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Testosterone

  • What Your Father Never Told You

    Ask the average American man what his greatest health concerns will be as he ages, and his answer would likely be drawn from a familiar list: heart disease, prostatic hyperplasia, prostate cancer, osteoarthritis, erectile dysfunction. Few would list osteoporosis, the degenerative skeletal condition that is generally considered a “woman’s disease.” Most would be surprised to learn that the prevalence of male osteoporosis is close to that of prostate cancer; about 20 percent of the 10 million Americans with osteoporosis are men. Men account for over a quarter of all osteoporotic fractures annually. It is estimated about 25 percent of men will suffer an osteoporotic fracture in their lifetime, more than the estimated 16 percent that will be diagnosed with prostate cancer. Yet, male osteoporosis remains a relatively over looked condition that is poorly understood amongst men. For example, on the National Health and Nutrition Examination Survey (NHANES) only one percent of male survey takers over 65 reported they had osteoporosis; bone mineral density (BMD) testing revealed that four times as many actually had the disease. In this article, we will briefly discuss the progression of male osteoporosis, its specific risk factors, and potential treatments.

    What is Osteoporosis?
    Osteoporosis describes a condition of improperly or incompletely crystallized bone tissue. This results from an imbalance in bone remodeling. Remodeling is a critical process in bone metabolism that involves the removal (resorption) of older bone tissue and its replacement with an equivalent amount of pristine bone at the same site. Remodeling becomes an important mechanism for repairing damage from repeated stress on the skeleton, and is vital for removing older bone tissue, which has lost its resilience. Resorption also serves as a means for releasing calcium or phosphorous when there is a dietary deficiency. Bone remodeling continues in such a fashion that most of the adult skeleton can be replaced about once per decade.

    The maintenance of a static density and mass of bone depends on the balance of bone synthesis by bone-building cells (osteoblasts) and bone-resorbing cells (osteoclasts). Equivalent levels of activity by both cellular processes allows for consistent bone remodeling and the optimization of the bone’s physical properties. A shift of this equilibrium towards synthesis adds new bone; a shift towards resorption results in net bone loss. If bone resorption were to progress unchecked, or if the bone formation process were somehow hindered, then bone would begin to lose minerals, leaving porous bone matrix. The less-dense “spongy” bone (trabecular bone) that predominates in the wrist, spine, and hip becomes thinner and weaker, with less mechanical strength and a higher probability of fracture.

    For practical purposes osteoporosis is defined as bone mineral density (BMD) of more than 2.5 standard deviations below the mean for a 30 year old individual of the same sex and ethnicity (called the T-score), which translates to a bone mass approximately >30 percent less than average. A pre-osteoporotic state of low bone mass (traditionally referred to as osteopenia), describes a BMD that ranges 10 – 30 percent below average and has some increased risk of fracture. The most common osteoporotic fractures are those of the spine (27 percent of all fractures); common non-vertebral fractures occur at the wrist (19 percent), hip (14 percent) and pelvis (7 percent). These fragility fractures are responsible for decreased quality of life due to pain and loss of mobility. Hip fractures are especially problematic; they increase the risk of additional hip or vertebral fractures by over two-fold, and about half of patients experiencing hip fracture will experience long-term loss of mobility. Hip and vertebral fractures also carry an increased risk of mortality, especially in men. Within six months of a hip fracture, the mortality rate is about 10 – 20 percent; about one-third of men will die within a year of hip fracture. Loss of independence is also more likely in men who survive hip fractures than in women.

    Primary and Secondary Causes of Osteoporosis in Men
    Primary osteoporosis is the cumulative loss of bone mass with age, as one experiences changes in sex hormone levels. Although men do not usually experience a sudden decrease in sex hormone production as do women during menopause, levels of testosterone in men begin to decrease as early as age 30, and can drop at a rate of 0.8 percent per year. Testosterone, one of the main androgens in men, is responsible for regulating not only secondary sexual characteristics, but also body composition, including lean body mass and bone mineral density. Like estrogen, testosterone signals osteoblasts to build new bone, while inhibiting the bone-resorption by osteoclasts. Androgens also stimulate the mineralization of bone, and indirectly stimulate the mechanical loading of bone (the stress on the skeleton, as experienced during exercise, that increases the synthesis of new bone). Low testosterone levels, not surprisingly, are associated with increased prevalence of osteoporosis and greater fracture incidence (particularly of the hip) in older men. Testosterone is also a source of estrogens in men (by conversion through the activity of the enzyme aromatase); low estrogen levels in men are also associated with lower bone mass.

    As is the case for women, low body weight, smoking, Caucasian race, limitations in physical activity, and history of previous fractures are also risk factors for primary osteoporosis in men. Inadequate calcium consumption, increased calcium excretion, and insufficient serum vitamin D levels are additional well-established risk factors for primary osteoporosis. Other dietary risk factors, such as soft drink consumption, low phosphorus, and high dietary acid load are beginning to gain more attention for their ability to push bone metabolism towards resorption in women; it is not unreasonable to expect these factors may present risks in men as well.

    Secondary osteoporosis results from specific medical conditions, diseases, or medication use. Although less common in women (20–30 percent of cases), secondary osteoporosis may account for over half of the cases in men. Frailty fractures or low BMD in younger and middle-aged men can be indicative of this disease. Most causes of secondary osteoporosis are similar between the sexes, and include endocrine disorders (diabetes and hyperthyroidism), gastrointestinal disorders that interfere with nutrient absorption (bariatric surgery has emerged as a condition which may double fracture risk), chronic inflammatory diseases (such as rheumatoid arthritis or lupus), and certain medications (particularly glucocorticoids and immunosuppressive drugs). Male hypogonadism (sudden drops in androgen levels) is a major risk factor for secondary osteoporosis, likely through the mechanisms mentioned above. Hypogonadism is a common side effect of the androgen-deprivation therapies that are the mainstay of prostate cancer treatments, and can result in significant bone loss. Alcohol abuse may be a more prevalent risk factor for decreased BMD in men than in women; low bone mass is common in men who seek medical help for alcohol abuse. Moderate alcohol consumption (perhaps up to 29 g/day; there is not a real definition for “moderate”), however, has been associated with a healthy BMD in multiple studies.

    Treatment of Osteoporosis in Men
    Despite its prevalence, osteoporosis in men has been relatively overlooked by researchers; therefore, most of our understanding of the disease has been derived from studies of the disease in women. Accordingly, studies of osteoporosis treatments in men are smaller and fewer in number than those in women. Calcium and vitamin D supplementation, often in conjunction with bisphosphonate drugs, has been the standard protocol for treatments of primary and secondary (hypogonadal men or those on androgen-deprivation therapy) osteoporosis. Testosterone supplementation therapy has been proven effective at increasing BMD in hypogonadal men, but requires consistent monitoring for increases in hormone-related cancer risk. Nutritional and lifestyle modifications (such as increased exercise and smoking cessation) are important practices for lowering fracture risk. It is unclear whether the bone-promoting activities, other well-characterized nutrients (such as the K vitamins, potassium, or trace minerals like silicon, boron, and manganese) will be as effective in men as they have been in women; this is certainly an important area for future scientific study.

    Summary
    Osteoporosis in men, although surprisingly common, is a frequently overlooked consequence of the aging process. It shares many of the same causes and risk factors as it does the condition in women. Secondary causes of osteoporosis (particularly prostate cancer therapies and alcohol abuse) are a more common cause of the disease in men, and require additional considerations for their successful management. It is hoped as male osteoporosis becomes more recognized and better understood amongst practitioners and patients, research into its causes and effective treatment will increase accordingly.

  • As pointed out last year in a review of pollen extract for prostate support, benign prostatic hyperplasia (BPH, formerly called hypertrophy), involves a renewed growth in the number of prostate cells late in life.1 Unfortunately, of men between the age of 40 and 59, nearly 60 percent can be shown to already be suffering from benign prostatic hyperplasia. This usually does not present a noticeable problem until after the age of 50; by the age of 80, however, some 85 percent of all men suffer from one or more symptoms of BPH. The primary effect of BPH is a progressive decrease in the ability to empty the bladder as the prostate enlarges and applies pressure to the urethra.

    BPH is hardly the lone prostate and sex hormone related issue that can be troubling to men. Aside from prostate cancer, which for most men is so slow growing as to not be life threatening, many men are concerned about low testosterone, which has its own repercussions. Two of the repercussions of low testosterone are a low level of muscle-maintaining free testosterone and elevated levels of estrogen produced from testosterone by a pathway referred to as the aromatase pathway. Fortunately, there are a number of safe natural compounds that can help to regulate both sides of this equation.

    Protective herbs and nutrients have counterparts that increase the risks of various conditions. Some of these potentially damaging compounds are prescriptions given for unrelated conditions and this provides a rationale for being cautious about prescription drugs. What you do not know definitely can hurt!

    PROTECTIVE AND SUPPORTIVE NUTRIENTS AND HERBS

    Omega-3s
    In 2013, experts slammed a claimed fish oil/omega-3 fatty acid intake link to prostate cancer as “scaremongering.” The trial in question purported to find increased risks for total prostate cancer as well as increased risks of both low-grade and high-grade prostate cancer, an increase of 71 percent in this latter category.2 The responses were quick and brutal. One nutritionist (Duffy MacKay, vice president of scientific and regulatory affairs at the for Responsible Nutrition (CRN)) pointed out, quite correctly, that the findings of this study were based on blood level differences so small that “[t]his change [of 0.2%] literally could have occurred if somebody ate a fish sandwich on their way to get their blood drawn.”3 Both the consumers of the low and the high levels of long chain omega-3 fatty acids were within the normal blood range.

    Others pointed out that the findings of the study clearly imply that men in countries with high levels of consumption of seafood, such as Scandinavia and Japan, should exhibit high levels of prostate cancer, yet the opposite is the case. Alan Ruth, PhD, CEO of the Irish Health Trade Association observed, “[i]n a 2010 meta-analysis of 31 studies published in the American Journal of Clinical Nutrition, the risks of prostate cancer diagnosis calculated for high fish consumption ranged from a 61% decrease in risk to a 77% increase in risk, and several showed no significant differences in risk at all…In the same meta-analysis, pooled data from four studies on fish consumption and death from prostate cancer (rather than diagnosis of prostate cancer) found a 63% decrease in risk for high fish consumption.”4

    Especially interesting in this dust-up is the recent attempt to rehabilitate omega-6 fatty acids. In pre-modern times, the intake of omega-3 to omega-6 fatty acids in the diet typically was in the range of one-to-two, whereas today in the United States it regularly may be as low as one-to-twentyfive, with prostate cancer rates climbing steadily over the last 60 years. In this instance, a headline is revealing: “Corn oil, omega-6 could speed up prostate cancer.”5 Journal article titles are more prosaic, yet just as damning: “A high ratio of dietary n-6/n-3 polyunsaturated fatty acids is associated with increased risk of prostate cancer.”6

    Barry Sears, who has written for years on the health effects of fatty acids, both good and bad, tartly comments in his blog, “Omega-3 fatty acids and prostate cancer? Oh, really?”7 Among other things, Sears demonstrates how easily a statistically significant blood reading of fatty acid profiles can be attached to otherwise clinically irrelevant findings. The take away message in this case is that the experience around the world repeatedly has been that prostate risks, especially death from prostate cancer, are lower in matched populations that consume more fish. There is nothing in recently published research that should make us doubt that improving the omega-3 to omega-6 ratio in our diets is a good goal at which to aim.

    Grape Skin Extract & Resveratrol
    In many areas in the US and the United Kingdom (Scotland has not yet opted out of the Union), one cannot visit a doctor without being queried about alcohol intake and then the required lecture on the evils of alcohol. The distinction as to the source of alcohol in the diet routinely drops out despite the fact that red wine has been recognized in Europe for centuries as exhibiting various health benefits and little downside as long as consumed in moderation. It turns out that red wine, often thought of in terms of the heart, may benefit the prostate, as well.

    The trick to the studies is that the researchers must work vigorously to screen for the different sources of alcohol over the course of a man’s life. If this is done, then the research is likely to confirm that a glass of red wine per day may be protective against the risk of prostate cancer.8 Less clear is which compounds in red wine are protective. Perhaps many are. A recent study on grape skin extract and resveratrol identified several protective mechanisms of action.9 Some of the factors linked to resveratrol have been known for years, whereas other mechanisms and, similarly, the benefits of other red wine compounds, are being vigorously researched. Grape seed components (proanthocyanidins) are another example of a source of anti-cancer benefits.10 Given the huge volume of papers being published today on the healthprotective benefits of red wine and its ingredients, it is a reasonable conclusion that most men may benefit from one or two glasses of red wine per day consumed with meals.

    Quercetin & EGCG
    The dietary bioflavonoid quercetin is well known to readers of this magazine, as is epigallocathechin gallate (EGCG). Both compounds are considered to be health protective and quercetin, in particular, is known to improve the uptake (bioavailability) and the benefits of many other compounds found in the diet and in herbs. Papers routinely show greater efficacy or even benefits where none initially were found, when quercetin is combined with resveratrol, with sulphorafane, with EGCG, etc. One of the more interesting recent findings is that these combinations sometimes not only can help to prevent the transformation of cells from precarcinogenic stages to active cancer, but also can interfere with or eliminate entirely cancer stem-cell characteristics. Cancer stem cells are the ultimate source of cancer self-renewal, so this action by the combination of quercetin and EGCG is a warm recommendation.11

    Bitter Melon
    Bitter melon has received quite a bit of publicity recently with regard to pancreatic cancer. It would be unfortunate were the exploration to end there. Several researchers have reported that treatment of bitter-melon-related products in a number of cancer cell lines induces cell cycle arrest and apoptosis without affecting normal cell growth.12 Researches targeted specifically at prostate cancer have demonstrated that the impact of bitter melon extends to this area.13 Admittedly, bitter melon is not a staple at the American table. Perhaps that should change. See my earlier article, “Going WILD with Bitter Melon for Blood Sugar Support.”14

    Pomegranate
    Pomegranate is a fruit long associated with healing and medicine. Indeed, the pomegranate is on the crest-of-arms of the British Royal Society of Medicine and of many other ancient organizations devoted to healing. A quick look at the PubMed database shows that the keywords “pomegranate” and “prostate” bring up 60 studies. Many of these studies have been promising, especially when pomegranate was added to other ingredients with related and differing mechanisms of action. For instance, in 2013 the polyphenol rich whole food supplement Pomi-T® (pomegranate seeds, green tea, broccoli, and turmeric) was reported to have a direct anti-cancer effect in men with prostate cancer.15 These results were confirmed in a larger clinical trial published in 2014.16

    Thymoquinone and Black Seed
    Few Americans have heard either of black seed or thymoquinone (TQ). The former is famous for healing in the areas in which it grows naturally, meaning much of the eastern Mediterranean through the Near and Middle East all the way to India. Mohammed is reputed to have said that the seed cures every condition except death itself.

    With regard to the prostate, black seed is useful for both BPH and in preventing prostate cancer induction. One of the important ingredients in black seed oil, thymoquinone, promotes healthy apoptosis in prostate cells and therefore helps the body to regulate the size and health of the prostate.17,18 Similar effects have been found in, for example, breast cancer, so TQ has a broad spectrum of applications.19

    Cactus Flower
    A couple of decades back, the herbal extract chrysin was introduced to the athletics and body building world as an answer to improving free testosterone levels and reducing the pathway (aromatase) that transforms testosterone to estrogen. Chrysin has some benefits, as long as one does not expect too much and is willing to focus on the anxiolytic qualities of the compound (found in passion flower). However, much more successful compounds for this purpose of increasing free testosterone, and so forth, have been found. One of these is an extract of cactus flower (Opuntia ficus-indica).

    I ran across this almost a decade ago being sold in Germany and Israel for BPH,20 but at the time could not find a reliable source of supply. Since then, a friend with whom I was working took this item and continued to dig until he found a reliable source that he could market as increasing serum free testosterone levels and reducing aromatase (reducing estrogen production and inhibiting the binding of dihydrotestosterone/DHT.) As my friend writes at his website, based on preliminary laboratory research, “Opuntia flower extract (1 mg/ml concentration) inhibited over 80% of the activity of 5-alpha reductase in human prostate tissue homogenate and inhibited over 80% of aromatase activity in human placenta tissue homogenate.”21 This particular product also contains supporting ingredients, such as an extract of stinging nettle root.

    Some Prostate-Questionable Foods and Pharmaceuticals Now for a few items that men may want to remove from their daily habits or environment.

    • Non-and low-fat milk (but not whole milk or other dairy products) intake by men is linked to higher rates of prostate cancer22
    • Long-term use of statins increases the risk of prostate cancer23
    • Oral contraceptive use is associated with prostate cancer—this refers to these contraceptives getting into the environment at large and not to use by one’s partner24

    Conclusion
    There are protective foods, nutrients and herbs of which men should take advantage to maintain and regain prostate health as well as improve other parameters of health and performance. Omega-3 fatty acids and the active compounds found in red wine (grape skin anthocyanidins and other compounds, resveratrol, grape seed proanthocyanidins, quercetin), green tea (EGCG) and bitter melon are on this short list. More exotic are black seed and thymoquinone as well as cactus flower extract. For the most part, these can be characterized as special foods since they can be consumed over the long term and have few or no downsides even when consumed chronically in large amounts. Indeed, this should be the goal—a little prevention is always worth a whole lot of cure.

    References
    1. 1. F. Hinman, Benign Prostatic Hypertrophy. New York: Springer-Verlag, 1983.
    2. 2. Brasky TM, Darke AK, Song X, Tangen CM, Goodman PJ, Thompson IM, Meyskens FL Jr, Goodman GE, Minasian LM, Parnes HL, Klein EA, Kristal AR. Plasma phospholipid fatty acids and prostate cancer risk in the SELECT trial. J Natl Cancer Inst. 2013 Aug 7;105(15):1132– 41. doi: 10.1093/jnci/djt174.
    3. 3. Experts slam omega-3 link to prostate cancer as overblown ‘scaremongering.’ http://www.nutraingredients.com/content/view/print/796071
    4. 4. Ibid.
    5. 5. http://www.foodnavigator-usa.com/news/printNewsBis.asp?id=65537
    6. 6. Williams CD, Whitley BM, Hoyo C, Grant DJ, Iraggi JD, Newman KA, Gerber L, Taylor LA, McKeever MG, Freedland SJ. A high ratio of dietary n-6/n-3 polyunsaturated fatty acids is associated with increased risk of prostate cancer. Nutr Res. 2011 Jan;31(1):1–8. doi: 10.1016/j.nutres.2011.01.002.
    7. 7. http://zonediet.com/blog/2013/07/
    8. 8. A glass of red wine a day keeps prostate cancer away? http://nutraingredients.com/news/printNewsBis.asp?id=54898
    9. 9. Hudson TS, Hartle DK, Hursting SD, Nunez NP, Wang TT, Young HA, Arany P, Green JE. Inhibition of prostate cancer growth by muscadine grape skin extract and resveratrol through distinct mechanisms. Cancer Res. 2007 Sep 1;67(17):8396–405.
    10. 10. Raina K, Singh RP, Agarwal R, Agarwal C. Oral grape seed extract inhibits prostate tumor growth and progression in TRAMP mice. Cancer Res. 2007 Jun 15;67(12):5976-82.
    11. 11. Tang SN, Singh C, Nall D, Meeker D, Shankar S, Srivastava RK. The dietary bioflavonoid quercetin synergizes with epigallocathechin gallate (EGCG) to inhibit prostate cancer stem cell characteristics, invasion, migration and epithelial-mesenchymal transition. J Mol Signal. 2010 Aug 18;5:14. doi: 10.1186/1750–2187–5–14.
    12. 12. Nerurkar P, Ray RB. Bitter melon: antagonist to cancer. Pharm Res. 2010 Jun;27(6):1049–53. doi: 10.1007/s11095–010–0057–2.
    13. 13. Ru P, Steele R, Nerurkar PV, Phillips N, Ray RB. Bitter melon extract impairs prostate cancer cell-cycle progression and delays prostatic intraepithelial neoplasia in TRAMP model. Cancer Prev Res (Phila). 2011 Dec;4(12):2122–30. doi: 10.1158/1940–6207.
    14. 14. http://www.totalhealthmagazine.com/articles/vitamins-and-supplements/going-wild-with-bitter-melon-for-blood-sugar-support.html
    15. 15. Goodman A. High Marks for Nutritional Supplement in Patients with Localized Prostate Cancer. Value-Based Cancer Care. September 2013 Vol 4, No 7. http://issuu.com/vbcc/docs/vbcc_september_2013_digital/50
    16. 16. Thomas R, Williams M, Sharma H, Chaudry A, Bellamy P. A doubleblind, placebo-controlled randomised trial evaluating the effect of a polyphenol-rich whole food supplement on PSA progression in men with prostate cancer-the UK NCRN Pomi-T study. Prostate Cancer Prostatic Dis. 2014 Mar 11. doi: 10.1038/pcan.2014.6.
    17. 17. Kaseb AO, Chinnakannu K, Chen D, Sivanandam A, Tejwani S, Menon M, Dou QP, Reddy GP. Androgen receptor and E2F-1 targeted thymoquinone therapy for hormone-refractory prostate cancer. Cancer Res. 2007 Aug 15;67(16):7782–8.
    18. 18. Kumar AP, Sethi G, Tan KH. Thymoquinone: potential cure for inflammatory disorders and cancer. Biochem Pharmacol. 2012 Feb 15;83(4):443–51. doi: 10.1016/j.bcp.2011.09.029.
    19. 19. Rajput S, Kumar BN, Sarkar S, Das S, Azab B, Santhekadur PK, Das SK, Emdad L, Sarkar D, Fisher PB, Mandal M. Targeted apoptotic effects of thymoquinone and tamoxifen on XIAP mediated Akt regulation in breast cancer. PLoS One. 2013 Apr 17;8(4):e61342. doi: 10.1371/journal.pone.0061342.
    20. 20. Palevitch D., Earon G., Levin I., Treatment of benign prostatic hypertrophy with Opuntia ficus-indica (L.) Miller. Journal of herbs, spices & medicinal plants. J. herbs spices med. plants 1993;2(1):45–49.
    21. 21. http://cleanmachineonline.com/science/how-it-works/ drawing upon Jonas A, Rosenblat G, Krapf D, Bitterman W, Earon G, Neeman I. Efficacy of cactus flowers miller treatment in benign prostatic hyperplasia due to inhibition of 5a reductase activity, aromatase activity and lipid peroxidation. HerbaMed paper; undated. Available at: http://www.herbamed.com/Portals/0/articles/Opuntia.pdf.
    22. 22. Park SY, Murphy SP, Wilkens LR, Stram DO, Henderson BE, Kolonel LN. Calcium, vitamin D, and dairy product intake and prostate cancer risk: the Multiethnic Cohort Study. Am J Epidemiol. 2007 Dec 1;166(11):1259–69.
    23. 23. Chang CC, Ho SC, Chiu HF, Yang CY. Statins increase the risk of prostate cancer: a population-based case-control study. Prostate. 2011 Dec;71(16):1818–24. doi: 10.1002/pros.21401.
    24. 24. Margel D, Fleshner NE. Oral contraceptive use is associated with prostate cancer: an ecological study. BMJ Open. 2011 Nov 14;1(2):e000311. doi:10.1136/bmjopen–2011–000311.
  • Endocrinologists have known for a long time that testosterone increases the body’s ratio of lean muscle mass to fat. In both animals and humans, tongkat ali extract increases muscle mass. In a study of men, half of the subjects ingested tongkat ali extract and half did not. In an eight-week physical training program the men who consumed tongkat ali extract experienced greater gains in muscle mass and strength than those who did not. This demonstrates the powerful anabolic properties of tongkat ali. Instead of turning to the use of dangerous and potentially lethal steroids, perhaps more athletes will opt for tongkat ali. In Malaysia, many professional field hockey players use tongkat ali extract as an androgen and swear to its performance-enhancing effects.

    The Extract Secret
    Dr. Johari has solved a problem with tongkat ali extraction: “One of the things we found is that when organic solvents are used to extract tongkat ali, you get a number of toxic compounds, especially the quassinoids, in the extract.” To get around this problem, Dr. Johari began to experiment with a water extract. Using water, pressure, a very specific range of temperature and freeze drying, he was able to develop a proprietary tongkat ali extract with a very low quassinoid level and high amounts of the active glycoproteins. That extract has been used in all the animal and human studies that have been conducted on tongkat ali. In the United States, Dr. Johari’s proprietary tongkat ali extract goes by the name LJ100. I asked him how much LJ100 tongkat ali extract people should take. “We have found that men need about 100 mg (milligrams) of extract per day, while women need about 50 mg,” he said.

    Tongkat Ali and Sexuality
    Dr. Ismail Tamby directs the Human Reproduction Specialist Center in the Malaysian capital of Kuala Lumpur. Dr. Tamby is one of the foremost experts on reproductive health in Southeast Asia. He works with men and women in all cases of sexual dysfunction, reproductive disorders and fertility problems. He is also the leading medical expert on the effects of tongkat ali root extract on human subjects. In his work with men, Dr. Tamby has found that use of tongkat ali extract significantly increases testosterone production. He said, “I was very skeptical at first about this type of thing, using some plant to change hormone levels. But I did some work with it and tongkat ali turned out to be highly potent. In our studies, we found that tongkat ali extract increased the serum level of testosterone considerably.” I asked Dr. Tamby if the men in his study experienced renewed sexual vitality or heightened sexual desire. “Oh, yes, most definitely,” he said. “The men found that tongkat ali boosted their sex drive quite a lot. I think that for low libido, tongkat ali extract is very valuable. I have seen this result for myself and can say that this plant really works.”

    Dr. Tamby conducted the PADAM study in which he investigated partial androgen deficiency in males. He selected 30 adult males of various ages, assessed their testosterone levels and then gave them 100 mg of tongkat ali extract daily. The testosterone levels of all the subjects rose, from somewhat to a lot, depending on age. Dr. Tamby’s study resulted in a 91 percent improvement in libido, a reported 73 percent improvement in sexual function and an 82 percent psychological improvement relative to sex among the men who participated in the study. His work shows that while the level of testosterone in the blood decreases with age, tongkat ali can reelevate the level of this important sex hormone.

    Using Tongkat Ali
    Dr. Johari, Dr. Tamby and other experts involved with this plant recommend around 100 milligrams of FDAE (freeze-dried aqueous extract, or LJ100) tongkat ali daily for men, and around 50 milligrams for women, to boost testosterone, enhance sexual function, increase ATP production and improve lean muscle mass.

    Though tongkat ali extract is by no means a cure-all, it does offer a solution to some of the vexing problems of aging. Demonstrating a high level of safety, tongkat ali delivers youth-enhancing effects. For this reason, its increased use in dietary supplements seems guaranteed.

  • Thanks to a combination of new advances into natural remedies and a veritable treasure trove of time-tested information, it is more possible than ever to preserve and improve your health through holistic means. The growing popularity of such products can be witnessed both in the proliferation of the specialty stores that carry them and their emergence on the shelves of more traditional retailers. More importantly, this isn’t due to any hidden financial agenda, as these products lack the backing of the big pharmaceutical corporations that have made so many pills and powders household names. Instead, a handful of the natural remedies are gaining steam for one simple reason: they work. When taken properly, natural supplements can offer all the benefits of their synthetic counterparts without the considerable drawbacks of side effects, making them an essential part of one’s day-to-day wellness regiment.

    While there are all-natural supplements and nutrients suggested for the treatment of every ailment from the flu to foot fungus, here are a few that are particularly relevant to those going through the male aging syndrome—associated with declining testosterone levels—known as Andropause (Male Menopause) or what I like to call; the Beer Belly Blues.

    Testosterone-Supporting Nutrients

    Just in case you haven’t heard (or read any of my books), testosterone is good—very good in fact. It helps regulate a number of our vital functions and its natural tendency to diminish along with aging is what ushers in the Beer Belly Blues. Therefore, maintenance of testosterone levels is absolutely a priority, especially when it can be done through healthy, natural and research-proven means. Following are some of my favorite nutrients to help support optimal testosterone levels.

    Peruvian Maca—Found high in the Andes mountain range in Peru, Lepidium meyenii is a perennial root vegetable with a number of medicinal properties.1 Similar to a radish or turnip, maca has seen over 2,000 years of use dating back to the indigenous people of the area, who employed it as a foodstuff, a form of currency, and an aphrodisiac.2 While still used for the first purpose (much less so for the second), maca remains even more relevant to the third, especially in terms of this article.

    While maca has yet to be tied directly to the increased production of testosterone, its unique combination of nutrients are thought to have an overall salutary effect on the endocrine system, thus allowing for the optimization of its functions.3 Maca seems to work by enhancing the overall message of the body’s hormones—yes, including testosterone —through a better binding of the hormone to its receptor4, thus causing an amplification of the overall hormonal response (kind of like turning up the volume on your headphones).

    Chrysin (with Bioperine)—Unfortunately, as men age they become very efficient—too efficient in fact—at converting their testosterone to estrogen. This happens when belly fat increases, as belly fat manufactures a nasty enzyme called aromatase, which is responsible for synthesizing estrogen from testosterone (think “man boobs”). Yes, aromatase is a very, very bad thing (at least when left unchecked). Fortunately, chrysin is around to help prevent a future in which we need to choose a t-shirt based on how well it accentuates our cleavage. It is a naturally-occurring flavoring agent found in both blue passion flower and honeycomb, and is popular with those undergoing rigorous strength training (such as athletes or bodybuilders) for its renowned ability to keep aromatase levels (as well as our cup sizes) in check.5

    While research has found that there may be difficulty in absorbing chrysin into the bloodstream, it has also found a natural way to improve results. Bioperine, a component of black pepper and long pepper, is thought to help the body in deriving the maximum benefit possible from chrysin when the two are taken together. It does so by slowing down the process of metabolism, thereby enhancing the bioavailability of certain substances, including the active agents in chrysin.6

    Stinging Nettle Root—The medicinal use of stinging nettle root can be traced all the way back to the 10th century, when it was included in a pagan manual called the Nine Herbs Charm. Since then, stinging nettle root (and leaf) has been used as a folk remedy for a maladies such as rheumatism, arthritis7, and dandruff. It has also been researched as a potential tool in the treatment of benign prostatic hyperplasia (BPH)8, the overgrowth of the prostate gland which leads to uncomfortable experiences like getting up way too many times in the middle of the night to pee (on the seat of course).

    Stinging nettle root is also taken by those wishing to increase their levels of free testosterone. It works by preemptively occupying the binding sites of a protein that binds to testosterone called sex hormone binding globulin or SHBG.9

    Indole 3 Carbinol (I3C)—I3C is the by-product of the breakdown of glucosinolate glucobrassicin, a nutrient found in high concentrations in the leafy green cruciferous plants such as cabbage, bok choy, and broccoli. It has been noted for its ability to convert estrogens from a form particularly problematic to those in the midst of the Beer Belly Blues (16-alpha hydroxyestrone)10 into other harmless ones.11 By this virtue it also helps protect our valuable testosterone levels.

    Bioavailable Zinc—According to the Journal of Nutrition, zinc is considered a nutrient of “exceptional biologic and public health importance.” An essential mineral, zinc deficiency affects an estimated two billion people worldwide, especially those in developing nations, and can result in stunted growth and fertility problems.12 While it can also be fatally poisonous in excess, zinc taken in the proper amount can prove vital in ensuring both testosterone and prostate health.

    Studies show that zinc is essential for the maintenance of healthy testosterone levels and men who have low levels of this master mineral usually find their testosterone lowering along with it.13 Aside from this, it is currently being researched for its astounding ability to target and kill prostate cancer cells.

    Conclusion—Although the nutrients listed above have been validated both through studies and anecdotal reports, it is important to understand that not all products on the market contain the right extracts or dosages of each one. Aside from this, dosages may vary depending on each individual case, so speaking to a naturally trained health professional can help determine which ones and what dosages are best for you. Having said this, there are also products available that contain synergistic blends of these nutrients, which could end up saving you big money in the long run—please visit www.UltimateMaleSolution.com for more info on these. Finally, properly designed libido-enhancing supplements take time to work—sometimes up to one month—so be patient and enjoy the results!

    Referencess:
    1. Kilham C. Tales from the Medicine Trail: Tracking Down the Health Secrets of Shamans, Herbalists, Mystics, Yogis, and Other Healers. [Emmaus PA]: Rodale Press (2000).
    2. Gonzales GF, et al. “Lepidium meyenii (Maca): a plant from the highlands of Peru—from tradition to science.” Forsch Komplementmed 16 (6):373–80.
    3. Gonzales GF, et al. “Effect of Lepidium meyenii (maca) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men.” Andrologia (2002) 34 (6): 367–72.
    4. Gonzales GF, et al. “Effect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing properties, on serum reproductive hormone levels in adult healthy men.” J Endocrinol. (Jan 2003) 176 (1): 163–8.
    5. Kellis JT Jr, Vickery LE. “Inhibition of human estrogen synthetase (aromatase) by flavones.” Science (1984) 225 (4666): 1032–4.
    6. Majeed, M. Use of piperine as a bioavailability enhancer. US Patent 5744161
    7. Teucher T, et al. Cytokine secretion in whole blood of healthy subjects following oral administration of Urtica dioica L. plant extract. Arzneimittelforschung 1996 Sep;46(9):906–10
    8. Afarinejad MR. Urtica dioica for treatment of benign prostatic hyperplasia: a prospective, randomized, double-blind, placebo-controlled, crossover study. J Herb Pharmacother. 2005;5(4):1-11.
    9. Schöttner M, et al. Interaction of lignans with human sex hormone binding globulin (SHBG). Z Naturforsch [C]. 1997 Nov/Dec;52(11–12):834–43
    10. Lila M.A., Raskin I. 2005. Health related interactions of phytochemicals. J. Food Sci. 70: 20-37.
    11. Rogan E.G. 2006. The natural chemopreventive compound indole-3-carbinol: state of science. In vivo 20: 221–228. PMID: 16634522
    12. Zinc deficiency: Has been known of for 40 years but ignored by global health organisations.” British Medical Journal 326 (7386): 409–10.
    13. Ambridge, K. M. and Krebs, N. F. “Zinc deficiency: a special challenge.” J. Nutr. (2007) 137 (4): 1101–5
  • Hormones play an integral role in the way we look, feel, and perform from day to day. The premiere sex hormone testosterone is important for men, but it also plays an important role for a woman-especially a woman's healthy interest in sex.

    Testosterone has been called the "hormone of desire" for good reason. Without enough testosterone, desire for sex all but disappears. Testosterone plays a major role in almost all aspects of sexual health in both genders (low testosterone levels are implicated in many cases of erectile dysfunction—not exactly something you ladies need to worry about). But testosterone is required for a lot more than just a good time.

    Men produce testosterone mostly within their testicles with less then 5 percent produced in their adrenal glands, whereas women produce testosterone primarily from their ovaries (before menopause) and their adrenal glands. On average, women produce about one tenth the testosterone levels as men. Even though women produce a pinch of the amount a man produces, this hormone is still required for the same reasons:

    • increased metabolism-more energy, less body fat
    • increased lean body mass-especially muscle and bone
    • healthy sexual function-libido
    • healthy mind set-better moods

    No more headaches
    Studies have confirmed that testosterone is the primary hormonal message behind a woman's (and man's) sex drive. It is well accepted that most women after menopause experience a less than adequate sex drive, commonly referred to as female sexual dysfunction, or FSD. This condition can often be due to lowered testosterone levels-especially lower levels of free testosterone (the most biologically active testosterone). Most of your testosterone is bound to a special carrier protein called a sex hormone-binding globulin, or SHBG. It is only the "free" or unbound testosterone that can exert its wonders on your biochemistry.

    Many doctors now prescribe testosterone treatment-along with other hormones (hormone replacement therapy or HRT, preferably as bioidentical hormones)-for women suffering from FSD, with great success. In fact, at least 20 percent of all testosterone prescriptions are written for women.

    Swedish researchers recently published a study showing that testosterone gel given to postmenopausal women with low libido had positive effects on several aspects of sexual life such as frequency of sexual activity, orgasm, arousal, fantasies, and sexual interest.

    Israeli researchers discovered that women suffering from loss of sexual desire may not have to consume testosterone on a regular basis in order to benefit from its powerful libido-enhancing effects. The study, which appeared in the Journal of Sexual Medicine in January 2007, showed that women who used a specially prepared testosterone gel experienced increased genital sensations and sexual lust three to four hours afterward. The researchers concluded that this may be a safer way to administer testosterone in women suffering from chronic low libido.

    Raising testosterone levels the natural way
    Now that you are a little more in touch with the importance of maintaining healthy testosterone levels through age, following are a few more testosterone tips for women:

    • Exercise-especially weight-bearing exercise. Regular exercise has been documented to increase free testosterone and maintain lean body mass.
    • Lose the fat-excess body fat may interfere with healthy testosterone levels.
    • Reduce stress-stress enhances the hormone cortisol, which reduces testosterone.
    • Try supplementing with a Southeast Asian herb called tongkat ali (Eurycoma longifolia). The Asian Congress of Sexology published a paper in 2002 touting the incredible aphrodisiac and testosterone-boosting powers of this amazing herb.

    A healthy sex life is indicative of good health. The good news is that you now know it is possible to maintain a healthy supply of testosterone at any age.

    Burning fat with testosterone
    A major frustration for women is that most men can control their weight more easily and can even lose more weight when following the same weight loss program. A large part of this metabolic advantage can be found in the extra 30 to 40 pounds of muscle a man's body carries. This extra muscle helps men burn up to 30 percent more calories than women-exercising or sleeping-and it can be attributed largely to the extra testosterone a man produces.

    References
    1. Travison TG, et al. The relationship between libido and testosterone levels in aging men. J Clin Endocrinol Metab. 2006 Jul;91(7):2509-13. Epub 2006 May 2.
    2. Guay AT, Jacobson J. Decreased free testosterone and dehydroepiandrosterone-sulfate (DHEA-S) levels in women with decreased libido. J Sex Marital Ther. 2002;28 Suppl 1:129-42.
    3. Nathorst-Boos J, et al. Treatment with percutanous testosterone gel in postmenopausal women with decreased libido--effects on sexuality and psychological general well-being. Maturitas. 2006 Jan 10;53(1):11-8.
    4. Chudakov B, et al. Transdermal testosterone gel prn application for hypoactive sexual desire disorder in premenopausal women: a controlled pilot study of the effects on the arizona sexual experiences scale for females and sexual function questionnaire. J Sex Med. 2007 Jan;4(1):204-8.
    5. Vogel RB, et al. Increase of free and total testosterone during submaximal exercise in normal males. Med Sci Sports Exerc. 1985 Feb;17(1):119-23.
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