Testosterone isn’t just the male hormone—it’s essential for energy, focus, libido, muscle growth, and overall vitality. But here’s the problem: men’s testosterone levels are plummeting at an alarming rate. Even more shocking? Young men today have lower testosterone than their grandfathers did at the same age. If you or a man in your life struggles with low energy, brain fog, or a dip in drive, this episode is a must-listen.
I’m joined by Dr. Geo Espinosa, a leading expert in men’s health, to break down the truth about testosterone—what actually affects it, what labs your doctor isn’t ordering, and how to optimize it naturally. We also dive into the role of estrogen in men, the biggest mistakes men make when trying to increase their testosterone, and the best foods and supplements for testosterone support.
We’re breaking down everything you need to know about how to increase testosterone naturally, including the best foods, supplements, and lifestyle changes to support optimal hormone balance. Here’s a deeper dive into what we cover:
Grab my free Hormone Friendly Recipes
If you’re ready to optimize testosterone naturally and learn the latest science-backed strategies, this episode is for you! Hit play now and share this with the men in your life.
Dr. Espinosa: [00:00:00] You actually need a good amount of estrogen for men to have libido or sexual desire. So it's not only testosterone that helps with desire, estrogen or estradiol helps with desire. In western medicine, when you look at the research, it actually shows that, um, when men don't ejaculate enough, there is an association with prostate cancer.
Dr. Brighten: Is it true that men have about half the sperm count as generations before them? No.
Narrator 2: Dr. Gio Espinosa.
Narrator 1: is a groundbreaking naturopathic functional medicine doctor and one of the world's foremost authorities on men's health and urology.
Narrator 2: As the first naturopathic physician to complete an internship, residency, and fellowship in urology at Columbia University,
Narrator 1: Dr.
Espinoza has revolutionized how men approach their health.
Narrator 2: A prolific researcher and published author, he has contributed extensively to scientific literature and is the author of the best selling prostate cancer guide, Thrive Don't Only Survive.
Narrator 1: As clinical assistant [00:01:00] professor of urology at New York University Grossman School of Medicine and co founder of XY Wellness,
Narrator 2: Dr.
Espinosa continues to lead the charge in integrative, science backed solutions for men's health.
Dr. Espinosa: One of the things I do in most men is actually do a semen analysis. Even if they're not coming for fertility issues, that's sort of a barometer to their overall health. And one of the things that lowers testosterone is
Dr. Brighten: We're seeing a lot of media, testosterone is lower in men who are, you know, in their 20s have lower testosterone than men in their 40s.
What's going on?
Dr. Espinosa: I don't want to oversimplify it, but
Dr. Brighten: Welcome back to the Dr. Brighten Show. I'm your host, Dr. Jolene Brighten. I'm board certified in naturopathic endocrinology, a nutrition scientist, a certified sex counselor, and a certified menopause specialist. As always, I'm bringing you the latest, most up to date information to help you take charge of your health and take back your hormones.
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Dr. Geo Espinoza. Welcome to the podcast.
Dr. Espinosa: Thank you so much. Thank you for having
Dr. Brighten: I am so excited. Now, for everybody listening, uh, this has been highly requested, because all the ladies in my [00:03:00] audience are like, I need the info for my hubby or the man in my life.
So we're going to talk testosterone today and how to optimize what gets called the male hormone. Women have it as well, but we are specifically applying this to the male body.
Dr. Espinosa: Right, right.
Testosterone, you know, is the male hormone only because it's significantly higher in men, right? And, um, it very, very, uh, everyone, many people are still confused about it. Including clinicians, honestly. So,
Dr. Brighten: you teach doctors.
Dr. Espinosa: right, that's right. Um, you know, we're at a perfect conference here where they talk a lot about it.
And again, there's a lot of misinformation out there. So, why don't we, you ask questions and I'll answer if I can.
Dr. Brighten: you know I'm going to.
What are the biggest myths around testosterone
Dr. Espinosa: That total testosterone is everything. Okay. So, this is a blood panel. Total testosterone is not everything. What should the people look for instead?
test result is not everything, what should [00:04:00] people look for inside?
just,
I mean, just yesterday, clinically, or the day before where a patient going to
Dr. Brighten: 200.
Dr. Espinosa: he feels low libido. Things are not right. What's happening. He doesn't have enough free testosterone.
The magic is in the free testosterone. You could have 3000. Testosterone. If the percentage that's free is below
Dr. Brighten: Mm-hmm . It,
Dr. Espinosa: it's not going to do what it's supposed to do.
Dr. Brighten: And how will people feel if their testosterone's too low?
Dr. Espinosa: They feel like if they have, um, low libido, low desire, a little bit more like a mental fatigue, a little less of a zip in their step. Actually, that's the way they describe it. Um, you know, executive decisions are, you know, they lag a little bit,
Dr. Brighten: Mm-hmm
Dr. Espinosa: those kinds of things.
Dr. Brighten: Yeah. And that's an important thing to note because whenever we talk about executive function, people go right to neurotransmitters, not recognizing that there's such an interface between hormones and neurotransmitters in the [00:05:00] brain.
Dr. Espinosa: 1000 percent, you know, dopamine and testosterone, they're like, you know, right there next to each other. And the receptors are right there next to the brain in the brain. Um, so that's a, it's a very important, um, component. Um, yeah, and just general like fatigue, uh, that's abnormal to them, right? That they just, you know, that, that's the way they describe it anyway.
Okay,
Dr. Brighten: Okay, so we don't want to look at just total testosterone.
We want to look at free testosterone. Are you also looking at sex hormone binding globulin?
Dr. Espinosa: A thousand percent. So, um, that is the thing. So sex hormone by binding globulins attached to the testosterone really tightly and doesn't free it up.
So you want to do things that may, um, modulate that. You still need it because you don't want to have, you know, 5 percent free testosterone. Men will go
Dr. Brighten: crazy or high estrogen 'cause that's gonna be a problem. so that's
Dr. Espinosa: so that's the second myth. Yeah. Yeah. We could go to that if you want.
Dr. Brighten: Yeah. Okay. Let's, let's talk about what to do about modulating sex hormone binding globulin and then let's get to the estrogen.
Dr. Espinosa: So, um, high carb intake, [00:06:00] um, elevates, uh, SHBG because it's made in the liver and all kinds of liver things happen when there's insulin resistance and those kinds of things. So a high carb diet is not good for many things, simple carbs, um, but certainly not good for, um, SHBG, uh, have, you enough SHBG in the body.
That's number one. Number two is, um, you know, there's some, um, herbals, um, unless you want to go there now, we could wait towards, so we could discuss all the herbals that, you know,
Dr. Brighten: no, let's talk about it in context of sex hormone binding globulin. So,
Dr. Espinosa: one of the ones that, um, It's used for prostate problems. Typically it's nettle root
Dr. Brighten: Mm hmm.
Dr. Espinosa: So a lot of formulas with testosterone have them.
But the thing is that they have nettle leaf. It's not the leaf is the root. So buyer beware, right? Um, they need to take nettle root and I would not do it in a, in a formula. They need to take enough of it somewhere between. 500 and 1000 milligrams a day in order to modulate s H B G. So [00:07:00] they have enough free.
Dr. Brighten: Mm hmm.
Dr. Espinosa: Um, and, um, also Tongkat Ali has a lot of benefits. Um, that's the name that's known in the brand name. Yeah. Yeah. and one of them is that it lowers I say, or modulates SHBG, I should say. If it's already very low, it's not going to lower it more than that. So those are the two biggies, I think, in the herbal world that can help with that.
Dr. Brighten: Okay. So if your sex hormone binding globulin is elevated and your free testosterone is low, but your total is looking fine, these are a couple of things that people can use to bring down that binding protein and so that they can optimize that free
Correct.
All right. I love that. Yeah. Let's talk about the myth around estrogen.
Dr. Espinosa: The myths are on estrogen right so with men as it relates to men is how low can we go right they take um, These aromatase inhibitors drugs like an astrozole and it's provided in many clinics.
That's a problem. Why?
Dr. Brighten: You
Dr. Espinosa: actually need a good [00:08:00] amount of estrogen for men to have libido or sexual desire. So it's not only testosterone that helps with desire. Estrogen or estradiol helps with desire. Aside from the fact that estradiol in men helps with bone health, just like it does with women. So, the myth of low or better is a bad
Dr. Brighten: Mm hmm.
Dr. Espinosa: what do you do? I like my ratios to be around 20 to 1 or 40 to 1, total testosterone to
Dr. Brighten: Mm hmm,
Dr. Espinosa: right? Um, as an absolute value on estrogen, give or take, I like that to be 20 to 30 nanograms per per milliliter, men. Right? Obviously, it's much higher in women, right?
Dr. Brighten: and depending on where you're at in your cycle.
Dr. Espinosa: your cycle.
C correct. for reminding me. It's been a long time.
Dr. Brighten: I know. I
Dr. Espinosa: the last time I saw a female hormone panel, I think I was still in school, actually. Like, over 20 years
Dr. Brighten: know what we [00:09:00] need, we need, like, we should have had like, um, you know, like little headbands or something with like ovaries over here and testes over there.
Dr. Espinosa: That would, that would have been cool.
Maybe you could create one like, you know, you could do anything with AI yeah, I'd be serious. I
that would be cool.
Dr. Brighten: But yeah, I'm like, this is the testes talk, this is the ovaries talk. Well, it's interesting because you, you brought up the fact of estrogen being involved in sexual desire and we see the same is true for women.
In fact, when estrogen is involved. It's optimized. Women will have more fantasies. So this is where I'll say to people, like, if you ever catch yourself and you're in the grocery store and suddenly you're like, Oh, I'm like in the mood, I'm like checking out this magazine or you're scrolling social and you're like, Oh, I'm like feeling something.
Usually you're around ovulation. Usually your estrogen is up.
Dr. Espinosa: Oh, good to know.
Dr. Brighten: Yeah. I have many
Dr. Espinosa: women in my life, a wife and two daughters. So I don't think I want to have that conversation with my daughter there.
I don't think that's a good look. I don't think I want to do that. You're like, are you still store?
Dr. Brighten: cringed.
Dr. Espinosa: Exactly, I [00:10:00] see you looking at that magazine a little too hard. What are you doing in that magazine right there?
Dr. Brighten: Oh, okay. So estrogen, men need estrogen too. You talked about the ratios, which is perfect. I'm curious what, you know, we're seeing, and is it true? We're seeing a lot of the media say testosterone is lower in men. Like men who are, you know, in their twenties have lower testosterone than men in their forties.
What's going on?
Dr. Espinosa: What's going on? Man, that's true. And it's a, and it's a, uh, I think it's a, it is a phenomenon that is concerning. Yeah. Right? So we, I'm talking about men, um, in their 30s. I've had a few in their 20s with, I mean, this is unheard of.
Yeah. What's going on? Um, I don't want to oversimplify it and I know we don't have that much time, but I think that, um, is a combination of, uh, too many, uh, chemicals that are estrogenic in the plastics and, um, cans and things like that, even receipts when they, you know, that's why I think men should, you know, [00:11:00] not get a physical receipt.
Because there's estrogenic compounds in what makes the receipts so slippery and Yeah. uh, that, you know, it's absorbed in the skin. Um, so I think that's number one. So a lot of it is, uh, or some of it is environmental.
The other is that, um, honestly, a lot of these guys are just overweight. Um, they're in a basement somewhere, uh, playing video games and ordering Uber
Dr. Brighten: Gamer life is not good for your T.
Dr. Espinosa: Well, exactly. I mean, you just, so what happens when that man has a lot of body fat, uh, there's a lot of, um, what's called aromatization in the body fat where it turns testosterone into estrogen. So while I always say, uh, on average, I never bring down to step test, um, estrogen. in a man, um, that ratio is not 20 to 1 or 40 to 1, uh, in some of these guys.
It's like, you know, 10 to 1 or 9 to 1 or 8 to 1. So what's the goal there? They're bring down estrogen? No, bring up testosterone. [00:12:00] That's the way you do that. And then, so that, that's part of the issue. Um, they have, I don't know, that's the fact that they're, Uh, you know, they're not moving their bodies and not exercising.
They don't have enough muscle. I mean, some of the guys that come to my office and 28 years old, um, they have like 40 percent body fat. Um, so that's the other issue. Um, uh, metabolic syndrome, right? Uh, so they have all kinds of metabolic dysfunction, insulin resistance, hypertension, big, big waste, all these things contribute to it.
Dr. Brighten: Is it true that men have about half the sperm count as generations before
Dr. Espinosa: A thousand percent. Yes. Yes, it's a significant decline in sperm count, in sperm health, mobility, uh, every element, uh, of, of that. And, and I can say that, um, with a lot of confidence because one of the things I do in most men is actually do a semen analysis.
Even if that, they're not coming for fertility issues. You know, that's, um, that's sort of, that's sort of a [00:13:00] barometer to their, Overall health and there's a lot of research to support that
Dr. Brighten: Yeah, I actually, uh, say that quite a bit as I've been on a fertility journey is that I'm like, sperm is, if we could only analyze women's eggs, like we could have so much data about their overall health, but like this is one parameter I don't think is actually tracked and measured enough.
Until there's been a diagnosis of infertility in a woman.
Dr. Espinosa: Correct. So yeah, I do a semen analysis on most men that come to my office as a general, as a biomarker,
Dr. Brighten: Mm hmm. And what parameters are you looking for?
Dr. Espinosa: for?
I am looking for amount of sperm cells that are produced, that are active, that they look right, Mm hmm. They're
Dr. Brighten: They're not
Dr. Espinosa: They're not mutants. three heads and they're going in different directions, you know, those kinds of
Dr. Brighten: kinds of things. So when it comes to low testosterone, so we're seeing the environmental factors, we're seeing lifestyle factors. What are the interventions? We're going to talk about herbs, but I assume there's [00:14:00] some foundational things that you recommend to all patients who want to optimize their testosterone.
Absolutely.
Dr. Espinosa: So, sleep is important, right? So, I need them to at least spend an average of 90 minutes or so a night in REM. Right? So, they all have their wearables of one kind or another, and we look at that, and they need to be in REM. REM is where the testosterone is actually produced
produced
Um, um, so, so, that's key.
Dr. Brighten: How do people get into REM sleep?
How can you, like, optimize your sleep habits so that you can hit that?
Um,
Dr. Espinosa: Uh, When you exercise in the
Dr. Brighten: Ah, it all comes back to exercise.
When you exercise in the morning, you hit more REM at night. And particularly if you do more outdoor things in the morning, the circadian rhythms start working where you get some sunlight, hit your eyes, and so forth. That starts the process, the circadian process. Where now, later on at night, you hit, you know, You get more REM
I love that. So if you want good REM [00:15:00] sleep at night, you hit it in the morning. Hit
Dr. Espinosa: it in the morning. At night. Those digital devices, you gotta, yeah, you gotta put those away. Um, they, they are digital de device. I mean, look, here we are, this is probably gonna be posted everywhere, right? So
Dr. Brighten: I know! We're like, don't look at us.
Dr. Espinosa: no, not right now. Not right now. It's 11:00 PM Put that away tomorrow morning. Uh, right. Um, you know, it's a problem, right? They, by the way, that's also a problem with, um, when we talk about what's the, you know, overview of overall problem is digital devices, not only gaming, but just, you know, they're not going to sleep.
They're not sleeping as a result of being, you know, connected to connected, uh, overnight. So, um, so yeah, that's, uh, that's, uh, I mean, magnesium at night, also all kinds of things. That seems to help. Um, and enough sleep at night. I have not seen either a study or a case that if you get, you know, if you, if you get four hours of sleep of night, a night, there's [00:16:00] enough REM there.
It's just not possible. Um, so my understanding, and even my, you know, With myself, um, you need at least six hours of sleep a night. Yeah. I'm clearly talking as a New Yorker because some people say, That's it? Six? Why not seven or eight? There's no New Yorker that sleeps more than six hours a night. That I know anyway.
Dr. Brighten: could never live there. I'm a nine hour a night person.
my goodness. And you do so much. So that's admirable.
I'm very productive because I get those nine hours of sleep. Yeah. But I mean, when you, the, you know, it was so interesting this year that a study finally came out being like, Oh yeah, women actually need more sleep. And to recognize that men can get by on six hours of sleep, women, when follicular phase and testosterone's riding, you know, with estrogen, we might be able to get away with it.
But luteal phase, not, it's nine to 10 hours. Like that's what you need to feel recovered. You talked about
Wait a a [00:17:00] minute, one more question. Let's reverse this. So how about women on menopause? Is it still the same story or
Well, see, here's the thing. thing is that a lot of women going through menopause aren't sleeping well because their progesterone is gone and they may still be having hot flashes.
And so we're just working to get them optimized and to get their sleep optimized. But I mean, spoiler, we haven't done enough research in menopause altogether, but certainly not on the sleep component. But it is something that, you know, When you look at the sleep studies and you, um, you remember IFM had an entire sleep conference and I remember, um, there's the praising over and over of naps and like how good it is.
So even if you don't get, you know, that eight hours every night, if you're napping during the day, that does contribute to longevity as well.
Dr. Espinosa: I love it.
Dr. Brighten: Yeah. But I want to go to the You mentioned exercise. So if somebody wants to optimize their testosterone, we want to exercise in the morning. What's the best type of exercise.
Dr. Espinosa: There's no way around it. It's weight resistant to exercise. [00:18:00] Um, because so a lot of people think that, um, you raise testosterone when you lift, uh, weights, particularly big muscles. So
Dr. Brighten: that's
your
Dr. Espinosa: chest, your back, your lower extremities. You raise testosterone. That actually happens acutely. The other element, maybe a third myth. Hmm. Maybe we can call it a third myth. Um, uh, the, the other element that's important. It's not, okay, so we know you need to have eating a free testosterone, about two, about two percent. We know you need a good ratio between total and estradiol. But the other thing is that it, those receptors, if they are not healthy and dense and ready to connect with the testosterone, it ain't happening.
So what studies show is that, yes, it increases testosterone acutely, But it actually strengthens those receptors, those androgen
Dr. Brighten: Yeah,
Dr. Espinosa: So from a receptor perspective, these are guys, this is a guy, it's beautiful. This is a guy who has great total, 2 [00:19:00] percent free, great ratios. I don't feel That's a receptor issue.
Dr. Brighten: Okay.
Dr. Espinosa: That's a receptor issue.
Dr. Brighten: that's a lift weight
Dr. Espinosa: a primary as best as I know. Yeah, that's a, you gotta, you gotta push and pull something heavy Mm and about two or three times a week and particularly big muscles, you know, uh, bicep curls is not doing it.
Dr. Brighten: Okay.
Dr. Espinosa: You could bicep curls to the cows come home. That's not doing it. You need back and legs.
So whatever deadlift squats bench Press pull down something like that. Yeah,
Dr. Brighten: Maybe this is a myth. I would, I'm curious your take. There are men who will avoid ejaculation because they say it will lower their testosterone.
Dr. Espinosa: Yeah,
that's a myth
Dr. Brighten: Okay.
Dr. Espinosa: that's a myth. Maybe that comes from
Daoism.
Dr. Brighten: right
Dr. Espinosa: what I learned when I did my training and Chinese medicine
Dr. Brighten: as well And,
Dr. Espinosa: And I'm like, there's something wrong with that. And, uh, there's something wrong with that concept, with that
Dr. Brighten: Yeah.
Dr. Espinosa: Um, in Western medicine, when you [00:20:00] look at the research, it actually shows that, um, when men don't ejaculate enough, uh, there is an association with prostate cancer.
Dr. Brighten: hmm. Right? What is it? Is it 21 times a month? Yeah.
Dr. Espinosa: everybody seems to remember that
Dr. Brighten: No you want to know, you want to
know it's want to meet the men. I want to meet these guys with 20. They must have, I want to meet them, check their prostate.
Dr. Espinosa: I mean, let me, how do you, how? But yeah, that's what, that's what it
Dr. Brighten: to tell you. I remember where I was when I learned that.
I was in Amsterdam staying at this Airbnb and I can remember the wallpaper. I can remember everything about learning that. And I was like, cause I'm married to a man. And I'm like, let's save your prostate. See
Dr. Espinosa: See, if women knew that they're actually doing something therapeutic for their men, You know, there would be more intercourse and more quality of life, if their estrogen's optimized, then like it's a win-win. Right.
right? I tell you, I interview, uh, I interviewed on my podcast, Minhaj Siddiqui.
Dr. Brighten: Sidiki. Mm-hmm I [00:21:00] interviewed him on prostate cancer. Then I look at that paper of the 21 times a month. He's the author. He's the primary Oh, yeah. didn't and I and so when I did some research on dr Siddiqui that paper came up. He was a resident when he wrote that paper. And so what he wanted to do is say, okay There's already a paper written that Men who don't ejaculate enough or yeah ejaculate enough They have a higher increase of prostate cancer
yeah,
Well,
Dr. Espinosa: If you live long enough, any man will have prostate
Dr. Brighten: Mm hmm.
Dr. Espinosa: What he wanted to know is What's the, what's the association with advanced prostate cancer, the, the type that can actually kill you. And then, so that's the paper that he wrote about, uh, 21 times a month. So, yeah, that's apparently what it's about
Dr. Brighten: Yeah. Well, and I often will get asked by women, like, what's enough?
Because the reason, you know, there's research on longevity, on optimizing inflammation, like so much about, you know, sexual health and women will say like, well, what's enough? What's enough? Like men, we have this like 21 number, [00:22:00] but the thing I always say for women is it's enough that both partners feel satisfied.
Men can handle themselves if they want to hit the Well, they have to sometimes I mean, there's very few partners that are I mean, I know they're they're It's very interesting. Uh, you would think that many of the people that come see me is like the male the men are driving it because they're men and they Oftentimes it's their female partner saying, Hey, what's going on?
Dr. Espinosa: You need to see Dr. Geo.
Dr. Brighten: Yeah,
Yeah. Um,
Dr. Espinosa: because things are not, you know, working out. That must be a very interesting conversation, right? Because men are so, um, in that regard, uh, you know, very much, that's part of the ego. And, um, yeah. Oftentimes it's the woman that brings them in and says, You know, can you check him out?
Dr. Brighten: Well, that's why we're doing this podcast. 'cause oftentimes it's women who bring their men to health. Yeah. Who will support them, who will take them to the doctor, who will give, who will be like listening to this podcast with to hear this. Good. So I'm very curious. Herbs. What works? What is bunk?
Let's start with like, what's bunk? Like, what's out there that you're just like, I hate this. It's garbage. I wish it didn't [00:23:00] exist.
Dr. Espinosa: One of the herbs that is, um, overused right now, and they're gonna hate me, um, that seems to lower to come for us. Listen, don't come for me. Don't come for me. It's cannabis.
Dr. Brighten: Oh, okay.
Okay. It's cannabis.
To lower
Dr. Espinosa: It lowers testosterone. Yeah. Now, the good news is that, there's a, there's a dose element to it that I don't know what that is, and no one that I've spoken to knows, right? So, so if you smoke every day, Yeah. And that's, that's probably an issue, and that's an issue in many ways. Well, that's what I
Dr. Brighten: cannabis is, it shows up on the
Exactly. that's is, shows up on the list. That's one of the things that lowers testosterone. But some of the things that, so my big three, and it's going to be part of the lecture this weekend. There are a few, right? That are, that are, uh, that are up there or that people promote.
Dr. Espinosa: The big three, in my opinion, is, um, uh, Tongcat Ali,
Dr. Brighten: These are the big three herbs that work [00:24:00] for optimizing testosterone.
Dr. Espinosa: Well, Let me come back on that, right?
Dr. Brighten: okay, okay.
Dr. Espinosa: When I say optimizing testosterone, I mean optimizing functional Free testosterone Right the whole thing total free good ratios If it's not a, if it's not functional testosterone, it's not, you know, you're not, you're not going to get the benefits.
So anytime I talk about these are the herbs or these are the lifestyle, it's about functional testosterone, right? So what are those, right? So Tongkat Ali is definitely one. Um, and there's been, you know, some hype around it and, you know, with good reasons, good studies, systemic reviews. I've seen it clinically, very good.
The other is, um, um, well, the group is adaptogens. I think adaptogens are great. Why? Because, um, adaptogens like the name implies, helps the body adapt to stress and stress chemicals. Um, I know you're a big fan. Cause I follow you. I follow
Dr. Brighten: follow you.
Dr. Espinosa: Rodeola. I'm surprised we didn't name our son, Rode, for [00:25:00] Rodeola. I tried, I tried.
I mean, I'm such a fan. I'm like, he should be named Rode. Um, so Rodeola. But if I have to choose one adaptogen, it's ashwagandha.
Dr. Brighten: Oh yeah, well, ashwagandha in women has been shown to increase sexual desire and self lubrication, so I'm not surprised that you picked that one.
Dr. Espinosa: It Lowers cortisol. Mm hmm. Um, and cortisol, people love this, hashtag cortisol castrates. I was
Dr. Brighten: I was like, cortisol is a cock blocker.
Dr. Espinosa: You say, you said
Dr. Brighten: I said it,
Dr. Espinosa: you said this is your, this is your show. could say whatever you want on your show. right now but cortisol castrates, right.
So Ashwagandha has shown to lower cortisol and to actually increase, um, testosterone and free testosterone, lower estradiol, uh, if it's too high, and, um, and it helps with, [00:26:00] uh, proper. So it's good for male fertility as well.
Dr. Brighten: Um, actually
Dr. Espinosa: the studies that show the hormonal benefits are from fertility studies. So it increases sperm count and all the wonderful things that men would want to need.
Dr. Brighten: That's amazing. Okay, so what's our third one?
Dr. Espinosa: So we got Tom kind of Lee, we got ashwagandha. I think, um, um, epimedium or known as horny goat weed is very good.
Dr. Brighten: That's Such a great name,
Dr. Espinosa: It's such a great name. And the reason, actually, it's really good, men who are sexually active, just the act of being sexually active increases testosterone, so it's like what comes first. So Epimedium is probably as a result of, um, that it has this chemical in it called Icarin.
Icarin is a What's called a PDE5 inhibitor. Well, what else? What else is a phosphodiesterase 5 inhibitor? Viagra, Tadalafil, or Cialis and all those drugs. [00:27:00] So there's a little chemical in there that does exactly what some of these drugs do. The question is, you know, do you get enough vicarin from the herbs that you take?
So, So it does help in that perspective if you're able to get enough of the Icarin. Um, the herb is very expensive. To get enough Icarin, it's very expensive. So there's not a lot of good formulations out there, but as just a botanical itself, it's very good.
Dr. Brighten: You formulated your own product. Yes. Is that, is that in there?
What do you have in
Dr. Espinosa: so I, there's only so many herbs, your formulator that you can put it in a, in a product, right?
So you're looking at the bigger picture, right? So you're not just looking, there's not a drug. What is the thing that increases testosterone? All right, that's the thing I'll put in, right? I'm looking at the bigger picture from an herbal perspective. You'd be surprised. One of the things that lowers testosterone is chronic inflammation. And ginger extract in one great paper, there's only one paper has shown to increase testosterone in that pathway of lowering inflammation. [00:28:00] So ginger extract, no one would ever use any prostate in a testosterone formula. I do very successfully and we studied it and it does, it does very well. So ginger extract is actually, uh, one of my favorites, uh, in that regard. Um, and then there's other, uh, we could stick just to herbals, uh, but if I, if I want to, if we can talk about two minerals, um, boron,
Dr. Brighten: Yeah. actually
Dr. Espinosa: boron lowers SHBG, so it's more free testosterone, and zinc.
Dr. Brighten: Oh, right.
Dr. Espinosa: Zinc is important, magnesium also
Dr. Brighten: Eat your steak.
Eat your steak. Yeah. eat Yeah. Well, let me ask you, because you know, as we, we talk about eat your steak, that's a great source of zinc. Do you find that diet plays a role? Yeah. Tell me more.
Dr. Espinosa: more. The research is actually very interesting. It suggests that a, um, A diet that's not low in fat is better for testosterone.
Dr. Brighten: Yeah, So the 90s destroyed us all men and womene
Dr. Espinosa: those, those, um, those, [00:29:00] those cookies, those
Snackwell
Dr. Brighten: Oh gross yeah
Dr. Espinosa: Remember those Snackwell cookies? Low fat, no I
Oh my,
Dr. Brighten: that was
Dr. Espinosa: believe that was even out? Or
Dr. Brighten: I know people are like literally pooping themselves just to not eat fat
Dr. Espinosa: Snackwells just getting diabetes and all kinds of other issues. How crazy that time.
Dr. Brighten: Yeah.
Dr. Espinosa: I wonder what was the testosterone, I'm sure it was very low as well.
Dr. Brighten: We were too young.
We were were too young. We were too young. Um, so, so yeah, so, um, a diet that is not low in, in fat is actually helpful, um, according to a lot of research. And I guess the, the connection there is that this is with cholesterol. Actually, you need cholesterol. If you want to. If you want a man to really struggle to make their own testosterone, um, have their cholesterol go down really low.
Dr. Espinosa: This is, you know, sometimes they come to me, it's funny, but not funny, right? They come to me very, Uh, proud that, look, my cholesterol is so low. Yeah. You know, my doctor, my cardiologist says it needs to be low. [00:30:00] And that's the, that's the worst thing that a man can do is to lower their cholesterol to the point that they cannot even make their sex hormones.
Dr. Brighten: So does it need to be like above one 50?
Dr. Espinosa: Yeah. I mean, way above 150. First of all, you know, yeah, I'm getting excited here because
Dr. Brighten: well, they're, I've seen cardiologists be like, you gotta get it one 50 or lower, so that's why
Dr. Espinosa: and they're, they're barking at the wrong tree. I think many of us know that. And even my cardiologist friends know this as well. Um, we get, that's a different conversation with bad cholesterol, LDL and, Yeah,
Dr. Brighten: and inflammation. I mean, 20 years ago, I was taught that inflammation was the driver of cardiovascular disease. But even still, I'm like, I was taught that in nutrition 20 years ago. And here we are, and there's still people being like, it's just about the
Dr. Espinosa: ago, and here we are, and there's still people being like, it's just about the class. Right? So, [00:31:00] so, you know, hydrotherapy, that's part of our history, and now cold plunges and things, right?
Dr. Brighten: When I tell people that, like, you know, it's on as cold plunges, like alternating hot and cold, apple cider vinegar, castor oil packs, like when I talk about all of that and people are like, Oh yeah, I just learned about that in this new thing.
thing and like this influencer taught me and I'm like, this is so wild to me.
Dr. Espinosa: why you're your own influencer getting the right information right out there. Um, by the way, cold plunging, I think also, um, stimulates production of androgen receptors. okay. So there's benefit there as well. Yeah. Not to completely digress.
Dr. Brighten: Yeah. No, but I love that. So it's the strength training and the cold plunges, which you could just end your shower as well in that super cold, like if you live in New York and it's winter, is going to be so
Dr. Espinosa: It's perfect. Yeah, exactly. Exactly.
Dr. Brighten: Okay. So I have a question. Is it a myth that lack of morning wood is a health problem?
Dr. Espinosa: ha [00:32:00] ha. Alright. Lack of morning wood. So, I mean, I guess your audience would know that that's an erection that men have. They, they wake up with an erection. It's not a health problem.
Okay.
Now men, as they get older, they experience it less in the morning, but, um, they do have three to five a night. So there is, um, there is a technology out there.
There's probably here, this conference, uh, it's like a Fitbit to the right? It's called Firm Tech. I have no association with the company whatsoever, but you can actually measure the, the, um, the strength of an erection. overnight and how many a man has. So that's one way to differentiate is it really a physiological problem or a psychological problem. That said, if men after, if they don't wake up with one or don't experience one, then that's not, uh, a big deal. Um, but they should get about at every night. And there's no way of unless they, uh,
Dr. Brighten: unless someone's monitoring you every night. exactly. [00:33:00] Yeah, your partner's sitting up.
Dr. Espinosa: Right,
Dr. Brighten: Just watching you. exactly.
Dr. Espinosa: Right. Oh, I'm behind a computer getting all that data from the firm tech.
Dr. Brighten: Yeah.
Dr. Espinosa: This is a good one in here. 2 a. m., wow.
Dr. Brighten: Okay, so if you get to a certain age and you're like, I never wake up with morning wood, that's not necessarily a problem. When would it be a problem? Like, what else would you have going on that's like, okay, if you're concerned about that, check these other
Dr. Espinosa: Well, if they don't get it, if they don't experience an erection erection for about three months
Dr. Brighten: Okay, at all?
Dr. Espinosa: all, red flags, Okay. red flags, it could be a metabolic situation. It could be a diabetic situation or pre diabetes. it could be a cardiovascular situation where the vasculature is not in good shape to get the blood in.
And that can be indicative of a heart situation or a heart attack even so men typically studies have shown men that don't get erections for a prolonged period of time have higher risk of a heart attack or a stroke
Dr. Brighten: Okay.
Dr. Espinosa: it's it's really you know a barometer [00:34:00] to a man's health and that's the other element uh the other uh organ that a man has that women don't have to determine you know their the state of their health
Dr. Brighten: Mm hmm. That is fascinating. Yes. What is something that you wish every patient knew before they came into your office that would just like help them so much more with their hormones?
Dr. Espinosa: I wish that they knew that, um, to make sure it's checked.
Dr. Brighten: Okay, how often should someone check their testosterone?
Dr. Espinosa: I'll say that because most, you know, it's not, a lot of physicians are not testing for it. Unless they come up with symptoms, you know, that, but a lot of men don't talk about these Mm hmm. Um, they are still ashamed to talk about, yeah, you know what, I'm not feeling it. You know, feeling, um, my libido is low or, uh, my erection is not great. They're not openly talking about this. And they're definitely not openly talking about this to their female
Dr. Brighten: physician. Mm Mm hmm. Mm hmm.
See?
Dr. Espinosa: so, so they need to, uh, [00:35:00] advocacy, right?
Self advocacy, um, get a full panel. The full panel to be not only total testosterone, which is what it's ordered. It needs to be total. It needs to be free testosterone. Uh, then the free percentage could be calculated on, uh, online, SHBG.
Dr. Brighten: uh,
Dr. Espinosa: Estradiol, I include cortisol, morning
Dr. Brighten: there
Dr. Espinosa: well because that's, that's a, there's a ratio there that, um, it should be looked at and dihydrotestosterone and DHEA, um, dihydro, so a man produces testosterone, right?
And you have enough free. One of three things happens. The testosterone itself hits a receptor and something happens, some male stuff, whatever. Um, It's converted, it's the other way, it's converted to estradiol. So now, a man has the estrogen in their body from conversion. We don't make estrogen, you guys do, we don't. The other, third thing is, it's converted to [00:36:00] dihydrotestosterone,
And so DHT is actually, binds to these receptors.
Dr. Brighten: two or
Dr. Espinosa: or three times stronger than total testosterone. So a lot of the male characteristics comes from DHT. It's not a bad guy. And that's the other, I guess, thing that men need to know. Why?
One of the drugs that's used is a DHT inhibitor, either to, um, for their prostate or to grow hair.
Dr. Brighten: Mm-hmm
Dr. Espinosa: So, um, whether it's, um, finasteride is the drug, right? And it lowers DHT Great. You have hair. But you can't do anything because now oftentimes men are feminized from it and there's like all kinds of finasteride Um syndrome going depression and things like that.
So clearly I don't take finasteride
Dr. Brighten: Yeah,
Dr. Espinosa: As you can tell because I have no hair
Dr. Brighten: You're like, I'd rather be
Dr. Espinosa: I'm proud
Dr. Brighten: than have
Dr. Espinosa: Then not and I figured that out 30 years ago So [00:37:00] so that's a full panel that includes dht as well And men who are actually jokes aside men that You don't want to keep their hair. Be careful with finasteride, I would say.
And I was low dose, and yeah, finasteride syndrome is a, is a, is a, about two to three percent of men who take it, but it's
Dr. Brighten: really no good. So what is finasteride syndrome look like?
Dr. Espinosa: Um,
Um, depression,
Dr. Brighten: okay
Dr. Espinosa: that they didn't have before. Um, erectile dysfunction, low libido. Like, a lot of feminization that occurs
Dr. Brighten: through,
Dr. Espinosa: through
Dr. Brighten: the
consumption. Are we talking man boobs? Oh, yeah. Can happen? Okay. Oh, yeah. Yeah. I think that's important for people to hear because I think it's really easy when men start to see breast enlargement to just think like, Oh, I must be out of shape.
I must be gaining weight. And not realize that this could actually be a sign that there's issues with their hormones and they need to pursue that because that can lead to other issues in the body.
Correct.
Dr. Espinosa: They're uh estrogenizing [00:38:00] I think I just made that word up actually. never uh, estrogenizing.
Dr. Brighten: I like it. It's true. What about, uh, saw palmetto as an alternative?
Dr. Espinosa: So saw palmetto, I guess you're mentioning it because it, it, it should be on some of the literature, a 5 alpha reductase inhibitor, which means that
it reduces the conversion
of total
to DHT.
It's actually very regard and
I'm I don't want to to lower my DHT. there's no reason to so
don't
believe
hype. Right?
Don't believe the hype. You don't need to lower DHT Yes. If your total testosterone
and your DHT,
it's all about
Dr. Brighten: That
Dr. Espinosa: ratio is off. Then your prostate will grow
and no one wants a big prostate.
So
the, you know, roughly is about 12 to
total testosterone to DHT.
If it's much, uh, lower than that then,
there's just too much DHT and
it does,
can make your prostate grow a little bit. [00:39:00]
But, into prostate, but I'll say this, I mean, somebody's gonna listen, Oh, so how big the prostate?
I'll say this a bigger prostate doesn't matter What matters
is the urinary problems that come with it. Some people
have a
big prostate no urinary problems so the bottom line is
you don't need to take these drugs
that I think
are,
um,
more of a problem
than, than, than a solution.
Dr. Brighten: You know saw palmetto has been studied so extensively in men But I find it's actually better used in women because it is weak it can help with like pcos hair loss
Dr. Espinosa: A thousand percent.
Dr. Brighten: It can help with so many women's health and they don't need all of this dht
Dr. Espinosa: And because
Dr. Brighten: it's not such a strong arm to shut things down It works a lot better, but I was curious from
Dr. Espinosa: great
there. Thank you for that
Dr. Brighten: Yeah, but I was just from the male perspective because I think, you know, hair loss Does come with you know a loss of self in some in some instances like it can take a mental health toll and so I think people need to look at [00:40:00] weighing, you know, the ratio as you said and the cost to benefit because becoming depressed Becoming feminized like you know That's, I mean, if you think losing your hair is bad, you might want to consider what it looks like when the tissues start to shift to be more female body archetype.
Dr. Espinosa: as you can
imagine, not too many
come to see me for hair
They
They just look me that guy may
know nothing Ha ha ha, yeah.
nothing about hair
Dr. Brighten: Well, I wasn't gonna ask you about hair loss.
Dr. Espinosa: loss. He's not the guy for that. Um, but jokes aside, a few times that I did try with some people for that regard and um, they felt their dht dht too high and a problem Um because they want trt and things like that. not as,
strong in
few times that
But again,
I don't think dht
under natural
DHT is not a problem.
When
men are not that i'm
to it, I I think it's
for [00:41:00] many men, but
then you got to labs and
what, is it converting to what?
it's
too much, too much estrogen is a problem, Yeah. Yeah.
And if it's
Dr. Brighten: to too much DHT is a problem.
Mm hmm. Well, that's a perfect place to wrap. I think we should do another episode where we talk all about testosterone hormone replacement therapy, the ins and outs of that for men. As always, you guys drive the conversation, so you can leave comments, you can let us know what questions you still have, what should we have Dr.
Gio Espinosa back to chat with us about. But for today, I want to thank you so much for giving us your time and sharing all of your knowledge.
Dr. Espinosa: Thank you for having me. It was fun.
Dr. Brighten: Thank you
