Posts Tagged ‘aromatase’

How To Raise Your Testosterone, Naturally

September 3, 2016

Andrew Siegel MD  9/3/2016

17373-men-and-women-performing-aerobic-exercises-pv

(CDC/Amanda Mills from Public Health Image Library)

Two weeks ago, my entry was about the medication Clomid–a nice alternative to testosterone replacement therapy. What about a non-pharmacological, natural approach to raising testosterone levels?

Testosterone (T) is produced mostly in the testes, although the adrenal glands also manufacture a small amount. T has a critical role in male development and physical characteristics. It promotes tissue growth via protein synthesis, having “anabolic” effects including building of muscle mass, bone mass and strength, and “androgenic” (masculinizing) effects at the time of puberty. With the T surge at puberty many changes occur: penis enlargement; development of an interest in sex; increased frequency of erections; pubic, axillary, facial, chest and leg hair; decrease in body fat and increase in muscle and bone mass, growth and strength; deepened voice and prominence of the Adam’s apple; occurrence of fertility; and bone and cartilage changes including growth of jaw, brow, chin, nose and ears and transition from “cute” baby face to “angular” adult face. Throughout adulthood, T helps maintain libido, masculinity, sexuality, and youthful vigor and vitality. Additionally, T contributes to mood, red blood cell count, energy, and general “mojo.”

The amount of T made is regulated by the hypothalamus-pituitary-testicular axis, which acts like a thermostat to regulate the levels of T. Healthy men produce 6-8 mg testosterone daily, in a rhythmic pattern with a peak in the early morning and a lag in the later afternoon.  Low T levels can be low based upon testicular problems or hypothalamus/pituitary problems, although the problem most commonly is due to the aging testicle’s inability to manufacture sufficient levels of T. T levels gradually decline—approximately a 1% decline each year after age 30—sometimes giving rise to symptoms. These symptoms may include the following: fatigue; irritability; decreased cognitive abilities; depression; decreased libido; ED; ejaculatory dysfunction; decreased energy and sense of well-being; loss of muscle and bone mass; increased body fat; and abnormal lipid profile. A simple way to think about the effect of low T is that it accelerates the aging process.

Lifestyle factors are strongly associated with variations in testosterone (T) levels, with healthy lifestyles correlating with higher levels of T and unhealthy lifestyles with lower levels.  Some physicians regard T level as a laboratory marker of male physical health.

One of the key factors responsible for some of the decline in T that accompanies aging is excessive body fat. In fact, there is an inverse relationship between obesity and T levels, with increased body mass index (BMI) correlating with decreased T.

Factoid: Every 5-point increase in BMI translates to a 10% dip in T–an equivalent decline as would typically occur with 10 years of aging.

Fatty tissue – particularly visceral abdominal fat (the “beer belly”) – contains an abundance of metabolically active factors and hormones including aromatase, an enzyme which functions to convert T to the female sex hormone estrogen. Men with large bellies consequently are often found to have lower T levels and higher estrogen levels, which can result in “emasculation” with loss of sex drive, diminished erections, the disturbing loss of penile length and the presence of gynecomastia (man boobs)

Factoid: In addition to the decline in T, for every 35 lb. weight gain there is a 1-inch loss in apparent penile length because of the pubic fat pad that hides the penis.  

The good news is that weight loss will increase T levels and is capable of improving all of the aforementioned signs and symptoms. This has been demonstrated with all means of  weight loss, ranging from caloric restriction to bariatric surgery.

Another important lifestyle factor associated with variations in T levels is the extent of one’s physical fitness. Exercise is clearly associated with higher T levels. The degree of potential increase in T is related to both the quantity and quality of exercise. In general, the more time invested in moderate intensity exercise, the greater the increase in T.  As important as aerobic exercise is for health, resistance exercise is superior in terms of increasing T.

Bottom Line:  To optimize your T level, maintain a healthy weight and engage in an exercise program emphasizing resistance training.  If you are obese and sedentary, it is likely that you have low T, a situation that can be reversed with a modification to a healthier lifestyle. 

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health– and MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health available on Amazon Kindle, Apple iBooks, B&N Nook and Kobo; paperback edition available at TheKegelFix.com

Author page on Amazon: http://www.amazon.com/Andrew-Siegel/e/B004W7IM48

Apple iBook: https://itunes.apple.com/us/book/the-kegel-fix/id1105198755?mt=11

Trailer for The Kegel Fix: https://www.youtube.com/watch?v=uHZxoiQb1Cc 

Co-creator of the comprehensive, interactive, FDA-registered Private Gym/PelvicRx, a male pelvic floor muscle training program built upon the foundational work of renowned Dr. Arnold Kegel. The program empowers men to increase their pelvic floor muscle strength, tone, and endurance. Combining the proven effectiveness of Kegel exercises with the use of resistance weights, this program helps to improve sexual function and to prevent urinary incontinence: www.PrivateGym.com or Amazon.  

In the works is the female PelvicRx DVD pelvic floor muscle training for women.

Pelvic Rx can be obtained at http://www.UrologyHealthStore.com, an online store home to quality urology products for men and women. Use promo code “UROLOGY10” at checkout for 10% discount. 

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Fat: Location, Location, Location Matters

September 14, 2012

Andrew Siegel, M.D.     Blog #74

 

We all have body fat; even elite athletes have a body composition that is a svelte 5-10% fat—this translates into roughly 10-20 pounds of fat for a 180-pound athlete.  What is important is that all fat is not created equal—where the fat accumulates in our bodies dramatically effects how that fat behaves.  So, the very location where your fat takes up residence has a tremendous influence on your health.

Fat on our body surface is much less problematic than fat deep within our body. Humans have two basic types of fat: subcutaneous fat and visceral fat. Subcutaneous fat—also known as “love handles,” “spare tires,” “muffin tops,” or “middle-age spread”—is present between the skin and the abdominal wall. When present in normal amounts, it gives us nice contours and makes us look less bony and skeletal and more smooth and curvy. When present in excessive amounts, it makes us look plump, roly-poly and pear-shaped. A moderate amount of subcutaneous fat is of little danger to our health and, in fact, provides us numerous advantages including padding and insulation to conserve heat and help with temperature regulation, a means of storage of fat-soluble vitamins, and a ready source of energy. Visceral fat—also referred to as a “pot belly,” “beer belly,” or “Buddha belly”—is internal fat deep within the abdominal cavity that can make us apple-shaped.  It wraps around our internal organs including our liver, kidneys, and pancreas. Visceral fat is always unhealthy fat that can have dire metabolic consequences. In general, waist circumference is a reasonably good measure of visceral fat. (Of course, morbid obesity due to either type of fat can prove extremely  dangerous to one’s health.)

It’s kind of like real estate, the value of which is predicated on location, location, location. Think of visceral fat as prime, expensive beachfront property on the gold coast with a short walk to the ocean, the ocean of metabolic disasters.  Think of subcutaneous fat as less expensive, inland property, quite removed from this ocean of metabolic disasters.  Clearly, visceral fat is fat that behaves badly and fat that is strongly desirable to avoid.

In many ways, the distinction between subcutaneous and visceral fat parallels the distinction between good fats and bad fats in our diet.    The not unhealthy one or two inches of subcutaneous fat that you can pinch around your waistline can be thought of as a good fat such as the fat in olive oil, avocados, or nuts.   On the other hand, the unhealthy visceral fat that causes a man to have a big protuberant abdomen—creating an appearance not unlike a very pregnant female—can be thought of as bad fats such as the partially hydrogenated fats present in vegetable shortening that are commonly used in fast foods and other processed baked goods.

Visceral fat storage is not static but dynamic, meaning that there is continuous mobilization of our fat (as fatty acids) and storage (as triglycerides).  Lipolysis is the chemical reaction in which the fat is broken down into fatty acids that the body can use as energy. This can occur very readily in visceral fat. Likewise, accumulation of visceral fat can occur in a very rapid fashion. Excessive intake of calories will be rapidly stored as visceral fat, whereas under circumstances of a reduced calorie intake, the visceral fat is broken down to provide fuel for our bodies’ metabolic processes, particularly muscle contraction.

Visceral fat is not just a bland collection of fatty tissue sitting inertly within your belly causing an oversized appearance to your abdomen.  It is an extremely metabolically active endocrine organ with a life of its own.  Fat is the largest endocrine organ in our bodies and it releases a myriad of pro-inflammatory factors, hormones and immune cells that can affect metabolism and other bodily functions. Fat has an abundance of the hormone aromatase, which converts testosterone to the female hormone estrogen.  One consequence of too much fat in men is excessive conversion of testosterone to estrogen. Men with plentiful visceral fat often will bear the consequences of lower testosterone and higher estrogen levels, including sexual issues and breast development as well as numerous other negative consequences of insufficient levels of testosterone.

Visceral fat is intimately connected to the inflammatory process and can result in insulin resistance, metabolic syndrome, cardiovascular disease and an entire array of negative health ramifications, including chronic diseases such as arthritis and cancer.  This is in contradistinction to subcutaneous fat, which produces far less inflammatory chemicals. Since men have a tendency towards visceral fat collection whereas women have a tendency towards subcutaneous fat collection, this might explain why women are less susceptible to cardiovascular disease then men are.

Insulin is the principal regulator of fat metabolism. After a sugar and carbohydrate load, insulin is released to get the fuel into our cells. When we go without food, as happens when we sleep, insulin levels decrease and fat is released to be used as fuel.  Insulin levels are determined primarily in response to our carbohydrate intake in order to keep our blood sugar regulated. Insulin has much to do with the way our bodies store or burn fat. You can think of insulin as our fat hormone—when insulin levels are elevated, we accumulate fat; when levels are low, we burn fat for fuel.  So if you have a substantial collection of visceral fat, it becomes highly desirable to reduce sugar and refined carbohydrate intake to decrease insulin and burn away that bad, pro-inflammatory fat as fuel. The good news is that by losing abdominal fat, the potentially bad health repercussions can be reversed. The dangerous visceral fat submits relatively easily to diet and exercise whereas the less harmful subcutaneous fat at the waist is more stubborn and resistant to reversal measures.

How To Burn Fat:

  • Eat in accordance with nature’s design—meaning whole foods.  Avoid processed foods.  The best diet is an “anti-processed-atarian” diet.
  • Avoid “naked” calories (stripped of fiber), so restrict sugar, simple white carbohydrates, and liquid calories. Specifically avoidsugared drinks, white pasta, white rice, white bread, doughnuts, bagels, potatoes, etc.  Aggressively steer clear of high fructose corn syrup.
  •  Eat high-quality, whole-grain, high-fiber carbohydrates (whole grain pasta, brown rice, whole grain breads, legumes, whole fruits and vegetables), lean protein sources (easy on meat and dairy) and healthy fats (vegetable and seafood-origin).
  • Avoid giant meals in which the caloric load will be stored as fat; substitute with multiple smaller meals in which the calories will be used for immediate energy.
  • Limit after dinner snacking since unnecessary calories at a time of minimal physical activity will be stored as fat.
  • You must incorporate exercise into your lifestyle, achieving balance between aerobic, resistance and core workouts.  Aerobic exercise has great potential in burning fat for fuel and interval training seems to really rev up our fat-burning capabilities.
  • Portion control is the name of the game: in order to burn fat, energy intake must be less than energy output.  Even if you eat only the healthiest of foods, if calories in exceed calories out, you will not burn fat for fuel.
  • Minimize stress; if you can’t eliminate it, work to manage it.
  • Get adequate amounts of quality sleep.  See my previous blog entitled “Sleep To Slim” to find details: https://healthdoc13.wordpress.com/2012/07/20/sleep-to-slim/

The bottom line is that while body fat in any excessive amount is unhealthy and unattractive, it becomes a potentially life-threatening issue depending on its location in our bodies.  An enormously protuberant belly can lead to processes that result in disease—and even death.

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

www.PromiscuousEating.com

Now available on Amazon Kindle

 

Man-Oh-Pause: When Things Are Not So Good Under The Hood

September 1, 2012

Blog #73     Andrew Siegel, M.D.

 

“T”  (an abbreviation for testosterone) has become a very commonly used and in vogue term. Many of my patients come into the office specifically asking for their T levels to be checked.  The pharmaceutical industry has been responsible for direct-to-consumer advertising of testosterone replacement products, a practice that has promoted this recent grass-roots awareness of testosterone issues, a subject that was previously the domain of urologists and endocrinologists.

T is that all-important male hormone that goes way beyond male sexuality.  Testosterone has moved to the endocrine vanguard and is now regarded as a key factor in men’s health. Current evidence suggests that a man’s testosterone level might serve a function as a good indicator/marker of general male health.

Aside for contributing to libido, masculinity and sexual function, T is responsible for the physical changes that commence at the time of puberty, including pubic, axillary and facial hair, deepening voice, prominent Adam’s apple and increased bone and muscle mass.  Additionally, T contributes to our mood, bone and muscle strength, red blood cell count, energy, and general mojo.  Most testosterone is manufactured in the testicles, although a small percentage is made by the adrenal glands.

There is a gradual decline in T that occurs with the aging process—approximately a 1% decline each year after age 30.  This will occur in most men, but will not always be symptomatic.  40% of American men aged 45 or older have low or low range T.  Low T is associated with metabolic syndrome and diabetes, bone mineral loss, and altered sexual function.  Specifically, symptoms of low T may include one or more of the following:  fatigue; irritability; depression; decreased libido; erectile dysfunction; impaired orgasmic function; decreased energy and sense of well-being; loss of muscle and bone mass; increased body fat; abnormal lipid profiles. Essentially, low T can accelerate the aging process.

Belly fat is literally the enemy of masculinity and a testosterone-choker that can push you in the direction of the female gender.  Perhaps when you are standing naked in the shower and you gaze down towards your feet, all you see is the protuberant roundness of your large midriff, obscuring the sight of your manhood.  Perhaps you’re wondering where your penis is hiding.  In most cases, the abundant pubic fat pad that occurs coincident with weight gain obscures the penis—the “turtle effect.”  If your belly blocks your view of your penis, your pubic fat pad makes your penis difficult to locate, your breasts have filled out, and your libido and erections are sub-par, it may just really be time to rethink your lifestyle habits!

Abdominal obesity—an accumulation of fat in our midsections—not only is unattractive from a cosmetic standpoint, but can have dire metabolic consequences that can affect the quality and quantity of our lives. Obesity has a pivotal role in the process leading to low T and waist circumference is a reasonable proxy for low T. Fat is not just fat—it is a metabolically active endocrine organ that does way more than just protrude from our abdomens.  Fat has an abundance of the hormone aromatase, which functions to convert T to the female sex hormone estrogen (E).  The consequence of too much conversion of T to E is the potential for gynecomastia, aka man boobs.  Too much E slows T production, and with less T, more abdominal obesity occurs and even more E is made, a vicious cycle (literally a vicious circus) of male castration and emasculation.

Obesity can steal away your masculinity, male athletic form and body composition, mojo, strength, and also one of your most precious resources—the ability to obtain and maintain a good quality erection.  Remember the days when you could achieve a majestic, heaven-pointing erection simply by seeing an attractive woman or thinking some vague sexual thought?  Chances were that you were young, physically active, and had a svelte build with a hard abdomen. If those days are mere memories, it is probable that you are now carrying extra pounds, have a soft and protuberant belly, and are not physically active.  When you’re soft in the middle, the consequence is that you will probably be soft down below. The good news is that by losing the abdominal fat, the unfortunate consequences of low T can often be reversed.

How To Turn On Your Testosterone Boosters: 

  • A healthy lifestyle, including good eating habits, maintaining a healthy weight, engaging in exercise, obtaining adequate sleep, moderation with respect to alcohol intake, avoiding tobacco, and stress reduction are the initial approaches to treating low T engendered by abdominal obesity.  Insufficient sleep can lower T.  Excessive alcohol increases the conversion of T to E.  Maintaining an active sex life can help maintain T.
  • It is of paramount importance to lose the abdominal fat, with the caveat that a sufficient caloric intake of quality food and nutrients is necessary to prevent the body going into “starvation mode,” which can substantially decrease T production.
  • In terms of exercise, a healthy balance of aerobic, resistance, and core training is best, but in particular, vigorous resistance exercise is crucial.  This will help the flabby abdomen disappear and build lean muscle mass, which in turn will increase metabolic rate.

If lifestyle modification fails to improve the symptoms of low T and T remains measurably low via a simple blood test, a trial of T replacement under the supervision of your doctor can provide a meaningful improvement of your quality of life.

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

www.PromiscuousEating.com

Available on Amazon/Amazon Kindle: http://www.amazon.com/Promiscuous-Eating-Understanding-Self-Destructive-ebook/dp/B004VS9AC6

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Male Obesity Causes Low Testosterone With Potentially Dire Medical Consequences

July 30, 2011

Testosterone (T) is an important male sexual hormone that promotes the physical changes that commence at the time of puberty including pubic, axillary and facial hair, deepening voice, prominent Adam’s apple and increased bone and muscle mass.  Throughout adulthood, testosterone helps maintain libido, masculinity, sexuality, and youthful vigor and vitality.  The lion’s share of testosterone is manufactured in the testicles, although a small percentage is made by the adrenal glands.

There is a gradual decline in T that occurs with the aging process—approximately a 1% decrease each year after age 30. The decline will occur in most men, but will not always be symptomatic. Symptoms of low T may include one or more of the following:  fatigue, irritability, depression, decreased libido, erectile dysfunction, ejaculatory dysfunction, decreased energy and sense of well-being, loss of muscle and bone mass, increased body fat, abnormal lipid profiles. Essentially, low T can accelerate the aging process.

Obesity can have a pivotal role in the process leading to low T. Fat is not just fat—it is a metabolically active endocrine organ that does not just protrude from our abdomens in an inert state.  Fat produces pro-inflammatory factors, hormones and immune cells—including cytokines—which function to inhibit T production in the testicles and the release of hypothalamus and pituitary hormones that govern the release of T.  Low T is present in about half of obese men.   Fat has an abundance of the hormone aromatase, which functions to convert T to the female hormone estrogen (E).  The consequence of too much conversion of T to E is the potential for gynecomastia, aka breast enlargement or alternatively, man boobs.

There is a strong relationship between low T and metabolic syndrome.  Metabolic Syndrome is defined as having three or more of the following: high blood glucose levels; abdominal obesity; high fats (triglycerides); low levels of the “good” cholesterol (HDL); and high blood pressure. If we have a substantial amount of belly fat, then by definition we have insulin-resistance, a condition in which our pancreas works overtime in order to make more and more insulin to get glucose into our cells.  This is a precursor to diabetes, cardiovascular disease and all the havoc they can wreak.  Those with metabolic syndrome have a much-increased risk of cardiovascular disease and type 2 diabetes.

Bottom line:  Abdominal obesity—an accumulation of fat in our midsections—not only is unattractive from a cosmetic standpoint, but can have dire metabolic consequences that can unequivocally affect the quality and quantity of our lives. Obesity in males often promotes low levels of the all-important male hormone testosterone, which can have a number of detrimental effects on our sexuality, bone and muscle health, energy, well-being, etc.  The good news is that by losing the abdominal fat, all of the potentially bad consequences can be reversed.

Andrew Siegel, M.D.

http://www.PromiscuousEating.com for information on Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship With Food

http://www.youtube.com/incontinencedoc for educational videos on low T and a variety of other urological and wellness subjects