TPV Podcast Episode 364: Men's Health

On this week’s episode, Stacy and Sarah cover men’s health and hormone health as it relates to testosterone levels. What is the role that testosterone plays in the body? How do you know if you are deficient? And what can you do to regulate your hormone levels? All of this and more in episode 364. Enjoy!

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The Paleo View (TPV), Episode 364: Men’s Health

- (0:40) Welcome
  - Welcome back to The Paleo View everyone!
  - This is the last week that Stacy will be coming to you from a location other than Virginia
    - Matt and Stacy have been on the road for 61 days
    - They are heading back to Virginia the day after this show was recorded
    - Stacy is looking forward to being back home and snuggling her pets
  - Stacy is looking forward to discussing this week’s topic, as Sarah and Stacy have been wanting to cover this topic for a while now
    - This week’s episode will include information on hormones and body parts, so if you typically listen to this show with little ears around you may want to be careful, depending on your comfort level
    - Sarah noted that this week’s episode is about men’s health, which is a really fun topic for the hosts
      - The discussion will focus on men’s hormonal and reproductive health
    - If you aren’t yet ready to discuss these topics with your little one, be sure to listen to this show without your little people around
    - Stacy is looking forward to sharing this discussion with her three teenage boys
  - This episode is sponsored by EverlyWell
    - This is an awesome sponsor for this episode since Stacy and Sarah will be talking about testosterone
    - EverlyWell is an at-home lab testing company that offers a variety of tests, ranging from food sensitivity to metabolism, to a thyroid test, vitamin D, testosterone and general men’s health
    - The tests are private, simple and all processed through certified labs
    - All you have to do is head to EverlyWell, choose your tests, and they’ll be shipped directly to your doorstep
    - Then, once you complete your sample collection and send it back into EverlyWell’s certified labs, they will process your sample and send you your results via EverlyWell’s secure online platform within just 5 days
    - EverlyWell takes all of the guesswork out of lab testing and puts the power into your hands to complete a range of important health tests all from home
    - To check out EverlyWell visit: https://everlywell.com/thepaleoview
      - You can get 15% off with the code ‘ThePaleoView’
  - For Stacy, while this week’s topic doesn’t particularly pertain to her, she is looking forward to applying this week’s information to the men in her life
- (6:52) Q & A
  - This week’s episode is inspired by a question from John
    - John writes:
      - “Hi ladies! I know if I say nice things, there’s a better chance my question will be answered. Fortunately, that’s easy to do. As a researcher myself I love that the Paleo View emphasizes facts over dogma. I know when you answer a question, I will learn something, and that is about the highest compliment I can give a podcast. I love that the two of you are interesting to listen to, and I have been a regular listener since (about) episode 20 (the early shows were good too!!). As one of your ‘6 male listeners’, my question involves men’s health. While there have been a number of shows dedicated to women’s health, I have often wondered if there would be any link between a Paleo diet (or other dietary factors) and testosterone and/or erectile dysfunction. There’s also a pretty substantial supplement business that claims to raise testosterone; any truth in these claims? I know there’s the basic ‘eat a healthy diet and exercise’ but I thought maybe you could bring a more scientific approach to the question. I also feel that many women who have husbands/boyfriends dealing with these issues would be interested in understanding whether/how Paleo might help. Thanks!!”
  - Stacy noted that testosterone is not just a male hormone
    - She isn’t sure what all this hormone effects and is looking forward to Sarah diving in on this
  - Sarah wants to take John’s question and focus in on:
    - The role that testosterone has on men’s health
    - The things that cause testosterone deficiency
      - What this looks like
      - What diet and lifestyle factors might be involved
      - What supplements will help raise testosterone levels
  - Testosterone as the predominantly male sex hormone has a major role in development and puberty
    - It also has a fundamental role in health
    - The crossover with women’s health happens as testosterone regulates muscle size/strength, the general turnover of muscle tissue, bone growth and strength, sex drive, sperm production, it impacts mood, cognition, attention, memory, spatial awareness, behavior, negotiation abilities
      - It regulates libido in women as well
    - Sarah shared details from a study that was done on the correlation between testosterone levels and men’s negotiation tactics and skills
    - Overall testosterone has a pretty big impact on psychology and physiology
    - Low testosterone can be seen in lack of motivation, lack of healthy competitive nature
      - Stacy thinks about the way healthy competition can be a really good thing
    - Sarah noted that in the male body you really only see testosterone excess in the context of a bodybuilder or a professional athlete doping with testosterone
      - It is not a common physiological occurrence that the male body will make extra testosterone
      - In women, we see testosterone excess in PCOS
        
        This condition is hallmarked by elevated testosterone levels
        
        Women have so little in our bodies compared to men that we have this room for excess
        
        With men, this is not the case
        
        The health challenge with testosterone for men is low levels
  - Testosterone generally decreases with age, starting in middle age
    - We see this at a rate of 1 to 2% a year
    - This is considered part of normal aging
    - It is not as dramatic as menopause since it is a gradual decline
      - There are some symptoms that echo menopause though when a man’s testosterone is low
  - Symptoms of testosterone deficiency:
    - Hot flashes
    - Reduced body and facial hair
    - Loss of muscle mass
    - Low libido
    - Erectile dysfunction
    - Impotence
    - Small testicles
    - Reduced sperm count
    - Infertility
    - It can lead men to form breast tissue
    - Irritability
    - Depression
    - Low concentration
    - Osteoporosis
  - As is the case with all hormones there is a spectrum
    - A small deficiency in this hormone is going to cause an amount of these symptoms that might be easily dismissed
      - We typically see this in something so minor that we brush it off
    - It is not until it is a really big problem that we ask the question – what is going on
    - With a lot of these symptoms, you might not even tie them with testosterone levels unless you have a really good functional medicine specialist or you go and do the men’s health panel from EverlyWell
  - The problems with elevated testosterone levels we classically associated with bodybuilders
    - We see:
      - Really bad acne
      - Liver damage
      - An increase in heart attack risk
      - Weight gain
      - Aggressive behavior
      - Irritability
      - Impaired judgment
      - Delusions
    - The dominant studies of this are on athletes who dope
  - Stacy noted that she feels there is a stigma around low testosterone levels and the idea of doping or supplementing to raise these levels
    - She reminded listeners that Stacy and Sarah are not judging men for what they might need to do for their health
  - Sarah noted the difference between doping and hormone replacement
    - Doping specifically refers to taking excess
      - You are not trying to achieve normal levels
      - You are trying to achieve high levels for the sake of performance
    - If your levels are low, hormone replacement may be the best treatment
      - This is a conversation to have with your doctor
      - The best treatment may be to take exogenous testosterone
        
        This is the exact same thing that an athlete would take
        
        The difference is the philosophy behind it
        
        If you are taking it as a hormone replacement your goal is to reach normal levels and to regulate your levels
        
        As opposed to an athlete who is taking it to increase performance, and their cost-benefit analysis is very different in the context of testosterone excess
- (23:08) Testosterone Deficiency
  - Beyond the symptoms associated with testosterone deficiency, the health risks include some other bigger risk factors
    - Deficiency increases your risk of:
      - Metabolic syndrome
      - Cardiovascular disease and mortality
      - Inflammation
  - It is worthwhile doing some investigating and really trying to dig a little deeper in terms of measuring testosterone levels and potentially either addressing diet and lifestyle factors and/or testosterone hormone replacement in order to bring levels up to normal in order to reduce those other risk factors
  - Stacy asked how one would know about normal levels
    - Sarah noted that the “normal” range for testosterone levels is huge
      - There is not really a good indicator if one should be at the higher or lower end of the range in order to have optimal whatever it is
      - It is typically diagnosed based on the combination of the actual number and the symptom checklist
      - This is why working with a functional integrative medical practitioner can be very helpful
      - Again, EverlyWell has a straight testosterone test that is quite inexpensive and also a Men’s Health Panel that includes testosterone, DHA, estradiol, and cortisol
  - There are no studies that look at named diets and men’s sexual health
  - There is still a lot of information about the role that micronutrients, lifestyle factors and broader dietary factors that can help influence how we implement a Paleo diet to best support testosterone regulation
    - Exercise is one of the best things that both men and women can do to support testosterone levels
      - Specifically resistance training
      - Endurance training does tend to lower testosterone when combined with calorie restriction
    - Sleep is one of the biggest lifestyle influences on testosterone
      - Sarah shared the findings from studies done in an institution
        
        When participants were only getting 5 hours of sleep a night, they saw a 15% decrease in testosterone
        
        This is basically the same levels as what is seen in a 65-year-old man
        
        Testosterone levels seem to be closely tied to the amount of REM sleep we get each night
    - Stress levels are also an important factor to consider when looking for ways to impact testosterone levels
      - Chronic stress is linked to low testosterone
    - As far as diet, there is not much data out there in terms of big dietary trends
      - The relation with diet and testosterone is much more micronutrient focused
        
        Deficiency in a few nutrients can cause low testosterone
        
        Vitamin A
        
        Vitamin D
        
        Zinc
        
        Magnesium
        
        Vitamin K
        
        Supplementation in all of these nutrients can restore your levels
        
        Through liver, you can get vitamin A
        
        Testing your vitamin D levels will be best to see how to reach sufficiency
        
        Check out this podcast episode for more information
        
        Omega 3 fats help to support testosterone metabolism
        
        If you supplement men with these nutrients it doesn’t cause testosterone excess
        
        It is only related to deficiency in these nutrients driving low testosterone
        
        Once you have enough, the system can help regulate itself
    - Chronic alcohol consumption can also cause low testosterone and antioxidants in general
      - If you are not getting enough nutrients from your diet, magnifies the reduction in testosterone
    - There is not a good link between testosterone and BMI
      - But there are some interesting studies that show that losing weight can boost testosterone levels
    - Sarah recommends looking at your intake of the micronutrients mentioned above, evaluating sleep and other lifestyle habits, and see if there is an obvious place where you can make some changes that are likely to help regulate testosterone
      - If testosterone is really low, you are going to want to go right to a functional medicine specialist and look at testosterone replacement therapy
    - Supplements Sarah looked into and recommends based on how safe the supplements are:
      - Get a professional opinion before taking supplements to address a deficiency
      - DHEA
      - Creatine
      - D-aspartic acid
      - Fenugreek
      - Ginger
      - Ashwagandha
    - Stacy wants to reiterate that before you make a smoothie with all the things, that testing your hormone levels and knowing where you are is so impactful
      - While you could do this a variety of ways, Sarah and Stacy both use and recommend EverlyWell
      - You or a loved one can test your hormone levels for under $50 using the code ‘thepaleoview’
      - Once you know where your levels are, then you can work with a functional medicine professional to look at your hormone levels and develop an action plan on how to handle
      - Sarah emphasized how important it is to make decisions based on data when we are talking about hormone levels
- (59:04) Closing Thoughts
  - Thank you so much for tuning in listeners!
  - We hope you found this show helpful
    - There are a number of other topics related to both female and male hormones and health that Stacy and Sarah are hoping to cover in upcoming episodes
  - If you liked this episode, be sure to leave a review on iTunes and share it with people you love
  - Thank you again so much for being here!
  - Stacy looks forward to joining the show from Virginia
  - Sarah thanks EverlyWell for sponsoring this episode
    - As a reminder, get 15% off with the code ‘thepaleoview’ at this link