How to Optimize Your Hormones for Health & Vitality | Dr. Kyle Gillett

1. Adopt a Balanced Health Approach

Become obsessed with optimal human performance by adopting a balanced approach to total health that includes body, mind, and soul, as these elements are interconnected.

2. Consistent Lifestyle Interventions

Implement lifestyle changes consistently over a long period, as doing a little amount over time is far more efficacious than doing a lot intermittently.

3. Prioritize Diet and Exercise

Focus on diet and exercise as the two strongest pillars for hormone health and overall well-being.

4. Cultivate Spiritual Health

Recognize that your spiritual health profoundly impacts your mental and physical health, regardless of specific beliefs, and integrate it with other health aspects.

5. Optimize Stress Management

Actively manage stress, as it directly impacts cortisol levels and overall mental health.

6. Optimize Sleep

Prioritize and optimize sleep, as it is extremely important for mitochondrial health and overall hormone regulation.

7. Embrace Sunlight and Outdoors

Regularly expose yourself to sunlight and engage in outdoor activities, which can include beneficial cold and heat exposure.

8. Emphasize Preventative Medicine

Focus on preventative medicine by viewing exercise as medicine and food as medicine to proactively manage health challenges.

9. Avoid Processed Foods

Consume as few highly processed and highly palatable foods as possible to support overall health and hormone balance.

10. Individualize Your Diet

Tailor your diet to your individual genetics and performance goals, as different ‘fuels’ are required for different ‘cars’.

11. Achieve Health as a Unit

Attempt to achieve optimal health together as a household unit or with close friends, as collective efforts are far more helpful for lifestyle changes like hormone optimization.

12. Regular Preventative Blood Testing

Get regular blood testing every three to six months for preventative purposes to analyze factors impacting your immediate and long-term health.

13. Test Blood Fasting and Non-Fasting

Obtain blood tests both when fasting and not fasting to get a comprehensive view of your health, similar to looking at both low and high tide.

14. Consistent Zone 2 Cardio

Aim for a minimum of 150-180 minutes of Zone 2 cardiovascular exercise per week for cardiovascular, brain, and musculoskeletal health.

15. Incorporate Resistance Training

Include resistance training in your exercise routine, as it is particularly helpful for hormone health.

16. Strategic Caloric Restriction

Consider caloric restriction if you are obese or have metabolic syndrome, as it can improve testosterone and increase health span, but avoid it if you are young, healthy, and lean as it may decrease testosterone.

17. Optimize Growth Hormone Overnight

To improve growth hormone output, avoid food in the two to three hours before going to sleep, as longer fasting periods lead to more significant overnight growth hormone spikes.

18. Natural GH Increase is Safe

Understand that increases in growth hormone from natural methods like saunas or intermittent fasting are quite unlikely to cause cancer.

19. Communicate Symptoms to Doctor

When discussing hormone health with your doctor, describe specific symptoms like reduced energy, focus, or athletic performance compared to a younger age to indicate a need for lab work.

20. Men: Discuss Libido and Energy

Men should overcome hesitation to discuss libido and energy levels with their doctor, as these are crucial for assessing hormone health.

21. Women: Know Testosterone Levels

For health optimization, knowing a woman’s testosterone level is just as important as knowing estrogen and progesterone levels.

22. Women: Test Total Testosterone

When testing testosterone in women, focus on total testosterone rather than just free testosterone, as most testosterone is bound by SHBG.

23. Understand DHT’s Role

Recognize that DHT activates the androgen receptor, contributes to motivation and drive, and is active in cardiovascular tissue.

24. Adjust Curcumin/Creatine for DHT

If your DHT is low or you have insensitive androgen receptors, avoid bioavailable curcuminoids (turmeric, black pepper extract) and consider creatine, as it can increase testosterone to DHT conversion.

25. Supplement Effects are Reversible

Be aware that the effects of most supplements, especially those impacting 5-alpha-reductase, are nearly always reversible if you stop taking them after side effects appear.

26. Recognize PCOS Symptoms

Women should be aware of Polycystic Ovarian Syndrome (PCOS) symptoms, including androgen excess, insulin resistance, and irregular menstrual cycles.

27. PCOS: Optimize Body Composition

If you have PCOS and are on the insulin resistance spectrum, focus on optimizing your body composition, decreasing body fat, and treating metabolic syndrome.

28. PCOS: Consider Myo-Inositol

For PCOS, consider supplementing with myo-inositol, which acts as an insulin sensitizer.

29. PCOS: Consider D-Chiro-Inositol

For women with PCOS seeking to reduce androgen activity, consider D-chiro-inositol, a weak antiandrogen often found in combination with myo-inositol.

30. PCOS: Consider DIM

Women with PCOS should consider DIM (diindolylmethane) as a weak anti-estrogen and anti-androgen.

31. Avoid Smoked Marijuana for Testosterone

Avoid smoked marijuana, as it is likely to increase aromatase, leading to higher estrogen and subsequently lower testosterone by inhibiting LH and FSH release.

32. Limit High Alcohol/GABA Agonists

Limit high alcohol intake and any potent GABA agonists (barbiturates, benzodiazepines) as they can decrease testosterone.

33. Moderate Alcohol Intake Strategy

If consuming alcohol, it’s better to have two drinks on two separate days of the week rather than one drink daily, as daily intake can be mildly immunosuppressive.

34. Cycle GABA Sleep Supplements

Avoid daily use of sleep supplements that are GABA agonists (e.g., GABA, trazodone), as they can be immunosuppressive; magnesium, L-theanine, and apigenin are generally safe for daily use.

35. Maintain Gut Health for Prostate

To prevent prostate infections, maintain a diet rich in healthy prebiotic fiber and probiotics, ensuring regular bowel movements and avoiding chronic constipation.

36. Maintain Low CRP for Prostate

Aim for a very low C-reactive protein (CRP) level, measured by a high-sensitivity CRP test, to decrease inflammation and reactive oxygen species that can contribute to prostate issues.

37. Strengthen Pelvic Floor

Maintain a healthy pelvic floor by strengthening it through exercises, potentially with the guidance of a pelvic floor physical therapist.

38. Low-Dose Tadalafil for Prostate

Consider low-dose tadalafil (2-2.5 mg or 5 mg daily) to decrease prostate congestion and improve urinary flow, even if not for erectile dysfunction; however, be aware it can lower blood pressure and should be avoided before heavy lifting.

39. TRT: Aim for Steady State

If on Testosterone Replacement Therapy (TRT), aim for a nice, even steady state of testosterone levels (e.g., 100-120 mg per week, administered 2-3 times weekly) to avoid undesirable peaks and troughs.

40. Avoid Aromatase Inhibitors

Avoid aromatase inhibitors unless truly necessary, as lifestyle interventions often suffice to control estrogen, and crashing estrogen can disrupt brain function, cause connective tissue issues, and reduce libido.

41. Control Estrogen with Supplements

To help control estrogen, consider calcium deglucarate (500-1000 mg) which aids excretion and estrogen receptor sensitivity, or consume cruciferous vegetables (source of DIM).

42. Avoid DIM with TRT

If you are on TRT and also taking DIM (diindolylmethane), you are likely on too much TRT, as DIM is both an anti-estrogen and an anti-androgen.

43. Avoid Aromatase Upregulators

To improve your testosterone to estrogen ratio, avoid substances that upregulate aromatase, such as HCG, alcohol (especially if estrogen sensitive), and high-fat/high-calorie meals.

44. Ensure Healthy Fats for Hormones

Ensure adequate intake of omega-3s and naturally occurring healthy trans fats (found in ruminant products like grass-fed cheese, milk, butter, and meats) to support hormone health; vegans may need to supplement with algae or other sources.

45. Consider Tongkat Ali for SHBG

Consider Tongkat Ali (Longjack), particularly Indonesian varieties, to potentially reduce sex hormone binding globulin (SHBG) and free up testosterone, which may improve libido and vitality; cycle 11 months on, 1 month off, or 3 weeks on, 1 week off if combined with Fadogia.

46. Tongkat Ali Post-Birth Control

For women coming off birth control, Tongkat Ali may help lower persistently elevated SHBG and prevent subsequent hyperestrogenism.

47. Consider Fadogia Agrestis for LH

Consider Fadogia Agrestis (Nigerian shrub extract) to increase testosterone by increasing luteinizing hormone (LH) release and LH receptor sensitivity, cycling three weeks on, one week off, especially if LH is low and estrogen/prolactin are fine.

48. Consider Boron for SHBG

Consider boron (3-6 mg once or twice a day) to help regulate SHBG, especially if sourced from rich soils like the Mediterranean (e.g., dates, raisins).

49. HCG and Selenium for Thyroid

HCG can potentially improve thyroid function, and selenium is also beneficial for thyroid health; ensure adequate selenium intake (e.g., 3-5 Brazil nuts daily).

50. Manage Dopamine Wave Pool

Aim for nice, even ‘dopamine waves’ to avoid excessive dopamine increases that lead to a crash, as prolactin levels follow estrogen and dopamine.

51. Avoid Prolactin-Increasing Foods

If concerned about dopamine or high prolactin, eliminate foods that could be increasing prolactin, such as casein (milk protein) or gluten, which are mu opioid receptor agonists.

52. P5P for High Prolactin

If prolactin is under 40 and there’s no adenoma, consider dopamine agonists like P5P (pyridoxine 5-pyrophosphate, the active form of vitamin B6) at 50 mg once or twice a day to help decrease prolactin-producing cells.

53. Use P5P for B6 Safety

To avoid potential neurotoxicity, take P5P (the pre-activated form of vitamin B6) rather than pyridoxine, especially at higher doses, as it does not build up.

54. L-Carnitine for Fertility/Mitochondria

Consider L-carnitine for enhancing sperm quality, egg quality, and conception rates, as it acts as a shuttle to get fuel into mitochondria, improving their function and flagella.

55. L-Carnitine for Androgen Receptors

L-carnitine can slightly increase the density of androgen receptors.

56. Oral L-Carnitine Dosing

If taking oral L-carnitine (e.g., L-carnitine L-tartrate or acyl L-carnitine), take approximately 10 grams to achieve an efficacious dose of 1 gram due to its low (10%) bioavailability.

57. Manage TMAO with Garlic

If taking L-carnitine or choline precursors and concerned about elevated TMAO, take 600 mg of garlic capsule (allicin) or eat garlic, as it can effectively reduce TMAO levels.

58. Annual Blood Tests

Get a blood test at least once a year to monitor hormone levels, metabolic markers, and lipids, rather than waiting for a problem to arise.

59. Adjust Relationships for Dopamine

Understand that relationship excitement is dopamine-regulated and changes over time; purposefully build time apart into relationships to allow dopamine to settle and then be re-excited upon reunion.

60. Plan for Relationship Crises

Plan ahead for relationship crises, especially during periods like having an infant (which brings high prolactin, low dopamine, and low testosterone), by having good times and understanding hormonal shifts.

61. Cold Exposure for Testicular Health

Utilize cold exposure (ice baths, cold showers) to acutely help testosterone, especially if testes are too warm (e.g., due to varicocele or primary hypogonadism), but be careful not to get frostbite.

62. Avoid Heat for Sperm Production

If experiencing infertility or low sperm count, avoid saunas, hot tubs, and jacuzzis, as they raise testicular temperature, which is detrimental to sperm production.

63. Cold Exposure Benefits for Women

Cold exposure can be beneficial for women, potentially decreasing the drive for food by increasing beta-adrenergic receptor activity.

64. Peptides Require Doctor Prescription

Understand that peptides should be prescribed by doctors, similar to insulin, as there are both very dangerous and very safe ones.

65. Avoid BPC-157 with Cancer Risk

If you have cancer or a high cancer risk, avoid BPC-157 (body protective compound 157) as it increases VEGF, which promotes blood vessel growth and is the opposite mechanism of anti-cancer drugs.

66. Source Peptides from Compounding Pharmacy

If using peptides, work with a physician and a good compounding pharmacy to ensure the product is free of LPS (lipopolysaccharide) contamination, which can cause inflammation and fever.

67. Question Peptide Dosing Regimen

If prescribed peptides, ask your doctor about the specific dosing regimen (e.g., why six weeks vs. two weeks) and if it is individualized for your condition.

68. BPC-157 for Injury Recovery

For injuries, BPC-157 can significantly increase blood flow to the injured area, especially tissues with poor blood flow like cartilage and ligaments, potentially aiding recovery.

69. Brimelanotide for Hypoactive Sexual Disorder

For women with hypoactive sexual disorder (low libido with other hormones in check), consider brimelanotide (PT-141) via nasal spray, injection, or troche, as it is FDA approved and acts centrally.

70. Melanotan: Melanoma Risk

If considering melanotan (like brimelanotide), be very careful about long-term administration if you have a family history of melanoma or a potential melanoma, as it can increase alpha-melanocyte stimulating hormone and grow existing melanomas.

71. Caffeine and Hormones

Caffeine has negligible effects on testosterone, estrogen, or other hormones, unless it negatively affects your sleep quality.

72. Supplement Vitamin D3K2

Supplement with Vitamin D3K2, as D3 is essential for brain and body health (even with sun exposure) and K2 regulates cardiovascular function and calcium in the body.

73. Hydrate with Electrolytes Morning

Dissolve one packet of Element in 16-32 ounces of water first thing in the morning to ensure adequate hydration and electrolytes (sodium, magnesium, potassium) for optimal brain and body function.

74. Hydrate with Electrolytes During Exercise

Drink Element dissolved in water during any physical exercise to ensure proper hydration and electrolyte balance, which is critical for cognitive and physical performance.

75. Consider Low-Carb for Risk Groups

Consider lower-carb diets if you are at risk of cancer or autoimmune diseases, as these groups tend to do well on such diets.

76. Monitor Diet with Biofeedback/Genetics

Use biofeedback (how you’re feeling) to determine which foods you tolerate well, or consider genetic testing for more precise dietary insights (requires physician interpretation).

77. Caloric Restriction for Obese/Metabolic Syndrome

If you are obese or have metabolic syndrome, caloric restriction will improve your testosterone levels.

78. Avoid Caloric Restriction if Lean/Healthy

If you are young and healthy and do not have metabolic syndrome, caloric restriction will likely decrease your testosterone.

79. Intermittent Fasting for Growth Hormone

Intermittent fasting, if in caloric maintenance, is not deleterious for hormone health and can contribute to improved growth hormone output, especially overnight.

80. Address Growth Hormone Deficiency for Sleep

If you have a true growth hormone deficiency, whether as an adult or child, replacing it with therapy will significantly improve your sleep.

81. Manage Vasomotor Symptoms for Sleep

If experiencing vasomotor symptoms of menopause or andropause due to lower progestogenic activity, addressing these can lead to significant improvements in sleep.

82. Monitor Sleep on TRT

Be aware that starting Testosterone Replacement Therapy (TRT) can drastically raise the risk of sleep apnea and may induce a hypersympathetic state in the initial months, potentially causing sleep issues.

83. Discuss Menstrual Irregularities

Women should discuss any menstrual irregularities (too heavy, too light, or absent periods) with their doctor, as these provide objective data for assessing hormone health.

84. Women: Understand Hormone Ratios

Women should understand that they naturally have significantly more total testosterone than estradiol, and significantly more DHEA than either.

85. Monitor DHT for Heart Health

Be aware that DHT levels can impact cardiovascular tissue; if you have heart failure or cardiac hypertrophy, DHT binding to androgen receptors in the heart can contribute to muscle enlargement.

86. Finasteride for Cardiac Hypertrophy

If recovering from cardiac hypertrophy (e.g., ‘bodybuilder heart’), taking finasteride or dutasteride (5-alpha-reductase inhibitors) can improve heart health by decreasing androgen receptor activity and promoting cardiac remodeling.

87. Be Aware of Polyphenol Effects on DHT

Be aware that a diet high in plant polyphenols (e.g., certain curcuminoids from turmeric, black pepper extract) can inhibit 5-alpha-reductase, the enzyme that converts testosterone to DHT.

88. Creatine and Hair Loss

Understand that creatine monohydrate can potentially exacerbate male pattern baldness by increasing DHT, but it doesn’t directly ‘cause’ it, and hair loss from creatine is reversible if stopped early.

89. Strategies for Androgenetic Alopecia

If experiencing androgenetic alopecia (male pattern baldness, even in women), consider strategies to decrease the activity of the androgen receptor.

90. Localized DHT Inhibition for Hair

For localized hair loss treatment without systemic side effects, consider dutasteride mesotherapy (localized injections in the scalp) to decrease testosterone to DHT conversion only in the scalp.

91. Oral Contraceptives Alter Attraction

Be aware that oral contraceptives increase SHBG, decreasing free testosterone and free DHT, which can flatten day-to-day peaks and troughs in libido and attractiveness.

92. Oral Contraception and Fertility

Oral contraception taken for six to 12 months, followed by cessation, is unlikely to cause permanent damage to fertility beyond age-related decline.

93. Choose Progestin Wisely for Clot Risk

If predisposed to blood clots, choose a synthetic progestin in oral contraceptives that does not cause as high a response in platelets and SHBG, as higher levels increase blood clot risk.

94. TRT and Prostate Cancer Risk

Understand that Testosterone Replacement Therapy (TRT) will not cause prostate cancer, but if prostate cancer is already present (common with aging), TRT will grow it; individual assessment and PSA monitoring are important.

95. Prevent Prostate Infections

To maintain prostate health, focus on preventing prostatitis (infections of the prostate), which can be related to sexually transmitted infections or gram-negative/anaerobic bacteria from the colon.

96. Consider Saw Palmetto/Curcumin for Prostate

If there’s a strong genetic predisposition to enlarged prostates or early prostate cancers, consider saw palmetto or curcumin as anti-androgens, if tolerated and on an individualized basis.

97. Pilots: Avoid Viagra

If you are a pilot, avoid Viagra (sildenafil) as it can potentially alter your vision (rays and cones), affecting red-green discrimination.

98. Viagra for Hair Growth

Viagra (sildenafil) may increase eyebrow hair growth and potentially help prevent androgenetic alopecia by increasing blood flow in the scalp.

99. TRT: Choose Ester/Delivery Wisely

For TRT, consider different types of esters or topical testosterone, depending on SHBG levels and absorption, as lower SHBG may benefit from longer esters.

100. Individualized Testosterone Optimization

Understand that the ‘optimal’ testosterone level is individualized due to varying androgen receptor sensitivity; L-carnitine and tadalafil can alter receptor sensitivity.

101. Consider Ecdysteroids for Low Estrogen

Consider terkesterone or ectesterone if you have naturally low estrogen, as they are beta-estradiol receptor agonists that can promote water retention but not typically reduced libido or closing growth plates.

102. Naltrexone for Low LH

If luteinizing hormone (LH) is low, consider naltrexone to potentially antagonize opioid receptors and increase LH, especially for those recovering from opiates or alcohol.

103. HCG for Fertility

HCG (human chorionic gonadotropin) is commonly prescribed for fertility in both men and women, often at doses like 10,000 IU.

104. HCG Monotherapy Considerations

HCG monotherapy can be an alternative to TRT, potentially offering better lipid profiles, but it is suppressive of LH and can potently increase estrogen.

105. HCG for Post-Finasteride Syndrome

HCG is a common and extremely helpful treatment for Post-Finasteride Syndrome (PFS), as it helps re-upregulate DHT, improving genital sensitivity.

106. HCG Causes Positive Pregnancy Test

Be aware that HCG will make any pregnancy test positive, which is a risk some women may not know.

107. Plan for Post-Breastfeeding Hormones

Plan ahead for the post-breastfeeding period, as it involves a prolactin spike, leading to low dopamine and low testosterone, which can impact sexual activity.

108. Maintain Prolactin During Pregnancy

Ensure prolactin levels are not too low during pregnancy, as a very high spike during pregnancy is crucial for the maturity of infant lungs and can reduce the risk of respiratory distress in the newborn.

109. Injectable L-Carnitine Dosing

If taking injectable L-carnitine, a dose of 200-500 mg (or 1 gram per day divided) is likely efficacious, as it is 100% bioavailable and absorbed faster and more evenly intramuscularly.

110. GHRPS: Be Aware of Cancer Risk

If considering growth hormone releasing peptides (GHRPs) like sermorelin, be aware of risks such as tumor growth and cancer, as they may confer a similar cancer risk to a type 1 diabetic with high growth hormone.

111. Alternative Benefits to GHRPS

For benefits like lipolysis (fat breakdown) and increased lean body mass, consider other methods besides GHRPs if you do not have lipodystrophy or a growth hormone deficiency.

112. GHK Copper Peptide for Nervous System

Consider GHK copper peptide if copper deficient (e.g., after bariatric surgery) for nervous system health, as it is synergistic with other growth agonists and helps with liver regeneration.