Age Management Optimal Wellness

Do we no longer eat according to who we are? Our health and well-being have taken a back seat to our materialistic values. We have lost our connections to who we truly are, and due to that we have fallen victim to unfortunate circumstances of dis-ease. We are no longer functioning according to our unique true existence. These negative acquired human habits we take upon ourselves are altering our bodies chemistry and taken the body, mind, and spirit off alignment. Eating according to your unique type goes beyond what you physically can see. It must go deeper into fully knowing one selves. We nourish our body to maintain and restore our eternal and physical being. We are so unique and indigenous people that we are even broken down into different dosha, metabolic type, blood type, etc..Have we taken time to appreciate who we are to understand how to heal ourselves and maintain a perfect alignment of body, mind, and spirit. Allow your whole You to connect as One to stay in the proper state of optimal balance. Healing our selves in all levels is effortless if we hold the key to understanding ourselves beyond the materialistic values and the naked eye. Our health should not continuously be shifting out of balance. Balance is key in all areas of our lives. True balance comes within ourselves. Doesn't matter what foods you may eat, healthy or not, if you are off balance mentally, emotionally, spiritually your physical health will continue to shift continuously towards dis-ease.

Sleep is commonly viewed as a restorative process that influences the nervous, neuroendocrine and immune systems. Sleep is considered critical for the maintenance of health; abnormal sleep patterns are associated with increased risk of cardiovascular disease, mood disorders, chronic pain and a shortened lifespan.11 In a lot of ways, sleep is like sex— you can never get too much of it. In addition, sleep is a lot like your boss when he’s working…don’t disturb him or he gets pissed. Well, your body is the same way— don’t disturb its sleep or he will take it out on you.                                                           

A 1999 study in The Lancet reported that when healthy young men had four hours of sleep for six nights, it resulted in a harmful impact on carbohydrate metabolism and endocrine function. Subjects experienced an increase in insulin resistance and reduced thyroid levels. In addition, evening cortisol and increased sympathetic activity of the nervous system was also reported.18 Other studies have documented that sleep deprivation doesn’t give the nervous system a chance to rest and results in elevated adrenaline levels. One study demonstrated that subjects exposed to sleep deprivation (i.e., 3.3 hours of sleep) resulted in a significant elevation in circulating levels of norepinephrine and epinephrine during the night.15 Circulating catecholamines are normally supposed to decline with sleep.

Another less well-known hormone identified as increasing during sleep is prolactin. Now don’t freak out, you’re not going to start squirting milk out of your nipples like a breastfeeding mother, but circulating levels of prolactin rise during the night with sleep. There’s a linkage between GH and prolactin secretion during non-REM sleep in humans. Prolactin and GH share 40 percent of the same protein sequence. Prolactin is secreted in the anterior portion of the brain, but is also synthesized and secreted by a broad range of other cells in the body, including various immune cells. It’s interesting that sleep deprivation reduces nightly prolactin levels, which may explain why there’s reduced immune functionality with sleep loss. Mice that are made genetically deficient in prolactin are immunocompromised to which sleep loss shares a resemblance.12 Prolactin has also been shown to be a regulator of testosterone. When men were given the anti-depressant drug, haloperidol (which lowers dopamine, but results in an increased release of the prolactin), the resulting significant increase in prolactin corresponded with a significant increase in testosterone 60 minutes later. In the same study, the control group’s mean testosterone levels showed the normal decline during daytime hours. This delay between increased prolactin and increased testosterone is consistent with a similar delay between the increases of these two hormones occurring at night during sleep.13

8 a.m. and are at their lowest around 8 p.m.6 It’s been reported that in young men, the sleep-related rise in testosterone has been linked to the first episode of rapid eye movement (REM).5 REM sleep is an active period marked by intense activity in the brain and rapid bursts of eye movements. At the same time, REM sleep is when dreaming occurs. The stimulus for testosterone production is regulated by gonadotropin-releasing hormone (GnRH), which then stimulates leutinizing hormone (LH) production from the hypothalamus (see figure 1).
During sleep, episodic bursts of LH drive testosterone production in men. The frequency and amplitude of these pulses are essential for appropriate testosterone production. There’s generally a 40-minute lag time from when the first burst of LH is secreted to stimulation of testosterone production.7 So, now you understand that during normal sleep there are episodic pulses of LH-stimulating testosterone production, however when sleep is disrupted, the circadian rhythm of testosterone is disrupted as well.

Partying Without Sleep Is Bad for Testosterone
Who the hell wants to stay home at night when you could be dancing with some hot MILF at the club?! Well, while you’re trying to “score,” the loss of sleep can be detrimental to your testosterone levels. Schiavi et al.8 reported that in a group of healthy young men, sleep deprivation causes decreases in sleep quality and REM episodes, which were associated with lower bioavailable testosterone levels, regardless of one’s age. Every bodybuilder knows he should be getting eight to 10 hours of sleep a night, but most of us take it with a grain of salt.
A single night of disrupted sleep can really take its toll on your testosterone levels. For example, when young men were exposed to a night of partial sleep loss, it resulted in a blunted testosterone response during the night. In that study when men were allowed to get a full eight hours of continuous sleep, all subjects had a nocturnal rise in testosterone. When the same subjects were allowed two hours of sleep, none of the subjects without REM sleep showed any rise in testosterone during the night.5

17.5 inches) has been associated with sleep apnea. Obesity is a major contributing factor to sleep apnea as the excess adipose tissue around the neck collapses the trachea during sleep. Sleep apnea results in a reduction in both LH and testosterone levels. Luboshitzky et al.17 examined healthy young men and compared them to overweight sleep apnea patients and found that sleep apnea resulted in severe testosterone dysfunction. Compared to healthy young men, sleep apnea patients had lower total LH and testosterone levels due to decreased LH pulse amplitude and decreased pulsatile testosterone secretions during the night. When obese patients lose weight, the nightly circadian rhythms of LH and testosterone are restored.19

Obesity in itself suppresses testosterone levels, but the hypoxia that occurs during apnea suppresses testosterone levels as well. Additionally, when apnea patients are placed on nasal continuous positive airway pressure (CPAP) machines (which delivers air into your airway through a specially designed nasal mask), testosterone levels revert back to normal, demonstrating that obesity alone isn’t the sole cause of decreased testosterone levels occurring during sleep.20
When patients with sleep apnea were compared to each other, the degree of testosterone suppression taking place with sleep apnea was directly related to the amount of hypoxia occurring during sleep. Decreased morning testosterone levels, but not LH, is related to the degree of hypoxia.20 For example, Kouchiyama et al.31 found that when sleep apnea patients were compared to each other, the patients who had less severe oxygen saturation had testosterone peaks at 6 a.m., whereas the patients who were classified as having severe oxygen desaturation during sleep exhibited delayed peaks in testosterone for example, at 10 a.m.

Responses to Aging
It’s no surprise that with aging there’s a decrease in testosterone and lean muscle mass. Cross-sectional studies have demonstrated that after the age of 40, testosterone declines by  about two percent per year with increases in sex-hormone binding globulin, follicle stimulating hormone and LH concentrations.26 The disruption in testosterone can be attributed to several mechanisms, but the stimulus for testosterone production becomes lower as we age and the male testes don’t respond as rapidly. Houston we have a problem….!!
That’s right. As men age, we experience testicular dysfunction and the testes don’t respond to LH like younger males. For example, in healthy elderly men given a dose of human chorionic gonadotrophin hormone, which causes a sharp rise in LH production, researchers found it doesn’t increase testosterone like young men. In fact, there’s a blunted response in elderly men, which indicates a defect in the Leydig cells in the testes to produce testosterone.28
During sleep, older men demonstrate less testosterone production as pulsatile LH release in elderly men is marked by lower amounts secreted, but are secreted more frequently than pulses in young men.27 This physiological dysfunction can occur as early as 45 years of age. Luboshitzky et al.29 reported that middle-aged men (i.e., 45 years of age) had significantly less pulsatile secretion of testosterone during sleep and more LH bursts secreted at night than younger adults (i.e., 24 years of age). Additionally, the middle-aged men had decreased sleep stages three and four (deep sleep) and an increased number of nocturnal awakenings.30 In one analysis, older men who experienced reduced REM sleep were correlated with reduced serum testosterone levels.8
In conclusion, decreases in sleep won’t only reduce your immune system, impair GH secretion, raise cortisol and daytime catecholamines, but also lower testosterone production. All hardcore bodybuilders should be getting as much sleep as possible. I remember reading that Lee Haney always made sure he took a nap every day when he was training hard— in addition to his nightly nine hours of sleep. It’s hard to think that something as small as sleeping a little more could be all we need to get the most out of training.Key Points:
•    Sleep is an important regulator of testosterone function.
•    Sleep deprivation results in a blunted nocturnal rise in testosterone.
•    Sleep apnea can impair nocturnal rises in LH and testosterone levels.
•    High levels of testosterone can result in sleep-disordered breathing through unknown mechanisms.
•    Aging is associated with a blunted rise in nocturnal rise in LH and testosterone.

Seminar Report

The seminar was presented by Pamela Smith, MD, MPH. The focus was on the dietary supplement containing prohormones and all-natural nutrients that improves mood and boost energy without stimulants.

Summary- Supplement: ProHormones & All-Natural Nutrients

Cortisol

· Cortisol has to be normal

· Stress for a long time, cortisol becomes too low

· Best way to meaure cortisol metabolically salivary testing is best way to measure cortisol

· If cortisol is too high or too low we can give adaptogenic herbs

o ginseng & ashwagandha

o stress reduction technique

· Elevated Cortisol can be treated with calming herbs

o Lemon balm

· Low Cortisol (Adrenal Fatigue)

o Can treat with licorice root

§ Don’t give licorice to those that are hypertensive (can drive up their blood pressure)

§ Deglycyrrhizinated licorice (DGL) is good for treating gut

§ Regular licorice root works for Adrenal glands

o If treatments mentioned don’t normalize cortisol levels, then it might need to be suggested to start on Cortef.

§ More information on Cortef (read safe usage of coristol)

§ 20mg a day of Cortef is augmenting and replacement of cortisol

· 7.5mg in morning, 5mg in afternoon, 2.5mg at 5pm

§ Only use this treatment for 6-12months with adaptogenic herbs

· Optimal is to have normal cortisol

• Takes 1 to 2 years to normalize coritsol
  • changing lifestyle for the better can normalize cortisol
• Note* For adrenals to run well we must be nutritionally sound
  • all the basic nutrients affect how the adrenal act

Serotonin (Happy Neurotransmitter)

• Is made in the gut....
  • 5% is made in the brain (platelts and retina of the eye)
  • 90% made in the gut
  • If one has reflex, diarrhea, constipation, yeast overgrowth, IBS, etc...it can cause the effect of serotonin (affecting happy mood)
  • The gut is 70% of the immune system

Energy

• Hormonal fluctuations: imbalances causes headaches, irritability, lack of sleep and fatigue
• Roadblock to fulfillment: lack of energy can prevent active participation in exercise, hobbies, family activities, excelling at work and quality time with spouse/partner
• Lack of energy and sleep can lead to poor health:
  • worsening of blood pressure and cholesterol
  • Increased stress
  • Lethargy and low alertness
  • Overweight
  • Lower levels of serotonin and melatonin

DHEA

• Has to be normal and balance cortisol
• Treating DHEA with those under the age of 60, we must treat cortisol if levels are not normal
• If you give DHEA to a patient and they are young (under 60)...and its due to stress

without treating cortisol with such things like adaptogenic herbs, DHEA will even go lower.

• Note* Always Always Always if cortisol levels are abnormal cortisol and the person is young, and you are treating them for DHEA, make sure you treat adrenals at the same time.
• If person cortisol is abnormal and they are hypothyroid ...you never treat the hypothyroid until you treat the adrenals first.
  • At least 6wks of treating the adrenals...the reason is because if you give thyroid therapy first you will rave up the system and there is nothing to rave up
    • It will give them symptoms of hyperthyroidism when they not even hyperthyroid (heart racing, headaches, etc...)
  • Note* Fix cortisol (adrenal) first then the thyroid

Thyroid

• Vital to run these test for thyroid function
  • TSH - should be under 2 for optimal functioning , if it runs at 4.5
  • Free T3 - dead center of normal or slightly above
  • Free T4 - dead center of normal or slightly above
  • Reverse T3 - dont want it to be high or they will be storing too much
  • Thyroid antibodies positive thyroid anti bodies and have hashmito disease...it’s important to give a synthetic form of thyroid hormone
• Many things affect the conversion of T4 to T3
  • Toxins metals, too much calcium, too much cooper, stress
  • Bad sleep hygiene
    • Need minimum of 6.5hrs
    • People who go to bed after midnight and get up before 5am are sheding 10yrs off their life.
    • Hard to normalize cortisol level with bad sleep hygiene
    • Studies show insulin will climb in the body and move towards diabetes/insulin resistance.
    • Weight gain occurs

Hormonal Mood

• Hormonal fluctuations: hormones affect mood, often, imperceptibly. low or inadequate hormone affect can cause a woman to feel irritable, off balance and moody
• Depression: depression is twice as common in women as in men
• Bad moods have bad health indicators: higher blood pressure, elevated stress levels, strained relationships, increased depression
• Estrogen (important when it comes to mood)
  • Has 400 functions in a womans body
• Progesterone is key
  • If too high or too low...these symptoms follow, anxiety, insomnia, mood swings, depression,
• Normal testosterone is important (for male and female)
  • Testosterone = the hormone of desire
  • Pro hormone DHEA and pregnenolone in supplement are the nutritional building blocks of natural testosterone
  • Testosterone are prohormones decline with stress and age
  • Supplement includes pro sexual nutrients"tribulus terrestris, damiana, black cohosh, chrysin, korean ginseng, naturally boost testosterone effect.
  • If too high, can be agitated and angry
  • Can increase risk of heart disease, weight gain, and diabetes
  • If too low causes low self-esteem and low self confidence
• DHEA is too high in woman and men it can cause roid rage

Lifestyle

• Must have passion throughout your life
• Active sex life is key
• Important to exercise
  • Decreases stress, helps maintain memory, and mood
• Proper diet
• Nutritional supplement
  • You can’t eat your way to good health…must supplement your diet
  • Supplements are formulated to:
    • Boost energy and mood without stimulants
    • Ignite desire and passion
    • Support optimal women's heath
    • Relieve normal PMS or menopausal symptoms

A decade ago, it would have been hard to write this column. While there were all kinds of foods and supplements sold with promises to burn fat, none of them had any scientific data to support the claims. Today, scientists are beginning to understand how certain foods actually do rev up metabolism or enhance hormones to help us burn fat. You’ll read about the six best fat-burning foods below. Ten years from now, a column on fat-burning foods is bound to be full of science-based information on dozens of foods that can help boost metabolism and burn fat. So stay tuned.

PROTEIN
In addition to helping build muscle, your metabolic furnace for burning fats, lean protein helps stoke the fat-burning fires— its thermogenic effect is 20 to 30 percent compared with an anemic 3 to 12 percent for carbohydrates. This basically means that it takes many more calories to digest, absorb and utilize protein versus carbohydrates. As you include protein in every meal and snack all day long, you raise your fat-burning potential, as well.
Make sure to choose lean protein sources such as eggs, chicken, turkey, fish, lean red meat and vegetable proteins. If you don’t already have a blender and some protein powder, buy them. When you crave a high-fat or high-carb snack, reach for a protein shake instead.

FISH
For many years, nutritionists assumed you lost weight when you ate fish because it has fewer calories, pound-for-pound, than red meat. Now however, it appears that reasons go above and beyond calories. Most important, the type of fat found in fish appears to enhance the efficiency of the hormone leptin. This protein circulates in your bloodstream and, like the hormone insulin, is a key hormone in the weight-management equation. Leptin regulates your food intake as well as your body’s energy expenditure. When cells in your brain sense a rise in leptin, they signal other parts of your nervous system to turn down your appetite and turn up your metabolism.
I recommend that all my clients eat five fish meals a week. The omega-3 fats support a healthy heart, a healthy brain and nervous system, and possibly enhance the efficiency of leptin, helping you boost your metabolism and control appetite. It hardly gets better than this. While all fish have more omega-3 fats than a hot dog, the fatty fish like salmon, black cod, herring, sardines, mackerel, halibut, fresh tuna and shellfish are highest in omega-3 fats.

OLIVE OIL
The kinds of fat that you eat can influence your energy expenditure and bodyweight. Energy is released through heat production in a process called nonshivering thermogenesis, which is controlled by uncoupling proteins (UCP) in the cells of brown fat, white fat and muscle. Researchers interested in finding out if diet can influence this process investigated possible dietary enhancements of thermogenesis in rats. They found that olive oil, which is high in monounsaturated fats, increased the activity of the UCPs, and hence of metabolic rates. Because of the short duration of the study, published in the American Journal of Clinical Nutrition, no differences in bodyweight were recorded between the rats fed olive oil and those fed other fats. However, international studies have shown that Mediterranean-style diets higher in olive oil are associated with weight maintenance and little weight gain over time compared with diets lower in olive oil. However, overall fat consumption still does add many calories to the diet, and those subjects with a very high fat consumption were overweight compared to those who controlled their total fat intake.

GREEN TEA
Certain natural chemicals called catechins are abundant in green tea; animal and human studies show that these chemicals appear to increase fat burning and stimulate thermogenesis, and the combination with caffeine in tea appears to boost the effect. The amount that you need to consume isn’t absolutely clear. A 1999 study in Maryland used syx, one-quarter cups of tea per day for four days. A more recent Japanese study found successful results feeding two one-half cups every day for 12 weeks. A study from the UK published this year demonstrated increased fat burning in exercising young men. In this study, researchers used a green tea extract of three capsules (containing a total of 890 +/- 13mg polyphenols and 366 +/- 5mg EGCG [the catechins]). Since the amount of catechins is difficult to control with brewing, many practitioners recommend using a green tea extract for better dose control.

MILK
Milk ranks high on the list of fat-burning foods. No doubt you’ve read about or heard the commercials for how milk can help you lose weight. The high calcium content of milk helps it turn off a key obesity gene, keeping your body from turning up the fat-making machinery to high, and helping your fat-burning metabolism run smoothly. At the same time milk is the primary source of whey protein, shown in studies to enhance fat burning and limit the turnover of calories into fat storage by the liver. Subjects on a calorie-reduced diet given 20 grams of whey protein supplement every day after an exercise bout lost significantly more fat and maintained significantly more muscle mass compared to subjects given a placebo. Milk is a natural source of whey protein, and you will also benefit from adding a whey protein supplement to your diet.

CHILI PEPPERS
Studies have shown a thermogenic effect of capsaicin, a compound found in chili peppers. When chili-containing meals have been fed to subjects regularly for four weeks, results have shown an attenuation of high blood insulin levels after the meals. While weight loss was not studied, a lowering of blood insulin levels in overweight subjects may ultimately lead to weight loss. Other studies using a capsaicin supplement have been shown to be effective, but the dosage must be strictly followed. One Danish study using a supplement combining green tea extract, capsaicin, tyrosine and calcium for seven days showed a 2 percent increase in energy expenditure in overweight and obese men. The researchers found that only the capsules that were not enterocoated were effective. The coating, which inhibits digestion in the stomach, inactivated the efficacy of capsaicin

Seminar Report

The seminar was presented by Thomas E. Levy, MD. The focus was on the role of glutathione in anti-aging medicine.

Summary- The most powerful antioxidant : Glutathione

• Most disease that is highly symptomatic has minimal anti-oxidative status
• People that have utilize high dosage vitamin C therapy has such profoundly positive outcomes
• Vitamin C is the most important extracellular antioxidant
• Glutathione is the most important antioxidant inside the cell

it is extremely concentrated inside the cell

· Vitamin C w/glutathione is synergistic

· Glutathione

o an important toxin neutralizer

o support of protein and prostaglandin synthesis

o support amino acid transport across cell membrane

o support immune system

o support of critical enzyme function

· The greater the deficiency of glutathione the greater the heart damage during a heart attack

· The greater glutathione the greater the exercise efficiency

· Neurological disease has been linked to a deficiency in glutathione levels in the neurons

· Note* Tylenol depresses glutathione levels...

· The greater intake of acetaminophen the more damage to the lung function

In Conclusion:

Glutathione empowers each cell to function at its full potential, thus promoting the following:

• Healthy aging
• Neutralization of free radicals
• Energy and Stamina
• Optimal cellular health
• Recovery from exercise
• Detoxification of the body at the cellular level
• The immune system

Most anti-oxidants work from the outside-in, while glutathione is such a force within the cell that it works from the inside-out. As the body’s most powerful and prevalent antioxidant, as well as a natural detoxifier, glutathione is essentially a cell protector. It has the power to do what no other anti-oxidant can-including well-known substances such as vitamin C and E. It is found in very cell of the human body. And since your body is composed of trillions of cells, your complete health is dependent upon your cellular health. As the cell goes, so goes the entire organism – your body.

“I can assure you that if I was not on testosterone, I would not be what I am today. I was a great athlete as a kid, but now most of the day I’m forced to be sedentary. I take testosterone to maintain my muscle strength, which is something I could not do at my age with exercise alone. My energy level is up, my musculature is up, and my fat is down because of testosterone. I feel the same way sexually as I did in my 40s. Maybe I should accept the fact that at age 73, things change and I should just let it happen, but I don’t want to and with testosterone I don’t have to.” —Dr. Norman Orentreich, Pioneering Researcher on Aging

Samson was a legendary warrior and is something of a Herculean figure, using massive strength to combat his enemies and perform heroic feats unachievable by ordinary men: wrestling a lion, slaying an entire army with nothing more than a donkey’s jawbone and tearing down an entire building. Samson would have definitely been a hardcore reader of MD with feats of strength like that. Eventually Samson tells his wife Delilah that he’ll lose his strength at the loss of his hair. Delilah (who’s not exactly on Sampson’s side) calls for a servant to shave Samson’s head as he sleeps. Sampson wakes up an ordinary man, having lost all his superhuman strength. But it may not have been the loss of Samson’s hair that caused his strength loss…maybe it was his testosterone levels!

Zero Strength Gains
The research on testosterone and strength training is complex and isn’t as clear-cut as one would expect. For example, examinations of elite Olympic weightlifters have shown no changes in testosterone over a one-year training period.5 Others have shown that during a two-week heavy weight-training session there was a 12 percent reduction in resting testosterone concentration.6 There’s a fine line between training hard enough to present an overloading stimulus and prompt new muscle growth and training too hard to where the body can’t adapt quickly and efficiently enough before the next training session. When one pushes the body past its limits it’s termed “overreaching.” Being involved in a heavy resistance exercise “overreaching” program can result in reductions in testosterone during strength training as well.32 Furthermore, women can have large increases in strength from a resistance exercise strength training protocol, yet have low endogenous testosterone levels.4

Just how important is testosterone for increasing muscle strength? In a recent issue of the American Journal of Physiology Endocrinology and Metabolism, a research study documented that without testosterone, you can expect zero strength gains from a heavy resistance training protocol. Testosterone is just like Sampson’s magic hair…you need it to be strong, but just like Sampson cutting his hair, loss of testosterone will impede strength gains. In the study, 22 young men with minor experience with strength training participated in this double-blind intervention study. It was important to use relatively untrained subjects because when untrained subjects start a strict weightlifting program, they make huge gains in strength. Some subjects were randomized to treatment with a medication called goserelin, which is a gonadotropin-releasing hormone agonist. Goserelin acts on the pituitary gland in the brain and affects leutinizing hormone (LH) release, which stimulates testosterone release. Chronic administration of goserelin desensitizes the pituitary gland. This means that the pituitary gland produces less LH, which in turn stops the production of testosterone. Other subjects received a placebo subcutaneously every four weeks for a period of 12 weeks.

The strength-training period of eight weeks included exercises for all major muscles (three to four sets per exercise x six to 10 repetitions) and one-minute rest periods between sets. The protocol was designed to cause acute increases in testosterone, which has been validated by previous investigations.2 The subjects who received goserelin had a decrease in testosterone that was 10 percent lower than that of normal males, whereas testosterone remained constant in the placebo group. So here’s where the importance of testosterone becomes clear for muscle strength and weight loss.

Resistance Exercise and Strength Gains
The gym is filled with all sorts of people who can sabotage your workout. The guy who does a set and talks to his friends for five minutes isn’t going to have significant increases in testosterone or GH from his workout. All readers of MD know that in order to stimulate testosterone during a workout, training sessions must have short rest periods (30 seconds or less) with multiple sets, a training volume with 65 percent to 80 percent of a 1 RM, repetitions between 10 and 12, and use large muscle mass exercises such as deadlifts, squats and jump squats, which have been shown to produce large increases in testosterone and GH compared to small muscle mass exercises such as arm curls.18,22
Back in 1990, researcher Bill Kraemer reported findings that changed the way men needed to exercise with weights. In that study, men trained with an equal weight-training volume, except one group trained with moderate exercise (using a weight they could lift for 10 reps) and short rest periods (one minute) while the other group used heavy exercise (five reps) with three-minute rest periods. The results were that men using high reps with short rest periods had increases in both GH and testosterone, whereas the group using heavy weights with long rest periods had no changes in either testosterone or GH.2

Acute Metabolic Stress Increases Muscle Hypertrophy
In life nothing comes easy…especially when you’re trying to put on muscle. Ever notice how some people go to the gym day after day but never make gains? It’s not because they’re “hard gainers” or have “bad genetics” as they would like to believe, it’s because they have zero training intensity! Researchers have determined that strength and muscle mass gains can come from mechanical stress (intramuscular IGF-1) and hormonal mediated (GH, testosterone, IGF-1) muscle hypertrophy. Though mechanical factors are essential to resistance training adaptations, metabolic factors have also been shown to play a role in hypertrophy. The feeling of the “pump” or “burn” is associated with the buildup of these metabolic products (hydrogen ions, lactate and potassium) in the muscle; the higher the number of reps in a set, the greater their accumulation and effect. Although many people may think that in order to pack on muscle you have to lift heavy weights, this isn’t always the case. For example, Olympic weightlifters lift considerably more weight than a bodybuilder or weight trainer, but they don’t have nearly the same amount of muscle mass. Muscular hypertrophy and strength gains following a resistance-training program are thought to be due to an intensity level of 65 percent of a 1 RM to achieve an effect.2

Powerlifters and Olympic weightlifters use considerably more weight with longer rest periods than bodybuilders, but bodybuilders have much more muscle mass than both powerlifters and Olympic weightlifters. Let’s look at the different types of training: powerlifters and Olympic weightlifters generally use 5 RM with training percentages of 80 percent to 95 percent with prolonged rest periods (five minutes). Bodybuilders use high repetition (10 to 12 repetitions) with short rest periods (30 to 60 seconds). Bodybuilders produce much more metabolic stress during workouts than either powerlifters or Olympic weightlifters. If you were to make a powerlifter perform a high-intensity bodybuilding program, more than likely he would be puking from the extreme metabolic stress from the short rest periods. In fact, an older study by Kraemer et al., documented nausea from the extreme metabolic stress of a high-intensity bodybuilding program that powerlifters just could not withstand.48 Bodybuilders and powerlifters were matched for age, size and experience. Each performed a 10-station, heavy-resistance exercise protocol. Each subject performed three sets of 10-repetition maximum with a 10-second rest between sets and alternated 30-second and 60-second rest periods between exercises. No significant differences were observed between bodybuilders and powerlifters for any of the physiologic responses (lactate and adrenaline) measured. However, powerlifters exhibited a higher incidence of clinical symptoms of dizziness and nausea compared to bodybuilders…get out the barf bag!

Is a 30-second Rest Period too Long?
Most bodybuilders rest 30 seconds or less between sets, but what happens if you don’t rest at all? According to one study, a no-rest period bodybuilding routine produced greater increases in GH, testosterone, adrenaline and lactate that led to larger increases in strength and muscle mass.38 The researchers compared the acute and long-term effects of a “no-rest regimen” and those of a regimen with “rest period within a set.” The no-rest regimen consisted of three to five sets of 10 repetitions at 10-repetition maximum with a one-minute rest period between exercises (lat pulldowns, shoulder presses and bilateral knee extensions). In the rest-period regimen, subjects completed the same protocol as the no-rest regimen, but took a 30-second rest period at the midpoint of each set of exercises in order to reduce exercise-induced metabolic stress. So, at the end of the study, the results were impressive. The subjects who performed the high-intensity, no rest period exercise protocol had a 13 percent increase in muscle cross-sectional area while the rest-period group had no increase in muscle mass. Interestingly, both groups performed the same exercise volume, the only difference was the training intensity. No wonder why the guy who spends more time talking than working out next to you looks the same every year!

Another study examined metabolic adaptations in muscle to intermittent (prolonged rest periods) and continuous muscle (short rest periods) contractions. Subjects trained both their right and left legs with a protocol that used the same weight; the only difference was the rest period duration. The right leg (intermittent contractions) was trained using four sets of 10 contractions, each lasting three seconds with a two-second rest period between each contraction and two minutes between each set. The left leg (continuous contractions) was trained using four 30-second contractions with a one-minute rest period between each. Both protocols involved isometric contractions at 70 percent of a maximum voluntary isometric contraction. The increase in isometric strength was significantly greater for the continuous leg training than for the intermittent training. In addition, the leg that was trained with the short rest periods gained more muscle mass than the leg that was trained with prolonged rest periods. These findings suggest that factors related to the greater metabolite changes during high-intensity, high-lactate, high-GH and testosterone-producing exercise training results in greater increases in isometric strength and muscle mass.37 Furthermore, when acute and chronic hormonal responses to resistance training were evaluated in 11 college men who completed 12 weeks (33 sessions) of high-volume resistance training, only the acute increases in GH during exercise were associated with increases in muscle hypertrophy. No differences in resting concentrations of growth hormone, insulin-like growth factor-1, testosterone or sex hormone-binding globulin occurred from pre- and post-training. Significant correlations existed only between absolute mean GH increases that occured during each exercise session and the degree of muscle fiber hypertrophy for type I and type II fibers.43 It may be that the combined acute metabolic stress and hormonal responses to short-rest exercises lead to greater acute increases in GH and testosterone.

How to Increase GH During Exercise…Go for the Burn!
So, what’s the key to getting a good increase in GH in response to your exercise session? The key is to use high-intensity, short rest periods and multiple sets. The “one-set to failure is all you need” approach isn’t going to increase GH optimally. For example, Gotshalk et al.,39 reported that subjects who performed a heavy resistance training protocol, which consisted of eight exercises with a training volume of three sets at 10 RM, produced greater GH secretion than the same exercises with one set at 10 RM. Results of the study demonstrated that higher volumes of total work produced significantly greater increases in circulating GH during exercise and upon recovery from exercise. Exercise intensity should also be performed above 65 percent of a 1 RM for optimal gains in muscle mass and strength. Pyka et al.,40 reported that young men who performed a circuit training routine consisting of 13 stations with 30-second rest periods had minimal GH responses at 60 percent of 1 RM, while GH increased progressively using the same protocol at 70 percent and 85 percent of 1 RM. Minimal GH responses from the 60 percent protocol were attributed to the lack of training intensity.

Training intensity must rise above a certain threshold in order to cause augmented GH responses. Both the duration of rest periods between sets and training volume seem to influence the magnitude of plasma GH increases during exercise. In order to get a large increase in GH, the resistance-exercise protocol needs to produce large increases in lactate. Weltman et al.,41 reported a dose-dependent response between lactate and GH levels to low- and high-intensity running protocols. In that study, five treadmill-running intensities were studied at various percentages of the subjects’ lactate threshold (LT; 0.25 LT, 0.75 LT, 1.25 LT, and 1.75 LT). Lactate threshold is the exercise intensity at which lactate (lactic acid) starts to accumulate in the bloodstream. This happens when it’s produced faster than it can be removed (metabolized). GH responses were the lowest with low lactates being produced, while GH responses were the highest with increasing production of lactate being produced.

Additionally, a study by Gordon et al.,42 reported that even if the subject exercised at high thresholds without a large increase in lactate production, GH responses are blunted. In this interesting study, researchers administered sodium bicarbonate (sodium bicarbonate reduces lactate accumulation in the blood. It increases the pH in the blood and makes the blood pH less acidic) to athletes and had them perform a cycle exercise test to exhaustion. Ingestion of sodium bicarbonate resulted in a blunted GH secretion in response to exercise. Moderate-volume training programs, which have reduced rest periods (less than one minute) and produce high lactate levels during exercise, result in greater GH responses than those with high volume and protracted rest periods (greater than five minutes).

A New Era of Metabolic Stress Training: Occlusion Training
When resistance-training protocols of equal volume yet different training intensities are performed, the higher intensity protocol, which produces higher lactate levels, results in the greatest GH secretion. Earlier, it was mentioned that muscular hypertrophy and strength gains following a resistance-training program are thought to be due to an intensity level of 65 percent of a 1 RM to achieve an effect.2 Well, this is true for traditional weight training routines, but a new type of training called occlusion training has yielded increases in muscle mass and strength with training intensity as low as 20 percent of a 1 RM.44 Occlusion training or blocking blood flow may revolutionize bodybuilding training with huge increases in strength and size, although the exact mechanisms of how occlusion training increases muscle mass   an increase in metabolic by-products   may only be a partial answer. It has been reported that five sets of leg extensions with 30-second rest periods performed at 20 percent of a 1 RM with vascular occlusion resulted in a 290 percent increase in GH above baseline. The increased lactate resulting from tissue metabolic stress elevated GH significantly, although training volume was low.45 Let’s examine the endocrine responses of occlusion training to regular resistance training. A recent study in the Journal of Applied Physiology compared light-resistance exercise with partial occlusion to a moderate-resistance exercise protocol with no occlusion, and finally occlusion alone. Three sets of single-arm biceps curls and single-leg calf presses were completed to failure with one-minute rest periods between sets. Workloads for light-resistance exercise with occlusion were performed at 30 percent of a 1 RM, while at 70 percent 1 RM for moderate-resistance exercise. Lactate increased significantly in the light resistance exercise with occlusion and moderate-resistance exercise trials and wasn’t significantly different from each other at any point. GH increased significantly by four-fold from pre- to post-exercise in the light-resistance exercise with the occlusion session, but didn’t change significantly during this time period in the moderate-resistance exercise and occlusion alone. It was interesting that occlusion alone— without any voluntary muscular activity— tended to cause a rise in GH to a similar extent as that of the moderate-resistance exercise protocol.46

High Metabolic Stress in Muscle Increases Muscle Hypertrophy at Low Workloads
Restricted blood flow training is so powerful that even walking programs result in significant increases in strength and muscle hypertrophy. Yes, let me repeat that. Walking with restricted blood flow increases muscle hypertrophy in the legs! Researchers at the University of Tokyo had men walk on a treadmill with automated cuffs (which restricted blood flow) during exercise. Training was conducted two times a day, six days per week for three weeks using five sets of two-minute bouts, with a one-minute rest between bouts. Compared to the control group who did the same protocol without restricted blood flow, the occlusion group had more than doubled the GH levels during exercise, while the walking group with no occlusion had no increase in GH. Additionally, the increase in cross-sectional area of muscle increased approximately 2 percent per week.47

Occlusion training is rapidly being investigated as a possible means to treating sarcopenia. Sarcopenia is the degenerative loss of skeletal muscle mass and strength in old age. This loss of mass reduces the performance of muscles. Due to the increasing number of elderly people, sarcopenia is an up-and-coming health issue in the developed world. The level of sarcopenia can be so severe that it prevents an elderly person from living an independent life and requiring constant assistance and care. You can’t just have grandma start squatting to increase her muscle mass, but low-intensity walking with occlusion may be the new treatment for sarcopenia in the future. After all the research presented on growth hormone and testosterone it would seem that it’s a no-brainer for increasing muscle mass and strength, however the data on the effects of testosterone on muscle performance are contradictory.

The “Intramuscular Growth Factor” Camp
Elevated testosterone levels have been reported to occur in some studies,2,7,8,9 whereas several studies have shown no difference10,11,12,13 or even reductions.6,15 Not all studies in aging older men have shown that testosterone replacement therapy increases muscle strength.33,34 It should be mentioned that some studies have used low-dose testosterone gels and creams, which aren’t as effective as shots for increasing testosterone and which may negatively obscure results. Additionally, different dosages have been used in different studies. Some researchers have even gone on to believe that the gains in strength and size are all related to “intramuscular growth factors” that are independent of testosterone.

A paper about the relationship between muscle growth and testosterone presented by Dr. Goldberg in 1975 stunned scientists. In his research, he castrated rats so that they couldn’t produce testosterone and put their leg muscles on tension overload. Surprisingly, the rats’ leg muscles grew in size, suggesting that mechanical overload increases muscle hypertrophy independent of testosterone.17 Research scientists are now discovering the signaling pathway by which mechanical stimulation of contracting muscle and intramuscular growth factors such as IGF-1 activity leads to changes in satellite cells, muscle DNA content, increased muscle protein synthesis, increased muscle mass and strength.

Other recent research has demonstrated that IGF-1 increases intracellular calcium ion concentrations, leading to the activation of the muscle growth signaling pathway and subsequent muscle fiber hypertrophy.15,16 For example, in one study, 10 healthy men completed eight sets of maximal eccentric squats. The intramuscular IGF-1 mRNA concentration increased 62 percent, but serum testosterone showed little change.35 The results suggest that mechanical stress leads to hypertrophy in the absence of testosterone. This very well may have been a reason why the subjects in the study mentioned earlier, who had been taking a medication to reduce testosterone, still had small increases in muscle mass despite having low testosterone. An increase in muscle hypertrophy can lead to greater increases in muscle strength. Reports in the literature have suggested that the insulin-like growth factor-1 protein plays a major role in strength training-induced skeletal muscle hypertrophy and strength improvements. Due to differences in genetics, some people express higher levels of IGF-1 than others— that’s what we call “lucky bastards.” One study compared those who expressed high levels of IGF-1 levels to those who didn’t. After 10 weeks of training with a single-leg knee-extension strength training program, one-repetition maximum, muscle volume and muscle quality increased significantly for all exercising groups. Subjects whom expressed higher natural levels of IGF-1 gained significantly more strength than those who didn’t. Thus, the data suggests that IGF-1 may influence the strength response to strength training. Hold on…before I lose you to the side of the “intramuscular growth factor” group, there are some important considerations about testosterone and strength that need to be addressed.

Acute Increases in Testosterone after Exercise are Essential!
The magnitude of the increase in testosterone can be affected by the amount of muscle mass used during exercise,18,19 intensity and volume,2 training experience20 and nutritional intake.21 There are a lot of variables influencing testosterone’s secretion after exercise, but it seems that acute elevations in testosterone are necessary components for strength gains. Hansen et al.23 measured muscle strength changes in muscle flexion in the arms following nine weeks of resistance exercise. One group performed muscle flexion exercises only, whereas the second group performed a lower-body exercise prior to doing elbow flexion. Performing elbow flexion exercises only failed to elevate testosterone after exercise, however testosterone was significantly elevated when lower-body exercises were performed before elbow flexion exercises.

Muscle strength increased to a greater extent in the arms when the lower and upper-body exercises that were combined produced increases in testosterone compared to training arms only, which yielded no changes in testosterone. Another study reported that the acute increase in both testosterone and free testosterone correlated with the individual changes in strength that occurred during a six-month training period.12 Although some studies have reported no long-term changes in resting testosterone after resistance exercise, acute increases in testosterone, which may only last for 15 minutes after exercise, are essential for muscle strength and hypertrophy gains. It appears that the acute response to resistance exercise is more important to muscle growth and remodeling than chronic changes in resting hormonal changes, as many researchers haven’t shown a significant change in resting hormonal levels despite increases in muscle strength and hypertrophy

Testosterone Dose-dependently Increases Muscle Strength
During adult life, the average male produces about 7 milligrams of testosterone daily. The normal range of plasma testosterone in males is 300-1,000ng/dl, but the average value declines by age 80 to approximately 50 percent of that at age 20.26 The low levels of the anabolic hormone testosterone may be a limiting factor as to why older adults tend to have lower gains in strength compared to younger men. The impressive gains in strength from testosterone can be demonstrated in one study where hypogonadal men receiving testosterone increased muscle strength on the bench press by 22 percent without exercise.27 Testosterone is a wonderful hormone for men, but it can’t perform miracles if you lay on your ass!

NASA investigated the usefulness of using testosterone to prevent muscle atrophy and strength loss during spaceflight. Men were assigned to bed-rest while using low supraphysiological-range testosterone. Interestingly, a significant anabolic response was achieved, as both whole-body nitrogen balance and leucine kinetics were improved by testosterone treatment, but there was still a decline in muscle strength. These results suggest that in the absence of daily physical activity, testosterone administration won’t increase or, in the case of this bed-rest model, preserve muscle strength.28 The natural changes in testosterone throughout the day make measuring testosterone complex, as there are several studies that have shown no change in testosterone over several weeks of training, but when pharmacological testosterone is administered in combination with resistance exercise there are clear increases in muscle strength. When supraphysiological dosages of testosterone are administered to healthy young men, there was a significant increase in muscle size and strength without exercise.24 When exercise is added to supraphysiological dosages of testosterone an even greater effect on strength is achieved.
The same research group conducted an interesting study on different dosages of testosterone and how it affected muscle strength. They first gave all the healthy young men in the study a gonadotropin-releasing hormone agonist (GnRH antagonist) to suppress natural testosterone similar to the earlier study mentioned. The men then received 25, 50, 125, 300 or 600 milligrams of testosterone for 20 weeks. The researchers discovered that testosterone was associated with a dose-dependent increase in leg press strength and power. Meaning that the changes in leg press strength and power was highest for the 600-milligram group and lowest for the 25-milligram group. Another interesting finding was that the strength and muscle power were not correlated with serum IGF-1 levels.

How Testosterone Enhances Muscle Power
Theoretically, testosterone should improve strength by increasing muscle mass (via increased protein synthesis, nitrogen retention and anti-glucocorticoid actions), as well as by increasing exercise motivation. Moreover, recent studies in humans indicate that testosterone may increase muscle protein synthesis, possibly through stimulation of intramuscular insulin-like growth factor-1 (IGF-1) gene expression.31 Testosterone may also enhance strength by altering the way neurotransmitters are produced for muscle contraction. Contraction of muscle is a duty of the central nervous system comprised of brain and spinal cord. The connection between a motor neuron (a neuron that conveys impulses from the central nervous system to a muscle) and muscle fiber is a specialized synapse called the neuromuscular junction. With adequate stimulation, the motoneuron releases a flood of neurotransmitters that bind to receptors and trigger muscle contractions.

The first step in the sequence of events causing contraction of a muscle is the chemical messenger from a nerve (in the form of the neurotransmitter molecules, acetylcholine) to the muscle. Testosterone has been shown to alter the neurotransmitter acetylcholine within motor neurons, which could result in a more efficient muscle contraction. For example, castration causes a decrease in the activity of an enzyme called choline acetyltransferase, resulting in less acetylcholine, which technically, could result in lower force output. However, if the rats are supplemented with testosterone, the levels of acetylcholine return to normal. Furthermore, if the levels are supraphysiologically elevated— as with testosterone abuse— the levels of the neurotransmitters are increased even further.30 Both motor neurons and muscles have androgen receptors located on them and are, therefore, potential sites of androgen action. Patients with Kennedy’s disease, a degenerative disease in which androgen receptors are defective, can exhibit the significance of how androgen receptors affect muscle strength. The disease is characterized by severe muscle weakness. How testosterone interacts with the receptor is like a lock and key system. If you have lots of locks (testosterone) and no keys (receptors), it’s not going to do you a whole lot of good. A study in the Journal of Steroid Biochemistry and Molecular Biology reported that when resistance-trained men had muscle biopsies taken, the greatest predictor of males’ 1 RM strength wasn’t testosterone, but the androgen receptor content in the thigh muscle.36 It appeared that the quantity of androgen content in muscle was a better predictor of muscle strength than circulating androgens in the men studied. Both motor neurons and skeletal muscle have androgen receptors. Testosterone causes enlargement of motor neurons, causing greater force enhancement. Males have larger motor neurons than females due to the actions of testosterone. Research in rats has shown that testosterone administration causes an increase in motor size while castration causes a decrease in the motor size of neurons.29 The data suggest that testosterone may increase strength by increasing motor neuron size.

The research suggests that both mechanical stress from muscle overload and acute anabolic hormone (GH and testosterone) responses are key mediators of muscle growth and strength gains. Although some studies have shown no changes in resting testosterone after resistance exercise, more recent research has demonstrated the importance of acute testosterone responses and mechanical stimuli from resistance exercise acting as upregulators of the androgen receptor, which influence muscle strength and size. Other factors such as nutrition, overtraining, intensity and rest duration all influence the secretion of testosterone during exercise. The acute increases in testosterone are associated with changes in lean muscle mass and strength.

Key Points:
• Increased metabolic stress (short rest periods) results in greater increases in strength and muscle mass than prolonged rest periods.
• Lactate increase GH responses in a dose-dependent fashion.
• A decrease in testosterone as little as 10 percent below normal will impede strength gains in response to a strength-training program.
• Acute elevations in testosterone are a potent stimulator of muscle mass and strength.
• Testosterone produces a dose-dependent effect on muscle strength.
• Motor neurons contain androgen receptors and increase in size in response to testosterone, which may mediate muscle strength.
• Testosterone increases the neurotransmitters’ firing potential of muscle, which may enhance force production.

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Testosterone Research Update: Low Testosterone is Associated With Increased Mortality
Not only will low testosterone completely blunt strength gains in response to a workout and increase your waistline…even more frightening is that a low testosterone level is associated with increased death rates in men. Several studies have noted that low testosterone levels are associated with multiple risk factors for heart disease, including hypertension, central obesity, blood clots and increased markers of inflammation such as C-reactive protein.
A report published in the August issue of Archives of Internal Medicine revealed a correlation between reduced levels of testosterone and an increased risk of mortality during up to eight years of follow-up. Researchers analyzed the association between testosterone levels and death in 858 male veterans over the age of 40. The participants’ testosterone levels were measured at least twice between 1994 and 1999. Subjects were followed through 2002, and any deaths among the group were noted. Participants were placed in either low total testosterone or normal testosterone levels. After adjusting for age, illness and other factors, men whose testosterone levels were classified as low experienced an 88 percent adjusted increased risk of dying over the course of the follow-up compared to those with normal levels. To reduce the effects of acute illness on the findings, the researchers re-examined the data excluding men who died within the first year of follow-up, yet they still found an increase of 68 percent in the risk of dying among men with low testosterone.

Estrogen, progesterone, and thyroid hormones are interrelated. The thyroid is the hormone that regulates metabolic rate. Low thyroid tends to cause low energy levels, cold intolerance, and weight gain. Excess thyroid causes higher energy levels, feeling too warm, and weight loss. The thyroid gland makes two versions of thyroid hormone from tyrosine and iodine.

Both versions are then enveloped in a relatively large glycoprotein complex called thyroglobulin and stored in the thyroid gland. To be released into the bloodstream for circulation throughout the body, the hormones are separated from thyroglobulin and bound to a much smaller globulin thyroxin-binding globulin or albumin. However, only 0.5% of thyroid hormone is “free” to be biologically active. Thyroid’s action in the cell is to increase the biosynthesis of enzymes, resulting in heat production, oxygen consumption, and elevated metabolic rate. Thyroid stimulates the oxidation of fatty acids, and reduces cholesterol by oxidizing it into bile acids. Thyroid also stimulates enzymes for protein synthesis and, when present in excessive amounts, can catabolize (destroy) muscle protein. Estrogen causes food calories to be stored as fat. Thyroid hormone causes fat calories to be turned into usable energy. Thyroid hormone and estrogen have opposing actions. Estrogen inhibits thyroid action in the cells, interfering with the binding of thyroid to its receptor. Both hormones have phenol rings at a corner of their molecule. The respiratory enzymes of cells are thyroid-dependent. When thyroid function is low, cellular oxygen is low (cellular hypoxia). Thus, estrogen-induced thyroid interference contributes to less-than-optimal brain function. Excess estrogen may compete with thyroid hormone at the site of its receptor. In so doing, the thyroid hormone may never complete its mission, creating hypothyroid symptoms despite normal serum levels of thyroid hormone. Progesterone, on the other hand, increases the sensitivity of estrogen receptors for estrogen and yet, at the proper level, inhibits many of estrogen’s side effects. GABA (gamma-aminobutyric acid) is an amino acid that acts as a neurotransmitter-inhibitor and tends to have a calming effect. When estrogen interferes with thyroid production and slows the metabolism of brain cells, it indirectly decreases GABA production and increases brain cell excitability, a factor in epilepsy.

Since the first published article by Dr. Simeon in 1950’s, few small controlled clinical trials implied that hCG had no significant advantages over calorie restrictions alone. Recently, hCG use for weight loss has become widely popular and has led to new interest in studying the role of hCG in weight loss. While we need a large controlled clinical trial of hCG in weight loss for definitive answers, contemporary medicine cannot ignore its benefits.

While we need more research to study the effect of hCG, it is clear that hCG does have an advantage for weight loss when compared to diet alone. Modern theories focus on the hypothalmic action of this hormone. The hypothalmus is an “off/on” switch that controls hunger and the fat burning temperature of the body. There are well known clincial conditions with hypothalmic dysfunction that are associated with obesity.

Additionally, alterations in opioid and other neurotransmitter receptors have a complex effect on hunger and weight gain/weight loss. We have seen patients gain weight with clinical depression or with use of certain antidepressants.

When hCG is administered to a patient, it appears to concentrate preferentially in the hypothalmus. hCG also seems to promote beta oxidation (break down of fat into free fatty acids) and decreases lipogenesis (fat accumulation). In order for this to work, the patient must be in a hypocaloric state.

Our program is physician supervised along with a nutritionist aiding you in the process. We address the short term and long term weight loss. There is no need for appetite suppressants while on hCG because you will feel full the whole time since you will be living off of the fat stores in the body releasing about 2000-3000kcal this varies person to person. We notice with patients after 4-5 days they are very full and maintaining satiety. If you would like to know more about the hCG program please call 813 341 2600.

Seminar Report

The seminar was presented by Pamela W. Smith, M.D., MPH. The focus was how to lose weight and keep it off.

Summary- Causes of obesity are Physiological & Psychological

• Certain foods have mild opiate effects which causes addiction
• Chocolate has opiate effects which release chemicals that encourage addiction.
• Cheese and dairy has mild opiate effects released during digestion
• Wheat protein(gluten) breaks apart in the digestive process and the breaking down of the compounds has mild opiate effects
• Overweight patients have fewer dopamine receptor sites, so this causes them to eat more to experience the mild opiate effects (euphoric feeling) released by certain foods
  • Exercise releases dopamine
  • Healthy foods can turn on dopamine
• Men whom avoid dairy has a 30% reduction in prostate cancer
  • Dairy consumption suppresses Vitamin D activation
    • Deficient in Vitamin D causes issues in breast cancer, prostate cancer, MS, depression, colon cancer, back pain, etc…
• Sugar causes the release of opiates in the brain
• Serotonin in the brain has a considerable affect in eating behavior
  • Carbohydrate rich foods boosts serotonin
  • Diets low in tryptophan tend to decrease serotonin levels which causes people to never feel satiate
  • Serotonin levels decrease when dieting (restriction...cookie cutter diets)
    • Restrictive diets affect neurotransmitters (must consume an array of whole foods)
• Secrets to Losing Weight and Keeping it off
  • Need to eat Breakfast
    • Body makes insulin at 10a and 5pm, so we must utilize the release of insulin in those hours
    • No breakfast and release of insulin at 10a will raise triglycerides and make it harder to lose weight
  • Choose foods that hold blood sugar steady
    • Note: Cortisol is a major issue of why people don’t lose weight and keep it off.
• Add fiber to meals
  • Help stay satiated
  • Decreases calorie intake by 10% if an additional of 14grams are added per day

• Boost Leptin
  • Dieting (calorie restriction/cookie cutter) decreasing leptin
  • Leptin is a hormone that helps tame your appetite
  • Leptin also boosts metabolism
  • High bad fats interfere with leptin
  • Exercise increases leptin sensitivity
  • * Do not diet, eat enough calories to not impair leptin system
    • Dieting causes body to go into flight and fight response (stress) preventing effective fat loss
      • Example: Consuming as low as 800 calories makes the body think it’s in the state of emergency...releasing cortisol, which causes the body to store everything in the fat cells.
• Exercise is essential
  • Exercise increases insulin sensitivity and mitochondria function
    • Increases in mitochondria activity has to be there to make fat burning effective
• Stress Management
  • Elevated stress increases cortisol levels

• Sleep
  • Releases growth hormone which aides in fat loss
• Vitamins
  • People need to be nutritional sound (vitamin, minerals, enzymes)
    • *All patients should be on a good multivitamin and fish oil
      • Obesity is an inflammatory response, and must be treated with fish oil and other anti-inflammatories
• Supplements
  • CLA – helps insulin work more effectively in the body
    • *Best for plateau stages – suggested 3-4,000mg daily
  • L-Carnitine – helps with fat loss
    • *Best for plateau stages – suggested 3-4,000mg daily

Note:

• Patient losing or gaining more than 20lbs will experience a change in their hormonal status (re-balancing of the hormones is essential)
• Suggest 40%Protein, 40%Carbs, 20%Good Fats
• Never consume Carbs by itself
• Add shakes to meals of those that are addicted to food
• Add shakes and bars to assist those that complain about convenience
• Depending on how quickly the patient wants to lose weight depends on what program they should be put on.
• Allergy with foods can cause a patient not to lose weight
  • Start with an allergy elimination diet (note: people crave foods that they are allergic too)

In Conclusion: To lose weight and keep it off, patients need to be:

• Hormonally sound (female & male hormones, insulin, thyroid, melatonin, cortisol,etc..)
• Nutritionally sound (not lacking in co-factors and enzymes)
• Neurotransmitters (serotonin, dopamine, epinephrine, GABA, histamine, etc..) have to be normal
• Eliminate allergies
• Decrease inflammation
• Detoxification

1. Set specific goals Narrow it down. Be specific – right down to the digit. Exactly how many pounds do you want to lose? When do you want to complete your goal? How much body fat do you want to lose? How much do you want to weigh? What measurements would you like to have.What size clothes do you want to wear?

2. Set measurable goals You must have a way to objectively measure your progress; otherwise you’ll never know whether you’ve actually reached your goals or not. The mirror is definitely a useful tool, because ultimately the only thing that really matters is that you’re happy with the way you look.

3. Set big goals Too often, people shortchange themselves and make statements like, "I could never look like that" or “I’m too old.” Most people get scared when setting goals and ask only for what they think they can get, not what they really WANT. This is a mistake because “realistic” goals are NOT motivating. WANTS are motivating. Don’t let the fear of failure or the feeling of discomfort prevent you from going after what you really want. Always step forward into growth; never pull back into safety

4. Set realistic deadlines the safest and most intelligent approach to fat loss is a gradual one. It’s possible to lose more than two pounds per week, but if you do, most of the additional weight will usually be water and muscle. When you lose water weight, you will gain it back immediately as soon as you re-hydrate yourself. When you lose lean body mass, your metabolic rate slows down and your body goes into “survival mode.” There are no unrealistic goals, only unrealistic deadlines.

5. Set long-term and short-term goals As you begin to think about what you want specifically, don’t just write down one goal, make an entire list.

1. Your ultimate long-term goal

2. 12 month goal

3. Three month goals

4. Weekly goals (Weekly body composition test and weigh-in)

5. Daily goals (habits to develop, things to do every day repeatedly)

6. Remind yourself why your doing this. There are time you just don’t fell like exercising or eating the right foods. The secret to staying motivated at times like this is establishing the "reason why" you want that goal- it is the purpose behind the goal that will help. The philosopher Nietzsche said, “ If you have a strong enough why you can bear almost any how.”

7. Make it your number one priority. Because being healthy is important make it your priority. Because feeling and looking good makes you happy make it your number one priority you deserve it.

8. Read your affirmations (your goal list) at least twice a day and always keep your goals “in front of you” and “on your mind.” Psychologists have proven that repetition is an effective way to penetrate and program the subconscious mind. Why is it that people reach for Coke, Pepsi,Budweiser, Marlboro, Crest, and other brand name items? It’s because the repetition of the advertising has penetrated their subconscious minds and moved them to action. Read them has often has you can.

9. Read your goals with faith. All thoughts which have been emotionalized and mixed with faith begin immediately to translate themselves into their physical equivalent. Have faith, believe in yourself.

10. As you read your affirmations, mentally visualize them as already achieved. Because your brain thinks in pictures, adding a bright, clear, moving mental picture of what you want to achieve will help you to penetrate your subconscious mind more rapidly and more deeply than if you just read your goals.

Exercise creates the stimulus to lose weight and get in shape but it can only ever happen if you get the nutrition routine behind your training in place. Often when people are trying to lose weight then they focus more on reducing food (and hence nutrients). The focus should be on increasing the foods that will help you achieve your goals and reducing those that do not. General nutrition advice is NO help to you.

When it comes to nutrition advice the only guarantee you will find is that one ‘expert’ will be contradicting another ‘expert’ when it comes to weight loss. Where one person says high protein, a vegetarian may propose the opposite point of view. Some people say follow a whole grain diet while others say go low carbs to lose weight. In every case you will always find a few people swearing by the plan yet more often than not it does not work for you. You are You and they are them!

The reason one plan works for some but not others is because you are not them and they are not you! The only thing that counts is what works for you. This exists because we are all very different. One person may be hungry six times a day while another just once a day. This means that two people may get very different reactions to eating the same foods.

As we are all different and what works for one person is the complete opposite of what works for another you must THROW OUT today’s concept of healthy eating. It is merely a one size fits all nutrition strategy which FAILS as many people as it helps. The way round this problem is to use Metabolic Typing which allows us to work out what foods your body needs and at which end of the diet spectrum your body lies at the moment. When you eat these foods you will get results.

“You become great by thinking great thoughts and by backing those thoughts with your words, energy, emotions, and actions. Encourage yourself to leave behind negative and uphold positive uplifting ideas with your speech. This is how your dreams will be able to manifest from the inside out.” – Carol Tuttle.

"I believe that you can, by taking some simple and inexpensive measures, extend your life and your years of well-being. My most important recommendation is that you take vitamins every day in optimun amounts, to supplement the vitamins you receive in your food."

-Linus Pauling, Ph.D., Two-time Nobel Prize Laureate