Dear Faithful Reader, as you might expect, I have been obsessively studying everything related to testosterone, free testosterone, sex hormone binding globulin, estrogen and how to improve my current endocrine status. I’ve gone deep into the world of testosterone replacement therapy, erectile dysfunction medications, anabolic steroids, SARMS, diet, vitamins, minerals, herbal concoctions and the power of positive thinking. Well, the last one is not true.
Since I last spoke to you on this topic, I have altered my diet and added some new supplements, as well as scheduled a visit with my Dr. to discuss daily tadalafil, aka Cialis. I’ll give you an outline on each, why I did it, why I might do it, and then for the wrap up, the results of my retest. Yes, I was going to wait until March 1st, but I couldn’t. I also wanted to add estrogen to my test result which I didn’t get the first time, so that helped me justify spending the cash on an early retest.
First things first. I’ve learned that testosterone levels fluctuate a lot during the day. For men, the early morning brings a peak, followed by a decline into the afternoon, and some stabilization in the evening. So if you want to test your levels, get blood drawn in the morning, no later than around 10:00 AM. Contrary to what I always believed; that sex drive and libido were driven by the levels of testosterone one has, it’s quite the other way around. When the brain identifies that a possibility exists for mating, it pumps out the signals to produce more testosterone. Single dating men have higher average levels of testosterone than single men who are not actively dating, who have higher levels than married men, who have higher levels than married men with children. Married men with newly born children have the lowest levels of all. If you think about this from an evolutionary standpoint, it makes perfect sense. The purpose of life is to continue life. Nature cares not one iota about anything else. Stay alive long enough to pass on your genes to the next generation. That’s the whole kit and caboodle. Studies have shown that just watching porn for a few minutes spikes testosterone levels. Why? Because we’ve fooled our reptilian brain into thinking there’s a possibility for procreation and it prepares to send the troops into battle. It doesn’t know that you’re on your smartphone as you sit in the parking lot before going in for your blood draw. Yes, I did that. So a perfectly natural way to improve testosterone levels, at least temporarily, is to provide the brain some visual stimulus that sex could be imminent. A little porn as a pre-workout is a good idea. Interestingly, actual sex causes testosterone to plummet, so don’t have sex before you do heavy Squats.
Not all of your testosterone is actually biologically available. Sex hormone binding globulin (SHBG), produced by the liver, brain and other tissues, binds with testosterone very strongly and while it’s supposed to be transporting it around the body, it holds it captive and won’t let it attach to the androgen receptors on the muscle cells, which is where I want it to go. Not all of the testosterone is attached to the SHBG, and that’s called free testosterone (FT). That T is available to do the anabolic and androgenic things us males want it to do. The more SHBG circulating around in your blood, the less FT you have.
There’s a pesky enzyme called aromatase that converts some of the T your body produces into estrogen (E). Even men need estrogen so that we’ll watch romantic comedies. Your body likes to keep a steady balance between T and E, which appears genetically determined. I should have picked better parents.
Since the results of my December test showed an alarmingly low level of T and FT, with an alarmingly high level of SHBG, I took immediate action with the things I could quickly change. I started increasing my fat and cholesterol intake, switching from ground turkey to ground beef, adding more beef, switching to chicken thighs instead of chicken breasts, and not trimming off all that gross fat. I’ve been eating 4 eggs for breakfast every day. I felt the evidence was pretty compelling that a ketogenic diet increases T levels, so I slowly cut the carbs (which was pretty easy to do as I had to anyway, since my fats were so much higher) until I ran out of them in the fridge. I went fully keto 1/13/21.
Next up were the supplements. The most impressive result was the DHEA. I started with 25 MG of oral DHEA, but read that a lot of that gets destroyed by the liver, so sublingual is the way to go. I started doing the sublingual and bumped the dose to 50 MG. DHEA is a testosterone precursor, so with more of it around, the body will convert it to the androgen hormones, T and E. My DHEA supplementation really boosted my DHEA levels. I mean, almost doubled. I stopped taking it this morning, will give it a week or so to clear my system, and then start again. The most disappointing is D-Aspartic Acid. I had already seen conflicting evidence of its efficacy, so I didn’t think it would work anyway. Honestly, I don’t have any way of knowing if it contributed to the results because I threw everything at the problem at once, but the studies I’ve read are pretty strongly suggestive that it does not increase T levels. I tossed what I had left this morning.
As I mentioned above, our bodies create and maintain a T/E ratio by aromatizing some of the T to E. If we could inhibit the aromatase enzyme, the ratio would get out of the preferred balance, with T rising more than E. This will cause the body to produce more T to convert to E and restore balance, thus increasing levels. There are prescription level aromatase inhibitors (AI), but I didn’t go black market to buy those. Instead, I went the herbal route and found a handful with pretty good evidence behind them. They include:
- Fenugreek
- Saw Palmetto
- Astaxanthin
Based on my results, they seem to work. My E levels and prolactin levels were at the very low end of the normal range, so they are probably responsible for my current T levels, which as you may be guessing, are higher than they were a month ago.
Now to the persistent issue of elevated SHBG levels. I’m still in the normal range, but at the high end of it and even higher than I was in December! That, my friends, is not acceptable. The supplements I’m taking to address it, while apparently ineffective, are:
- DIM
- Boron
- Stinging Nettle
- Tongkat Ali
So I’ve increased the dose of each, and am now scouring the internet for what could be driving my elevated levels, besides my age and genetic predisposition. My first thought was the SSRI I’ve been taking for at least a decade. But I can’t find any evidence to show that’s the case. I’m still contemplating coming off them and seeing what happens, but my anxiety was pretty debilitating back in the day, and I’m anxious just thinking about being anxious! Not sure if it’s worth it to return to that state of mind for potentially improving my FT. Just typing that makes it seem absurd. Imagine if I did get a slight drop in SHBG and get 1 or 2 points on my FT. Doubtful I would feel anything from it, get any hypertrophic or strength benefits from it, and run the risk of anxiety overcoming my relatively chill state of being.
The next likely culprit is a Catch-22 if I’m using that correctly. SHBG is decreased by insulin, but I’m using a ketogenic diet, which creates low insulin levels, but raises T levels. So if I went back to a more carb-based diet to increase insulin secretion, thereby decreasing SHBG, I’d risk lowering T levels.
Then I struck on something very interesting. Growth hormone and IFG-1 appear to be negatively correlated with levels of SHBG. Higher growth hormone levels correlate with lower SHBG levels. I don’t know if one causes the other, or it’s just how they interact in the body, but the data seems pretty clear. I discovered this in a deep dive into the wild world of Selective Androgen Receptor Modulators (SARMs). I’d heard of SARMs before, but just casually from a few mentions on videos or articles I’d seen. They are a fascinating new medical product still being researched, but the results are really promising. As the name implies, these chemicals are selective in which androgen receptor (AR) they impact. Some SARMs are designed to interact with the AR in muscle cells, causing them to grow in response to the SARM, without having any impact on other tissues in the body. It’s an amazing development in the treatment of muscle wasting diseases and muscular atrophy. RAD 140 is an interesting SARM I took a good look at, and it’s rolling around in the back of my mind, but I’m not quite ready to go there. SARMs are not anabolic steroids (AAS), but they are very similar. The biggest difference is that AAS effect all the AR receptors in the body, where SARMs selectively just impact muscle cell AR. Another major difference is that they’re legal to purchase and own, although they are not intended for human consumption but as research products. AAS on the other hand, are illegal to own and purchase, at least in the USA. One product in the SARM family that is apropos to what I’m talking about here is MK 677, which isn’t actually a SARM, but a growth hormone secretagogue. It tells your body to produce more growth hormone. Well how about that? I’m not saying I’m going to take it, but I did buy some to have on hand.
Speaking of AAS, that was a fascinating week or so of study. AAS are obviously very popular in the world of fitness and has resulted in many tested athletes getting busted as they are banned substances in competitive sports, because they work really well. Users will be more muscular, stronger, faster, recover better from training and just generally be better athletes than their non-steroid using competitors. While they’re illegal to buy and own in the USA, they are incredibly easy to actually buy and remarkably inexpensive. You can buy a nice AAS and post cycle therapy (PCT) setup for less than you might spend at Vitamin Shoppe getting pills and powders. I am not considering using illegal substances obviously, but they are fascinating to learn about. It did prompt me to look into the legal alternative though, which is testosterone replacement therapy (TRT).
TRT is a legal, medically prescribed therapy to replace one’s natural testosterone. It’s commonly used in older men whose natural production has put them in a hypo-gonadal state resulting in symptoms and increasing their risk of all kinds of diseases. It’s also used in younger men whose bodies don’t produce enough testosterone. My December results put me very close to the level at which TRT would be considered, and I’m willing to bet a local men’s clinic or an online men’s clinic would happily hook me up with a prescription for 100MG or so of testosterone every week. The good news for me, is my levels are now much higher and safely out of the Danger Zone because going on TRT is a serious decision. It’s permanent. Literally lifelong. Once you start providing the body with levels of testosterone it didn’t have to make, it stops making it altogether. That’s the reason AAS users have to cycle off the AAS and do a PCT to try to kick start their normal T production which essentially shut down while they were injecting steroids.
Last but not least, I mentioned I will be talking to my doctor about getting a scrip for Cialis. While Cialis (generically known as tadalafil) is an erectile dysfunction drug, one of the lovely side effects is a decrease in E with a resulting improvement in T/E ratio and more T. Studies have even shown a gain in lean muscle mass from men taking a low daily dose of tadalafil. Talk about a sweet deal.
To wrap up, here’s what a little over a month of effort did for my T levels. If I had to guess, I’d say the DHEA had the most impact, followed by the AI supplements, and perhaps the dietary changes. I’m not sure when I’ll retest, but what I might do to save a little cash (the full hormone panel was pretty pricey) is just test the SHBG and/or the DHEA which are $79 vs. $299 for a full panel. I use Accessa Labs by the way, and they are awesome.
December 8, 2020:
Total T: 364 ng/dl (low normal)
Free T: 33.7 pg/ml (low)
DHEA-S: 263 mcg/dl (high normal)
SHBG: 60 nmol/l (high normal)
January 21, 2021
Total T: 476 ng/dl (normal)
Free T: 43.3 pg/ml (low normal)
DHEA-S: 483 mcg/dl (high) Yowza!
SHBG: 67 nmol/l (high normal) dammit
Estradiol: 17 pg/ml (low normal)
Prolactin: 4.8 ng/ml (low normal)
There you have it Faithful Reader. The quest continues, but I have moved away from the edge of the cliff and have reclaimed some lost territory N.O.V.
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