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Is Constant Ketosis Necessary – Or Even Desirable?

Good morning, folks. With next week’s The Keto Reset Diet release, I’ve got keto on the mind today?unsurprisingly. I’ve had a lot of questions lately on duration. As I’ve mentioned before, a good six weeks of ketosis puts in place all the metabolic machinery for lasting adaptation (those extra mitochondria don’t evaporate if/when you return to traditional Primal eating).

But what about the other end of the issue? How long is too long?  I don’t do this often, but today I’m reposting an article from a couple of years ago on this very topic. I’ve added a few thoughts based on my recent experience. See what you think, and be sure to share any lingering questions on the question of keto timing and process. I’ll be happy to answer them in upcoming posts and Dear Mark columns.

Every day I get links to interesting papers. It’s hard not to when thousands of new studies are published every day and thousands of readers deliver the best ones to my inbox. And while I enjoy thumbing through the links simply for curiosity’s sake, they can also seed new ideas that lead to research rabbit holes and full-fledged posts. It’s probably the favorite part of my day: research and synthesis and the gestation of future blogs. The hard part is collecting, collating, and then transcribing the ideas swirling around inside my brain into readable prose and hopefully getting an article out of it that I can share with you.

A while back I briefly mentioned a paper concerning a ketone metabolite known as beta-hydroxybutyrate, or BHB, and its ability to block the activity of a set of inflammatory genes. This particular set of genes, known as the NLRP3 inflammasome, has been linked to Alzheimer’s disease, atherosclerosis, metabolic syndrome, and age-related macular degeneration. In other words, it’s in our best interest to avoid its chronic, pathogenic activation, and it looks like going into ketosis can probably help in that respect.

One thing led to another, and this paper got me thinking: once we “go into ketosis,” how long should we stay? If some is good, is more better? Is there a point where the benefits slow and the downsides accrue?

We absolutely know that ketones, particularly BHB, do lots of cool things for us. There’s the NLRP3 inflammasome inhibition, for one. There’s also the effect it has on brain health and function, particularly in the context of neurodegenerative diseases and other brain conditions.

Brain Aging:

Whether it’s severe hypoglycemia in a live rat or direct glucose deprivation of cortical cells in a petri dish, the addition of BHB protects against neuronal death, preserves energy levels, and lowers reactive oxygen species.
In an animal model of Cockayne syndrome, a condition characterized by premature aging, short stature, and early death (about age 10 in most human children with it), increasing BHB through ketosis postpones brain aging.

Brain Disorders:

Ketogenic diets are classic therapies for epilepsy, with BHB being the most important ketone for preventing seizures. The degree of seizure control tracks almost lockstep with rising BHB levels.
There’s also evidence that patients with bipolar ? a disorder sharing certain neurobiological pathways and effective therapies with epilepsy ? can also benefit from ketosis. Recent case studies show complete remission of symptoms in two patients as long as they adhered to their diets (which were fairly Primal-friendly, for what it’s worth).
Parkinson’s disease patients who adhered to a ketogenic diet saw improvements in their Unified Parkinson’s Disease Rating Scale scores.

Brain Function:

Type 1 diabetics who experience reduced cognitive function because of low blood sugar see those deficits erased by increasing BHB through dietary medium chain triglycerides (the same fats found in coconut oil).
In memory impaired adults, some with Alzheimer’s, BHB improved cognition. Scores improved in (rough) parallel with rising ketones.
A ketone-elevating agent (purified medium chain triglycerides) improved cognition in patients with mild to moderate Alzheimer’s.
A very low-carb diet improved memory in older adults. Again, ketones tracked with improvements.

Mitochondrial levels of the endogenous antioxidant glutathione increase on a ketogenic diet; this is likely a major reason for many of its beneficial effects.

It’s quite clear why constant ketosis is attractive to people who read about (and experience for themselves) the benefits of BHB and ketosis in general: There don’t appear to be many downsides. Improved brain health? Increased antioxidant capacity? Inhibition of an inflammatory set of genes involved in the worst kinds of degenerative diseases? What’s not to love? Why wouldn’t someone remain indefinitely ketogenic?

Ketosis also activates the NRF2 pathway ? a set of genes that regulate the body’s detoxification, antioxidant, and stress response systems ? by initially increasing systemic oxidative stress. If that sounds a bit like hormesis, you’d be right. Ketosis, at least in the early stages, exerts some of its beneficial effects via hormetic stress. Various other stressors also activate NRF2, like plant polyphenols from foods like blueberries and green tea, potent spices like turmeric, intense exercise, and intermittent fasting. These all improve our health by triggering our stress resistance pathways and making us grow stronger for it, but they can also be taken to an extreme and become negative stressors.

Consider intermittent fasting and exercise. While the most famous way to increase BHB is to go on a ketogenic diet, it’s not the only way. Both fasting and exercise also do the trick:

A properly-executed fast puts you into full-blown ketosis. In healthy adults, two days of fasting increases brain BHB almost 12-fold (and almost 20-fold after 3 days). Even just an eight hour fast, AKA a good night’s sleep, will put you into ketosis and increase BHB (PDF) if you have strong metabolic health.
Exercise-mediated increases of BHB are a good barometer for the amount of fat a person will lose during a workout program. The more body fat you carry, the greater the elevation in BHB and the more weight you’ll lose.

What do you notice?

These are both transient states that grow problematic when extended indefinitely.

You can’t fast forever. That’s called starvation. And, eventually, dying.

Instead, you fast for 12, 16, 24, or on the very rare occasion 36 hours, and resume your normal diet after the fasting period has ended. You introduce an acute bout of food deprivation to upregulate your fat burning, trigger cellular autophagy, and generate ketone bodies.

You can’t train every waking hour. That’s called working in a forced labor camp, and it too leads to very poor health.

Instead of training 12 hours a day, you sprint, or lift weights, swing a kettlebell really intensely, or any other type of training two or three times a week. Then, you rest and recover and eat, and grow stronger, more fit, and faster in the interim.

Ketosis isn’t fasting. It’s not starvation. You’re still eating, although your appetite may be reduced (which is why many people lose weight from ketogenic diets). You’re still taking in nutrients, even if glucose isn’t among them. And ketosis isn’t anywhere near as acutely stressful as a strong training session. But I think the principle stands: these are all stressors that exert benefits, at least in part, along the hormetic pathway. And when it comes to hormetic stressors, too much of a good thing usually isn’t very good.

What Does This Mean for Indefinite, Long-Term Ketogenic Dieting?

If you’ve got a legitimate health condition that responds well to ketosis, all bets are off. There’s evidence that people can thrive on good ketogenic diets for at least five years without incurring any serious side effects. For controlling epilepsy, there’s nothing better than a strict ketogenic diet maintained long term to quell the overexcited brain. For any of the neurodegenerative diseases, like Alzheimer’s or Parkinson’s, ketogenic diets look very promising and are worth trying. It even looks promising for bipolar disorder. If you’ve got a problem that ketosis helps or fixes, go for it. It’s helping you, and there’s no mistaking that.

My personal hunch (and I’ve said this for as long as I can remember) is that indefinite ketosis is unnecessary and perhaps even undesirable for most healthy people, and that occasional, even regular dips into ketosis (through fasting, very low-carb cycles, intense exercise) are preferable and sufficient. That way, you get the benefits of cyclical infusions of BHB and other ketones without running afoul of any potential unforeseen negative effects.

Plus, cycling your ketosis means you can eat berries and stone fruits when in season, and enjoy those otherworldly-delicious purple sweet potatoes without worrying. Personally, I like food too much to go full-on, indefinite keto. You may not, and that’s okay.

If you’re thriving on a ketogenic diet, and have been for some time, keep it up. No one can take that away from you, and the studies indicate it should be safe. I certainly know people who have lived a keto lifestyle for years without issue.

But if you don’t have to remain in ketosis to resolve or stave off a health condition, if you’re just doing it to do it or for yet-to-be-realized benefits, consider rethinking your stance. And if ketosis doesn’t agree with your health or your personal performance goals, then don’t consider it an obligation.

Because the goal of keto isn’t keto itself. It’s the metabolic reset that confers a potent and enduring flexibility. It’s the recalibration of inflammatory patterns along with other aforementioned benefits. How we customize our keto (or more traditional Primal) approaches should ultimately serve optimal personal health, not technically-minded dogma.

That’s it for today, folks! What about you? If anyone’s been on a long-term ketogenic diet, I’d love to hear how it’s worked for you in the comments below. Thanks for reading!

The post Is Constant Ketosis Necessary – Or Even Desirable? appeared first on Mark's Daily Apple.

9 Ways to Normalize Your Hormones

There are straightforward, pharmaceutical methods for altering specific hormones, and, as I showed in last week’s testosterone replacement therapy post, they can really help. But a safer intervention for your overall endocrine environment is a systemic one. Some might call it scattershot approach in that one input affects multiple endocrine targets. I’d say, “That’s the whole point.”

Today, I’m going to give you some tried and true methods for helping to normalize your endocrine health. These are things that apply to everyone, as far as I can tell. They won’t fix every problem, but they’re good places to start. Whether you’re a post-menopausal woman, a 21-year-old bodybuilder worried about overtraining, or a thyroid patient, these interventions can’t hurt and will probably help.

Get Your Sleep in Order

When you sleep poorly, everything falls apart, including the normal function and patterns of testosterone, thyroid, and growth hormone. Sleep loss itself alters the activity of the master endocrine organ, the pituitary gland, so following good sleep hygiene is a non-negotiable.

Sleep in a cold, dark, quiet room.

Get plenty of bright natural light throughout the day, especially the morning, and limit bright light after dark, especially blue and green lights. Sun lamps can help if actual natural light is unavailable during the day. Blue-blocking goggles or glasses like these (inexpensive, block blue but not much green light) or these (expensive, but block both blue and green) can help at night.

Use the seasonal variation of daylight as a rough barometer for how much sleep to get. In the summer, when it’s lighter longer, you can probably get by with 7-8 hours. In the winter, when it’s darker longer, you should aim for 8 at a minimum and 9 as an ideal.

Check out TS Wiley’s Lights Out for a full treatise on seasonal sleep variations, and why they’re so important.

Make the effort—nay, commitment—to get more sleep. Stop fiddling with your phone at 10 PM (you always regret doing it). Don’t fall asleep with the TV on (read a book instead). Get a bedtime routine.

Get Your Diet in Order

To make hormones, you need the basic structural building blocks. That means eating enough dietary fat, especially saturated, monounsaturated, and omega-3 fats.

Cholesterol is an important building block, too, and has been shown to increase muscle and strength gains in weight training adults, an indication of testosterone boosting.

Minerals like zinc, selenium, magnesium, and calcium are also extremely important for healthy hormone production and metabolism.

You also need to make sure you’re eating enough calories—not too many, not too few—as the amount of food you eat sends a strong signal about the bountifulness of the environment around you. Hormones like leptin, thyroid, testosterone, insulin, and others all perceive and are modulated by the caloric balance. Your endocrine system responds to the availability of energy by up- or down-regulating hormone production. You’re not going to get pregnant very easily during a famine, nor will you produce much testosterone if you’re obese.

Carb/glycogen balance is another indicator your endocrine system uses to determine production. If you’re training hard and burning through glycogen, you’ll probably need to eat some carbs. If you’re just doing easy slow movement, some sprints, and strength training, you probably don’t need extra carbs. The key is to eat the carbs that you earned—no more, no less.

Hammer Home Primal Style Exercise—and Avoid Any Whiff of Chronic Patterns

For Crossfit hardcores, that might mean dropping from 4x/week to 2-3x. For endurance heads, that might mean trading 140.6 goals for 70.3 goals, or 26.2 2 for 13.1 (and buying the requisite new bumper sticker, of course). For everyone, that means making your short, intense workouts even shorter and more intense.

My good friend, former co-competitor, and current writing partner, Brad Kearns, more than doubled his free testosterone simply by sucking it up and lowering his assumed aerobic base heart rate (the heart rate at which you’re burning primarily fat) from 145 to 130. Didn’t change his actual training, diet, or anything else. Staying at or below 130 HR during long slow days was enough to get his free T to the 99th percentile for his age.

Increase Your Non-Exercise Movement

Increased daily movement—fidgeting, walking, housework, gardening, carrying groceries, playing with your kids/pets—adds up, and it’s something that the most health- and fitness-conscious tend to ignore or discount. This is the stuff Katy Bowman talks about in Move Your DNA and Don’t Just Sit There.

Sitting time predicts estrogen metabolites in postmenopausal women, with more sitting time predicting rises in the same metabolites associated with breast and endometrial cancer.
Breaking up sitting with frequent standing and easy movement improves insulin sensitivity.
The more men sit in front of the TV, the lower their testosterone.

Exercise isn’t enough.

Manage Your Stress

When we’re stressed out, everything gets put on hold until we can deal with the stressor. This makes sense, because back in the day a stressor was usually a life or death situation like an enemy tribe encroaching on your tribe, a huge predatory cat, or famine. Even though most stressors these days aren’t life or death in the immediate sense, our body treats them like that—and there are a seemingly endless string of them to contend with.

What happens when stress hits? Cortisol appears. If stress sticks around, or constantly wells up, cortisol levels become chronic and disrupt your endocrine system. Chronic cortisol opposes testosterone production. Chronic cortisol reduces thyroid hormone production and impairs the conversion of inactive T4 to active T3. Chronic cortisol makes you insulin-resistant.

Everyone’s stressors are unique, but there are some big ones to watch out for: toxic relationships, terrible commutes (at the very least, find a great podcast you can listen to on the drive/ride), lack of time in nature, excessive technology exposure (especially social media). 

Discover Meaning in Your Life

Hormones direct physiological processes in the body. They’re a bit like software programs—if they’re riddled with bugs, nothing gets done. But just as computers need a user to tell the software what to do, our bodies need a narrator to give the hormones a goal to work toward. Without meaning or life purpose, the endocrine system drifts aimlessly. Why produce testosterone if there’s no competition on the horizon?

There’s admittedly not a ton of clinical support for this hypothesis. Middle-aged women with strong life purposes have better sex lives, indicating a more favorable hormonal environment. I suspect a lot of the links between life purpose and hormonal function are circular, with causation going in both directions. But that means disrupting the circle at any point can help.

Search within for what makes you tick. What makes you get up in the morning. What inflames the passions and makes you feel strong and good and right when you’re knee-deep in it. Then stick to that.

Test Frequently and Track Relevant Variables

I’m a big believer in following the symptoms, in going by how you feel, look, and perform. But having the numbers in front of you can really help, especially if you if you pair them with your symptoms, get tested at regular intervals, and track the trends.

Case in point is the earlier example of Brad Kearns, who more than doubled his free testosterone by tweaking his training and tracking the trends in his numbers. Had he not done the testing, he wouldn’t have any reference points.

Directlabs has good deals on male and female hormonal panels.

Get Uncomfortable

We lead comfortable lives. Everything works. We don’t have to face pulse-pounding situations or bring down large game just to eat. If we get cold, we turn up the heat. Hot, we turn up the AC. Things are so easy that we can spend all winter in short sleeves. It turns out that exposure to uncomfortable physical and mental sensations is important for hormone function.

Cold exposure is great at improving insulin sensitivity and reducing insulin levels. In one study, women swam in cold water at least twice a week for 7 months, enjoying huge increases in insulin sensitivity and drops in insulin.

Heat exposure also has positive hormonal effects. It increases endocrine homeostasis in Russian fighters. Sauna use increases insulin sensitivity. A 1989 study found upwards of 5-fold increases in GH after using a sauna.

Bring In the Professionals

Sometimes you just need modern professional medical help. As I’ve said time and time again, the Primal Blueprint is about availing ourselves of everything both traditional wisdom and modern science have to offer. And because our environments are so wildly different from our evolutionary environments, we occasionally need to step outside of “natural” methods to get the help we need. Sometimes replacement therapy is the ticket. Sometimes supplementation and healing protocols. That’s okay, especially if they’re laid atop a strong foundation of ancestral health practices. There are no purity tests.

And yes, they may recommend hormone replacement therapies or pharma/nutraceuticals. Exercise caution and implement extreme vetting, but don’t dismiss them out of hand. According to Weston A. Price, North American Indian tribes would often harvest moose thyroids when they were at their largest and most potent and reserve them for men and women trying to conceive. They may not have known the word “thyroid” or even understood the concept of a hormone, but they took artificial steps to enhance men and women’s hormonal health.

For more guidance, check out the podcasts Elle Russ did with Dr. Gary Foresman. He’s a former UC Irvine doctor who got sick and tired of all the nonsense and decided to branch out into integrative medicine.

NourishBalanceThrive does comprehensive testing and consultation for the peak performance minded client interested in maintaining or regaining hormonal health.

I can vouch for Dr. Howard Liebowitz in Santa Monica. A former athlete with an athletic mindset, he curates customized regimens that emphasize hormonal health, especially for the aging adult.

Don’t sell traditional docs short, either. At least not before you actually see them. They may know more than you assume, and if nothing else, they can help you order the necessary tests.

That’s it for today, folks. There are plenty of other ways to modulate your hormone function, I’m sure, and I’d love to hear about any of the ones I missed. Thanks for reading!

Question: Has anyone done all these measures and had your hormone situation worsen?

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6 Food Products I Love to Hate and 5 I Just Love

Any old time readers remember the Fuming Fuji? He was the lovable yet ornery food critic of early MDA who railed against chocolate milk, cocoa puffs, chicken fries, applesauce (he was seriously biased here), and frozen waffles. He’d get a little carried away, and we eventually had to put him down (ironically, by turning him into applesauce), but his heart was in the right place. Today, I’m paying homage to the Fuming Fuji by having a little fun with some of today’s more absurd food offerings. Then I’ll follow up with some that I’m enjoying these days.

Let’s go:

1. Peeled Sumo Mandarins in Shrink Wrap

Whole Foods is a great store. They carry the best brand of mayo, for one. And two, they offer some of the most nutrient-dense food around. But now and then I find myself raising an eyebrow (or two) at something on the shelf.

Last year, they began offering pre-peeled sumo mandarin oranges in plastic shrink wrap. Because mandarin oranges weren’t already expressly bred to be easy-to-peel. Because orange peels weren’t crafted by evolution to protect the delicious interior. Because even if you were able to somehow peel your own orange, what the hell are you going to do with the peel?

2. Fried Gluten with Peanuts

The anti-Primal, fried gluten with peanuts has everything you’re not supposed to eat on strict paleo or Primal:

Gluten.
Rancid soybean oil (both frying and storage medium).
Soy.
Sugar.
Legumes.

And it’s all packaged in a can no doubt lined with ample BPA. If you were to toss a pallet of these into a CrossFit box, the universe would implode on itself.

3. Gluten-Free Water

The best satire is indistinguishable from reality. I’m pretty sure that Clara Gluten-Free Water is a real brand whose earnest mission is to give you “peace of mind throughout the day,” but boy is it tough to tell from the “portraits” of the water to their commitment to a diverse customer base (intended for anyone “at a vipassana retreat or simply working as an account manager at an award-winning boutique ad agency”) to the odd phrases they coin (“lifestyle-oriented individual”).

Who am I kidding. I’m going to start drinking this stuff and get on the righteous path. Who could say no to this face?

4. The Juicero

Ah, how I love the hubris on display when Silicon Valley tries entering the food space. From Soylent diarrhea to shmeat to disappointing vegan “mayo,” it rarely goes right. The Juicero is another example.

A $700 juicer that used proprietary packets of fresh produce, like a Keurig coffee maker only for kale juice, the Juicero just never made sense to me. How could such a set-up—shipping refrigerated single-serving produce packs—work?

It hasn’t. The company just announced they’re pulling out and issuing refunds for the Juicero.

5. Unicorn Froot Loops

I just don’t understand the “unicornization” of foods. What makes Unicorn Froot Loops unicorn Froot loops? I assumed they would have severed cereal horse heads with horns interspersed with the loops, but that doesn’t appear to be the case. They’re just different colored loops. There’s a unicorn on the box. Is that it?

Do kids really like unicorns so much that they’ll clamor for Unicorn Froot Loops? Is there a huge demand for unicorn-themed foods? Sure, put enough sugar in it and they’ll eat it, but what specifically about the unicorn is drawing people in?

Maybe if these were made of real unicorn meal, I’d sing a different tune. That’d be a healthy high-protein breakfast. I imagine magical beast flesh has plenty of undiscovered micronutrients, too. Oh well.

6. Yoni Beer

It was inevitable, in hindsight. Of course they were going to make beer using vaginal bacteria. I’m actually surprised it took this long. After all, “The secret of the beer lies in her vagina.” You get this message in fortune cookies, for crying out loud.

Look, I’m not going to disparage reproductive organs. But, well, the vagina a person chooses to consort with is a personal decision. I don’t just want any vagina’s lactic bacteria in my beer.

Then there’s the inevitable question I’m sure we’re all wondering right now: when’s the male version coming out—and will it derive active cultures from smegma? How long do we seriously have to wait?

But enough negativity. What do I love?

1. Turkey Legs at Disneyland

My kids are grown. I have no real reason to brave the crowds and visit Disneyland. And the product I’m about to recommend isn’t good enough to get me to go anymore. But when I did go, when my kids were of age and I did go to Disneyland, the turkey legs were a lifesaver. I still think about them.

There’s no gussying it up: It’s just a big tender smoked turkey leg. For about $9, you get around a pound of meat and sinew and tendon and gelatinous unctuousness. I’ll happily wait in line for Star Tours if I’ve got a turkey leg to gnaw on.

2. The SousVide+

Mike and Mary Dan Eades are good friends of mine, so when they asked me to highlight their upcoming SousVide+ I was more than happy to do it. Then I got to try the thing, and came away even more enthusiastic.

3. Chili Peppers

The farmer’s market has been great for fresh chilis lately. I’m loving fresno and serrano chilis, or any chili with moderately high heat that retains its fruitiness. There’s even a stand that sells Thai chilis on the vine. Just look around at your local market, as there are many different types. Ask to try them! I keep a tupperware container full of chopped chilis, garlic, shallots, and ginger that I can quickly add to stir fries without messing up a cutting board or getting hot chili residue all over my hands.

I’m also really into dried ancho chilis, which I eat like fruit bark. Seriously. Try it. I got the idea after listening to a podcast episode of “Conversations with Tyler” with Mark Miller, where they do a dry chile tasting and discuss how to choose dried chilis. Even better is a handful of dried ancho chili strips mixed with beef jerky.

On the powder front, chipotle chili powder is essential. Mix it with cumin and garlic powder for an incredible addition to any meat dish.

4. Wide Mouth Canning Jars

I’ve been pickling a fair bit of produce. Stuff like sauerkraut and kimchi, while delicious and not that hard, still take a bit more effort than I’m willing to expend these days. Plus, you have to worry about keeping torn up cabbage that loves to float submerged under the brine. It’s a big headache.

Instead, I’ve been pickling whole garlic cloves (I just get the big bag of organic peeled cloves from Costco), various spices like ginger and turmeric, small onions and shallots, and all the chili peppers I just mentioned. It’s great. Add the produce to the wide mouth canning jar, fill with salty brine (teaspoon of salt per cup of water or thereabouts), and wait for bubbles to start appearing. The relative density of the ingredients means keeping them submerged is simple. Sometimes I’ll spruce it up with a few dashes of fish sauce, or maybe a layer of olive oil at the top.

5. Short Rib “Steaks”

My new favorite “steak” is the short rib. Not the Korean cut with the little bone islands dispersed throughout, though that’s great, too. I prefer the English cut with the whole rib bone. To get a “steak,” I use a sharp knife to separate the meat from the bone. I season the meat with salt and pepper, throw it in the oven for 15-20 minutes at 270°, then sear it over high heat for a minute on each side. Even better—you can reserve the bone for soup.

Perfection.

That’s it for today, everyone. Do you have any personal favorites (or absurd discoveries) to add? Share ’em on the board, and have a great week.

The post 6 Food Products I Love to Hate and 5 I Just Love appeared first on Mark's Daily Apple.

Dear Mark: TRT Edition

Last week’s post on testosterone replacement therapy generated a lot of comments and questions, so for today’s edition of Dear Mark I’ll be answering some of them.

From the prostate and heart disease issues to the high T/low free T phenomenon to the question of women and TRT to keto’s effect on testosterone to chronic cardio’s, you folks came up with some good ones.

First, Polyphemus made a suggestion:

Probably worth addressing the worry about heart and prostate issues. The prostate is SUCH a classic issue for the same population that might want TRT. (including me)

Absolutely.

Let’s look at prostate cancer first.

The most recent studies (and many of the older ones) suggest that TRT is safe, or even protective, for the prostate.

In May of this year, a study found that while TRT patients had an increased diagnosis of favorable-risk (less deadly) prostate cancer, they had a decreased incidence of aggressive prostate cancer. Furthermore, the authors suggested that the increased incidence of favorable-risk prostate cancer was an artifact of detection bias.

A February study of men with low testosterone found that those receiving TRT were just as likely as those not receiving TRT to develop prostate cancer.

Even men at a high risk for prostate cancer don’t get prostate cancer at any greater rate when they take TRT.

Same goes for men with a history of prostate cancer. Taking testosterone has no impact on their risk of recurrence.

Now let’s look at heart health and TRT.

First of all, testosterone deficiency is a widely-recognized risk factor for heart disease. It’s linked to poor glucose control, endothelial dysfunction, insulin resistance, atherosclerosis, and poor lipid markers.

If anything, heart patients do better with TRT. One study found that a combo of resistance training and TRT helped heart failure patients halt muscle wasting and recover lost strength and functionality. Another study found that men with androgen deficiency saw fewer heart attacks when they took TRT.

The trick is achieving testosterone normalcy. Getting things back to normal is protective; steroid abuse is dangerous.

The human studies are enough to give me confidence, but the mechanistic animal studies put me over the top. A 2015 study found that giving testosterone-deprived rats TRT protected them against induced cardiac arrest by limiting mitochondrial dysfunction. Mitochondria are the lynchpin for almost everything that goes on and goes wrong in our bodies. If testosterone deficiency negatively impacts mitochondrial function, TRT is essential.

KTT requests:

I’m 46 and my total testosterone is in the 800’s but my free testosterone is very low, 40’s or .6%, can you address this scenario.

I can’t give out medical advice of course, but I’d suggest looking into the possibility of high sex hormone-binding globulin, or SHBG. SHBG binds to testosterone to modulate its transmission to tissues, but this has the effect of nullifying the bioactivity of any bound testosterone.

All else being equal, older men tend to have higher levels of SHBG than younger men. This throws off test results and explains why many older men can have “normal” testosterone while suffering from deficiency symptoms.

Boron reduces SHBG and increases free T. In one study, subjects took 10 mg of boron per day.

Make sure you’re eating enough zinc. There’s a “specific decrease in the affinity of human SHBG for C18 steroids in the presence of a zinc ion.”

Get a handle on stress, as cortisol opposes free testosterone. Chronic stress, remember, can also come from too much or too little exercise, inadequate calorie intake, and just about too much of anything

Statins can reduce free T, but they also tend to reduce total testosterone. You don’t suffer from that problem, nor did you mention taking statins, so it’s probably not that (but anyone reading for whom this does ring true should consider it).

Amanda asked:

what about for women with T lower than is ideal for women

As I’ve written in the past, women need testosterone. A lower than ideal testosterone level causes problems in women, too:

It lowers libido. If a doctor prescribes testosterone to a woman, it’s usually to correct a libido deficiency.

Older women with very low testosterone levels are at a greater risk for urinary incontinence and elevated stress, perhaps because of atrophied pelvic floor muscles. In low T rats, TRT cures urinary incontinence.

It can exacerbate anxiety. Socially anxious women may benefit from T supplementation, as it can lower reactivity to angry faces and decrease threat avoidance.

Note, though, that testosterone assays are notoriously unreliable in women. Some research shows that “guessing” women’s T levels based on symptoms is “nearly as good” as direct testosterone assays.

Matt asked:

Hey Mark,

Did all of this happen while you were in ketosis? Perhaps prolonged ketosis can lower testosterone

No, this was well before my keto experiment. I was eating low-carb in range of 50-150g/day, so not classically ketogenic, though I did drift in and out of ketosis due to fasting, training, and the general variation of my day-to-day carb intake. But it wasn’t a concerted effort to get into and remain in ketosis.

David asked:

Mark, two questions:

1) Do you think your chronic cardio years contributed to low T later in life?

2) There are a ton of herbal supplements that purportedly improve T. Any chance of a post reviewing some of the more legitimate ones? (Personally, I’d rather spend money on steak and eggs, and do resistance training and sprinting, but if there is a legit supplement, I’m willing to experiment)

Thanks for this post and thanks for all you do!

Chronic cardio absolutely tanks testosterone. That’s not in question. Those days are long past, however. I haven’t done any serious endurance training for almost two decades, which is plenty of time for testosterone levels to recover from overtraining.
Sure. That sounds like a good idea for a post. I’ll add it to the docket.

Gary wondered:

My total testosterone is over 800 but I don’t know the free count. Will supplementing at my level increase free. I have read proper level is 25. My age is 73.

TRT supplies testosterone. It’s up to your body to render it bioavailable. As I understand it, TRT is meant to increase testosterone directly and free T indirectly. If you have 800 at age 73, that’s plenty (and very impressive) of substrate. Any low free T readings you experience won’t have anything to do with the amount of raw testosterone your body produces. That’s covered. That’s adequate.

It’s better to focus on lowering SHBG (see my answer to KTT’s question for ideas), which binds testosterone and reduces free T.

Thanks for reading, everyone. Take care and keep the questions coming!

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The post Dear Mark: TRT Edition appeared first on Mark's Daily Apple.

Weekend Link Love ? Edition 470

Research of the Week

Prenatal fluoride exposure (albeit higher than occurs in most municipalities whose water receives fluoride treatment) linked to lower offspring IQ.

You’re seasoning your food with plastic.

Fat dogs have fat owners.

High triglycerides and poor glucose control are responsible for most of the risk associated with being overweight or obese.

It’s not just how much total time you sit each day. It’s the length of your sitting bouts.

Whole eggs are better for vitamin D status than vitamin D3 supplements.

Patients without heart disease who took antidepressants experienced greater mortality and more heart attacks.

“Healthy” low-fat “spread” infused with plant sterols has no effect on inflammation or endothelial function in subjects with high cholesterol.

Even breastmilk has a circadian rhythm.

MUFAs, found in olive oil and avocado oil, are important for brain function.

New Primal Blueprint Podcasts

Episode 187: Evan Brand: Host Elle Russ chats with Evan Brand about finding the root causes of depression, fatigue, obesity, and a host of modern afflictions.

Each week, select Mark?s Daily Apple blog posts are prepared as Primal Blueprint Podcasts. Need to catch up on reading, but don?t have the time? Prefer to listen to articles while on the go? Check out the new blog post podcasts below, and subscribe to the Primal Blueprint Podcast here so you never miss an episode.

What Primal Types Can Learn From Plant-Based Diets (and Dieters)

Interesting Blog Posts

On “supergenes.”

I know what I’m giving out for Christmas.

Weeds you can eat.

Media, Schmedia

Now that’s branding.

There’s a lot to admire about Tom Brady, but there’s plenty to discard, too.

Everything Else

Not even vegetarian dinosaurs could resist meat.

Macaques hunt shellfish using tools, and they’re so good that they’re threatening shellfish populations.

Neanderthals likely lived in small, genetically-isolated bands.

If you’ve ever wondered about nootropics, this great new 30-minute documentary is a must-see.

Things I?m Up to and Interested In

Podcast I just appeared on: The Balanced Blonde, where I discussed Primal living, keto eating, and how I built the Primal brand.

Oldie but goody: Woman goes on gluten-free diet, her metabolic syndrome completely resolves.

Racy title aside, I found this article made good points: “The iPhone X proves the Unabomber was right.”

Concept I’m pondering: The trouble with Facebook is that it provides content without context.

I’d love to visit some of these: The 12 oldest wineries in the world.

Recipe Corner

Cauliflower “rice” tabbouleh.
Sri Lankan king prawn curry.

Time Capsule

One year ago (Sep 24? Sep 30)

How Should You Balance Your Fat Intake? ? Fat’s not fat.
10 Ways to Optimize Your Meat Consumption ? Make your meat even healthier.

Comment of the Week

“Mark, you put ‘get yourself a little butane torch’ immediately after warning ‘you will fart.’ You had to expect our brains to put those two things together in a rather predictable and childish fashion??

– I was hoping for and expecting it, Rambler.

The post Weekend Link Love ? Edition 470 appeared first on Mark's Daily Apple.

Weekend Link Love – Edition 470

Research of the Week

Prenatal fluoride exposure (albeit higher than occurs in most municipalities whose water receives fluoride treatment) linked to lower offspring IQ.

You’re seasoning your food with plastic.

Fat dogs have fat owners.

High triglycerides and poor glucose control are responsible for most of the risk associated with being overweight or obese.

It’s not just how much total time you sit each day. It’s the length of your sitting bouts.

Whole eggs are better for vitamin D status than vitamin D3 supplements.

Patients without heart disease who took antidepressants experienced greater mortality and more heart attacks.

“Healthy” low-fat “spread” infused with plant sterols has no effect on inflammation or endothelial function in subjects with high cholesterol.

Even breastmilk has a circadian rhythm.

MUFAs, found in olive oil and avocado oil, are important for brain function.

New Primal Blueprint Podcasts

Episode 187: Evan Brand: Host Elle Russ chats with Evan Brand about finding the root causes of depression, fatigue, obesity, and a host of modern afflictions.

Each week, select Mark’s Daily Apple blog posts are prepared as Primal Blueprint Podcasts. Need to catch up on reading, but don’t have the time? Prefer to listen to articles while on the go? Check out the new blog post podcasts below, and subscribe to the Primal Blueprint Podcast here so you never miss an episode.

What Primal Types Can Learn From Plant-Based Diets (and Dieters)

Interesting Blog Posts

On “supergenes.”

I know what I’m giving out for Christmas.

Weeds you can eat.

Media, Schmedia

Now that’s branding.

There’s a lot to admire about Tom Brady, but there’s plenty to discard, too.

Everything Else

Not even vegetarian dinosaurs could resist meat.

Macaques hunt shellfish using tools, and they’re so good that they’re threatening shellfish populations.

Neanderthals likely lived in small, genetically-isolated bands.

If you’ve ever wondered about nootropics, this great new 30-minute documentary is a must-see.

Things I’m Up to and Interested In

Podcast I just appeared on: The Balanced Blonde, where I discussed Primal living, keto eating, and how I built the Primal brand.

Oldie but goody: Woman goes on gluten-free diet, her metabolic syndrome completely resolves.

Racy title aside, I found this article made good points: “The iPhone X proves the Unabomber was right.”

Concept I’m pondering: The trouble with Facebook is that it provides content without context.

I’d love to visit some of these: The 12 oldest wineries in the world.

Recipe Corner

Cauliflower “rice” tabbouleh.
Sri Lankan king prawn curry.

Time Capsule

One year ago (Sep 24– Sep 30)

How Should You Balance Your Fat Intake? – Fat’s not fat.
10 Ways to Optimize Your Meat Consumption – Make your meat even healthier.

Comment of the Week

“Mark, you put ‘get yourself a little butane torch’ immediately after warning ‘you will fart.’ You had to expect our brains to put those two things together in a rather predictable and childish fashion…”

– I was hoping for and expecting it, Rambler.

The post Weekend Link Love – Edition 470 appeared first on Mark's Daily Apple.

Chicken and Spinach Alfredo

This chicken and spinach Alfredo is a celebration of high-fat diary and butter. If cream, aged Parmigiano-Reggiano, crème fraiche, and grass-fed butter are high-fat ingredients that your body craves, then you’ll absolutely love this easy recipe. Mix in chicken breast and baby spinach, and pour the sauce over zucchini noodles for an irresistible low-carb, high-fat dinner.

It’s true that dairy isn’t for everyone, but if dairy agrees with you, then you absolutely have to try this recipe. The Alfredo sauce is unbelievably creamy and so good you’ll eat it out of the saucepan with a spoon. It’s also easy to make…a little too easy, actually, because it’s tempting to pour it over everything—from grilled steak to sautéed greens and roasted cauliflower.

When you do indulge in this Alfredo sauce, enjoy every bite. You’ll be serving up the healthy fats, protein, fat-soluble vitamins and important minerals that full-fat dairy has to offer.

Time in the Kitchen: 35 minutes

Servings: 2 to 4

Ingredients

2 boneless, skinless chicken breasts
2 tablespoons avocado oil (30 ml)
¼ cup grass-fed butter (60 g)
1 clove garlic, finely chopped
¾ cup whole cream (175 ml)
1/2 cup grated Parmigiano-Reggiano cheese (45 g)
2 tablespoons crème fraiche (30 ml)
2 ounces baby spinach (about 2 large handfuls) (57 g)
Fresh basil, for garnish

Instructions

Pound chicken breasts to even thickness, about ½-inch. Generously season the chicken with salt.

Warm the oil in a skillet over medium-high heat. Add chicken to the pan (the pan should be hot enough so the chicken sizzles when added). Cook about 4 minutes a side, so the chicken is cooked through. Remove chicken from the pan and set aside. When the chicken is cool enough to touch, cut into thin strips or bite-sized pieces.

Turn heat to medium low.

Add butter and garlic.

As soon as the butter has melted, add cream, whisking or stirring to blend with the butter. Make sure to loosen any crispy bits of chicken that are stuck to the pan.

Keep stirring, and slowly add the cheese.

Gently simmer the sauce until thickened, about 10 minutes. Stir in crème fraiche. Stir in chicken to re-heat. Add handfuls of spinach, keeping in the skillet just long enough to wilt.

Toss the chicken. Garnish with chopped basil. Serve the Alfredo sauce over zucchini noodles or simply eat it with a spoon!

The post Chicken and Spinach Alfredo appeared first on Mark's Daily Apple.

Goodbye, Sugar Addiction!

It’s Friday, everyone! And that means another Primal Blueprint Real Life Story from a Mark’s Daily Apple reader. If you have your own success story and would like to share it with me and the Mark’s Daily Apple community please contact me here. I’ll continue to publish these each Friday as long as they keep coming in. Thank you for reading!

My weight gain happened when I was pregnant—I had 2 pregnancies back to back. When my first child was 4 months I was pregnant again, so I didn’t have time to lose the first amount of baby weight I put on. All in all I was 91 pounds heavier.

For years I would yo-yo diet, going on extreme calorie counting diets of

around 700 calories. I would lose loads of weight and once the event was over I would not be able to sustain the low calories and I would pile the weight on plus more.

It got so bad that I stopped taking my kids to school and my husband had to take them! I was fearful of the parents judging me and my weight that I

missed out on so much.

I was depressed, had extreme anxiety, inflammation in my joints, you name it I had it, I was starting to get blurred vision which was worrying as it’s a sign of early onset of diabetes. I was a complete mess but I was still so addicted to sugar.

I was so good at secretly eating and hiding my chocolate and cake wrappers from my husband. I would go to the shops and sneak the sugary treats in the house and then binge eat them in secret. My days revolved around my binges. It got so bad that I would often cry whilst I was bingeing but yet so addicted to the sugar I couldn’t stop!

In my early years I followed a pretty lowish carb diet and held a slim

weight. I had seen Mark’s Daily Apple and I soaked up all the information on how effective a low carb, high fat diet could stop you from craving sugar. I started the diet and I wanted to document my journey on Instagram to keep myself accountable. It’s called @healthy_girl_jen and is quite successful. I put all my time and effort into it and take pictures of my food and also post my transformation pictures.

The low carb diet stopped me from craving the sugar. Months went by and the weight was falling off me. Within 9 months I had lost 84 pounds and by the following year I had lost a total of 91 pounds.

I can’t tell you how much better I felt. I was able to take the kids to

school and go on play dates. My inflammation went, depression, anxiety, blurred vision went. I had the best Christmas ever! I wasn’t insecure, I was able to wear leggings that I had always dreamed to wear!

Thank you very much for all the information you put out there on this low

carb lifestyle! I am living proof that it works! Feel free to follow my Instagram page. I am so passionate about passing on the low carb journey to as many people as possible so they can benefit from all the wonderful things that it gives you!

I have my life back! I am truly blessed!

Jennifer xxxx

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Try the Definitive Guide for Troubleshooting Weight Loss for free here.

The post Goodbye, Sugar Addiction! appeared first on Mark's Daily Apple.

Should I Take a GLA Supplement?

Recently, a reader inquired about gamma linolenic acid (GLA) and inflammation. Is GLA everything it’s made out to be? Is it something all of us should add to our diets? Can we obtain it through real foods, or do we need to rely on supplements? There’s certainly a lot of hype about GLA’s ability to heal chronic inflammation and even to facilitate an easier transition into menopause (something I’ll cover more in a follow-up post). For today, let’s take a closer look at GLA and the role it may play in anti-inflammatory nutrition.

Quick review of inflammation here… Inflammation might seem like the root of all peril, and for many of us struggling with inflammatory conditions, it’s hard to think otherwise. However, we also recall that it exists to protect us. A little acute inflammation helps the body to heal from injury. It brings blood flow to the area of injury or pain as a protective mechanism. The blood vessels become more permeable, thus allowing the plasma and leukocytes to flow through the vessel walls, and into the injured area where they help the body to heal. The area becomes warm, swollen and painful. This is all necessary in order for the body to repair itself.

However, like any extreme response, inflammation can become chronic and harmful. These days many people are struggling with chronic inflammation in some capacity. It’s all part of the stress overload, the typical American diet, the lack of sleep, a lack of outdoor time, poor gut health, insufficient vitamin D, rampant overtraining—or (alternatively) being too sedentary, working too hard, feeding fatty acid imbalances, absorbing environmental toxins, etc., etc. This kind of chronic inflammation can lead to serious health conditions like painful arthritis, heart disease, troublesome skin conditions, irritable bowel syndrome, Crohn’s, and so forth.

There are many ways to fight chronic inflammation, including promoting antioxidant intake and fatty acid balance. I’ve written about foods and supplements to fight inflammation before. But today I thought I’d explore GLA in particular.

What Exactly is GLA?

GLA is an omega-6 fatty acid that’s both converted in the body (in a series of LA to GLA to AA) and is found in dietary sources—most notably borage oil, black currant seed oil, and evening primrose oil (and a genetically-modified version of safflower oil). It’s also found in whole foods like hemp seeds and spirulina, organ meats, and human milk.

Dietary GLA is associated with higher blood levels of dihomo GLA (DGLA), the elongation product of GLA and a potent anti-inflammatory fatty acid in its own right. Although it can be part of  a complicated picture, DGLA’s own eicosanoids (signaling lipids) can often out-compete AA’s generally pro-inflammatory eicosanoids. (PDF)

What Does Science Say about GLA?

The science surrounding GLA benefits is a bit contradictory (like we haven’t heard that before). Research reveals both benefits and non-benefits, as well as some contraindications and side effects. Here are some of the issues I took a look at with regard to GLA use.

Rheumatoid Arthritis

In this recent study, adding evening primrose oil with a fish oil decreased inflammation and resulted in significant clinical improvement with rheumatoid arthritis symptoms. (Would it have been effective without the fish oil?) In a review of 22 studies, GLA reduced pain, reduced intensity, and improved disability associated with RA. Apparently dosage makes a difference as well. GLA doses equal to or higher than 1400 mg/day showed benefit in the alleviation of rheumatic complaints, whereas lower doses (approximately 500mg) were ineffective. When using GLA for RA symptoms, it can apparently take several months to feel the benefits.

Immunomodulation

GLA has been studied for its immunomodulatory properties as well. GLA improved overall sciatic nerve function following a crush injury in lab rats. GLA also showed 1,000 times stronger immunomodulating activity than muramyldipeptide (a a common immunomodulator). On the contrary, in a study done on patients with acute lung injury, twice daily GLA supplementation did not improve any clinical outcomes.

Skin Conditions

GLA has been shown to help with skin conditions such as eczema and keratosis pilaris, and even acne. These researchers found that small and large does of evening primrose oil helped improve atopic dermatitis in children.

However, I found research surrounding this to be contradictory. Some studies show no changes in eczema with the use of GLA containing oils. Investigators reviewed 27 studies and concluded that borage oil and evening primrose oil didn’t have a substantial effect on eczema. Improvements experienced were similar to placebo. So there you have it—more mixed results.

Hormonal Health

Finally, GLA is often taken for women’s hormonal health issues and for labor and delivery purposes—including breast tenderness, cyclical acne, depression, menopausal and premenstrual cramping, cervical ripening, and labor inducing.

However, there hasn’t been significant science to back  up these claims. Anecdotally, GLA (particularly in the form of evening primrose oil) has been used for female reproductive health for centuries. The symptoms that seem to improve the best from GLA use are breast tenderness, depression, irritability, swelling, and bloating from fluid retention.

A Few Words of Caution…

With regard to evening primrose and borage oil, gastrointestinal issues can occur during short-term use. During long term use, there was a potential risk of inflammation, thrombosis, immunosuppression, as well as increased bleeding when on blood thinners or Phenothiazines. Those with seizure disorders should avoid GLA supplementation, as should pregnant women. These are some serious implications that I would keep in mind, but I’d also discuss GLA supplementation with your doctor if you’re on any kind of pharmaceutical medication, as a number of drug interactions may be possible.

Reported side effects include headaches, abdominal pain, nausea, and loose bowels. In animal studies, GLA was reported to decrease blood pressure. More than 3000 mg has been shown to be pro-inflammatory, so be careful on the dosing, and don’t take more than you need.

Finally, many experts particularly caution against borage oil, which may contain pyrrolizidine alkaloids that are toxic to the liver.

Should I Buy a Supplement?

Although GLA is anti-inflammatory in nature and necessary for the body, upping anti-inflammatory omega-3 fatty acid consumption from wild caught fish or a quality fish oil supplement is still of utmost importance. Some research indicates that intake of omega-3s can encourage the conversation of supplementary GLA to DGLA.

I would increase consumption of wild fish and organ meats in preference to purchasing a seed oil—or at least make sure I did both if I was going to add a GLA supplement. If you do decide to go that route, I can’t stress quality enough—cold-pressed, hexane-free, dark-bottled varieties are available and worth the added cost. Try it out, see if you notice a benefit, and make your own assessment.

That’s it for me, folks. I’d love to hear your experiences with GLA supplementation for inflammatory conditions, and I’ll be back with more on GLA sources for women’s health in the coming weeks. Thanks for stopping by today.

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The post Should I Take a GLA Supplement? appeared first on Mark's Daily Apple.

Testosterone Supplementation: My Primal Take

After I turned 60, a routine checkup showed that I had lower-than-normal free testosterone levels. I hadn’t noticed anything that would have alerted me. No symptoms. No indication. Everything worked well. But it nagged at me. I knew testosterone did much more for a man’s health than just “build muscle”—which I had no real interest in at this point—so I decided to explore TRT, or testosterone replacement therapy.

I did a careful survey of the literature, coming away pleasantly surprised. The evidence was almost uniformly in favor, with the well-constructed studies showing major benefits for TRT. This is TRT, mind you. Not “juicing,” not steroid abuse. Restoration of biologically-appropriate levels of testosterone. Thus began my experiment….

In men with low testosterone levels, restoring those levels with TRT reduces the risk of atrial fibrillation.

In diabetic men aged 50-70, TRT improves muscle mass, reduces fat mass, and increases physical function.

In older men with low libido, TRT increases it. In men with diabetes, TRT increases libido and erection quality.

In older Japanese men, 12 months of TRT improved waist circumference, triglycerides, fasting blood sugar, body fat, and HbA1c.

Stepping back to look at the big picture, TRT starts looking even better:

Thirty-six months of TRT improves quality of life and sexual function while reducing anxiety.

In studies where TRT increases T levels to the normal range, all-cause mortality drops.

Not bad, right? Most people have a knee-jerk reaction to the notion of TRT. They think it means “cheating,” or “trying to look like one of those bodybuilding cover models.” But these are reasonable things to want as a person ages—no atrial fibrillations, an existent libido, lower body fat, strength maintenance, better metabolic health, and the ability to simply function in life. I’d go so far as to say everyone should have those things. It would take care of a lot of issues our world faces.

So, I talked to my doctor. He prescribed a small dose of supplemental testosterone, and (as I’ve mentioned on podcasts over the last few years) I began taking it.

What did I notice?

Really subtle things. My sense of “well-being” improved. Instead of ruminating on the things I wasn’t doing , I’d just move past them. Or take care of them, one way or another.

Maybe a small increase in overall energy. This wasn’t an issue, so it was difficult for me to perceive, but I think I felt a trifle more energetic throughout the day.

A boost to strength—with a caveat. It wasn’t that testosterone was making me stronger. It was giving me a more pronounced response to the training I was already doing.

Recently, I did two months without the TRT to see how I’d fare. It was fine. My free T got “up” to 6 pg and my total hit 600 ng. Free T is a little on the low end, but, again, there were no symptoms.

Using both ancient wisdom and modern science and technology, the Primal Blueprint seeks to restore ancestral metabolic health, emulate evolutionary movement patterns, and undo the damage modern living has wrought on our physiology and psychology. Testosterone levels in Western men have plummeted in the last few decades. We don’t have to just accept it.

To the extent you can find ways to improve your quality of life both short-term and long and not mess with delicate feedback loops, I suspect certain meds might be useful, like T3 for thyroid issues, despite one’s being full Primal, or metformin for life extension.

My wife, Carrie, has taken bioidentical hormones for years to deal with the symptoms of menopause. They’ve worked great for her. They weren’t available for most of human (pre)history, yet they’ve been an unequivocal boon to her life. 

I see TRT filling a similar role: as a modern tool to restore the ancestral baseline.

Just like taking antibiotics to eliminate a nasty infection you picked up at the hospital.

Just like using Meetup to find your tribe in your city.

Just like using iron barbells and weights forged in industrial metal plants run by robots to get stronger, fitter, and faster.

Being Primal is about utilizing modern tools to achieve ancestral health and wellness.

Once we hit a certain age, 50, 60, 65, “nature” doesn’t care about our ability to provide resources, hunt, fight, compete, or do any of the other things testosterone enables and enhances. That doesn’t mean we’re useless in an evolutionary sense—we still offer wisdom and leadership and grandparenting and our social support, all of which can improve the survival of our offspring—but our roles have changed. We just don’t “need” the same levels of testosterone.

That’s at a population level. Those are the selfish genes talking. We aren’t populations. We’re individuals. And as individuals, we don’t want to wither away into obsolescence. Live long, drop dead, remember?

But before you even think about TRT, confirm that you actually need it. And talk to a physician about risks, particularly if you have heart or prostate related issues.

Even if you get tested and your T and free T show up on the low end of dismal, consider other avenues you’ve been overlooking. First square away all the other factors that affect testosterone levels and ask yourself some questions. Are you sleeping 5 hours a night? Do you eat fast food every day? When’s the last time you picked up anything heavy or ran a sprint—or even taken a walk? Do you pamper yourself to the exclusion of ever feeling challenged? Do you blast the heat or air as soon as the temperature starts getting a little uncomfortable? Do you run from discomfort?

If you answered “yes” to any of these questions (or “never” to the third one), your lifestyle is the problem and TRT won’t address the real issue.

We live evolutionarily aberrant lives. Even someone like me, the Primal guy himself, can’t keep up with all the lifestyle tips and optimizations. I still work a lot, maybe too much. I still stress too much. I wish I could play more. I move around a lot and have streamlined my workstation to allow constant low level movement, but at some point there’s no getting around the fact that I spend an inordinate amount of time staring into a lit-up screen. As do hundreds of millions of people every day. And this all impacts our hormones.

Whenever we critique an observational study, we point to the confounding variables you can’t control. Because there’s always something screwing with the results that the researchers can’t quantify or detect. The same goes for life: We can’t control every variable that confounds our quest for optimal health. We do our part, certainly. We take responsibility. But then we also recognize we have modern choices as well. 

TRT, or thyroid hormone, or antibiotics when you need them, or a CrossFit membership might look evolutionarily novel or synthetic at first glance, but they seek to right a wrong perpetrated on the human body, to restore a balance, to achieve your genetic destiny.

Anyway, that’s my take on testosterone replacement therapy—and use of meds or hormones in general for the purpose of restoring what was lost or taken from you. It’s a messy world, this modern one, and we can use all the help we can get.

Thanks for stopping by today. What do you think, folks? What’s your take on the subject? Have a great week.

Want to make fat loss easier?

Try the Definitive Guide for Troubleshooting Weight Loss for free here.

The post Testosterone Supplementation: My Primal Take appeared first on Mark's Daily Apple.