HORMONE OPTIMIZATION An Evidence and Wellness Based Approach To Increasing Testosterone Through Supplementation By Zachary C. Allison, B.S. Nutrition 1/21 Philosophy 2/21 Philosophy Of Supplementation In this guide, we will exclusively discuss supplemental methods to help regulate testosterone production. However, supplemental methods of increasing testosterone are only one part of a very large picture. By in large, the most important factors leading to optimized hormonal health are other lifestyle factors beyond supplementation. However, there are a handful of supplements that have been clinically shown to help move the needle, and in this PDF we will discuss the most well-researched options. When pursuing optimal hormonal health, there are generally 3 areas that are essential for immediate and long-term success: diet, lifestyle, and supplementation. The latter should be used in order to help meet any nutritional deficiencies, as well as temporarily compensate for other lifestyle factors. When deciding which supplemental options to incorporate into your lifestyle, there are several factors you must take into account, including but not limited to age, activity level, current testosterone levels, current nutrient status, and exogenous hormone use. 3 Factors LIFESTYLE DIET SUPPLEMENTS Sleep, Stress, Training Nutirion, and Weight Micronutrients, and Herbs 3/21 Philosophy While doing research over the past several years, and for this guide, in particular, there were three primary categories of research that were considered; 1. Compounds that have been shown to be effective in healthy human subjects, 2. Compounds that have been shown to be effective in hypogonadal/ infertile subjects AND in healthy animals, and 3. Compounds that have only been shown to be effective in hypogonadal/infertile men or animals. With this in mind, the supplements that are listed in this guide are categorized into 4 main categories: 1. Micronutrients 2. Primary Herbal Options 3. Secondary Herbal Options and 4. Experimental Options. At the end of the guide, we will also discuss, some popular supplements that have zero/poor evidence and should be skipped altogether. Most products that are on the market currently, are complete garbage, and I would avoid any supplements that are based on these compounds. For most individuals, the most immediate concern to address is possible nutrient deficiencies. There are several micronutrients that have been clinically shown to raise testosterone levels under the condition that they correct a deficiency. Without these being addressed, it is impossible to optimize hormone status. The second portion of this guide will be dedicated to the herbal options that are available that have been shown to improve testosterone production. Because my personal approach to supplementation is that of a wellness-based approach, supplements that have been shown to cause harm to testicular function, as well as exogenous hormones such as DHEA have been intentionally left off of the list. If you are looking for something to increase testosterone at any cost, no matter what damage it does to your body, this is not the guide for you. 4/21 Micronutrients 5/21 Micronutrients 1. Zinc Zinc is an essential mineral that plays a major role in the body as an enzyme co-factor. Deficiency has been clinically shown to decrease testosterone levels, and upregulate the expression of estrogen production and receptors. In cases of deficiency, infertility, hypogonadism, or low testosterone, zinc supplementation has been clinically shown to reliably increase testosterone levels to a modest degree. Because zinc is readily lost through sweat, athletes and those that work outdoors are at higher risk of deficiency and would particularly benefit from supplementation. Zinc should be taken in the range of 5-15 mg of elemental zinc per day with athletes leaning towards the upper end of the range. Avoiding consumption of more than 30 mg per day would be prudent as too much zinc can cause a deficiency of other minerals in the body through various mechanisms. Zinc can also cause an upset stomach, so it may be best to consume zinc with a large meal at lunch or dinner. 2. Vitamin D Vitamin D is an essential vitamin that is produced by the skin when exposed to prolonged sunlight exposure. Vitamin D has a unique role in the body in that it acts as both a vitamin and hormone and supplementation is warranted when inadequate blood levels are present. Individuals with inadequate sunlight exposure are at particular risk of deficiency and would benefit most from vitamin D supplementation. In instances where blood levels are low, vitamin D supplementation has been clinically shown to increase testosterone and is recommended. 2,000-3,000 IU of vitamin D per day is generally recommended for anyone with insufficient vitamin D levels. Because of the risk of Vitamin D toxicity, a test should be done in order to properly assess how to properly dose your vitamin D. Because Vitamin D can be stimulatory to some, it may be best to take it during the first half of the day. 6/21 Micronutrients 3. Magnesium Magnesium is a dietary mineral that plays a crucial role in the body as both an electrolyte and enzymatic cofactor to hundreds of reactions. Deficiency is extremely common and has numerous health consequences, one of which being decreased sex hormone production. In instances of deficiency, magnesium supplementation has been clinically demonstrated To slightly normalize testosterone production. Magnesium, like zinc, can be lost through sweat, and supplementation is especially beneficial in populations of individuals that sweat excessively. Because magnesium has such a positive regulatory effect on sleep, it is generally recommended to supplement just before bed for the added benefit of improved sleep quality, which also has a positive regulatory effect on testosterone production. 200-400 mg of magnesium aspartate per day is generally recommended in order to correct and prevent deficiency. Because magnesium can be inhibitory in nature, it is best to take in the evening before bed. 4. Boron Boron is a dietary trace mineral that is not well understood at this moment. However, supplementation of boron at levels higher than typically found in food has been shown to raise levels of free testosterone in both males and females. It does this by downregulating a protein called Sex Hormone Binding Globulin that typically binds to testosterone, rendering it inactive. By hindering this protein, more testosterone can then be free to act on receptors in the body and exert its typical effects. Boron has also been shown to decrease estrogen after 2 weeks of supplementation. However, it has also been shown to increase estrogen levels after this point, and so supplementation should therefore be limited to this time frame. 3-10 mg of boron per day is generally recommended. Because boron may positively interact with other minerals, boron may be best to take alongside magnesium and zinc. 7/21 Micronutrients 5. Creatine Creatine is a molecule consumed most readily through meat consumption. Consuming creatine in amounts higher than what is normally found in food has been repeatedly found to increase power output, lean mass, and androgen status in both trained and untrained individuals. Creatine supplementation is the most comprehensively studied supplement there is, and the benefits of taking it on a daily basis extend well beyond athletic performance and testosterone production. Individuals on a vegan or vegetarian diet are at particular risk of deficiency, however, creatine is one of a few compounds that most individuals would benefit from taking. 5 grams of creatine monohydrate per day is generally recommended and is the most efficient form of creatine. Because creatine may be stimulatory to some, it may be best to consume in the first half of the day to avoid disruption to sleep. 6. Other Important Micronutrients Aside from the previously mentioned micronutrients that have established literature on their effects on testosterone, there are other important micronutrients to be aware of. These don't have any direct research on their explicit ability to increase testosterone levels, however, there is some data to suggest that they are critical for proper testicular function, and therefore critical for proper testosterone production. These micronutrients include, in no particular order, Vitamin A, Vitamin B6 and B12, Folate, Vitamin C, Vitamin E, Selenium, and Manganese. These nutrients are important on several different levels and perform various functions in the body that can help improve testosterone production. When in a deficient state, there will likely be less than optimal testosterone production. However, testosterone production can be optimized by correcting these deficiencies. It is also important to note that if you are already consuming proper amounts of these micronutrients, consuming more than what is necessary may not provide any further benefit, and may actually be detrimental. 8/21 Getting Tested How to Get Tested One of the best things you can do in order to properly prioritize your micronutrient intake is to have a micronutrient blood test done to assess your current vitamin status. Now the good news is that there is a great test out these days that can test your blood micronutrient status from home with a super quick and simple blood test. I can't recommend this more, as it will give you some absolute clarity and quantitative data on which micronutrients you should prioritize. Below is a link to the company that I personally use for this purpose. They offer the best service in existence. Use code LIBRARY30 for 30% off of your first order! At-home vitamin and mineral blood test 9/21 Primary Herbs 10/21 Primary Herb 1. Ashwagandha Ashwagandha is an herbal supplement that is native to India and had been used for thousands of years to mitigate the effects of stress on the body. Ashwagandha is the first herbal option because it is one of only 3 herbs on the list that have been shown to increase testosterone in healthy men. Because of its ant stress effects, individuals under abnormal amounts of stress will benefit the most from ashwagandha intake. However, the effects of ashwagandha seem to be unilateral when it comes to improving athletic performance and increasing testosterone. One of the primary mechanisms of Ashwagandha is its ability to reduce cortisol. Cortisol is your primary stress hormone and has a direct inverse relationship with testosterone. This means that as cortisol goes up, testosterone goes down, and vice versa. Individuals with abnormally high levels of cortisol may especially benefit from ashwagandha. If you suspect that you are experiencing abnormally high levels of stress, it is recommended that you check your cortisol levels. For the purposes of lowering stress and increasing testosterone, anywhere from 300-900 mg of a KSM-66 extract is recommended. Because Ashwagandha tends to be inhibitory in nature, it is generally recommended that it be taken in the latter half of the day, preferably after a workout. This will inhibit postworkout cortisol spikes. At Home Cortisol Test 2. Shilajit Shilajit is a mixture of minerals that is usually present as a black tar-like substance. There is currently not much research on Shilajit, however, the evidence that does exists suggests a marginal effect on testosterone in infertile men, as well as healthy men. There are no supportive studies performed in animals yet, and direct mechanisms aren’t known yet. 500 mg of shilajit containing at least 50% fulvic acid should be consumed if supplemented. Because Shilajit tends to be stimulatory in nature, it is generally recommended that it be taken in the first half of the day to avoid disruption to sleep. It can also be taken before workouts. 11/21 Primary Herb 3. Tongkat Ali (Eurycoma Longifolia) Tongkat Ali, otherwise known as Eurycoma Longifolia, is an herb that draws its origins back to Indonesia, where it has been used for centuries for its ability to increase libido, and sexual performance. However, recent research suggests that Tongkat Ali may also increase testosterone. Because it has only been shown to be effective in healthy BUT stressed men, it is relegated to 3rd on the list. However, because it also shows promise as a potent anti-estrogenic, Tongkat Ali may be a great option for individuals with high estrogen levels. A comprehensive male hormone blood panel will also test for estrogen levels. 200-600 mg of a 100:1 extract of Tongkat Ali is recommended for maximum benefit to testosterone levels and suppressing the effects of estrogen. Because Tongkat Ali can be slightly stimulatory, it is typically recommended that it be taken in the first half of the day, or before a workout. 12/21 Secondary Herbs 13/21 Secondary Herbs 1. Mucuna Pruriens Mucuna Pruriens is a legume native to regions of Africa, that has been used for hundreds of years for energy and vitality. Most of the current research suggests that it is remarkably potent at improving libido, fertility, cognitive performance, and as well as modestly potent at increasing testosterone. It is the first secondary option because though there are no studies performed in healthy males, Mucuna does show promise in infertile men, as well as healthy animal models. Mucuna does this by providing a molecule known as L-DOPA, which is an immediate precursor to the neurotransmitter dopamine. Dopamine has a positive regulatory function on the HPG axis that helps to stimulate the production of testosterone in the testicles. Dopamine also has the powerful ability to suppress prolactin which is a hormone that suppresses testosterone levels. Men that have especially high levels of prolactin will especially benefit from Mucuna Pruriens. Prolactin is tested in the At-Home Male Hormone Test. At Home Male Hormone Test 30-120 mg of standardized L-DOPA is recommended for the purposes of increasing testosterone production. Because Mucuna can be stimulating in nature, it is typically recommended that it be consumed in the first half of the day, or before a workout to avoid disruption to sleep. 2. Coleus Forskolii Coleus Forskohlii is an herb that traces its roots back to India, where it has been traditionally used as a fat-burning agent with moderate efficacy. Recent research suggests that not only is coleus forskohlii effective at burning fat, but also at raising testosterone levels. It does this by increasing levels of an enzyme in the body known as cAMP. By doing this, coleus forskolii is able to reliably increase testosterone production in the testicles through a cAMP-dependent pathway. Coleus Forskolii is a secondary option because there is currently only one study on the effects of Coleus Forskolii on testosterone that was performed in healthy overweight men and no studies have been performed in animals yet. However, because the effects theoretically extend to most individuals, it earns a high ranking on the list of secondary options. 14/21 Secondary Herbs 500 mg of a coleus forskohlii extract containing 10% forskolin is recommended for optimal results. Isolated forskolin is less effective, and therefore should be avoided. Because Caffeine can inhibit some of forskolin's effects, it is typically recommended that it be consumed apart from caffeine intake and can be taken at any time. 3. Royal Jelly Royal Jelly is a compound created by bees to be consumed exclusively by the queen. However, recent research suggests that human consumption of royal jelly may carry an array of health benefits. Some research suggests that royal jelly may increase testosterone in infertile men, and has also shown promise in healthy animal models. As little as 50 mg up to 3,000 mg has shown effectiveness in various trials. However, because long-term higher doses may have negative effects, dosing between 50-1,000 mg per day is recommended. Because Royal Jelly does not affect neurotransmitters, it can be taken at any time. Royal Jelly has also shown promise at increasing lifespan in some animal models and is, therefore, a very promising and respectable compound. Royal Jelly may also help lower prolactin levels and may be useful for those with high prolactin. 4. Ginger Ginger is a spice that has been heralded for many centuries for its medicinal properties. It has been traditionally taken to aid in digestion and reduce inflammation. However, recent research suggests that it may also increase testosterone in males. There is currently only one clinical trial that has been conducted in infertile men. However, there is a good amount of research in healthy animals that suggests it can also increase testosterone in healthy subjects. For the purposes of increasing testosterone, up to 10 grams of the dry root may be required. However, lower doses equivalent to 1-3 grams of the dry root have shown some promise in animals models. Because ginger can be stimulatory to some, it may be best to take it in the first half of the day. 15/21 Experimental Herbs 16/21 Experimental Herbs 1. Tribulus Terrestris Tribulus is an herb that has also been traditionally used as an aphrodisiac and has fairly potent effects. It has also been traditionally used to increase testosterone, however, because the evidence is so mixed, it should only be used as an experimental option. Studies in both humans and animals suggest that there may only be a slight benefit to testosterone levels in infertile and hypogonadal males. However, if you do fall into this category, it may be worth a shot. If you decide to try Tribulus, 2-6 grams of the basic root or fruit powder is recommended, or an equivalent extract. 2. D- Aspartic Acid DAA is an amino acid that shows some promise as a testosterone booster, but only in specific populations, and for a specific amount of time. DAA acts on an area of the brain that stimulates the production of testosterone in the testis. However, it only appears to be effective in untrained individuals. DAA supplementation would be advised for anyone with diagnosed sub-optimal testosterone levels or infertility issues. Individuals that are currently undergoing a resistance training program will likely experience no benefit. However, because DAA has shown promise in healthy individuals that aren’t trained, it can be considered an experimental option for those that may be hypogonadal and are currently not undergoing a training regimen. For the purpose of increasing testosterone and improving fertility no more than 3 grams per day of DAA should be taken. However, because DAA loses its effectiveness after 2 weeks of consumption, it should be regularly cycled. It has also been shown to increase prolactin levels, so DAA would also not be advisable for those with elevated prolactin. A comprehensive male hormone blood test will also test prolactin levels 17/21 Experimental Herbs 3. Cordyceps Cordyceps is a mushroom that is typically touted in Traditional Chinese Medicine for its antiaging properties, though there is no direct research investigating these claims. The current evidence in regards to its effects on testosterone is preliminary and has only been performed in healthy rodents, however, seems to be promising. The mechanisms seem to be complicated, however, it appears that cordyceps increases levels of a protein known as the StAR protein that is involved in the production of testosterone. 1-3 grams of a high-quality extract daily is typically recommended. 4. Panax Ginseng Panax ginseng is a generally healthy compound that can be used to improve cognition and libido. It does have some evidence to suggest that it may improve testosterone levels in hypogonadal and infertile men. However, similarly to fenugreek, this effect may be due to Panax Ginseng preventing the conversion of testosterone into DHT. Because Ginseng has so many other health properties, it may prove to be a worthwhile option for some. 18/21 Options to Skip 19/21 Herbs To Skip 1.Maca Maca has absolutely zero evidence to suggest that it can improve testosterone levels. However, it does have a considerable amount of research to suggest that it can effectively improve libido. It is for this reason that a lot of testosterone-boosting supplements include maca in their formulation. It gives the impression that testosterone has increased. 2. Fenugreek The evidence to support that fenugreek can improve testosterone is scant at best. The available research seems to indicate that fenugreek does not increase testosterone in healthy individuals. And because it has not been tested in hypogonadal men or rodents yet, there is no indication that it might be effective for those that are suffering from clinically low testosterone. Future research may change my stance on this, however, at the moment it seems that any interaction that fenugreek has with testosterone may be from a backlog that is caused by the prevention of testosterone being converted into other more potent anabolic compounds such as DHT. This is not a good thing. Fenugreek is also a potent libido booster which is why many companies include it in their testosterone boosting products. 4. Stinging Nettle Stinging Nettle does not raise testosterone. There are some test-tube studies that suggest that it may interact with various hormonal mechanisms, however, the only study performed in a living model suggests that it doesn't do anything once you ingest it. 20/21 Getting Tested How to Get Tested "I was absolutely shocked when I got my test results back, and it completely altered my approach to balancing my hormones." One of the first steps to optimizing hormone status is getting a full hormone blood panel done. This used to be a lengthy process of getting an appointment with your primary care doctor, and then a referral to a hormone specialist. However, these days it is possible, for the first time ever, to get a blood panel done from the comfort of your home, for a fraction of the cost. I personally use a company that is at the forefront of innovating this industry called LetsGetChecked. Their service includes a complete hormone test that is sent to your home that tests for Testosterone, Estrogen, Sex Hormone Binding Globulin, and Prolactin. They are competitively priced and can be paid using Health Saving Account. Their service also includes online results, as well as a consultation with a practitioner to go over your results. No other company that I am aware of offers a service like this. I recommend that ANYONE over the age of 30 get a full hormone blood panel done, as well as anyone under the age of 30 that has ever used exogenous hormone replacement. Without getting data in your hands, it is impossible to take an evidencebased approach to correct hormone imbalances. Follow this link to purchase your at-home male hormone blood test. Male Hormone At-Home Test 21/21