Tuesday, May 28, 2013

Is Your Testosterone Getting the Job Done?


Before we tackle the numerous causes of low testosterone (low T), I'd like to go over the symptoms of low T? Men usually equate low libido and sexual dysfunction with low testosterone. But long before sexual issues arise, men may experience poor sleep, loss of strength and decreased vitality. If you feel over the hill, consider that it may be due to low testosterone. Severe fatigue (especially after exercising) and muscle weakness could be due to low T. Irritability, feelings of being overwhelmed, sadness, poor concentration and even memory lapses are also symptoms of low T. If a man is experiencing sexual dysfunction, he probably has a lot of other symptoms from low testosterone.
Low testosterone is also associated with high cholesterol, hypertension, accelerated heart disease, bone loss, prostate cancer and prostate enlargement. If you have any of these illnesses you need to be screened for low T.

Low testosterone is increasingly common. In fact, studies have shown that, on average, men's testosterone levels have dropped dramatically over just the past few decades. In 2002, 65-year-old men had testosterone levels approximately 15 percent lower than 65-year-old men in 1987. That same age group would have even lower levels today. There are many different reasons why men experience low testosterone, and it's not just a matter of age.

Disturbances throughout the body can result in lower testosterone levels in men of any age. It helps to think of the testosterone production in your body as a company, where each employee and division's role is critical to completing the final product: healthy testosterone function.

When the CEO Can't Communicate
It may surprise you to learn that problems of low testosterone can sometimes start in the brain rather than the testicles. Over the past decade, neurosurgeons have noticed a connection between head injuries, like concussions, and low testosterone. 

Head injuries may bruise the underside of the brain where the hypothalamus is located. It controls basic functions like hunger, thirst and sleep. And on the very bottom of the hypothalamus sitting right on the inside of the bottom of the skull, is the CEO of testosterone production in the body. This portion of the brain decides how much testosterone will be made and gives the order to middle management...the pituitary gland.

If CEO is bruised or damaged, it will send a weak signal to the pituitary gland. The pituitary gland produces a number of endocrine hormones—including luteinizing hormone (LH), which is required for testosterone production. Because this hormone middleman receives its marching orders from the CEO, it may produce lower LH when the brain is injured. And if the pituitary gland makes less LH, the testicles will not get the orders to manufacture sufficient amounts of testosterone.

As mentioned, the CEO can be damaged by a head injury. In the case of major head trauma, a drop in testosterone can come on fairly dramatically over a period of weeks or months following the injury. However, the effects of minor head trauma, perhaps experienced when a young man is playing football or falls, can build slowly over time—sometimes not showing up until a man is older.

Trouble in Middle Management
As mentioned, the pituitary gland is another critical area in testosterone production. The CEO in the hypothalamus may be giving the correct orders, but it's possible that the pituitary gland isn't receiving the signal. This happens when a man has a tumor in the gland.

The most common pituitary tumor is a benign one called a prolactinoma. Fortunately, these tumors are relatively rare. But if a man has one, it means that his pituitary gland is sending a weak signal down to his testicles, which results in lower testosterone production. Other symptoms a man may experience if he has a prolactinoma are blurred vision, headaches, weight gain and milky discharge from the breasts.

When the Couriers Can't Deliver the Memo to the Factory
Your testosterone CEO in the hypothalamus might be in top shape. And your pituitary gland, middle management, may be receiving its orders and running smoothly. That doesn't mean there still can't be problems with the appropriate message getting to the testicles.

LH, which is produced in the pituitary gland, must be able to communicate to the testicles the need to manufacture testosterone. Normally, the message penetrates through the cell wall, but if the cells aren't healthy, the message won't make it past the outside of the cell. This can happen when a man doesn't have sufficient amounts of fish oil. Think of fish oil as WD-40 for cells, it lubricates and opens the door for LH (the messengers) to pass through the cell's membrane.

If this is a problem in your body, it won't just apply to testosterone; it will affect your sperm count too. Men who have very low levels of fish oil are unlikely to receive the appropriate message from FSH (follicle-stimulating hormone) that also comes from the pituitary gland. FSH knocks at a different door in the testicles, but if it can't get its massage  through, it cannot give the testicles the go-ahead to produce sperm. Both sperm and testosterone can be made in such scenarios, but they are usually produced in very limited amounts because the testicles don't have clear orders to manufacture testosterone or sperm.

Testosterone Manufacturing Plant
Testosterone is made in the Leydig cells in the testicles once clear orders are received. Since testosterone is made from cholesterol, too low cholesterol results in low testosterone. Zinc, Vitamin A and D are all essential in the manufacturing process and deficiencies of any of these will reduce production. Numerous toxins interfere with production of testosterone.


Testosterone Delivery to the Body
Testosterone ultimately increases the vitality of all cells. If it's a heart cell, testosterone helps the heart pump better. If it's a brain cell, testosterone makes the brain sharper. If it's a muscle cell, testosterone makes the muscles stronger. If it’s a skin cell, the cell will fatten up and make more collagen to make stronger skin that doesn’t sag, wrinkle or tear easily. However, there has to be enough fish oil in those different kinds of cells for testosterone to have the desired effects.

If all of the other cells in the body don't have enough fish oil, their cell walls will be more rigid and less pliable.  Testosterone and other steroid hormones are small enough to slip through cell membranes without going through a specific doorway. But the membranes have to be “permeable” and pliable. Fish oil keeps these membranes healthy so that testosterone can get though into the cell and join with its receptor. This coupled unit then goes into the nucleus to turn on DNA to help the cell regain vitality.

Other Problems in the Testosterone Delivery Process
Because a number of problems can cause low testosterone levels within the body, it's important to take a comprehensive look at a man's health to see what other areas may be impacting his production of testosterone.

Estrogens: Estradiol is made from testosterone, and all men have some of it in their bodies (although healthy men make less of this hormone than women). This conversion can be increased by a number of factors, such as too much alcohol intake, trunkal obesity or a zinc deficiency. If a man is making too much estrogen, it reduces his testosterone production. Abdominal fat cells convert testosterone to estradiol the fastest because they have higher than normal levels of an enzyme, aromatase, that convert testosterone to estradiol. So beer bellies are bad for testosterone.

Damage to the Testicles: There are many things that can damage the testicles. You can lose a testicle in an accident. Maybe you got hit in the crotch with a hard ball when you were a little boy. Any type of injury in the testicles can affect testosterone production. Other things that can cause damage include mumps, varicocele (a varicose vein in the scrotum) and vasectomies*. Such factors and events compromise the functioning of the testicles and result in higher estrogen production and lower testosterone production.

*Note that not all men will experience a reduction in testosterone following a vasectomy. However, studies in lab animals, and observations by individual physicians, suggest that anywhere from 10 percent to 40 percent of men can be affected.

Undesirable Protein Levels: Testosterone doesn't just float around in the blood by itself, it's carried on proteins. The primary proteins involved are albumin and SHBG (sex hormone binding globulin). If a man has too much of these proteins, his testosterone is going to be bound up on the albumin and SHBG and very little is going to drift off as free testosterone. And free testosterone is the most active testosterone in the body. A number of things can increase the production of these proteins, including excess estrogen production, estrogenic toxins and liver problems.

Participating in Strenuous Activities: While not always permanently damaging to the testicles, strenuous activities like long-distance running and cycling can lead to lower testosterone. Regular exercise is fine, but do it in moderation. If you like to run for fitness, keep it under 15 miles a week.

Not Enough Cholesterol: Eating a vegan diet with too little cholesterol in it can contribute to lower testosterone. The body is supposed to make enough cholesterol to produce all of the steroid hormones, including testosterone, but it doesn't always. In some people the delivery can't keep up with the demand. So eating an animal protein-based diet can enhance the production of testosterone.

Diet: In addition to a lack of animal protein, other types of poor nutrition can affect testosterone function. A diet that is high in sugar, high fructose corn syrup, trans fats, grains and alcohol are more likely to contribute to obesity resulting in increased estrogen production, which interferes with the production of testosterone. 

Certain Medications: There are more than 250 prescription, over-the-counter (OTC) and illegal drugs that can cause problems with testosterone production and function. There are medications that can negatively impact the hypothalamus (the testosterone CEO), the pituitary gland (the middle managers), the message delivery process in the cells (couriers), and the testicles themselves (the factory). In addition to affecting how testosterone is utilized, there are also many drugs that increase estrogen production. If you have low testosterone and you're taking any prescription or OTC medication, you have to consider the possibility that your medication might be contributing to your lowered testosterone levels. (See the sidebar for a list of medication categories known to cause low testosterone.)

Stress: If a man is under significant emotional stress, it can lower his testosterone levels. The reason is that the stress hormone, cortisol, is made from cholesterol too. And if a man is experiencing a lot of stress, the body has a choice: it can make more cortisol or it can make testosterone. The body is always going to choose to produce cortisol because it keeps you alive. Without it, you die within three days. You can live a much longer time without testosterone. That's why, with abrupt, intense stress, such as that experienced during a period of grief or sudden life change, one can experience an immediate drop in testosterone. Generally, after a short-term period of stress, a man’s testosterone levels will recover if you're otherwise healthy. However, if you're chronically stressed, your testosterone will gradually drop over a period of time.

Toxins: There are many environmental toxins that damage all aspects of testosterone production, delivery and response. Most men would benefit from a cleanse since the average American has 90 different chemicals in the body. Many of these are xeno-estrogens or environmental estrogens from petroleum products and plastics.  A cleanse and a daily supplement to enhance liver detoxification may help increase a man’s low testosterone. Many toxins including bisphenol A (BPA), phthalates, chlorine, toxic metals, hormones in dairy products and animals we eat, and estrogenic drugs in the drinking water just to name a few lower testosterone in a variety of ways.

Finding the Cause
With an increase in poor diets resulting in greater abdominal waistlines and lower omega 3 fats, chronic stress and exposure to toxins, it's easy to see why men today are more likely to have lower testosterone levels than men in the past. Fortunately, most of these causes are easily treatable.

If you suspect you have low testosterone—or if you've already been diagnosed with it—there are a number of things you can start doing right away to raise your levels. These actions include improving your diet, reducing alcohol intake, reducing your exposure to toxins, consuming more fish oil, and reducing your stress levels. If you've made these changes and you're still suffering from low testosterone, see a physician and have appropriate testing performed.

The important thing is to get it checked out. Testosterone levels aren't simply a matter of male pride. They affect every single organ system in a man's body. Inadequate testosterone function leads to weight gain and increased risk for diabetes, premature heart disease, osteoporosis and depression. Basically, testosterone impacts everything related to being a healthy male, and long-term low levels of the hormone will shorten a man’s life. Get your testosterone checked today!

Tuesday, May 21, 2013

Tuesday, May 7, 2013

Nutrition for a Healthy Pregnancy

Here's the script from my latest appearance on MyFox8, WGHP:

Dr. Vaughan is here today to talk about something you would not expect her to talk about. Pregnancy.

Anchor: As an integrative physician what is your particular interest in pregnancy?
Dr. V.: First I want to congratulate one staff member who delivered in early April and another staff member who just learned that she is pregnant. I see patients who have difficulty getting pregnant. Sometimes it's due to toxins, nutritional deficiencies or hormonal imbalance.

Anchor: What about nutrients during pregnancy?
Dr. V.: There is a great article in Natural Triad this month called Nutrition for a Healthy Pregnancy. Emily Saunders, the author, talks about the importance of protein, fiber, Omega 3 fats, folic acid and several other important nutrients.  It’s a good review of what women need in their bodies to have a healthy pregnancy. And she gives specific suggestions of snacks to eat that are healthier. Salty cashews instead of salty chips or a few bites of dark chocolate instead of a Snickers Bar.

The nutrient I find most interesting is vitamin B6 which is useful for treating vomiting during the 1st trimester of pregnancy. Many women take pyridoxine or B6 and it works.  But then there are other women that it doesn't work for. I learned at recent medical meeting that if you look at your toes you will be able to tell what kind of B6 you need to take.
Anchor: Your toes tell you about Vitamin B6?
Dr. V.: Absolutely. Look it up in Wikipedia. If your 2nd toe is longer than your big toe it has a special name. It is called a Morton’s toe. People who have a Morton's toe, sometimes called a bossy toe, do not activate vitamin B6 well.  When we eat B6 or pyridoxine, our body has to add a phosphorus group to it in order for it to be most effective as a cofactor for numerous enzyme reactions. If one cannot add that phosphorus group, the person does not dream well and doesn't remember their dreams. Other predictable symptoms of inability to activate B6 are migraine headaches, depression, and nausea and vomiting early in pregnancy. 
Anchor: So if a woman has a longer 2nd toe than her big toe what should she do?
Dr. V.: Take activated B6 instead of regular B6.  It's called.  Pyridoxil-5-phosphate or P5 P for short. 50 mg once or twice a day is a safe dose. She should start dreaming within a few days and her nausea and vomiting should also calm down. 
Anchor: Thanks, Dr. Vaughan...