Category Archives for Clinical Excellence

3D illustration of thyroid gland in human body

What to Know About Hypothyroidism

Keep your vitality. A life without health is like a river without water.

Maxime Lagacé

The thyroid is a small, butterfly-shaped gland located at the front of the neck. Despite its small size, however, the thyroid plays an important role in many key processes throughout the body. It influences metabolism, helps to regulate body temperature, and aids in growth and development.

Under normal circumstances, the thyroid secretes optimal levels of two hormones, thyroxine or T4, and triiodothyronine, or T3. Outside the thyroid, in organs such as the liver, kidneys, and brain, T3 is also converted from T4. Both T3 and T4 are stored in certain amounts within the thyroid, and when it is needed by the body, the gland secretes the hormones into the bloodstream to meet the cells’ metabolic needs. [1]

In certain cases, the thyroid is unable to produce sufficient critical hormones. Known as hypothyroidism, this condition can spur a chain reaction in which a number of body-wide symptoms arise. Here, we take a closer look at hypothyroidism, including its causes and treatments.    

What Is Hypothyroidism?


Illustration of healthy thyroid gland with anterior and posterior views

At the most basic level, hypothyroidism refers to an underactive thyroid. In individuals with hypothyroidism, the thyroid gland cannot produce enough thyroid hormone to keep the body functioning normally. Doctors can confirm hypothyroidism based on symptoms and blood test results. Blood tests may measure thyroid-stimulating hormone (TSH), which is used as a messenger from the pituitary gland to tell the thyroid how much thyroid hormone to produce. When TSH is low, it signals the thyroid to slow down hormone production. This essentially slows down all of the body’s functions, causing you to experience a number of seemingly unexplainable symptoms. [2]

What Are Symptoms of Hypothyroidism?


Mature male businessman wearing suit holding the bridge of his nose with closed eyes, Tired businessman suffering from cognitive/mental fatigue

The symptoms of hypothyroidism can develop slowly over time. In many cases, patients experience weight gain, despite maintaining a regular diet or even eating less than normal. Because the thyroid regulates body temperature, another common symptom of hypothyroidism includes increased sensitivity to cold. Fatigue, dry skin, hoarseness, constipation, and muscle weakness may also ensue.

Since the hormones produced by the thyroid have body-wide effects, symptoms are rarely isolated. Some of the other widespread symptoms patients tend to notice include:

The thyroid is also a part of the endocrine system, which includes the ovaries in women and the testicles in men. With hypothyroidism, symptoms such as heavy or irregular periods may occur. The condition can also lead to fertility issues, as improper hormone levels could affect ovulation.

The challenge with hypothyroidism lies in the fact that the signs and symptoms may be difficult to notice at first, and can vary based on the condition’s severity. Symptoms such as fatigue and weight gain may creep up slowly, and are often attributed to the natural aging process. Nonetheless, symptoms tend to become more pronounced as the metabolism continues to slow.

In some cases, the root cause of this chain reaction is easy to pinpoint. Thyroid surgery, for example, will likely lead to diminished production of hormones by the thyroid. There are other potential causes behind hypothyroidism, however, which are discussed below.

What Causes Hypothyroidism?


Stethoscope and tablet with blue screen and white letters stating HYPOTHYROIDISM

While there are many potential causes behind hypothyroidism, the most common is autoimmune disease. In particular, an autoimmune disorder known as Hashimoto’s thyroiditis is the most common reason behind an underactive thyroid. In this condition, the immune system attacks the thyroids, resulting in inflammation of the gland and an inability to produce sufficient hormones. While it is unknown why certain individuals produce antibodies that target the thyroid gland, this condition often runs in families. It tends to occur in middle-aged women, but it can affect individuals of any age, including men and children. [3] Another autoimmune disorder that can affect the thyroid includes atrophic thyroiditis.

As mentioned above, thyroid surgery can also result in hypothyroidism. If all or a large portion of the thyroid is removed, it typically results in a lifelong need for thyroid hormones. Radiation therapy to treat cancers of the head and neck may also lead to hypothyroidism.

In addition, there are some cases in which medications can contribute to hypothyroidism. For one, patients being treated for hyperthyroidism, in which the thyroid produces too much thyroid hormone, may over-respond to medications. Radioactive iodine or anti-thyroid medications are implemented to restore normal thyroid function, but in pursuit of correcting hyperthyroidism, it’s possible to lower thyroid production too much, causing hypothyroidism. In addition, lithium, which is commonly used to treat psychiatric disorders such as bipolar disorder and mania, can also cause hypothyroidism.

Causes of Hypothyroidism

Hypothyroidism can be caused by the following:

  • Autoimmune disease
  • Thyroid surgery
  • Radiation treatment
  • Certain medications
  • Failure of the pituitary gland
  • Pregnancy
  • Iodine deficiency

While rare, hypothyroidism can also result from other conditions. For example, congenital hypothyroidism, in which a baby is born with a missing or defective thyroid gland, can occur. Most states require thyroid screening in newborns to assess for this condition. Failure of the pituitary gland, which may be a result of a benign tumor, can also lead to insufficient TSH, and subsequently, hypothyroidism. Some women also experience hypothyroidism during or after pregnancy. Finally, the condition can also be caused by an iodine deficiency. Although rare in many parts of the world, the addition of iodine to table salt has almost altogether eliminated the deficiency in the U.S.

Certain populations face an increased risk for hypothyroidism, including women and individuals over the age of 60, as well as people with a family history of the condition. Other autoimmune diseases, including type 1 diabetes and celiac disease, appear to be associated with a higher risk for hypothyroidism as well. [4] 

How Is Hypothyroidism Treated?


Diagnosing and treating hypothyroidism is important, as leaving it unaddressed can lead to a number of complications. In an attempt to prompt the thyroid to produce more hormones, the pituitary gland will make more TSH. This constant stimulation can lead to an enlargement of the gland, known as a goiter. While not typically uncomfortable, a pronounced goiter may lead to swallowing or breathing difficulties.

In individuals with an underactive thyroid, increased levels of low-density lipoprotein, also known as the “bad” cholesterol, may occur. This can increase the risk for cardiovascular complications, including heart disease and failure. Depression and peripheral nerve damage may also occur. A rare but life-threatening condition caused myxedema can also result from prolonged, untreated hypothyroidism, and is characterized by severe drowsiness, intolerance to cold, and potentially, unconsciousness.

Luckily, treatments are available to combat hypothyroidism. Typically, the synthetic thyroid hormone levothyroxine is used daily to restore hormones to their appropriate levels. This hormone is identical to the hormone the thyroid produces naturally. It can also help alleviate or reverse the signs of hypothyroidism. Finding the right dose may require some trial and error, so medical professionals perform further blood tests a few weeks after introducing hormones. [5]

In addition to using medications, certain lifestyle changes, including adopting a diet for hypothyroidism, may help control symptoms.

The Best Diet for Hypothyroidism


Birdseye view of food including green grapes, grapefruit, blueberries, black cherries, strawberries, who grain crackers, cheese, shish kabobs

Dietary changes alone won’t restore normal functioning in the thyroid, and aside from an iodine deficiency, eating habits are unlikely to cause hypothyroidism by themselves. With that being said, diet can have a significant impact on symptoms in individuals with hypothyroidism. While certain foods can improve symptoms, others may worsen them or interfere with medications.

Widely recognized for their health benefits, cruciferous vegetables such as broccoli, Brussels sprouts, collards, cauliflower, cabbage, and Russian kale with plenty of fiber, vitamins, minerals, and phytochemicals and relatively few calories, have been linked to benefits such as protection against cancer. [6] Yet, they also contain goitrogens which, in some hypothyroid scenarios, are not heavily advised to be consumed in excess.

Nonetheless, having hypothyroidism doesn’t necessarily mean you must avoid cruciferous vegetables altogether. These foods are part of a well-rounded diet and can usually be enjoyed sparingly, since experts believe goitrogens may only impact hormone levels when eaten in excess. Moreover, cooking can deactivate the effects of goitrogens. Individualized lifestyle modifications such as these can be beneficial not only for hypothyroidism, but also any health issues affected by diet. [7]

Soy is also believed to affect the thyroid when consumed in excess. Soy products include soy milk, soy sauce, edamame, tofu, and miso. For this reason, enjoying these foods only in moderation, especially if you have a known thyroid condition, is recommended. Processed foods that can promote weight gain, which is a common struggle in hypothyroidism, should also be avoided.

At the other end of the spectrum, foods with the nutrients iodine, selenium, and zinc can help maintain optimal thyroid function. Iodine-rich foods include eggs, milk, cheese, and saltwater fish. Selenium, which aids in the production of thyroid hormones, is found in Brazil nuts, turkey, chicken, beef, and tuna, along with eggs and oatmeal. Zinc can be found in oysters, crab, beef, pork, legumes, and yogurt.

An Underactive Thyroid – In Conclusion


If you’re experiencing fatigue, slow weight gain, or any of the other symptoms described herein, it’s a good idea to discuss a potential thyroid issue with a medical expert. While there’s no guarantee hypothyroidism could be behind your symptoms, ruling out this or any other root cause is important to optimizing your quality of life, both now and into the future.

In fact, wellness optimization is at the forefront of what we do at Cenegenics. We believe that to feel one’s best and minimize disease risk, we must establish a complete patient profile, compiling data from factors like hormone levels and other key indicators. With this knowledge, we make informed and individualized treatment recommendations to help our patients maintain the greatest possible level of wellness. For many individuals, our strategic, patient-oriented approaches such as dietary modifications and hormone replacement where clinically indicated can make a life-changing difference in restoring energy, regulating weight, and enhancing overall quality of life.

Next Steps to Combating Hypothyroidism

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] Garber, Jeffrey R., Ph.D. The Harvard Medical School Guide to Overcoming Thyroid Problems. McGraw-Hill.

[2] Garber; see above.

[3] “Hashimoto’s Thyroiditis.” American Thyroid Association. Retrieved from URL: https://www.thyroid.org/hashimotos-thyroiditis/

[4] Mayo Clinic, “Hypothyroidism.” 4 Dec. 2018. Retrieved from URL: https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

[5] Mayo Clinic; see above.

[6] Wallig, M., et al. Journal of Nutrition, 2005;135(12S):2972S-7S. Steinmetz, K.A., and Potter, J.D., Journal of the American Dietetic Association, Oct. 1996

[7]

Marengo, Katherine, LDN, RD. “Hypothyroidism: Foods to eat and avoid.” Medical News Today. 28 Mar. 2019.

diagram of skeleton holding knee joint radiating red for pain

A Guide to Osteoporosis & Bone Strength

When you know in your bones that your body is a sacred gift, you move in the world with an effortless grace. Gratitude and humility rise up spontaneously.

Debbie Ford

Osteoporosis is commonly perceived as a condition experienced exclusively by elderly individuals. In reality, our bones begin to change much earlier than most people realize, which is why it’s never too early to start thinking about what we can do to preserve bone strength. In fact, like health in general, caring for our bones should be a priority at every age. Whether you’ve already been diagnosed with or face an increased risk for osteoporosis or you’re taking the steps to safeguard your health against disease in the future, here’s everything you need to know about bone health and osteoporosis. 

What is Osteoporosis?


Osteoporosis stage 4 of the upper femur bone in 3D rendered image

The literal meaning of osteoporosis is “porous bone.” All bone is somewhat porous, and when viewed under a microscope, healthy bone has a honeycomb-like appearance. In individuals with osteoporosis, however, the holes and spaces within this honeycomb structure are much larger.

Like other types of living tissue, bone tissue is constantly broken down and regenerated. This process slows down over time, and when new bone can’t be created as quickly as old bone is lost, it results in osteoporosis. Bone density and mass is reduced, leaving bones weaker and more vulnerable to fractures.

In fact, osteoporosis significantly increases the risk of fracture — so much so that simply mild physical activity (such as bending over) could result in fracture in individuals whose bones have become especially brittle. The most common sites for fractures related to osteoporosis are the hip, wrist, and spine.

Risk Factors of Osteoporosis

The following factors can increase your risk of osteoporosis:

  • Gender
  • Family History
  • Smaller Body Frame
  • Age
  • Ethnic Background
  • Certain Health Conditions
  • Specific Medical Procedures
  • Autoimmune Disorders

Unfortunately, osteoporosis is a common condition. More than 50 million Americans either have the condition or are at an increased risk for it due to low bone mass. [1] It’s most prevalent in individuals over 50, at which age 1 in 3 women and 1 in 5 men experience an osteoporosis-related fracture. [2] Bone density typically peaks during the late 20s, and begins to weaken by the mid-30s. Thus, age is one of the non-modifiable risk factors of osteoporosis.

Another non-modifiable risk factor is sex. Women are more likely to develop osteoporosis than men, especially after menopause. Individuals with a family history of the condition and smaller body frames also tend to face a higher risk. Having a smaller body frame means there could be less bone mass to draw from with age. Being of white and Asian descent can also increase risk.

In addition, certain health conditions and medical procedures can contribute to bone loss. Autoimmune disorders, such as rheumatoid arthritis, lupus, and multiple sclerosis, as well as diabetes, premature menopause, low levels of testosterone and estrogen in men, and certain types of cancer have been linked to osteoporosis, among other medical conditions. In terms of medical procedures, gastrointestinal bypass surgery and gastrectomy have been linked to bone loss. [3]

In addition to these non-modifiable risk factors, there are also risk factors within your control. We’ll discuss these in an upcoming section on osteoporosis prevention. First, let’s look at some of the symptoms of osteoporosis.

Symptoms of Osteoporosis


Mature man gripping backside from pain

During the early stages of bone loss, individuals may not notice any identifiable symptoms. Once bones become weaker, however, issues such as loss of height, back pain, and stooped posture may occur. These can result from a fractured or collapsed vertebra. Of course, another telltale sign of osteoporosis is a bone which breaks far more easily than expected. If you’re over the age of 50 and have broken a bone, you may be a good candidate for a bone density test.

Bone Density Tests

A bone density test is the only assessment that can be used to diagnose osteoporosis before breaking a bone. The DEXA scan is one cutting-edge test that can accurately measure bone density. This noninvasive body composition test sends multiple X-ray beams through the body at different energy levels to measure total body bone density, as well as bone density specifically in the spine. This helps physicians determine a patient’s risk of fracture. The findings from bone density test scans can also be used to form treatment plans, which brings us to our next section.

How to Treat Osteoporosis


Woman in bright orange shirt laying on DEXA machine as doctor operates mechanics via computer

Osteoporosis is now largely treatable. Through a combined approach encompassing lifestyle changes and tailored medical treatment, fractures can often be avoided. The objectives of treatment include:

  • slowing the development of osteoporosis
  • maintaining adequate bone mineral density and bone mass
  • minimizing pain
  • preventing fractures
  • optimizing quality of life for the patient

A patient’s treatment plan is usually based on their projected risk of fracture within the next 10 years. Data such as findings from bone density tests is the common basis for informing treatment recommendations. For patients whose risk is low, treatment might focus on modifying risk factors for falls and bone loss.

Treatments can include:

  • Bisphosphonates
  • Monoclonal antibody medications
  • Additional bone-building medications
  • Hormone replacement therapy
  • Lifestyle modifications

If there’s an increased risk of fracture, bisphosphonates may be prescribed to strengthen the bones and slow or prevent bone loss. These medications inhibit the development of osteoclasts, which break down and reabsorb minerals such as calcium from bone tissue. Monoclonal antibody medications can also be given via injection to specific patients to reduce the risk of fracture and increase bone density. In patients who can’t tolerate more common treatments, other bone-building medications may be explored.

When clinically indicated, hormone-related therapy may also be used to treat osteoporosis. Estrogen, in particular, can help post-menopausal women maintain healthy levels of bone density. Hormone replacement therapy (HRT) can also be used as a primary prevention for osteoporosis and, in conjunction with a calcium-supplemented diet, has been shown to prevent hip, vertebral, and other fractures, even in low-risk patients. [4]

In addition to the above treatments, the following lifestyle modifications used to prevent the condition may also be used in combination to optimize quality of life in patients who have already developed osteoporosis.

How to Prevent Osteoporosis


Your likelihood for developing osteoporosis depends, to some degree, on the amount of bone mass you attained during youth. Peak bone mass is partly inherited and can vary by ethnic group. The higher your peak bone mass, the more bone you have stored, and thus, the less likely you are to develop osteoporosis.

With that being said, there are ways to promote bone health at every stage of life and regardless of your individual risk. We’ll explore some of the most effective ways to strengthen bone tissue below. 

Calcium-Rich Foods for Bone Health

Set of natural calcium rich food on marble background viewed from top

Most adult men and women need 1,000 milligrams of calcium per day. When women reach the age of 50 and men turn 70 that amount increases to 1,200 milligrams. [5] The body constantly removes small amounts of calcium from the bones and replaces it with new calcium, which is why a calcium-rich diet is important for maintaining bone health at every age.

Calcium-rich foods for bone health include:

  • dairy products
  • leafy green vegetables such as:
  • collard greens
  • spinach
  • kale
  • certain varieties of beans and lentils
  • tofu and other soy products

If you find it difficult to take in enough calcium through food alone, you could be a good candidate for calcium supplements. Be sure to discuss any new supplements with the specialist overseeing your wellness and nutrition treatment plan, however, as it’s also important not to exceed a certain amount of calcium on a daily basis.

The Importance of Vitamin D

Vitamin D helps the body absorb calcium, and these nutrients therefore play an important collaborative role in promoting bone health. The body can take in vitamin D when direct skin is exposed to UV rays, or through supplements. Vitamin D is also found in very few foods, but even the food it is found in contains a very small amount of the nutrient. Vitamin D supplementation is therefore widely recommended for patients — especially those at risk of developing osteoporosis. In elderly individuals, the risk of falls is reduced by 20% with vitamin D supplementation, and the risk of hip and vertebral body fractures is also reduced.

Hormones

Fracture risk has been shown to be reduced in women who take HRT, regardless of whether or not they have established osteoporosis. In fact, women who used HRT over a 10- to 20-year timeframe experienced a risk fracture reduction ranging from 40% to 50%. Estrogen is instrumental in bone development, through the constant ebb and flow of formation, remodeling, and resorption. [6] Thus, when clinically indicated, HRT is a practical treatment option for promoting bone health and preventing osteoporosis.

Weight & Exercise

Happy mature woman listening to music with earphones while jogging

Finally, some important lifestyle factors which can support bone health include maintaining a healthy weight and exercising regularly. While being underweight can increase the chance of bone loss, and subsequently, fractures, being overweight can also increase the risk of fractures. Achieving and maintaining an appropriate weight can therefore promote bone health and help to optimize wellness in general.

Regular exercise can also contribute to bone strength. No matter how or when you start, exercise can benefit your bones and your overall health. With that said, the younger you can begin, the better it will be for your bones. A combination of weight-bearing exercises and balance training can help to minimize the risk of falls and build strength in the body.

Controlling Osteoporosis with Cenegenics – In Conclusion


Whether you have a family history of osteoporosis or you’re simply seeking ways to take control of your health for long-term, optimized wellness, bone strength should be a priority at all stages of life. Osteoporosis is common yet largely preventable, and even when it does develop, there are both lifestyle modifications and medical treatments available to minimize the condition’s impact on daily life.

If you’re looking for ways to feel stronger and healthier now while pursuing practical disease prevention strategies, Cenegenics can help. Our physicians specialize in wellness optimization programs tailored to each patient’s unique needs. Through our strategic lifestyle, nutrition, and exercise recommendations, along with supplementation and HRT when clinically indicated, we give individuals the resources they need to enhance their health and feel their best at every age. To learn more about how Cenegenics can help you, contact your nearest location for a consultation. 

Next Steps to Preventing Osteoporosis

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] National Osteoporosis Foundation

[2] International Osteoporosis Foundation

[3] National Osteoporosis Foundation

[4] Leake, Jeffrey Park, M.D., CPT, and Greenberg, Todd David, M.D., CSCS. Textbook of Age Management Medicine: Volume 2. Leake-Greenberg Ventures, LLC, 2015. p. 75.

[5] Mayo Clinic

[6] Leake, Jeffrey Park, M.D., CPT, and Greenberg, Todd David, M.D., CSCS; p. 128-129.

Are you at risk for heart attack and stroke? A carotid intima-media thickness (CIMT) test is often used as a preventive measure to check just that!

What is the Carotid Intima-Media Thickness Test?

Information leads to transformation.

Isrealmore Ayivor

Diagnostics have come quite a long way in recent years, and the carotid intima-media thickness (CIMT) test is no exception. Nowadays, this noninvasive assessment can give physicians in-depth insights into heart health, accessing information which has traditionally only been available through more invasive means. Moreover, the data gleaned from this test often goes overlooked, as the conditions for which CIMT tests aim to identify often present no outward symptoms.

Yet, some patients may wonder if the CIMT test is really necessary. After all, most individuals have never even heard of it, let alone received a referral for one. Is the CIMT test right for you? Discover what it entails and how it could be the very test to unlock life-changing results below.

What is a CIMT Test?

Panasonic CardioHealth Station, Carotid Artery Testing Equipment

The CIMT test is often used as a preventive measure to check for serious conditions such as heart disease and stroke. Heart disease often exhibits no symptoms or warning signs, and many people only become aware of their individual risk through biomarkers uncovered by lab work. While in some cases symptoms such as fatigue, irregular heartbeat, and chest pain may be present, in many cases, the first symptom of heart disease is a heart attack. [1] This is because plaque can slowly and silently build up along the walls of the arteries for many years. While the arteries can become thickened, resulting in what’s known as atherosclerosis, there may be little to no outward sign of a medical issue. Blood pressure changes and elevated C-reactive protein (CRP) levels (identified through blood work) are among the few indicators that might alert physicians to this systemic inflammation.

The CIMT test is used to evaluate the carotid arteries by measuring changes in plaque and the thickness of the vessel walls. Even if no atherosclerosis is present, there could still be changes in artery thickness which can alert doctors to an elevated risk for heart attack or stroke. With this early intervention, medical experts can determine and predict risk for cardiovascular disease or stroke and can subsequently make clinical recommendations to support the best possible patient outcomes.

Using ultrasound scanners, sonographers perform CIMT tests, which use sound waves to pinpoint the extent of plaque buildup in the walls of the arteries which supply oxygenated blood to the head. The sound waves are high-frequency and inaudible and are measured by a computer to depict real-time imaging on a monitor.

Why is Carotid Intima-Media Thickness Important?

ultrasound image of carotid artery

The carotid intima-media thickness measures two separate layers of the carotid artery: the intima and the media. There are actually two carotid arteries; one on either side of the neck. Because this artery branch supplies blood to the brain, it’s one of the most important systems within the body. Clinically examining these arteries can uncover important evidence of a number of conditions. For instance, inflammation within this artery could suggest an autoimmune condition or previously undetected infection.

An increase in intima-media thickness (IMT) is often the first structural change that can be detected in atherosclerosis. [2] Moreover, the state of the carotid arteries corresponds with the state of the arteries all throughout the body, including those within the heart. Having thicker arteries can increase the risk of developing coronary heart disease, peripheral artery disease, carotid artery disease, and chronic kidney disease. [3]

While aging contributes to thicker carotid intima-media, there are a number of other factors which play a role in the arteries’ thickness:

These can all lead to increased thickness in the carotid intima-media. [4] Although certain behaviors can certainly contribute to increased risk for heart conditions, researchers have determined that CIMT predicts future vascular events independently of conventional risk factors for heart disease or stroke. [5] Thus, while increased IMT may exhibit no outward symptoms at all, it’s among the most powerful predictor of a cardiovascular event — but continues to go overlooked by most practitioners of traditional medicine.

Consider the fact that four times as many fatalities are caused by heart events compared to cancer, and traditional medicine mischaracterized 50% of patients as low-risk who would later experience a heart event. Physicians who employ the CIMT test aim to take a more accurate approach to assessing heart attack risk, while also preventing heart events in at-risk populations by offering effective, proactive interventions.

Benefits of the CIMT Test

mature man smiling as he stretches before run

Aside from the fact that research shows the CIMT test to be an effective predictor of future vascular events, there are a number of other advantages of the assessment. [6] For one, CIMT is believed to be valuable for collecting a more refined perspective of an individual’s risk for cardiovascular disease. For another, the test is noninvasive, requires no blood draws, and uses ultrasound waves, which are generally considered safer than many other types of waves. The test itself is fairly quick, and no special preparation is needed on the patient’s part. Likewise, there is no required recovery time, and the test is therefore non-disruptive to an individual’s daily lifestyle.

Compare this with other forms of testing used to evaluate heart disease risk. While many of these tests still have their place in certain circumstances, some may present certain challenges. For example, cardiac CT angiograms require the use of contrast dye, to which some individuals have an allergy. Left heart catheterization requires the use of a catheter in the femoral artery in the groin or wrist, which can lead to bleeding or hematoma formation at the site. [7]

Yet, despite the many advantages of CIMT testing, there are some factors to consider before pursuing it. For one, it is only offered in the most modern facilities, as it’s still generally considered cutting-edge technology. Moreover, not all physicians are trained in interpreting the test’s results, which is why it’s critically important to work with a clinical team well-versed in CIMT testing.

What Should You Expect from This Carotid Artery Test?

The ultrasound exam will be painless and non-invasive, but it’s still a good idea to wear loose-fitting, nonrestrictive clothing so you can stay comfortable during the test. An open-necked shirt is ideal, as the technician will need to access your neck area. There is no other preparation required for the carotid artery test.

The technician will apply a thick gel to the skin, which allows soundwaves to move from the machine into the body with the help of a transducer. As the sound waves bounce off the arteries, echoes are communicated to the transducer. The transducer then creates electronic signals which are processed by the computer. A report will then be generated identifying your unique risk profile.

Results of a CIMT are typically classified into four categories:

  • normal CIMT with no plaque
  • abnormal and no plaque
  • normal with plaque
  • abnormal with plaque

Depending on your unique results, your doctor will go over risk factors and generate an individualized treatment plan to help you manage your risk for heart disease or stroke.

Typically, doctors who are familiar with the CIMT will only order the test if a patient is believed to have a moderate risk for heart disease.

Risk Factors for Heart Disease

Risk factors could include:

  • sedentary lifestyle
  • obesity or being overweight
  • history of smoking
  • hypertension
  • family history of heart conditions, among others

Nonetheless, it’s important to bear in mind that patients are often mischaracterized as low-risk. Thus, physicians with a focus on disease prevention are likely to recommend this test as a worthwhile preventive measure for most adults approaching or in their middle ages.

Do You Need a CIMT Test – In Conclusion

At Cenegenics, our focus is always on helping patients defy their age through practices that help to minimize the risk for serious disease. In particular, heart health is one of our most important priorities, as we know that heart disease is the leading killer in the U.S., and far too many patients go undiagnosed with cardiovascular concerns which could otherwise be addressed proactively. For these reasons, we include the CIMT test in all of our patient evaluations.

Our carotid artery ultrasonography exam is an FDA-approved, noninvasive exam which allows for early detection and proactive strategies to help reduce the risk of catastrophic events. When clinically indicated, our team of expert physicians will empower you to take control of your health with prescriptive lifestyle and diet modifications as needed. In doing so, we give you the tools that will help you cultivate a rich and healthy life well into your retirement as you reclaim your glory days™. 

Next Steps to Schedule Your CIMT Test

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] Mayo Clinic, “Heart Disease.” 22 March 2018. Retrieved from URL: https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118

[2] Simova, Iana. “Intima-media thickness: Appropriate evaluation and proper measurement, described.” European Society of Cardiology. 05 May 2015. Retrieved from URL: https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-13/Intima-media-thickness-Appropriate-evaluation-and-proper-measurement-described

[3] Rogers, Graham, MD. “What You Should Know About the Carotid Intima-Media Thickness (CIMT) Test.” Healthline. 31 Jan. 2017. Retrieved from URL: https://www.healthline.com/health/heart-disease/cimt-test

[4] Cedars-Sinai. “Carotid Intima-Media Thickness Test (CIMT).” Retrieved from URL: https://www.cedars-sinai.org/programs/heart/clinical/womens-heart/services/cimt-carotid-intima-media-thickness-test.html 

[5] Matthias W. Lorenz, et al. “Carotid Intima-Media Thickening Indicates a Higher Vascular Risk Across a Wide Age Range.” Stroke. 8 Dec. 2005.

[6] Matthias W. Lorenz, et al. “Prediction of Clinical Cardiovascular Events With Intima-Media Thickness.” Circulation. 30 Jan. 2007.

[7] Rogers, Graham, MD. See above.

cholesterol build up in arteries blocking significant blood flow

What Does High Cholesterol Mean for Your Health?

Healthy citizens are the greatest asset any country can have.

Winston S. Churchill

High cholesterol is very common in the U.S., but being commonplace doesn’t make it any less serious. While 95 million U.S. adults over the age of 20 are believed to have high cholesterol, it’s possible there are many more undiagnosed cases. [1] Oftentimes, people who have high cholesterol don’t know they have it. This is concerning considering the fact that high cholesterol is associated with serious health issues such as heart attack and stroke.

Despite its widespread nature, there are many things most of us don’t know about cholesterol. From understanding the differences between “good” and “bad” cholesterol to determining what you can do to improve your levels, there’s a lot to learn about this health phenomenon. Luckily, even if you’ve been diagnosed with high cholesterol or have a family history of the condition, there are many risk factors within your power to change. Explore what you need to know about high cholesterol below.

What is High Cholesterol?


Cholesterol is a waxy substance naturally produced by the liver. It’s a type of lipid which is crucial to the development of cell membranes, vitamin D, and key hormones. Yet, while it plays a critical role in these functions, having high cholesterol can be dangerous—particularly when there’s too much “bad” cholesterol. Thus, to understand the ways in which cholesterol can impact our health, it’s important to first explore the different types.

Types of Cholesterol

Because cholesterol can’t dissolve or move through blood on its own, it must be attached to proteins to be transported throughout the body successfully. The combination of cholesterol and proteins is referred to as a lipoprotein. There are two main forms of lipoproteins:

  • Low-density lipoprotein (LDL): Also known as the “bad” type of cholesterol, LDL carries particles of cholesterol through the blood. It can also accumulate within the artery walls, causing them to harden and narrow.
  • High-density lipoprotein (HDL): Commonly referred to as the “good” cholesterol, HDL carries excess cholesterol back to the liver. 

If your body has too much LDL, you could face an increased risk for serious health issues. Alarmingly, however, high cholesterol exhibits no symptoms, and the only way to test for high cholesterol is to have a blood draw.

Dangers of High Cholesterol


mature man gripping chest while sitting on couch in pain, mature man having heart attack on couch at home alone

Having high LDL cholesterol increases the risk for heart disease, the leading cause of death in the U.S. [2] Heart disease refers to a range of conditions which can affect the heart, many of which can lead to heart attack or stroke. Also known as hypercholesterolemia, high LDL increases fatty deposits within the arteries, thereby also increasing the risk of blockages. When cholesterol builds up on the artery walls, it forms what’s known as a cholesterol plaque. This plaque can restrict blood flow, also increasing risk for blood clot. Should a blood clot block the artery in the heart or brain, it can lead to a heart attack or stroke.

The good news is that high cholesterol can be treated with medication and managed through lifestyle modifications. First, however, you must know where you stand. Here is a general scale of LDL cholesterol numbers and what they mean.

  • Less than 100: optimal
  • 100-129: near optimal
  • 130-159: borderline
  • 160-189: high
  • 190 or higher: very high [3]

Keep in mind that in addition to having high LDL, having low HDL (again, the “good” cholesterol) can also put you at risk for heart disease. Thus, this too should be measured, with an ideal score of 60 or more. If HDL is less than 40, it could be considered a risk factor. [4]

Causes of High Cholesterol


Mature man eating donut while holding a second donut in his hand

The causes of high cholesterol span far and wide. Some contributing factors are within an individual’s control to change, while others are not. For example, while diet, weight, and exercise levels can influence HDL, factors such as age, gender, and genes can also contribute to LDL or HDL levels. Thus, the best way to maintain healthy cholesterol levels and thus support better cardiovascular health, is to focus on the factors within your control to change. Let’s take a closer look at the causes behind high cholesterol.

  • Diet: Cholesterol comes from two sources. While the liver produces all the cholesterol the body needs, we also take in cholesterol from foods derived from animals. This isn’t to say that eating meat or dairy products is bad for you. Foods with trans fats, however, cause the liver to produce even more cholesterol, which can lead to high cholesterol levels in some individuals. In addition to heavily processed animal products with trans fats, many baked goods can also trigger the liver to produce excess cholesterol. [5] 
  • Exercise Habits: Having a sedentary lifestyle can contribute to high LDL cholesterol. Regular aerobic activity, in particular, can help control LDL and in some cases promote healthy HDL levels. [6]
  • Weight: A large waist circumference and obesity are also associated with high cholesterol. [7]
  • Smoking: Smoking can lower your good HDL cholesterol, but it can compromise cardiovascular health in many other ways. In itself, smoking can increase the buildup of plaque in the blood vessels, damage the cells that line the blood vessels, and cause the vessels to thicken and narrow. [8]
  • Age & Gender: Cholesterol levels tend to rise naturally as we age. Prior to menopause, women’s total cholesterol levels tend to be lower than their male peers. After reaching menopause, however, their LDL cholesterol levels tend to rise, and HDL may also decrease. [9]
  • Hereditary Factors: Genetics play a role in the amount of cholesterol the body produces. High cholesterol can run in families, so individuals with relatives who have high cholesterol should be especially proactive in getting their levels checked.

The American Heart Association advises every adult over the age of 20 to have their cholesterol tested every four to six years, but these figures will vary based on the factors outlined above and on previous clinical indications.

Should high cholesterol be discovered in your blood test results, there are many ways to begin controlling it.

How to Lower Cholesterol Levels


Mature couple jogging and running outdoors in the city, Mature couple carrying reusable water bottles while jogging through the city

Lifestyle and diet changes are among the most effective ways to prevent and lower LDL. Additionally, if you’re a smoker and haven’t already done so, make a plan to quit. Here, we’ll explore some detailed changes that work well for lowering LDL cholesterol.

Dietary Changes

While there are many wise eating habits you can incorporate into your dietary plan to improve cholesterol levels, the lowest cholesterol levels are found in diets with the highest soluble fibers. [10] Diets high in soluble fiber often align with the typical anti-inflammatory diet, which emphasize foods like kidney beans, Brussels sprouts, and apples. Soluble fiber has the ability to reduce cholesterol absorption in the blood, making it a powerful nutrient for individuals with high LDL cholesterol. [11]

Additionally, eliminating trans fats found in margarine and store-bought, processed snack foods can help to reduce cholesterol. Individuals may also wish to incorporate foods rich in omega-3 fatty acids such as walnuts, flaxseeds, salmon, and mackerel. While these foods won’t affect LDL cholesterol themselves, they do have other cardiovascular benefits, such as the ability to help reduce blood pressure.

Exercise

Regular physical activity can support better cholesterol by increasing HDL. [12] Generally, most individuals can benefit from 30 minutes of exercise five times per week, or 20 minutes of high-intensity exercise three times a week. With that being said, it’s important for each person to work with an experienced physician who can make exercise recommendations based on the individual’s starting physical health.

Losing weight is another helpful way to control cholesterol, which can often be achieved with a strategic approach to dieting and exercising. Reducing alcohol consumption may also help to control cholesterol levels.

In some cases, medications may be needed in conjunction with the lifestyle and dietary changes described above to control especially high cholesterol levels. Even if medications are needed, maintaining a healthy lifestyle can help keep medication doses as low as possible. 

Understanding Your Risk for High Cholesterol – In Conclusion


Because it exhibits no outward symptoms, high cholesterol is a dangerous threat to health, which can have serious implications if left unaddressed. Its impact on heart health cannot be overstated, and while there are some factors which are beyond an individual’s control to change, many behaviors that influence cholesterol can be modified.

At Cenegenics, your individualized treatment plan begins with a comprehensive lab panel to test for underlying health issues, such as high LDL or low LDL cholesterol. Based on the findings, our clinical team devises tailored roadmaps to help you become healthier and enjoy a better overall quality of life. For instance, while our approach to healthy eating and exercise will certainly help to lower high cholesterol with ongoing compliance, it can also support weight loss, improved cardiovascular health, and reduced risk for disease. With the knowledge that the many measures of health are complex and often interconnected, we treat the entire patient, not just a single symptom or isolated condition.

If you’re interested in controlling your cholesterol and optimizing your wellness overall, contact your nearest Cenegenics location for more information.

Next Steps to Controlling Your Cholesterol

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] CDC, “High Cholesterol Facts.” 6 Feb. 2019. Retrieved from URL: https://www.cdc.gov/cholesterol/facts.htm 

[2] CDC; see above.

[3] Cleveland Clinic, “Cholesterol Numbers: What Do They Mean.” 26 July 2017. Retrieved from URL: https://my.clevelandclinic.org/health/articles/11920-cholesterol-numbers-what-do-they-mean

[4] Cleveland Clinic, see above.

[5] American Heart Association, “Control Your Cholesterol.” 30 Apr. 2017. Retrieved from URL: https://www.heart.org/en/health-topics/cholesterol/about-cholesterol

[6] Bhatt, Ami, MD, FACC. “Cholesterol: Understanding HDL vs. LDL.” Harvard Health. 12 Apr. 2018. Retrieved from URL: https://www.health.harvard.edu/blog/understanding-cholesterol-hdl-vs-ldl-2018041213608

[7] Bhatt, Ami; see above.

[8] CDC, “Smoking and Heart Disease and Stroke.” 28 Jan. 2019. Retrieved from URL: https://www.cdc.gov/tobacco/campaign/tips/diseases/heart-disease-stroke.html

[9] Cleveland Clinic; see above.

[10] Leake, Jeffrey Park, M.D., CPT and Greenberg, Todd David, M.D., CSCS. The Textbook of Age Management Medicine: Volume 1. 2015, Leake-Greenberg Ventures. (125)

[11] Mayo Clinic. “Top 5 lifestyle changes to improve your cholesterol.” 11 Aug. 2018. Retrieved from URL: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/reduce-cholesterol/art-20045935

[12] Mayo Clinic; see above.

= Mature business man in suit standing outdoors with urban background

How Marine Fish Oil Supplements Support Mental & Overall Health

We need, ultimately, to be able to view mental health

with the same clear-headedness we show

when talking about physical health.

Matt Haig

While physical health may command the most attention from the media, flooding inboxes and capturing magazine headlines with information on how to lose weight, brain health is equally deserving of our attention. After all, without our mental acuity, very little is possible. It’s therefore essential that we begin looking for more ways to boost our mental health, giving it equal respect and effort as we do our physical wellbeing.

Supporting mental health doesn’t just mean practicing self-care and doing things that improve your mood. It also means nourishing the brain in the same ways you would your body. We tend to put so much emphasis on how what we eat will affect our physical appearance and fuel our body, that we wind up overlooking how our diets can influence one of the most important organs of all: the brain.

Frustratingly, the modern American diet has many gaps, even for those who follow healthy eating principles, but that doesn’t mean you can’t address these gaps. While mental health is influenced by many complex factors, some of which are not always within our control to change, it is possible to supply your brain with the type of fuel it needs most. Specifically, incorporating a supplement into your daily routine could help to nourish your brain with powerful essential nutrients. Discover the benefits of the leading supplement for brain health, marine fish oil, here.  

What is Fish Oil?


Fish oil pills in wooden spoon on table

Fish oil is a natural substance derived from certain types of marine life. It’s rich in two essential polyunsaturated fatty acids which are necessary for normal growth and development: EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). These nutrients cannot be produced by the body and can therefore be obtained only through diet. Because omega-3 fatty acids are difficult to take in through diet alone, taking a dietary supplement is the most effective way to address gaps.

Why Should We Be Taking Fish Oil Supplements?


middle-aged woman hugging mature man sitting in chair outside

The omega-3 fatty acids DHA and EPA are extremely valuable for promoting healthy brain function. They can even support cognitive function in patients with Alzheimer’s disease (AD) and, in fact, research suggests that low intake of the two nutrients could be associated with an increased risk for AD.  This could be because DHA plays an important role in nervous system function, which may influence AD and overall cognitive function. Studies have found that diets high in omega-3 fatty acids are strongly associated with a lower AD risk. [1]

Benefits of Fish Oil

Fish oil supplementation plays a large role in brain health, as well as mental health. Fish oil can: 

  • Support cognitive function in patients with Alzheimer's disease
  • Alleviate symptoms of schizophrenia and bipolar disorder
  • Promote better overall brain health
  • Slow rate of mental decline with age
  • Support mental health

Beyond potentially aiding in AD prevention, however, it’s suspected that fish oil can support brain function in other ways. The brain is nearly 60% fat, much of which is made up of omega-3 fatty acids. Certain research shows that people with some mental disorders, including major depression and schizophrenia, have lower levels of omega-3s in their blood. [2] Studies have shown that taking marine fish oil supplements regularly can improve symptoms of or even prevent certain psychotic disorders in at-risk individuals. [3]

Supplementing with fish oil could also alleviate symptoms of schizophrenia and bipolar disorder. [4] Thus, while there may be a complex interplay of factors contributing to the risk and development of brain and mental health conditions that are beyond our control, we should take full advantage of the steps that are within our control, such as nourishing the brain and adopting healthy lifestyle habits overall.

Support Brain Health

mature businessman smiling while assisting younger female coworker

Fish oil doesn’t just help to lower your risk for AD and mental disorders, however. It can also support better brain health in all individuals. While brain function slows down as we age, certain nutrients have the power to slow the decline in mental function. Individuals who eat more fish, in particular, have been shown to experience a slower rate of mental decline through old age than their peers. Fish oil has also been associated with improved memory in healthy elderly populations. [5]

Clearly, getting enough omega-3 fatty acids is one of the best things you can do to support brain health. Yet, the American diet has evolved over the years and, while the current American diet tends to be high in saturated fats, it’s generally low in omega-3 fatty acids. Fish oil supplements are primary sources of EPA and DHA, which is why they’re so widely recommended as a powerful preventive health tool. [6] Yet, there are even more compelling reasons to take fish oil supplements. Outside of their ability to support mental health, they also have a number of other advantages on wellness overall.   

What Are Some Additional Benefits of Fish Oil?


Mature man stretching before jogging in urban area

The benefits of fish oil extend far beyond brain health alone, improving health outcomes in a number of key areas. Here are just a few of the ways taking fish oil supplements can support your physical wellness:

  • Improves cardiovascular health: Heart disease is the number-one cause of death worldwide. Individuals who take in sufficient fatty acids have lower heart disease rates. This is likely because fish oil can regulate cholesterol levels, lower triglycerides, lower blood pressure in individuals with elevated levels, reduce arterial plaque, and reduce fatal arrhythmia events. [7]
  • Supports flexibility of joints and cartilage: The Arthritis Foundation® recommends fish oil as a treatment for reducing inflammation and morning stiffness in joints, especially for individuals with rheumatoid arthritis (RA). In fact, the foundation even suggests that fish oil may inhibit RA development. RA patients who took fish oil supplements regularly were able to reduce or eliminate their use of over-the-counter painkillers. [8]
  • Promotes a healthy immune system: Fish oil is used to support immune system health and is even incorporated into therapeutic protocols for many chronic conditions such as asthma, eczema, psoriasis, multiple sclerosis, cystic fibrosis, and systemic lupus erythematosus. Research shows fish oil can improve immunity by reducing inflammation, which contributes to a number of autoimmune disorders. [9]
  • Boosts metabolism: Supplementing with fish oil could improve body composition and support weight loss when used in combination with healthy eating and exercise. While not all studies have observed the same effects, in some cases, fish oil supplements helped to increase metabolism and reduce appetite. [10]
  • Increases bone health: Individuals who have higher concentrations of omega-3 fatty acids in their blood also have better bone mineral density. This is critically important in older individuals, as the risk of bone-related issues including osteoporosis increases with age. [11]
  • Supports healthy skin: The skin is the body’s largest organ, and it’s rich in omega-3 fatty acids. Thus, supplementing with fish oil can promote healthy skin, and it may even help to prevent or control conditions such as psoriasis and dermatitis. [12]

These are just some of the most noteworthy benefits of taking fish oil supplements, but there are even more not listed here. Overall, the fatty acids found in fish oil provide tremendous value both in healthy individuals and those with many medical or mental disorders. If you suspect you could benefit from incorporating a fish oil supplement into your daily regimen, be sure to reach out to a Cenegenics physician for more information.

Fish Oil Supplementation – In Conclusion


While fish oil indeed holds tremendous promise for supporting a number of mental and physical benefits, it’s important to remember that not all supplements – or patients – are the same. As the industry leader in wellness optimization, Cenegenics takes a comprehensive approach to treatment and ensures each patient’s individual needs are prioritized.

Our supplements are also of higher quality than others available on the market and are manufactured in the U.S.A. We provide custom doses for all of our patients based on our clinically indicated findings gathered through comprehensive patient evaluations. This promotes the greatest possible outcome in terms of reaching both short-term wellness goals and long-term disease prevention.

To find out how fish oil supplements and our wellness optimization program as a whole can help you reclaim your glory days™ and achieve the healthiest version of yourself, contact your nearest Cenegenics location today.

Next Steps

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] Danielle Swanson, et al. “Omega-3 Fatty Acids EPA and DHA: Health Benefits Throughout Life.” Advances in Nutrition. Jan. 2012. Retrieved from URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262608/

[2] Robertson, Ruairi, PhD. “13 Benefits of Taking Fish Oil.” Healthline, 18 Dec. 2018. Retrieved from URL: https://www.healthline.com/nutrition/13-benefits-of-fish-oil

[3] GP Amminger et al. “Long-chain omega-3 fatty acids for indicated prevention of psychotic disorders: a randomized, placebo-controlled trial.” JAMA Psychiatry. Feb. 2010. Retrieved from URL: https://www.ncbi.nlm.nih.gov/pubmed/20124114

[4] Robertson, see above.

[5] Robertson, see above.

[6] Swanson, see above.

[7] Robertson, see above.

[8] “Fish Oil.” Arthritis Foundation. Retrieved from URL: https://www.arthritis.org/living-with-arthritis/treatments/natural/supplements-herbs/guide/fish-oil.php

[9] McGlashen, Andy and Fenton, Jenifer. “Fish Oil May Improve Immunity.” MSU Today. 01 Apr. 2013. Retrieved from URL: https://msutoday.msu.edu/news/2013/fish-oil-may-improve-immunity/

[10] Robertson, see above.

[11] Robertson, see above.

[12] Robertson, see above.

Middle aged couple shopping for fresh produce in grocery store

What Happened to Our Food?

To eat is a necessity, but to eat intelligently is an art.

Francois de La Rochefoucauld

Food is supposed to be for sustenance - but instead of giving us the building blocks for health and life, food today is perhaps our most toxic daily exposure. The quality of our food is directly tied to the quality of our health, and changes in our food supply since World War II have resulted in a significant increase in inflammation, infertility, cancer, birth defects, infections, and neurologic diseases like Alzheimer's and Parkinson's. It is no longer true that all you have to do to be healthy is to eat a low glycemic diet, exercise, and balance your hormones.

A Brief History – Patented Herbicide


Man spraying herbicide in non-organic garden

What happened? The decline of the quality of our food production began with the end of WWII, as weapons manufacturers looked for another market to sell the nitrogen that had been used in weapons production. Farmers began to use this to fertilize their crops, neglecting proper care of the soil. This caused nutrient deficiencies in the soil that led to more weed growth, which became quite problematic for farmers. Instead of returning to proper soil stewardship, which naturally controls weed growth, they turned to the use of pesticides. In 1964, glyphosate was patented as a descaling agent used to clean out mineral deposits from water pipes. Glyphosate was accidentally found to kill weeds and, in 1969, it was patented as an herbicide under the name Roundup.

Glyphosate – Beyond Pesticides


Glyphosate is a broad-spectrum chelating agent, which means that it grabs onto mineral ions (calcium, iron, manganese, magnesium, etc.) and makes them soluble in water so that they wash away. It is very effective at pulling minerals and vitamins not only out of the soil to which it is applied, but out of microorganisms, plants, animals, and humans. Why is that bad? Enzymes are proteins that catalyze biologic reactions within the body. These enzymes require cofactors like vitamins and minerals in order to accomplish the reactions which support life. If the cofactors are absent because they have been chelated out by glyphosate, the normal enzymatic reactions that support life, including reactions such as protein synthesis, fat and carbohydrate metabolism, and DNA repair cannot occur. Dr. Arden Anderson, an expert in this field, refers to these vitamin and trace mineral cofactors as the ignition keys that activate the enzymes; "If the key is deactivated or removed, the enzyme cannot function any more than can your car start without the key in the ignition."

When trace minerals are removed, an organism becomes weakened and can no longer resist pathogens. This is actually the main way in which glyphosate kills plants - it weakens the immune system so that the plant can no longer resist attack by pathogenic bacteria and fungi. Glyphosate also kills beneficial bacteria in the soil and in the gut of animals and humans, allowing overgrowth of harmful bacteria. In fact, glyphosate was patented as an antimicrobial in 2010.

Genetically Engineered Crops


Man in coveralls and gloves examining corn crops in field

The other perhaps even more sinister side of the use of glyphosate is the development of genetically engineered crops. Genetic engineering of crops is not the same as plant breeding. It is, rather, the introduction of foreign DNA into the plant genome that codes for an insecticide, fungicide, or confers resistance to the application of glyphosate. This foreign DNA is introduced into plant cells by infection with a viral vector attached to a gene for antibiotic resistance, necessary for crop developers to identify the plants that have taken up the foreign genetic material. The plant, then, is able to produce its own chemicals to resist attack by insects, fungi, herbicides, or pesticides. The goal was to decrease crop damage and increase yield, but instead genetic modification has led to more resistant pathogens, which has actually resulted in an increase in the application of pesticides, herbicides and insecticides, lower crop yield, horizontal transfer of antibiotic resistance to gut bacteria, and further nutritional impoverishment.

Becoming a Smarter Consumer – In Conclusion


Unfortunately, when you or another animal eats that plant, or you eat an animal that has dined on those plants, you are consuming not only the new genetic material and the proteins for which it codes (insecticide, herbicides, or fungicide) but you are also consuming more pesticides/herbicides which have been sprayed on those plants. Since the proteins that are encoded by the inserted gene are completely foreign, your immune system reacts, beginning with inflammation in the lining of your intestine. Since you consume foods containing these foreign proteins nearly every day, your body is in a state of chronic inflammation, which leads to diseases like cancer, inflammatory bowel disease, autoimmune diseases, arthritis, heart disease, and dementia.

mature man shopping for in season fruits and vegetables at farmers market

With this sort of daily toxic exposure, how can you expect to remain healthy? A change in this system will only succeed if it comes from the consumer and spreads upward. Remember that your most powerful vote comes at the grocery store with the money that you spend on food - please vote daily to stock the shelves with wholesome food.

* This information was adapted from a lecture by Arden Anderson DO, MSPH, PhD at the AMMG 2013 conference in Hollywood, FL

Next Steps

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Author

Julie McCallen, M.D.
President of Cenegenics Denver

Dr. Julie McCallen is the President of Cenegenics Denver. She is board-certified in Family Medicine, a member of the Endocrine Society, the International Hormone Society, American Academy of Family Physicians, and the Age Management Medicine Group. After earning an undergraduate degree in Biochemistry from Cornell University, Dr. McCallen received her MD from the University of Pittsburgh School Of Medicine in 1990. She completed her residency in Family Medicine at the University of Wyoming-Casper in 1993.

Mature woman with glasses on laptop in café.

HRT for Women: Dispelling the Myths & Understanding the Benefits

Greatness can be captured in one word: lifestyle.

Mae Jemison M.D.

Hormone replacement therapy (HRT) for women has been a topic of much debate in recent decades. This is due largely to the fact that the Women’s Health Initiative (WHI) study in 2002 was halted prematurely because of a reported increase in the instance of breast cancer in women participating in the hormone replacement arm of the study. Thereafter, thousands of women were taken off or stopped taking HRT unnecessarily, despite the fact that many studies have debunked the WHI conclusions.   

The media has been slow to report the more recent findings, which indicate that not only is HRT not an identifiable causative agent of breast cancer, but that when begun early, hormone therapy actually has a collective mortality risk reduction of 40%. [1]

HRT for women has indeed developed a bad reputation, but any fears surrounding the treatment are unfounded. Here, we examine the relationship among HRT and breast cancer, colon cancer, cardiovascular disease, osteoporosis, and brain health to dispel the myths once and for all. Discover how this powerful treatment helps, rather than harms, postmenopausal women in tremendous ways below. 

HRT & Breast Cancer: What’s the Connection?


Mature woman holding breast cancer ribbon.

One of the major flaws of the WHI was the confusion and fear it spread by projecting its results to all women receiving HRT. In the original study, more women who took estrogen plus progestin (E+P) developed breast cancer than those taking placebos. The results showed that 41 women in 10,000 taking E+P developed breast cancer compared to 33 in 10,000 on the placebo. [2]

Yet, the updated WHI analysis released in 2006 clarified this finding, stating that estrogen-alone HRT does not increase the risk of breast cancer in postmenopausal women. [3] Further research published in a 2013 article in The Journal of Clinical Endocrinology and Metabolism shows that breast cancer rates were actually found to decrease significantly with estrogen alone. Moreover, the article goes on to say that even though there isn’t a significant increase with E+P used together versus estrogen alone, for illustrative purposes, any increased risk of breast cancer associated with E+P originally publicized with the WHI trial is less than the risk conferred by obesity, being a flight attendant, and many other common exposures. [4]

Another noteworthy difference which can play a role in breast cancer risk is the use of synthetic progestins versus bioidentical progesterone. Synthetic progestins, which were used in the WHI, are hormones which are synthetically produced, and thus different in structure from bioidentical progesterone. Bioidentical progesterone, while produced from a plant source, is structurally and chemically identical to the progesterone produced by the ovaries. Synthetic progestins mimic some effects of the natural hormone, but react differently with progesterone receptors within the body and are felt to be responsible for the increase in breast cancer seen in WHI. On the other hand, bioidentical progesterone does not increase, and may actually reduce the risk of breast cancer. [5]

For many women, HRT is a powerful means of regaining quality of life and maintaining optimal wellness through the postmenopausal years. In fact, avoiding estrogen therapy can actually have serious implications. One article published in the American Journal of Public Health indicates that as many as 91,610 postmenopausal women died prematurely because of the avoidance of hormone therapy. Estrogen therapy, especially when used in younger postmenopausal women (aged 50-59), is linked to a decisive reduction in all-cause mortality.

Yet the use of HRT in this group continues to fall. If the potential for reducing breast cancer risk isn’t compelling enough to take another look at hormone therapy, consider how it could also combat colon cancer, below.

How Does HRT Influence Colon Cancer Risk?


Mature woman speaking with physician in doctor’s office.

Colorectal cancer is the third-most commonly diagnosed cancer in the U.S., and is anticipated to cause more than 51,000 deaths this year alone. [6] As with many types of cancer and serious illness, the risk for colorectal cancer increases with age. While screenings have helped to reduce the death rate of the disease, taking preventive steps to minimize risk remains the most powerful approach in combatting the disease.

One especially effective tool for reducing risk in women is HRT. After adjustment for other known risk factors, the use of HRT indicated a 63% relative reduction of colorectal cancer risk in postmenopausal women. Aspirin users and women who participated in sports regularly did not receive the same benefits. While the mechanism of this protective effect remains unknown, it’s suspected that HRT use contributes to lower rates of colonic adenomas, and that duration of use, medication type, and age could all factor in to individual prevention rates. [7]

Cancer isn’t the only thing HRT may help prevent, however. Research also indicates it could play a role in boosting overall cardiovascular health – find out how in the next section.

Can HRT Help Prevent Cardiovascular Disease in Women?


Mature businesswoman working on laptop while gripping her chest.

Cardiovascular disease is responsible for 1 in every 4 deaths in the U.S. It’s the leading cause of death in both men and women, and leads to more than 600,000 deaths across the country annually. [8] It’s therefore critical that as the risk for cardiovascular disease increases with age, individuals find ways to optimize heart health.

HRT may not be prescribed for women primarily as a means for improving cardiovascular health, but this is indeed a powerful byproduct of the treatment. According to research published in the BMJ, women receiving HRT early after experiencing menopause had a significantly reduced rate of heart failure, myocardial infarction, and mortality overall. At the start of treatment, women on average were aged 50 and had been postmenopausal for seven months. Roughly half as many women using HRT experienced cardiovascular events compared to those in the control group. Additionally, these results did not correlate with an increased risk in any cancer. [9]

Moreover, evidence shows that there is a clear benefit in using estrogen alone, with coronary calcium scores significantly reduced. This measures the buildup of calcium and other substances which can narrow or close the arteries, leading to cardiovascular issues. In particular, women under 60 who receive hormone therapy have a statistically significant reduction in coronary disease. [10] Women who were given hormone therapy during early menopause also experienced reduced atherosclerosis progression (buildup of fats and cholesterol in the artery walls). [11]

These aren’t the only positive outcomes of HRT, however. Hormone therapy has been commonly used as an osteoporosis preventative, which brings us to our next segment.

HRT: Good or Bad for Osteoporosis?


Mature woman in bright orange jacket doing yoga pose on the beach.

The most pronounced symptoms associated with a sudden drop in estrogen include hot flashes, mood swings, and other readily noticeable physical or psychological impacts. Yet, it isn’t until much later that the ways in which hormonal changes affect the bones become realized. When estrogen levels dip, special cells called osteoblasts are no longer able to produce bone as effectively. For this reason, estrogen replacement is a common and effective treatment for conserving bone mass.

In fact, HRT decreases the risk of fragility fracture by as much as 35%. [12] And, women who discontinued hormone therapy had an increased rate of hip fractures compared to those who remained on it. [13] Even in women who do not have established osteoporosis or are not at a significant risk for fracture, HRT can still improve bone health and reduce fracture. [14] 

Next, let’s take a look at a lesser-known way HRT influences health by examining its impact on brain health.

How Does HRT Affect Women’s Brain Health?


In 1991, research suggested HRT could increase dementia risk for postmenopausal women over the age of 65, but it’s worth noting that these women were approximately 15 years past menopause when they began hormone therapy. [15] Since then, several studies and meta-analysis have suggested that estrogen prescribed to younger women can decrease the risk of Alzheimer’s disease or delay onset. [16]

As with the benefits of HRT for cardiovascular disease, timing is critical when it comes to realizing the advantages of HRT for brain health. Specifically, HRT used past age 65 could reduce Alzheimer’s risk if begun during the critical window when menopause first develops, and taken continuously over a decade. [17] This could be a result of the fact that, according to a study published in Neurology, HRT may preserve areas of the brain responsible for memory and thinking, while also reducing beta-amyloid plaques which contribute to cell death in Alzheimer’s. [18]

Hormone Therapy for Women – In Conclusion


Smiling middle-aged woman sitting in garden outside.

HRT for women has clearly acquired an undeserved poor reputation, all because of one study in which results were misinterpreted. This single event has prevented thousands of women from getting the care they truly need, when they need it most. Moreover, as mentioned above, it’s possible that as many as tens of thousands of women could have gone on to enjoy longer, healthier lives had their doctors prescribed HRT during the critical window at the onset of menopause.

At Cenegenics, our expert physicians believe in optimizing wellness with the tools available to us. This includes HRT for women. Our doctors only prescribe hormones when clinically indicated, and even then, perform rigorous and frequent testing to closely analyze the effects of treatment on critical biomarkers. This ensures the greatest benefit while minimizing any risk to the patient.

As a result, women in our program are able to enjoy not only short-term benefits such as a significant reduction in unfavorable symptoms like hot flashes and mood changes, but also long-term, protective qualities like those described above. For the right populations, HRT is an immensely powerful instrument for promoting optimal health through a woman’s middle ages and beyond.

Next Steps to Optimizing Hormones for Women

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Authors

Julie McCallen, M.D.
President of Cenegenics Denver

Dr. Julie McCallen is the President of Cenegenics Denver. She is board-certified in Family Medicine, a member of the Endocrine Society, the International Hormone Society, American Academy of Family Physicians, and the Age Management Medicine Group. After earning an undergraduate degree in Biochemistry from Cornell University, Dr. McCallen received her MD from the University of Pittsburgh School Of Medicine in 1990. She completed her residency in Family Medicine at the University of Wyoming-Casper in 1993.

Raymond Ishman, M.D.
President of Cenegenics Philadelphia 

Dr. Ishman focused on a career in emergency medicine, eventually becoming board certified. After nearly 20 years in the emergency room, Dr. Ishman shifted his focus back to primary care and preventive medicine. His goals are to keep patients well and prevent disease, rather than trying to deal with full-blown medical problems that could be prevented. In other words, keeping patients out of the emergency room.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] BMJ 2012;345:e6409

[2] WHI.  https://www.whi.org/participants/faq/Pages/faq_eplusp_bc.aspx#1

[3] NIH 2006; https://www.nih.gov/news-events/news-releases/whi-updated-analysis-no-increased-risk-breast-cancer-estrogen-alone

[4] Lobo, RA. (2013). https://www.ncbi.nlm.nih.gov/pubmed/23493433.

[5] Leake, Jeffrey Park, M.D., CPT and Todd David Greenberg, M.D., CSCS. Textbook of Age Management Medicine: Volume 2. Leake-Greenberg Ventures, LLC, 2015. 108-109.

[6] American Cancer Society, 2018. https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html

[7] Rennert, Gad et al. “Use of Hormone Replacement Therapy and the Risk of Colorectal Cancer.” Journal of Clnical Oncology. Sept. 20 2009.

[8] CDC; 2017. https://www.cdc.gov/heartdisease/facts.htm

[9] BMJ; see above.

[10] Lobo; see above.

[11] J Clin Endocrinol Metab 104: 293–300, 2019)

[12] International Osteoporosis Foundation, https://www.iofbonehealth.org/hormone-replacement-therapy-hrt.

[13] Islam S, Liu Q, Chines A, Hetzer E. Trend in incidence of osteoporosis-related fractures among 40-to 69-year-old women: analysis of a large insurance claims database, 2000–2005. Menopause. 2009; 16:77–83.

[14] de Villiers TJ, Stevenson JC. The WHI: the effect of hormonal replacement therapy on fracture prevention. Climacteric. 2012;15: 263–266.

[15] Shumaker SA, Legault C, Rapp SR et al. (2003) Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women: the Women's Health Initiative Memory Study: a randomized controlled trial. JAMA 289, 2651-2662.

[16] Lobo; see above.

[17] Alzheimer’s Drug Discovery Foundation, https://www.alzdiscovery.org/cognitive-vitality/blog/new-debate-on-hormone-replacement-therapy-and-dementia-risk

[18] Neurology Apr. 17 2018; 90 (16)

Mature man wearing hat while kayaking on lake

How to Naturally Boost Testosterone with Healthy Life Choices

You can, you should, and if you're brave

enough to start, you will. 

Dan Millman

The aging process brings on a host of changes throughout the body. In particular, one of the most pronounced shifts we see through the years is a substantial decrease in testosterone. The decline begins in our 30s with a 1-2% decrease every year thereafter. The sharpest decline is typically seen around our middle ages, during the mid-50s to early 60s.

While the inevitable changes brought on by aging might at first seem to merely be a fact of life for which nothing can be done to combat, at Cenegenics we feel differently. There are two ways we can look at time. We can sit back and let the punches connect, allowing our dwindling testosterone levels to slowly but surely diminish muscle mass, metabolism, and overall wellbeing. Or, we can take matters into our own hands and fight back. In the following guide, we’ll show you how to do just that.

How to Naturally Increase Testosterone

Aside from the aging process itself, there are many factors which contribute to diminishing testosterone levels. While we may not be able to change our age, there are ways to address the other factors within our control—no matter where we are in life. Practical and effective measures can be incorporated into a healthy lifestyle for everyone. And, while testosterone is critically important for men’s health, these principles apply to both males and females, as both rely on this hormone to maintain muscle mass and a strong metabolism, two key factors that help us maintain optimal health as we age.

On the surface, improving testosterone naturally seems to be a losing battle for many people. However, research has indicated that there are many ways in which a person can take the fight against age into their own hands. If you’re wondering how to naturally increase testosterone, start by taking a look at your overall lifestyle. The most powerful tactics for boosting this essential hormone align precisely with those that support overall wellness, including regular exercise, an optimized diet, and healthy sleep practices. We’ll explore each of these pillars in greater detail below.

Exercise Principles for Boosting Testosterone

Mature man smiling as he jogs in tree-covered area

You’ve probably heard this before, and chances are you’ll hear it again: A body in motion stays in motion, and a body at rest stays at rest. We’re not talking about physics here, though—we’re talking about your health.

When we exercise, our body responds and adapts. Believe it or not, stress is very healthy for the body—as long as it’s the right type, which in this case is physical stress. Physical stress brought on by working out is recognized by the body, which then activates the proper physiological response to adapt.

During exercise, there is an acute increase in both testosterone and growth hormone. Testosterone and growth hormone are our main anabolic hormones, and they increase in the presence of increased physical stress. Research has shown that intensity, resistance, and consistency are the keys to maintaining healthy testosterone levels through training. Here are the ways in which you can maximize the intensity, resistance, and consistent progression of your exercise routine to elicit testosterone growth.

Weight Training

man smiling as he bicep curls EZ curl bar with weights

Exercise is one of the most powerful tools we have in our arsenal for improving health, minimizing the risk of chronic illness and, of course, naturally increasing testosterone. By now, the advantages of regular exercise are widely understood by medical practitioners. Cardiovascular activities, such as running and cycling, boost respiratory health. Functional training, which can include Pilates and yoga among other exercises, can increase stability and structural control. And weight or resistance training, in which we use gym equipment, free weights, or our own body weight, can help us increase:

  • Muscle size
  • Strength
  • Power
  • Control

Benefits of Increasing Motor Unit Recruitment

Resistance training also provides an added benefit that often goes overlooked: Weight training that provides an unaccustomed stimulus to the body can lead to a spike in anabolic hormones such as testosterone and growth hormone.

When we weight train, the body is loaded with a stimulus it is not used to, also known as mechanical loading. For instance, if your body is unaccustomed to hoisting weight over your head but you incorporate overhead presses into your weight training regimen, the body will be unfamiliar with this stimulus. When the mechanical load against the body increases, the body must respond accordingly. It does so by increasing what’s called “motor unit recruitment.”

Motor units are critical muscle components that work to build force. These complex components are made up of different types of fibers which attach to bones with connective tissue. They are made up of nerve cells which innervate a group of skeletal muscles. The nerve cells within our motor units receive signals from the brain which stimulate the corresponding muscle fibers.

The more motor neurons that innervate the muscle fiber, the more efficient the muscles become. This greater efficiency leads to increased adaptation from weight training. At the same time, the external load also forces the body to release anabolic hormones. This is due to the increase in stress on the body. Stress indicates to the body that a response is needed, most of the time in response to catabolism (breakdown of some kind). In order to manage the stimulus, testosterone and growth hormone are released to combat the force generated and the pending catabolism.

Most Effective Multi-Joint Strength Movements

The most effective strength exercises for increasing total testosterone release during training are compound movements. These exercises are defined as “multi-joint movements” as they recruit multiple muscle groups for the most efficient and impactful workout. Some powerful multi-joint movements for increasing testosterone include:

  • Deadlifting variations
  • Bench press/overhead press variations
  • Squat variations
  • Pull ups/pull down variations
  • Rows
  • Lunges

Because all of these movements require the use of multiple joints, they effectively maximize testosterone release. As previously mentioned, the greater the stimulus the greater the neurological response. The greater the neurological response, the greater the muscular innervation. And finally, the greater the muscular innervation, the greater the testosterone release.

Most Effective Single Joint Exercises

With that being said, single joint exercises are also effective for increasing muscle mass. These, too, will elicit a testosterone increase and are effective for isolating single muscle groups. Consider incorporating the following single joint exercises into your workout routine:

  • Biceps curls
  • Triceps pull downs
  • Leg extension and leg curls
  • Calf raises
  • Lateral and forward raises

These exercises are effective because they strengthen the individual components that help the whole body train optimally. However, in order to maximize testosterone release and training response, progressive overload of large muscle groups should be priority.

When taking on a training routine, target multi-joint movements, but do so slowly. Adding weight too quickly to compound movements can be very dangerous and lead to serious injury. Just using all of these muscles at once, even with light to moderate weight, will initiate anabolic hormone release. Be sure to work with your nutrition/exercise counselor to ensure proper technique and programming for your individual needs and fitness levels.

While weight training is most effective for increasing testosterone, cardiovascular exercises can also support ideal testosterone levels by helping you maintain healthy fat levels. Yet, because achieving optimal health requires a complex balance among exercise and nutrition practices, it’s also important to make sure you’re fueling your body to support both optimal testosterone and demanding workouts. In the following section, we’ll take a closer look at some key nutrition principles for supporting healthy testosterone levels.

Nutrition for Testosterone Enhancement

As always, nutrition and exercise work together as the perfect crime-fighting duo to combat the effects of aging. When it comes to boosting testosterone naturally, the nutrition/exercise balance is no different. When we improve our exercise routine, a concurrent change in nutrition needs to occur as well. This will ensure that performance and recovery are maximized. Explore some general nutritional guidelines for testosterone health below.

Protein Intake

Seasoned steak on a black plate with fork and knife

Protein intake is absolutely essential to building muscle mass. In order for muscle to grow, there must be a positive nitrogen balance. This means that we need to be building more than we are breaking down. As discussed above, testosterone is anabolic and will therefore thrive in a nutrition plan high in quality protein.

When protein levels are too low, we risk falling into negative nitrogen balance. This leads to catabolism, or breakdown. Lower levels of protein will reduce anabolism which reduces exercise performance and recovery and, as a result, testosterone production. In order to maintain an anabolic environment needed to support testosterone growth, we must take in ample protein.

Healthy sources of protein include lean poultry and meat, beans and legumes, and nuts. Of course, protein isn’t the only macronutrient to focus on for healthy eating, which is why working with a nutrition specialist who can help you master a balance is so widely recommended. We’ll discuss the other macronutrients, carbohydrates, and fats next.

Carbohydrate Intake

Healthy carbohydrates including cheese, fruits, and some grains

As most of us already know, determining the right level of carbohydrate intake for our bodies can be tricky. When it comes to this macronutrient, there are many factors to consider.

At Cenegenics, one of our main goals is to improve insulin sensitivity, blood sugar regulation, and hemoglobin A1c. Many of these objectives can be achieved largely through regulating carbohydrate intake. In fact, carbohydrates play a significant role in our overall health. However, the amount and type of carbohydrates we need for fuel varies based on many individualized factors. Before embarking on a new nutrition plan, be sure to consult your Cenegenics physician and exercise nutrition coach about the best carbohydrate structure for you.

Now, let’s say that you’ve established a strong training routine and have your blood sugar numbers well under control. Carbohydrates have a very large role in sustaining energy, exercise performance, recovery, and therefore, testosterone. When the body undergoes substantial carbohydrate depletion, it seeks out other fuel sources to use as energy. Of course, fat is one of them but, eventually, if overall calorie intake drops too low, protein becomes one as well. This breakdown of protein also results in catabolism and can lead to decreased muscle mass, metabolism, and strength. Again, it is thus critically important to have an expert help you establish the nutritional plan that corresponds with your precise workout structure and physiological needs.

Here are general guidelines on how to choose the right kinds of carbohydrates for your activity level.

Carb Intake for Light Cardio

If you perform light cardio a couple of times a week, your best bet is to stick with vegetables and the occasional high-fiber fruit, such as apples, pears, and oranges. These foods are high in micronutrients and fiber which makes them ideal for lower-intensity activity. This type of exercise is not very demanding which means carbohydrates will not be the primary driver for energy production.

Carb Intake for Moderate-Intensity Training

If you practice moderate-intensity training including moderate cardio and two days of light weight training, you may have a greater need for carbohydrates. This type of training would require moderate-glycemic carbs, such as berries and oranges. These carbohydrate sources should be consumed immediately after training along with a protein source. This approach will help you make the most of the natural insulin spike you produce during and after training, allowing you to use carbohydrates efficiently while building muscle protein.

Fat Intake

Healthy fats include fish, avocados, and certain nuts

The word “fat” has garnered a bad reputation over the years.  Recently, however, nutrition experts have encouraged us to embrace the powers of healthy fat. While healthy fat can help you maintain healthy cholesterol levels, its benefits extend even further. Cholesterol is the precursor for testosterone formation. Without adequate levels of healthy fat intake, we may suffer from low high-density lipoproteins (the healthy cholesterol). With low levels of healthy cholesterol in the body, our baseline production of testosterone can actually be blunted and decrease over time. To maintain healthy levels of good cholesterol, healthy fats should be added to your diet, such as:

  • Avocados and guacamole
  • Olive oil
  • Nuts (almonds, walnuts, pistachios, cashews)
  • Whole food nut butters
  • Fish (salmon, mackerel, whole tuna)
  • Grass-fed beef

All of these sources of fat contain high levels of quality nutrition that can help maintain a healthy cholesterol profile in the body. This, in turn, can also help you maintain healthy, natural testosterone levels. With that said, fats are very high in calories so always be aware of proper portion size for total calorie intake. Again, work with your nutrition and exercise team to establish a meal plan that works for you.

While exercise and nutrition are among the most important factors for regulating testosterone and supporting overall health, there’s one frequently overlooked yet critically important component to consider: sleep.

Sleep for Optimal Testosterone Levels

Man in blue shirt sleeping on side

Sleep deprivation is one of the main causes of diminishing health over time.  When we sleep, the body undergoes a recovery process that, when reduced, can create a cascade of severe health-related issues.

Within the first two hours of quality REM sleep, there is a significant increase in growth hormone and testosterone release. As stated above, maintaining healthy levels of these two anabolic hormones will reduce muscle protein breakdown. In general, seven to nine hours of sleep is typically recommended, which adds up to around three or four full REM cycles. Each REM cycles provides further recovery for the body, including a reduction in cortisol.

Unfortunately, pulling all-nighters, slamming down caffeine, and working our fingers to the bone are behaviors that are often worn as a badge of honor in our society. In reality, these unhealthy practices are among the worst things we can do for our health. Forcing the body to push through sleep deprivation initiates a survival mode. This prompts the body to attempt forced sleep by increasing cortisol, telling you that it is time to slow down. The more we push through this catabolic warning, the more our unhealthy stress levels and inflammation increase.

Sleep Deprivation – Sleep Study

In a study conducted by Leproult et al, college students were placed under a week of sleep deprivation. First, however, students received eight hours of sleep per night for a week, during which their testosterone levels were measured daily. For the following eight days, the students slept five hours per night, and testosterone was measured similarly. At the end of the eight days of sleep deprivation, each student saw a decline in testosterone of 10-15%. That is a massive change in less than a week and a half, and these students were in their early 20s. Imagine what’s happening if you’re in your mid-50s and you’ve been sleep-deprived for most of your adult life!

Ultimately, cortisol and testosterone work like a see-saw: when one goes up too much, the other one goes down. We can combat the rise in cortisol through healthy nutrition and sleep. However, when those two things are neglected, testosterone levels face a losing battle against cortisol from which they may not recover. Therefore, testosterone drops, leading to decreased energy, metabolism, muscle mass, and even joy. It is very common to feel anxiety and depression when you’re sleep-deprived, because that’s how your body feels when it is perpetually in breakdown mode.

So, do your body a favor: leave the office early, get away from the screen, and get some shut-eye. Ample sleep is essential not only for optimal testosterone levels, but for your health as a whole.

Boosting Testosterone Naturally – In Conclusion

Improving any one of these areas for increasing testosterone naturally may be beneficial in itself. However, the combined effect of all of these factors will provide the greatest boost in testosterone and overall wellness. Health is like a building that is held up by pillars: when all of the pillars are intact, the building will stand strong. Remove one pillar, and the structure becomes weaker. Remove another, and the same happens. Remove all of them, and the whole structure collapses.

When we work ourselves to the bone, we are unaware of how much damage occurs within our body every day. To maintain healthy testosterone and overall wellness, you must incorporate the recommendations described within this guide. As a brief recap, here are some key principles covered herein:

  1. Perform weight training using multiple muscle groups through compound movements. Be sure to practice proper form and select an appropriate weight for your fitness level.
  2. Consider adding high-intensity interval training to your training routine. It is time-effective and a natural testosterone booster.
  3. Follow a balanced nutrition plan that includes all macronutrients in some form. Be sure to speak with your exercise/nutrition counselor about the ideal nutrition plan to help you recover from and maximize your workouts.
  4. Sleep at least seven hours per night but, ideally, aim for eight—even if this means leaving the office a little early or watching one less hour of TV. You owe it to your body to do so.

As the leaders in personalized age defiance, Cenegenics provides the highest level of support for our patients. We’re here for you at every step, whether your goal is to increase testosterone, feel more energized, or improve your health overall. With that said, it’s up to you to make the change. The consistent effort you put in to the program will enhance your experience as well as our ability to help you. Our expert team will provide all the tools you need and set the path. We’ll be beside you the whole way, encouraging you to move forward towards the life you want to live.

Next Steps to Boosting Testosterone

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Author

Joshua D’Alessandro MS, CSCS, CISSN
Nutrition & Exercise Counselor at Cenegenics New York City

My name is Joshua D'Alessandro and I am an Exercise and Nutrition Counselor for Cenegenics in NY. My passion for fitness began at a very young age and has manifested into a career filled with possibilities. The countries largest epidemic, and quite possibly the root cause of most issues, is diminishing health. In my career, I hope to do everything and anything I can to improve the well being and lives of the people around me! 

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

Heiser, C. (2018, June 20). This Is How Working Out Affects Your Testosterone Levels. Retrieved from https://whatsgood.vitaminshoppe.com/exercise-testosterone/

R. Leproult, E. Van Cauter. Effect of 1 Week of Sleep Restriction on Testosterone Levels in Young Healthy Men. JAMA: The Journal of the American Medical Association, 2011; 305 (21): 2173 DOI: 10.1001/jama.2011.710

Purves, Dale. “The Motor Unit.” Neuroscience. 2nd Edition., U.S. National Library of Medicine, 1 Jan. 1970, www.ncbi.nlm.nih.gov/books/NBK10874/.

8 Proven Ways to Increase Testosterone Levels Naturally. (n.d.). Retrieved from https://www.healthline.com/nutrition/8-ways-to-boost-testosterone#section1

mature couple smiling at phone while standing outside of tropical hotel

4 Dos and Don’ts for Eating Healthy While Traveling

The habits that took years to build,  

do not take a day to change.

Susan Powter

As a resident of New York, it is no surprise that I need to get away from the stone torture tube that is the subway and the hustle and bustle of New York. I have always been a huge fan of traveling and have done so with my family since I was 2 years old. Over the last 5 or 6 years, I have found a balance when on vacation between fun and health and I actually enjoy vacation more because of it.

I just came back from Costa Rica and feel no different than when I left, in terms of motivation. I was able to have my fun, while also keeping in mind that going all out all the time can have some pretty immediate effects. Here is a list of do’s and don’ts when on vacation to help you enjoy but also stay on track:

Dos and Don'ts of a Healthy Vacation

While trying not to fall too heavily off the tracks during a vacation, incorporate the following tips:

  • DO something active
  • DO drink plenty of water
  • DO make healthy choices as often as possible
  • DO get good quality sleep
  • DON'T overindulge on unhealthy food
  • DON'T consume alcohol with every meal
  • DON'T oversleep
  • DON'T be physically inactive