Frequently asked questions

Sleep is necessary because it allows our body to clean away waste products that accumulate during daytime activities and excrete them in the urine. Also, sleep permits new connections between nerve cells to develop to improve memory and thinking. Moreover, sleep replenishes hormone and energy stores, depleted by daytime activities.

Humans need to sleep between six and eight hours. People who become centenarians, proof that their health is better than average, sleep for a bit more than seven hours.
In a study published in 1899, researchers determined that the average sleep time of 52centenarians was eight hours and most reported excellent sleep. In the famous French study of 368 centenarians, 80% of the centenarians had a restoring sleep, as reported by their siblings. In a more recent and better controlled study, centenarians had, on average, seven and quarter hours of sleep. Somewhat more than seven hours of good quality sleep appears to be necessary for health and a long life.

Hormone therapies are not eternal, but properly conducted life can live longer. The results obtained in experiments on animals and a few studies in humans suggest or confirm this increase in longevity for a series of hormones (such as melatonin, growth hormone, DHEA, estrogen, etc.). This likely increase longevity by hormonal treatments is explained by the beneficial effect of hormones on the development of many diseases associated with aging and which increase mortality. (Heart disease and vascular, cancer, infections cause the death of 90% of older adults). Putting these deadly diseases in ‘failure’ in us, hormone therapy (adapted, multiple, well balanced) can probably extend your life. For how many years? Ten, twenty or thirty years? Or more? It is too early to say. I personally think that well adjusted several hormone supplements prolong the life of ten to twenty years, offering what matters even more a condition better and a high quality of life.

The tiredness, irritability, and higher sensitivity to cold that we may experience after a too short or bad sleep are caused not only by the depletion of energy stores but also by the appearance of hormone deficiencies that accompany sleep disorders, such as thyroid deficiency, or hypothyroidism, which makes us tired in the morning, with puffy eyelids and an increased sensitivity to cold.
Sleep deprivation may also produce adrenal or cortisol deficiency, which, in turn, results in low energy levels and irritability, particularly in stress conditions. Cortisol is essential to build up glycogen stores(energy in the form of glucose) in the liver and muscles. Rats that are deprived of adrenal hormones store up to 20times less glycogen in the liver. As a consequence, they do not have enough energy molecules on hand to properly handle stress. Moreover, cortisol is equally essential to break down the glycogen into glucose, or sugar, which is the best energy nutrient. Thus, if we are deficient in cortisol, even if we have good glycogen stores, we cannot efficiently use the stored-up energy molecules in cases of stress, when we need more energy.
When we sleep less, we produce fewer of the hormones that are mainly secreted at night: growth hormone and melatonin. Growth hormone provides inner peace and calmness. Melatonin calms down anxiety and nervousness. Lower levels in these hormones may cause behavioral problems such as those found in adolescents who sleep less. The lower hormone levels of sleep-deprived adults may explain the higher risk of quarrelling and being selfish, without gratitude for what their partners do, submerged as they are by the anxiety of growth hormone deficiency, the nervousness and anger of cortisol deficiency, and the tenseness of melatonin deficiency.
A type A personality is characterized by nervousness and agitation and is more frequently found in people who are experiencing sleep deprivation. Depression is four times more frequent in people who sleep five hours or fewer, while anxiety and nicotine and alcohol dependence are twice as often found when sleep time is too short.
In contrast, babies and children who sleep longer are more adaptable and have better moods and easier temperaments. University students who sleep longer than eight hours perform better and are more cheerful. For these reasons, I am happy to sleep more—seven hours on average. This improves my physical performance. I finish running my traditional one-hour-long jogging circuit 10minutes earlier every time I have slept well and enough. My longer and better sleep is possible thanks to the intake of some nutrients that I will examine in more detail in the following paragraphs.

The hunger feeling after a bad night is produced by an imbalance between two hormones: leptin and ghrelin. Leptin reduces appetite and is secreted by fat tissue. Very overweight people who receive daily leptin injections see their weight melting away by losing their exaggerated appetites. Unfortunately for people with excessive appetites, the product is not on the market yet because it is still undergoing research. Ghrelin increases appetite and is secreted by the stomach. When rats or mice receive ghrelin, they have a voracious appetite, eating incessantly without limits.
In humans, ghrelin blockers have been successfully tried in experimental research to decrease appetite. When we do not sleep enough, leptin levels decline by 20to 30% and ghrelin levels increase by the same percentages, significantly increasing appetite and food intake by 30to 40%.Our appetites are greatest for sweet foods, which trigger the secretion of insulin, the hormone that makes us fat.

A low leptin level, along with high levels of ghrelin and insulin, facilitate weight gain. According to Belgian pioneer researcher Van Cauter, who works at the University of Chicago, sleep deprivation is a major cause of the obesity epidemic in the Western world because of the feelings of hunger and the tendency to choose the wrong (weight-increasing)sweet foods that it provokes. Five- to six-year-old children who sleep 10 hours or fewer have been found to have double the risk of becoming obese than children who sleep more. Young adults who sleep less have about seven times the risk of being overweight.
What about those of us who for professional or amusement reasons remain awake and are more active during the night? When we work at night or often go tonight time parties, we go to bed too late, in the early morning hours. If we are night owls, we often suffer from a degree of insulin resistance, a condition that may lead to diabetes.
During the day, when insulin goes up, the sugar level goes down. In the evening, however, both sugar and insulin levels rise in the blood, a condition called insulin resistance. The inadequately high evening insulin level in the presence of a high sugar level in the blood increases the likelihood of fat accumulation because insulin is the fat hormone. This mechanism explains why we become fatter with what we eat in the evening than what we eat during the day before 6:00p.m. The later in the day we eat, the more likely we are to convert what we eat into fat.
A too prolonged sleep is just as bad for the heart as sleeping too little. People who sleep nine hours or more and people who sleep five hours or fewer have a 40% increased risk of developing coronary heart disease, a disease in which the coronary arteries that bring blood to the heart become narrow by the appearance of atheroma plaques.
Sleep deprivation also facilitates the development of cancer. A twofold higher risk of breast cancer has been found in women sleeping fewer than nine hours. Women who are predisposed to breast cancer should sleep more.

Apparently, yes. Higher risks of dying sooner are reported in both short and prolonged sleepers. Men who sleep fewer than six or seven hours have been reported to double their risk of dying, which corresponds to approximately seven to eight years of shorter life compared to those who sleep longer. However, women who sleep too long—nine hours or more—have been shown to have a50% greater risk of dying, which corresponds to a loss of seven to eight years of life. Thus, sleeping too much is as detriment alas sleeping too little.

Everybody knows that stress, particularly excessive stress during the day, may occasionally disturb our sleep. Poor environmental conditions may disturb our sleep, such as too much noise coming from street traffic or a neighbor’s TV or stereo, insufficient darkness in the bedroom, high-intensity electricity cables above the house, or the presence of a nearby cell phone antenna tower. Drinking caffeinated beverages such as cola, tea, or coffee can keep us awake too. What most people do not know is that chronic, permanent, persistent sleep disorders are usually caused by hormone deficiencies, and sometimes by hormone excesses.

Telomerase activators are the new cutting-edge medical therapies that have become available in recent years to reverse aging. They signify a major breakthrough.
I have benefitted from telomerase activator supplementation for two years. I started taking an injectable telomerase activator called epithalon, and my beginning presbyopia—or inability to read texts close—reverted to normal eyesight with easy reading at a distance of 30 cm. A complete restoration was obtained within five to six weeks. However, it did not hold up for more than four months, so I started to additionally take another telomerase activator called ASTRAGALUS 8/250, which again fully restored my eyesight within six weeks. These treatments also made me feel younger inside, a feeling difficult to describe, a sort of mixture of greater energy with increased freshness, possibly with tighter skin as well.
My impression is that this type of treatments can be of most benefit to people above the age of 40. In order to understand what telomere activators are, let us first understand what telomeres, telomerase, and telomerase activators are.

It is important to measure your telomere length, both the average telomere length of all your telomeres and—whenever possible—the number of short telomeres. Do it before starting a telomerase activator and after 6-12 months of treatment to see if your average telomere length stayed the same or increased (without treatment, it should decrease yearly) and whether there was a decrease in the number of short telomeres.
Several laboratories throughout the world can test your telomeres. However, even though they do their best, beware of results that strongly deviate from what you would expect based on a good evaluation of your health condition. The measurement may not always be accurate. Beforehand, have a physician perform a physical exam and interview you about your health. Do lab tests and see if the telomere length measurements fit the picture. Differences between one lab and another are possible. The technology and accuracy of the test kits are continuously improving. I hope now that, when this paper comes out, the telomere measurement technology in each of these labs has become adequate and reliable but cannot guarantee.

1. Take 0.1 to 0.5 mg per day injected under the skin before a meal or before bedtime together with growth hormone, which opposes the moderate lowering of blood sugar or hypoglycemia, produced by IGF-1.

In addition to the rare hypoglycemia, stiffness can occur due to excessively tonic muscle development (muscles becoming hard),. Overdose effects of IGF-1 are similar to those with growth hormone excess such as swelling of the feet, hands, and nose as well as muscle overdevelopment.

If men are reluctant to treat themselves, it is first of all because information is missing on testosterone treatment and specifically on how important it is for men to get treated with testosterone in order to ageless quickly. A second reason is that the old education and stereotyped image of what a “real (manly)man” should look like have done a lot of damage. Many men and doctors embrace the belief that a “real man” should be brave, not how fear, or complain, which also implies that he would not need any medication to remain a man. Otherwise, he would not be a real male. This false belief can make him refuse to go to the doctor and receive testosterone treatment. Moreover, the use of testosterone and anabolic steroids—which are synthetic testosterone derivatives—by sportsmen to improve their performance has discredited this hormone. This abuse has persuaded big pharmaceutical companies, which do not wish to be accused of encouraging doping in any way, to put testosterone gels on the market at concentrations that are insufficient for doping, ranging from 1%to 2%. Unfortunately, these concentrations are also insufficient to correct testosterone deficiency in most adult men. So that when men try these products, they do often do not feel an y big change, if any at all. The last reason is the belief, not scientifically proven, that testosterone may increase the risk of developing prostate cancer. The prostate cancer scare has over the years discouraged many men from taking the treatment they highly need to maintain their masculine body and has stopped many physicians from prescribing it.

For a body of about 70 kg, the production of testosterone in a young man is roughly 7 mg/day, 6.7 mg produced by the testicles and 0.3 mg a day produced by the adrenal glands, an amount 10 million times less than the weight of the body. However, testosterone and its derivatives have a dominant effect on the body: they forge its appearance, providing firmness to muscles, making the body masculine and typically male.

Testosterone is mainly made by specialized cells called Leydig cells in the testicles. There are bout 7 million Leydig cells in the testicles of a young man. Very small amounts of testosterone are also produced in the adrenal glands, glands above the kidneys.

In fact, there is no conclusive evidence that testosterone may cause prostate cancer in men. On the contrary, there are serious indications that taking testosterone supplements could protect against the occurrence of prostate cancer, or at least act neutrally when this type of cancer occurs.
The incidence of prostate cancer in men gradually increases with age, while the levels testosterone progressively decreases—the opposing evolution of these two parameters with time should, in itself, be enough to make us doubt that there is an adverse action of testosterone on the prostate. Moreover, It has been consistently found that the lower testosterone levels are the higher risk there is for a man to develop aggressive prostate cancer and, if here is prostate cancer, the more aggressive cancer of the prostate is. Aggressive prostate cancer is a cancer that invades environing tissue and metastasizes (other areas with prostate cancer tissue) throughout the body. Furthermore, recent studies have shown that men who had prostate cancer and underwent tumor ablation do not experience any increase in recurrence nor do they die easier when they are put on testosterone. Instead, when testosterone or a derivative of testosterone is given to men with terminal prostate cancer that no longer responds to anti-cancer treatments, the prostate cancer re-sensitizes and its progression slows down, permitting these men to get better and feel better for a while, more than doubling their survival time.

Many epidemiological studies wrongly take the lower limit reference of a hormone as the threshold below which there is deficiency in the hormone, in this case testosterone. However, the lower and upper limits and the reference interval between these two of hormone tests, presented by laboratories and used to compare a male patient’s testosterone levels with the levels found in other men, are purely statistical limits and reference ranges with no real relation withhealth.95% of all men who get their blood checked for testosterone will have a testosterone level between the upper and lower reference limit, only 2.5% will have a level below the lower limit, and 2.5% have a testosterone level above the upper limit. Dogmatically relying on these limits to decide whether a testosterone level is healthy or not is a mistake, one that is unfortunately made every day by thousands of doctors worldwide.

If we were to take this criterion that any testosterone level between the upper and lower reference limit is healthy into consideration, only 2.5%of the male population—those with testosterone levels statistically below the lower limit—would have a testosterone deficiency. In fact, the frequency of testosterone deficiency is much higher. Every man from age 30 on sees his testosterone levels decrease. A reduction in testosterone of 10 to 20% is sufficient to allow the first signs and physical complaints of testosterone deficiency to appear. To make these signs and symptoms disappear, the patient should be treated with testosterone, even if his testosterone level is still between the lower and upper limits.
Many recent scientific studies have shown that men with a testosterone level situated in the lower 25%, 33%,and even50% of the reference range have higher risks of developing obesity, diabetes, bone loss, blood lipid disturbances, higher blood pressure, heart disease – especially coronary heart disease, the main cause of myocardial infarction, Alzheimer’s disease, prostate cancer, and premature death. There is strong evidence that at these levels there is already an intermediate degree of deficiency in male hormones. It is not enough to have a testosterone level between the references of the upper and lower limits to be free from problems. According to these studies, 25% to 50%ofmen aged 30 or older have testosterone levels that are too low for optimal health.

Traditionally, it is considered that only very old men have low levels of testosterone. This view is now completely out dated. Testosterone deficiency can occur at any age. Even a newborn and a baby may be deficient in testosterone. If newborns do not have a high blood peak of testosterone at birth and during the two months that follow, they may suffer from genital under development and behavior disorders. Cryptorchidism, which is the non-descent of the testicles into the scrotum, and less masculine behavior, may be examples of very early testosterone deficiency. Adolescents and young adults may be deficient in testosterone too and might therefore not develop many muscles, body hair and a beard.
From the age of 18 on, men lose every four seconds one Leydig cell (net), the cell that produces testosterone. As a man has about 7 million youthful and well-working Leydig cells at age 18, at age 80, the number has dropped to a small 2 million often poorly working Leydig cells.
Following my experience, most men between age 30and 40 undergo a sufficient drop in blood and tissue testosterone levels to justify at least a low dose of testosterone supplementation.

In my medical practice, I base my diagnosis of “testosterone deficiency” on the presence in a male patient of typical testosterone deficiency-related complaints and physical signs, and blood levels of testosterone, which are sufficiently low to be scientifically linked to higher risks of illness and death. In addition, to confirm this diagnosis, I prescribe a trial with testosterone therapy. If, during this treatment trial, the male patient loses his testosterone-deficiency complaints and physical signs, and shows no signs of overdose at physical examination and in laboratory tests, I then consider that the diagnosis is confirmed and testosterone treatment is justified, safe, and efficient.

Any man of average size needs a concentration of testosterone in the blood near the average level of a young man. This often varies from 6,500 to 7,500 pictograms per milliliter (or from 650 to 750 nanograms per deciliter). However, these rates are merely indicative. Taller and more muscular men often benefited from higher testosterone levels when they were young and should keep these higher levels throughout their life to keep their bodies healthy. Small-sized and weak-muscled men often do well with a testosterone level below the average level of young men, because they always had a below average testosterone levels that fits their body. Nevertheless the testosterone level they need is still much higher than the lower reference limit.
Let’s not forget that many scientific studies have now shown that men with testosterone levels within the reference range situated among the 25-50 percent lowest of the population are more exposed to diseases like diabetes, coronary artery disease, or bone loss and often have less sexual desire and less energy. It is, therefore, not enough for a man to have a testosterone level situated somewhere between the lower and upper limits of the laboratory tests (within the reference interval). Men whose testosterone level is below the lower limit of reference have a major androgenic deficiency. Those with a testosterone level close to the lower limit have a more moderate testosterone deficiency, but still sufficient to make them suffer a lot.

There are formulations of testosterone to be taken orally, applied to skin—transdermal testosterone gels—and injectable forms. The most common formulation that I prescribe to my patients is a transdermal testosterone gel of liposomal type at a concentration of 10% (100 mg per gram of testosterone). The liposomal formulation makes testosterone better penetrate through the skin. Injectable formulations are more appropriate for older men (above 60 years) whose skin does not absorb much testosterone gel. The use of injections assures that testosterone comes in the body. Oral formulations are often poorly absorbed and only give satisfactory results to some young men with mild testosterone deficiency.

First, avoid overdosing. Overdose symptoms include too-oily skin, too-dominating and aggressive “macho” behavior, an excessive sexual drive and sexuality, and a reddish face and upper torso (due to both a sharp increase in the number of red blood – cells that carry oxygen in the blood – in the blood and an greater blood flow in the skin).
Secondly, avoid excessive conversion of testosterone to estradiol, the main female hormone. Testosterone exerts most of its beneficial effects by converting in the target cells into estradiol, the dominant female hormone or into dihydrotestosterone, the super male hormone. Whenever testosterone excessively converts into estradiol the high amounts of estradiol levels enlarge the prostate by stimulating the proliferation of fibrous tissue, an effect that hardens the prostate and may make it difficult to urinate (because the excessive fibrous tissue narrows the urethra, the urine tube). Excessive levels of estrogen also block testosterone receptors, blocking thereby many of testosterone ‘s effects in the target cells, resulting, for example, in erectile dysfunction, as erections are testosterone-dependent effect, and a weaker heart function.

Avoid the most the favoring causes:

• Stop drinking daily alcohol or drinks containing caffeine: One glass of alcohol or two cups of coffee or more per day increases the estradiol level by approximately 60 percent. Stopping the drinking of these beverages or limiting their intake to a maximum of two days per week, on weekends, for example, reduces the estradiol level by 30 to 70%.
• Lose weight: Being overweight is characterized by an excess in fat mass. Fat is rich in the enzyme aromatase that converts testosterone to estradiol. This explains why estradiol levels are 30 to 100% higher in obese males. The volume of the prostate is also, for this reason, 30 to 100% greater in them. Losing the excessive fat mass can decrease the estradiol level by 30 to 50% in obese men.
• Do not wear tight underpants. Tight-fitting underpants crush the testicles against the pelvis. This slows down the blood supply to the testicles. Furthermore, as the pelvis is warmer, the temperature in the testicles increases by two degrees Celsius, a higher temperature that alters the function of the testicles, reducing testosterone and sperm production. The reason why the testicles are usually two centimeters lower than the pelvis in standing position without clothes is to keep them two degrees Celsius below the body temperature, the ideal temperature for optimal testicular function. Optimize your testicles by wearing lose boxer-shorts in large trousers.

The following interventions improve the testosterone level or effects without taking testosterone:

• Firstly, avoid excessive stress, including intensive sports, a big consumer of testosterone, which also block some testosterone production. Get plenty of rest; avoidance of unnecessary stress can make a significant difference.
• Secondly, improve your diet. Eat more foods rich in protein and healthy fats such as meat, poultry, fish, butter, skin from an organic chicken cooked at low-temperature, and eggs and bacon boiled in water (preferably organic) as they increase the benefits and/or level of testosterone (in particular of the free testosterone level, the one that enters the target cells). These foods are rich in cholesterol, essential to make testosterone, and amino acids, essential to obtain the beneficial effects of testosterone such as muscle development.
• Avoid whole grain bread, whole grain rice, and pasta because they are too rich in fiber. 60% of testosterone is secreted by the liver into the gut and is normally reabsorbed further in the intestine to be used again by the body. The presence of indigestible cereal fibers (whole grains) tightly binds to this testosterone and drags it with them into the stools, causing a real waste in testosterone! Consequently, blood testosterone levels in individuals with high intakes of wholegrain based foods fall by 20 to 40%.
• Avoid sugars and sweets. Consuming large amounts of sugar (70 g or more per day) significantly drops the testosterone level, as well as the levels of DHEA and androstenedione, two other important androgens.
• Take zinc and vitamin A, the two most important micronutrients for testosterone secretion. In those who are deficient in these micronutrients, testosterone levels may decline by 20 to 60%. This is reversible by taking 25-50 mg of zinc per day or 50 to 100 000 IU of vitamin A per day during 3 to 6 months. Magnesium can also increase levels of free testosterone in the blood, the testosterone that easily penetrates into target cells.
• Correct other hormone deficiencies such as growth hormone. Although growth hormone reduces the blood testosterone level, it also increases even more the testosterone effects in cells and tissues by reducing the levels of SHBG, testosterone transporting binding protein, thus making the testosterone better penetrate the target cells.

More than 50% of patients coming to my consultation complain of fatigue as main reason to consult. It is the main complaint and motivation seen in patients to consult me, as a study done in 2005 showed. A low resistance to stress and a lower mood are the numbers two and three complaints that motivate people to come to the office. Concerns about the physical appearance obesity or aging, are only in fifth position.

Daily anxiety symptoms are frequent. Over 50% of very old people—aged between 85 and 103, for example—say they experience anxiety symptoms every day. Nevertheless, the incidence of anxiety disorders, a more severe and persistent form of anxiety, is a little over two percent in the very old, half that of people 15 to 20 years younger (4%).
In fact, real anxiety disorders are more frequent in people with disease. In one study on patients with myocardial infarction (heart attacks), the incidence of anxiety disorders is about 22%. In breast cancer patients, anxiety disorders rank between 13% and 25% at hospital admission.

People with high anxiety levels suffer from more and greater adverse physical health complaints. They also have a higher risk of dying if they remain with a similar level of anxiety symptoms for six months without improving.
Anxiety disorders are associated with higher serum cholesterol levels, lower immune parameters, and an unhealthy echocardiogram,
Anxiety increases the risk of various diseases: cancer (50% more), atherosclerosis adverse heart complications after a first heart attack (three to five times more), heart attacks (2.5 times more), and dying from heart attacks (50% to three times more). People who will suffer a second heart attack, or who die from a heart attack, are typically persons with greater anxiety. Anxiety also increases five-to six-fold the risk of suicide.

You can change your psychological attitude toward life, your profession, and/or your family or people at your work. My personal experience is to adapt and convert the energy from any anxiety that comes up into work energy, making something useful out of it. I do not want to endlessly worry about how unjust it is to suffer in life. I feel more comfortable trying to turn all my energy into positive actions. I’m not a champion of meditation. On the contrary, I feel better moving and doing something useful. Spiritually, I believe there are two kinds of people: those who meditate and get from meditation benefits for their destiny and those, like me, who need to act.
You can also become calm by improving your diet and consuming foods made for your body including fruit with low sugar content, vegetables, and protein rich-food cooked at low temperatures. Cooked fat, milk products, and starch are toxic because they tend, after an initial mood and energy improvement, to increase anxiety by digestive troubles and intoxication of the body’s tissues.
You can also take nutritional supplements to calm down. These nutritionals present a good safety margin and efficiently reduce anxiety. The most efficient of all nutrients to reduce anxiety is GABA (gamma-amino-butyric acid), the neurotransmitter that calms down the worst physical anxiety. It reduces all types of anxiety manifestations including the lump in the throat, butterflies in the belly, body sweats, and persistent tenseness with an inability to relax. It generally does not induce sleepiness. GABA has to be taken at high doses—750 to 2,500 mg a day—for efficacy, not at the low doses found on the Internet. It is worth noting that oral treatment with gamma-amino-butyric acid improves glucose tolerance and insulin sensitivity in mice fed a high-fat diet by inhibiting inflammation. People with inflammation often are anxious, too. The GABA reduction of inflammation may be one of the anxiety-reducing mechanisms of GABA. Although I myself experience a great reduction in physical anxiety and tenseness at high doses of GABA, and GABA is without contest considered one of the major calming neurotransmitters by the scientific world, there are practically no scientific publications on the anxiety reduction with oral nutritional GABA supplements. The evidence is greater for the use of baclofen, a synthetic derivative of GABA (30 mg/day for 4 weeks), which has been shown to reduce the incidence and severity of panic attacks.

To find out what hormone deficiency is behind your anxieties, check when they appear. If fear appears in the morning upon awakening and disappears thereafter, reappearing when you sit down and rest, the anxiety is likely caused or aggravated by thyroid deficiency and is likely to disappear with thyroid treatment. If you feel anxious all day, moderately but persistently enough to make you complain, then the anxiety is due to sex hormone and/or DHEA deficiencies. If the anxiety is overwhelming, think of growth hormone deficiency as the likely cause. If you feel anxious at night, melatonin or growth hormone deficiency may be the most likely causes.

When cortisol is given as a treatment, it is named hydrocortisone, which is a synonym for the word cortisol. Cortisol is the term used for the same molecule found in human blood. Hydrocortisone is the term used in therapy. Hydrocortisone is associated with an acid, generally acetate, forming hydrocortisone acetate, which may irritate the stomach. Even cortisol derivatives such as prednisolone, methylprednisolone, or dexamethasone in prescription drugs are generally bound to an acid to improve absorption with the possible undesirable side effect of stomach acidity. To overcome this problem, patients are advised not to take the cortisol, or one of its derivatives, on an empty stomach, but after a meal. This should not hinder absorption if the patients does not have important digestive troubles and may even improve it because, during meals, bile salts, which improve absorption of fat molecules such as cortisol, are secreted by the liver into the intestines. For example, the patient can take hydrocortisone after breakfast and just after lunch rather than at wake-up and before lunch. If taking it at the end of meals does not help sufficiently to avoid stomach pain from hydrocortisone, then the physician can prescribe enteric-coated capsules that have a protective layer around the capsules so they do not dissolve in the stomach but in the intestines. In some countries, the synthetic derivative prednisones, or its active metabolite prednisolone, are sold in both normal and in enteric-coated forms.

Magnesium is necessary to prevent nerves from being tense and muscles from contracting unduly and excessively (cramps, spasms). When you take too much magnesium, the first side effect is diarrhea. People with sensitive intestines are more likely to suffer from diarrhea when taking magnesium supplements.
Efficient doses of magnesium range between 200 and 800 mg of elemental magnesium a day. To ensure better absorption, magnesium in therapy is associated to another molecule, often an amino acid. The association is called cheated magnesium. Generally, several grams of the association have to be taken to assure a sufficient supply in elemental magnesium.

Choose a better magnesium association, such as magnesium citrate, magnesium glycerophosphate, or magnesium malate, which are not only better tolerated, but also much better absorbed than the classical magnesium oxide that often produces digestive troubles, including diarrhea and abdominal pain. The inconvenience of these preparations is that, in order to have sufficient elemental magnesium, you need to take several capsules, usually two to four a day. Another solution is to take magnesium after breakfast and, possibly, also after lunch. A third way of avoiding diarrhea with magnesium is to use divided doses during the day. For example, take 100 to 200 mg elemental magnesium at wake-up followed by 100 to 200 mg of elemental magnesium at lunch.

In general, I advise my patients to go to the pharmacy and to buy their medications, in particular prescription drugs, such as hormones. For nutritional supplements, however, in Europe especially, the pharmacy is not always the best place to buy.
First of all, dosages of the nutrient capsules of tablets are often insufficient. The reason for this is that the European Union (EU) has promulgated a law that forbids the sales in pharmacies of high and moderate doses of vitamins and other nutrients. To correct a vitamin A deficiency, for example, 10 capsules of the highest dose authorized by the EU may need to be taken to efficiently reduce the deficiency in the blood, which is too much for a patient to take on a regular basis. One result of this law is that often doses of nutritionals sold in pharmacies may be enough for prevention but are insufficient to correct deficiencies.
Another problem of nutritionals in pharmacies is that many of the nutrient capsules and tablets in Europe have preservatives and other additives, such as color agents, that I do not advise to ingest in nutritional cures for periods longer than two months. Almost half of the nutritionals in pharmacies have titane oxide, a blood coagulator, for example, and or polyvinyl, plastics that actually can be found with many similar names, such as polyvinolidine, that are suspected of being procarcinogens.
Finally, nutritional supplements in pharmacies in the US and Europe do not necessarily fulfill all quality controls. We need to take the best quality products and namely those labeled as being “pharmaceutical grade”. In pharmacies, for example, it is not always certain that the fish oils (rich in omega-3 polyunsaturated fatty acids) they sell contain one or more healthy antioxidants to preserve them and are free of, or extremely low in, heavy metals because fish are often polluted with heavy metals, in particular with mercury.
For these reasons, I provide my patients with lists of several quality nutritional firms where they can buy safer nutritionals at more adequate doses and often at an acceptable or even better price because budget control should always be part of a therapeutic decision. One way to recognize the quality of firms is by checking whether they are officially registered in a country and publicly advertise that their products are of pharmaceutical grade (attested by an independent firm) and free of preservatives and other additives. I generally do not recommend my patients buy products from firms that only sell through the Internet because these firms avoid controls, and the safety and quality of their nutritional products are difficult, if not impossible, to verify.
Furthermore, one firm cannot provide you with all the best products. I haven’t found any firm that has all the good nutritionals that my patients need. There are just too many useful products so that one firm cannot specialize in all of them. This is why I work, on average, with seven firms to be sure I get the best for my patients. The inconvenience is that patients need to go not only to the pharmacy but also must order by themselves from other firms—one to three firms on average. What about the price? If you can buy the same quality product from an equally reliable firm at a cheaper price, don’t hesitate to do so, but I repeat: Be sure that the firm where you buy is officially registered and that its quality control is high.

Estrogens stimulate the development of mucous membranes, called “endometrium”, in the uterus. The endometrium is the inner layer of cells that faces the inner cavity of the uterus. When women have sufficiently high levels of estrogens, they develop a thick endometrium, which will detach itself and be excreted through the vagina as “menstrual blood loss” or “period” or “menstruation”. Thus, it is thanks to estrogens that endometrium inside of the uterus develops, and it is thanks to drop in the estrogen levels that the endometrium detaches itself and forms “menstrual blood loss”.

A menstrual cycle takes in general 29.1 days when all the menstrual cycles of premenopausal women are taken in a population (and not the 28 days thought before). However, younger women have a cycle of 29 days, while women older than 35 years have one day shorter cycle and thus 28 days on average. Thus, a menstrual cycle is divided in day 1 to Day 29 or 29. The first day of the menstrual cycle is the first day of the menstruation. The last day of the menstrual cycle (the 28th or29th day) is the day before the next menstruation. Out of easiness here, we will consider a menstrual cycle as 28 days. The menstrual cycle is subdivided into two stages: the first 14 days, the follicular phase and the last 14 days, the luteal phase. Menstruations take usually between 3 and 6 days in length. The ovulation, the moment where one or more egg cells are detached from an ovary and pushed into one of the uterine tubes to be fertilized and then the possibly fecundated egg cell comes into the uterus cavity, where it will fix (“egg implantation”) into the endometrium of the uterus.

In the first half of the menstrual cycle, the follicular phase, the estrogen production is low to medium, around the 50-80 μg per day and this is translated into low to medium blood levels of estrogens. Around day 13 of the menstrual cycle estrogen production peaks at 200-400 μg/day to form a very high one-day blood estradiol peak level (500-900 pg/mL; 34 hours before ovulation), which triggers, 24 hours later (after the estrogen peak) a peak secretion of the pituitary hormone LH or luteinizing hormone, which itself triggers ovulation (9 hours later then the LH peak). The higher the estrogen peak the higher the LH peak, the better the ovulation is. In the luteal phase medium to high estrogen levels (average
130-160 pg/mL) are found. What about the progesterone secretion? Very low levels of progesterone are found in the first (follicular) phase of the menstrual cycle. Almost no progesterone is secreted by the ovaries in that phase. Almost all progesterone found in the first phase of the menstrual cycle is secreted by the adrenal glands. Maybe 1-2 mg per day of progesterone is made then. But slightly towards ovulation, at the end of the follicular phase, progesterone secretion (and levels) increases slowly to peak in the middle of the luteal phase to 10-20 mg per day. If progesterone secretion peaks with 10-20 mg per day in, why are then much higher doses – 100-200 mg per day -of bioidentical progesterone given to women? For the simple reason that only 10-15% of progesterone gets into the blood, the rest being not at absorbed or broken down in the liver before reaching the blood.

Many women refuse even to think of taking additional female hormones to their own female hormones, even women in the post menopause who are almost totally deprived of them! Why? Because they think it is dangerous. They think that the use of its these hormones may increase the risk of breast cancer, endometrial or ovarian cancer, and cardiovascular disease. They forget that the women with the most of these hormones, are the young healthy women who are literally overwhelmed by these hormones. They ignore that without sufficient levels of these female hormones their body perishes. They do not know that the risk of developing these diseases can be minimized by optimizing female hormone treatments as discussed in the next chapter.

The synthetic estrogen of the birth control pill, ethinylestradiol, for example, accumulates in the liver and because of its high numbers in the liver over stimulate in the liver to produce excessive amounts of blood coagulation factors end hormone transporting proteins. High amounts of hormone transporting or plasma binding proteins will on their turn overwhelm the blood and bind to high numbers of hormones, which will too strongly attached to them in the blood and much less penetrate the target cells. Such a hormone sequestration in the blood creates milder to sever multiple hormone deficiencies in the target cells. Among the most important hormone deficiencies caused by the intake of the birth control pill are thyroid, cortisol, and testosterone and growth hormone deficiencies. Thyroid deficiency produces weight gain, hair loss, and dry skin. Cortisol deficiency causes low stress tolerance, lack of punch (energy) and pigmented spots on the skin. Testosterone deficiency creates hesitations, low libido and cellulite. Growth
hormone deficiency provides abdominal fat accumulation, cellulite and superficial sleep.

Usually a more androgenic pill (with a progesterone derivative that has ‘male’-like effects) such as the combination ethinylestradiol 30 μg/ levonorgestrel 150 μg. This pill increases much less the hormone transporting proteins and thus more hormones go in the blood. It is however an androgenic pill, and thus may make blood coagulate easier in predisposed women, especially in smokers.

Typical physical signs of estrogen deficiency are flat hair, upper scalp hair loss, droopy breasts, dry eyes, gums disease, droopy breasts (called “breast ptosis”), small breasts (or “micromastia).
Typical physical signs of progesterone deficiency are anxious and nervous behavior, enlarged breasts, breast cysts, tender breasts at palpation, and if the technical examinations are done, ovarian cysts, endometriosis and uterine fibroids.

Most women, who start to have female hormone deficiency, start with a progesterone deficiency that can be there already since puberty. Typical progesterone deficiency complaints are nervousness, anxiety, irritability, excessive emotions – they occur in particular in the premenstrual phase, before the periods. Long-term progesterone deficiency consequences of breast cysts, excessive breast enlargement, tender breasts before menstruation, abdominal bloating, ovarian cysts, endometriosis (the development of uterine mucosa or endometrium, in places inside the abdominal cavity, but outside of the uterus), excessive menstruations, fibroids (benign tumors in the uterus and possibly breast and endometrial cancer. Woman who have estrogen deficiency are more likely to complain of fatigue, depression, hot flashes, low libido, lack of enthusiasm, hair loss, droopy breasts, gums disease, droopy or too small breasts, poor or no menstruation, joint pains. This is true for young women, and even more for older women.

Pregnancies are very demanding for a woman’s ovaries. After pregnancies, a woman’s ovaries produce lower amounts of female hormones because of the exhausting (over)work they had to do during the pregnancy. This results in lower female hormone levels and effects after the pregnancy compared to women who never have been pregnant. Laboratory tests confirm it. Significantly lower estrogens and progesterone levels are found in blood and 24 hour urines of women who have been pregnant compared to women who never have been pregnant, as well as significantly lower levels of estrogen and progesterone metabolites in 24 hour urines. As metabolites are what remain of a hormone after it has exerted its effects, lower urinary metabolites reflect a lower degree of activity or impact on the body of these female hormones in previously pregnant women.
The presence of female hormone deficits explains why women who have been pregnant look like mothers. In fact mothers look and are biologically older. The hair of mothers is flatter. The face is paler, the skin drier. The libido is lower. They usually take less care of themselves and do not try as optimal to dress as attractively as before, not searching to seduce as much as they did before when they had not yet been pregnant. All these adverse conditions are typical consequences of female hormone deficiencies.
When I supply women after pregnancy with the missing female hormones, they look again as sexually attractive young ladies as before the pregnancy, and not anymore as mothers. This is good, because it means these women are healthier. I estimate that after each pregnancy women produced about 10% less female hormones. So four pregnancies, means 40% less female hormone production.

The best days is 7 day before the menstruation because you have peak levels then of female hormones?
In a normal menstrual 28-day cycle, the best day to check female hormones is then the 21st day of the cycle. The 19th,20th, 22nd or 23rd days are OK too.

The best days is 7 day before the menstruation because you have peak levels then of female hormones? In a normal menstrual 28-day cycle, the best day to check female hormones is then is the 21st day of the cycle. The 19th, 20th, 22nd or 23rd days are OK too.

Any day is OK, preferably in the morning. Later on during the day we consume hormones. The best is to measure the slightly higher level in the morning.

Estradiol is best given by transdermal route, which means that the safest and often most efficient form is by application of an estradiol gel on the skin. The skin absorbs the estradiol slowly and this slowness assures a constant 24 hour supply of estradiol to the blood.
Progesterone is more difficult to absorb through the skin and is therefore taken orally (by mouth: 10% absorption) or even better vaginally (12% absorption). I prescribe also now more frequently the progesterone transdermally but to ensure greater penetration it has to be given as a liposomal gel of 10% concentration and applied on high absorption areas of the body such as the upper chest and the face (where people blush there are more blood vessels for absorption).

The use of bioidentical hormones does normally not protect against pregnancy. It is mainly the synthetic derivative of progesterone used in the birth control pill that is highly potent and that blocks ovulation. It is true that once bioidentical progesterone is given the end or cervix of the uterus tends to close, not permitting spermatozoids to go through. This happens too in the second half of a normal healthy menstrual cycle when a lot of progesterone is secreted.
The closing of the uterine cervix sharply reduces the risk of getting pregnant, just like synthetic progestogens of the birth control pill do. However, as bioidentical progesterone is quickly metabolized in the body, it does not ensure a 24 hour protection against getting pregnant, unless high doses (200 mg/day or more) are given. In fact, by providing bioidentical estradiol in the first phase of the cycle a higher estrogen peak before ovulation is formed that stimulates better the LH peak and ovulation (see above for more explanation), thereby increasing fertility.
Note: For different treatments, please consult my Hormone Handbook for physicians or the
Patient Hormone Handbook (at www.hertoghemedicalschool.eu)

There is some hesitancy among physicians to give estrone, because a few reports have suggested that estrone could be carcinogenic. Estriol, on the contrary, has better press .Many voices say estrogen should be added to every female hormone treatment because several, but not all, studies have reported it to produce protective effects against breast cancer. If a physician decides with his female patient for estriol supplementation, the best way seems not to take estriol transdermally as it is hardly or not absorbed through the skin, but orally or vaginally. My experience is with the oral form. It is in this form hardly, if ever metabolized in the liver. The average dose is 2 mg/day. Estriol should be given the same days of the menstrual cycle or month as the estradiol gel. Never give estriol alone as one study showed that it may highly increase the risk of endometrial cancer if no progesterone is supplied.

In fact, due to their often opposite action to each other, estrogen excess signs are similar to progesterone deficiency signs, and progesterone excess signs are similar to position deficiency signs.

In the first half of the menstrual cycle, the follicular phase, the estrogen production is low to medium, around the 50-80 μg per day and this is translated into low to medium blood levels of estrogens. Around day 13 of the menstrual cycle estrogen production peaks at 200-400 μg/day to form a very high one-day blood estradiol peak level (500-900 pg/mL; 34 hours before ovulation), which triggers, 24 hours later (after the estrogen peak) a peak secretion of the pituitary hormone LH or luteinizing hormone, which itself triggers ovulation (9 hours later then the LH peak). The higher the estrogen peak the higher the LH peak, the better the ovulation is. In the luteal phase medium to high estrogen levels (average 130-160 pg/mL) are found.

Hormones are potent natural substances produced by the human body in specialized tissues called endocrine glands that release hormones into the blood stream. During this passage in the blood hormones stimulate blood cells and the cells that make up the wall of the blood vessels (endothelial cells, smooth muscle cells). Once arrived in organs, hormones pass through the walls of blood vessels and go on the surface of target cells or penetrate into them to bind themselves to hormone receptors. Once binding to the receptor is complete, hormones trigger a chain of reactions that results in beneficial “hormone” effects such as improvements in energy, mood, love and passion feelings, alertness, stress resistance, fat reduction, muscle tone, heart beats, breathing, digestion, inflammation reduction, etc.

There are over the 100 different hormones. About 30 of them have major effects and should be considered as indispensable for health.
Hormones are produced by specialized tissues called endocrine glands. These glands are found at various locations throughout the human body. Dominating glands are the hypothalamus and the pituitary gland situated in the brain or just below it, the thyroid gland situated in the front and lower part of the neck, the liver, the pancreas, the adrenal glands and the pancreas that are situated in the abdomen, and the sex glands – ovaries, located inside the abdomen or testicles that hang just below the trunk. Let’s take a look on each of these endocrine glands and which hormones they secrete and that may improve the physical appearance of the face.
The hypothalamus is a small structure made of many different tissues called “nuclei” at the lower part of the brain. It produces several hormones such as the releasing hormones that stimulate the hormone production by the pituitary gland, a little ball-shaped gland located at the basis of the brain, just beneath the hypothalamus. Among other important hormones secreted by the hypothalamus are oxytocin and vasopressin. Oxytocin is the hormone that makes us loving, warmhearted beings, and triggers and intensifies a flush in the face and orgasm. Vasopressin retains water in the skin, making the skin surface smooth, including the skin of the face.
The pituitary gland produces growth hormone, which makes children grow and in adults maintains the tightness of skin and muscles, also in the face, and the density of bones. Emotionally, growth hormone provides inner peace. For energy levels, a fast and deep recovery from efforts or stress. The pituitary gland makes also hormones that stimulate the hormone production of other endocrine glands such as ACTH or adrenocorticotrope hormone that stimulates the adrenals to make more hormones, thereby boosting our ability to cope with stress, and boosts pigmentation of the skin, make the face more brownish
A little butterfly-shaped tissue situated in the front and lower part of the neck, the thyroid gland, produces the thyroid hormones that heat up the body, warming up tissues but also thanks to the higher temperature, speed up the metabolic reactions and most hormone productions, thereby making people more alive with slimness, including a slim face, thanks to the thyroid hormone’s weight-reducing effects.
The liver produces most of the IGF-1 or insulin-like growth factor one, which is possibly the best hormone to thicken hair, skin, muscles and bones, including in the face.
The adrenal glands produce in their outer layer cortisol, a hormone that keeps us alive with a good blood pressure, making us strong, increasing the energy levels in front of stress. Cortisol provides more volume to the face, especially volume to the cheeks. The adrenal glands produce also DHEA or dehydroepiandrosterone, which by converting into sex hormones helps the immune system and improves our quality of life. It makes the skin of the face more oily, sometimes too much resulting in acne, and may improve the muscle volume and tone of the face, in particular in women. Last but not least, the adrenal glands make aldosterone a hormone that keeps blood pressure up and keeps the water in the body, making the skin of the face smoother, less or not wrinkles.
The pancreas produces the critical hormone insulin, which pushes sugar, amino acids and fats into cells, providing increased energy, muscle volume and fat mass.
The two ovaries produce estrogens, the female hormones that boost “fire”, excitement, in women, and develop in them beautiful breasts and a larger pelvis. Progesterone is the other female hormone made by the ovaries. Progesterone protects against estrogen overdose by reducing any swelling and overexcitement or aggressiveness triggered by estrogens in women.
The two testicles are glands that obligatory have to hang about two centimeters below the pelvis of men to be two degrees Celsius cooler than the rest of the body. Otherwise – at higher temperatures – when tight underwear is worn for example – the sperm produced by the testicles contains a lower number of spermatozoids and among the spermatozoids found more abnormal forms, resulting in a lower fertility. Also if the testicles are maintained at higher temperatures, they produce less male hormones such as testosterone, the hormone of muscle development and sports performance, and dihydrotestosterone, the hormone that provides moustache and beard growth and produces other typically male physical signs. Both these hormones make the face more tonic and masculine.

Two hormones have the major impact of providing the energy and bravery to meet a person and seduce him or her: cortisol, the adrenal hormone that makes you have the urge to go forward and testosterone, the male hormone that produces courage and desire to talk openly and declare your feelings of love. Men deficient in these hormones are often left behind.

Nerve impulses from the brain go through the spine, stimulating the parasympathetic nervous system, which makes people relax, and initiating erections by making cells in the penis secrete nitric oxide, which widens the structure of blood vessels within the penis, causing the penis to fill up with blood and become hard. Any nutritional or hormone treatment that improves one of the various stages that leads to an erection is a candidate to treat erectile dysfunction.

Erectile dysfunction is the medical and more respectful term for impotence. Erectile dysfunction can mean that a man has no erections or poor erections that do not allow him to fully penetrate the vagina of a woman for a long enough time. Many men feel that erectile dysfunction means that they are not capable of being a man and feel highly uncomfortable.

Men with erectile dysfunction have an increased risk of developing cardiovascular disease; two years after the first appearance of erectile dysfunction, (coronary) heart disease can be detected in many men. When atherosclerosis (ageing of the arteries) develops, it first attacks small blood vessels, such as those of the penis, producing erectile dysfunction, then later it weakens the larger blood vessels, such as the coronary arteries that feed the heart with blood. Men with a low frequency of orgasm-ejaculation have been reported to have an increased risk of prostate cancer and of dying.

Despite the worrying physical conditions that are associated with erectile dysfunction, its psychological consequences are probably more devastating. A man does not feel that he is a real man when he loses his erections. He is genetically programmed to have erections and feel that this is a major feature of his manhood. However friendly, loving, and understanding about the erectile dysfunction a female partner may be, it will not change much. In particular, the men who had very strong erections at a younger age will feel a major loss of self-image and self-esteem those pills such as Viagra, Cialis, and Levitra only partially restore. I always say to the physicians in training that erectile dysfunction is a psychological emergency. Even when later erectile function is restored with good sex hormone therapy, a man will continue doubting his potency during an average period of two years thereafter. Only the use of the most potent of all hormone treatments to restore erectile function, melanotan II, can shorten the period of time of decreased self-confidence to two or three months. Read on for more information.

Several nutrients may have an interesting impact on erectile function.
Plant extracts such as Maca and Tribulusterrestris at 200 to 600 mg a day taken twice a day can help. Maca mimics some of the effects of testosterone, the male hormone. Tribulusterrestris increases the amount of the male hormone, testosterone, in blood in the free form (not bound to a transporting protein), a form that is immediately available for the target cells. There are other herbs that have been reported to have some efficacy: Ginseng and Muira-puama, at similar doses as the herbs mentioned above.
Intake ofyohimbine, also from plants, improves sexual function in many men too, but generally it does not by itself make them regain full sexual potency: 25 to 50% improvement on average.
Amino acids such as arginine and glutamine also may reverse erectile dysfunction in an interesting way. Also, carnitine supplementation has shown in one study even better ability to improve erectile function than testosterone. There exists on the market in Europe a complex containing pycnogenol, a powerful anti-oxidant, and arginine, which may reverse erectile dysfunction by 30 to 40%.
Men who are physically tense in their body often lack GABA (gamma-amino-butyric acid). GABA at high dosages of 500 to 750 mg a day may nicelyrelax them and also make them less affected by stressful events, features that may contribute to better erectile function. However, too much GABA (over the 750 mg per day) just before sex may hinder the erection. As for all things in life, too much of a good thing may work out less well.

Testosterone, the male hormone, is not the major hormone for erection. MSH, melanocyte stimulating hormone, the hormone that darkens our skin when we go in the sun, increases erectile function in most men more substantially than testosterone and even more than products such as Viagra or Cialis, especially in the form of its synthetic derivatives of melanotan II and bremelanotide, or PT-141. In contrast with Viagra, MSH not only increases the frequency, volume, and persistence of erections, but also psychological effects such as sexual desire, excitement, sensitivity of the skin to sexual caress, love, orgasm intensity, and attachment.
If testosterone increases the frequency of erections and morning erections, growth hormone, the hormone that provides volume to tissues, increases the duration, firmness, and volume of erections.
Some men are just too tired in the evening to have good erections. This typically occurs in men with severe adrenal deficiency. These men should receive the essential cortisol, the hormone that increases the blood level of sugar, the main energy nutrient, to get their urges and energy back. DHEA therapy can also improve erectile dysfunction scores, by converting into testosterone, but an improvement only appears at a high dosage of 50 mg per day after 3-4 months and may then become substantial after six months of treatment.

The primordial hormone of desire in men is testosterone. The higher the levels of testosterone, the more likely a male wants to have sex. Other hormones that may increase sexual desire are oxytocin, the hormone that makes men warmhearted and sociable, and the hormones that increase suntan, MSH derivatives.

Spontaneous nighttime and morning erections are necessary to maintain penis health. These erections at regular intervals cause the tissues of the penis to exercise and bring more blood and oxygen to oxygenate and feed the cells within the penis. Spontaneous erections are typically stimulated by testosterone and the other major male hormone, dihydrotestosterone. Men with low testosterone levels generally lose their morning erections. Treatment with testosterone restores the situation. Melanotan II can also increase morning erections.

The glans penis, the top of the penis, is full of receptors for male hormones. When tissue levels of male hormones are low, especially low in dihydrotestosterone, the number of male hormone receptors also decrease in the glans penis, reducing sexual sensitivity. As androgens receptors are also distributed all over the skin, although in a much lower concentration than on the glans penis, in a state of testosterone deficiency, the sexual arousal capacity of the skin declines, reducing the pleasure men can get from sex and its foreplay.

The frequency of erections in the presence of a potential sexual partner is improved by the same hormones (testosterone, dihydrotestosterone and melanotan II) that facilitate spontaneous erections.

To improve the firmness and volume of erections, growth hormone therapy may do a good job in growth hormone-deficient men. Testimonies that even the penis size has increased by 1 to 3 cm from growth hormone therapy are heard from patients. This is not surprising, as growth hormone is one of the two hormones that determine the penis size. The penis is small in people who have (untreated) growth hormone deficiency since childhood. To achieve good erections, high levels of nitric oxide must be produced within the penis to permit the filling of all its blood vessel structures. Growth hormone increases nitric oxide production. The other hormone for penis size is dihydrotestosterone, the hormone of male sexual characteristics like body hair and beard growth.
MSH derivatives, such as melanotan II and bremelanotide, also powerfully increase the volume and firmness of erections, even more than growth hormone. Whenever a man takes melanotan II, and the dose of melanotan II is high enough, he should have a regular partner, as he may need to have sex many times per week to calm his potent erections. Alcohol intake completely neutralizes the sexual effects of melanotan II and growth hormone.

In order to ejaculate, men need oxytocin. Oxytocin sharply improves the ability to reach orgasm and ejaculate. It also increases the intensity of the orgasm. Physically, oxytocin increases sperm volume and concentration at the first ejaculate. One of my patients was practically not able to ejaculate; once a year, one weak ejaculate was the maximum he could achieve. He could have easy erections and maintain his erections for regular intercourse, but an ejaculation would not come. With small doses of oxytocin 5 international units twice a day, he could then ejaculate eight times out of 10intecourses. MSH derivatives such as melanotan II,bremelanotide, and dihydrotestosterone can also increase ejaculation. The likelihood of orgasm or ejaculations in a man has been shown to become increasingly higher at higher blood levels of dihydrotestosterone, the hormone that stimulates body hair growth and scalp hair loss.

DHEA, ONE OF THE MAJOR HORMONES SECRETED BY THE ADRENAL GLANDS TOGETHER WITH CORTISOL AND PROTECTS AGAINST CORTISOL OR CORTISONE SIDE EFFECTS SUCH AS THINNING SKIN AND BONE DENSITY LOSS, AND ALSO INCREASES A WOMAN’S LIBIDO AND THE NUMBER AND INTENSITY OF HER SEXUAL FANTASIES, WHILE IMPROVING SEXUAL SATISFACTION WITH INTERCOURSE, ALTHOUGH WITH LESS POTENCY THAN TESTOSTERONE. DHEA DOES THIS BY CONVERTING INTO TESTOSTERONE AND ESTRADIOL, THE MOST POTENT ESTROGEN.

Cortisol works by reducing inflammation. The excessive migration of white blood cells into inflammatory zones, which causes pain and swelling, is drastically reduced by cortisol. Cortisol also limits any overproduction of collagen. Collagen is the main protein that fills up the spaces between cells in our tissues, holding cells together. By reducing collagen formation, cortisol avoids thereby fibrosis, the excessive accumulation of fibrous tissue as occurs in keloids, excessively thick scars, which may occur in the presence of inflammation. A possible side effect of cortisol’s anti-inflammatory effect is the reduction of the immune system with atrophy of the major immune gland, the thymus. However this immune depression and thymus atrophy only appears when cortisol treatment is imbalanced: two much cortisol and no addition and protection by building-up (anabolic) hormones. Another side effect of overdoses of cortisol without DHEA protection is atrophy of the skin and muscles and bones, which are due to an excessive breakdown of fibrous tissue by overdosing with cortisol. It is always the same story too much of a good thing is too much. To safely use cortisol, small doses are requested that may be temporary increased to higher doses on the condition that sufficient adrenal androgens such as DHEA, androstenedione, another adrenal anabolic hormone, and/or other anabolic hormones are additionally given. By reducing inflammation, cortisol also efficiently counters the appearance of allergies. The increasingly higher frequency of allergies in people is not only a sign that we are becoming polluted and have intestinal problems, known triggers of allergy, but is also almost always a sign that the adrenals glands do not secrete sufficient amounts of cortisol, the anti-allergy hormone. Moreover, people who are intolerant to many medications are generally cortisol-deficient. They miss the inflammation-reducing action of cortisol. A second major beneficial effect of cortisol is psychological. Cortisol considerably increases energy levels and the stress resistance by increasing the production of sugars stores (glycogen) in the liver and in the muscles up to 20 times more compared to situations where there is an almost total absence of cortisol. Additionally, cortisol increases the utilization of these stores, converting the glycogen into pure sugar (glucose) each time there is a greater need for energy, an effort to make or whenever stress occurs for example. Consequently, in presence of a cortisol deficiency, the blood sugar tends to excessively drop, an event called “hypoglycemia” in particular in stress conditions. Another way cortisol boosts energy is by increasing in brain cells the number of receptors for dopamine, the number one neurotransmitter for energy. In severe cortisol deficiencies, dopamine cell receptors drop by 20- 30%, a level that brings tiredness. Cortisol also helps energy levels by increasing the blood pressure by making the kidneys retain salt and water retention and by stimulating the contraction of the thick muscle layers around arteries. A higher blood pressure brings more blood and thus oxygen and nutrients to the brain and tissues. Cortisol has antioxidant effects. Cortisol can neutralize free radicals that are known to damage tissues. Free radicals usually come from oxygen molecules that have lost an electron and become, consequently, tissue damaging compounds. The more free radicals are formed, the greater the “oxidative stress they inflict on the body, the more damage is done to tissues and the greater likelihood there will be premature ageing. Cortisol’s antioxidant effects are very interesting to minimize any tissue damage in stress situations, conditions where higher levels of free radical are produced. Last, but not least, cortisol breaks down fat. Any weight increase due to cortisol supplementation is not due to a direct effect on fat mass production, as cortisol does the opposite, but is usually obtained through an increase in appetite and thus food intake and almost always of the intake of weight-increasing foods such as sugar and grains, particularly found when doses of cortisol are excessive.

As mentioned before, glucocorticoid is the common name given to cortisol and all other adrenal hormones such as cortisone that increase the blood sugar levels. From there the name “gluco” that recalls the word glucose and the name “corticoid” that is a common name given to all hormones that are secreted by the adrenal cortex.
Cortisol, also called hydrocortisone when it is used in therapy, is the body’s most potent glucocorticoid hormone. Cortisone is the precursor hormone made by the adrenals. It is slightly less potent than cortisol. Supplementation with cortisone is therefore always slightly higher in milligrams than with cortisol or hydrocortisone to get the same effects: 25 mg per day of cortisone are given there where 20 mg of hydrocortisone would do the same job.
However, the name cortisone is misleadingly used nowadays to name synthetic derivatives of cortisol, which are not identical to the body’s own cortisol and cortisone and have somewhat different effects.
Should people always privilege the use of bio-identical cortisol and cortisone (bio-identical means they have the same structure at the body’s own molecules) rather than the use of synthetic derivatives of them? In most cases, where more energy and a better stress resistance are required, yes cortisone and in particular cortisol/hydrocortisone are indicated, because the human body is entirely adapted to these types of molecules.
Thanks to this better adaptation, the use of the bio-identical cortisol and cortisone reduces the risk of developing side effects and, whenever side effects occur, reduces the duration of the side effects in comparison with synthetic derivatives, because bio-identical hormones are more quickly metabolized (consumed) in the body. Bio identical hormones usually provide also better beneficial psychological effects on energy, mood and personality. Nevertheless, non-bio identical glucocorticoids such as prednisone, prednisolone, methylprednisolone or dexamethasone are preferable to cortisol whenever inflammation is prominent as these compounds have a longer, more persistent 24 hour on 24 hour, anti-inflammatory action. Whenever I prescribe them to my patients I do it most of the time for a limited time, two to six-months, the time necessary to reduce the inflammation, then switch back to bio-identical cortisol or hydrocortisone.

Sedentary men needs to get a minimum of 2.9 liters per day of new water supplied every day. This amount does not all have to come from drinking. On the average, 1.65 liters comes from drinking non-caffeinated, nonalcoholic beverages and soups. One liter comes from eating solid foods (fruits, vegetables) and 0.25 liters per day comes from within the body, namely from water derived out of oxidation of molecules. In other words, humans produce water!
A woman needs to drink, eat and produce less water to maintain her body water at an optimal level: about 2.2 liters a day.

At least 400 g per day of fruits and vegetables. Experts from the Rush University Medical Center suggest eating four servings of fruits and five servings of vegetables per day as they may help reduce the risk of cancer and other diseases in addition to providing your body with fluids, reports.

After physical exercise, I recommend my patients to eat fruits and vegetables rich in water because they contain activated water full of nutrients that accelerate recovery, replenishing the water stores and restoring the electrolyte and energy balance, impoverished by sweating and nutrient consumption. In contrast, pure water has no energy, provides no calories and is very poor in nutrients that permit tissue repair.
If water alone is taken, the water must contain an addition of salt (sodium) and other minerals such as potassium and magnesium to compensate for the mineral losses in the sweat. Drinking a mineral-containing beverage keeps the water in the body for more hours after fluid ingestion than drinking pure water. A good drink should contain moderately high levels of sodium (perhaps as much as 50-60 mmol/l or 1. 1–1.4 g/l (as 1 mmol of sodium is 23 mg) and also some potassium to replace losses in the sweat. To surmount ongoing urine losses, the beverage volume taken should be greater than the volume of sweat lost. Adding macronutrients is not necessary for rehydration, although a small amount of carbohydrate (less than 2%) may improve the intestinal uptake of sodium and water. A study showed that ingestion of carbohydrate-electrolyte drinks in the post-exercise period restores exercise capacity more effectively than plain water. The effects on performance of an uncorrected fluid deficit should persuade all athletes to attempt to remain fully hydrated at all times, and the aim should be to start each bout of exercise in a fluid replete state.

Growth hormone is an anabolic hormone, which means that it builds up your body. It does this partly directly by regenerating tissues and mildly increasing the blood sugar level, partly indirectly by stimulating the secretion of another powerful hormone—called IGF-1 or insulin-like growth factor I—because of its analogy with insulin in structure and action (lowering the blood sugar level).
Growth hormone not only builds up your muscles, blood vessels and bones more than testosterone—the male hormone—can, but it also builds up the nervous tissue, including the brain and its neurons (brain cells), and increases the blood sugar level to provide more energy. Thus, growth hormone has not only powerful actions on our physical appearance and health, but also, and even more, on our minds and moods.
In the brain, growth hormone intensifies the number of contacts between the neurons or nerve cells while increasing their activity. In the nervous system, growth hormone strongly stimulates the parasympathetic nerves, the nerves that calm us down. In the blood, growth hormone increases the sugar level, the main substrate for energy in the neurons. These various actions of growth hormone on the brain may explain why it helps considerably to improve our memory and our capacity to multitask—doing different activities at almost the same time, while going from one into the other with easiness. They also explain why growth hormone may deeply reduce anxiety and provide a sort of sixth sense for many patients, or a capacity to find solutions all the time to almost any problem, while others who are not treated seem confused, hesitate, and turn around the pot when confronted with the same problems.

 

Meditation or spiritual practices may help to increase growth hormone. One hour of training, for example, significantly increased the blood concentrations of growth hormone in elderly men. Increases of 5 to 15% can be expected with such practices. This may not seem like much, but for people with borderline low growth hormone levels, it may make the entire difference. These increases in growth hormones may also explain some of the calmness and inner peace felt by practitioners after a session

Taking a birth control pill reduces IGF-1 levels and thus growth hormone effects by 30–35%. This explains why many women get fat, including getting cellulite, and lose muscle tone when taking a contraceptive pill, as the pill’s synthetic estrogen (ethinylestradiol) accumulates in the liver after absorption in the intestine. The excessive amount of estrogen in the liver over stimulates the liver to produce growth hormone-binding proteins. These proteins transport growth hormone in the blood to target tissues. An excessive amount of these binding proteins in the blood will bind most of the growth hormone molecules and prevent many of them from leaving the blood and penetrating into the target cells, including the liver cells, resulting in a drop in IGF-1 production by the liver and a decrease of growth hormone and IGF-1 effects.

Before even thinking of taking a testosterone treatment, try to improve your testosterone level by improving your diet. Below is a table with the main foods and drinks to take or avoid in order optimizing the testosterone levels. Pay attention: sugar and carbohydrates from cereal origin reduce the secretion and levels of testosterone! They do it quickly within an hour after intake and it takes many hours, if not a full day, to overcome this!

Zinc and vitamin A are probably the most potent nutritionals to make the ovaries and adrenals secrete more testosterone. Vitamin E and vitamin B have been reported in men to stimulate testosterone’s beneficial effects on animal reproductive organs, and it is likely that these vitamins may also help women to have more testosterone effects on genital areas. Carnitine seems to mimic some of the effects of testosterone, such as energy and muscle mass increase, without increasing the testosterone level.

Curiously, having sex with a man may even more than double the testosterone level in women through sperm “contamination”! The sperm is rich in testosterone. Two conditions need to be fulfilled: having sex more than two times per week with ejaculation into the vagina and a partner who is very masculine.
A very masculine partner with high testosterone levels has also a sperm rich in testosterone. In many cases, the unexpectedly high levels that I see in consultation in women who are not under androgen treatment (no testosterone and no DHEA) are due to the newly installed testosterone treatment of her husband or male partner, who not only sees his blood but also sperm testosterone concentrations increase while he becomes more masculine and has more sex with his wife. In many cases, the transmission is not from the sperm, but from close body contact during intercourse for example. In these cases the male partner rubs the testosterone gel on his belly and some of this testosterone of high 10% concentration is transmitted during the skin from the male partner to skin of the female partner during nude belly to nude belly contact. To avoid contamination by transdermal applied testosterone on the male partner’s skin, men should put the testosterone gel on other areas of the body where there is no transmission possible during intercourse. Better areas to apply the testosterone gel on the male partner are the forehead, sides of the neck, above the collar bones, and on the sides.
The higher testosterone transmission through sperm or abdominal skin may also explain why some women find that their libido increases when they have sex more frequently with their husband.

DHEA is the most abundant hormone in the human blood, whether under the form of DHEA sulfate—DHEA bound to a sulfate molecule—it is at a concentration 20 times higher than that of any other hormone! Because of this impressively high blood concentration compared to other hormones, Professor Baulieu probably thought as me that DHEA must be important for some particular yet undiscovered reasons.

Are there any risks of taking DHEA? Yes, there are two types of risks: one is overdosing; the other is a possible, not sufficiently evidenced, higher risk of breast cancer in postmenopausal women not taking female hormone replacement. Researchers have reported in two different studies that a higher DHEA sulfate level in women after menopause was linked with an increase in risk of developing breast cancer, while the opposite has been reported in women before menopause. Apparently, DHEA, to exert its cancer-protective effects, needs the presence of a sufficient amount of estrogens and progesterone in tissues. After menopause, these hormones are lacking. In men, no increased risk of prostate has been shown at higher levels of DHEA. In fact, DHEA seems to be very safe for men.

Any person above age 30 is likely to suffer from a DHEA deficiency because the levels of DHEA start to decrease at that age on in our blood. Of course, the deficiency will be mild at age 35 and severe after age 55.

Compared to cortisol- and sex-hormone-deficiency complaints, the symptoms of DHEA deficiency are more moderate: mild fatigue and mildly low mood, sex-drive loss, and sexual insensitivity in women, and a milder form of erectile dysfunction in men, et cetera. The table below shows an overview of DHEA-deficiency complaints.

Pubic and armpit hair is closely related to the presence of DHEA. When children start puberty, the first (puberty) sign is the appearance of body hair in the armpits and on the pubis. At the same time, the only hormone that increases in blood is DHEA sulfate. At age 30 years, pubic and armpit hair already slow start to regress and the only hormone level that is apparently decreasing is DHEA sulfate. Beard growth only decreases from age 60 on, when the levels of the male hormones testosterone and dihydrotestosterone have sufficiently dropped in blood. Beard grow is not DHEA dependent, but armpit and pubic hair are.

Legs and feet age due to nutritional and hormone deficiencies that progressively appear with aging and are aggravated by dietary errors and a lack of movement. A lack of movement accelerates the aging of the legs and feet because legs and feet need movement to keep in shape. Our legs and feet are there for movement. People who sit in their armchair all the time and do not want to leave it except for going to the bathroom and getting into their bed, quickly lose their ability to walk and in the end develop gangrene (tissues that die) and thrombosis (blood clots) in their feet. It is sad to see how many occupants of nursing homes lose the use of their lower legs lose by not moving enough. Their legs literally atrophy. A thin and fragile parchment-like skin seems to stick almost directly on the bones of the lower legs and feet with disappearance of most of its muscles.

Legs and feet must remain tight and strong to walk, to move, to jump and to be fully alive in a world full of movements. Remember the comparison mentioned before on people who cannot move their legs and have to remain in wheelchairs. Apart from some exceptional individuals who overcome their handicap brilliantly and sometimes make the headlines of newspapers with their sports performances, most people in wheelchairs are dependent on others for many activities. To remain fully autonomous it is essential, especially in older age, to keep the legs and feet powerful by walking every day or practicing other activities such as cycling or jogging that keep the legs and feet in movement.

Let’s remember that repeated movement such as walking over longer distances and eating high-protein foods are the first essential steps to improve the legs and feet. If there is no movement, blood will not much reach the not moving areas. Regular movement activates the blood supply in the legs and feet, making it possible for oxygen, amino acids and vitamins to reach the tissues. Without frequent movement no supplementation therapy will succeed. Failure is then almost certainly the end outcome. Nutritional and hormone treatments require movement to improve the skin, muscles and bones of the legs and feet. Also with age many people digest less well proteins and absorb less amino acids, the building blocks of the skin and muscles. A higher intake of amino acid supplements of, is then recommended. Amino acids are much easier to absorb than whole protein foods. Proteins are composed of amino acids attached one to the other. An adequate digestion spits efficiently the proteins into amino acids. ). In sick and elderly people, the digestive system does not succeed in splitting all proteins into amino acids.
When the blood supply to the feet or legs is not sufficient, thalasso therapy-type treatments with water such as foot baths, hot water jacuzzi where the feet and sometimes legs are plunged into water, or applications with humid towels or plastic-wrapped solutions or gels onto the skin of the legs and feet may do wonders to bring much more blood supply to the feet.
When a disease does not cure, remains chronic, it is because inside of the sick organ or tissue only a few capillaries, the miniature blood vessels that supply blood to the tissues, are open, 20-30%.
To reopen all the capillaries, the best method is to repeatedly alternate applications or baths of ice cold water and hot water. Each cold and each hot water session should take about 30-120 seconds. For example, start by applying cold water to the feet or by plunging the feet into a cold bath. Then, after 30-90 seconds, do the same with hot water for 30-90 seconds. Then, use cold water again, then hot water again, then cold again, etc. I generally apply four sessions of cold, each one followed by a session of hot water. When the predominant problem is a lack of blood supply and/or damage to the tissues with a need to repair, the last application or bath should be with hot water, definitely widening all capillaries necessary for the healing process. In case pain or inflammation is the biggest problem, the last application or bath should be wi

th very cold water, as cold substantially reduces the inflammation, edema and pain.

Our back ages as the years go by. For many of us back pain is often the first sign that of aging of our back. For others, the first signs of back aging are the appearance of loser back muscles, which atrophy and start sagging like curtain draperies. Others observe as first sign a greater amount of pigmentation spots on the skin of their back. With age, small skin tumors may develop on the back, skin tags or warts, almost always benign, but never beautiful. The vertebrae of the spine become with age smaller (they atrophy) and more fragile, losing tissue and density, a process which ultimately may make vertebrae collapse into vertebral crushes, making the back smaller and bowing forwards more, providing elderly people with a typically bowed back. The soft discs between vertebrae, which allow movement between vertebrae and make the back flexible, shrink, flatten and lose elasticity, and may protrude out of the spine because the ligaments, which attach vertebrae one to another and keep the disc sealed between two vertebrae, become lax and weak with age. This process ultimately makes the disc protrude backwards out of the vertebral column, a phenomenon called “disc hernia”, which squeezes and crushes nearby nerves causing pain all along the trajectory of the nerve from the back through the legs up to the feet, a pain irradiation called “sciaticus pain”.

The incidence of back pain, often due to an aging back, is high in the population. At any moment in time, 9 to 12% of people (630 million) suffer from low back pain, and nearly one quarter (23%) report having it at some point over any one-month period. Low back pain is more common among people aged 40–80 years. Its incidence increases in the world because the population ages.

It is important to make the back younger simply because a healthy back is a young looking back and without a healthy back, there is literally no or a poor future. Just look at people with chronic back problems! They appear clearly handicapped when trying to accomplish professional work and fulfilling activities of daily living. An old back is a back of full problems. Such a back must and can become straighter and tighter with a smoother skin, firmer muscles and stronger bones again. This reduces the likelihood of back problems.

To make an excessively bowed upper back straighter against the back muscles should regularly be put into action with isometric exercises. Isometric exercises increase the volume and tone of the back muscles through repeated and prolonged contractions of these muscles. But exercise is nothing without an appropriate diet. The diet should be rich in saturated fat and proteins to increase the production and levels of hormones known to improve the back muscles such as male hormones and growth hormone and IGF-1. Eating more protein-rich foods is of particular importance because these foods provide the necessary amino acids for the skin, muscles and bones of the back. If the patient doesn’t want to increase the amount of proteins because of dislike, intolerance or philosophical rejection of foods from animal origin, supplements of a mixture of all amino acids, enriched with branched chain amino acids (for muscle enhancement) is recommended as an alternative. When the bowed back is due to osteoporosis (ageing of the bones with atrophy and loss of consistence), taking supplements of vitamin D3 and calcium may oppose any further aggravation of the bending over of the back.
The best treatment to reverse an excessively bowed upper back is to correct growth hormone deficiency with daily subcutaneous (under the skin) growth hormone injections. I am frequently amazed by the change in posture in patients who receive growth hormone. They hold their back almost systematically straighter after 2-3 months of treatment. I myself have a straighter back with no difficulties since the 20 years I am taking growth hormone. This treatment has made my breathing better, deeper, more starting in the abdomen. This deeper breathing expands my trunk and helps me further in getting my back straight, by the air pressure after breathing in. Growth hormone also increases the tone and volume of the back muscles, while at the same time it deeply relaxes the back muscles. IGF-1 (insulin-like growth factor 1) and testosterone improve tone and volume of the back muscles as well, and can also make aging atrophic vertebrae recover a greater volume. Female hormones also help to get a straighter back, not by increasing muscle ton, but by making the vertebrae stronger and denser.
To make a stiffened back more flexible, stretching exercises may help but only in the very beginning of Scheuermann disease before fusion of the vertebrae one to another. AsScheuermann disease is an inflammatory disease, eating fresh fruits and vegetables, foods that calm down inflammation, and foods rich in protein and saturated fat, food that increase the production of the anti-inflammatory hormones such as cortisol, helps to reduce the inflammation in Scheuermann disease. Patients should avoid foods that increase inflammation such as sweets and grains. Taking vitamin D 3 and omega 3 polyunsaturated fatty acid supplements may also decrease the inflammation in Scheuermann disease. However, the number one treatment of Scheuermann disease is next to a good diet, to correct the cortisol deficiency with preferably moderate doses of a synthetic derivative of cortisol such as prednisolone and methyl prednisolone. The reason here for is that synthetic derivatives reduce the inflammation better and remain efficient longer after intake because they are not broken down as easily as the bio-identical (same structure as the human) cortisol, which makes them stay available for the tissues of the vertebral column longer in the blood. I remember how grateful a patient was to my father, who was also a physician, for giving him a low dose cortisol treatment, which had saved his back from curving over and getting fixed. Even 35 years after starting and continuing this treatment, when I had him as a patient, you could not see in any way that he had Scheuermann disease! Of course, never forget to add DHEA when cortisol or a synthetic derivative is given to avoid adverse tissue over consuming effects of cortisol. I speculate that growth hormone, which increases tissue flexibility and makes the back straight, may help in Scheuermann disease too to oppose the progression into a severely bowed and fixed back, the final outcome in most people with this disease. However, there is a danger to provide growth hormone without cortisol in Scheuermann disease as growth hormone therapy may increase inflammation of the back by reducing the production and levels of cortisol by 20-40%!

1. Regular practice of isometric exercises of the same type as those useful to straighten a bowed back again may help. Patients with a droopy back should choose and consume a better type of foods, foods rich in amino acids such as meat, fish poultry and saturated fat rich foods such as egg yolk, (boiled, non toxic) lard, liver, which increase levels of testosterone, the major muscle hormone. Those people who are reluctant to take more protein rich food or do not absorb amino acids well from the proteins, taking supplements of branched chain amino acids, amino acids necessary for muscle development, and a mixture of different amino acids may be a useful alternative. To improve protein digestion and thus amino acid absorption, I frequently supply to patients supplements of hydrochloric acid and pancreatic enzymes when the intestinal absorption of these essential nutrients for the muscles and bones is poor. The best hormone therapy to reverse the droopy back is growth hormone therapy. Its effects are greater, more rejuvenating, when combined in a same injection vial or cartridge to other hormones such as IGF-I, long acting insulin and relaxing, hormones that people with droopy back usually are lacking. Of course, testosterone, the muscle hormone, will help improve the back muscles in both men and women. Do not forget that each time a woman receives testosterone as a treatment, she often should take daily finasteride or another blocker of the conversion of testosterone to the masculinizing dihydrotestosterone, and that she should always at the same time add female hormones to the regimen to avoid acquiring masculinization signs such as a moustache or beard.
Doing regular isometric exercises with the back muscles may help to reduce an excessively forwardly curved lower back or hyperlordosis, together with consuming more foods rich in proteins, which enhance muscle development, and foods rich in saturated fat, which increase the production and levels of testosterone, the muscle hormone. If in childhood, the most efficient therapy of hyperlordosis is to correct the underlying thyroid deficiency with daily thyroid supplementation, in adults growth hormone therapy is the most potent treatment. Testosterone, especially with injections at high doses may also reveal to be an efficient treatment to reduce the lower back curvature by toning the lower back muscles.

Two major ways: first of all one should avoid lifting heavy weights or falling on the butt, and, secondly, make the vertebrae of the vertebral column so strong that even falls or heavy weights cannot break them. Vertebrae can be made stronger by increasing the supply of amino acids and calcium through first a better diet, richer in protein-rich foods and low in acid foods such as sweets that make one loose calcium, and secondarily, by nutritional supplementation, in particular a mixture of amino acids with calcium and vitamin D to absorb calcium better. In older people, fundamental is also to correct any deficits in growth hormone, IGF-I, sex hormones (estrogens, progesterone, testosterone), calcitonin and parathormone deficiency, the major bone-enhancing hormones. Hormone therapies help considerably to maintain the volume and density of the vertebrae, preventing thereby the appearance of vertebral crushes.

Once a vertebra has collapsed and has become a vertebral crush, only surgery could reconstitute a new vertebra with a risk of surgery-induced damage to the spine and its out coming nerves. I have witness this in a young women who had a vertebral crush by traumatic injury and who is now paralyzed by the surgery, not by the accident, in the lower half of her body and we have a hard time to regenerate her nerves for what seems irreparable damage. For this reason, surgery for vertebral crushes is rarely done, only in cases of persisting debilitating pain or loss of nerve function because the nerves that come from the spine to the arms or legs are squeezed by the collapse of the vertebra (e). In most elderly patients with vertebral crushes an adaptation occurs after several months and back problems remain tolerable. When a vertebral crush has just happened, daily calcitonin injections under the skin(subcutaneous) or in the muscles (intramuscular), reduce the pain well in two weeks time, a pain that otherwise persists for one to two months at least. Calcitonin is a hormone that increases the bone density of the vertebrae by putting calcium in the bones, an effect that explains why calcitonin also lowers the calcium levels in blood.

Many women refuse even to think of taking additional female hormones to their own female hormones, even women in the post menopause who are almost totally deprived of them! Why? Because they think it is dangerous. The think that the use of these hormones may increase the risk of breast cancer, endometrial or ovarian cancer, and cardiovascular disease. The forget that the women with the most of these hormones, are the young healthy women overwhelmed by these hormones. They ignore that without sufficient levels of these female hormones their body perishes. They do not know that the risk of developing these diseases can be minimized by optimizing female hormone treatments as discussed in the next chapter.

The belly ages due to increasingly greater number and degrees of hormone deficiencies. A diet high in “modern” foods such as sandwiches and milk products, and perhaps (too) low in protein and micronutrients, together with a lack of regular physical exercise further let the abdomen fall into ruins.

As for other parts of the body, improving the aging abdomen not only makes people physically more attractive, but also shows that health inside the abdomen improves as well.

For the aging abdomen, improving the diet with more protein and (healthy) fat and less carbohydrates is fundamental. Regular physical exercise of the abdominal muscles may help but in sedentary people dietary improvement alone may already restore the youthful abdominal appearance. Later on, with advancing age the effect of hormone supplementation becomes increasingly more important to improve the belly than improving the diet or ding exercise.

As suggested in the paragraph just above, a person’s arm ages because of multiple dietary, nutritional and hormone deficits that gradually appear with aging. One of worst dietary errors that can be made is to eat a lot of foods based on cereals (bread, muesli, porridge, pasta, rice, etc.) as this irritates the intestines, reduces intestinal uptake of nutrients and makes arms and hands age quicker is.

Having strong and firm hands and arms is valuable for everybody, not only because it helps to work and perform and to defend oneself easier in case of physical aggression, but also because strong and firm hands and arms give to the outside world an unconscious, but correct, signal that the individual is strong and able to do what s/he says.

The chest ages primarily because of increasing hormone deficits. A low-protein diet, nutritional deficiencies and a lack of regular physical exercise aggravate the problem.

As for any other part of the body, rejuvenating the aging chest with the adequate treatments (see further) not only makes us looking more attractive, but is also a proof that the treatments are improving health inside of the body.

 

For the aging chest, much more than for the neck, a high-protein diet and regular physical exercise of the chest muscles really help to improve the aspect of the chest even in the presence of important (anabolic) hormone deficiencies. However, in people of advanced age severe hormone deficits have appeared that limit the effect of exercise and good food on chest firmness and attractiveness – in my experience to one-third of what would be obtained if adequate hormone supplements were given.