Men—Stay On Top of Your Health
Henry David Thoreau once wrote that “The mass of men lead lives of quiet desperation.” Among other things, what he meant was that men tend to go about their business in a rather stoic fashion, and are hesitant to show their real feelings or exhibit vulnerability. Nowhere do I find this truer than in my practice, where it usually takes either a life-altering event or a major shove by the wife to prompt a man to take care of himself and pay me or any other physician a visit.
June 13-19 is National Men’s Health Week, so it’s a good time to focus on men’s health issues. But it’s important to note that while one week may have been designated for men only, attention should be paid to your health year round.
New Hope for Male "Menopause":
Identifying It and Treating It
Men, if you’re experiencing fatigue, a loss of libido, weight gain and/or depression, please don't chalk it up to the fact that you may be "getting old."
Yes, you may be chronologically older, but age is not your enemy. You can grow older and have a perfectly good quality of life. You just need to know what you're dealing with.
The truth is, you could be going through "andropause," the male equivalent of menopause. This condition, while trickier to treat than menopause, is indeed treatable.
While menopause can come like a "thief in the night," often bringing about abrupt changes in quality of life, the symptoms of andropause often go unnoticed as they occur over the course of a decade.
So, while a woman's estrogen levels may fall precipitously, a man's testosterone levels may drop only 1%–1.5% a year. Over ten years, this dip can really take a toll on a man's body.
Unfortunately, the andropausal male is often labeled with one or more diseases when, in fact, his problem is excessive loss of testosterone. Unfortunately, these men get little relief from traditional medical approaches that typically fail to address the cause of the problem.
The first study on andropause was published in 1944 in the Journal of the American Medical Association. Researchers tried to determine whether falling testosterone levels could be causing similar symptoms among a group of men and affecting their quality of life. Of the 38 men they evaluated, 23 had a testosterone deficiency. Almost all of these men reported an improvement in mood, fatigue, hot flashes, sweating and libido after testosterone injections. Potency returned to normal in 18 of those men.
How to Find Out if Your Testosterone Is Low
- The first order of business is to check your testosterone levels. Because mean testosterone levels fluctuate (they may be 700 ng/dL at 8 a.m., then drop to 425 ng/dL at 10 p.m.), have your blood drawn at least twice over a two-week period, at different times of day. The test provides a baseline, which is important if you go with a testosterone patch/injections.
- You also may want to test your growth hormone, as well as your estrone (a measure of estrogen), DHEA, PSA and sex-hormone binding globulin. This comprehensive profile can help pinpoint the cause of your problem and better tailor your therapy. For example, I give pregnenolone, a precursor to DHEA, to men with low DHEA levels and low testosterone. This combo is broken down into DHEA and progesterone. Progesterone inhibits the aromatase enzyme which interferes with testosterone production
- If your tests reveal low testosterone levels, you should be screened for hemochromatosis (excessive iron) and have your insulin levels, blood sugar, fibrinogen and LP(a) (ugly cholesterol fractions) checked. These risk factors for heart disease may be—and often are—elevated when testosterone is low.
Matching the Treatment to the Problem
Suppose you find out your testosterone is in the basement...then what?
Well, you have several options. Remember, though, this is not a one-size-fits-all approach. Every man is different.
My first choice is a transdermal testosterone patch (oral testosterone is not effective and may be dangerous to the liver). The patch delivers testosterone at a controlled rate and avoids the peak-and-valley effect of testosterone injections. The best place to put the patch is on the scrotum since scrotal skin is at least five times more permeable than any other area of the skin. But I must warn you that skin irritation can be a problem for many men and scrotal hair must be shaved to secure contact with the skin. It's for this reason that pharmaceutical companies have developed 5-mg patches to be applied nightly and rotated on the body: the back, abdomen, upper arms and thighs.
The 5-mg patches are a suitable alternative to scrotal patches and can improve sexual function, energy and mood, but about 12 percent of men who use them still report burn-like blisters, which can occur after a single application.
If either type of patch irritates you, ask your doctor to write you a prescription for a testosterone cream or gel that can be applied to the backs of your knees after a morning shower.
Creams and gels are an effective remedy for treating low testosterone, and there's very little irritation. The only problem is they can be messy and sticky and, if applied unevenly, you may not get what you need to boost your testosterone.
Another option is testosterone injections. Even though this is the least expensive and most common form of hormone-replacement therapy for men, I do not like injections. They often result in wide swings in testosterone levels. Yes, testosterone increases, but it's often followed by low or even subnormal levels.
These disturbing fluctuations can affect a man's energy, mood and sexual function. Some men have told me that they feel great for about a week after an injection, and then fatigue sets in and sexual desire/performance are lackluster.
Note: There are two things to consider before trying testosterone patches or injections. Overly high levels of testosterone may predispose you to acne and a blood disorder called polycythemia (excess red blood cell production).
Excessive testosterone also can lead to overly high libido, urinary obstruction, swelling of breast tissue, priaprism (excessive duration of an erection) and mood swings (especially for those receiving testosterone injections).
Also, before you begin hormone treatment, you should have a digital rectal examination and a PSA test. Once you receive testosterone, in any form, you must have periodic evaluations to make sure that no changes have occurred to your prostate gland (enlargement, cancerous changes).
For Those Who Want a More Natural Approach…
Chorionic Gonadotropic Stimulation, an injectable hormone, can jump-start the testes to increase testosterone production. It uses natural hormones to stimulate the Leydig cells in the testes that make testosterone. A lot of men do well with this. If you're getting sufficient testosterone production and feel good with this method, stick with it. It's best to build your own supply of natural testosterone when you can. If this method doesn't work for you, then consider one of the synthetic forms of testosterone that I've just discussed.
Another natural approach is soy (tofu and other soybean products), which can help suppress aromatase activity. Some people would say that real men don't eat tofu, but I would say that real men eat these foods! I always get a bowl of soybeans at my favorite Japanese restaurant when I go. Soy is good for any man approaching mid-life, regardless of which option he ultimately chooses. I recommend one serving of tofu or soybeans at least once a week.
Zinc (15–30 mg daily) and vitamin C (500 mg daily) also help boost testosterone production, and so does ginkgo biloba (120–240 mg daily. Many of my male patients have reported enhanced libido and erections and less depression when taking ginkgo. Researchers believe ginkgo may support the production of dopamine, one of the brain's "happy" hormones that can enhance sexual function.
Talk to your doctor about the options I've laid out here. If your health professional can't help you, ask him if he knows of an anti-aging specialist who can. The right professional may help you add years to your life and life to your years. There could be some light at the end of the tunnel for you!
For Impotence, It's L-Arginine
As a cardiologist, I often recommend L-arginine to enhance heart health. It not only improves blood flow to the heart, but to the penis. Many of my patients report stronger, firmer erections and more satisfying sex lives!
Restore Male Potency With This Nutrient
Over the years, many of my male patients have complained about impotence. This is a subject that most men won't discuss with anyone but their doctors. Millions of U.S. men have trouble in the bedroom. In fact, nearly 20 percent of men age 55 report potency difficulties, and that percentage doubles by age 75.
Contrary to popular thinking, diminished sexual function isn't age-related. It can be tied to prostate problems, cardiac drugs and/or a lack of vital nutrients to promote blood flow to the organs, including the penis.
When I hear complaints about poor "bedroom performance," the first thing I do is check the patient's cardiac drugs. It often helps to change, reduce or even discontinue some of these medicines, which can cause, among other things, impotence. I also look for signs of benign prostatic hypertrophy (BPH), a non-malignant enlargement of the prostate that may be related to impotence.
Once I uncover the cause of the patient's potency problem, I typically put him on a nutritional support program to bolster potency and help improve prostate health.
Many of my patients have had success with L-arginine. I was initially drawn to this powerful vasodilator because of its ability to promote cardiac and circulatory health. But when my patients reported stronger erections after taking it, I began recommending it for potency.
This amino acid pumps up the body's natural supply of nitric oxide — an odorless gas made of nitrogen and oxygen that relaxes muscles and increase blood flow to vital organs, including the heart and penis.
Quite frankly, if you don't have enough nitric oxide, your erection will be soft, limp or, more likely, nonexistent.
What about Viagra?
This relatively new drug may help men who have been left impotent by prostate disease, diabetes or atherosclerosis, but I prescribe it with caution. It needs more study before I can endorse it as the be-all end-all cure for male impotence. I won't even consider it for those with angina who take nitroglycerin-like drugs because it can cause blood pressure to quickly plummet downward and trigger serious problems and even death.
If you decide to try Viagra, discuss it with your spouse first and then work with your doctor to find the lowest effective dose. A 50-milligram tablet goes a long way; I've seen men do well on as little as 12 1/2 mg.
A better alternative for impotence is my herbal/supplemental program. Indeed, natural remedies can be just as effective as, if not more so than, prescription drugs — and without the dangerous side effects. There's no need to risk serious side effects from Viagra when such effective alternatives as L-arginine are available. Korean red ginseng helps increase the release of nitric oxide, thus increasing erectile ability. However, I caution men with hypertension about using this herb because blood pressure can sky rocket.
To learn more about Dr. Sinatra's top recommendation for men's health, click here.
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Why Does the Mediterranean Diet Promote Prostate Health?
Because it contains:
- fiber, garlic, onions and fresh fruits and vegetables which are loaded with precious antioxidants and other phytonutrients.
- omega-3 essential fatty acids (fish, shellfish, soy products and nuts).
- fewer saturated fats, hydrogenated oils and vegetable oils (the Mediterranean diet calls for olive oil as a major source of monounsaturated fat and fewer chemical and hormone-laden meats; meat is used more to flavor sauces).
To protect your prostate, you should also eat:
- tomato products (including sauce). The literature indicates that 10 servings of tomato-based products a week, including tomato sauce, can promote prostate health.
- oranges, grapefruit and other fresh, organic fruits and vegetables. Modified citrus pectin, a substance that comes from citrus products, promotes prostate health and healthy PSA levels. However, avoid grapefruit if you are taking pharmaceutical drugs like Calcium channel blockers, antibiotics, or antihistamines.
- seeds, sunflower seeds, soybeans, cashews, almonds, kidney beans, broad beans and pecans.
Other supplements and herbs for prostate health:
- Vitamin E: Promotes prostate health by preventing prostate cancer from moving to the progressive stages. Take 400-800 units daily.
- Selenium: A major player in promoting prostate health. Take 100 micrograms in supplemental form.
- Saw palmetto: A premier extract for male health. Contains fatty acids, esters and sterols that promote and maintain prostate health. Take 160-320 milligrams daily.
- Quercetin and fish oil: 1-2 grams of quercetin and 1-2 grams of fish oil daily can help maintain prostate health.
- Zinc: Take 15-30 mg daily to support the prostate gland.
- Phytosterols: Contain vital plant nutrients that support prostate health. The best sources are corn oil, soybean oil, olive oil, and sesame.
To learn more about Dr. Sinatra's top recommendation for men's health, click here.
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Prostate Health — A Key to Sexual Function
The health of your prostate and a satisfying sex life are in many ways interconnected and dependent on each other. By taking steps now, you can maintain proper prostate function, and reignite your sexual desire and performance.
Here's why...the prostate, a walnut-sized gland under the bladder produces a large portion of a man's seminal fluid. It also provides power to expel seminal fluid and works in the bladder to control the flow of urine. You can see why maintaining prostate health is so important - not only for normal urinary function, but also for your sex life.
Thankfully nature provides us with certain herbs and nutrients that are known to maintain prostate health. Saw palmetto, widely used in Europe and studies there for decades, inhibits conversion of testosterone to unhealthy dihydrotestosterone (DHT) which causes prostate growth. Pygeum contains natural compounds, called sterols; the most effective of these being beta sitosterol to help maintain prostate health.
These herbs, along with others like pumpkin seed extract, nourish your prostate to promote healthy sexual and urinary function as well as normal prostate size.
To learn more about Dr. Sinatra's top recommendation for men's health, click here.
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