Tag Archives: Hormone Optimization Therapy

Testosterone Is Important To Heart Health: How to Raise It Naturally

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In the last blog, I mentioned that my “patient” (myself) was experiencing uncharacteristic fatigue and lack of motivation.  The regular blood tests showed a normally-functioning thyroid, no anemia and blood sugar regulation within normal parameters.  The cholesterol level was slightly high but not significantly changed over the last few years.  The total testosterone was within the “normal” range, but the free or “active” testosterone was in the very low part of the range. Remember what I said about testosterone and heart disease?  The free or “active” form of Testosterone helps to protect a man’s heart and arteries.  Dr. Edward Lichten, M.D. in his “Textbook of Bio-Identical Hormones” states that “scientifically, vitamin D, human growth hormone, thyroxine (T4), and triiodothyronine (T3), DHEA, and testosterone in men and estradiol in women have strong cardio-protective or therapeutic applications”.

Man running in a gym on a treadmill concept for exercising, fitnWhat can a 58-year-old male do to increase his testosterone? Exercise – especially resistance training – tends to increase the testosterone level and the HDL.  Reducing fat mass increasing lean muscle mass also reduces the tendency of the body to convert testosterone to estrogen and decreases insulin resistance.  It is important for a man’s reproductive health that his body have the correct levels of Zinc, Vitamin E, and certain amino acids (like L-Citrulline and L-Arginine) vitamin C, B vitamins, and magnesium.  Certain herbs are reputed to raise the free testosterone level – in particular, Tribulus terrestris and Eurycoma longifolia.  Taking the natural precursors to testosterone production may increase levels e.g., DHEA, if it is available.  Reducing stress is very important because high levels of cortisol (produced when stressed) suppresses DHEA.   In general, I prefer patients to raise their testosterone levels through natural stimulation – rather than immediate testosterone replacement – if at all possible.  Read on as I make testosterone stimulation very personal….

In my case, Blood Spot testing (done by finger prick and is a combination of arterial and venous blood) had previously been done in 2012 and was repeated on the same day as the regular blood tests last month.  In 2012, the only parameter that was slightly below normal was the Testosterone level.  The current test showed a further 30% drop in testosterone and a 56.5% reduction in DHEAS values.  The current results show that there are four cardiovascular parameters that are now abnormal:  the triglycerides are elevated (20% more than 2012); the HDL or good cholesterol has decreased by 40%; the VLDL (the very bad LDL cholesterol) is elevated as is the insulin level.  In addition, the Vitamin D level is also severely low – which is surprising because I routinely take 2000 IU per day.

In a nutshell, it is my contention that most, if not all, of these cardiovascular-related changes are due to a less-than-optimal testosterone and vitamin D level .  Unless I take appropriate action, I will become insulin-resistant (Type 2 diabetic) and the mechanisms of arteriosclerosis will continue to increase.  Rather than immediately going for Bio-identical testosterone replacement, I will attempt to raise the testosterone level through exercise, stress reduction, weight reduction, nutrient supplementation and so on over the next few months and will report back to you when the tests are repeated in January 2015.

Until next time…..

Dr. Gatis

Blood Tests and the Naturopath

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A 58-year-old male Naturopathic Doctor (myself) presented at my clinic complaining of unexplained low energy, feeling uncharacteristically emotional with a decreased of motivation to do any physical or mental beyond that required for his job. Power naps during the day did return some energy but at the end of the day he has little left to do anything other than watch television. The diagnosis could be anything from depression, to low thyroid, so blood work was requested (14 vials to be exact) In addition, a blood spot test was completed – a relatively new way to measure to measure hormones like testosterone.

The preliminary results of the blood tests have returned. Iron metabolism (Ferritin, Hemoglobin, Serum Iron and Iron Saturation) were normal. Thyroid parameters were normal – although the Free T4 was at the lower end of the range. No thyroid antibodies and the ANA was negative (which reduces the possibility of autoimmunity). In other words, low thyroid and anemia were ruled out. The Fasting Blood Glucose was normal as was the HBA1c. His waist-to-hip ratio, however, is 1.0 (and should be less than 0.9) and a previous blood insulin reading was at the top of the range, so he may have some Insulin Resistance.

The most revealing parameters have to do with cholesterol, heart and hormones. Total Cholesterol was 5.32 (which Man with conceptual spiritual body artis slightly above the upper range of normal). His total cholesterol had been around 5.4 for 20 years. Cholesterol usually is released by the liver when the body has a need to make more testosterone or when there is a low thyroid state (Both conditions are on the rise in aging males). When the cholesterol is high there is also a suspicion that plaque may be forming on the arteries. Of the blood parameters tested, the HDL was low (1.03 versus the optimal 1.5 or more) and the Apolipoprotein B was 1.13 (any value above 0.8 is associated with an increased risk of heart disease). The Total testosterone, although in the normal range was in the lower third and the Free Testosterone was so low that it was almost out of range. Testosterone in males is heart protective and anti-plaque as estrogen is in women.

From the first round of blood work, the working diagnosis is Low Testosterone – especially low Free Testosterone (some of the symptoms include fatigue, tiredness, depression and lack of motivation).
The first line of defense is to attempt to increase the testosterone naturally. In this case, moderate exercise – both interval training and strength training was prescribed which will increase the testosterone and the HDL and reduce the insulin resistance. To protect the heart by decreasing the Apo B and increasing the HDL, Niacin, Pantethine (B5), Resveratrol and Green Tea were also prescribed.

The answer to the question from the last blog is Homocysteine. Homocysteine is an indirect measure of methylation. “More than any other single test, homocysteine correctly identifies the risk of such conditions as heart attack, stroke, and dementia years before the onset of any symptoms.” (Dr. Hyman, M.D.)

In the next blog, we will track the progress of the patient, discuss the results of the blood spot analysis (if available) and investigate certain herbs that are reputed to raise testosterone naturally.

Until then…

Dr. Gatis

How to Naturally Increase A Man’s Testosterone Level

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In the last blog, I talked about what testosterone does to maintain a man’s health (in addition to maintaining erections). Most men would probably choose to die doing the horizontal mambo – but would in their 80’s and not in their 50’s. Testosterone levels are extremely important to males. How then can we optimize these levels? To my mind, it is always better to attempt to raise levels naturally rather than initiate hormone replacement as the first therapy option – and testosterone levels fluctuate according to diet and lifestyle
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GET ENOUGH SLEEP

Seven to Eight hours of sleep per night is extremely important to optimize testosterone
levels. A lack of sleep affects many important hormones and chemicals in your body including melatonin. Melatonin, in addition to helping you fall asleep is an extremely strong antioxidant and some researchers claim that melatonin production is somehow linked to testosterone production.

MAINTAIN A HEALTHY WEIGHT

Men who are overweight convert testosterone into estrogen in their fat cells due to an enzyme called aromatase. In other words, having abdominal fat lowers a man’s testosterone and increases estrogen. Losing the extra weight can bring the testosterone back up because the fat-cell conversion of testosterone to estrogen is reduced and the normal ratio of testosterone to estrogen is restored.

BE ACTIVE

Testosterone reacts to your body’s needs. When a man is physically active, the brain sends out the signal to increase testosterone in order to build muscles and bones. Take time to move your body. Walk, run, skate. Do Tai Chi. Remember the old adage “Use it, or lose it”. This is true whether you are using a regular muscle or the “love muscle”. Interestingly, only short intense exercise has been shown to boost testosterone while aerobics and prolonged moderate exercise do not raise testosterone levels.

REDUCE YOUR STRESS

When a man is “stressed” the hormone cortisol is produced. Chronic elevations of cortisol affect a man’s ability to create adequate levels of testosterone. Learn to relax from the brain on down. Spend an hour-a-day on an activity that isn’t work or exercise related. Learn meditation or self-hypnosis techniques.

CHECK YOUR MEDICATIONS

Many medications affect testosterone level. Discuss the drugs you are taking with your doctor or pharmacist to rule out drugs as the cause of your symptoms or low testosterone.

I value your feedback and would like to know the topics that are pertinent to you.

In Health,
Dr. Gatis

Testosterone Is Not Just For Sex

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funkyicon_maleHormone Optimization Therapy is important to every man, and at every age past puberty.  It might surprise you to know that the average man in his thirties these days has less measurable testosterone than his grandfather did at the same age – which probably explains why many thirty-year-olds are still living at home!  My theory is that these lowered testosterone levels (and the availability of online pornography) are killing the desire for young males to go out and start families of their own.  In other words, “the population-level declines are greater in magnitude than the cross-sectional declines in testosterone typically associated with age.” (J. Clin. Endocrinol. Metab 2006, Oct 24)

What do optimal levels of testosterone do for a man?  If we take sexual desire and erections out of the equation for a moment, an adequate level of testosterone contributes to brain, bone, muscle and heart health – and reduces overall mortality rates.  A 2007 study had been following 800 men over the age of fifty for 18 years.  The group of men with values in the lower 1/3 testosterone level had a 33% increased rate of death from all causes than those men whose values were in the upper 1/3 testosterone level.  Another way to say this is… a higher level of testosterone that a man has as he ages reduces his risk of dying.  High free testosterone levels correlate with improved cognitive function and memory, and reduce the risk for Alzheimer’s disease.  Lower testosterone levels are associated with coronary artery disease and atherosclerosis.  Testosterone improves exercise-induced angina as it dilates coronary arteries.  High cholesterol has been associated with low testosterone and testosterone therapy has been shown to lower total cholesterol.  Testosterone therapy builds muscle mass in elderly men and increases bone strength.  These are just a few examples in current literature of the benefits of having enough testosterone.

The following is a list of symptoms indicating that a man may be low in testosterone:  decreased muscle mass and strength;  decreased sex drive;  reduced frequency and firmness of erections;  reduced ejaculate volume;  hot flushes;  excessive emotions/sensitivity to difficulty;  unnecessary worry anxiety, fear;  depression;  loss of self-confidence;  joint pains;  persistent fatigue that increases with activity; dry eyes;  reduced muscle tone;  depressed attitude;  nervous, irritable;  poor concentration and memory;  pale skin/anemia;  increased fat in breasts, abdomen and hips;  metabolic syndrome.  If you have any of these symptoms/signs on a continuing basis, please mention them to your primary health care provider and ask for testing to rule out testosterone deficiency. If, after the testing is done, your provider says that you are in the “normal” range, please ask him or her where in the normal range do your values fall?  If you are in the lower 1/3 of the range you are at risk (re-read paragraph number two above) and should consider or hormone optimization therapy.  In the next blog, I will talk about the ways to optimize testosterone levels – both naturally and by replacement.

~ Dr. Gatis

HOT & Aging Go Together

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Hardly anyone would say that I need to “optimize my hormones” for good health and longevity.  In fact, many of the signs of aging can be directly related to declining amounts of major hormones.  Testosterone, DHEA, Progesterone, Estrogen, Growth Hormone all decline with age, for example.  Why are many people almost obsessed with the idea of anti-aging?  We all are going to die, right?  Well let me tell you a simple fact.  When I reach the age of sixty and beyond, when asked “How are you?”, I want to be able to look them in the eye, give them the thumbs-up sign and say “Golden” (and mean it).

That is why I am a proponent of “H.O.T.” or Hormone Optimization Therapy.  To this end, for myself and my Naturopathic patients, I have taken the training and become a Fellow and Board-Certified in Anti-Aging, Regenerative and Functional Medicine from the American Academy of Anti-Aging Medicine – and I have decided to “blog” about relevant

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issues that we all should know about when it comes to healthy aging.

H.O.T. is not just bio-identical hormone replacement therapy– as important as this can be.  Excessive hormonal levels – like insulin and cortisol – also adversely affect health.  Hormone Optimization Therapy takes into account that hormone levels and organ systems are all interactive.  Reducing stress and restoring adrenal function is absolutely necessary for individuals with low thyroid activity, for example.  Optimizing both adrenal and thyroid function is necessary to have balanced female and male hormones. A Naturopathic Doctor by virtue of his or her training is a specialist in supporting and optimizing the body’s functions.

It was a surprise to me that a high percentage of men have symptoms of and suffer from hypothyroidism and low testosterone as they get older.  The “grumpy old man” syndrome is actually the result of low T!  Maybe it is just the male in me, but there is a distinct difference between being sensitive to your female partner’s needs and being an emotionally “sensitive” male as a man ages.  One of my patient’s just today mentioned that as her father has gotten older, he cries much more often – and “that isn’t my dad”.  In my opinion, his Testosterone to Estrogen ratio has changed and he has become more hormonally like a female.   Please understand that I am not saying that there is anything wrong with a man or a woman crying.  In a man, however, inappropriate or increasing crying (or anger) may indicate a testosterone deficiency.  Optimal testosterone levels are absolutely essential to a man’s health – his mind, heart and “bone” in particular.  More on this in the next blog.

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Until next time,

Dr. Gatis