Episode #81 Full Transcript

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Podcast #81 from https://bengreenfieldfitness.com/2010/02/podcast-episode-81-could-low-testerone-levels-be-affecting-your-health-performance-drive-body-tone/

Introduction: In this podcast episode: all about testosterone, whether wheat germ helps you with performance, research on Diet Coke, getting enough calories, Duathlon training, leaning up quickly, saturated fats and magnesium.

Ben: Hey podcast listeners, this is Ben Greenfield, and yes the results are in. I got my lab tests back on my testosterone levels and hormone ratios and so that’s what today’s podcast episode is about. Testosterone and how it affects your health. How it affects your performance. What the results of my testing actually were and what I ended up doing to take care of my testosterone, which if you listened to podcast episode number 62 you know was pretty low. And especially too low for the type of triathlon competition that I do. So, we’re going to get a great interview with Dr. Cohen about that. We’ve also got some wonderful listener questions. You guys always challenge me with your questions, but I will continue to answer them. So let’s get right into this week’s podcast.

Remember that if you have a question, you can email [email protected]. You can call toll free to 8772099439. Or you can Skype Pacific Fit. So for this week’s questions, we’re going to start off with a question from listener Deb.

Deb asks: I’ve recently heard about a natural supplement called Octacosanol. I’ve read that it enhances athletic performance by increasing the body’s ability to use oxygen during exercise. I’ve also read that it increases endurance by bolstering the oxidative capacity of the muscles and thus helps athletes hang on to glycogen stores. (For those of you who absolutely do not understand what that sentence just said, essentially it means that you could use your fat utilizing muscles a little bit better and not go through carbohydrate quite as quickly.) I’m wondering how accurate this information is. If this supplement is that powerful, why is it that it that it isn’t promoted more for endurance athletes? I am a half Ironman triathlete and would love it if this supplement is as fantastic as it sounds.

Ben answers: Well, Octacosanol is like you say something that you can get out of wheat germ. You don’t have to get it out of a bottle, out of a capsule. You can actually go buy powdered wheat germ and sprinkle a little bit of that on your salad or in your oatmeal or in some soup. But basically it’s kind of a waxy substance. You can get it from other plant oils, but it’s pretty prevalent in wheat germ. Believe it or not, you can also get it out of sugar cane extract. It’s called polycosinol when you get it out of sugar cane extract. Not a lot of side effects that research has shown, but in terms of the actual research that has been done on its effect, specifically for the type of things that you were talking about, there are a few research studies that I’m aware of. One looked into the actual metabolism of these types of what’s called a long chain fatty alcohol. And they found that it could possibly assist with cholesterol metabolism. Meaning that it could be something that could help you lower your cholesterol a little bit. And that study was not done in rats or mice, it was actually done in humans. So that’d be something to look into for that, but obviously it doesn’t have a lot of performance applications. Those are more health implications. Now there was another study that was done back in 2003, that looked at rats and whether Octacosanol supplementation in rats actually helped them run for a longer period of time. The results actually did show that the rats could run about 184% longer when they were taking this supplement. Which was very interesting. I’m sorry, 46% longer. 184% longer was in a control group of rats who weren’t exercising at all. But 46% longer, which is pretty significant and they did show some bio-chemical markers that suggested that the rats actually weren’t burning through carbohydrate quite as quickly and were able to – like I said earlier – use a little bit more of that slow twitch fat utilizing type of muscle. Of course, rats are different than humans, but it’s a very interesting study and it definitely would have implications in terms of suggesting that Octacosanol supplementation could be something that would help an endurance athlete. There have been a few other studies that looked into things like lateral sclerosis and some other chronic diseases and we don’t get into those today. But essentially, what it comes down to is that yes, there is some evidence in rats nonetheless, but evidence, that suggests that this wheat germ extract could actually help. So thanks for the question, and thanks for pointing that out to the listeners and definitely something to look into.

Christina asks: I absolutely love your podcast, and consider you a rare diamond in the rough among the health and fitness podcasts on iTunes.  (Thank you Christina.) I am a runner just turned triathlete, and probably have some of the healthiest eating habits of anyone I know.  I limit sugar, empty calories, and processed foods to special occasions only, like birthdays. My plate is always full of vegetables, I’m taking the recommended supplements, drink lots of water, limit alcohol to one glass of wine or so on the weekends and cook my own healthy, natural foods. Here’s my vice.  I love Diet Coke. In fact, I can’t imagine a workday without it.  On workdays, I typically have two, and on weekends about one or so. I never or rarely indulge in more than that. Looking at the ingredients I find Carbonated Water, Caramel Color, Aspartame, Phospohoric Acid, Potassium Benzoate, Natural Flavors, Citric Acid, and Caffeine in that order.  I have no idea as to what most of those are. Am I truly doing myself a disservice by drinking Diet Coke, and if so, how? I have not read any medical research that has convinced me to give it up.

Ben answers: Well, the main thing Christina that you would want to worry about with a Diet Coke is not necessarily the carbonated water, some of the acids are risky in terms of putting your body in a net acidic state which has a lot of health and immune system complications as well as performance implications. But the main thing you want to consider is the aspartame or the artificial sweeteners that are in diet soda. And there has been research that has been done on aspartame. Now the idea is that the FDA approved aspartame back in 1981 for use as kind of a food preservative, and they approved it for soft drinks in 1983. The FDA declared it to be one of the most thoroughly tested and studied food additives that the agency had ever approved. They claim that there were over 100 toxicological and clinical studies that confirmed aspartame to be safe for the general population. But there have been studies that have been done since then that suggested that may not be the case. There was a study done in psychiatry, where they had about 40 patients that were given 30 mgs per day, per kilogram of body weight of aspartame versus a placebo. They found that the aspartame significantly affected mood disorders. Which is interesting because one of the most moody guys in the PGA, John Daly, he drinks about 12 Diet Cokes a day and he’s all over the map in terms of mood. The suggestion for this is that aspartame can inhibit something called serotonin in your brain which can decrease the availability of a mood stabilizer hormone in your brain called Tryptophan. Now there was another study that suggested that diet soda consumption could actually increase your risk of obesity, and this study was done at the University of Texas and they used 600 patients of a wide age range, 25 to 64 years old. And participants were 65% more likely to be overweight if they consumed one diet soda a day compared to if they drank none. And two or more of these diet sodas raise the odds of becoming obese or overweight, even higher. Now there’s no evidence that suggests that all of those diet sodas were actually Diet Cokes, but there’s definitely – and I’m sure that most of the listeners have kind of realized this, there’s a little bit of an appetite stimulating effect when you consume diet foods, and that can be even be said for something as simple as some of the gums out there. I’ve actually switched to chewing a gum which is primarily only a Xylitol based gum. Still a sugar alcohol. Still metabolized a little bit differently, but it doesn’t have a lot of the other artificial sweeteners like aspartame and sucralose that some of the other gums do. Now, you’ll find in addition to the aspartame or the Nutrisweet that you get in diet soda, there has been some studies that have been done on sucralose and specifically animal studies have found that sucralsoe can shrink your thymus glands which can severely affect your metabolism, enlarge your liver and your kidneys, atrophy some of your lymph follicles which affects your immune system, reduce your growth rate, decrease your red blood cell count and cause some gastrointestinal problems like bloating and diarrhea. So, some problems with the sucralose as well, which obviously isn’t in the Diet Coke. But another study that was done on artificial sweeteners was again done on rats where they gave rats one type of artificial sweetener called saccharine and the other rats were given a natural high calorie sweetener like a sugar. The rats that were given the artificial sweetener actually ate more in the meal after they had consumed the artificial sweetener than the rats that had consumed the regular sweetener, so they were suggesting that there may be a little bit of an appetite stimulating effect there. So the two main things that I would be concerned about would be mood stabilization and appetite cravings. There’s a ton… if you were to go on the Internet and look…tons of anecdotal research that people say that aspartame has given their kids seizures and resulted in a bunch of different neurological disorders and people say it’s responsible for Alzheimer’s. And there’s just tons of kind of single case studies and anecdotal evidence out there that has gently pushed me in the direction of completely not drinking diet soda at all. Because I figure that even if there’s not medical research that proves it, there’s enough anecdotal evidence out there that suggests that it may not be the best thing to be consuming for some of those more serious neurological disorders. So, what I personally do is when I’m craving a diet soda or a diet coke is I do sparkling water with gum. And usually I’ll do the type of sparkling water that’s like natural lemon infused or lime infused and doesn’t have the artificial sweetener. So great question, Christina.

Jose asks: I have two questions for you today. The first is regarding a recent episode, in which a listener asked you about what would be an example day of your diet. I was surprised when I heard your answer because, even though you didn’t give details of the amounts of food that you eat for each meal, it seems pretty difficult to get the necessary calories that you probably burn each day from just almond butter, oats once in a while, salads, fruit, a little yoghurt, cheese, oil and protein powder. Did I miss anything in the explanation? Do you eat any bread, cereals, meat at all?

Ben answers: That’s a great question, Jose. I have actually written a book about how to dump thousands of calories into your body without destroying your body. It’s called Holistic Fueling For Endurance Athletes, and there’s pretty much two places you can get it. There’s a Web site called www.mindsettriathlon.com or you can get it and also my book www.triathlondominator.com or my package www.triathlondominator.com includes that book. Then all the members at the Rock Star Triathlete Academy get that book for free. But basically what I lay down in that book are a bunch of calorie dense foods that you can consume that make it so that you don’t have to eat things like bread and oatmeal and cookies and bagels and all these types of sugar laden but nutrient depleted foods that a lot of athletes tend to eat as empty calories. What it comes down to, Jose, is that you could easily eat 1000 calories every meal and just be doing things like healthy fats, nuts, seeds, nut butters, potatoes, yams, parsnips, beets. There are all sorts of foods out there. The list goes on and on. But it really is a myth that you have to have bread and cereal to fill up your caloric needs. Now I do do meat every now and again. Last night I had about 8 to 10 ounces of halibut and I prepared that with mushrooms and onions and garlic and my evening meals tend to be a little bit lighter like that. Typically meat and vegetables and I really frontload my calories and eat more of the carbohydrate based foods earlier in the day and I would encourage you to do so as well. But what it comes down to is that yes, you can easily get as many calories as you need without consuming breads and cereals. Paleo diet is another fantastic example. So he has another follow up question.

Jose asks: This happened to me about 4 months ago. I’m recovering from an ankle sprain from running downhill in a mountain, basically because I was going flat out, and the terrain wasn’t the best for that. Anyway because my joints are kind of strong, and I only got a grade 1 sprain. The problem is that, following a recommendation from a friend of mine, and adding the fact that I didn’t want to stop training for too long, I only rested for one day and then began doing some low intensity cycling and walking right after. I also didn’t wear any protection for longer than the first day. The consequence is that, even though my ankle is now almost fully functional, I still feel some pain when doing certain movements. Is there any way in which I could make it heal completely?

Ben answers: Well basically Jose, when your body is healing it lays down scar tissue and the scar tissue is laid down in not super nice little neat formations, but in a certain structured pattern. If you’re trying to exercise or move a joint while it’s going through the process of forming scar tissue – and for a grade 1 sprain, that’s typically about a one to three week process – then that scar tissue is not laid down properly and can become very immobile and inflexible and even produce pain. You can also get areas of hypoxia where the proper amount of capillaries aren’t feeding that tissue – the oxygen and the sugar the way that they should. So you can cramp as well if it’s not properly healed. That’s why it’s important to make sure that you really don’t aggravate an area of your body as it’s healing and try to train through an area. That being said, there are some options for you to go back and try to mobilize that scar tissue. Soft tissue mobilization is something that a lot of massage therapists can do. There is something called cross friction massage as well as trigger point massage. Another thing called myofascial release, and you’ll also get kind of a scar management technique used by physical therapists which is a combination of massage with a silicone gel. Ultrasound therapy can help out a little bit as well. Most of the time it’s going to be a massage therapist or a physical therapist who would be able to do this kind of work for you. If you’re overseas, that would be a physiotherapist, and there are also some other things that you could look into that are a little less established but could also work, something called Grastin technique which is kind of an instrument assisted soft tissue mobilization, cold laser could help a little bit, infra red light could help a little bit. So there are lots of things that you could throw at the issue but ultimately what it comes down to is that you want to re-mobilize that scar tissue, try and break it up a little bit and while you’re doing that, don’t be doing workouts that put a lot of stress on that joint. Try and stay non-weight bearing on that ankle with things like water running. So great question.

Jen asks: For a sufficient type of drink for calories and nutrients, what is a good alternative to Ensure?  Since I no longer want to drink it after listening to your podcast on Suicide By Sugar.

Ben answers: Jen has a follow up question, but first I’m going to address this question. My answer Jen is I’m going to call you out on that one and tell you that you actually shouldn’t be drinking your calories and your nutrients. I find that my clients who do best at weight control and fat loss are the people who eat their calories primarily and then any drinking is typically like an antioxidant beverage or a mineral beverage or an electrolyte beverage or something like that, that doesn’t have a lot of calories in it because the fact is when you drink your calories and your nutrients, you tend to consume too much too quickly and it usually doesn’t satiate your appetite. I would really not be fueling yourself with a calorie laden drink unless you’re right in the middle of exercise. If you are exercising, there are some drinks that I like. Hammer Nutrition makes a few. I like Perpetuem or Heed. GU Sports which I use when I’m training for a triathlon, they make one called GU Electrolyte Brew. They also make one called GU Recovery Brew, but for me I try and stay away from liquids as much as possible, even after a workout I tend to go for real meals because they satiate my appetite and I tend to overeat a little less. So I would not be looking for a high calorie drink unless it’s for during an exercise session. And then in your follow up question, you say…

Jen asks: If sugar causes damage to arteries and imbalanced insulin levels leading to heart disease, does that mean saturated fats and regular fats are alright to eat in their pure forms i.e. not fried in vegetable oil?

Ben answers: Well, yeah. There are a lot of good things about saturated fats. That’s why I don’t like the fact that butter and some of the fats that you find in meats and coconut oil and things like that have been given such a bad rap. Saturated fats contribute to about 50% of your cell membranes. They’re what gives your cells that stiffness and that integrity that they need for proper metabolic function. So if you don’t eat enough saturated fat, you aren’t going to be able to form healthy cell membranes. For calcium to be effectively incorporated into your bones, at least 50% of the dietary fats used for that process are saturated. Saturated fats can lower levels of lipo protein A which is a substance in your blood that’s highly correlated with heart disease. Saturated fats can help your liver to function properly. It can help protect your liver from things like alcohol and pharmaceuticals. You got to have saturated fats if you want to properly utilize a lot of the essential fatty acids like the Omega 3 fatty acids and the Omega 6 fatty acids that you hear about and get from the flax seed oils or the fish oils. You also need cholesterol in your body. Cholesterol is a precursor to a bunch of different steroids and hormones including one we’re going to talk about a little bit – androgen, estrogen, progesterone, testosterone. It’s a precursor to vitamin D which is a super important kind of super vitamin, fat soluble super vitamin. Your body makes bile out of cholesterol and you have to have bile to be able to digest food and properly assimilate nutrients. So there’s a lot of benefit to cholesterol and a lot of benefits to saturated fats and the trick is that you just need to make sure that you eat them in moderation. Like half of a can of regular coconut milk, that’s almost 100% of the average person’s daily needs for saturated fats. So the trick is that you really have to moderate your intake of these, okay? One marbly piece of red meat is probably giving you about two to three days worth of saturated fat. So the idea is that yes, you can consume saturated fats but just like about any good thing, it needs to be in moderation.

Jeff asks: Hi Ben, I live across the pond in England. I came across you and your podcast purely by accident when I heard you in an interview on the ” Indoor cycle instructor” podcast to which I also subscribe, Now my question, which is a two part question. I am, as you may have gathered, an indoor cycling instructor who teaches eight classes a week. As you can see I’m fairly active and try to watch what I eat. However I have just enrolled myself in my first Duathlon so am trying to shed a few excess pounds and get to a lean race weight but this is proving hard despite my best efforts which draws me to the conclusion that my diet must need some adjusting. So can you give me some tips on the sort of diet I should be following and also at what sort of time I should be eating my last meal ?

Ben answers: A few things that I’ll do when I’m leaning up for a race, Jeff, is A, I completely quit eating two hours before bedtime. Okay? Enormously important that you not go to bed with high insulin levels or a lot of food in your stomach when you’re not going to be metabolizing that blood sugar or moving to enhance your sensitivity to that insulin. The next thing that I do is I really, really focus on something I talked about earlier in this podcast – front loading my carbohydrates and eating more of my carbohydrates earlier in the day. Another technique that I use is I get up in the morning on an empty stomach and I do aerobic exercise for 20 to 30 minutes – light walk, light jog, light bike ride, light swim, a little bit of elliptical work – anything like that, but it needs to be on an empty stomach. And I will enhance that by consuming caffeine in like a cup of black coffee before I actually do that. And then the final trick that I’ll use is I kind of shift to a little bit of higher protein intake especially in lunchtime and in the afternoons, higher protein, higher fat intake. A lot lower carbohydrate intake so my body has to dip into some of that adipose tissue stores for energy. Then the second part of Jeff’s question, he says…

Jeff asks: As I mentioned earlier I’ve enrolled in my first Duathlon which is in a little over two months time. It is only a short sprint distance so I should be ok. I don’t expect to place first but I don’t want to place last so the second part of the question is could you recommend a good training schedule that would help me to hopefully complete the event in a respectable time?

Ben answers: For Duathlon, Jeff, I would really recommend that you focus on the most important component and that is making sure that you get bricks in. I would actually be doing one to two bricks a week where you’re focusing on running off the bike, sometimes doing multiple bricks where you’re biking and then running and then biking and then running. As far as actually putting a good training schedule together, shameless promotion here but that’s what people pay me to do… is actually write out training schedules. If you go to www.pacificfit.net, what I do is I have a comprehensive form that you fill out. It tells me your family life, your schedule, what you have available to you to train, basically everything and then I create a training program for you based off that. But it’s really tough for me to do anything than give you some general recommendations on a question like that. So hopefully that helps you out and then I had a call in question actually from one of my clients because I suggested the magnesium oil to him.

Bill Sutherland says: Hey Ben, this is Bill Sutherland. I just wanted to let you know that I tried that Ancient Minerals Magnesium Oil and it’s really been great stuff for me. In a matter of about five days – I started on the 28th – my wrist had arthritis or still has arthritis in it but it no longer hurts, and I’m rubbing a little bit on there every day. The other thing I was going to tell you was I had kind of a skipped heartbeat and I’ve had it for ten years and I’ve noticed since probably Sunday, which would have been the 31st that all of a sudden, it’s not skipping anymore. So I’ve been monitoring that every day and everyday it’s not missed a beat. So anyway, just wanted to let you know that was that I used that Ancient Minerals magnesium oil and works real well. Thanks a lot.

Ben: Thanks Bill. I’ll put a link to that magnesium that Bill talks about in the Shownotes to this episode, episode number 81. If you remember we did have a listener who asked a question last week about restless leg syndrome and he wrote me back in and after the podcast, he did find something that also helped him out a little bit. It’s called Restful Legs and he wrote me and told me this so I looked at the ingredients of this thing called Restful Legs and it is a homeopathic – meaning that it is a blend of different extracts – and this one in particular has an arsenic extract, something called pulsatilla and then sulfur and zinc. So there you go, if you have restless legs syndrome and you listened to last week’s podcast, then look at that Restful Legs and thanks for the tip on that Paul. So if you’re liking this podcast then please leave us a ranking in iTunes. It takes me quite a bit of work to put this out there for you and help you out in the way that I do, but I really love to do this and I love to be able to get some of the people that like Dr. Cohen, who I’m going to be interviewing next on the show, and by you leaving a ranking it truly helps me in those efforts. So go to iTunes. Do a search for “Ben Greenfield Fitness” and leave us a star ranking and even a comment. Love to see your comments as well, and I change things in the podcast if you guys suggest them in those comment areas. Just be nice. Please. So let’s move on to this week’s interview on testosterone with Dr. Cohen.

Hey podcast listeners, this is Ben Greenfield and I have a guest on the other line who you may be familiar with. The doctor from Bioletics, Dr. Richard Cohen. Dr. Cohen thanks for coming on the line today.

Dr. Richard Cohen: Hey, my pleasure Ben.

Ben: Alright, well cool. What we are going to be talking about today are hormones. As many of you may know, I actually have been tested by Bioletics to find out some of the factors that are essential in terms of what are called internal performance factors and you’re definitely going to want to supplement this podcast by going back and listening to podcast number 53 and 62 if you really want the full picture of how to understand what’s going on inside your body, and both of those podcasts were with Dr. Cohen as well. Today, we’re going to talk about how I got my testosterone levels, why I did that, and what the results actually were. And then we’re going to talk about how we attack some problems that were identified so I could have better energy, be stronger and get better performance as an athlete. So, I think a really good place to start here Dr. Cohen, would be for you to explain to the people listening about what hormones are essential to test and why?

Dr. Richard Cohen: Got it, okay. So, as Ben was saying the hormonal or we call it the stress and recovery hormones… they’re sort of a critical marker of these two phases of physiology and one is anabolic, and the other is catabolic. In a real simplistic way, anabolic is growth, recovery, repair and it’s youth. You look at a teen, is anabolic, they can continue to wear themselves down and even into our 20s. We have this huge anabolic reservoir and while there are other many factors that come into play, at least the messengers are the hormones and we could talk a little bit more about that. So we have anabolic hormones that signal the cells of the tissue to repair or recover and to grow. I don’t want to misnomer anabolic steroids… that’s sort of a wastebasket of a term anyway, but that’s what the term anabolic is. So anything that will repair, recover and grow has an anabolic nature and that’s youth. Catabolic is aging. Catabolic is the ability of the body to break down. And there are times we need to do that. There’s always a yin and yang in any process, but the key is the balance. So any hormone that would have a catabolic or breakdown nature, inflammatory nature tends to be in that area and predominantly, the catabolic hormone of major is cortisol. It’s the stress hormone that we experience and the predominant anabolic hormones are testosterone  growth hormone and variants of breakdown products of those two. So in youth, we have large amounts of testosterone growth hormone. Obviously women will have a much lower percentage than men but it’s still relatively high as they get older and as you get older, those begin to decline and this ratio – this anabolic, catabolic ratio will begin to lessen. And not only will it lessen with age, it will lessen with training or types of training, and that’s sort of the key point there. That’s why it’s an important marker of not only your training program or overtraining but it’s also a marker of how are those other factors involved helping the body signal these messengers. And that’s what hormones are. They’re messenger.

Ben: Okay, and so several months ago you tested me for my anabolic, catabolic hormones and we found essentially that I was pretty low. I was disappointingly low especially as an athlete.

Dr. Richard Cohen: Correct.

Ben: Now, when you tested me and I’ve been tested twice now, once just a couple of weeks ago and once a few months ago. You sent me a tube that I dripped saliva into, stood over for about five minutes and I smelled a jar of peanut butter to make my salivate but you also put a little thing there that you can chew to include saliva with, which I discovered the second time. I didn’t find that in there the first time. I missed it. But basically I dripped the saliva and then I sent it off with kind of the pre-paid mailing box that you included along with the tube. And I know that a lot of people have asked me why I didn’t just go to the doctor and get blood drawn to find out my testosterone levels when I did this. Could you explain to people the difference between getting a blood testosterone test or hormone test and a salivary?

Dr. Richard Cohen: Sure, well I’ll try and whittle down an hour chat to two minutes here. There are lots of ways to look at hormones. You can look at hormones through the blood. You can look at hormones through saliva and you can look at hormones through urine. Each one of those has their particular benefits. The key benefit of saliva without getting technical is when the serum… where the hormones are present gets into saliva… actually that process through the lymph acts as sort of a sieve. So whatever hormones are present in the saliva are the actual bio-available… you see, when hormones go through the blood, they’re actually bound predominantly to proteins. So when you check a blood level – most people will have a blood level check, they’ll check total testosterone. What total testosterone is is it tells us how much hormone testosterone is present, but it doesn’t differentiate between that which is bound to protein and that is actually freely available to actually make a difference. So while there’s a correlation if your total testosterone is high, it’s generally assumed that you’re okay but frequently that’s not the case especially for testosterone levels that might be mid-range, and you could say a doctor might say “Oh that’s fine,” because it’s within the range but if there’s a large amount of this binding protein then the testosterone is not doing its job. Saliva sort of eliminates that factor completely because everything you see from saliva is bio-available. So it just gives you a very clinically relevant level of hormones. And while you can measure free testosterone in the blood, there are very few labs that actually truly measure it. A lot of times they will calculate it and that can give you erroneous results. So, as baseline testing, saliva is a wonderful tool. The other benefit to saliva is you do it at home. It’s painless. And you could do it multiple times. We’re actually using a new lab from… the lab we use for Bioletics actually uses four tiny little tubes, Ben, so you could do them through the day and the new assessments will average out the hormone levels which fluctuate through the day. So you can sort of see peaks and valleys and they’ll account for that. Or you could do a series of testosterone on different days. It’s much more user friendly. It’s much less expensive. And generally, it’s more reliable and clinically relevant. Like I said, we could go on about are there some downsides to saliva, if you’re using topical hormones, you need to be aware of that because the levels change and that’s a topic of a different conversation. But as a baseline assessment – extremely reliable, convenient, easy and inexpensive.

Ben: Okay. So I got my saliva tested a few months ago and I sent it off to you and the results were not good. I think I was at – let me check my results – I think I was at 43. I know you have a place online where I can go log in and check my results. I just don’t have that pulled up. But, you wanted that to be – okay, I’m sorry. 46.3. When we talked, what were your recommendations for people who are wanting better energy levels or to enhance their performance in sports?

Dr. Richard Cohen: Right, that’s a good question. And here’s one of the highlight points of what we try and do and sort of the Bioletics concept. You have to be wary of lab tests. Lab tests typically are set up to rule out disease. At Bioletics and what I did for many years in my practice was we look for optimal health. So standardizations of labs don’t necessarily distinguish whether you’re healthy or not. It just distinguishes if you’re not outright deficient and that’s the case with testosterone. The laboratory ranges for saliva are going to be different than testosterone in a serum. We’re looking at a different compartment. But the overall lab range that we’ve seen or the lab has seen will vary depending on the lab you’re using by a little bit, but in essence the range might be 35 to 120. So if you’re under 35, you’re outright deficient or it’s a medical issue. It’s hypogonadal. You’re severe deficiency in hormones. If you had come tested this when you were 18 perhaps, maybe your hormones were 100 or 110 at that point in saliva. It will vary. The same way ever person is a little different and believe it or not there are studies that look at testosterone levels in orthopedics surgeons versus pediatricians, and guess what? The orthopedics have higher testosterone levels. Football players have higher testosterone levels than chess masters. There is a psychological-biological link to that high testosterone with regard to competitiveness and combativeness and risk and threat. So everyone’s baseline, where they were in their youth is different. That’s sort of nice to know. In retrospect, you can’t go back. But if you’re in your early 20s or mid 20s, get a baseline. Know where you are at least. Training will throw that off and we’ll get to that. So you were 46. So if we look at that range of 30 to 35 to 120, you’re down there at the bottom. Now, you’re not outright deficient, but are you where you were 10 years ago before you started training hard? No way. Maybe you were 80 or 90. So you’re not at your youthful optimal levels – your individual optimal level. And that was a concern…

Ben: I’m only 28 years old. I know there’s a lot of people a lot older than that who listen in to the show.

Dr. Richard Cohen: Right, so my analogy always for guys is if you imagine going back again to hormones… it’s almost like living life – I used to say to guys, it’s okay. The signal is getting through. But it’s almost like the bandwidth has narrowed down now. So your signal is in mono or it’s dial up as opposed to DSL. So, it’s just a slower connection, not as much of a signal and you’re not going to recover as quick. All the benefits of testosterone are just not going to be amplified the way you should be. That’s where you were. So the challenge was why? Why is that the case? And that’s where we went from, trying to understand that.

Ben: So what we did over the past few months is kind of interesting. Because you had me start a few different protocols and basically I was doing three things. And I was taking vitamin D. I was taking an essential amino acid powder and then I was also taking the last thing which I’m holding right now in my hands – something you sent me called a testosterone support formula. And that has kind of a cocktail of ingredients in it that I’m looking over. But can you walk the audience through why you had me to what you had me to do to get my testosterone levels back up?

Dr. Richard Cohen: Sure. Let’s look at some of the causes and just so we highlight, I was not that surprised that you were low. It may have been more shocking to you, but we frequently see doing more and more testing now at Bioletics, endurance athletes are less than optimal, we’ll call it in their anabolic, catabolic ratio. Which highlights the point that you can be very fit, but not necessarily healthy. So it’s understanding why this occurs. So endurance training or high level endurance training is a major stressor on their anabolic, catabolic ratios. It’s almost a given. So what we need to do is understand why – what’s going to amplify the signal? And the evaluations we put you through – we’re looking at some of these key foundational factors, these performance factors that will go into play to allow the body to do what it needs to do. Vitamin D, amino acids, magnesium, zinc levels, mineral levels, essential fatty acids – they’re all critical to be at an optimum level because they control the cells. They control enzymes, they control neurotransmitters and all these physiological biochemical parameters are necessary for that signal to be released from the brain. And that’s what happens. The brain releases this signal which tells the testes in men to produce testosterone and then that testosterone is released, it has to circulate through the system. It’s bound to a protein as a carrier and then it needs to stimulate the receptor. So there’s a number of different areas – the pituitary gland could be out of whack. The testicles could be not producing. There could be too much protein carriers. The receptors could be down regulated. So it seems very complicated but the beauty of it is when the body is balanced, it figures out how to fix it. Yes, you could do all sorts of biochemical blood tests to try and figure out where the imbalance is and if someone is very low, someone has severe issues and they’re hypogonadal and you can’t recover it – that’s a medical workup to begin to identify the causes but what we found is by restoring some of these optimal levels and addressing nutritionally – which you’re pretty dialed in on, although we did find that maybe dietarily wise, more protein were going to be important for you. But lifestyle, training, stress… in today’s world a lot of the… zeno-estrogens, especially bisphenols from plastic water bottles – I’ll highlight there, any man who is drinking from a soft water bottle and putting it in their bike in heat is getting a good dose of estrogen. Just throw them away.

Ben: Yeah, there are water bottles out there that are BPA free. You can just check…

Dr. Richard Cohen: You can get BPA free now. So we’ve actually seen estrogen levels up after guys drinking water out of a bottle. So it’s a problem. All these modern lifestyle factors are a major load within the system. So getting back to you, we knew you were pretty good, very good compared to everyone with regard to the lifestyle factors. We made some tweaks and then we just picked off one – the three or four things that were not optimal – your amino acids, I recall. The D was pretty good. But we made sure that was ideal. We didn’t do EFA with you, did we? I don’t think we were doing that at that point.

Ben: No, we haven’t done much with the essential fatty acids, yet.

Dr. Richard Cohen: Right. So we’ve talked about that, but that’s a newer test of ours. But by restoring those few things and then in your case, we had an option of okay, do we just do that and then wait and re-test you or are you low enough and certainly since you are in active training, do we just give you some support to cover you? Some nutritional herbal support. I think that’s the key point here, is there are lots of ways to recover hormones and primarily the first thing to do is restore imbalances. Restore these blatant imbalances which we’re assessing, and generally if the body is in a good place you can see a boost in hormone levels. But if you’re going to continue to train hard, that’s still going to be a stressor on the system so it’s like okay, what else can we do? There are particular herbs and nutrients that have been well studied to have effects on these key pathways that we discussed. The brain’s ability to release a signal to the testes, the testes’ ability to produce testosterone, the body’s ability to not bind up too much testosterone in the serum and then the receptors in the cell’s ability to recognize that. So there are four areas and the fifth one I consider is the major issue – is not having too many estrogens in your system. Because estrogen will actually down regulate… it serves as the body’s natural feedback to stop testosterone production. Testosterone naturally converts to estrogen so that’s the body’s thermostat system. It’s like the heat in the house going too high, the thermostat shuts off the heat. So, having too much estrogen besides having the side effects of too much estrogen would not be desirable for a man. It shuts down natural testosterone production. So the formula we use uses a number of different herbs that have the ability to support all those systems in a nutritional manner. So working with your body to help that process along. Now you can go out and go to a bodybuilding store or sports supplement stores and you can find pro-steroids and pro-hormones and things such as that and they work differently. In essence, those are just “legal hormones.” And the fact that some have direct receptor activity, meaning they sort of act like testosterone. Some don’t act directly but they’re one or two biochemical steps away so you take them and they convert to a testosterone-like molecule which directly stimulates the receptors. So in essence that’s a testosterone replacement and that has issues with testing and also has issues where you’re not really working with your body at that point….

Ben: When you say that has issues with testing, what do you mean?

Dr. Richard Cohen: If you’re a competitive athlete who might have drug testing…

Ben: Okay, gotcha.

Dr. Richard Cohen: So anyone who has drug testing and is using a pro-steroid or a pro-hormone product, they may find it works really well for them but you’re going to probably be called to task on that because you’ll test positive within the parameters. That’s a second or third line choice and it’s really in my book someone who is very deficient, can’t recover by doing all these basic core steps and the other risk of using some of these pro-steroid, pro-hormone is if you continually use those, you can further reduce your body’s natural production. That’s why… there’s a place for that. That’s why people cycle them. Because if you use them for periods of time, you do shut down and develop some issues. But that’s not our goal. We’re working with the biology, so the herbal formula that you used – just natural herbs, none of them have any issues with regulatory racing testing and they work to support those different pathways. Does that make sense?

Ben: Yeah, yeah. Makes perfect sense.

Dr. Richard Cohen: I guess one other thing is while you don’t need to cycle them to be concerned about negative effects, most herbs when you take them, it’s generally good to cycle them just to have the continued effect. Like anything, the body continues to recognize things and become familiar with them. So some of these active constituents in the herbs become a little less effective.

Ben: Right. That’s why I’ve been following your instructions that you sent along with this. I kind of have cycled through it through the week so there are some days that I don’t take it and some days that I do take it.

Dr. Richard Cohen: Right, and then take a break every four weeks or so, for a week and then come back to it. So it’s basically fresher to the body and these phytonutrients that are present… herbs have a greater likelihood of having a stronger effect.

Ben: Okay so I did all these things. The testosterone support formula you sent, the vitamin D and then the essential amino acids and then I re-tested and while I was actually on this protocol, I wasn’t actually getting numbers. I didn’t know what was happening to my testosterone but I was feeling some of the changes that I guess I would have expected to feel if my testosterone levels were increasing. A little less sore after workouts, I actually was getting a lot more… I did a lot of basketball and stuff in the offseason, I felt like I was getting a lot more competitive. Not in a bad way, I wasn’t ripping people’s heads off or anything or going Incredible Hulk in the grocery store but I felt like I had a little more aggressiveness and competitiveness. Definitely noticed changes in terms of the bedroom – sexual energy. I noticed changes in the amount of weight that I was able to or even wanting to lift in my weight room workouts and then I also found that I was bouncing back a little bit quicker from my workouts in terms of energy. So I kind of knew that some things were happening. I just wasn’t sure if they were placebo or if they were actually real. And then I re-tested the testosterone levels and literally just a few days ago, you sent me my results back. Now, from 46.3, my testosterone is at 74.2 and I haven’t talked to you since I got these results. But is that good?

Dr. Richard Cohen: It’s much better, correct. So you see 74 for that, we’re not really concerned at all. It’d be nice if it were 90, but ultimately I don’t know where you were when you were 20. So based on – I couldn’t have said it any better. You really just explained exactly the normal beneficial effects you’re going to get from having a good hormone level. So it’s right on. You’re feeling the effects, your hormone levels are up – it’s not worth worrying about at this point. Whatever we’re doing is getting the job done and you have to – while we like to use numbers doing these assessments, ultimately it’s also feedback. A number is a number and ultimately it’s using those numbers to guide you and determine, hey are you experiencing this or not. Where that may be a great number for you, but some guy who was 130… 76 initially would be a problem. Especially if he’s saying, hey I’m not recovering well. I’m flat in the bedroom. And my drive… I don’t want to go out and race, etc. It’s like okay. So it’s a little bit of – well it’s a lot individualized as well.

Ben: Right, now one last thing I wanted to ask you was some of the other hormones that I’m seeing on my results sheet – obviously the one we really wanted to focus in on was the testosterone, but you’ve tested some other things as well and can you talk about that.

Dr. Richard Cohen: Sure. So you can test a number of different hormones. We try and screen out currently four: testosterone, estrodial, DHEA and cortisol. So as we talked at the beginning, testosterone and cortisol are the primary anabolic, catabolic hormones for men and women. While the ratios are different you certainly can pick off women who it might be too low in and similar type symptoms if testosterone is very low. The concern is more so in men because we’re not looking at estrogen or progesterone which are present in both men and women but it’s just different levels. We all have the same hormones. It’s just the ratios and levels which are different. My concern is anyone that might have a lower testosterone –I  want to make sure that their estrogen isn’t too high because as we said, estrogen can suppress testosterone and there’s just so many environmental chemicals now that it’s a problem. Generally seeing less of an issue – estrogens in endurance athletes tend to be leaner and estrogens tend to get stored in the body fat. In fact, the more fat you have, the more estrogen you make and the more estrogen you have, the more body fat you have. So it’s a vicious cycle. So anyone who has trouble losing weight or feeling doughy or soft – generally it’s high… estrodials are higher than they need to be and also cortisol, because those will work together. In men, estrodial works as a catabolic breakdown hormone. It’s opposing the anabolic testosterone. The other hormone we look at is DHEA and DHEA is sort of right in the middle. It’s in an adrenal hormone but it can go to testosterone especially in women. And it acts as a stress recovery booster. It declines as we age and it declines with stress. So if I see DHEA, low, and although there’s no cortisol shift, it’s a definite sign that the body is under stress and you can restore that or take some – we use a DHEA cream actually. Different ones in men and women. One DHEA called 7-Keto DHEA that doesn’t convert to estrogen. That’s one of the problems with DHEA. In men, DHEA will not convert very readily to testosterone. But in women, DHEA can be a nice kind of precursor to enhancing testosterone. So, we’re not also prescribing testosterone… that gets again into medical type issues but if your DHEA is low, you can get an over the counter although again, someone who is racing is going to be testing. They’d probably not want to use DHEA or be aware of that since that can go to testosterone, a small amount and that may shift some of the urine testing and come up as… I think in most professional cycling races DHEA is a banned substance. The rules are sort of strange. But from a practical point of view, DHEA gives you a sign of that stress response and women if their testosterone is low and DHEA is low, that’s a good hormone to consider taking a small amount of. I think they’ll get a nice… generally get a good boost from that. Like I said, estrodial, definitely in men – you want that to be less than an average amount. In your case that was good, so we saw… I think your estrodial was .7 and a good range is .5 to 1.5. I like to see it 1 or under. You actually need a little bit because going too low is also an issue. Estrogen has some effects on the brain in a positive way for men. So it’s all yin and yang. Same thing. Catabolic, anabolic. You need a balance. So we’re looking at that more and we’ve actually added – we didn’t originally do the estrodial and DHEA. I started looking at the pictures coming back and trying to understand the scenarios and we’re just missing out some information. So we just get a more complete information from this. So we can get a better sense of where people are. So it’s nice to see that whole picture, and again if we go back to blood – these are numbers that typically you’re not going to get. So just doing a total testosterone in blood doesn’t tell you where your estrogen is, doesn’t tell you where the catabolic cortisol is and actually cortisol done by blood is a stress so you could actually get a misleading result. So that’s one of the benefits again from saliva. The best way to look at cortisol because it’s a hormone that has a very strong circadian rhythm and the levels will be 20 times higher in the morning than it will be at night, which just as an aside, if you’re ever sick sometimes you feel better in the morning and at night you feel thrashed out or you’re tired – well your natural cortisol levels have gone down and part of the reason to sleep is to recover. And you’re recovering your cortisol levels. It’s that circadian rhythm. So if you can do – if someone is truly having a stress response and not recovering, you can do four samples of cortisol with saliva through the day and you can begin to see where that rhythm is off and make some changes. You’re not going to do that. Another benefit of saliva from a practical testing point of view.

Ben: Well obviously a lot of information as far as hormones are concerned and like I said, if you’re listening in and you just want the full picture of everything – after you listen to this, go listen to podcast 53, go listen to 62 and it’ll kind of put everything together for you and you’ll be an expert on what you need to know about as far as what’s going on inside your body, whether it’s just for your health, for your energy, for your performance levels, whatever.

Dr. Richard Cohen: I guess Ben, it’s a little bit like an owner’s manual to our body. The body never came with an owner’s manual. We’ve relied on doctors to tell us how that works and unfortunately nowadays we’re primarily disease oriented and what we’re hoping and what we’re trying to do is give you a healthy orientation of some of the most important things you need to know about your body and the ability to do your own monitoring which is sort of cool.

Ben: Right. Alright, well cool. I’ll put a link to Bioletics in the Shownotes so that people can go check out how to order a testosterone kit to get themselves tested and you can go to the Shownotes for this episode, number 80 and check that out. So just go on and read the Shownotes. There’ll be the links for you to read a little bit more. I’ll put a link to the other podcasts on which Dr. Cohen was giving us more information, and Dr. Cohen I want to thank you for coming on the line today.

Dr. Richard Cohen: Hey, I appreciate it. It’s always fun.

Ben: Alright, we’ll catch you later.

Dr. Richard Cohen: Thanks Ben.

For personal nutrition, fitness  or triathlon consulting, supplements, books or DVD’s from Ben Greenfield, please visit Pacific Elite Fitness at http://www.pacificfit.net

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