Dr. Kyle: 5 Tips To Boost Testosterone

Feeling slowed down? Always tired? Dwindling sex drive? These may be signs that you are suffering from low testosterone.

You may think that supplementing with testosterone is exclusive to hardcore bodybuilders. Social media is often flooded with testosterone boosting supplements that are marketed to increase muscle mass and improve physique.

Whatever the reason, more and more average Joes are turning to testosterone supplementation. According to recent studies, an increasing number of men are being diagnosed with hypogonadism. After discovering that their hormone levels are below average, many turn to their family doctor to start hormone replacement therapy. Others are looking to boost their levels naturally through diet, exercise and lifestyle modifications.

Here are 5 simple tips to naturally boost testosterone:

1. Exercise

• Not only will exercise improve muscle strength, bone density and balance, regular physical activity will boost serum testosterone levels as well. Weight training and high intensity interval training are the most effective forms of exercise to increase testosterone.

2. Diet

• Get a sufficient and healthy balance of proteins, fats and carbs. Eating lots of high-quality proteins will improve testosterone levels and enhance fat loss. Don’t over eat and don’t restrict food intake for too long either. Some testosterone boosting foods include oysters, tuna, almonds, egg yolks and beef.

3. Sleep

• Sufficient hours of sleep will vary person to person. It is recommended that you get 7-9 hours of sleep per night as a young adult. As we age this number will drop. Those that sleep <4 hours per night are often testosterone deficient. Men who sleep 5-6 hours per night have testosterone levels equivalent to men 10 years older! Must I continue? Sleep!

4. Minimize stress

• Research has shown that long periods of stress lead to chronically high cortisol levels. Too much cortisol in the system causes a reduction in testosterone. Stress often leads to over eating and accumulation of fat, thereby lowering testosterone levels further. Consider meditation or finding an activity you really enjoy. Be sure to utilize the strategies above to keep your stress in check.

5. Supplement

• A number of herbal supplements may help reduce symptoms associated with low testosterone. In addition to increasing testosterone levels, the herb “Ashwagandha” is thought to reduce stress, improve brain function, lower blood sugar and reduce inflammation. Ginger extract may produce similar improvements. Prohormones such as Tribulus terrestris, Tinospora cordifolia, and icariin (horny goat weed) have not demonstrated significant improvements in testosterone in human trials.

Have any questions or concerns? Contact me at drkyle@forwardhealth.ca and visit @drkylearam on Instagram and facebook.

References:

Kovac, J. R., Pan, M., Arent, S., & Lipshultz, L. I. (2016). Dietary adjuncts for improving testosterone levels in hypogonadal males. American journal of men’s health, 10(6), NP109-NP117.

Carol S. Johnston, Sherrie L. Tjonn, Pamela D. Swan; High-Protein, Low-Fat Diets Are Effective for Weight Loss and Favorably Alter Biomarkers in Healthy Adults, The Journal of Nutrition, Volume 134, Issue 3, 1 March 2004, Pages 586–591, https://doi.org/10.1093/jn/134.3.586

SamuelMelamed*†UrsulaUgarten‡ArieShirom§LunaKahana∥YehudaLerman†PaulFroom*† Chronic burnout, somatic arousal and elevated salivary cortisol levels Journal of Psychosomatic Research Volume 46, Issue 6, June 1999, Pages 591-598

Walker, M. P. (2017). Why we sleep: Unlocking the power of sleep and dreams.

D. C. Cumming, M. E. Quigley, S. S. C. Yen; Acute Suppression of Circulating Testosterone Levels by Cortisol in Men, The Journal of Clinical Endocrinology & Metabolism, Volume 57, Issue 3, 1 September 1983, Pages 671–673, https://doi.org/10.1210/jcem-57-3-671

Ambiye, V. R., Langade, D., Dongre, S., Aptikar, P., Kulkarni, M., & Dongre, A. (2013). Clinical Evaluation of the Spermatogenic Activity of the Root Extract of Ashwagandha (Withania somnifera) in Oligospermic Males: A Pilot Study. Evidence-based complementary and alternative medicine : eCAM, 2013, 571420.

Dr. Laura: Why do processed foods get such a bad wrap?

Advanced Glycated End products

AGES– Advanced Glycated End products area product of food processing. AGEs appear to stimulate chronic low-grade inflammation and promote oxidative stress and affect the pancreatic beta cell function leading to the development of insulin resistance. Stop AGE diets in animal models and diabetes stops.

Bad Fats

Fats– Not all are created equal! Processed foods use trans fats to prolong shelf life, saturated fats because they are cheap and tasty. Transfats and arachadonic acids create inflammation in the body. This increases risk for plaques in the vascular system, increases cholesterol and ultimately blood pressure. In contrast, when healthy fats like omega 3 fatty acids (aka high quality fish oil) the inflammation markers go down, the cell is better able to perform its function. Since every cell has a phospholipid bilayer. This means that every cell’s skin is made of fat. When fat is of a fluid nature, nutrients are able pass in and out more effectively and the cell’s function is optimized.

Food Dyes

Dyes–The processed food industry uses food dyes to add colour to colourless foods, to enhance colour and to avoid colour loss due to environmental elements and to preserve consistency when there are variations in the colour of food. Food dyes are know to cause inattention, hyperactivity, irritability, temper tantrums or trouble sleeping.

Sugars

Sugar & high fructose corn syrup. Most processed foods have some sugar added including soda pop, breads, cereals, yogurts, processed meats, soups and condiments. High-sugar diets may make a significant contribution to cardio-metabolic risk.  High fructose corn syrup, when digested by the body produces reactive carbonyls, which creates tissue damage. Countries using high-fructose corn syrup had rates of diabetes that were about 20% higher than countries that didn’t mix the sweetener into foods, even when total sugar and total calories remain the same.

Salt

Salt– Processed foods use salt to help preserve it and for added flavour. The amount of salt in restaurant and packaged foods are the main culprits in the Western diet, not the salt added to home-prepared whole foods.  Research shows that the average North American consumes 4000mg sodium per 2000kcal diet. This is almost twice as much as the 2300mg/day recommend by some health experts. If the amount reduces even to 2700mg/day, a 5mmHg smaller rise in systolic blood pressure would be noted in those 25-55 years of age. This results in an estimated 150,000 lives saved from death due to cardiovascular events. The kicker is, if not getting annual checkups, often the first sign of high blood pressure, is a deadly heart attack.

White Flour

White flour  – Without the fibre, white flour easily breaks down quickly into simple carbohydrates, which is essentially sugar to the body. Processed foods are full of white flour. The fast breakdown quickly elevates blood sugar, induces insulin release and quickly and causes cravings for more sugar to restore blood sugar levels. The cycle easily repeats itself as quick carbs are continually fed into the body. Over time and continued food abuse, the insulin that works diligently to get the sugar into the cells, becomes less effective, the sugar stays in the blood stream and the person is now experiencing high blood sugar levels and insulin resistance… a path well travelled to the diabetes destination.

Dr. Kyle: Why You Should Use The Sauna

Everyone enjoys a day at the spa for some much-needed relaxation, but did you know that time spent in the sauna may actually increase muscle gains?

Originating in Finland, this traditional passive heat therapy is becoming increasing popular world-wide. Saunas are often used for the treatment of musculoskeletal pain as well as headaches. Recent evidence has suggested benefits for high-blood pressure, neurocognitive diseases and pulmonary conditions.

Emerging studies have found a protective effect for cardiovascular disease with regular sauna use for both men and women. It turns out, the more you use the sauna the better. More time spent sweating it out, the more health benefits!

Need any more reasons to hop in the sauna?

Sauna use has also been associated with increased net protein synthesis. This is why amenities such as saunas and steam rooms have become more common place in gym and fitness facilities. After your workout may be the best time to jump in the sauna and here’s why:

1. Intense short-term heat exposure stimulates the production of heat shock proteins that reduce muscle degeneration cause by oxidative stress.
2. Produce Growth hormone for increased lean muscle mass.
3. Increased NO (nitric oxide) availability to promote blood flow and circulation.
4. Decrease inflammatory pathway activity and free radical production.
5. Improve insulin sensitivity, allowing your body to utilize glucose more efficiently.
6. Enhance the production of BDNF (brain derived neurotropic factor) which synthesizes new brain cells.

Essentially, saunas stimulate the bodies autonomic nervous system in order to maintain a constant core body temperature in extreme heat. Short durations of heat stress induces adaptive mechanisms similar to exercise and have profound physiological effects.

It has also been found to help with anxiety, depression and improve parasympathetic function! Who doesn’t want a little extra mental clarity in their life.

For any questions or comments please email me at drkyle@forwardhealth.ca and be sure to follow my Instagram and Facebook page @drkylearam.

References:

Hussain, J., & Cohen, M. (2018). Clinical Effects of Regular Dry Sauna Bathing: A Systematic Review. Evidence-based complementary and alternative medicine : eCAM, 2018, 1857413. doi:10.1155/2018/1857413

Laukkanen, T., Kunutsor, S. K., Khan, H., Willeit, P., Zaccardi, F., & Laukkanen, J. A. (2018). Sauna bathing is associated with reduced cardiovascular mortality and improves risk prediction in men and women: a prospective cohort study. BMC medicine, 16(1), 219. doi:10.1186/s12916-018-1198-0

Dr. Kyle: Cracking Down on Low Back Pain

 

2 people with low back pain attempt 10 minutes of moderate exercise on an elliptical machine. One reports that the pain is better. The other reports that the pain is worse.

What’s the deal?

It turns out that one of the main predictors of stubborn low back pain is hip mobility. You may have heard of the term “hip hinge” before, and this refers to bending at the hips while keeping a neutral spine. Elliptical machines in particular work the gluteal muscles group and keep the spine relatively straight.

When restrictions in the hip develop, the body is unable to “hinge” properly and the low back folds forward to compensate. Over time this repetitive flexion of the lumbar spine causes accumulative stress that is linked to pain!

Could it be serious?

If the pain intensity does not change with alterations in posture, loads and movement, it may not be mechanical in nature. Some “red flags” that may indicate something more serious include:

• Bowel or bladder incontinence
• Numbness in the groin region
• Unexplained weight loss
• Low back pain with fever
• Progressive and constant low back pain

Once these red flags have been ruled out and your back pain has been deemed mechanical in nature, it’s time to develop a plan of management.

What to Do

The first step is to remove aggravating factors. If your back pain is worse bending forward, stop bending forward. If your back pain is worse bending back, stop bending back. To a point. The trick is to find that pain free range of motion and to work within it.

Train the hip hinge! A major part of the process is cueing patients to bend at the hips and not with the low back. This will keep the back straight and reduce shearing forces through the spine.

Next, we train the exercises or movements that take the pain away. For many this involves abdominal bracing to stabilize the spine. A few key exercises include:
• Modified curl up
• Bird dog
• Side plank

Fine Tuning

The final step is to develop strength and endurance. Try to include exercises that challenge one side of the body at a time. This includes lunges, suitcase carries, and one arm rows.

As always, consult the expertise of a registered healthcare professional before starting a strength and conditioning program. Check out my Instagram page @drkylearam for more videos of exercises to prevent low back pain. It’s time to get you out of pain and back on the elliptical!

Dr. Kyle: Symptoms, Causes and Treatments for Tinnitus and Vertigo

 

Feel like the room is spinning around you? This may be a sign that you are experiencing vertigo, a common disorder characterized by dizziness.

Vertigo is typically a result of damage or disease affecting the inner ear. The most common form of vertigo is Benign paroxysmal positional vertigo (BPPV). BPPV manifests as sudden, short lived episodes of vertigo elicited by specific head movements. This is caused when crystals or debris break off and become dislodged in the semicircular canals in the inner ear.

The semicircular canals in the inner ear provide our brain with information on where we are in time and space. In other words, they allow us to know which was is up, down and side to side. When particles accumulate in the canals, they disrupt our ability to detect head position. This leads to the sensation of the room spinning around you.

Often times, vertigo is accompanied by ringing in the ears. This irritating noise is known as tinnitus. Tinnitus can occur when microscopic hairs in the inner ear become damaged, sending impulses to the brain that are perceived as noise. Tinnitus can also be caused by temporomandibular joint dysfunction and turbulence in the carotid artery or jugular vein.

Who is most at risk for developing vertigo?

Risk factors include:
• Increased age (>50)
• Head trauma
• Migraines
• Infection
• Neurological conditions

Vertigo can be very scary and debilitating, especially when you have no idea what is going on. Fortunately, there are some treatment methods that may work for you!

• Education and reassurance!
• Particle repositioning maneuvers (if it is BBPV)
• Medication
• Diet and lifestyle modifications

Other forms of vertigo such as Meniere’s disease can be treated with vestibular rehabilitation, hearing aids, positive pressure therapy, or medications used to reduce fluid retention and nausea. Unlike BPPV, Meniere’s disease is caused by abnormal amounts of fluid in the inner ear. Fluid build-up can be cause by anatomical variation, infection and genetic predisposition

All this said, the exact root cause of Meniere’s disease is not entirely understood. This has made diagnosis and treatment protocol inconsistent among health care professionals. Some doctors have tried conservative approaches such as anti-inflammatory supplementation and manual therapy. Other practitioners will recommend invasive surgery if symptoms are severe and persistent.

If you or someone you know is suffering from vertigo and tinnitus, please advise them to seek medical attention. A medical doctor or chiropractor can help determine the cause of your dizziness and assist you in getting the best care possible.

References:

Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. 2003 Sep 30;169(7):681-93.

Hilton MP, Pinder DK. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database Syst Rev. 2014 Dec 8;(12):CD003162.

50. Cohen HS, Kimball KT. Effectiveness of treatments for benign paroxysmal positional vertigo of the posterior canal. Otol Neurotol. 2005 Sep;26(5):1034-40.

Ménière’s disease. Vestibular Disorders Association. http://vestibular.org/menieres-disease. Accessed Nov. 1, 2018.

Dr. Kyle: Diet Do’s and Don’ts for 2019

 

Looking to start a new diet in 2019? Here are a few tips on what to avoid and what to incorporate into your nutritional regime this year.

FATS ARE GOOD

The human body is designed to process and burn fats as one of its primary energy sources. Fat enhances food digestion and nutrient absorption. Accompany sides of vegetables with a fat source to increase nutrient bioavailability.

Try cooking with animal fats, organic grass-fed butter and coconut oil. Avoid trans fats and poly-unsaturated vegetable oils like canola oil.

Add some wild-caught salmon into your diet to balance out the ratio of omega-3’s to omega-6’s. The typical western diet has an abundance of omega-6’s so eating salmon 1-2 per week will boost your levels of anti-inflammatory omega-3’s.

DON’T SHY AWAY FROM CHOLESTEROL

Cholesterol is vital for the synthesis of hormones and vitamin D. It also helps form cell membranes and other structural components.

Eat whole foods and at least 1 yolk with your egg whites. This will give you a better nutrient profile and a healthy dose of cholesterol.

RED MEATS

Red meats have almost everything you need to not only survive but thrive. They are one of the most micronutrient dense fuel sources on the planet. Red meats are high in b-vitamins, iron, zinc, magnesium, and creatine.

Red meat also includes Lamb! It is an excellent source of heme-iron as well.

GET YOUR PROTEIN

It is most commonly recommended that daily intake should be 1g of protein per pound. Older athletes will need more due to less efficient protein absorption.

Keep in mind that dietary needs will fluctuate based on physical demands and training goals. Athletes trying to put on mass should eat 40g before bed to maintain protein synthesis throughout the night.

20g per meal will provide 90% of muscle protein synthesis. 40g will provide 100%.

Carbohydrates

Some carbs are better then other! So, we want to pick the right ones.

Avoid refined sugars (obviously). Include variation and eat 2 forms of carbs at a time for faster absorption. I recommend sweet potatoes, spinach, red peppers and carrots. These foods have plenty of micronutrients and produce low levels of gas.

Add a side of white rice to your meat and vegetable dish. White rice is easy to digest, and can help supplement your macronutrient intake. Oats on the other hand can be hard to digest – soak them in warm water overnight or add yogurt.

Remember, carbohydrates are used to fuel workouts! Getting adequate carbs to sustain your athletic performance will protect against muscle tissue breakdown.

As always, ask a healthcare professional for dietary recommendations that best suit you. Some foods that work well for others may not sit well for you. Listen to your body.

Stay healthy and good luck achieving all your health and wellness goals for 2019!

Dr. Kyle: Debunking the Salt Myth

Do you pay attention to how much sodium you take in?

Maybe you should!

It turns out that sodium may not be as bad as we previously thought. In fact, sodium is essential for many metabolic processes. Sodium is responsible for regulating blood pressure, maintaining blood volume and is required for neuron function and signal transduction.

Many believe that high (or adequate) salt intake will lead to high blood pressure. Most cases of hypertension are actually a result of genetics or stress. A small percentage of the people who are sodium sensitive may experience an increase in blood pressure, but an overwhelming benefit for the rest of the population cannot be ignored.

Sodium has several benefits including:

• Increased performance
• Increased stamina / endurance
• Increased blood volume
• Increased recovery

During high intensity exercise, the body actually responds better to a higher blood volume. This improves delivery of oxygen and nutrients to the working cells of the body. High blood volumes are also optimal for kidney filtration and removal of toxins and metabolic waste products.

Low dietary sodium and elimination diets can have detrimental effects for high performance athletes. Low salt intake will decrease overall blood volume, making the blood thicker. This can cause muscle weakness, cramps and lethargy.

What Type of Salt?

I recommend iodized salt. Iodine helps with thyroid function and regulates metabolism. Unbleached, pure Himalayan salt is also a good option.

So if you are hitting a wall during your workout it may be due to sodium depletion. Bottom line, make sure you are drinking plenty of water, eating sufficient carbs for your training needs, getting a balance of micronutrients from a variety of whole foods, and don’t be afraid to sprinkle a little salt on your meals every once in a while!

Dr. Kyle: Sport Injury Rehabilitation

 

There are many factors to consider before clearing an athlete to return to sport. Time since injury, improvements in range of motion and increases in joint stability are all good metrics to evaluate before giving an athlete the green light.

Many rehabilitation programs focus primarily on enhancing maximal muscle strength. Current research suggests that Rate of Force Development (RFD) may actually be a better predictive factor in determining whether an athlete is ready for sport.

Common athletic maneuvers such as pivoting, jumping and stop-and-starts require rapid stabilization of the joints in the lower limb. This requires almost instantaneous muscle activation to prevent joint displacement and avoid re-injury. Factors such as neural activation, fiber composition and muscle contractile properties influence RFD and the body’s ability to absorb load on the joint. Therefore, it may not matter how strong the muscle is, but rather how fast the muscle can fire.

So how might this change rehabilitation programs?

Most physical rehabilitation protocols help build strength but fail to include an explosive component. Because athletic demands are often variable and unpredictable, it is important for the muscles to be able to react to any situation. Incorporating explosive plyometric exercises and a variation of sport specific drills will improve RFD and prevent future injury.

Take home points for sport-injury rehab:

• Allow sufficient time to for healing process to occur
• Recover full range of motion and flexibility
• Progressively overload the muscle to build strength
• Explosive training to enhance ability of muscle to generate force rapidly.
• Incorporate plyometric and sport specific drills to complement athletic demands.

As always, the best way to stay in the game is to avoid injury in the first place. So don’t wait for the pain to start before implementing an effective strength AND conditioning program.

If you or someone you know is suffering from a sport injury, call and book an appointment today for a complete musculoskeletal assessment!

 

Reference:
Buckthorpe, M., & Roi, G. S. (2018). The time has come to incorporate a greater focus on rate of force development training in the sports injury rehabilitation process. Muscles, ligaments and tendons journal, 7(3), 435-441. doi:10.11138/mltj/2017.7.3.435

Dr. Laura on Mould and Indoor Air Quality

Mould is very important factor in indoor air quality. If you are chronically ill and can’t seem to shake it, test the places you spend time.

Mould Related Health Issues

  • nasal stuffiness
  • throat irritation
  • coughing or wheezing
  • eye irritation
  • skin irritation

The Centre for Disease Control and Prevention  is firm about the removal of any visible mould. Health impacts vary from person to person. Mould, once inhaled, can grow in the lungs and upper respiratory tract. It also has the potential to spread through the rest of the body.

Where is Mould found?

Mould is found where there is moisture, on just about any surface and can be tracked from place to place. Be sure to check basements, bathrooms, laundry room, kitchen, roofs and around leaky pipes. A professional can be hired to investigate anything beyond a visual check. Or if you are up to it, there are some at home kits available. The Amazon DIY Mold kit (Americans spell it without the “u”) or try the Canadian option, which includes air tests at http://www.CanadaMoldTestKits.com‎ (they must sell to Americans!)

What’s the proper indoor humidity?

Too dry and your nasal passages can dry out and make you more susceptible to infection. Too humid and the dampness can be a breeding ground for mould and mildew.

Indoor humidity should be kept around 45-50%.

A humidity reader, also called a hygrometer, is available at any local hardware store. Review and compare some of the best hygrometers evaluated in 2018.

De-humidfiers are helpful in damp spaces. Their filters should be kept clean and collection bins rinsed with white vinegar every couple of weeks. Humidity in Ontario is generally higher spring through fall and drier once the indoor heating starts.

 Health issues persist?

Long term exposure to mould means you need some serious detoxification. If health related mould issues persist, a visit with Dr. Laura may help you clean up the damage and get clear of the problems.

Dr. Laura M. Brown, ND

Dr. Kyle: Can Changes in Weather Predict Pain?

 

 

I always thought my grandma was crazy when she’d say I can “feel” a storm coming as she’d rub her knees. To my surprise, her knees were often better at predicting the weather than our local news. How come?

It’s believed that changes in barometric pressure can lead to increases in musculoskeletal pain. In particular, for individuals suffering from osteoarthritis. But what’s surprising is most of the research is either inconclusive or there’s little evidence to support these claims.

After hearing a number of my patients describe similar changes in pain levels due to the changes in weather, I thought I’d take a further look at these claims.

In one survey by Von Mackensen et al., one to two thirds of patients with rheumatoid arthritis believed their symptoms were weather-sensitive (1).

Other studies found an increase in barometric pressure or a drop in ambient temperature are both associated with an increase in pain (2).

At first glance it appears there may in fact be some credible evidence to support this strange phenomenon, but why?

Joint Pain in Scuba Divers

Have you ever swam to the very bottom of a pool in the deep end and felt your ears pop? This sudden change in pressure is similar to what scuba divers experience but on a smaller scale.

Sudden changes in tissue gas tension surrounding the joints can cause fluid shifts and interference of joint lubrication. When divers go deep, their joints may hurt as there’s not as much fluid surrounding their joints. This becomes worse if severe osteoarthritis exists (3).

Why Your Joints Hurt More on Colder Days

Colder temperature and its association with increased pain is much easier to explain. We know that cold temperature reduces inflammatory markers, changes the viscosity of the fluid in our joints, and can decrease the strength and support of our muscles around joints (4). Patients tend to experience more severe joint pain during the cold winter months.

Show Me Your Search History and I’ll Diagnose Your Pain

I still recommend an in-person consultation but we’re close to this becoming a reality. A recent study found an association with local weather and rates of online searches for musculoskeletal pain symptoms.

Searches for arthritic related symptoms are significantly more common in climates closer to -5 degrees Celsius than 30 degrees Celsius. Although this doesn’t explain WHY osteoarthritic patients suffer more pain, it gives us a better idea of WHEN they experience worse symptoms and under WHAT conditions (5).

Well there you have it folks. There are still many uncertainties and unknowns on why joint pain increases when the temperature drops or pressure rises. But if you can sense the next snow storm or torrential downpour from your knees and not the news, you may be experiencing some underlying osteoarthritis.

1. Von Mackensen S, Hoeppe P, Maarouf A, Tourigny P, Nowak D.
Prevalence of weather sensitivity in Germany and Canada. Int J
Biometeorol. 2005;49(3):156-166.

2. McAlindon T, Formica M, LaValley M, Lehmer M, Kabbara K.
Effectiveness of glucosamine for symptoms of knee osteoarthritis:
results from an internet-based randomized double-blind controlled
trial. Am J Med. 2004;117(9):643-649.

3. Compression pains. In: US Navy Diving Manual. Revision 4 ed. Naval
Sea Systems Command; U.S. Government Printing. 1999:3-45.

4. Golde B. New clues into the etiology of osteoporosis: the effects of
prostaglandins (E2 and F2 alpha) on bone. Med Hypotheses. 1992;
38(2):125-131.

5. McAlindon T, Formica M, Schmid CH, Fletcher J. Changes in barometric pressure and ambient temperature influence osteoarthritis pain. The American journal of medicine. 2007 May 1;120(5):429-34.