking so great.

“...your stress levels could

be one of the primary

factors throwing off your

testosterone levels!”

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The more cortisol your body produces to adapt to chronic stress, the less testosterone it is

able to make, because they are both made from the same hormone building block called

pregnenolone.76 This is bad both because high cortisol levels over time wreak havoc on the

body to increase your chances of obesity, and because we have less building blocks to make

testosterone. Talk about a 1-2 punch! Even exercising too much, especially in combination

with poor nutrition and sleeping patterns, can lead to increased cortisol levels.

Studies have shown that prolonged mental stress and lack of sleep lead to significantly

lower testosterone levels, even when controlling for many other factors such as smoking

and alcohol intake.74-76 One study even used medical residents undergoing very long,

stressful work hours in combination with lack of sleep to observe testosterone levels.

The study measured them against a control group of normal, full-time, male hospital

employees to compare changes in testosterone levels. The control group had almost twice

the testosterone levels of the hyper-stressed and sleep deprived male medical residents.74

Another study looked at males purposely exposed to significantly increased physical and

psychological stress, and showed free testosterone serum levels over 6 times lower than the

control group. At the same time, this study revealed they had urinary cortisol levels over

80% higher than members of the control group!76 Are you stressed yet?

What to Do About It

So what can we do to control chronic stress and optimize testosterone levels?

• Get 7 or more hours of sleep every night, and at roughly the same time. This is when

the body can repair itself and reset. Reducing sleep and/or changing your sleeping

times significantly will not only increase chronic cortisol levels, but potentially flip

your cortisol cycles to further confuse your body’s optimal sleep cycle. This in turn

chronically suppresses your testosterone levels.

• Get out of chronically stressful or abusive relationships. Need I say more?

• Avoid excessive alcohol intake. It both increases cortisol levels and lowers

testosterone levels. Beer is actually worse than most alcoholic beverages, as more

hops especially lower testosterone levels.

• Do you hate your job? Life’s too short to spend the majority of your time at a job that

you hate and stresses you to no end. Find a job you enjoy to lower your cortisol levels

and increase your testosterone levels.

• Nutritional & Herbal Options. Ashwagandha, skullcap, eleuthero, rhodiola, L-theonine,

phosphatidylserine, magnesium, and DHEA

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Natural Testosterone Optimization E-Book 23

Nutrients/Herbals & What They Do Related to Stress

NUTRIENT/HERBALS WHAT IT DOES RELATED TO STRESS

Magnesium (preferably

in the form of amino acid

chelates if supplemented)

• Regulates H-P-Adrenal Axis to moderate stress/anxiety15

• Primary natural nutrient to relax the nervous system by

blocking excitatory NMDA receptors8

• Supports proper sleep through multiple

relaxation mechanisms8

• Required for serotonin production8

Ashwagandha Root Extract

• Adaptogenic herb clinically shown to support more balanced

cortisol levels and better adapt to stress and anxiety77

Studies using ashwagandha have found a 25% decrease in

cortisol, as well as a 17% increase in testosterone levels.”124-126

Skullcap Root Extract • Herb with antioxidant and antiinflammatory properties78

Eleuthero Root Extract• Adaptogenic herb shown in studies to reduce mental and

physical fatigue during stress79-82

Rhodiola Rosea Root Extract

• Adaptogenic herb that lowers anxiety and supports mood,

memory, and mental function83-85

L-Theanine

• Induces relaxation by increasing alpha brain waves86,87

• Helps increase both serotonin and dopamine production in

the brain to support improved mood86,87

Phosphatidylserine• Lowers ACHT signaling to lower cortisol levels

and aid sleep88-90

DHEA

(dehydroepiandrosterone)

• Improves DHEA to cortisol ratio to improve and

balance mood91-92

• Precursor to testosterone

Summary

Chronic stress can take a huge toll on your testosterone levels. Therefore, taking the

necessary steps to control your stress will not only help improve your testosterone

levels, but your overall health and happiness as well. Even if you manage to blast your

testosterone levels sky high, this will be greatly impeded by chronically high cortisol levels

due to stress. Various lifestyle and nutritional changes can help you manage stress. This

is where magnesium makes yet another appearance to optimize testosterone levels by

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Natural Testosterone Optimization E-Book 24

another means. Remember that magnesium threonate best crosses the blood brain barrier

to support brain related functions such as anxiety, sleep and mood.5 Magnesium mixed

chelates are also a great way to increase your body’s general stores of magnesium.5 Lastly,

there are many adaptogenic herbs that can support the adrenal glands during stress77-90,

especially high-quality ashwagandha root extract, but a well-formulated combination herbal

is generally the best bet here.

Recommendations in Summary

RECOMMENDATION HOW IT HELPS MANAGE STRESS

Lifestyle Changes

(relationships, sleep, work

environment, alcohol, etc.)

• Reduces the root causes of mental stress and fatigue

Adaptogenic Herbal

Formulations

• Supports the body in healthy adaptation to stress by

optimizing cortisol, serotonin, and dopamine levels,

among other mechanisms to ultimately increase

testosterone.77-90

Magnesium Supplements

(Amino Acid Chelates)

• Regulates H-P-Adrenal Axis to moderate stress/anxiety15

• Primary natural nutrient to relax the nervous system by

blocking excitatory NMDA receptors8

• Supports proper sleep through multiple relaxation

mechanisms8

• Required for serotonin production8

DHEA

• Best as a last-line option here, and generally under

healthcare provider guidance, but a great short-term

option in the right patients

• Improves DHEA to cortisol ratio to improve and

balance mood91-92

• Precursor to testosterone

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Natural Testosterone Optimization E-Book 25

2.4 Obesity, Cardiometabolic Disease & Chronic Inflammation

Background

While testosterone levels go down as men

age, the statistical significance of this

disappears when chronic disease states like

obesity, metabolic syndrome and insulin

resistance, type-2 diabetes, high blood

pressure, high cholesterol, chronic pain, and

related opioid use are accounted for.9 In other

words, I’m saying stop making the excuse

that you’re simply getting old! You have

the power to change the risk factors, which

matter far more than your age regarding

testosterone deficiency. Around 70% of men

with testosterone deficiency have some

related cardiometabolic disease, or diseases

tied to both obesity and heart health.12

Many aspects related to obesity and heart

health have already been discussed in

previous sections of this book, such as poor

nutrition and chronic stress. Obviously poor

nutrition can contribute to obesity and

heart disease, but did you know that many

doctors now think chronic stress could be

a leading cause of obesity and heart disease? Never underestimate the power of chronic,

uninhibited cortisol to wreck not only your testosterone levels, but your heart and overall

health as well!

With that said, this section will focus more specifically on the areas related to obesity and

heart health not cross-covered in previous sections of the book.

Insulin resistance is an important term to understand as we start this discussion. Simply

stated, it implies someone is well on the way towards becoming diabetic as their body doesn’t

use insulin optimally anymore to control blood sugar. Most insulin resistant people don’t

become fully diabetic unless they are unfortunate enough to have more susceptible genes.

“Around 70% of men with

testosterone deficiency

have...diseases tied to both

obesity and heart health.”

70%

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Natural Testosterone Optimization E-Book 26

What will happen to most people as they become more and more insulin resistant, though,

is obesity, greater risk of heart disease, and lower T. Have you ever known someone that was

slender as a teenager, and possibly as a twenty-something, but between their 20s and 40s

they became significantly more obese, and often unrecognizable from their younger self?

They became more and more insulin resistant, and in turn, their body’s ability to burn fat for

energy decreased significantly as they relied almost entirely on carbohydrates (primarily

simple processed carbs such as sugar) for energy. Fatty acid stores within fat cells even

become more and more trapped due to various inflammatory mechanisms. This has a huge

impact on chronic inflammation, risk of chronic disease, and aging within the body.

Saturated fat and cholesterol have been so greatly demonized ever since Dr. Ancel Keys

published the very biased and misinterpreted Seven Countries Study in 1978. I can hardly

meet someone within the baby boomer generation that doesn’t hold negative thoughts

against saturated fat and cholesterol like it’s gospel. This has ultimately led to treatment of

cholesterol as the primary means of fighting heart disease in the medical community. It has

also made use of statins (i.e.; Lipitor®, etc.) to treat cholesterol by far the largest money-

generating type of medication in history. This also led to mass fear of fat and cholesterol

leading to heart disease, assuming they plug up arteries the first chance they get

like evil villains.

So what is wrong with these theories against fat and cholesterol that have dominated

American culture for decades? To say the Seven Countries Study was massively flawed

would be the understatement of the century. To sum it up very quickly, they

collected data from 22 countries, but only reported on 7. Why would they do

this? It showed the data they wanted, and unfortunately, it has gone on to

support the financial interests of many special interest

groups in the decades since. Just a few examples include the

pharmaceutical industry, grain industry, sugar industry, and

vegetable oil industry. Many experts have since taken data from many other combinations of

the 22 countries used to collect data, and found the exact opposite results. Also, in case you

haven’t noticed, rates of obesity and heart disease have skyrocketed in the decades since

“...rates of obesity and heart disease

have skyrocketed in the decades since

the anti-fat and cholesterol boom...”

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Natural Testosterone Optimization E-Book 27

the anti-fat and cholesterol boom.41,42 We now know for scientific fact that intake of more

cholesterol through diet doesn’t matter in most people with healthy liver function, as the

liver simply decreases its own cholesterol production in response.93 In addition, we need

cholesterol for proper hormone production. Most Americans are eating diets primarily

comprised of processed and pro-inflammatory carbohydrates, while avoiding most good

sources of protein and healthy fats such as naturally raised animals (grass-fed cattle,

pasture-raised chicken & eggs, wild-caught fish). As a result, our nutritional health is more

and more degraded, while we rely on advancements in prescription medications to treat

symptoms of our chronic diseases.

This is more highly tied to testosterone deficiency than you can even imagine. The reason

I’m such a huge fan of optimizing natural testosterone levels over taking prescription

testosterone is not due to the dangers of injectable or gel testosterone supplementation,

but because the root causes of testosterone deficiency still lie below the surface silently

killing you. Prescription testosterone will often alleviate some basic symptoms of low T, but

it will not fix the underlying chronic-inflammation based problems tied to all of your chronic

cardiometabolic diseases.

This topic is far too massive to cover in-depth in this primer to optimizing natural

testosterone. However, some basic recommendations for preventing or reversing

cardiometabolic diseases (i.e.; obesity, insulin resistance, type-2 diabetes, high blood

pressure, atherosclerosis, poor cholesterol profiles, and other forms of heart disease) are

summarized below.

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Recommendations to Prevent and/or Reverse Cardiometabolic Diseases

RECOMMENDATION REASONING

Significantly lower intake of processed carbohydrates (i.e. sugar, processed grains, etc.)

Most people do not have the genes to continually consume heavy amounts of processed carbs and avoid insulin resistance, which leads to obesity and heart disease. Plus, why would your body ever burn fat for energy with abundant carb supplies? Just food for thought.

Manage body weight, especially to lower visceral fat around the midsection

This type of fat is most highly associated with chronic inflammation and chronic disease.

This also lowers aromatase enzyme activity to lower conversion of testosterone into estrogen.

Eat a well-rounded diet that includes healthy fats, as they and their fat-soluble vitamins are critical to testosterone production. Eat a wide variety of vegetables and fruits, but if trying to lose weight also remember fruits are primarily sugar.

The fat soluble vitamins, as well as cholesterol and various fats are needed by the body for overall health and optimal testosterone production.

Increase omega 3 fatty acid intake and lower omega 6 fatty acid intake

• 1:1 to 1:4 ratio preferred

• Up to 1:25 omega 3:6 ratio typical in U.S.

We now know that most chronic disease is likely related to chronic inflammation, and an out of control omega 6 to omega 3 ratio is a great way to be as chronically inflamed as humanly possible.

Exercise Primarily through weight training and/or HIIT-based cardio

Exercise lowers body fat, risk of chronic disease, and increases muscle mass, if done properly. It also reduces insulin resistance, stress, and improves energy production.

Increase protein intakeMaintains muscle mass, and therefore higher metabolism. Also assists in fat loss by controlling appetite and improving ratio of protein to fat and carbs.

Improve mitochondrial health (Body’s ability to use fats for energy production) through dietary strategies

Certain nutrients, such as acetyl-L-carnitine, alpha lipoic acid, and omega 3s for example, as well as dietary strategies like intermittent fasting, have been shown to improve energy production processes, and even have potential anti-aging mechanisms. 94-97

Manage chronic painOpioid use to manage pain has a more negative impact on testosterone levels than any other drug class116, 117

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Summary

Testosterone deficiency is largely correlated with cardiometabolic disease, which

again includes obesity, insulin resistance, type 2 diabetes, high blood pressure, poor

cholesterol profiles, atherosclerosis, and other heart related chronic diseases.9-14, 98-112 All of

these cardiometabolic disease, as well as testosterone deficiency, are rooted in chronic

inflammation. Chronic inflammation stems from many factors in our lifestyle and diet, which

we have the power to improve through the above recommendations as a starting point.

Recommendations in Summary

RECOMMENDATION REASONING

Improve Diet (Less processed carbs and vegetable oils, adequate healthy fat and protein intake, increased vegetable / fruit intake)

Adequate vitamin/mineral intake

Lowers Inflammation, increases antioxidant and repair capabilities, lowers obesity, and increases muscle mass and metabolism

Increase Omega 3s (3 grams EPA/DHA daily)

Decrease Omega 6 dietary intake

Lowers inflammation by improving omega 3 to omega 6 ratio

Improves the body’s ability to use fat for energy processing

Improve mitochondrial health through specialized nutritional support

Improves the body’s ability to use fat for energy processing and overall energy levels94-97

Exercise - Primarily through weight training and/or HIIT-based cardio

Exercise lowers body fat, risk of chronic disease, and increases muscle mass, if done properly. It also reduces insulin resistance, stress, and improves energy production.

Ultimately increases testosterone levels significantly113-115

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3 Closing Notes on Testosterone Deficiency

Hopefully the knowledge contained in this book has been useful in your journey to

optimize your natural testosterone levels, thereby improving your energy levels, mood,

physical recovery, physique goals, sex life, as well as reducing your chances of many

related chronic diseases. In fact, testosterone deficiency is likely one of the leading

associations with depression and declining mental function in middle aged men,119-123 so

get off the anti-depressants and fix the root causes of your low T. You’ll be glad you did!

As previously mentioned, there is no one magic pill to fix all of your low T woes, although

there are different lifestyle and dietary changes, along with high-quality supplements to

support you in various categories of health related to low T. Depending on your particular

health situation, some, or even all of these strategies, may assist you in increasing and/or

optimizing your testosterone levels naturally. The categories are summarized below, and

linked to the appropriate sections of the book for your reference:

PRIMARY REASONS FOR LOW T BASIC DESCRIPTION

Nutritional Deficiencies• Vitamin D, Magnesium, Zinc, Vitamin A, Vitamin E,

Selenium, Protein, Fats, Cholesterol

Testosterone Metabolites, Carriers, & Estrogen Metabolism

• Aromatase = T to Estrogen

• 5-AR = T to DHT = Hair loss, prostate/urinary

problems

• SHBG = Less free testosterone

Chronic Stress • Stress = Cortisol = Lower T

Obesity & Related Cardiometabolic Diseases

• Obesity & most related chronic diseases such

as insulin resistance, type 2 diabetes, and heart

disease are highly correlated with low T

From Nexus Health Partnership, best of luck in your journey to optimize your T!

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4 Disclaimers And Notices

Medical DisclaimerWhile the authors of this book have tried to make sure the content within is as accurate as

possible, it is only intended for informational purposes, and does not constitute medical advice.

Nexus Health Partnership strongly encourages everyone to maintain a working relationship with

a local qualified healthcare practitioner for medical care. The content within is only the opinion

of Nexus Health Partnership as formed by their collective health, nutrition, fitness and medical

experience working with other professionals, patients, and/or clients based on a combination of

real life results and scientific literature. Please discuss anything you plan to do with your local

licensed healthcare provider. The statements in this book have not been evaluated by the U.S.

Food and Drug Administration (FDA), and are intended for informational purposes only.

Copyright NoticeCopyright © 2018 Nexus Health Partnership, Inc. All rights reserved. The contents of this

publication may not be copied or distributed in any way, shape, or form without the written

consent of an official company officer of Nexus Health Partnership, Inc.

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5 Index of Supplements

SUPPLEMENT DOSAGE MECHANISM TO SUPPORT T

Vitamin D (Preferably with vitamin K2 in MK-7 form)

• 5,000-10,000 IU daily pending need (K2: 45-180 mcg daily as long as not on vitamin k based blood thinners)

• Increases T synthesis

• Increases free T

• Lowers SHBG

Magnesium (Preferably in amino acid chelate forms or topicals)

• 300-1,000mg daily pending need

• Supports heavily against cardiometabolic diseases highly associated with low T, especially insulin resistance

• Supports against stress & high cortisol levels

• Helps regulate the HPA hormone axis to increase testosterone output

Zinc (Preferably in amino acid chelate forms)

Can be part of high-quality multivitamin/mineral if lower supplementation needs

• 10-60mg daily (Generally avoid doses greater than 40mg daily without medical supervision.)

• Aromatase inhibitor

• Detox supporting testes

• Supports T production

Selenium Generally get as part of a high-quality multivitamin/mineral

• 100-200mcg daily• Supports detox pathways

to repair testes

Vitamin A Generally get as part of a high-quality multivitamin/mineral

• 5,000-10,000 IU daily (Natural mixed carotenoids)

• Supports T production and T receptor sensitivity

• Regulates cell division in testes

Vitamin E Generally get as part of a high-quality multivitamin/mineral

• 50-100 IU daily (d-alpha tocopherols)

• Antioxidant support in testes

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Natural Testosterone Optimization E-Book 33

SUPPLEMENT DOSAGE MECHANISM TO SUPPORT T

Protein• 0.5-1gm/lb daily pending

needs

• Supports lean body mass

and lower body fat

• Lowers body fat = less

estrogen conversion

T-Metabolite Formulas

(Typically in natural herbal

combination product)

• Stinging Nettles Root

Extract 100-150mg daily

• Saw Palmetto Extract

300mg daily

• Pygeum Bark Extract

50mg daily

• *Important to not dose

too high or too low to

avoid side effects*

• Lowers T conversion

to estrogen

• Lowers T conversion

to DHT (hair & prostate

support)

• Lowers SHBG

(more free T)

Estrogen Metabolism

Formulas (Typically in

natural combination product)

• DIM 100mg daily

• I3C 200mg daily

• CDG 1 gm daily

• Supports proper estrogen

metabolism to support

estrogen balance and

prostate and gut health

Stress/Adrenal Support

Formulas (Typically

in natural herbal

combination product)

• Ashwagandha Root

Extract 250-500mg daily

• Skullcap Root Extract

250-500mg daily

• Eleuthero Root Extract

200-400mg daily

• Rhodiola rosea Root

Extract 200-400mg daily

• L-Theanine 100-200mg

daily

• Phosphatidylserine 100-

200mg daily

• Adaptogenic herbs

that support proper

stress response and

optimize testosterone

to cortisol ratio

• Supports mood

DHEA

• 5-50mg daily

(Generally best if

medically supervised)

• Improves testosterone to

cortisol ratio

• Supports mood

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Natural Testosterone Optimization E-Book 34

SUPPLEMENT DOSAGE MECHANISM TO SUPPORT T

Omega 3 Fatty Acids

(Concentrated EPA/DHA

triglyceride form)

• 3-5gm EPA/DHA daily

pending needs

• Lowers chronic

inflammation

• Supports optimal omega

3 to omega 6 balance

• Supports insulin

sensitivity and fatty acid

utilization for energy

usage to support fat loss

Fat Loss & Mitochondrial

Health Formulas

(Typically in natural

combination product)

• Alpha Lipoic Acid

200mg daily

• Acetyl-L-Carnitine

600mg daily

• EGCG 45 mg daily

• Chromium 50mcg daily

• Other various metabolic

support ingredients

• Boosts cellular

energy production

• Supports usage of fat for

energy metabolism

• Supports fat loss program

to lower aromatase-based

T conversion to estrogen

*It is very important to take supplements in the highest quality forms possible, as they were used and

dosed in clinical evidence-based studies, as well as in the proper forms for adequate absorption, to

achieve the best results.

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