Tools for Hormone Optimization in Males | Dr. Kyle Gillett
Dr. Kyle Gillett, a dual board-certified physician, discusses male hormone optimization, covering behavioral, nutritional, supplement, and prescription tools. The episode provides actionable strategies for men of all ages to optimize testosterone, estrogen, growth hormone, and thyroid for overall health and longevity.
Deep Dive Analysis
23 Topic Outline
Puberty's Impact on Adult Height and Body Composition
Childhood Obesity, Resistance Training, and Early Puberty
First and Second Puberty in Males
Importance of Early Blood Work for Hormone Optimization
Lifestyle Pillars for Optimal Male Hormone Health
Assessing Hormone Status: Subjective Feelings & ADAM Questionnaire
Dopamine Wave Pool, Libido, Pornography, and Masturbation
Sustainable Exercise Regimen for Hormone Health
Testosterone Replacement Therapy (TRT) for Young Males
Supplementation: Creatine, Betaine, L-Carnitine, Allicin
Vitamin D, Boron, SHBG, and Free Testosterone
Tongkat Ali (Longjack) and Steroid Pathways
Fadogia Agrestis and Testosterone Production
Optimizing Growth Hormone and IGF-1
Optimizing Thyroid Hormone: Iodine and Goitrogens
Peptides for Growth Hormone and Tissue Healing
Testosterone Therapy Dosing and Monitoring
Prescription Hormone Modulators: HCG and Clomiphene
Maintaining Fertility During Testosterone Therapy
Impact of Marijuana, Nicotine, Cycling, Alcohol, and Diet Fat
Prostate Health, Tadalafil, and PSA Monitoring
Hair Loss, DHT, and Turmeric/Curcuminoids
Environmental Endocrine Disruptors: BPAs and Phthalates
6 Key Concepts
Sex Hormone Binding Globulin (SHBG)
A protein that binds to androgens and estrogens in the body, regulating the amount of 'free' (active) hormones available to act on receptors. Stronger androgens bind more strongly, and a very high SHBG can lead to less free testosterone.
Dihydrotestosterone (DHT)
The strongest bioidentical androgen, playing a prominent role in secondary sexual characteristics like beard growth. Its levels are influenced by the conversion of testosterone and the amount of SHBG, which binds it.
Dopamine Wave Pool
An analogy describing the natural fluctuations of dopamine, or motivation, in the brain. Very high peaks of dopamine (e.g., from intense stimuli) can lead to deeper troughs, depleting overall dopamine supply and sensitivity.
Goitrogens
Compounds found in certain foods (such as cruciferous vegetables and boron) that can interfere with thyroid function by inhibiting iodine uptake or hormone synthesis. Consuming more goitrogens necessitates increased iodine intake to maintain thyroid balance.
Miniaturization of Hair Follicles
The process where hair follicles shrink over time, producing progressively thinner, shorter, and less pigmented hairs, eventually leading to hair loss. This is often driven by the sensitivity of hair follicle androgen receptors to hormones like DHT.
Xenoestrogens
Estrogens from external sources, such as environmental chemicals like Bisphenol A (BPA). These compounds can bind to and activate estrogen receptors in the body, potentially disrupting natural hormone balance.
12 Questions Answered
Childhood obesity can cause earlier puberty by increasing leptin, which activates the hypothalamus, leading to earlier release of gonadotropins and increased testosterone and estrogen. This can prematurely close growth plates, potentially decreasing adult height.
For healthy children, blood work can be considered in the later Tanner stages of puberty (four and five) when secondary sexual characteristics are developed, or earlier if there are concerns about precocious or delayed puberty, always with parental and physician agreement.
After an initial baseline at age 18 (or as early as possible), a good follow-up frequency for monitoring hormone levels and other health markers is approximately every six months.
Daily or multiple times per day masturbation, especially with pornography, can be detrimental to hormonal profiles by increasing prolactin (which inhibits LH and testosterone) and depleting dopamine, leading to reduced real-world libido and motivation.
Vigorous exercise should be limited to around three to four times a week, with sessions lasting no longer than an hour. This can be supplemented by three to four additional instances of less vigorous exercise.
Theoretically, creatine can slightly increase the conversion of testosterone to DHT, which is linked to male pattern baldness. However, it typically only brings an individual to their natural inclination and is not considered a strong reason to avoid creatine.
Dosages for Tongkat Ali typically range from 300 to 1200 milligrams per day. The standardization of the supplement, specifically its uricominone content, is an important factor for efficacy.
While fasting potently increases growth hormone release, the sensitivity of the growth hormone receptor and downstream gene transcription activity may be less affected. This means fasting may not significantly increase the *effect* of growth hormone for those with normal signaling.
Peptides can be sourced from unregulated companies that may contain contaminants like lipopolysaccharide (LPS), causing inflammatory responses. Additionally, some (like Ibutamoren/MK677) can significantly increase blood glucose and cause side effects like anxiety or extreme hunger.
Side effects can affect nearly every organ system, including acne, skin pathologies, bruising, hair loss, mental status changes (potentially inducing manic or bipolar episodes), cardiovascular concerns, ferritin buildup, fertility issues, and lipid concerns.
Yes, alcohol significantly increases aromatase activity, the enzyme that converts testosterone into estrogen, and this effect is dose-dependent. It can also activate inhibitory neurotransmission, decreasing LH and FSH release.
Bisphenol A (BPA) is a known xenoestrogen that can bind to estrogen receptors, and phthalates (often found in pesticides and processed foods) are widely associated with negative impacts on male reproductive health, making avoidance advisable for adults as well.
48 Actionable Insights
1. Prioritize Quality Sleep
Aim for enough quality sleep at least 80% of the nights of your life, as it is critical for overall hormone optimization and well-being.
2. Manage Stress Effectively
Learn to manage stress through mindfulness, relaxation techniques, spending time outdoors, dietary changes, exercise, or talking with friends/family, as excessive stress negatively impacts all other lifestyle pillars for hormone health.
3. Foundational Diet & Exercise
Prioritize diet and exercise as the foundational lifestyle pillars for hormone optimization throughout your entire life.
4. Get Regular Blood Work
Get comprehensive blood work done for hormones (testosterone, SHBG, free testosterone) and other markers starting at age 18, or as soon as possible if older, and monitor these markers with a physician every six months.
5. Engage in Sustainable Exercise
Engage in vigorous exercise 3-4 times per week, ensuring sessions do not regularly exceed one hour, and supplement with 3-4 instances of less vigorous exercise (e.g., Zone 2 cardio) per week for sustainable hormone optimization.
6. Avoid Dirty Bulking
Limit the amount of abnormal body fat accumulation or ‘dirty bulking’ (purposely acquiring body fat by overeating) indefinitely throughout your entire life, especially during puberty, as it can stunt height, accelerate early puberty, and limit long bone growth.
7. Limit Porn & Masturbation
Avoid daily or multiple-times-a-day masturbation and pornography use, as this frequency can be detrimental to hormonal profiles (e.g., increased prolactin, blunted libido) and decrease motivation for real-world sexual interactions.
8. Limit Alcohol Consumption
Limit alcohol consumption to no more than two standard drinks (20g alcohol) per week, as higher intake significantly increases aromatase activity (converting testosterone to estrogen), can decrease LH/FSH release, and negatively impacts overall health and hormone profiles.
9. Optimize Hydration & Electrolytes
Ensure proper hydration and adequate electrolytes (sodium, magnesium, potassium) without sugar for optimal brain and body function. Drink one packet of Element in 16-32 oz water first thing in the morning and during physical exercise.
10. Cultivate Social Connections & Purpose
Cultivate strong social connections with family and friends, and find a purpose in life (a goal or target that can change over time) to support overall well-being, which indirectly aids hormone optimization.
11. Get Outside & Move
Get outside regularly to engage in a lifelong movement pastime, which provides sunlight, heat/cold exposure, and promotes overall physical activity, counteracting the negative effects of artificial environments.
12. Include Dairy in Diet
Include dairy in your diet, especially during puberty and up to age 25, as it can help increase IGF-1, which is beneficial for growth, genital development, secondary sexual characteristics, and bone density.
13. Ensure Adequate Vitamin D
Ensure adequate vitamin D intake, as it supports testosterone production, bone mineralization, and stature.
14. Consume Prebiotic Fiber
Consume adequate prebiotic fiber throughout your lifespan, especially during teenage years, 20s, and 30s, to establish a healthy gut microbiome and support brain development.
15. Avoid Caloric Restriction if Lean
If not overweight, avoid caloric restriction as it can lower testosterone by reducing hormone building blocks, increasing catabolism, and raising SHBG.
16. Finish Workouts with Energy
Finish workouts with energy, avoiding exhaustion, to maintain vigor throughout the day and prevent negative impacts on mood and cognitive function.
17. Exercise Early Morning
Exercise early in the morning (before 9 a.m.) to experience sustained energy throughout the day and avoid an afternoon crash.
18. Include Weekly Jog
Include at least one 45-minute jog per week to support healthy blood profiles, including testosterone and estrogen levels.
19. Take Creatine Monohydrate
Take 5 grams per day of creatine monohydrate for benefits in amino acid synthesis, oxidative stress, mitochondrial function, slight increases in total testosterone and DHT, tissue voluminizing, and cognitive effects; it is not a significant cause of hair loss.
20. Consider Beta-Alanine
If you are a creatine non-responder, consider taking 1-3 grams of beta-alanine daily to aid amino acid synthesis and energy shunting.
21. Take L-Carnitine
Take 1-5 grams of oral L-carnitine daily to increase the density of androgen receptors in cells, which can enhance testosterone binding and its effects, despite its low bioavailability.
22. Ingest Garlic with L-Carnitine
If taking high doses of L-carnitine or choline, consider ingesting garlic (specifically allicin) to help decrease the conversion to TMAO, a potential carcinogen.
23. Consider Boron Supplementation
If you have high SHBG (sex hormone binding globulin), consider taking 5-12 milligrams of boron daily, as it can acutely help lower SHBG and increase free testosterone.
24. Take Tongkat Ali (Longjack)
Take 300-1200 milligrams of standardized Tongkat Ali (Longjack) daily, preferably in the morning due to its stimulant effect, to upregulate steroidogenesis enzymes, increase total and free testosterone, DHEA, and potentially lower high SHBG.
25. Take Fadogia Agrestis
To increase luteinizing hormone (LH) and testosterone, consider taking Fadogia Agrestis; a safe regimen is 300 mg daily, or 600 mg every other day/three times a week, with a more aggressive regimen of 600 mg daily for a month followed by 1-2 weeks off.
26. Avoid Eating Before Sleep
Avoid eating for at least two hours before bedtime to help optimize the pulsatile release of growth hormone during sleep.
27. Optimize Iodine for Thyroid
Ensure a balanced intake of iodine (around 200 micrograms per day), ideally from ocean sources, to support thyroid hormone levels, adjusting intake if consuming more goitrogens.
28. Exercise Caution with Peptides
Exercise extreme caution with peptides (e.g., GHRPs, GHRHs) purchased online, as sources can be unclean, contain contaminants, and dosages often exceed physiologic ranges, making their use precarious and potentially dangerous.
29. Avoid Young TRT
Avoid exogenous testosterone therapy if you are young (teens, 20s, 30s) and have normal testosterone levels, as benefits rarely outweigh detriments.
30. Monitor TRT Closely with Doctor
If considering testosterone therapy (typical starting doses 100-120 mg/week, divided 2-3 injections), work closely with a physician to monitor all organ systems for potential side effects like acne, hair loss, mood changes, cardiovascular issues, ferritin buildup, fertility, and lipid concerns.
31. Avoid Clomiphene Monotherapy
Avoid using clomiphene (Clomid) or HCG monotherapy for long-term testosterone optimization, as they are not clinically useful for most individuals, have many pharmacodynamic effects, and can cause significant side effects like visual changes.
32. Protect Fertility on TRT
If on testosterone therapy and concerned about fertility, consider taking HCG (human chorionic gonadotropin) several times per week, as it can help maintain spermatogenesis, though individual responses vary.
33. Avoid Testicular Heat Exposure
To protect fertility and sperm viability, avoid excessive heat exposure to the testes (e.g., daily hot tubs, saunas, heated car seats, prolonged sitting) and consider cold therapy like ice baths or cold packs.
34. Avoid Smoked Nicotine
Avoid smoked nicotine and high doses of chewed nicotine, as it can negatively impact testosterone, estrogen, and increase risk for cardiovascular and neurodegenerative diseases due to its vasoconstrictive effects.
35. Limit Prolonged Cycling
Limit prolonged cycling, especially when seated and putting pressure on the perineum, as it can damage the prostate and weaken the pelvic floor, potentially leading to incontinence and impotence.
36. Strengthen Pelvic Floor
Strengthen your pelvic floor through exercises like Kegels and proper form during Valsalva maneuvers, especially if you have a history of inguinal hernia, but avoid excessive contraction to prevent limiting blood flow.
37. Include Healthy Fats
Include healthy fats like omega-3s and olive oils in your diet. While saturated fat correlates with hormone optimization due to nutrient density, it’s not vital; focus on eliminating unhealthy trans fats.
38. Consider Low-Dose Tadalafil
Consider discussing low-dose tadalafil (2.5-5 mg daily) with your physician to improve prostate health, increase androgen receptor density, and reduce nocturia, which can secondarily enhance sleep, growth hormone, and testosterone optimization.
39. Monitor PSA Levels
Monitor Prostate Specific Antigen (PSA) levels, noting that healthy ranges vary by age (e.g., 0-1 for 20-year-olds, 1-3 for 40-year-olds), and consult a physician for interpretation.
40. Consider Topical DHT Blockers
If concerned about hair loss, consider topical anti-androgens like ketoconazole or caffeine, as they are less likely to cause systemic side effects (e.g., diminished sex drive, motivation) compared to systemic 5-alpha reductase inhibitors.
41. Avoid Turmeric/Bioperine if Sensitive
Be aware that turmeric and curcuminoids, especially when combined with black pepper fruit extract (Bioperine), can act as 5-alpha reductase inhibitors, potentially crushing DHT levels and negatively impacting vitality for some individuals.
42. Avoid BPA & Phthalates
Avoid drinking from plastic bottles and cans containing BPA (bisphenol A), as it acts as a xenoestrogen. Test your tap water for microplastics and other contaminants to ensure water quality.
43. Use ADAM Questionnaire
Use the ADAM (Androgen Deficiency in Aging Males) questionnaire as a self-assessment tool to gauge men’s health and hormone-related well-being, but do not use it for self-diagnosis.
44. Recognize ED as Warning Sign
Recognize erectile dysfunction (ED) as a potential early warning sign for underlying cardiovascular issues like plaque buildup, as symptoms may appear in the genitals before the coronaries.
45. Practice Yoga Nidra/NSDR
Practice yoga nidra or non-sleep deep rest (NSDR) for 10-minute sessions to restore cognitive and physical energy. This involves lying still with an active mind.
46. Dieting for Childhood Obesity
If a young person (around puberty or younger) is overweight, it is safe and wise to diet and actively try to lose body fat under the supervision of a physician to change body composition.
47. Avoid Vegan/Carnivore in Teens
Avoid strict vegan or carnivore diets during teenage years and early 20s, as they can significantly decrease free androgens and testosterone.
48. Multivitamin for Exclusionary Diets
A multivitamin is generally safe but not always necessary; consider taking one if your diet is exclusionary (e.g., celiac disease) or if planning for fertility.
4 Key Quotes
Erectile dysfunction is known as the canary in the coal mine.
Dr. Kyle Gillett
Screens exist in the real world, the real world doesn't exist in the screen.
Andrew Huberman
Consistency is key here. If you are not consistent, then the law of diminishing returns certainly applies. So 80 or 90 percent of the benefit over many, many months is far better than a hundred percent, but only half the time.
Dr. Kyle Gillett
Every androgen binds to the same androgen receptor, so there is nothing special about DHT. DHT is just a stronger androgen.
Dr. Kyle Gillett
2 Protocols
Fadogia Agrestis Dosing Regimen
Dr. Kyle Gillett- Take 300 milligrams daily (considered a safe dose with no toxicity in rat studies).
- Alternatively, for a more aggressive regimen, take 600 milligrams every other day or three times a week (e.g., Monday, Wednesday, Friday).
- Another aggressive regimen is 600 milligrams daily for a month, followed by one to two weeks off.
- Monitor GGT (gamma-glutamyl transferase) and Alkaline Phosphatase (Alk Phos) levels if using higher doses to check for potential toxicity.
Testosterone Therapy Administration (Physiologic Eugonadal Dose)
Dr. Kyle Gillett- For individuals starting testosterone therapy, a general normal dosing range is around 100 to 120 milligrams per week.
- Divide this dosage over the course of the week, typically administered either every other day or three times a week.
- Occasionally, twice a week administration can be used, especially for individuals with slightly higher SHBG.
- This protocol assumes the use of testosterone esters like cypionate or enanthate.