In Your Pants with Dr. Susie G - Guys Have Hormones Too!

Episode Date: November 17, 2017

Have you ever wondered why you get morning wood? Movember is Men's Health Month and what better way to celebrate than to talk about boners with my good friend and naturopathic physician Dr. Ralph Esposito. I just had to invite him back for a second episode to answer all your questions about testosterone, boners, and male fertility (yup, it takes 2 to make a baby guys). So, if you're looking to optimize your health and um, your erection selection, listen up 'cause this episode bares it all, literally, ha-ha! http://drsusieg.com/  

We've always had stressors, but I think our ability to manage that stress is much more compromised in today's age than 20, 30, 40 years ago. You're listening to In Your Pants with Dr. Suzy G, the physiotherapist for your private, helping you get in the know down below. Today, Suzy welcomes back to the show, Dr. Ralph Esposito. Dr. Esposito is a naturopathic physician, licensed acupuncturist, and functional medicine practitioner. Join us as they discuss the rarely talked about topic of men's hormones. Hey guys, it's Dr. Suzy G bringing you another In Your Pants episode. So I hope you're ready

to get in the know down below. So there's been a lot of talk about women and their hormones, but what about the guys? In today's show, I bring back naturopathic physician and men's health specialist, Dr. Ralph Esposito. I pick his brain about men's hormone cycles, testosterone, and fertility, and you guessed it, boners. Oh, come on. It's a show about what's going on in your pants. So I'm not going to beat around the bush anymore. Let's get the conversation started. Dr. Esposito, thank you so much for coming back on the show. Our last conversation about prostatitis was extremely helpful and I'm pretty sure put a lot of guys at ease about their pelvic pain. Yeah, my pleasure. You know, all of these topics are right down my alley. And it's just a

pleasure to be talking about them. And even more so with you, because we have the guy girl combo two perspectives. And I really think people are gonna like it, they're gonna get some help. And that's the bottom line, get help. That's right. That's right. So today's show is all about hormones. And honestly, I've been dying to pick your brain about guys and their hormone cycles, like do they exist you know we have our periods and we have cycles do men have the same thing right so this is a funny question and me and my guy friends we you know we joke sometimes it's like it's like man stop pmsing what is going on with you and the the women's cycles are uh monthly right you fluctuate you know in the beginning the first 14 days the last 14 days the men have

their hormonal cycle is actually daily. So it's cyclical throughout the day. And basically what I'm saying is testosterone levels, they can fluctuate depending on the time of day. And they impact the way a man can act, respond, his emotions, his libido, his drive, all of that can fluctuate throughout the day. And it's pretty funny because a lot of people will say, well, most of the time I wake up with a morning erection or morning wood. So does that mean that my testosterone is higher in the morning? But then I like to have sex at night. So is my testosterone highest at night? And yes and no. So there's different types of cycles that men might go through, but basically bottom line, and this has been debated, but typically testosterone

levels tend to be highest in the morning and then they cycle throughout the day so when should guys be making the best decisions or making assertive decisions throughout the day oh so it depends on what type of decision you're talking about right like let's say they have to be assertive at work or confront someone or talk to their boss you know sometimes those high pressure situations that we find ourselves in so what what what time of day is best for for a man to do that so there are some originally and traditionally in uh most endocrinologists and urologists most research would say that the testosterone levels are highest in the morning usually around uh seven to nine a.m sometimes uh maybe even 10 a.m that's when

they're at their peak and now we're talking by the way we're talking um ideal right and very rarely do i see ideal uh well i do see men whose testosterone levels are ideal but most of the time they're coming to see me because they're having the problem so i try to say yes your testosterone level should be high in the morning but that is not always the case because there's there could be a dysfunction but if you had to make if you had to pick a time where testosterone levels are going to be the highest where your drive is going to be the highest where your ability to make assertive decisions that would probably be in the morning around seven to nine or seven to 10 a.m. And I mean, look, if you have to make an important decision at 11 a.m.,

is that going to make a huge difference? I don't know. Don't freak out. Right. Exactly. Don't freak out. Like, oh, my God, I didn't tell my boss I'm quitting at 1030. I can't quit. And then, you know, it's not like that, but it typically testosterone levels will be highest in the morning. Now, this is where things get a little bit gray is that testosterone levels are highest in the morning because of basically LH and FSH. Those are two hormones that mostly LH, which is luteinizing hormone in men, is responsible for stimulating the testicles to make testosterone. And that typically is highest in the morning. But the hormone that then stimulates LH and FSH, so you have the hypothalamus, which will make something called GNRH. And then the

pituitary makes lh and fsh and then that tells the testicles to make testosterone i don't know why the body decided to make this all so complicated and cyclical but that's how it works and um and so testosterone typically is highest in the morning but interestingly gnrh gonadotropin releasing hoping uh releasing hormone actually fluctuates during the day so it goes up and down in cycles. So a lot of the times, I won't even test it because, number one, it's hard to test and find out, but GnRH fluctuates so frequently that that can have an impact as to when testosterone levels are going to be highest or lowest. So you can't even follow that number. You really need to try to follow FSH, LH, and then testosterone levels. So what could essentially impact

the production or the fluctuation of these hormones and the levels of testosterone? Tons of things. So if we're talking about environmental aspects, certainly there's environmental toxins that can impact the production of these hormones. And that is not to be taken lightly. But what I see most often is something called the cortisol steel. Have you heard of that? I have that sneaky little hormone. Yeah, exactly. I actually, this is very, very relevant and it's a theory, but it certainly does hold weight when you look at people clinically. So basically, to make testosterone, you need cholesterol, bottom line. Cholesterol is essential for making testosterone. Now, cholesterol is also

essential for making cortisol, which is, for your viewers who are not familiar, it's the stress hormone. That is most of the time anti, it has opposite effects of testosterone. Testosterone is responsible for building, for drive, for fat loss, for burning, for building muscle and burning fat. And cortisol typically does the opposite, increases blood sugar levels, increases stress hormones, increases fat deposition. So because testosterone and cortisol, now I'm making it very simple so there's a lot of other hormones that are involved but basically if testosterone and cortisol are both derived from the same source the body needs to decide okay which one do i make now in the morning cortisol levels should be highest and so should testosterone levels but now

if the body is overstressed it's going to say forget you i'm making cortisol because i need this anti-stress hormone which then becomes a stress hormone which then causes more problems so that's where cortisol will steal from testosterone and then cortisol levels increase and then testosterone levels drop that's what i see most commonly in my male patients so all that increased belly fat when when guys are trying to lose weight and getting there in the gym and their diets are great but their stress is a 10 out of 10 are you saying that cortisol is contributing to the problem yes most likely cortisol is going to be the biggest issue in that aspect now that creates another problem is because now you have guys are like

okay i need to go to the gym every day for an hour and a half lift as heavy and hard as i can and you know be the the super athlete that i think i am well great but not everybody is michael Phelps. Not everybody is. I mean, let's just be honest. We're not. And if you have, they live that lifestyle, you know, these CrossFit people and these bodybuilders, um, they live that life. Now that's great. If you want to live that life, make that your life, make that your job. But if you actually have a nine to five job, or you have a family and all these other things to take care of that is really kind of a hobby for you right so if you are then dealing with the lifestyle issues of work stress life stress family stress um eating stressors environmental stressors and

then you're going into the gym and working out for an hour and a half trying to burn more fat well you're actually doing the opposite and you can cause more stress on the body and then further exacerbate the issue and further drop your testosterone levels. One of the tips that I give men is weightlifting for increasing testosterone levels. And then I tell them that and they're in the gym six to seven days a week, weightlifting, you know, an hour and a half. And I'm like, Oh my God. Okay. Absolutely. 100%. And men need to realize that there is a balance between weightlifting and recovery and the biggest thing here and when i say recovery i don't just mean like recovery from not working out but recovery from the daily stressors of life like

sitting down having dinner and relaxing and putting your feet up and enjoying your meal with family or friends that's recovery right so a lot of men are not doing that and they end up basically burning the candle at both ends, testosterone levels drop, cortisol levels jump. And now they're basically sabotaging their metabolism and their, um, and their hormones. Right. Right. And so this brings me to my next question is all of this talk now in the news about infertility in men at a younger age. Yeah. Tell me, tell, tell me a little bit about that. So this is actually becoming a lot more of a bigger issue than we actually thought it was. And I started seeing this, even as a medical student, I started seeing this issue where a lot of men, younger age, you know, and I'm not saying young like 18, I'm saying, you know, 25 to 32, they're having issues with fertility.

and i questioned myself i said man you know why is this such uh such a common thing and then recently i would say i don't know maybe in the past month or two a study came out and said that the um the total sperm counts and like sperm concentrations are basically male fertility is dropping in um north america australia europe by about it's since 1973 or like the 1970s it's dropped by 50, 50, five, zero percent. You're kidding. Yes. And I'm trying to figure out like, what are we doing to ourselves that we're making our men infertile stress? Well, yeah, stress is the biggest, uh, culprit, right? But I don't think it's stress. I think it's, Oh yes, it is stress. But what is stress? Like if somebody tells you, you know, I'm stressed,

how do you how do you interpret that it's really hard to interpret like what kind of stress are you talking about like are you running from a tiger or or are you running from the bank or like what are you running from your credit card bills like what is it that you are considering stress and i think that we've always had stressors but i think our ability to manage that stress is completely uh or much more compromised in today's age than 20 30 40 years ago right because it's all about the stress response how you respond to the stressor right i mean some people think it's positive it's not bad for you they can handle it very well they know how to come down from a stressful day self-care is important right versus being on the go and completely

distracted right and and not giving your body recovery time like you mentioned earlier exactly right. So a lot of men are now, there's a lot, I mean, look, women have gained a significant increase in their responsibilities in the workforce. Women are, they're running things and they're doing really well at it, but it also puts more stress on men. Men have, I mean, I was just talking about this the other day and men have the, um, I was talking about it with some friends and they're like, yeah, man, I feel like I'm responsible for taking care of the family. and if my wife or my my girlfriend or my partner is uh making more money than me then i don't feel like as much of a man so that is a daily stressor that men are dealing with on a daily basis it's

just a societal uh stressor right you have to be the bread maker you have to be the one bringing in the money and then there's the other big issue in this i think is the environmental aspect And that's something that in the study that published this research, they said, and they clearly said, this decline in sperm count is really a sign that something's going on and we really need to pay attention because if not, this can become a very significant issue. And I think a lot of newspapers are like, are we on the way to extinction or men are becoming infertile and we're not going to be able to reproduce. Well, I mean, I don't know about that. fear mongering that's all yeah i mean i mean exactly but good for me because i could fix that right so if a meteor hit this earth and there was one or two men on this earth and that one man was infertile and i was on this earth i could probably help him out nice we we got this we're

going all right and then you can count on me because i know how to fix it too so hopefully i won't be infertile i mean i don't know i never did a sperm count but i think i'm okay you've got super sperm don't worry you practice what you preach i do i really do practice what i preach um i mean i can't say i've done a sperm count on me uh but i would say that my diet and my lifestyle really does um make me a good suitor is uh very good very good so what kind of environmental things are we talking about in terms of the sperm right so when you say lifestyle environmental i the one thing that comes to mind are pesticides pesticides and herbicides and whether we want to admit it or not roundup or glyphosate glyphosate however you want to call it

basically one of the most common pesticides in the agricultural business is very toxic and it's found in almost every non-organic food. It might even be found in some organic foods. I don't know because, you know, with cross-contamination and such, but this pesticide has been shown to literally kill sperm cells. This is in vitro. So it's not, you know, in humans, they're not testing it. And I would hope they wouldn't give men this stuff and see if it kills them, but it definitely is an environmental toxin and any environmental toxin, the sperm are very fragile. So kind of like how women are very, you know, women, I always hear, I do a lot of fertility work and like, no, I only have a certain amount of eggs or I did IVF and only 10 eggs came out.

So women are very protective of their eggs. Men have an unlimited supply of sperm. Women are stuck with a certain amount, but sperm are very fragile and they are very sensitive to a lot of environmental toxins. So we're talking, I mean, even as much as heat. So I do not recommend jacuzzis at all for men because that heat can cause a lot of pressure on their testicles and then their sperm can suffer as well. Another stressor are PCBs and those are an environmental toxin found in a lot of farmed fish and even freshwater fish. So that those themselves can be endocrine disruptors. What does that mean? Basically, your body identifies them as a hormone, whether it's estrogen or a pseudo-estrogen, and then they play tricks on your brain. So you

know how in the beginning we were talking about the hypothalamus to the pituitary to the testicles? Well, these PCBs and these environmental toxins then can interrupt and damage the way our brain normally functions and stimulating testosterone production. And that on its own can lead to fertility hormones as well, like FSH and LH, those can all be impacted. And now you have an issue with making healthy sperm, right? What about cell phones in the pocket? Yes, please, guys, just put your cell phone on the table in your bag. I mean, even your back pocket, don't don't even don't even put in your back pocket. You know, the research is a little bit mixed on that. And just from common sense, in my opinion, I don't want to wait 30 to 40 years for a study to come

out saying hey cell phones are bad for your sperm count exactly yeah there are some studies that are hinting that having your cell phone in your pocket can lead to fertility issues but that that's radiation there that is constant so we're not talking about you know sitting next living next to a power plant yeah obviously that's going to be bad for you but the the things that are most problematic are the things that occur every day at a low level, which then continue and contribute to a larger issue. And those are the things that we're trying to take care of. And that makes sense. So do you think since, and I've read somewhere where the electromagnetic fields from the cell phones can impact sexual function in general, and maybe this is going back to the endocrine

disruptors and testosterone levels and sperm count, but I'm noticing more in the clinic, and I'm sure you are as well, that younger and younger men are experiencing sexual dysfunction, such as premature ejaculation or erectile dysfunction. So in your opinion, I'm curious, what do you think is the issue? And I'm sure it's just not one issue, but multiple issues at play, which you probably already touched upon earlier. There's not just one answer here, but it certainly is more common now there's a lot of things that go on here being a men's health expert it's you're dealing with the physiology the psychology the biology the biochemistry of men when i say well what did the psychology of men's health have to do with you know fertility and premature ejaculation

and erectile dysfunction well actually has a lot to do with it so number one young men and their teens are now taking more testosterone or i don't want to say they're taking more testosterone younger men more and more younger men in their teens and early 20s are taking testosterone like steroids more than ever before and what is the one thing that can turn off your testicles from making its own testosterone is taking exogenous testosterone so that one thing on its own, maintaining that at a younger age certainly can set off and set a whole lifestyle of lower testosterone levels. And you just, it creates a problem from a young age and that's hard to fix because if that's an issue at 17, 18, those are your prime years. That's when

hormones are being developed. That's when the body's learning and adjusting. So that alone can be uh can be an issue and i've had actually i have one patient um who i followed even through med school so he first saw me in med school and then i followed him throughout and he first took testosterone literally it was two it was one cycle so usually that's like a month to 45 days and since he he stopped it and he literally just dive bombed his thyroid hormones were out of whack his libido was gone his he had brain fog he had issues with erections the only thing he could really use was viagra and even that really didn't give him the drive so he was able to have an erection but didn't have the drive and then he started developing Hashimoto's thyroiditis which

is basically autoimmune thyroid disease just from taking testosterone I'm not saying there was the testosterone cause it I mean it seems like it but basically he took the testosterone stopped the testosterone and then started developing these issues so just taking testosterone on its own is one big factor. And there's a lot of other things as well. And I'm sure you see this too. Right. And I actually had a follow-up question on that. There are these things now, these DHEA shots. I mean, there's a guy that I don't know his name, but there's a book like The New Miracle Fountain of Youth is this DHEA supplementation or shots that they're doing. Do you know anything about this and yeah so dhea is actually very i mean you can inject it and

dhea is a precursor to testosterone but it's also a precursor to estrogen so you have to be very careful with throwing dhea in your body with a shot now it's a very common um it's a very common supplement that men use because they think all right well if i can't take testosterone i'm going to take a supplement that I could buy at a health food store or a vitamin store and go ahead and just increase testosterone levels. Now, anytime you take something that's going to increase, decrease, modify, adjust testosterone or hormone levels, be prepared for the consequences if you're not doing it properly because it can lead to adverse effects. So there are a lot of studies showing that DHEA is actually an anti-aging hormone. And if I were to pick one thing that

before men would go and take testosterone, I would say, well, why don't we just try DHEA? Because the side effects are almost non-existent. So I'm not completely opposed to DHEA supplementation, but it really needs to be controlled by a physician because you don't want it to go down the estrogen level because if you go down the estrogen uh route then you're at risk of decreased libido gynecomastia which are for the men who are unaware is man boobs yeah right it is and then you now you're at risk for like erectile dysfunction so you try to fix the problem but you actually created another problem right right so what are some early signs of hormonal imbalance like you mentioned some things just a little bit ago brain fog lack of erections weight disturbance

anything else that depends on the age if you see a young man with decreased and when i say young i'm thinking teens 20s 30s if you see a young man around that age with decreased libido or decreased drive then that's kind of like you know textbook this guy probably has low testosterone levels and now if you see an older man 40 50 i mean 40 50 60 70 years old and they have decreased drive. Well, that could be a normal thing, right? Because their testosterone levels typically might be a little bit lower, but not low enough where they're causing a problem. So in a younger man, decreased libido, erectile dysfunction has been correlated with low testosterone levels, a decrease in height. So if you see a kid or a man who's, they notice that their fingers are

getting smaller, or maybe like their shoes got really big, or their gloves are huge, or they kind of feel like they've kind of, I don't want to say shrunk, but they don't feel as tall, then you have to start paying attention to see if there's testosterone issues going on, because then that becomes a very serious clinical issue. Other things you want to pay attention to are decreased muscle mass. So guys would be like, and now we go back to the same thing, right? Guys in the gym six days a week is like i can't get big well that's because you're stressed out but right but if you see a guy who's working out three days a week four days a week and he's still not able to gain any mass he's gaining body fat that is something that i want to investigate a little

bit more and then the what i call is it's it's not brain fog but it's not libido but it's kind of like a like a vibrant feeling i guess like you know when you see those cartoons and you see those cartoon character like they're really proud and they're walking with like their chest out and their their arms out and they're like really proud of themselves and then when you see a guy kind of just walking in really like for lack of better terms like mushy and and low mood depression those are things that you want to really be aware of if you see a young man or even older man who's who's really just not feeling themselves i call it grumpy old man syndrome well i've heard some of my patients that have had vasectomies mention a lack of vitality like their their inner

life being is gone you know they feel so that emptiness so exactly yeah they don't feel like now look are you ever going to feel like you're 20 years old again i don't know you know as you age it's not just part of lower testosterone levels but you become wiser you you know you don't make stupid decisions like you know just running out and doing random things so you become wiser as you're an adult so that doesn't mean that your testosterone levels are lower but if if you see a guy who just literally all of a sudden is like yeah i guess you know because very passive and if that's not typically them, then I become a little bit cautious. The people who notice also are their partners. They'll notice very quickly. Right, right. And so you mentioned this. So

levels, testosterone levels, because I'm sure the guys that are listening are like, I want to check my testosterone levels. I've read, and in my own opinion, I feel like reference ranges and lab values vary based on the lab itself. And so it's very hard. I guess what I'm trying to get at is how do you know what's normal for that man versus abnormal for that man is it a combination of their test values and their symptoms yeah exactly so this is this is hard and this is a this is where i get a lot of uh questions from men and other physicians too where you know you have to look at free testosterone levels total testosterone levels so according to i believe it's a european endocrine society they say that in order to be

diagnosed with hypogonadism or low testosterone levels you need to be clinically low testosterone levels total testosterone low clinically low free testosterone levels and then also have the symptoms. So you need to have low T or low free T plus having the symptoms of low testosterone, which are all the things that we kind of mentioned. So now you have to basically have both of those to tell somebody, well, you have low testosterone, now I need to treat you. And I disagree with that because if a man is not feeling well, and he's telling you that his testosterone levels are, or he feels that his testosterone levels might be low and then he tests them and they're still within that range well that doesn't mean that that's normal that just means like if they're

within range it may be normal for the immense amount of people that they tested right but but for that guy it might not be normal and that is where i really that's where personalized or precision medicine comes into place because it needs to be um personalized to that person so i like testosterone levels total testosterone levels depending on their age usually above five to six hundred uh nanograms per deciliter and then free testosterone levels they vary because it depends on the type of lab that you're using um but i like to see them between like 12 to 20 nanograms so those are two numbers that i like to see so i have a lot of men and they're coming in and they're like i don't feel well my doctor told me that my testosterone levels are

normal. And I look at their testosterone levels and it's like three 25 and the range is 300 to like sometimes a thousand to 1100. Exactly. It's like saying, you know, pick a number between, you know, one and a hundred. And if, if you get a number between one and a hundred, you win. It's like, well, yeah, obviously you're going to get between one and a hundred. So it's, it's, that's not something that I follow, but there's other lab markers that you want to look at. So for the men who are listening or for the women who are listening for their men, so testosterone levels, if it's below 500, then I would be a little bit cautious depending on the age, especially if you're younger. And then free testosterone levels are typically more important. And I would like to

see those above usually a 10 to 12. But there's other lab tests that you want to check. So if you're going to your doctor and they just test one thing, well, you want to also check DHEA-S. Now, don't forget that S part because DHEA-S is more consistent and it fluctuates less in the bloodstream, and that's a more definitive measure of what your DHEA levels are. And then you also want to check something called SHBG, which is a sex hormone binding globulin, and that tells you how much testosterone is bound to this sex hormone binding globulin, which basically means sex hormone binding globulin makes testosterone less useful so you want that to be low but if it's too low it's a problem but then if it's too high it's also a problem so you have

to get a proper range for that as well estradiol levels you want to make sure your estrogen levels are not too high because if your testosterone levels can be normal but if your estrogen levels are high that that means there's a lot there's a lot of conversion going to estrogen and you also want to check, um, androstenedione, which is another precursor to testosterone. So as you can see, there's, it's not that simple. It's not simple at all. And that's, well, that's basically why I do this. So you have to make sure that if you're going to go to your doctor, don't let them, you know, shortchange and say, Oh, well, your levels are normal. You're out. I don't agree with that. Right. And, and no man should really, right. If you're not feeling well, then, then tell them

i'm not feeling well right right and sometimes doctors and i've seen it they just slap you know give them a dose of testosterone without evaluating the labs like you do functionally really exactly so i i feel very strongly about that like don't just slap give you know viagra or oh here's a shot or here's a patch or here's some cream it's like throwing spaghetti at a brick wall let's see what sticks and they end up feeling worse exactly and you know it's funny because your hair follicles have high levels of aromatase and aromatase is converts testosterone to estrogen so what is a common way for men to get testosterone replacement is a topical gel right testosterone gel so now if you're putting testosterone on a man who has you know a hairy shoulder or hairy arm or hairy

belly wherever he's putting it that a lot of that testosterone is converted to estrogen before it even gets absorbed right and now you have to be careful who you're touching so if it's rubbing off on your shirt and then you give you know your friend a hug or something and now it's rubbing off on them and that's that's not safe um and you know a lot when i see men who are complaining of low testosterone levels and they go ahead to the doctor they just give them a shot or give Viagra, the problem, I mean, okay, look, if you're not making enough testosterone and you're 50, 60, 70 years old, then maybe testosterone replacement is an option, right? But if you're in a fertile age or a vibrant age and testosterone is not an option for you, whether it's for risk factors or

whatever it is or cost on its own, then you need to have other options to figure out why the body's not making these this testosterone especially if you're in the 20s you start a guy on testosterone in his 20s or 30s he's not going to have kids it just makes him infertile i had a patient like that who had pelvic pain believe it or not went to see an endocrinologist who's actually works with women and you know it's one of these guys that kind of works with hormone replacement bioidentical hormones and they went to see him and he prescribed first the dhea shot for him and then gave him testosterone supplementation thinking that that might be the cause of pelvic pain and in my research that's certainly not the cause of pelvic pain there's nothing to prove that and and he was

in his 20s and so i feared that i i did i seriously and i had a conversation with this doctor over the phone to ask you know what what's the reasoning behind that um because there are other factors that deplete your sperm count. Um, and that was what was slightly low. I mean, pituitary gland was fine, but it's, it's scary to, to, it's scary for me. And it's scary from, for the patients that I see what stuff is out there. And I think bottom line is be an educated consumer, be an educated patient and go in there with a mindset of, I I've done my research. I know what I need to do. If it doesn't feel right, it doesn't feel right. And we shouldn't just blindedly trust. Absolutely. I have seen a lot of medical doctors or physicians prescribe

testosterone for men with pelvic pain, thinking that this testosterone is going to solve their issue. And sometimes they do get relief, but it doesn't get rid of the actual pain. It can be a little bit of a bandage so they start feeling you know better about themselves because you know when men have pelvic pain they don't feel well pelvic pain alone can lead to um it's a chronic stressor and that alone can lead to lower libido and whether their testosterone levels are low or not it i mean it doesn't matter you're still not feeling it's if you have normal testosterone levels right but before i forget and this is something that um is very much uh involved in a lot of my research and in some of the papers that I wrote, I talk about this a lot. It's

actually in everything that I talk about in terms of testosterone, is androgen receptors. Now, not many people talk about this because they think, okay, I'm going to give, it's like thyroid hormone. I'm going to give thyroid hormone. And you might know when you take level thyroxin or armor thyroid or any type of thyroid medicine, there's this sweet spot. It's like, okay, what we get, we need to get the thyroid hormone. Then we measure TSH and T4 and T3 levels. And then we try to figure out where their thyroid is working. And then we find that perfect medium. Well, the same thing works for testosterone. So you can have men and, and I want you guys, I want your listeners to really pay attention here because this is really important.

You can have two men. One guy has testosterone levels of 700 and feels like he has poor libido, right? Erectile dysfunction, no drive, no interest in sex. And then you have another guy who has testosterone levels of three to 400, but he's good to go. Like really high testosterone, really good drive, really good libido, no issues with erectile dysfunction. So why does that happen? Now that's where I see the endocrine society and I see where they say, well, you need somebody with both of them, with both, you know, low T and the symptoms. But there's a reason why these two men the one with the low testosterone or low normal testosterone feeling normal and then the one with high testosterone feeling like crap and that has to do with the androgen receptors

so the androgen or testosterone receptors are really what matter so testosterone is a steroid hormone in order for it to be effective it has to bypass the cellular membrane um which we all remember from high school biology go into the nucleus and then come on you remember that oh yeah oh yeah oh yeah don't quiz me just kidding i'm kidding no i remember i remember oh boy oh i remember when i quizzed you on the last uh in the last podcast you must be the teacher in you i know i just listened to i'm like wow what an asshole no no not at all man not at all i'm a student for life yeah so am i i mean we learn every day right that's right so you have these two guys and you know in order for testosterone to be effective it needs to go

into the cell through the cell membrane into the nucleus and then tell the cell hey these are the changes that we're going to do and some of them are called cyclic amp and cyclic gmp and all these other molecules and fancy stuff um then it tells the body how to respond that's what matters right because it's like throwing um you know uh what's a good analogy here it's like it's like throwing a uh a um oh geez it's like throwing a water balloon at somebody right you have the water balloon you throw it at the guy and then it just throws you throw it at them and it just like bounces right off them you've seen those videos right where it doesn't it doesn't like pop all over them that's really what happens you're throwing testosterone at the guy and it's

really not doing anything it's just bouncing right off because the receptors are not are not active and what can cause that is actually low testosterone excuse me low testosterone throughout your life but also these endocrine disruptors the testosterone replacement therapy i mean a lot of guys go into these gnc and vitamin i'm like yeah i want test boosters and you get these test boosters and then you're like all right and then four years later you're like oh i have low t well i wonder why right so it's the androgen or testosterone receptors which are really important and that's what i'm doing a lot of research on now trying to figure out how do i work on those receptors because that's where the action is that's where you have to work on so i have a few things that

i use um and i'm and i'm testing them right now on a few patients and the ones that i've given them to are actually responding really well so i want to do more research on that and see what's what's going on there and there's a lot of genetic things that i use with that genetic testing with um you know 23andme and and snips and things like that that's awesome i can't wait for that research to come out you're gonna have to share it with all of us we'll get you back on the show part two well that was awesome now for the listeners we can sum it all up in three tips okay like that wasn't enough but you know what are your top three tips to super sperm but also for reproductive health and overall you know men's health and well-being just three well come on you

just had this jam-packed session 40 minutes of awesome awesome information but practically what if you have to tell tell your patient to do three things keep it simple right keep it short and simple got you okay keep it simple now guys i'm a guy i hear you so if i had a guy tell me you need to meditate if they told me that five ten years ago i would have been like get the f out of here i'm not even talking to you go away right it's like who do you think i am right but it is essential and i'm not asking you to go out and walk barefoot in the woods and wear special like pants and like be one with nature and burn some incense and sage i'm not asking you to do that i'm not asking you to do that all i'm asking you to do is just do

mindful breathing right and that is as simple as breathing in slowly strong deep breaths and breathing out slowly for the same count. So if you breathe in for seven, breathe in for six seconds, hold it for a few seconds and then breathe out slowly. You cannot help but lower cortisol levels by doing that. So that is actually getting to the cause. So that's tip number one is mindful breathing. Tip number two, weightlifting. So I don't want to say I'm opposed to running and marathon running and endurance racing if that's your thing go for it but that automatically can increase testosterone increase cortisol levels it can put more stress on the body and actually you your body goes into a catabolic state so you start breaking down

so weight lifting three times a week heavy weights put stress on the body make it want to grow that that by itself will stimulate the brain to say all right i have this 200 pounds on my back i better grow or else so that's number two and that costs you practically no money right you're just you're breathing and you're exercising with weights i mean whatever the gym costs or there's other options out there and then uh my other third tip would be a herb and that is ashwagandha have you used ashwagandha i have used ashwagandha it has been it's been it's a good one and i and I'll let you explain. Yeah. Ashwagandha, the Latin name is probably one of the most effective and successful herbs for fertility, for increasing testosterone

levels, for making these, as you put it, these super sperm and improving reproductive health. It's actually a traditional Ayurvedic herb, which is an ancient Indian herb, which is one of the most ancient forms of medicine. If you ask anybody in India or from Indian background, about ashwagandha or withania they'll know that oh yeah i know that that's what we use for you know it's basically like a i don't know like a like a natural viagra or as they would say or something like that now it doesn't necessarily do that please it won't don't expect to to take that and have a hard-on for four hours that's not gonna happen right right hey but you know what i have read saw palmetto is that in the same family because i've read a lot of studies that that saw

palmetto have been they're actually comparable to viaga with less of the side effects but so so saw palmetto is a different herb so ashwagandha is a an adaptogen so what it does and it's very smart i call it an intelligent herb what it does is that if testosterone excuse me if stress levels are high, it will help bring them down. And if you're overstressed where the adrenal glands can't make testosterone or where the testicles can't make testosterone, then it'll help stimulate them to go up. And what it does, it helps just basically reprocess or recalibrate the hypothalamus, pituitary, adrenal, and testicle axis to basically make the body normalize its function. salt palm metal works by increasing testosterone levels by preventing its conversion to dht

so that that in itself can help you with increasing testosterone levels but more importantly it helps decrease dht levels which can be problematic but there's a lot of research now saying that there's a lot of other metabolites after dht that we really need to start paying attention to so um my research never ends and i am grateful for that because i can go on forever for this with this stuff well that's awesome so mindful breathing number one weight lifting yes stress on the body make it grow and then the herb ashwagandha the most effective and successful herb for testosterone fertility super sperm viagra yes and then the kicker is and then the kicker is a visit with dr espel that's right exactly no i and i and i say that jokingly but

half so you need to find somebody who knows what they're doing you need to find somebody who actually understands this and is makes this their thing there are there are the men health experts out there um but there are a lot of people who are like yeah i specialize in men's health and mental health and gi health it's hard to just you know i'm saying like okay good you know enough but you really want to see somebody who's makes this their life and um unfortunately i'm the nerd that does that yeah you're the man you are the man i love it thank you yeah that's right i am saying it guys dr espo is the man esposito is the man so dr esposito thank you so much for your time And honestly, all of that priceless information.

We are so lucky to have a doctor so passionate about men's health. I'm glad to be on your team. So how can our listeners connect with you? Yeah, well, number one, it's a pleasure. And I'm grateful to have been on this show and with your followers and your listeners. So number one, thank you. Where can you find me? So you can find me on my website.

It's Dr. Espo, D-O-C-T-O-R-E-S-P-O dot com. on instagram at doctor spelled out d-o-c-t-o-r dot espo um instagram is the same thing facebook is the same thing you could search dr esposito you can find me basically in google and facebook and i practice in connecticut now uh at in in bridgeport connecticut and in danbury connecticut so all that information is on my website be stay tuned because i'm coming out with a testosterone own program. So even if you can't come see me in person, I'm developing a program that men can actually use and take on their own. So they don't have to go ahead and listen to the random guys on forums on how to get their T levels up. And this will be directly straight from me. It's basically

what my patients get, but in like four weeks. So stay tuned for that. I'm excited about it. Oh my, I'm excited about it. I mean, I'm going to sign up to that just to get all the knowledge that you have your brain is phenomenal and honestly we'll link it to the show so by the time it's set up and all done i'll have your links and all of your handles and social media and all that so if anyone needs to connect with you they can and honestly it's the best investment guys that you'll ever make is making an appointment with dr esposito if i was a dude and i'm a chick i would still see him so so on that note everyone thanks for listening guys as always and loving wellness for your pelvis. This is Dr. Susie G. Until next time, my friends, see you later.

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