In this episode, Dr. Rena Malik, MD provides an in-depth exploration of testosterone levels and their impact on men's health.

scientifically-proven-ways-to-boost-your-testosterone-naturally-explained-by-a-urologist

Scientifically Proven Ways To Boost Your Testosterone Naturally, Explained by a Urologist

when do we start seeing these symptoms so when you look at data on what levels we're starting to see sexual symptoms with related to Total testosterone levels which is a blood test and essentially how we test for low testosterone you find that somewhere between 230 to 250 nanog per deciliter you're starting to see erectile dysfunction and decrease frequency of sexual thoughts when you get a little higher than that around 320 you'll start seeing a decreased frequency of morning erections in terms of physical symptoms at about 370 you will start noticing that you're having decreased Vigor or energy and so very you know it's very correlated with the amount of testosterone that you have when you develop these symptoms so when do we treat as I mentioned you must have symptoms that are bothersome to you as well as low testosterone on a blood test so typically you'll do a total testosterone level but it's important to realize the testosterone by itself is not the indicator of how much testosterone is actually available to your body because a lot of it is bound the large majority of it is bound with something called sex hormone binding globulin as well as cortisol binding globulin and so it only remains a very small percentage that's available for free testosterone so that can also be evaluated as well as a sex hormone binding globulin to assess your total testosterone or actual free testosterone level you can also assess other hormone levels that could be affecting testosterone that can include estrodial prolactin maybe your LH and FSH to sort of assess if there are other factors that are contributing to low testosterone as well as your thyroid hormone because that can also play a role now if you are wondering about testosterone replacement therapy which we're going to talk about you cannot get testosterone replacement therapy if you have active prostate cancer if you have untreated sleep apnea or uncontrolled sleep apnea if you have a hematocrit or blood count of over 50 if you're planning to be uh have pregnancy or have a child because it can cause infertility and then if you have an elevated PSA or blood test that's testing for screening for prostate cancer that may be concerning you need to get that evaluated before you start any sort of testosterone replacement now how do you boost your testosterone naturally the first thing is exercise so we know that exercise particularly resistance training of large muscle groups can cause an increase in testosterone now it's not a prolonged increase in testosterone so typically you have to incorporate this resistance training in your regular week to week exercise regimen now you want to be careful not to do really high endurance like ultramarathons marathons if you're having symptoms because those sorts of exercises actually increase your body's cortisol which increases stress and can actually reduce your testosterone they've also done some studies that have shown that high-intensity interval training can be beneficial for testosterone now nutrition the best data we have on nutrition is with the Mediterranean diet and so that's generally a diet that's high in poultry and fish vegetables healthy fats including sort of lowfat dairy olive oils avocados and nuts as well as trying to get like sort of healthy and unprocessed Foods so you want to avoid processed foods and include healthy fats in your diet sometimes people go for a very lowfat diet and that actually is not beneficial for testosterone because testosterone is made through the cholesterol Pathways and you need some healthy fat in order to get good testosterone production now weight loss so there's a whole host of studies that have shown that weight loss improves testosterone so some Studies have shown that you need quite a large amount of weight loss like 46 lb weight loss or if you incorporate physical activity it can be 26 lbs but the best study is about a 10% reduction in body weight can show a pretty significant Improvement in testosterone levels they've also shown studies that people have had quite tremendous increases in testosterone after bariatric surgery for those who are obese and candidates for bariatric surgery and even an improvement in your body mass index of five points for those who are overweight or obese can be quite uh remarkable in terms of significantly improving testosterone now sleep is another really important area and this is because during the night is when our body our bodies work in a circadian rhythm and during the night time is when we sort of allow the body to rest and rejuvenate and then allow the surge in the morning of early testosterone and so each hour of sleep lost decreases your testosterone by about six points and they've shown that when they compare men who sleep about 5 hours a night versus those who sleep about eight or more hours a night they will see a 10 to 15% decrease in testosterone now if you have sleep apnea that's also correlated with lowest testosterone and using a c app has also shown to significantly improve testosterone levels by about 90 to 100 points reducing stress now stress is unavoidable but we've seen that people who have high levels of work stress meaning they're commuting more than an hour to work they may be working for more than one job they may have more deadlines or sales quotas or they have stressors about layoffs tend to have lower levels of testosterone also they did one study where they looked at resident doctors who were stressed and also sleeping less meaning sleeping about every four nights they' be on call that they found that their testosterones were significantly lower despite being typically young healthy men compared to other Hospital workers when it came to testosterone levels so if it's possible reducing stress can be very impactful in terms of testosterone avoiding endocrine disrupting chemicals so things like uh bpas which are found in Plastic Products or phalates which are found in plastic tubing uh have been shown to significantly negatively impact the hormone production of testosterone and sperm production so ultimately trying to avoid those as much as possible what I tell people is drinking from a glass water bottle or a metal bottle water bottle of plastic heat your food up in um glass plates instead of using the plastic containers don't use plastic Tupperware those are sort of the things that we can control and can help improve our exposures but unfortunately everyone is exposed and has some degree of these endocrine disrupting chemicals in their blood levels or urine that we can measure there are a whole host of different types of testosterones that are available for testosterone replacement therapy if these other Alternatives do not work they can include injections which can be done every other day to twice a week to weekly to every 10 days depending on your preference the nice thing about this is there is flexibility on how often you get the dosing It's relatively afford able however it is an injection so normally the male body makes about 5 Mig of testosterone every day but when you take it injected you're not getting that daily dose you're getting sort of a a larger dose at one time and then that sort of goes up and comes down there's transdermal gels which are you put on your arm typically daily there's patches you put on your body daily now these have some risk of the gels of transferring the testosterone to other people the patches sometimes people get skin irritation from the patches there's also Buckle tablets which means you like sort of rub them on your gums but you can have gum related side effects you can get pellets implanted and these essentially are implanted every 4 months or so and they release testas for an extend a period of time however they do have sort of Peaks and valleys of testosterone so very early when you get the pellets you may feel a very high rate of testosterone which will then sort of fizzle out over that course of 4 months there's also long acting injectables which are injected usually every 4 weeks and then every 10 weeks and again same thing with the levels going sort of up and down there's a nasal spray that you can do about three times a day and that can have some nasal side effects and there's now oral options available as well which are twice daily now both the nasal and oral have a rapid onset so you typically see symptom relief very quickly when you take the medication but it also wears off pretty quickly and the oral has to be taken with food so there are some obviously side effects the one thing is you need to be monitored once you're on testosterone you need to be monitored with your blood count to make sure you don't develop something called erythrocytosis and this essentially causes your your red blood cells and your blood to thicken putting you at higher risk for stroke or blood clots which is why we have to monitor that if you have sort of Peaks and Valley sometimes when your testosterone goes too high you may noce acne or oily skin and if you have prostate cancer and you start testosterone it will cause that prostate cancer to grow however there is new data showing that there is really no risk of developing prostate cancer from testosterone testosterone does not cause prostate cancer but if you have prostate cancer it will cause it to grow also it can cause infertility and sperm production there was a whole concern about cardiovascular disease with testosterone replacement and very recently we've had some very strong data showing that actually that's not true we do not see an increased risk of cardiovascular disease with testosterone replacement there are some other sort of less common side effects which are like having breast enlargement hair loss breast cancer and worsening of sleep apnea which we don't often see all the time but there is some concern of that

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