Fix your Testosterone Crash now!

When your testosterone [T] is seriously low there is no mistaking it - you have a CRASH. 

This is a medical ‘urgency’ as it is harmful and dangerous to your long-term health so needs sorting right now.

How do you know you have crashed?

You feel fatigued; your mood is low [you may even be suicidal]; your sex drive has disappeared; your erection is weak or non-functional; your brain is fuzzy and it is difficult to be decisive. Hell- you are not yourself at all.

Action Stations

First: Get tested

Be decisive about one thing - get a T test urgently. Show this article to your partner - you may need their resolve behind you. Take your partner with you to the consultation, this is critically important to back up your story and help you if the GP is difficult.

In an ideal world

• You are able to access a GP quickly.
• You tell your Dr about the dramatic change in how you feel, say you believe it is low T and ask for a T test - and the GP agrees.
• Your Dr understands how to interpret the result [you need a level of 18-20+ nmol/L at any age to be symptom free and optimal] and is in favour of Testosterone Replacement Treatment [TRT]
• You get TRT, a test shows your T is restored and life returns to normal

You may have problems with any of the above – what to do is below.

What Test?

The test you need is Total T and because the level varies across the day it should be taken in the morning. 

Keeping your marbles – Steps to Prevent Dementia

Steps to Prevent Dementia

What are you doing to prevent dementia? Yes, you can reduce your risk!

An influential report, the Lancet Commission Report of Dementia Prevention,  updated in 2024, details 14 risk-reducing steps. I have 3 steps to add to that list.

Why bother?

Dementia is a big problem that you don’t want to get:

• It affects a large number of people, and it is devastating. Over age 65, there are 1 in 14 people with dementia, and for over 80’s it rises to 1 in 6. 
• Women are twice as likely to suffer.
• Dementia is currently the most important contributor to death in the United Kingdom, ahead of heart disease and stroke.

What do you need to do?

Tackle the problems: these 17 risk factors are all modifiable and allow you to reduce your risk of dementia by at least 50%, and at the minimum, delay the onset. Worth doing, don't you think? Addressing some personal weaknesses, keeping slim and active with all your health issues under optimum control will make the difference.

 

The risk factors fall into 5 groups, 4 you can work on ie poisons, social isolation, lifestyle medical issues, major medical metabolic problems, and the public health issues that are less controllable. The additional steps are taking HRT/TRT, perfect oral hygiene and shingles control.

Diversity 30

Diversity 30: Summary

In this article, I discuss the critical role of dietary diversity in maintaining a healthy lifestyle. Research shows that a varied diet, including a wide range of fruits, vegetables, whole grains, and healthy fats, significantly contributes to better health outcomes. I emphasize the need to aim for 30 different varieties of plant-based foods each week rather than just five a day. I also recommend incorporating a mix of seeds and nuts to enhance nutrient intake. Please take action to diversify your diet for better health!

What makes a healthy diet?

Diversity in your diet does. Dietary research shows that best health results come from diets that include a wide variety of vegetables, fruits such as berries and apples, whole grains and pulses. Some oily fish is beneficial and animal protein should be moderate.

The evidence

A recent report of 30 years of follow-up in two USA studies: the USA Nurse’s Health Study and Health Professionals Follow Up study 1 , They found that 9,771 (9.3%) of 105,015 participants [66% women], studied from early 50’s onwards had an ideal diet and they achieved ‘healthy aging’, compared with those whose diet was poor. The good diet doubled their chance of living to 75 without chronic disease or dementia.

So far so good – how do you do this?

Herbal supplements 1 - Ashwagandha

Herbal supplements 1 - Ashwagandha

The wide variety of herbal supplements will confuse. This series of posts looks at the evidence for common recommendations.

Ashwagandha for sleep, cognition and anxiety

The areas of potential use: sleep, stress, anxiety. Possibly to aid cognition in over 50’s

How does it work?

Probably via GABA-ergic pathways and/ or suppressing ACTH and thus cortisol levels. GABA, is an inhibitory neurotransmitter that reduces overall brain signal levels. Studies in rodents show increased GABA activity in the central nervous system (CNS) and deeper sleep by promoting delta waves and increasing non-REM sleep duration [1].

For stress and anxiety Human Studies show a potential cortisol-lowering effect.

A 60-day, randomized, double-blind, placebo-controlled study investigated the stress-relieving and pharmacological activity of an ashwagandha extract [240 mg of a standardized ashwagandha extract (Shoden) once daily ] in stressed, healthy adults [2]

There was a 40% reduction in morning cortisol after 60 days of use and a significant reduction in the Hamilton Anxiety scale.

For Sleep, what is the data?

A Meta-Analysis on Sleep Benefits reviewed five RCTs (double-blinded, placebo-controlled) [3]. There were modest effects on overall sleep duration.

Blood pressure control – take the low road

Take the low road

Parts I and II of this series explain why this is important and how to recognize hypertension. This post is about how to get it all under control.

Your target and how to bullseye it

We need ‘normal’ [young person] levels of <120/<80 to minimise cardiovascular risk. For example, a level of 110/70 would be wonderful.

Two Key Questions:

1. How do we get to that level when our BP is up?
2. Is this degree of reduction safely achievable?

There are lifestyle and medical approaches.

The best approach is a combined one. Don’t say ”I will try the lifestyle approach first and see about medication if that fails”, because any time spent with high BP is damaging, and the acute events like heart attack and stroke that may occur with untreated BP are life threatening. SO do not delay getting your BP down. Fortunately, as modern BP medication is non-harmful there is no reason to be shy of taking treatment. 

The optimum approach is start on medication, get control, do the lifestyle change, too, and maybe later, reduce the meds a bit. Moreover, if you are overweight, a drinker, eat a lot of salt, and have insulin resistance you will only get optimum control by making lifestyle changes to alter those factors alongside your medication. Around 50% of you will need only one drug to get your BP down but equally 50% will need two.

Salt reduction is always helpful but has a low impact; magnesium supplementation at around 300mg daily has a significant effect.

The Short Answer

Reduce alcohol; lose 5-10 Kg depending on how over-heavy you are; try for 10,000 steps a day and a more active life overall; take either candesartan 8mg [potentially increasing to 16mg] or indapamide Slow Release 1.5 mg as your first line agent and add the other drug if you need a combination to get the needed result. It is possible that taking a magnesium supplement as I recommend for all over 60’s may have a beneficial effect.

To get the whole inside story read more

The Big 4 – Essential Supplements Over 50

Supplements for Over-50s

Lots of possibilities – 4 essentials

If you are over 50, there are the essential vitamins minerals and supplements you need in order to support health, then there are lots of other possibilities used to reduce inflammation and enhance your protection against life threatening illness.

This post is about the essential minimum 4 you need.

Blood Pressure Part 2: Accuracy counts

How to measure blood pressure accurately

Take your BP regularly at home and you have a reliable and useful record of a major index of your cardiovascular and dementia risk [1], [2].

• It is the only way to identify correct levels of medication for high BP.
• It controls the anxiety and ‘white coat’ effect that increases BP in the surgery or hospital.
• It allows taking 3 measurements to get a more reliable indicator.

Here are the key messages:

• Get the right device
• Be in the right position when you take it
• Always use the same arm
• Have the correct cuff size
• Rest 5 minutes before and measure 3 times at 1-Minute intervals
• Establish a baseline including your BP lying down
• Measure on the first day of every month and record.

Blood Pressure Part 1 - Don’t blow your top

Blood Pressure - Know the risk and check at home

What is your blood pressure today – Yes, what is it right now? Well you don’t know, how could you… unless you measured it today or let’s say within the last 7-10 days.

This is really important: you can only know if you are in trouble if you measure your blood pressure [BP] and find it raised. This is why they call BP ‘the silent killer’. In other words, you get life threatening illness that could have been prevented if only you knew your BP was dangerously raised.

In one recent US study of 7328 individuals 54% had BP above the safe zone, half of those were completely unaware of their problem [1].

Actually 8/10 of the hypertensives had ‘uncontrolled’ BP ie a level that is seriously damaging. Looking at those 8 - there were 5 out of 10 uncontrolled because they didn’t check their BP and had no idea they were ill and 3 out of 10 because they were inadequately treated or not taking their meds.

Most were in the 50+ range and that is my focus, but 12.5% were under 44 so have your adult children get their pressure checked regularly, too, say once a year.

Why do you need to know?

High BP causes heart attack, stroke, dementia and kidney failure and therefore contributes to early death. Treating the BP reduces the risks and prevents the disease[2]. More importantly treating the BP intensively improves the outcome.[3] [4]

The Dirty Dozen

The 'Dirty Dozen' and EDC's

Cancer causing pesticides, perfumes & preservatives. Cancer prevention? Here is an easy win.

Avoid known chemical cancer-causing dangers: choose your food intake and manage your environment. This is important for you but very much more important for your children and grandchildren because action now can prevent them ever getting certain cancers.

The key take home message is: 

1. Minimize your pesticide exposure.
2. Avoid EDC's [endocrine disrupting chemicals].

Nutrition, supplements and cancer

Nutrition is not the cure for cancer – but ….

Nutrition cannot eliminate your cancer; neither is homeopathy an alternative to proper chemotherapy. The Bristol Cancer Help Centre Scandal in the 1990's made that clear to the whole UK. [1]

BUT if you DO have a cancer diagnosis or as in my case, your spouse has, or a close family relative is affected, then naturally you are asking – "Does anything we do at home make a difference?"

How to walk

Walk as nature intended

In pre-history when we began walking on two legs, we walked barefoot. A walk with a shortish stride and midfoot/ forefoot strike. Walking this way, the muscles propelling you forward are the muscles of the foot and ankle, the hip flexors and the buttocks [but not the quadriceps on the front of the thigh]. This involves a high degree of ankle and midfoot flexibility. Much of the time the knee is slightly bent. This method is stable, the risk of falling is small and legs soak up the impact, rather than joints. When this transitions into a run it tends to become a pure forefoot strike, depending on speed. As you will see watching any competitive sprinter; they don't put their heels on the ground at any point.

Update your vaccinations. And teach your children well!

Your vaccine cover may be waning or there may be new options you have missed

 Vaccination saves lives, prevents damaging illness and can eradicate diseases altogether [eg smallpox]. It really is the cleverest aspect of our medical progress and is now being used as a regular part of some cancer treatments, too.

Medium Chain Triglyceride Oil

Why MCT oil can be beneficial

There is proven value in weight control, migraine and cluster headache, Minimal Cognitive Impairment [MCI], and in achieving muscle gain in frailty management.

Although there are many internet claims of sleep improvement there are no human studies of value to prove this.

Sex Hormone Replacement

Sex Hormone Replacement: Important Anti-Aging tools but are they safe? The Bottom Line

Testosterone Replacement Therapy for men [TRT] and Hormone Replacement Therapy for women [HRT] have major benefits in term of symptom relief and long term health.

A casual un-analytic search on the internet will bring up lots of negative information about potential risks for cancer or cardiovascular disease that is completely untrue for either TRT or HRT. The sex hormones testosterone [T] and oestradiol [E2] have many benefits in our pursuit of a longer HealthSpan, so I strongly recommend them to both men and women.

Musculoskeletal Problems

Summary

Musculoskeletal deterioration is a major cause of loss of function as we age. From 50 onwards loss of muscle, bone mass and collagen lead to reduced strength, susceptibility to fracture, and problems with joints. When somebody is 70 and these problems have been going on for 20 years, they frequently are frail. Frailty is a specific term for a tragic inability to perform daily acts of living and consequently reduced independence. When we say ‘so and so is looking old …’ what we mean is they are looking frail.

Fidgets

Be a fidgeter!

Start today. These extra movements can help you increase your activity, boost your metabolism, keep your weight down and maintain joint function.

In a café or on a train you can see the fidgets: they are playing invisible pianos, tapping out rhythms, bouncing their knees. This is all beneficial. – often they don’t know they are doing it. I just want you to make it systematic, conscious and targeted.

Managing Sugar

Sweet enough! Managing the sugars in your diet

You have a 'sweet tooth' and crave sugary things. OK, it's not a weakness, it's genetic ie you can blame it on your parents*. However, sadly the consequences of this are entirely your responsibility. If you are struggling with your weight, then you need a sugar [reduction] strategy, and that is also critically important for a good HealthSpan and Alzheimer's avoidance. A high sugar diet means blood sugar spikes after eating which leads to insulin resistance [lots of metabolic issues] and fat storage. You choose.

Ageing Internally

Are you older on the inside than you look on the outside?

From the foods you eat and how you exercise to your friendships and lifestyle goals — it all influences how fast or slowly your body ages.

Eat well

If you look at your eating habits, even just small changes can make a difference in the way your body ages. Bad habits need to go! 

Focus on eating mindfully and making healthier choices, the chances are you'll have more energy and you'll lose weight. Studies have shown that what we eat may be one of the most important lifestyle modifications each of us can make to significantly increase our HealthSpan and add quality years of enjoyable life as we age. It’s all about having a balance. Aim to fill up your plate with ‘the good stuff’. Good means a rainbow plate of many colours, to get the full spectrum you need.

Testosterone Replacement for Men

Reasons why you should consider Testosterone Replacement Therapy (TRT)

What happens to testosterone [T] with age?

First: available ie ‘free’ T declines with age.

Here is data from the European Male Aging Study.[1].

Dementia Prevention

You are aware of the curse of dementia [mainly as Alzheimer’s Disease – AD] either as a risk of ageing or more powerfully because of personal experience of a sufferer.

There IS an inherited ie genetic component related principally to the APOE e4 gene. But lots of people who have the gene don’t get AD. The important information is not whether you have the gene [so don’t rush to get a test] but whether the gene is switched on - this is called gene expression.