Dr. Kyle Gillett, MD, (@kylegillettmd) is a dual board-certified physician in family medicine and obesity medicine and an expert in optimizing hormone levels to improve overall health and well-being in both men and women. He is a firm believer in practicing medicine and focusing on prevention by approaching the body, mind, and soul.

“Doing a little amount of lifestyle interventions over a long period of time is going to be far more helpful or efficacious than doing a lot than doing nothing, then doing a lot, then doing nothing.” – Dr. Kyle Gillett

Six pillars of hormone health: (1) diet (specifically caloric restriction); (2) exercise (specifically resistance training); (3) stress & stress optimization; (4) sleep optimization; (5) sunlight; (6) spirit – dial in the body, mind, and soul connection

Men, how to know whether you should use caloric restriction: if you’re obese or have metabolic syndrome, the caloric restriction will increase testosterone in men

“There’s nothing special about intermittent fasting or caloric restriction or exercise when it pertains to body weight in general. When you lose weight about 33% of that is lean body mass and about 10% of fat cells are lean body mass.” – Dr. Kyle Gillett

The reason for exercise, caloric restriction, and intermittent fasting in general: it’s how you increase healthspan, not necessarily change the weight on the scale

Intermittent fasting & effects on hormones: more significant spike in growth hormone and IGF-1 levels which will help in older age groups than younger – the longer you fast, the bigger the spike

Major functions of IGF-1 and IGF-2: growth hormone acts on the liver to produce IGF-1 which is the active form of growth hormone with a much longer duration of action

Potential underlying hormonal causes of poor sleep: (1) growth hormone deficiency (very rare); (2) vasomotor symptoms of menopause or andropause (very common); (3) being on testosterone replacement therapy (TRT) increases the risk of sleep apnea

Women think they have very low testosterone levels because tests generally look at free testosterone which is the smallest proportion of testosterone in the body

If you look at the total amount of DHEA (weak androgen) and testosterone in a woman, it’s more than estradiol but it’s in different measurements

“Testosterone is not going to cause prostate cancer, however, normal aging causes prostate cancer and testosterone will grow your prostate cancer.” – Dr. Kyle Gillett

Men, be sure to check prostate-specific antigen (PSA) levels – also be aware, overweight and obese men have higher rates of prostate cancer

Tips to maintain prostate health: prostate is right by the colon so make sure you have regular bowel movements, be aware of any genetic predisposition to an enlarged prostate, there’s an interesting correlation between having female offspring and prostate cancer, check estrogen levels (there’s a link to high estrogen and prostate cancer), make sure CRP levels are low

General TRT doses: 100-120mg/week divided over 2-3x per week – but there is a law of diminishing returns here, TRT has its trade-offs so you have to find the right level for you

Very few people need aromatase inhibitors – there are a lot of ways to control estrogen through lifestyle or other interventions without the potency of aromatase inhibitors

Non-traditional supplements which increase testosterone: creatine, tongkat ali, stinging nettles, boron, turkesterone, fadogia acrastis

Fadogia acrastis (shrub from Nigeria): can increase testosterone by stimulating luteinizing hormone release and receptor sensitivity – but there’s not a lot of evidence supporting long term use

DHT is responsible for male pattern baldness so you can look to the males on your mother’s side – the better your androgen receptor works, the more likely you are to experience male pattern baldness

Role of DHT:

• In central nervous system: activates androgen receptor gene and helps make effort feel good and motivating
• In the cardiovascular system: androgen receptors are present in heart tissue

Impact of diet on DHT: a diet high in bioavailable plant polyphenols (such as curcuminoids, turmeric, black pepper) inhibits an enzyme that converts testosterone to DHT – but don’t worry, effects are nearly always reversible

Creatine can increase the conversion of testosterone to DHT

• If you’re worried about hair loss, creatine can potentially add fuel to the fire – but if the follicle is still there the hair will come back after a few months

For androgenetic alopecia: you want something to decrease the activity of androgen receptors – most promising treatment is dutasteride mesotherapy (localized injections in vulnerable areas)

Symptoms of PCOS: androgen excess (symptom would be excessive hair growth, deepening of the voice, etc.), insulin resistance, oligomenorrhea (more than 35 days between periods or less than 9 per year), infertility

If living with PCOS: be vigilant about addressing insulin resistance and insulin sensitivity (talk to a doctor about inositol variation, metformin)

Perceptual effects of oral contraception: some studies have shown that there’s a shift in how men and women perceive attractiveness in each other among women who take oral contraceptive

Ethanol estradiol (common synthetic estrogen): 100x more potent than endogenous estradiol in the liver so binds to estrogen receptor in the liver and increases sex hormone-binding globulin which decreases free-testosterone and DHT

Effects of contraception on fertility: if contraception is taken 6-12 months, fertility is likely equitable as baseline; beyond 12 months it’s still unlikely to have a long term effect on fertility unless you are experiencing side effects of the contraception such as insulin resistance   

Building in “prolactin adjustments” can be helpful for your relationship: take some time away from each other so it’s exciting when you see each other – prolactin and dopamine are inversely related

If you don’t know where the pelvic floor is – think of your body as a box: your abs are the front of the box, your back is the back of the box, your diaphragm is the top of the box, your pelvic floor is the bottom and serves as your port to the outside world

Prostate, bladder & urinary health: phosphodiesterase and tadalafil (low dose is not arousing) can help will flow regularity and decrease nighttime urination trips

HCG is (1) a hormone produced during pregnancy; (2) fertility treatment; (3) can help maintain testicular function while on testosterone

L carnitine can support fertility and can increase the density of androgen receptors – and can be supplemented or found in food but isn’t very bioavailable; you can find injectable L carnitine – try 500mg-1g per day

Smoked marijuana promotes significant reductive activity in aromatase (which converts testosterone to estrogen)

• Note, high-fat diets also promote aromatase activity

High alcohol intake will decrease testosterone (as will any gabba agonist, which you want to be cautious to not take gabba daily)

Interestingly, the American Heart Association recommends females consume 0-1 servings of alcohol per day and men consume 1-2 servings of alcohol per day

Avoid saunas if you are experiencing infertility or have a low sperm count – but the real enemy is warm water (i.e., warm bath, jacuzzi) which raises the temperature of the testes faster than a sauna

Peptides: short sequences of amino acids that resemble hormones enough, they mimic the effect of hormones in the body – some peptides change gene expression and set pathways for continued production of the hormone of interest

Benefits of BP-157: the healing of many different types of tissue from tendon, muscle, and the nervous system, increases blood flow back to injured sites, protects organs, prevents stomach ulcers and heals skin burns