Dr. Kyle Gillett: Tools for Hormone Optimization in Males
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Welcome to the huberman lab podcast, where we discuss science and science space tools for everyday life. I'm ander huberman and i'm a professor of neurobiology and optio logy at stanford school of medicine today. My guess is doctor cole gilead.

Doctor cole galette is a doll board certified physician in family medicine and obesity medicine, an expert in hormone optimization. He is an md that is a medical doctor, and he treats patients with a variety of backgrounds, ages and goals. Today, we discuss male hormone optimization.

We discuss behavioral al tools, nutrition base tools, supplement base tools, prescription drug base tools and their interactions in determining overall levels of testosterone, free testosterone, die hydro testosterone, s rogen, growth hormones, thread hormones and many other hormones, the impact, mood, libido, well being, strength, cognition and various psychological factors. We covered hormone optimization in both men and women in previous episodes of the huberman lab podcast, but today's discussion is different. dr.

Calculate offers very specific recommendations for people with different goals and of different ages. And we get deep into the weeds of, for instance, how does one know whether or not their testosterone is optimized or not, how often to test for specific hormones such as testosterone and other hormones, and really, how to gage how good one should feel? This is something that's often overlooked in discussions about hormonal optimization or health optimization of any kind for that matter.

For instance, people will talk about reduce libido and discuss whether not testosterone levels are to blame. But how does one calibrate their libido in the first place? That is, how does one know whether not their libido is Normal, too low or too high? We also discuss, for instance, whether or not hormonal optimization should be pursued continually throughout the year.

For instance, whether you should cycle on and off, supplement and or prescription drugs, gear towards home, on optimization. And we discuss the behavioral foundations of optimal hormones function. These are things that every male should be doing, and various things they should actively avoid if their goal is to have healthy hormones and to quote, quote, optimize their levels of every hormone from growth ormon to testosterone at any stage of life.

And while today's discussion is about male hormone optimization, I want to emphasize that we discuss all the various ages for male horn optimization. So for those of you that are parents, for those of you that are Young, those of you that are middle ages are old or teenagers, we explore adolescent puberty, teen and late teens, early adult hood, adult od and into the late geriatric ages. So regardless of your age and whether not you were male or female, today's episode ought to be of interest to you.

I should also point out that we will soon also be hosting an expert guest on female hormone optimization. One thing that i'm a certain people of all ages and biological sex will enjoy about today's conversation is that we also get into descriptions of how psychology and life events impact hormones, and how hormones impact our psychology and the way that we show up to various life events. So today is really a broad overview that goes all the way down to find details about male hormones optimization.

And i'm certainly, by the end of today's episode, you have an immense amount of new information about how this underground, that is, hormone system in your body works, and how to interacts with your brain and other tissues and many, many action tools that you can pursue regard the substation of life. Before we begin, i'd like emphasize that this podcast is separate from my teaching and researchers at stanford. IT is, however, part of my desired effort to bring zero cost to consumer information about science and science related tools to the general public.

In keeping with that theme, i'd like to thank sponsors of today's podcast. Our first sponsor is element. Element is an electoral light drink with everything you need and nothing you don't.

That means plenty of salt magnesium in patache, this so called electorate, and no sugar. Now salt magnesium um in patasse are critical to the function of all the cells in your body, in particular to the function of your nerve cells, also called neurons. In fact, in order for your neurons to function properly, all three electro lights need to be present in the proper ratios.

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I started using the waking up up a few years ago because even though i've been doing regular meditation since my teens and I start doing yoga edra about a decade ago, my dad mentioned to me that he had found an APP, turned out to be the waking up APP, which could teach you meditations of different durations, and that had a lot of different types of meditations to place the bringing body into different states, and that he liked IT very much. So I gave the waking up up a try, and I too found IT to be extremely useful, because sometimes I only have few minutes to meditate, other times have longer to meditate. And indeed, I love the fact that I can explore different types of meditation to bring about different levels of understanding about consciousness, but also to place my brain and body into lots of different kinds of states, depending on which meditation I do.

I also love that the waking up up has lots of different types of yoga eda sessions, those you don't know. Yoga edra is a process of lying very still, but keeping an active mind. It's very different than most meditations.

And there is excEllent scientific data to show that yogananda and something similar to IT called non sleep depressed or n sdr, can greatly restore levels of cognitive and physical energy even, which is to a short ten minute session. If you'd like to try the waking up, you can go to waking up that com slash huberman and access a free thirty day trial. Again, that's waking up dot com slash huberman to access a free thirty day trial. And now for my discussion with doctor called gelett doctor gill tt, great to have you back.

Great to be back. Thank you.

I'd like to begin with a question about one of the most mysterious and important phases of life, which is puberty. I've long wondered whether or not, how quickly somebody, those into poverty.

So at what age and how long puberty takes, so how brief for protracted that poverty is for them to acquire? This will called secondary sexual characteristics, things like hair growth on the face for males, and changes in bone and muscle density and growth at sea. You know, I was in middle school and high school.

I noticed that some people transitioned in all that very fast, and some people took a long time to acquire those characteristics. Can we learn anything about ourselves, our hormones and maybe even how long we're going to live based on the time in which we enter puberty and how long IT takes us to progress through puberty? I guess that also raises the question, does puberty ever truly end?

There are many takeaway from huberty um some of the actionable items from IT is yes IT can and does affect your adult height and also stature and also body composition. So puberty is a time um and if you if you're talking specifically about males, think of IT as A A time where if you have obesity as a child, you could potentially use that time to change your lifestyle habits and reset things.

And IT is a bit easier that was like A A free injection of testosterone one and metabolism m and drive an effort into your life. There is a wide variation in um how quickly puberty goes through, so their stages called tanner stages, which we don't necessarily need to get into. But if you enter puberty very early then I can uh decrease your adult hyder stature.

So for a given mail that enters puberty yet thirteen, verses of mail that enters puberty yet fifteen, can we say that the guy that entered puberty at thirteen is going to be shorter than the guy that entered puberty at fifteen? Or it's not quite straight .

forward if they are identical twins? And the individual who entered puberty at age thirteen also finished puberty when all the way through the tender stages. And if you do a bone scan, which I believe is usually on on the left to wrist and he says, yes, your growth plates are mostly closed. You're not going to grow more than a couple inches of height after that.

okay. But just a related question. When I was growing up, I was thought to at least people would say that resistance training, in particular lifting heavy weights, could stunt one's growth. Is that true? We're false.

IT is false. When you're talking about just lifting heavy weights. Dirty bulkin certainly has the potential to stunt one's growth for for two .

main mechanism.

Could you define dirty bulking? So dirty king is eating an excess of calories, not just to acquire lean meta icc active body mass or get stronger, but purposely acquiring body fat.

So purposely acquiring muscle and fat by over reading, yes, and lifting weights can stun one's growth. Do I have that?

correct? correct. So IT does two things. If you're doing IT, as a very Young child, I can that fat can can become lepton resistant and he can produce more lepton. And that lepton can activate the hypo palamas, which activates the tutorial, which releases could not at troops s, which basically just increased testosterone and estrogen earlier than that otherwise would have. It's the same mechanism behind why childhood bested causes early puberty.

interesting. I do remember a paper polishing science magazine. I believe IT was focused mainly on females, but showing that when enough body fat accumulates, the hormone left in is secreted and that trigger the onset of puberty. Given the increase in our childhood obesity that we're observing now, are we seeing an earlier onset of puberty in males and females? Yes.

in both males and females, not to get two decal, but there's a deep protein couple recept tor on the hypothalamus and left them directly by inset. So IT does appear directly caution and not just correlation. okay.

So and if I understand correctly, what you're saying is for a Young guy, lets say thirteen, fourteen, who wants to really bulk up and delivery deliberately, excuse me, over eats and is doing their squad and dead loves and benches Prices and really trying to get big. They will get big, but only in the lateral dimension they are there. Effectively limiting their total height and IT can shut down the long bone growth of of their limbs. Is that correct?

correct. The growth of the long bones is mostly related to the estadio alpha receptors. So basically one of the receptors for estero en, which can be secondary to uh, early puberty and also is related to body fat because you have that conversion of testosterone to estrogen.

So can we assume that if a Young male wants to get into resistance training, that body weight exercises are probably OK and maybe even some weight training cattle bell is set a, but that they should avoid doing so called dirty bulking, trying to deliberately gain weight up until what age, until poverty is over.

I would say an individual should limit the amount of, uh, body abb Normal body of accumulation or dirty bulking indefinitely throughout their entire life so again.

if I understand correctly, that recommendation to avoid deliberate weight gain or rapid weight gain is not just to allow an individual to reach their maximum height, but also to avoid lying down a lot of body fat sales. Correct.

correct. The baLance between that is, when you are going through puberty, you are able to add a lot of lean body mass, not just a muscle mass, but bone mass and other mass as well.

I started a lifting way to when I was sixteen, and I confess I trained pretty heavy at times. I don't know whether not I would have been taller than I am now, but when I started that training, I had already reached what was at least close to my predicted height. I can say that I deliberately waited until I grow IT. Just so happened that I stumbled into the weight room and found that I like that at age sixteen, at which point I was already hit, that I am now. So in any case, what i'm hearing is that lying down a lot of excess body fat is not a good idea. What if somebody grows up chubby or fat, uh, for whatever reason, reasons related to the eating patterns in their family, maybe in some genetic reasons, is IT safe end or wise for a Young person to, let's say, somebody whose around the age of puberty, or even Younger or in their like teens to be dating and actively trying to lose body fat? Is that safe .

under the supervision of a position IT is certainly safe to change your body composition. In pediatric bested medicine, you're often talking about a recomposition or a the Normalization of the growth curve compared to peers.

Thank you. So as you may have sense, we started chronologically with puberty. And I know that there is another puberty that even proceeds the puberty that were all familiar with. Maybe you want just briefly mention that because I was talking with you about this before we started the poverty that i'm most familiar with, and I think most people are most familiar with the acquisition of deepening of the voice, growth of muscle and bone, a body hair, acquisition of libido and things like that. That's actually the second puberty that we all go through, if we just mentioned for us and educators on the first puberty, I think most people will be hearing this for the very first time. The first pure .

beauty of everyone's life is the first three months of their life. You may notice that your baby has more active y the first three months and that they also have um h in general just more changes related to androgen and estrogen, perhaps oil your skin um even more genetic eric, like genetic growth during the first three months and this is mostly due to DHA which is an adjunct hormone, the second puberty, or the puberty that most people know have actually starts that same way as well, is called a generic is when the adrenals kick in. I guess for the second time.

is there a standard age or age range in which the testicles descended in males.

usually before birth? Um IT is not uncommon to have one or even two on distant teases, but there is a risk of testicular cancer, especially if they are not fixed early and also heat damage .

to the testy well, thank you for that coverage of the two poverties. So early in life, I imagine some of our listeners, probably still in one of the one of the other people of the ones, are in the first poverty, obviously aware that they are listening to this project, but maybe will be embedded in their subconscious.

But some a listeners probably are still in puberty, but I think everyone can remember back to their puberty, and roughly when they first entered puberty, and how quickly they aggregated the secondary sex characteristics. Like to turn out to a general question about what all males ought to do in order to optimize their hormones. So you could just list off the things that all males should do on a daily basis, weekly basis.

I mean, should guys in their teens and twenty years be getting their blood work done? Should they be taking supplements? We already talked about wait training, which should be doing. What should they avoid doing if the goal is to have a long arc of healthy hormone optimization on throughout the lifespan?

There's many things that you should do. An analogy that I often make is when there's a brand new car that comes off the umbly line, you do a full scope of diagnostic workup hook IT up to the computer. And I think we should do the same thing with humans as well.

The puberty, you know, obviously you're functioning human. But uh, I would say there is still development and I think that the human always developed. I don't think development ever wins, but you, anna, monitor that progress across a person's lifespan.

So sorry. So for blood work, I mean, what would be the earliest, let me put in this way, if bloodwork didn't cost anything and everyone could get IT, when would you want to see everybody get their blood work done for the first time of obviously.

individuals under the age of eighteen should talk with their parents about this and as long as that, uh, the parents and the child kind of agree and the parents are on board with this as well, you can start getting blood work.

Um often a child will come in with complaints to you, either precocious puberty or delayed puberty and this individual might be nine or this individual might be fifteen for a healthy child when they're going through kind of their later tender stages, which is four and five, they developed several secondary sexual characteristics. They might have uh hair growth or starting to notice more beard growth. That's a good time to do IT. Uh, if you're concerned with statue or heights or if you're not tracking along where most members of your family have not just their height and stature but also the timing of the property, and that's time to get lapse.

right? So if I could travel back in time, I would have gotten my blood work done for hormones and lipids and everything else at eighteen. I unfortunately didn't know where and how to get that, and I didn't have any pressing clinical issues. And so the first time that I got my blood works done, I was in my late twenty, maybe even my early thirties, and I still dying.

To know what my blood works was when for insinuation was seventeen, and I felt a certain way, and and I confess that in many dimensions, actually feel Better now, or be forty seven soon at forty seven, then I did in my teens and twenty. And I think he was more on the psychological side. I think that bite in terms of just understanding why we felt at great or why we felt or feel terrible or not so great, I think blood works is extremely informative.

What do you think are the key things to look for in blood working? And I just astre one is always the topic that comes up in the context of malta mono optimization. But certain ly, there are a lot of other hormones .

that are important as well. And with testosterone, you want to get either testosterone and H, G, or a free to ask.

could you to find us? H, B, G, for a listeners.

please. IT is sex hormones binding global. IT is the protein that binds up all android gen and androgen of the body. So the stronger the androgen, the stronger IT bines during puberty.

Strong androgen, especially D, H, T, which is the strongest bioidentical androgen, has a huge role, a prominent role in secondary sexual characteristics. And if your S H B G is very high, then your dht can run higher because it's not the tables zed, but there's not quite as much free dht. So you anna baLance between um high enough free D H T and a high enough total D H T. Obviously blood tester .

are going to have to be read and interpreted by a qualified physician must be learned going to be in a position to evaluate them properly at least not with the full debt that they could if they had an md like yourself looking at them. okay.

So everyone should get blood work as early as possible that um depending on their budget and availability, what should everybody do in terms of monitoring those markers? So assuming that there is no major intervention, how often do you recommend that people get their blood work done? I say.

let's take an individual who just turned eighteen, they just got their first set of blood work. They'll probably find something in IT that they may want to optimize using share decision making with their physician. Usually a good followup is about six months .

because so twice a year getting blood work, then having a physician evaluated, that sounds reasonable to me and for those didn't initiate this at eighteen such as myself, is the best time to start, then would be as soon as possible. Yeah right. In terms of the other things that all males should do, meaning all males of all ages um puberty and beyond uh should due what what are some of those things? So on a daily basis, maybe you could just take us through the art of a day and um and push out some of the protocols that you use are the things that you like to see your male patients use in order to try and to optimize their .

hormones or briefly touch on some of the lifestyle pillars to start diet and exercise or the first two um in puberty, sleep is particularly important of course um but with die and exercise throughout a lifespan, you want to not exclude things that are helping you. For example, during puberty, if you're consuming dairy and then of a set you cut out all dairy. Dairy can help increase I G F one and free .

I G F one we get for a aud. So maybe you just mention what what having enough I G F one can do for us. That beneficial is IT .

helps you grow. IT helps with a genital development, secondary sexual characteristics and long bone growth, scanner growth, hair growth, a host of things.

So getting in a ray of nutrient that include dairy, what other sorts of nutrient are important during development?

You want to have adequate vitamin. Vitamin d helps with tears. Strom production. That helps, again, with bone mineralization. And stature. And after an age of about twenty five and there's not a strict cut off, but up to about the age of twenty five, optimising your growth, ormond ID of one helps with bone density and bone growth. So from the dietary standpoint, you want to have enough free estrogen, not too much when you're growing, but you want to help um basically stock pile bone to prevent a risk of hostile process or thin bones fractures when you're older.

One of someone who broke his left foot five times while in high school can say, whatever Young people can do to optimize their a bone density would be great. That problem seems to have resolved itself over time, but I don't know. Back then, I was, I did a short run as a vegetarian, but i've always been an omnivore.

I realized that some of this relates to ethics and food allergies and things that sort. But would you say that, on baLance, that most people would benefit from eating a combination of quality proteins from animal sources and non animal sources, fruit to vegetables and starches? Mean, what do you think for incense about people following a pure carnivora, very a pure vegan diet in their twenty years and thirties.

in their late twenties, and might be a reasonable option in early twenties, and certainly teens? IT is a horribly idea, because IT is likely to significantly decrease your free energy, so he will have less testosterone, an acting on receptors through the body.

Are there any other mico nutrients or micro nuta ents that people in their twenty years in thirty should emphasise?

We haven't really touched on fatty assets or fiber too much. Fiber is going to be paramo in kind of like setting your set point of your gut micro biome. The rest of your life there is prebiotic fiber, which you can think of as fish food for your good got microbiome. You got microby. I'm just inking about gold .

fish swimming around and that gold fish eating people don't need gold fish. People help you live or dead.

Yeah but any fiber or food that you're putting in your gut, if neither are going to it's going to screw you got microbial toward something that is more beneficial or or more detrimental.

And would you say that the prebiotic fiver and getting essential fatty acids that would be important to do through out the life span are just for the people in their twenty years and .

throughout the lifespan, and particularly important in the teenage twenty thirties because that helps with brain development. You're certainly more than expert than me when IT comes to um brain development, but IT does continue to develop really throughout the lifespan, but certainly through the twenty years and thirties as .

well about taking a multivitamin. Why you're growing up so many people um do that, is that necessary, is IT useful. And if it's not necessary is is safe to do anyway.

It's generally safe to do anyway. I do not think everybody needs a multiple amin. The more exclusionary your diet is. For example, if you have see the act disease or if you're planned on fertility soon, than perhaps it's more reasonable to take a division.

In a previous discussion of ours, I asked you about chloric restriction and testoon. And if I recall correctly, the idea was that if somebody is over way, they have excess fat at a post tissue, then getting rid of some of that at a post tissue, but through chloro c restriction and exercise provide is done not too fast in a healthy way, is going to be beneficial for test astros in the long run. But that for individuals who are not Carrying an excess of body fat, clerk restriction is actually going to lower test first. Well, do I have that correct in second, are there any ateneo to that that you'd like you to give us?

Now that's correct. Um if you look at an individual in a chloric deficit, several changes will happen. One is that they're have less building blocks for hormones.

Another is that there will be in a catos c state more often. That baLance of anabolic m and catabolic m will be different. They're likely have less signaling from growth promoted I G F one. And they'll also have the high H B G that we defined earlier as the binding protein. So there are free androgen and free estrogen will go down OK.

We touched on sleep being critical. I would take throughout the lifespan, trying to get enough quality sleep at least eighty percent of the nights of your life. And the other twenty percent are just what happens when there's noise outside or your stress is just you have an exam or are having a great time for whatever reason there a lot of good reasons to lose some sleep now again as well.

But so we have sleep. We've got nutrition. We touched on that. I will get back into supplementation. Now what are some of the other pillars of creating the proper environment for hormonal .

optimization as stress is probably the next one um during um both puberty but also the twenty years and thirties, individuals are figuring out how they want to cope with stress and also figuring out what they want to choose to put their effort into. So if someone is over stressed that they can have you can put all the other lifestyle pillars and then they stopped dieting. Well um they stop exercising and everything else can go rescue um there is also some degree of uh social component to this so perhaps and you add a seventh pillar of social, you know during you're twenty years and thirties you maybe form in a family as well. Perhaps you have children and the health of the family unit is going to be vitally important um not only not necessarily directly for hormonal optimization, but it's going to throw everything else off if yours off.

And for people that are not starting their own families in their twenties and thirties, couldn't that social connection be extended to friendships and work relationships as well?

absolutely. In fact, if someone's not starting a family IT IT is just as concerning. But for other reasons, each individuals gonna have their close group of family and friends. And if someone does not have one of those connections, that's when things can potentially get bad, not just for them individually, but also society.

So when you say stress, you mean learn to manage your stress. What does that look like? I'm patient. Um you know as hyborian pressure even if they don't um you just sense that they stressed that they put lot of pressure speech or they are not feeling well or communicating that they are not doing well. What are some of the things that you recommend in order to trying to mear that stress?

There's different mindfulness for relaxation techniques going outside can often help with this as well. Um dietary changes and exercise can help with this too. Some people like prayer or meditation and a lot of people like a councillor therapy or even just talking a openly with a family member or a friend.

What would be some of the other pillars for home and optimization here? I feel like we're not just talking about people in their twenty years and theories, but again, wrapping our arms around basically puberty onward. I mean, I mean, I looking back, I start meditating pretty early.

I start way training and running earlier gave some thought to my died in high school but really was in college. I start thinking more about what I was interesting in why trying to do Better there. But people are coming to the table at different stages of um life and trying to optimize for hormones. So you know so what would be some of the additional things that everybody should do?

Everyone should get outside and find a movement past time to last a lifetime. You're going to get sunlight. You're gonna get some degree of heat and called exposure. And you're also just gone to move more being an artificial environment where there's artificial lights, artificial air conditioning um is going to have many effects on your body um so that's vital. Another one is finding what your purposes in life. So I call this spirit, but it's really just the self actualization component of mazo s hiroki of needs, which basically your physical needs, your mental needs, and then your purpose in life, what you really like to do.

Now picking some goal target, I have always say that you don't have to stick to the same goal over time. Certainly I haven't, although I got started really in the science game and i'm still in IT. Um the idea is not to pick the n goal, is to pick a goal and then once you reach that goal to and then take another goal and so on.

I think sometimes when people here about picking a purpose, like I going to have to define so are like naming oneself, that you actually can change your your goals and purpose over time. This is terrific. Would you suggest that people actively use or avoid supplementation prior to doing all these other things? I'm somebody likes to throw the kitten sink IT things, but I also like to do things pretty systematically.

So I always say behaviors first, then nutrition, then supplementation and then maybe and if and only if there's a real need and of course, working with a doctor, prescription drugs. But you know there are probably people in their twenty years or thirties, maybe in their fifties, they aren't feeling great and they want to do something in order to be able to train more or to um feel more confident to seek out social connection. They trying to go about the whole business from the other from the other side as well. What are your thoughts on that? I see .

supplements and medications as a very similar ones prescribed. And once not in general, medications have more side effects or potentially stronger therapeutics with more efficacy, but they're just tools to reach an end goal. So depending on on the goal, if there's an individual that's an athlete, then certainly they should consider supplementation. Or if someone desires optimum very a very high level of cognitive performance, they should also consider supplementation. At the same time, food is medicine, and a lot of benefits you can get in supplements.

you can get in food as well depends on how much time and energy you to spend and also finances. I know that when I was in college, I could afford just a few supplements, and they're basically way protein and some fishel. I was fortunate that I was pointed in the direction of those things in some creative. I couldn't afford much else over time. Of course, I could afford more, but IT really does often depend on on finances.

Before we get into some specific recommendations to optimize to stores, rogen thero growth and said, when I ask you a question I been wondering about for a long time, so often in the discussion about male hormone optimization, people say, well, you know, if your libitina is suffering, you know, you might want to be concerned about testosterone or even estrogen, right? Because we know that estrogen can impact the below as well. Sometimes having estrogen to low is detrimental for the beto or people say you're not recovering from work out or you're just are you feeling kind of depressed? The problem is, is also objective.

So how does one know whether not their recovery from workouts, their energy, their confidence, their libido is within a healthy range? I mean, obviously, ly, for people in the relationship, they can know whether or not their libido matches the sort of kindness of the relationship in their partner. But how should people think about this in maya and starts to talk about IT? Because one of the big differences, I think, between males and females is that because females have a monthly cycle, they are familiar with the changes that occur in their homes es over time, because every twenty eight days those hormones are changing dramatically in ways impact their physiology and psychology.

But for males, and I feel like they are sort of A A death of language to get into. The more subtle aspects of this also has to do with privacy issues and people feeling like they don't want to overshort um too much, not knowing what's appropriate to share. But when you talk to a patient whose in their thirties or maybe even in their seventies or sixties, doesn't matter a male patient, what are you listening for? And you know, I know you're not a psychiatry sport. You know, what are your ears tuned to in order to try and to figure out whether or not this person could really use some help with hormone optimization or whether not something else or maybe they are just doing great and they don't really IT because they're placing demands on themselves that are excessive.

You want to you want to use a lot of open ended questions. This process is called motivational interviewing. And your goal is to listen to the patient and not plant an idea in their mind that they can follow because everybody is going to have a different goal. Um some people are Better reading their biofeedback or um telling how they feel on a daily basis. There is screening questioners designed, for example, an adam questionnaire to look at men's men's health and hormone related health.

It's called an adam questioning. A D, A M S is IT available online that people could be administer to themselves, although we don't want people making clinical diagnosis of themselves or anyone else. Is that that sort .

of exam IT is interesting. I don't believe IT is a clinical validated tool like an A S C V D, which is like A A risk of heart attack and stroke tool or many other tools. Um there's one for depression, there's one for anxiety.

They're called pq nine and gas seven respectively. But anyway, there is often an in the atomic questionnaire. And what you hear from the patient, if you are a very careful listener, is often different.

Can you give me an example, all some of the questions on this adam questionnaire or the sort of motivational interviewing that you might do? So your patient, we sit down, what sort of questions would be asked to probe these kinds of dimensions of of hormones?

Questions about the beto, questions about athletic performance, questions about motivation? And often the patient will answer one thing about what you hear from them, subjectively, is far different.

interesting. Can you give me an example of of a question? I'm happy to be the the ginny pig here.

A classic one is a guy comes in and a lot of times they say, no, the wife made me go to the doctor. I go once a year. That's IT.

I don't want anything. I don't want any medications. Their screening questionnaire be zeros across the boards.

So nothing, no issues. They apparently in perfect health. They talk to you for a while. They get some very poor. They like you. And then right is your finishing of the visit and about to go out the room. They mentioned that um and their libido isn't quite there and they're having a little bit of E D as well and perhaps are even having some chest pressure tightness.

I see. So right is you're leaving in the room. A patient will tell you that they're having some sexual side effects or not side effects. They're ving some sexual chAllenges and then they mention chest pressure. Is the chest pressure at sort of general decoy for it's got to be my heart or is IT um is IT related to the other things they're reporting?

IT can be related in fact, uh, erectile, this function is not as the canary in the coal mine, so coal miners would take the canary down, and that would the canary would die before the coal miners would, I believe, carbon oxide poisoning. And often one of the causes of E D is black build up, which can happen in the coordinate is as well. But sometimes they noticed the symptom, the genitals, before they do in the corners.

So for such a patient um let say that patient was a Young person where black built up in the arteries and that is not all that likely if there but twenty years authorities, what would you be your next step of the interview at that point? And what what would you consider would you immediate alter labs for that person to try to rule out any kind of actual hormone .

level deficiency? I certainly would order labs. There are some individuals that are very similar and they come in and they have the same symptoms.

And one individual might have a very, very high test stone and one individual might be um severely hypocras ult. So there's A A big difference between subjective and what the labs look like. So I certainly order labs.

You also ask them about um if its situation or or not. You ask them if they have E D of their you know asking about their habits. You even ask about porn and mastermaid and all these issues, and of course, it's between the doctor and the patient and opinion what they tell you.

You can often determine if there is a situation components. Some people called its psychogenic E D, but I don't love the term psychogenic E D, because that kind of put some some blame on the patients mind. But a lot of the time that is the case. There is even a test and this is very rarely ordered, but it's called a doctoral penile to .

mesons because is is is true that there are period directions during sleep class.

Yeah so you basically put a cough to see if you are having A A Normal sized direction during sleep. And I believe about ninety percent of the time they do that test, they are indeed having interactions.

which would point to this psychogenic origin of whatever chAllenges they're having in terms of sexual interactions. You mentioned porn and masturbates. This topic has come up a bunch of times on this podcast. In another podcast, i've gone on because of the relationship between depine sexual motivation and sexual behavior.

And i've been of the pretty strong that, well, i'm not judging corner mastermaid IT can create a brain wiring situation where males in particular essentially teach their brain to be aroused by watching other people have success opposed to being the first person actor in sexual interactions so in that sense um you know that's more about the brain wiring in neural plasticity and depine. But what are your thoughts on important mastermaid as they relate to hormones? I mean, this is a big debate on the internet.

In fact, one of the most common debate is whether or not masturbation increases or decreases disasters. And males, certainly IT, will decrease motivation to go find sexual partners. We know this um and there are more and more data on this all the time in terms of the effects of pornography and masterful ation in here.

I suppose we'd need to be somewhat specific and Operationally define what we're talking about. We're talking about porn and mastery ation to the point of event lation, right? Because my understanding is that the event lation in an organ associated with IT causing increase in proactive, which you blunt slide to for some period of time.

The duration of that will vary from person to person, circumstances, circumstances, but specially, all of this points to the fact that pointer mastermaid can really limit libido in the real world. And to me, uh, pornography. And the screen is not the real world. The screen exist in the real world. The real world doesn't exist in the screen.

That's an accurate statement and proactive does have a significant acute increase after uh event lation IT does the some degree after orgasm as well but proactive acts on the batur tory to inhibit the release of the hormones L H and F S H of which l can increase to astre one. So this may be one of the cases where the dose mikes the poison. And if IT is a very frequent habit, certainly daily year or more than once a day would be very detrimental from a hormonal component, not even taking in to account the the neural wiring.

Listen I think is terrific. You ve actually defined frequency because this is the problem on the internet or even in the doctor's office you'll see um descriptions about pornography being dangerous for certain things are or detrimental the harmony to be a safe frequent but what's frequent so you are saying daily or multiple times per day would be potentially detrimental .

to the hormone profile of a male essentially any age and that's just for max page um with pornography, with porn use as well. I would likely be worse and .

what why is that? Just this the sort of dopamine e gic drive of the stimulus, just a really intense visual stimulus.

Dopamine sensitivity um I think that are using the analogy of a dopamine wave pool, IT would deepen the pool but not increase your supply of dupine. Maybe you could .

describe the dopamine way pool because I think it's such a powerful way of thinking about doping and what dope does. In fact, always credited you in when i've done IT. But i've i've generally stall in your analogy of the document way for because that is so astute. The dopamine .

wave pool describes the natural variation of absent downs in your dopamine or your motivation and um in the wave pool, depending on how hide the pickers, you often have a deeper trough so you do not want to hive a peak. In addition, if your peak is very, very high, for example, uh, when you're using mini substances like uh cocaine or like eat means your deep can go so hi, you lose almost all the water from the wave pool and then when you crash from that, not only as the trough low, you have less dopamine in the pool. To begin with, the dopamine reception is extremely sensitive, as is the gaba receptor, which is inhibitor ory recept tor, where as dupine is technically a stimulate, more related to a jinin nor drinking, the depth of the pool can change very quick. So you want to have the happy medium where you're fairly near the top, but you're not so near the top that the debt of the pools is going to go down.

So if I interpret that in the context of this discussion about um libido, sex or masturbation, if somebody has a very intense sexual experience here, we're not necessary talking about intense um organism. We're talking about just you know a lot of intense visual so very um a lot of intense imagery or auditory input or both. That is going to lead to a situation where document is going to be depleted afterwards.

A guest on this podcast before my colleague is stanford doctor on elegies extra edition talked a bit about this, a sort of sea, saying he were talking about a wave and a crashing out of water from the wave pool. There was a sea sign from pleasure, in pain, who is going to be a longer and deeper period of lack of pleasure following that? And I think a lot of people think, oh, that's great. You know, they want the intense experience, but if that intense experiences is coming from pornography and mastery ation, or I suppose coming from you high general and activities like, you know, life, life, risking park core hanging off the side of a building IT inevitably is going to lead to depressive episodes, low libido, epo des that follow.

Is that right? correct. In a similar physiologic way, a to withdraw from stimulants like .

ampt means. Now, is sex with a partner different? Because there are many people who are chasing more and more intense experiences with a partner, as opposed to through pornography. And masterful ation, again, here were talking about all ages. And I should always say, any time we're talking about sex with a partner, were talking about the four conditions that I was his layout on the human podcasts are that were talking about consensual age, appropriate context, appropriate species, appropriate interactions .

yeah and this is also a case where the dose makes the poison. So if there's you know obviously meeting all those criteria, if they have one preference um that for both of them is a positive experience, then that is likely okay. Um you're not gna be able to maintain dopamine e over a certain thresh hold for a long period of time. So there very well may be a crash from the experience as well and the crash may be different in one partner than the other.

Interesting well drawn analogy to food. Be like you don't you don't have to serve the bank with meal seven seven nights of the week, maybe just two. Is that right? And there are other delicious foods out there. We use that in all .

that is very reasonable.

okay. Not trying to be pg thirteen, just trying to parSimony oculus raiser. The ability to describe a lot of things in, in, in a few words.

I'd like to return to the key things that people should do, or I should say, the key things that men should do to optimize their harmony. So we talked about getting some move and getting some sunlight, getting quality social connection, one where the other avoid excessively frequent masseria in viewing pornography. And for some people, zero might be the optimal number.

And I keep coming back to this people, for most people, interesting. I feel so fortunate to have grown up prior to the availability of internet pornography. I i've never been a big consumer pornography.

I just not been my thing. But I hear so often from males of all ages about their addiction to IT their affliction by IT. It's really a serious issue and that's why the reasons why grateful that you're willing to talk about this in your clinical experience with these patients.

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Again, that's athletic Greenstock comm slash huberman en to get the five free travel packs in the year supply of vitamin d 3k two terms of exercise know here's again it's a double LED sort um on the one hand it's great to get exercise but i'm familiar with you know if I train an hour a day， tenants have warm up in fifty minutes to an hour of wait training or fifty minutes to an hour of cardio. I great, especially if once a week I take a complete day off that sort of my general schedule. I'm also familiar with when I go out for runs that are excessively long, two hour runs, I spend ninety minutes in the gym too frequently, start to feel like garbage, everything suffers, my sleeve starts to suffer.

Doesn't matter how much I eat, I don't seem to recover. I don't feel well. So I realized that recovery ability varies between individuals, but what you think is a healthy, sustainable exercise regiment that anyone can follow, that will also support their hormone .

status for really vigorous exercise around three to four times a week is very sustainable over a long period of time. On top of that, you could add in three or four more instances of less figure exercise.

okay. So for less Better, would you mean that no zone two cardio where you can hold a conversation, but beyond which you you can't? And for more vigorous, you're thinking, wait, training or hit a high intensity and a rule .

type training, right? correct? Um you can also wait, train and have some benefit even at a low to moderate intensity.

If you think about a weight training where you have and it's not necessarily LED to the incidence of domes, which is delayed onset muscle soas, but if you wait train, lazy or easy from time to time, obviously want to wait train very heavy from time to time as well because of a morally body mass growth. But um if you wait train, the lighter you're going to be able to do IT more often. And I can still help with the hypertrophy of um collagen, for example intendants and lichens.

So here again um like to perhaps drill into this notion of intensity and light ighly because for me some of the most brutal workout i've ever done were in what I would consider a high repetition range, fifteen to fifty actually I went up to or again to watch the international track and field championships.

We went by Cameron hands, his place by the Cameron hands, and he in his trainer put us through a workout that was twenty five to fifty repetitions percent. And IT was done in circuit. And IT was brutal.

So IT was light. I know that those weight were nothing. In some cases there was body weight, but the number of repetitions was brutal.

So when you say limiting intensity, are you talking about limiting the number of a sets to failure? Are you talking about um really being kind of a lazy bear in the gym? I like to do everyone to a long, long rest to that sort of thing. Your thoughts on that as IT relates to hormone optimization.

So i'll just mention and then i'll let you answer, I feel best overall when i'm training for ten minute warm ups and about forty five or fifty minutes of way training where i'm pretty lazy between set two to three minute rest, training somewhere in the sixth to ten rap range, going to failure every once in a while, but mostly getting that sort of last rap before, what I would think is failure. No four steps, that kind of thing. And then jogging on the other days, nice and easy when I do.

I feel fantastic in all other dimensions of life when I trained more intensely than that, even with light weight, so faster cats and low arrest, I feel like garbage. I get a headache, kind of ordinary, everything suffers. So what are your thoughts on kind of defining a optimal exercise strategy for hormones? I've never measured my hormones in those two different context, but I have to imagine that it's court is all .

related when they study the effect of exercise, specifically vigors exercise um one area that's been studied as vigor sexercise episodes lasting longer than an hour and they usually track IT by a rating of perceived exertion, which isn't perfect and it's not extremely actionable, but it's helpful for clinical science. But the take away from that is basically do not IT is not hormonally helpful to train especially regularly train vigorously for longer than an hour.

So i'm happy to hear that because this sounds like for most people that our of work is really the threshold I think is important for people to hear, especially males. Because I think with all of the incredible examples out there, people like can like David goggins, people who are training for very long periods of time, you know.

And leaving aside all issues of what people are doing in order to optimize the recovery, I think an hour a day of exercise is just a great program here that most anyone can follow. And beyond an hour, you start running into chAllenges. And I you know the occasional ninety minute or two hour workout is no big deal, but if you start doing that more than once every two months, I think you're headed for trouble. Have you seen that in people's blood, blood work and in their hormones? Do you ever see people that are just badly overtrained because they're .

just training too hard and too often? Yes, when the blood work is particularly bad, they're often in a large clerc deficit as well. There is a synergistic effect between a chloric deficit. Even if you're maintaining adequate protein intake, you might not be maintained adequate intake and you're also just literally in a cleric deficit, perhaps low cards as well, very low free testosterone and they're simultaneously doing a lot of vigorous exercise.

I often here and i'm starting to wonder whether not some of the quicker to results nutrition tactics, things like dropping all carbon hydrate or um the quicker to results exercise habits like starting to do six day a week, really intense workout, whether or not in the short run they work because they the cosmetic changes that people are seeking, but that they really undermine the overall goal, which is leads to me to have your hormones maybe not optimize to that, you know, one hundred percent, but to always be aiming for a hundred percent and be close to IT at every stage of life.

Consistency is key here. If you are not consistent, then the law dimension returns certainly applies. So eighty or ninety percent of the benefit over many, many months is far Better than one hundred percent, but only half the time.

Ah one thing that I found to be tremendously useful is to finish the work out while I still have energy to not take myself to exhaust. And then i'm able to kind of talk about the dog mean wave pull. I'm able to right that into the rest of the day feeling great.

I I sort save or bank some of the vigor from the training to bring IT into my work. But then again, i'm not an athlete. I, I get paid to think in, speak not to, not to live. Waiter, to run another component.

that is, the baLance between your sympathetic, which is your fighter flight nervous system, and your parasympathetic, which is your rest or digest nervous system. There is an anecdote which is likely, drew, that many elite ite body builders are very parasympathetic. Besides, while they are lifting weights.

you mean they're lazy and they like to eat a lot yeah the lazy bear in the gym kind .

of phenomenon absolutely. Um but that being said, after a very, very vigors workout, for example, one where you're trained to failure, which body builders and power lifters do all the time, you feel the a tireless or you feel the strain from that heavy a sympathetic activity when you are lifting the heavy weight and IT can potentially affect how you feel the rest of the day. So many people who have a job where that is highly cognitive do not like to have an extremely vigors work out in the morning, which is when a lot of people are able to exercise.

When I exercise early in the morning, that is before nine A M, I have more energy all day long. If I do at mid morning, I have experienced more than an afternoon crashed this point, some circling biology in their, I also noticed, and i've actually seen in my blood work that if I don't get out for a forty five minute jog at least once a week, all of my blood profiles suffer in direction that I don't want them to go.

In particular, testosterone, estrogen, move directions that are not conducive to my goals. I'd like to talk about some of the approaches that people can use in order to optimize hormones. And these days, for Better, for worse, I think for worse, Younger guys are asking about and using testosterone replacement therapy, so called T.

R. T. And I just wanted frame this up, but I saying there is no strict cut off. What is T R T? There are plenty of people whose um blood levels of testosterone, estrogen in the within the Normal reference range and decide to start doing these things course they can limit fillings, the a bunch of issues even at non coding steroid all performance and handing dosages.

Um I love to frame this up by first defining our terms because one of the chAllenges on the internet, people talk about T R T. They're talk about performance enhance drugs. I'll talk about they're all stereo ids.

I'm in the astro an astern are both steering ID hormones, but what one considered replacement therapy versus what one considers performance enhancing, it's going to depend, right? So here's my question. Why in the world why in the world would any male in his teens or twenties or even thirties whose blood levels of testosterone and asteroid are the appropriate levels being within the Normal reference range?

Why would they take exogenous test astern, given all the negative effects on fertility? Some of the chAllenges that I can present, if the dosages aren't quite right at at a, why would they do that? Is certainly if they are not being paid for particular endeavor like they're not making money, if they are playing a sport, chances are they not allowed to do that anyway on the pan substances. So to me IT just seems like a crazy idea. Um but then again, i'm of a generation that really hasn't thought about doing that stuff until people in their and fifties or even never so is there ever a case for somebody in there twenty or thirties to take test off rone despite if their blood levels are within the three hundred to nine hundred name grounds for decelea or reference range?

Not many cases, the reason for any performance in hinting drug, whether or not IT is a steroid, sthetic, bioidentical or otherwise IT, varies a lot. Some individuals do IT only for cosmetic reasons, even if you can have delicate ious effects on like the cosmetic appearance, for example, of your skin in a long run but know everyone has their different reason as far as like when does the benefit outweigh the detriment?

Not very often if you are in your twenties and certainly um probably almost hardly never there's always you know rare cases like commons and roman not but almost never if you are very Young. okay. So for people .

in are twenty thirties and beyond forties at at a whose teater one in astrogation levels are appropriate rate rios and in within the Normal reference range and they feel pretty good, I would talk about the ad as example, will deserve like feel pretty good as our code for libido, energy recovery IT that are feeling you at least workable for for their lifestyle.

For those people, what can they do besides get great sleep train, but not too harder, too often, IT said. IT said, what are some of the things in the realm of supplementation that can help them optimize their testosterone in estero en without suppressing their own indulgences? Production of testosterone.

a gid, let's mention creating, is the first one creating is interesting, because IT as a multiple different effects that helps with a minos c synthesis IT also helps with the oxidative stress IT can also service the backup fuel tank for your motor contro so kind of holding backup ATP and IT does slightly increased total testosterone and IT also increases the conversion of testosterone to die hydra stores one so potentially it's especially useful in um men in their even their teenage years and their twins.

You mention the conversion of testosterone dye, dr. testosterone. And there is mythology out there that creature can increase her loss.

I'm guessing because there's at least one study showing that create team can increase dht. The heredia in dht is one of the primary hormones that can promote male pattern boldness. Um so the question therefore is does creating supplementation increase in the rate of her loss?

Theoretically that can. But in in each individual, uh preventing her loss is a very poor reason. Take creatine because it's not going to take you to a supra physiologic level. It's not going to uh you know increase your dragons to an a Normal level of binding. So I feel like um this if that was a reason to not take creative for hair loss then mean sorry.

you mean hair loss is not a reason to avoid taking creative .

correct her loss is not a reason to avoid taking creative. Um think of IT as just bringing you to what you are um naturally inclined to have if you're conversion of tests N A D H T is already high then often creates does not affect this IT just kind of reset your baLance between testosterone being a romanticized to estrogen or being five after reduced D H T so it's not gonna ed up her loss more than um just naturally being made does so in some individuals they will have no effect. In some individuals, for whatever reason, they have almost no five. After a ductus activity, IT will return them to natural or Normal.

I see, well, I take five grams a day of creating model hydrate. I for the tissue liniers ing effects, exercise benefits also for the cognitive fect. I don't know, it's increasing my hair loss and we've got a little bit of sort of windows peak type hair loss.

That's where IT is for me. Um I suppose bedd growth is associated with the hg two most. Is that right? What I learned, but then again, I haven't been in the little in a long time, is that because of change differences in receptors that D H C causes hair growth on the face and hair loss on the head? Is that right?

yes. And the amount in the sensitivity and density of those receptors is genetically determined .

and is IT true that if your mother's father was bored, that you will be bold in the same pattern, and that he wasn't, you won't.

That is a decent correlation part of the proposed mechanism of this, whether several genes, and you can actually test your genes for hair loss, you do get a decent amount of them from your mother. The unique thing you get from her mother that he may have gotten from her fall, that he got one of the copy from her father, is your x chromosome. And the androgen recept gene is on your x chromosome. So all men got their androgen receptor gene from their mother.

It's on their x crisis, not on the y criminal. correct? Interesting, even though all of the sort of a coin quote male mail promoting genes are on the White chrome zone like malaria inhibiting, its such interesting.

okay. So five grams the day of creating for most people should be fine, beneficial for tissue varmin zing. So strength, I bring water into the muscles and for the the cogent effects and the clinical support regret, I think this is quite strong at the five grim prety damage.

What other sources of supplements um can people benefit from? We already talked about the omega and making sure that people are getting enough prebiotic fiber to support the gut and vitamin d. So what other supplement based tools um can people consider another .

one we can loop in with creative is beta in. Some people are non responded to creates you can increase that to ten grams or you can use its cousin beta in to help with the many asset synthesis and shunting of energy. Along with that, I would put l carnet, which is a actually the smallest pet. Hon is just two amo assets that are put together. So a i'm not A P, A, O, I would not call all, but I would call all so hard to define things .

as transmit or hormones at some level. I agree. So l carnet, actually, I should backtrack beta in. Do you recall what dosage people typically would take if there I creating non responder .

one to three grams and several versions of creating beta in, because that helps with the processing of mEthane and hoosiers in.

So if somebody is already taking creatine and likes IT in response to IT will raise my hand such as myself, would adding beta in help or is IT redundant with creating .

only if their hoosiers ine is persistently elevated and homosexuals kind like an enflame marker that can build up if you're not converting .

enough of IT down the stream.

How would I know just a blood test or if you knew your mt H F R polymorphism which is basically how you um add method groups, too many things in the body.

great. Any side effects of bidding that people should be aware of.

not that I know what. okay?

People will look at up on on examined outcomes. A great site for that dille surely listed. They just revamp their site, by the way.

And IT was awesome before in its plata now um so l carnet um what are the ways to take alternative tine? I know that there is an oral forms of captions and there is injectable injectables. I think you need a prescription. Is that right? correct.

You need a prescription. For the inject tables or you should really get a prescription for the inject tables for when you inject IT. Um of course at the supervision of your doctor is usually done in from muscularly. It's an acquired solution.

So IT does not have like an oil or a Carrier oil in IT like tear, like testosterone esters do um however, if you inject IT too superficially it's not gonna make a right anything often IT just burns if you inject IT subcutaneous sly and IT does not um decimate throughout the body as well. L carney potentially has localized effects. If you inject IT, if you ingested orally, then IT has a very low bio availability, maybe only ten, ten percent.

I think most people are going to be able to get l karta only, or you know, in its capsule form. So what are the dosages of l curtins that one needs to just then if they want to get a benefit? Because only ten percent is being absorbed. It's proba a lot of alternating. How much should people take per day?

Usually I recommend, uh, for oil alternative between one thousand milligrams and up to four, five thousand milligrams.

So wonderful, maybe in five grams, correct.

or up to five grams a day. If you're earn that much, especially if you have a deregulated gut microbiome, you should be concerned with tmo, which is a potential car senate that both carney and coin can convert to, and you're got microbiota determine how much that happens.

A is IT true that I can offset any negative effects of alph a gpc a calling that is N L carney. Um that I take by interesting garlic. Is that right?

There's a compound in garlic called alison. I believe it's A L L I C I N. It's also part of the scientific named the genus of types of garlic.

And this can help decrease the conversion to tmo. Burberry actually slightly decrease the conversion to tmo as well, probably through alteration of the gut microbiome. And then just um optimizing your gut microbial can decrease conversion. So not everyone needs, but at something that you should certainly consider if you were on a hypos.

I'm going to continue to take the six hundred milligrams of garlic every time I take my own, carney, but i'm going to skip the burberry because burberry is me. Brutal headaches and IT makes me cry carbo hydra ates because because IT drops my blood sugar.

IT has many other effects, including the dawn phenomenon where that drops your blood sugar when you're sleeping.

and you can't even realize that. I am not a fan of burden and i'm worried for those of you that are i'm not trying to offend anyone, Frankly, if you're being offended by by stands on burberry and maybe we should have another discussion, in any case, injectable carnet. If one can get that through a doctor, how much is absorbed and how much should one take?

Almost all of its absorbed. In general, you're taking between five hundred milligrams up to, you can take a pretty height dose up to two thousand milligrams.

Again, what we did not talk about is what our connection does. So why, why should someone go through all of this? Is IT to optimize the stock. One is IT working on the receptor side. What what's l count am doing?

It's a shuttle. So I think it's named carney palmated coin zine. A basically IT IT just takes nutrient from outside your medical a and puts them in IT also has a unique effect, not too unique because the elephant actually has the effect as well, is that IT increases the density of the other general sector in the siop asm of yourselves. So even if your energy receptor sensitivity doesn't change, and even if your does testosterone um does not change, you will have more testosterone on binding to the increased the .

number of receptors. Does one need to cycle l currency creating bedroom?

No reason to cycle any of those.

Okay, what other supplements can one use to try and improve hormonal profiles? And and here I realized we're using a very broad brush because we say improve hormonal profiles. What are really talking about? And for me at this, I I think about the subjective stuff.

You know, do people feel like they are going to have more energy as a consequences doing these things? Are they going to have the more optimized libido? Are they going to have more optimized recovery from exercise? right? Because, I mean, it's not clear to me that taking one test test from from six hundred and eight hundred is always going to be a good thing, especially if estrogen is increasing in parallel that could cause issues that could certainly make things Better IT could certain ly make things worse, right? So, with that backdrop， what are some of the other things people can take? And it'll go back to this issue of what really is optimization.

Let's briefly mention invitation d, which is also a hormone. It's actually a sterol hormone and have if you have deficient vitamin and you replace IT, then you will optimize your to stop drone. It's also matching boron, so you have a very high S H B G.

Boron can acutely help lower IT, usually endows of five to twelve milligrams per day. It's not really a sustained effect, but born is depleted in soils in many countries, I believe it's very high, and in greece and turkey. So eating dates are reasons that are from those areas potentially have more born. Born also might be one of the reasons why the reference range for testosterone is much higher in those countries, in other countries.

And just remind people, the S H P G six former mining global in is attaching to the disastrous trum molecule and liming the amount of so called free test astro that's available to have its impact on sales. Doctor Peter ratio was on this podcast. In fact, sitting in that very chair, he said that the ideal level of free test after on and mail should be about two percent of ones, total testa one do. Would you agree with that number or disagree? I'm sure Peter would be fine if you said either two .

percent is a good rule of thun. Usually, the references ranges between about one and four percent. Some people do have genetic polymorphism in H B G, A specific gene mutation where they have very low sbg also mean that have very coast veins in their tests also in a very ciel tend to have very high sbg.

So that percentage would likely be less than two percent. So just because your a percentage of free tea to total tea is a little bit above or below two percent, that's okay. We just need to figure out the reason why IT is .

how would somebody know if they have very coast veins in their testicles, les, especially if their texaco's are still in attached to their body?

Sometimes it's hard to tell. Um there is several grades. If you have a grade three or a grade four test, uh, very casual. IT has what's called a bag of worms appearance. So think about if you just resistance trained or it's a really hot day or you were in very tight fitting clothing, then if you feel IT and almost feels like there's worms in the scrotum. The other .

way is to do .

scary visual yeah back worms well.

just anyway, I think parasites when I hear that, but that's not what if you're refer to you're talking about just the the the texture.

The best way for most people to check is to val sylva. For a long period of time, when you vell Venus return, a will decrease. Can you playing about some people it's bearing down like you're lifting a way or having a ball movement? Where are you swallow? And a lot of times you can also see build up of blood in you're like drug lar rains as well. So you have decreased blood return to the heart and increased blood in the fans themselves. okay.

So vitamin d three i'm guessing your time about vitamin d three specifically when you say vitam d um and then born on five to twelve milligrams per day, right? And then what are some of the other things to optimize to astro that are in supplement form?

We could talk about things that affect us steroid in as this cascade so we could touch on tonka ali. I know we've talked about that a little bit.

I'm guessing a number of people probably haven't heard that conversation .

also as long jack and that up regulates several different in simes in the storage genestas cascade. And by that, what you mean if, and this is another good thing to google, I think anybody interested in a human optimization should understand where where sterol hormones come from. They come usually from collect al, and they can be shunted off, divide A D very easily.

They can be shunted off to testosterone or extra genes or progesterones quite easily as well. But tone cat helps with the conversion of multiple key steps where you synthesize a soft another. Um think of IT is like a co enzyme, a co factor and up regulator of these steps is insulin I G F one. So a good rule of thun is if you are not expecting as much growth ormon incident and G F one, for example, lower cb diets, chloric deficits, you are trying to cut body fat or body weight than tongue is going to be theoretically especially powerful.

What sorts of dosages of tongue do you recommend her? Patients anywhere .

from three hundred to twelve hundred milligrams a day with tone cat, you need to be careful with the standardization. Because in if you're thinking about a general tank cat supplement, which is by far the most well studied, then um you're looking at the eury common on content, which is a plant compound that is likely the main um active phmc ology c effect so that the compound is having the effect on the body. And if you standardize the euro common oed very, very high, then theoretically you're having more affect at loads.

I take four hundred milligrams of tonga alium per day. I take IT early in the day because he has a bit of a stimulant effect. And if I take IT after two P M, IT start to inhibit my sleep.

Um i've been taken for years um and I rather like that the effects that IT seems subber consistent. I've never cycled IT. Do you recommend cycling IT?

I don't seen any reason to cycle IT. Um there is there is a reason to cycle some supplements, but no reason to cycle tongue.

My blood work tells me that IT causes an increase in free test, test one for me, and also a slight increase in luti zing hormone for me. What are some of the other effects on various hormones you observed in the blood work of your patients taking tongue?

Ali tomcat can also slightly increase D A G A. And if you have a very high S H B G, again, that's the protein that binds up your androgen and emergence and extremely important protein. The higher year S H B G, the more helps decrease IT. So they're studied tone cat in a populations with very Normal S H B G S. And IT does nothing for S H B G.

Interesting, does that mean that does nothing for somebody overall? So if somebody has S H P G that in the Normal range while taking tongue benefit in the other way.

yes, IT, it'll increase their total and free testosterone got IT.

Um okay, does IT is IT no have effects on anything else like thread hormones, growth hormones? Is IT purely in these steroid synthesis pathway or steroid, I should asked as synthesis and receptor and modulation pathways.

there's no direct effect on those pathways. However, any time you alter your free androgen or free estrogen, uh, particularly one without altering the other, IT will alter the binding protein that binds thyroid hormones. So any change you make, whether it's natural optimization or a hormonal replacement, you're going to slightly rescue your thy road horon profile. One common like actionable example of this that I see often clinically is um someone starts, let's say, estrogen replacement or testosterone replacement. Maybe they are taking A A I with their testosterone .

replacement rotation inhibitor.

correct in a roman eva which blocks the conversion to estrogen. If they're taking testosterone and they have very little estrogen, then you are going to decrease the binding protein also in as throg sign binding global, which bines active thyroid ormonds. So if you start A T R T and you either have low roman activity or no, or romantic activity, no conversion to estrogen, then your free thy road hormones will go up, even just acute, the usually feedback inhibition, which is how the body talks to itself and says, you know, we need to make more of this or less of this. But acutely there's um not always enough time you're going to have very high thread hormones and you can have tack a cardio which is a fast heart rate or you can feel kind of like overly fight or flight due to increased five road roman activity in the in tissue.

interesting. okay. So tony ali, this is a broad range, three hundred to two. Open your milligrams per day and I realized that the source matters there. Um what are some of the other hormones that you prescribed your patients who do not want to go on test cost from replacement therapy or take exhausted D A G A or anything like that?

We can talk about photoshop next hodosh a interesting because it's a genus of plants. Photoshop gradus is one of them. There's many others that are very interesting that species is likely the most well studied and IT will increase L H.

So I would not consider an L H memetics. So IT doesn't really mimic IT, but IT increases the release of little nizing hormones from the battalia to hormone that bind to the latest cell to the electrode. Tor, kind of like H G, G.

does. And IT will increase the release of testosterone. I see. So I think for people .

aren't familiar with hcg, so human coy's ic can ada troopin is based synthetic luis's hormones in luminiferous ormond is the hormones released from the patternicity that is going to travel down to the tests to stimulate the of sperm in test astro, but mainly test astro.

Is that correct? Mostly correct technically synthetic age is also in as little R L or recommended l an H C G can be synthetic but often IT is just refined from the euro of pregnant ladies since the um since the lesson to mix. That's why it's called coronium in a troops.

So where are they getting all this pregnant women's urine? I mean, i've been there. There are a location. I mean, not that I want to go really. So they're there.

My master pregnant ladies is very high.

donating their urine and then they're purifying IT. And then men are injecting IT yes wow and that's actually .

the same for manipulable lady. So first chemistry al pregnant ladies that's how you can make um you know non synthetic H C G. And then four minute opens which are also known. There's a couple different names for IT like mep um you have many paussle ladies that have very high L H and F S H and the new refined the F S H and L H.

okay. So um moving away from the sources and from your in a photo. Gia gratis.

What dosages do you have patients? cake. I've heard of, uh, some potential toxicity to the testicular cells.

There is one study, and this is a rat study, but you can equate the dose of toxic and rats and humans. They did not give these rats any anti oxidant. But IT increases a couple different like pro inflammatory markers.

One is gg. T or gama glue. Tamil transfer race comes from both the testes and the liver. And one is alcohol foss potato, also in his alcohol, again, coming from both areas. There are several different ways that you can attenuate this increase. And you can also just check to see if you have increased in the rat dose that equates with humans that had no effect. So the safe dose was an average of three hundred milligrams.

So that would be three hundred milligrams a day in humans. Is the dosage that did not have toxic coral correct?

And often even if there is toxic in rats, there is not taxistan y humans. So it's not directly equitable but to be safe. Um another region that I have people take is six hundred milligrams every other day or six hundred milligrams three times a week, often monday, wednesday.

friday is very interesting and irrelevant because i've been taking photo gia for some period of time. All my markers and and teh indicate that there is no toxicity, but um i've been taking six hundred milligrams per day, but i've been cycling IT for about eight to twelve weeks on and then a few weeks off. But they somewhat you're saying i'm thinking maybe three times per week or or every other day might be Better. Is that right if .

you weren't onna get any labs? S that is certainly with the regimen that you want. If you're gona check your G G T and alcohol or even take other things to prevent those from increasing, then you can certainly um be more aggressive with you are photos a dozen, you can increase IT quite a bit. And IT has a dose dependent response in both the activities of secy with high testosterone and also just lh and testosterone. So the a more aggressive regiment would be six hundred milligrams daily for a month and then take one to two weeks off.

great. I think that's more or less what i've been doing. Um okay, terrific. In terms of other hormones, what are some of the supplements that can support growth hormones and hormones associated with tissue repair in some cases of metabolic at um what are some of the tools nutritional and supplement based one can do to um tap on the growth for moon pathway and in its lumb I G F one in their two since they essentially working along the same dimensions.

A quick on opposite growth hormone is a peptide hormone and IT is released by the batuta ary there is growth hormone releasing horn and a gallon that stimulate the release. So there's also peptides that are very analogous to these two things. You have that power tile secretion of growth for moon, a very fast half life of just a minutes.

And then IT increases. I G F one. There is both preferred I G F one and central I G F one and I G F two.

But knowing to get into the specifics, there is a happy medium to wear. Your growth hormone is at a adequate level, and your idea is an adequate level. Usually those two are consequent.

So in most cases, we just check an I G F one and occasionally the binding peptides for I G F one, kind of like H B G that we talked about earlier. But um your estimated a free I G F one is is kind of confusing because all hormones, almost all hormones have buying proteins to help regulate them. But often you want to look at free testosterone, free air dial, free I G F one or at least estimated free cortisol even and free thyroid mone.

But um when you're talking about a growth hormone and I G F one, usually you don't need to do anything to optimize IT. If you are diabetic, then independent on the type of diabetes, your I G F one and growth for man can be too high. Specifically in type of one diabetes.

Your growth for moon is extremely high, but your I G F one is low. So if you're in a deregulated status of pathology, I would just talk to your doctor about I G F one or growth ormon. Taking things, taking a meal assets before you got a bad could potentially help with growth hormones lease just because most growth hormones released while you sleep.

I've heard that fasting can increase growth more on, and I know there are certain parents of weight training that can increase growth more on some of those regiments in the weight room that increased growth home on have been covered by a doctor, duncan french, who is our guest on this podcast. But um so may be refer people to do um that episode for the specific protocols is high volume training during those training .

exercises that usually does IT transiently for a period of a few hours. And a lot of this I G F one is released to buy the muscle itself. So it's not necessarily lead by the liver. I G F one that is released directly due to growth hormones signally. Usually the growth hormones comes from the petitionary and binds to deliver, where usually has a half life about a week where the pain or order cin think of IT is like the performer acting or acting in the muscles itself, which is also helpful, um is released and is not as concerning because it's not related to insulin resistance, but IT is related to the .

training itself. So fasting and growth haron um is IT true that fasting can increase growth more on. And maybe as a little related tension, i've heard that limiting food intake for the two hours before going to sleep can increase the pulse of growth hormone that one experiences during sleep course.

Everyone gets a pulse growth room during sleep, but especially carbon hyder laden meals can blunt that peak that occurs during sleep. Quite a substantially so two questions. Um does avoiding food intake in the two hours prior to sleep help increase groth room on release? Maybe it's being overly neurotic. Maybe people need to avoid food in the four hours before sleep, but regardless, what is the relationship between fasting and growth home on released?

I find this really interesting. Fasting certainly potently increases growth on on release. However, the end bind to the receptor is less sensitive. So although fasting does increase growth, ormon the genes that are downstream to IT, both the growth hormone genes and I G F one related gene transcription activity will not be significantly higher.

However, if you are optimizing the growth hormone on that is released as a postle secretion, IT is helpful to avoid eating for two hours. So the general album is avoid eating about two hours before bed. I think that's clinically significant and helpful. But fasting otherwise, specifically for growth, ormond optimization in someone who already has Normal growth hormones signal. Is not helpful.

That's extremely useful to hear because one of the major reasons why people fast is get that growth from one increase. But if there are um adJusting things on the back end that negate that, well then uh, no such luck. Not that I have anything against fasting.

I do a suo intermit and fasting most because I prefer to eat fairly regular times as a day. okay. So IT doesn't like there's a lot that people can take in supplement form to improve growth horon. What about fire red home? And what are the some of the things that people can take or do in order to make sure that their thyroid home on levels .

are appropriate? You want to have a baLance of ioe and you will have a good source of iron. So there are some camps that say you should use a huge hyda of y and protocols for, and there are some that say you should use just barely enough.

I A, I, I believe it's like two hundred micrograms per day. But you want to baLance one of the things that I see that many people do not talk about when IT comes to hide and and five road is there is compounds on as goitre gans or great regents. And these great regions are neither good and or evil, but they're actually kind of a nice check and baLance.

You need more eyeline if you consume more goitre gans. And some examples of these are some of my favourite fruit. Ds, crucify.

Err, vegetables. Boron is also a guitarist. En, so hire glory. Gts, hire eyedee.

So adJusting ee dam containing salt as useful, yes or no?

I died. Salt does province goiter, but IT is not necessarily the ideal form of ian. Good forms of idan often come from the ocean. If you look at a short of hypothetical m, there is a tendency to have more hyppolito. Sm.

the more england you go. So trying to eat some preservers vegetables each day would be the best way to improve thora along .

with plenty of I you don't want too much I signalling. Many people are familiar with radioactive ion tablets and that's basically an extremely high amount of ioe to block out the um like the radioactive ioe that comes from after like a nuclear meltdown or what not.

So we've got creating bidding in alkon a teen with Allison garlic to offset the tma vita three boron toner ali fordyce fasting love to talk you about peptides. So I can imagine a hierarchy, ari, starts with behaviors and nutrition. Behaviors, of course, includes training and limiting stress, and all the things we talk to before sunshine is set up and optimize nutrition.

Then we talk about supplements, all the things we just listed off to optimize testosterone end. We can get into this, but estrogen as well, which is important for libido and brain function and tissue function and joint feeling good at sea, but then we get into the room where one might or could consider exogenous hormones, get taking a small dose of just one, or taking a small dose ve of G A G. And you know, if that we're appropriate and certainly only working with a doctor, but in between the there's a step of so called peptides.

And of course, there are many peptides. We've already talked about some of them. But when people talk about taking peptides, the ones that I hear most often about is A A category that increases gs and I G F one.

And those, to my knowledge, go by the things like simoleons I morale tea moreen served a kit of things that taken separately or in combination to increase g and I G F one. But then other people, for instance, are taking peptides like bpc one, five, seven to try and improve tissue healing in recovery. There is a lot of interest in peptides, please, if you would tell us about what you know about the safety of peptides in terms of their sourcing and the utility of peptides.

You know, is this something that people should consider? Uh, before thinking about herman replacement, should people be wary of these things? I am very wary of particular sources that are sold online that are not clean.

They contain contaminants that could be dangerous. I really love your thoughts on peptides. I'm just going to sit back and let you rip on peptide. But if you could touch on some of the ones that I mentioned, i'd be most grateful.

A peptide is just a chain of a minor assets between two and a couple hundred and links. So I think of peptides as several different categories. And the gr PS that you mentioned, I would consider those that stands for a growth hormones leasing pep side.

You have two main types, the Green agonist that are they hit the ground and receptor. And though IT helps released growth, ormond, because of that and then also the um G H R H like peptides. So they're very similar to growth hormone releasing hormone.

Often they just change a couple of mino assets and IT acts like that test. Moral in is one of them, sir. Morning is another one, and C, J, C is another common one.

I believe those are all in the class of G, R H, like peptides, whether ib marylin or I built a morn, which is also as M K six, 7， seven. Those two are in the class of grand agents, so more like they hit the reception grown does, or the other ones hit the G H R H. recept.

I think if glin is making me hungry, hungry and angry, why would I want to take something that would increase growler signal some people .

are trying to gain weight. IT also does increase your growth formal. So if your growth format is very low, you can consider IT. I build a morn is a long acting, so as a long half life, also, as mk six, seven, seven, IT is well, IT was studied mostly in growth hormone deficiency.

And do these people get angry also?

They can. Many people report a side effect of anxiety or significant hunger. Uh, most people take IT in the evening so they don't notice that hunger as much. I can also greatly increase your blood blue coast. So if your insulin resistance or prediabetic gets especially concerning.

this is one of those rare moments where I hear something in I in I think, okay, even though there is this kit of compounds that can increase g and G F one based on everything you're telling me, maybe just taking g is the Better option for those people. Because growth harmon, at least, sits synthetic growth ormond is mimicking and indulgence hormone. I am certainly not taking anything might be the ideal. But for those that want to increase growth home and you want to use pharmacology to do that something, these pipt tides are pretty precarious.

Yeah, I kind of depends on the situation. If there is an individual that struggles with hunger are not eating enough, for example, um you know someone who has a very small stomach or they just have a very low hunger drive. Sometimes you want more of that eric signalling the hypothalamus. You have an rex onic signalling, which is kind of like anxian and oregon signal, which is I called hungry center of the uh hypothalamus or the hungry center. And if there's an imbaLance ed between those two, then perhaps would be helpful, potentially theod ally helpful in interrex s of which um the incidence of anoxia an men is increasing significantly as you're tell me that .

I was remembering ing being fourteen or fifteen years old and I would go into the kitchen sometimes and I was so hungry I would just obliterate all the food. And I do remember being voice been pretty high energy guy, but having a meant sound of energy, I don't can't call F, E, was a hungry feeling. You're not. But unguessed, there was growth remote. I grew one foot in a single academic year.

So magine, that was at least part due to groth harmon in any case simmer ellinses is the pepi I hear the most often about um I admittedly tried to a run of IT I was researching a book um and decided to take IT before sleep on an empty stomach IT gave me a tremendous um depth of sleep but that sleep was really truncated which is as nerd speak for saying, deep but short sleep I would wake up after very intense dreams. I can't say that IT helped me recover from exercise that much. I didn't notice any additional fat loss or anything sort of abandoned IT except for occasional use. Again, this was prescribed ed by a doctor. Um you know I was trying to get the sense of these peptides and their effects are somewhat vague, distributed and highly individual is that a fair waited to describe them?

Part of the problem with the effective peptides is many people take them in levels that are far above the physiologic range, even individuals who are checking their I G F one. While they take these different gaps, most of them do not check the bind peptides. For example, I G F binding peptide one, two or three and um there free of one level might be significantly different. So the a common doses that people will take these off label for as a supplement are often much greater than the theraputics or physiologic range which for .

me just underscores is pretty precarious. I am, i'm not coming in here is the referee of what anyone shall shouldn't do trying to gather and distribute the information. But IT, i've heard for instinct that some of companies where people can acquire these things without prescription, they those companies are not good at cleaning out the the lippy police sacred the L P S which can cause in flaming response other resized dirty compounds um and that just sounds a risky IT just sounds Frankly IT just sounds .

really dangerous to me L P S is a common additive in many companies that are not pharmacies, but they are selling things that people often use a human consumption. One interesting note about lipo polacca, as your gut microbiome makes lot of if IT as well, especially private teller, which is specific species that can have to do with your baseline body temperature. So your baseline body temperature might also change depending on if you're on a peptide that .

has L P S in IT yx ikes any ex. But I tend to be a pretty conservative when IT comes to taking anything exogenous. But I do rely on many the supplements that we talked about earlier, and I do trying to optimize the behavior things and nutritional things for a long time.

okay. So then leaving peptides behind, we are now, I suppose, in the territory of exogenous harmon. So let's say that somebody decides they're not concerned with fertility or they're going to bank burn or they already have kids or or they're going to differ on this issue of wanted to have kids.

My understanding is that nowaday, a lot of people are using to stop on let's not even caught replacement therapy because some of these people have six hundred, seven hundred or even you know eight hundred nine gram produced to read. So they're not replacing anything that is diminished. They're just trying to augment what's all their increase, what's already there.

My understanding is that taking a low dose more frequently is going to be more beneficial than the end of old school way of giving one hundred or even two hundred milligrams in a single injection once every two weeks. Is that right in? And what do you do with your patients? So let me give you hypothetical.

Somebody comes in your office there um their blood work and they have um blood levels of would say six hundred and grants for december the post rone their emerge is also a Normal range. Everything else checks out but they're complaining of you know slightly diminished beto, slightly poor recovery from workouts. Maybe um you reduce motivation and drive, although no major depression and you come to the conclusion that to ask your own therapy, not replacement, but the stern therapy might be a good option to explore what's a typical dosage uh ranges and frequency of administration range that you might consider expLoring. And some of this .

depends on the S B G and free test astern as well. So if that same individual had a very high S H B G, which again is the binding protein that binds up the testosterone and all androgen, and if IT is extremely high and they have a free testosterone of two, then they might need a different dose because they need enough testosterone in order to have a Normal hugin atle free to dost.

But a general, Normal dozen range, especially for someone starting, is around one hundred to one hundred twenty millgram divided over the course of a week, usually either every other day or three times a week, occasionally twice a week. Many people with S H B G A bit higher can get away pretty easily with twice a week. This is assuming that the extra is sip onate or a minute.

So two sixty miligram injections of toaster and .

sip ante per week, very common.

those to hit hundred and twenty miles per week as the typical average rect.

and I would consider made like a physiologic yoga adult dose. For many people, even two hundred milligrams a week is far above the reference range. All of this is said with a cavy up that testosterone is not Normally released in a post tile manner. So it's high the morning law in the evening whereas if you're on uh testosterone therapy, then um you are going to have a steady state. So your testosterone on levels is gonna pretty much the same even in .

the evening and we need your experience. When patients do that, they i'm guessing they report the Normal consolation of positive effects, improved mood, improved energy, improve sleeping recovery, IT said. A what are some of the hazards or thinks that I can crop up in blood work or just subjectively that um can be warning science that even the dosage of one hundred and twenty milligrams divided into these two or three dosages per week is too high?

Every organ and system in the body so this is when you really have to be uh at least well versed ed in every organ system, not just the ganado um but you know genital system you need have you know dermatology provis iconic is very common change lots of different skin pathologies or even bruising can be related to hormone replacement hair loss is very common to see as well um mental status changes IT could occasionally even induce a manic or a bipolar so because testosterone is also dupin's gic and then a cardiovascular Larry not just in the heart but also concerns for like microbes ask their disease ferritin build up because the estrogen also increases and then fertility concerns as well and lipid concerns too so you really have to be no metalogy dermatologist, cardiologist, lipid ologies, the whole nine yards.

So another reason or set of reasons rather to if one is considering using tosta tron therapy to really do this in close communication with a really good physician because that's a lot to monitor. Knowing whether not you have acting you're not is one thing, but knowing whether or not your L D L is going up, your baby is going up, that's a whole other buzz. And that needs to be done through blood work. Is what i'm hearing correct?

And if you're physician, that is managing or proscribing your a testosterone therapy or your H R. T is not well versed in these systems, you would want him or her to be part of an into disciplinary team where they have other experts that can monitor those systems.

I skipped over a sort of still intermediate set of things, prescription drugs, but maybe talking about to stay on first was a bit of a mistake on my part because I am aware that there actually I think there are companies but certainly groups out there that say no way don't go straight from nothing to supplements to test from once you're doing behaviours in optimising nutrition supplements, let's forget peptides instead of going straight to test oster on therapy.

One idea that many people are pursuing is to um take the prescription drugs that triggers leutze zing hormones so taking H C G human coryon ic gana trooping, which my understanding is will increase the cost but also estrogen or they're take things like column in um in fact, I think there are bunch of companies out there now that are i'm saying don't take tester on IT shuts down spread genes, shuts down to stop production column is the way to go. Um maybe could educate us about the H C G mono therapy. I think it's called where you're just mono one just taking acg and clumping as a and or column in as a tool to ratchet up harmons.

So quick points on H C G human correc not trooping um made during especially the first trimester of pregNancy IT has affects other than binding to the l receptor IT also bins to the tsa recept tor in the thyroid d yid simulating hormone yes in fact if you look at a molecule of H C G and thyme an horton, they are extremely similar. However, you need a relatively high dose of H G G to bind to the T S H receptor.

This is the Normal mechanism in pregNancy that accounts for the increased need of the road hormone, usually about thirty to forty percent. So that's why if someone has hypothermia to increase the those of roy because the H C G is not gonna do in um the limit or close open. There's two main um I believe it's dystrophy summer and one of them is in column one of them is zoo clean and these two works slightly differently in clifton I believe has a faster half life and IT is potentially slightly Better tolerated.

However, they were studying IT. Um you know limit is a very commonly prescribed ed drug and obviously there is plenty of in women in climate. However, the drug, which was Andreas L A N D R O X A L um did not go all the way through the F D approval process, despite climate being F D A approved climate.

which contains column. But there are also because we're talking about men, male horn optimization. This episode there are nails out there who want to increase their test astro and other hormones, maybe groth minute that who opted not take exertions to the and no cream, no pilot, no no um pill, no injectable sup nate, but decided to take clip in a couple times a week my understanding i've never done this.

I would say if I had, my understanding is that taking place and maybe two fifty milligram tablets a week is what I hear people are doing will increase what luti zing hormone, the various estrogen receptor sub units, could you explain how commun would benefit anyone? And is this a good strategy appearing that is being done quite a lot? now?

IT will increase as stores one in a dose dependent manner, but that has many other pharmacological namic effects, which is the effect of the drug on the body other than its effect on the hypothalamus in the patuit ory. So in the hypothalamus, in the batuta IT, uh, does what's called negative feedback inhibition or IT IT blocks the action of estrogen. So a crowds out estrogen from the estrogen receptor on the hypotheticals in the battery.

And what's the subjective effect that that would cause? So my understanding and experience of a um if I ever took, and I did take a very low dose of an Robert and hibor once and I felt terrible, actually produced libido joint fell.

Ae, that's when I discovered that wow estrogens actually really important for your brain function, for joint function and for libido and suppressing expression, for me, turned, just turned out to be the the wrong idea. But my levels indicate that it's within reference range. Okay, so why would I want to take something that would increase the activity of an estrogens sept? Or I just can't find the rationally for that.

The main rationally behind taking assert is as a very temporary measure that is not going to suppress the treaty or hypothermic function. If you are, testosterone is just so drastically low that IT is unlikely to recover any anyway. So most of the time IT is not clinical useful and um sim should not be prescribed very often, certainly not as a long term testoon replacement or testosterone optimization in most individuals.

There's always exceptions to everything, but there's five different estrogen and estrogen related recept tors. There's two main estrogen receptors and climate and every term has a very unique profile because they selectively inhibit some receptors in some tissues but not other receptors and other tissues. For example, climate can inhibit receptors that are any ee and I can cause visual changes, blurry vision um especially at higher doses and IT also acts in every other tissue the body so side effects from clomid and other selective extradition modifiers are very common so i'm at least .

by my mind i'm gone to pull them with pipt tides and say that sounds precarious and probably not ideal for most people going back to to stop their own therapy. Then I get a notice folks, i've deleted the replacement part because I think so many people are using test tester on therapy without the need to the sort of reference range need to um to replace anything, but rather building on what they already have for purposes of increasing vitality.

Eta, going back to that, my understanding is that taking H C G uh, several times per week can help maintains per mage genois m fertility, even while people are on test after one. But anyone I were talking about this earlier that there's tremendous variation. Some people, we ll take a small amount to ask around and just crush their sperm count.

They just won't make any viable sperm. Other people can maintain vivo sperm production while on testosterone, especially if they are taking H C. G. Is that right?

correct. And there's many reasons for this. Some of us has to do with heat damage to the tests. So potentially called therapy could .

be helpful for that as cold showers, or are just a more certainty.

stop in the daily hot tub can restore fertility. And many people.

I know a number of of people that are trying to concede children that go into the sona. And then I just put a cold pack in their shorts or between their legs, depending on where where in shorts are not. Um where they will alternate icon and heat in a way that maintains um coolness of the the the um mill you in which they this firm live at the words they're cooling um they're scrotum deliberately in order to avoid killing the sperm. Actually I saw interesting paper that said that for every two degree increase in um a temperature uh of this scrotum there is a twenty percent decrease in in permai genocides uh and viability of sperm and that actually if you look at the difference between people who stand a lot, sit a lot and drive a lot, what you see is a progressive decrease in sperm count that because when people are sitting, there's an increase in temperature and then when they're sitting on the hot seat of the car, there's an um or using the the heated seats actually kills firm. I think there are a good data on that.

Yeah excEllent data and anew see as well. I've had several patients come in for fertility consultations and all we do is like you know no medications, no supplements. We change there like several lifestyle things um not tight IT very tight fitting clothing is another one and soon they have futility and um there are no longer they they have sperm whereas before they did not.

Interesting um like to talk about some of the dose and dots, but we have talked about a lot of dose things that one can do to optimize warmth. Maybe we could just do sort of um more rapid fire uh Q N A on some of the don't um and maybe threw in some science um where you feel it's appropriate um kind of us marijuana T H C yes or no, IT diminishes testosterone levels.

Smoked cannabis, I would say diminishes testosterone, increases that to know other can abode ds, not particularly horrible.

So C B D.

C B D, not particularly harder smoked. C B D, i'm not sure.

What about edible cannabis and T H C.

as far as I know, edible cannabis and T H E does not significantly increase production to a point where I would be disruptive of harmons. Can marijuana.

A T H C cannabis, what everyone to call IT increased gonna commas sty the growth of male breast issue?

Yes, IT certainly can. And there is a pretty good association between smoked T, H, E and going to come asia.

What about a nickel in test astro, an east gen in other hormones, smoke negative is particularly .

concerning not only for testosterone, but also for estrogen. Part of IT is, if you're talking about negative from tobacco, there are many other concerns and IT especially if IT smoked but nickey even if IT is true in a dose dependent manner. So if you can use an extremely small amount of nickel, then it's not as concerning in a long time, but it's a visual, constructive and um one of the main concerns with that would be a cardiovascular disease or even micro vascular, a scheme c disease that I can lead to neurodegenerative disease. So like a type of dementia that can be partly due to negative if you use nicotine for a very long period of time, especially at a higher dose, it's a dose dependent effect on your home profile.

Is that also true for the and other nicking gums .

at high doses? If you can use an extremely low doses of a negative gum, then theoretically that would be um you know maintainable it's not going to overload the nicotine reception. You have a seto, colleen and the colony gic system as one of your your main nervous systems.

Of course, you have muscular ic receptors and nickey receptors. And there's just Better ways to optimize your nick tonic reception activity, for example, as he to calling per like alpha gpc facial syrian capital. Coleen we eat to coal istory inhibitors, especially natural ones, potentially have a um like apart as well and then other alcoholic. So nick is an alcoholic from the bacco plant. There is other plants like singing and the um that genus of plants and that alcohol ads is also in naked recept .

agonist is IT true that cycling for too long, literally bicycling, sitting on a bike seat too long can damage the prostate.

yes, but IT can be very concerned and especially if you're seeded by all cycling, especially if you're putting a lot of pressure on the paranoia, your cores kind of like a box where your diagram sort of makes the top and your ABS. And so just make the front of the sides, your back muscles make the back, and then your pelvic floor makes the bottom of the box, which is arguably the most important part of your core. And that pressure can weaken and even lead to in contents and impotence.

So we were talking earlier today in the gym about how heavy network had squads, dead lives, those kinds of things a lot of guys are doing to increased just toss rone done correctly can actually augment and build up the strength of the perfect floor, done incorrectly can actually weaken the pelvic floor and leads all sorts of issues, including sexual effects, negative sexual effects. So um how does one go about learning whether not their movements are being done properly to support topic floor or to destruct topic .

floor at the pelvic floor is a conStellation of muscles, just like any other econic system in the body and uh you know form is important if you're doing deval manua, which again is that a kind of like bearing down or deep breath where you feel all of your apps or tight?

You can also notice that your pelvic floor is tight as well if you have a history of a uh an ingle hernia, which is a whole kind of like connecting the abdominal cavity down through the public c floor, even the score of in some cases and that can be uh a sign that um there is weakness in that area and you might have to concentrate on that most or even have a physical otherishness, a physical therapist specifically target the pelvic floor, many exercises in which you val sylva or use your glue or legs. You can learn to freeze them and have that mind muscle connection in order to help build up the private floor. And there's other things and many people are clear with eagles. That is just one of the many different exercises that can help you. A perfect floor understanding .

is that while strengthen the perfect floor is good, excessive contraction of the public floor can actually limit blood flow to the paley's area, the penis. And so for so this is again, it's a double edge sort, right?

I mean, you don't want guys out there to just start doing endless number of key goals every day because they're actually onna constrict blood flow to that area, right? There's and in fact, the the direction response is per para sympathetic as a relaxed induced response, right? So you know for the the reason I chocolate you for because we're talking about things, we don't have visuals or charts and and certainly it's hard to know whether or not I give an exercise like cases are gonna good or not good um if it's successive, what you know how many sets and raps does does IT take me before he goes from from good to bad? Is there a kind of general rule of thumper people? Think about this.

I mean, clearly blood float to that areas. Key right for sexual performance in yet when one trains, the legs even walks, you're getting blood flow. So my understanding is this that accumulate ation of way training to stimulate the positive hormonal and muscular and connective tisa growth is key, provides not over training, but so is casual exercise like walking and stretching and the sorts of things that will then return blood flow to that area. Is that a overly basic way to think about IT? Or will that surface?

I think that's a good way to think about IT. I think the main point with key goles is they're just a one of many different things. So if you're having some healthy floor psychology certainly or even just concerned about your pelvic floor, don't just h you know take the advice, do keyholes and you will be OK that is not near enough is just one of the mini aspects.

Um okay. So are going back to the rapid Q N A, and they will come back to this issue of blood floor because are some interesting science and protocols there. Christ I have is alcohol does IT increase a room that ends on that converts the stern into surgeon or not? And is there a dose dependence?

There IT significantly. Does there is a dose dependence? In general, I would not recommend more than a three to four.

You standard drinks. One huge glass of wine is probably five standard drinks. But say, every two weeks. Yeah that's .

consistent with what um I discovered researching alcohol and epsom we did on alcohol that no alcohol is definitely Better for all aspects of health than any alcohol. Anyone that says that well red wine contains these various things, well, that doesn't contain enough for those positive things to have a positive effect. But that if people do opt to drink alcohol, that two drinks per week and meaning twenty gramps of alcohol, so that's probably two twelve months or two four glass of wine is going to be the upper limit beyond which you're going to start seeing all sorts .

of negative effects. The other thing to keep in mind with alcohol is as a lot of calories, seven kilocalories program, almost as much as fat, which is nine. And then it's also very gaba argia.

So you can activate inhibitory al neural transmission um and that can also affect how many how much L H and f sages released. So that can also decrease to aster on almost kind of polar to how opiates can decrease to stop. Roo.

I feel very lucky that I don't enjoy alcohol, never really did, can take you to leave IT certainly don't like sensitives like value or anything like that which as you just mentioned, can suppress us astern um you set the word fat so um i'm going to pick up on that and say, in order to optimize warm production, is IT important to have some saturated fat in one's diet. And what happens on very low fat diet to test astern estrogen? In other story, hormones.

fat to interesting, because there are so many different beneficial fats. Or make a three, almost every american gets plenty of a maga sexes in any developed country, really, when IT comes to saturated fat, there is more of a correlation with hormonal optimization. If you're eating things with SATA fat, you tend to have those are things with more fat soluble fideles and things that are very nutrient dense.

Otherwise there is not vital. In general, you want to eliminate any trans fat unless it's trans fat from the remains. There's always an exception to everything, right? So there is healthy trans, or may get three fats which are informing the stomach of like grass fed and finished ruminants.

But investing mostly olive oils may be nut butters in in limited amounts because a very calorie dance. But unless people are trying to increase their calories, in which case are a great source of calories. Small amount of butter, gee, probably OK, but not excessive amount idea.

Yes, fat is perfectly fine. Cholesterol has an interesting as a cholesterol, and in general Fosters lipids, make the bike layer that's around the cell. But cholesterol is also a hormone in and of itself because IT binds to the estrogen related receptor alpha. So I consider that like in the extradition recept category and they can to help with metabolic but also potentially have concerns for cancer and tumor risk .

when to go back to the prostate and talk you about something that's going to a newer emerging trend. I know that you've talked to a little bit about this in previous podcast that a number of men are to say a number of physicians are prescribing low dose to dolphin, also known a seal's to their male patients.

So indosat ranges of like two point five milligrams to five milligrams per day, but not for erect out this function, but rather for improving prostate health and personably. They get sort of a boost in terms of blood flow um to the janella as well, but again, not specifically deal with real this function to deal with prostate health and blood flow to the prostate. Is that something that you sometimes often proscribed to your patients? And of what age .

to telephones are very underrated medication. The age would kind of depend on the indication. So telephone is also a blood pressure medication that can very slightly decrease blood pressure, especially at higher doses, at higher doses, at the high doses would be twenty milligrams, not two point five milligrams.

But consistently IT can somewhat affect with the coins in the eye that have to do with a red and Green sight. Although if you remove IT, that effect is reverse. So basically, if you don't need really, really good red, Green discrimination, you can take higher doses. But in general, I recommend no higher than ten milligrams a day, usually just two or five milligrams one, uh, other benefit or other use of telephone is that IT increases the density of the energy sector similarly to l. So that's an interesting benefit. Another benefit is that if you give IT to people with notice, which is united at night, in general, IT will cut the episodes in half, so I can go from two to one, which can make a big difference for your sleep, which will second darling, make a big difference for your growth. Woman in this tosta optimization interesting.

So you said two point five to five milligrams per days and typical for these pressed enhancing effects yes. And you mention the potential side effects on adJusting visual perception as a visual scientists um that rings in my mind but in terms of red Green color discrimination, i'm guessing less you can be a subject in one of the experiments in my lab or you want to be a fighter pilot. Chances are you can probably get away with a little less red .

Green color discrimination, correct? It's not considered clinical significant unless um someone is a commercial pilot, right? So if someone's getting there like pilot exam, that's one of the things we look for OK.

So commercial pilots aside, you might want to ask your doctor about low dose to delle for sake of enhancing prostate health. Certainly, monitoring PSA prostate visionary gen is important. I can give an antic there. Um when I tried to moral in one of the surprising side effects that was not welcome was a dramatic bike in my present specification tage. No one could explain to me why that would happen, but when I stop taking so moral and I went back to Normal, so it's one reason I avoid some moral and at least frequent use of Simon PSA should be kept at below levels of somewhere between one and four is considered healthy. Is that right?

IT depends on the age. If there is a twenty year old likely between zero and one, if there's a forty year old likely between one and three, and then if there is an eighty year old, IT would not be abNormal to have a PSA of five, and have that be well within the references range. Another thing we should mentioned about PSA, if you do take a five of a duct, inhibit like fanie, or do tasty de, often these will cut your pa and half. So if you, for example, if you have A P sa of six and you start from as ride or do tasty de, and then you reach check IT in six months and it's six point five, that is a huge concern because it's a doubled .

glad you thought this up because I almost overlooked the fact I get a lot of questions about drugs to offset hair loss. Most of those drugs are going to Operate through the D H T system that hedged astern system for the reasons we talked about before, the h receptions being on the scale and counting beer growth on the face. Um is IT the case that a number of people taking um things like perpetually and other things to block dht or disrupt the dh t pathway are going to experience diminished um sex drive, diminished um know of motivation and general vigor. And if so, are there alternatives like topical dht and tag ones that they might use if they want to keep their hair but not have those negative effects?

The way that I think about um hair loss is you have your fertilizers and also learned the growth agonist and then you have your anti android. Whether there is systemic or topical, there is both but that's the general lamon's way to think about hair loss if you only putting fertilizer in your hair but you have androgen galpy male powerful baldness and those hairs will still mineralists and eventually you'll still have loss .

such a great word. miniatures. Yeah, it's enough to send anybody off to find a thai dic, right? By the way.

it's difficult to tell if militarization happening unless you have magnifying glass. You first, second there, I don't know .

where that you are making a joke. You're going about miniaturising of the hair folic, correct? So can reverse that many interior ation got just a fun word to say. I'm not just keeps saying .

IT each individual has um again we mentioned the energy ine receptor males only have one energid recept genes on their extremo home so depending on health sensitive that energizing receptor is and depending on the density of the um receptor or in the hair follow, you can have a arbitrary threshold ld and you don't know what this threshold is until you start to have minimization and loss of hair.

But over the threshold the follow o will die and eventually system so will leave. But under the the threshold, you're okay. Every androgen bind to the same androgen receptor.

So there is nothing special about D H T. D H T is just a stronger androgen. So the higher your S H B G things that increase S H B G or beneficial for hair loss prevention because you have a less binding of that receptor.

So if you think about hair loss, specifically androgen ic or male pattern baldness in the terms of that energy receptor, and everything in general bind into IT, not just dht, but also testosterone, is helpful. It's just that D, H, T is a huge battering RAM. Whether the other energies are just like .

presses on the door got IT. So are some of the topical dht receptor tag is going to be a Better choice for people that want to maintain or their hair grow more hair um if they want to avoid side effects likely.

So some individuals benefit from stem c uh a systemic decreasing D H T for a couple reasons. One could be prostate and then one could actually be hyperrational y of the mile cardio. So D, H, T, also disproportionate thicking of the ventral.

So for someone on T, R, T, that might be a benefit that is prone to thicking into the ventral at baseline. However, many people that have just a bit of previous position, they can use things that are topical anti androgen. A kito cn is always one of them. Cafe is actually another one.

Drinking cafe.

Topical caffeine.

say my hair times to go pretty fast, so maybe, but I drink a lot of caffeine into topical cafe. Really Robing coffee on their head were taking caffeine tablets and does IT wait. You have to explain how this works. How do people get caffeine into the hef alcohol?

Um topically. The caffeine entered the scale and crowds out like somewhat crowds out the entertained is a weak effect. It's likely just strong enough to be clinically significant.

Usually caffeine is put into formulations with other things like kidon is all that are also weak. Anti androgen of notes, bruno lack tone can be prescribed typically, but IT is absorbed systemically because these sides are the molecule. So unless you're doctor specifically prescribes that for you, especially as a mail, do not use topical spray onto acone.

Topical fantasy ride is also a small or molecule, so IT is also systemically absorbed, but IT is not extremely well systemically absorbed. If you take topical fan asteroid, and usually your systemic dht will decrease by about thirty percent. Top code taste is likely a tiny bit stema ally abroad, but is unique because its half life is much faster, any lower dose.

So top code astride will not affect your systemic D H. D. At all. And i've seen as anecdotally on many people on total tasty therapy.

we're going to have to get you back on here to do and episode all about dht and hair loss and hair growth. You know, again, not a topic that focus on a lot for myself, but that I get a lot of questions about for men and women.

One thing that we could mention, I got a tone of questions about cucumber oids after the last episode.

oh yeah. But all, i'd reported my own anecdotal experience that taking tumeric really crushed my dht levels, and I did not feel good. I crushed all sorts of positive feelings of vitality. The moment I stopped taking to maric felt great again.

Many people report this. And the interesting thing about tumeric is most of its beneficial action, not all of IT. Some people benefit from systemic a tumeric, and some people that can tolerate IT that, well, it's actually great for the prostate.

But most of the action IT does not need to be by available IT acts on the gut microbial so you can take tumeric. And if IT is not absorbed, some tumor x has put in special formulations like my seller lipscomb a or complexed. But a lot of IT is put with the black pepper fruit extract, which is also in as bioern, which is actually also a five of a ducket hibor and IT affects liver side of crimes. And so many supplement companies put this black pepper fruit extract by appearing in almost everything. So some people around a really hydas, and that could also be making most of the effect of people who do not tolerate tumeric will yeah.

I avoid tumeric like the plague based on that one previous experience because I was clearly tumeric that causes the negative effect coming off IT. Everything reversed rapidly. And by Operating the black pepper extract, I also avoid that like the play based on everything you just sent.

I want my five alf duct. I want my dht to be optimize simply because my understanding is dht is. The more powerful and androgens one that yes, IT causes a little bit hair loss. I've got a few you know, patches here and there, but i'm willing to live with that based on all the other wonderful things that dht optimization .

does a quickly mention a few other things. One sap, all metal, is also a five of da NBA, but only a couple of the isoentropic three main ISO enzo. And a lot of the problem is that you're inhibit in a couple of the ioane mes, but not the other.

One fanatic. I inhibits one and two to test, tried actually inhibits all three and um fancied inhibits the ice so enzyme that is in genital skin but not in the skin throughout the rest of your body. So a lot of the side effects of fanatic I which is loss of sensation and loss of erectile function, have to do with the um this concordance between the sensitivity of the genital skin and the skin.

Again, another reason to not disrupt five alpha reductive and will definitely get you back on here to talk about. I think we should just do a whole epo de about dht because so often when people are thinking about optimizing hormones SHE male males trying to optimize their hormones, they're thinking to tosta one to stores, maybe nowaday they think a little bit more about free to stop drone.

And maybe they think about estrogen is also being important not to crush emerging. But dht is, you know, least to my mind, the linchpin of so many the things that subjectively, people are really focused on, libido, motivation, drive that set up. I have one final question is just a brief one.

But many of us have heard that the B P S that are present in in plastic bottles and even in certain illuming um cans and felts difficult word to pronounced, but a fun one nonetheless. Sales and worked by a doctor, shana swan has shown that valid exposure to the fetus to pregnant thers and the fetus very likely is negatively impacting sperm counts, testosterone levels and even changing gene italia size for the worse um in males nowadays. Um I saw beautiful lecture that a doctor shana wanted on this when I was in copenhagen and it's very clear that it's negatively impacting the male feet as he was also in da rogan's podcast I hope together on this podcast.

However, what SHE couldn't answer for me was whether not faded in bpa and these things present in plastics and some people who claim in tap water are bad for males after they're born and after puberty. What are your thoughts on where I should just ask you? Do you drink water out of plastic bottles?

Do you avoid drinking out of cans that are not specifically non B P. A. Containing cans? And do you actively void delay? Ts, my understand is that delights are most enriching pesticides. That's why you're seeing dramatic drops in sperm and testoon levels, mainly in rural areas where they're .

dust cropping. yeah. So I do avoid drinking out of cans that are plastics that may have B, P, A or this final a in them.

This final a is known to bind to what I would consider the fifth x rogen receptor estrogen related recept gamma. So I I would consider IT A Z O estrogen. So fight to estrogen or emergence from plants and in general, or not concerning or clinically significant.

And disco estrogen are just other estrogen so I do avoid B P A and I also test my water um I use a water testing service and I tested both after its through my water filter and the tap water that my two boys drink almost every day and it's very interesting. I only found one microplate tic just a bit over the reference range um so wasn't a terrible top score. But even in developed countries these are widely variable as far as pathology. Um again, very difficult to interesting to perth but I remember learning about these because there is, I believe, a lawsuit that had to do with mac and cheese. And this was probably five years ago and I was coming up with my list of each provider that does of start ics has a list what to avoid for the pregnant lady you know sketchy delly meat or high mercury fish like sd fish and samon and actually added processed mac and cheese to that list.

interesting. Well, thank you for that. I'm going to extract your statement that you avoid drinking out of plastic bottles when possible.

I guess you're not neurotically ally attached that if you are dying of thirst, you might crack a plastic bottle water to arrive. But in kyle doctor jet, thank you so much. You gave us an enormous wealth of knowledge, everything from behaviors to psychology to supplementation to prescription drugs.

We will make sure to point out where people can get a hold of view on instagram, on twitter and um and on other websites in our showed captions. But really, just on behalf of the audience and just for myself, thank you so much. You have an immense amount of knowledge and you're exquisitely good at sharing IT with people in an action way.

So thank my pleasure. Thank you for joining me today for my discussion with doctor college LED all about male hormone optimization. I just want to remind everybody that we will soon have an episode all about female hormone optimization if you're learning from and or enjoying this podcast, please subscribed our youtube channel.

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