December 12, 2022 • 2hr 20min
Dr. Kyle Gillett: Tools for Hormone Optimization in Males
Huberman Lab
Key Takeaways
- Puberty and development: The first puberty occurs in the first 3 months of life, while the second puberty is what most people think of as puberty during adolescence. Childhood obesity can trigger earlier puberty.
- Resistance training for youth: Lifting weights does not stunt growth, but "dirty bulking" (overeating to gain weight) can potentially limit height by triggering early puberty.
- Hormone optimization foundations: Focus on sleep, nutrition, stress management, exercise, social connections, and finding purpose. Get bloodwork done regularly starting in late teens/early 20s if possible.
- Key supplements: Creatine, betaine, L-carnitine, vitamin D, boron, tongkat ali, and fadogia agrestis can support hormone optimization when used appropriately.
- Testosterone therapy: For those considering it, a typical starting dose is 100-120mg per week divided into 2-3 doses. Close medical supervision is crucial.
- Alternatives to TRT: HCG or clomiphene can stimulate natural testosterone production as an alternative to exogenous testosterone in some cases.
- Hair loss treatments: Topical anti-androgens may have fewer side effects than systemic DHT blockers. Caffeine and ketoconazole are mild topical options.
- Prostate health: Low-dose daily tadalafil (2.5-5mg) may benefit prostate health in addition to improving erectile function.
- Lifestyle factors: Limit alcohol, avoid excessive cannabis use, be cautious with nicotine, and protect the pelvic floor during cycling. Get adequate healthy fats in the diet.
Introduction
In this episode, Dr. Andrew Huberman interviews Dr. Kyle Gillett, a dual board-certified physician in family medicine and obesity medicine, about optimizing male hormones. They discuss a wide range of topics including puberty, key lifestyle factors, supplements, prescription medications, and how to approach hormone optimization at different life stages. Dr. Gillett provides evidence-based recommendations and insights from his clinical practice to help men optimize their hormones safely and effectively.
Topics Discussed
Puberty and Development (7:44)
Dr. Gillett explains that there are actually two puberties in life:
- The first occurs in the first 3 months of life, involving hormonal changes and some physical development
- The second is what most people think of as puberty during adolescence
Key points on puberty:
- Childhood obesity can trigger earlier puberty onset due to increased leptin levels
- Entering puberty very early can potentially decrease adult height
- Resistance training does not stunt growth, contrary to popular belief
- However, "dirty bulking" (overeating to gain weight) can potentially limit height by triggering early puberty
Foundations of Hormone Optimization (16:41)
Dr. Gillett outlines key lifestyle factors for optimizing hormones throughout life:
- Sleep: Prioritize quality sleep
- Nutrition: Focus on whole foods, adequate protein, healthy fats, and micronutrients
- Stress management: Find effective ways to cope with and reduce stress
- Exercise: Engage in regular resistance training and cardiovascular exercise
- Social connections: Maintain strong relationships and social support
- Purpose: Find meaningful goals and pursuits in life
He recommends getting bloodwork done regularly starting in the late teens/early 20s if possible, to establish baselines and monitor hormones over time.
Key Supplements for Hormone Optimization (56:56)
Dr. Gillett discusses several supplements that can support hormone optimization:
- Creatine: 5g daily, benefits muscle and cognitive function
- Betaine: 1-3g daily, may help non-responders to creatine
- L-carnitine: 1-5g orally or 500-2000mg injected, increases androgen receptor density
- Vitamin D: Dosage varies, optimize levels through bloodwork
- Boron: 5-12mg daily, can help lower SHBG
- Tongkat ali: 300-1200mg daily, supports testosterone production
- Fadogia agrestis: 300-600mg daily, increases LH and testosterone
He emphasizes the importance of quality sourcing and potential individual variations in response.
Testosterone Replacement Therapy (TRT) (1:41:26)
For those considering TRT, Dr. Gillett provides insights:
- Typical starting dose: 100-120mg per week divided into 2-3 doses
- Close medical supervision is crucial to monitor potential side effects
- Side effects can impact multiple body systems (skin, cardiovascular, mental health, etc.)
- HCG or clomiphene may be alternatives to stimulate natural production in some cases
"Every organ system in the body... you need to have, you know, dermatology prowess. Acne is very common. Change lots of different skin pathologies or even bruising can be related to hormone replacement." - Dr. Kyle Gillett
Hair Loss and DHT (2:07:50)
Dr. Gillett discusses approaches to hair loss prevention:
- Topical anti-androgens may have fewer side effects than systemic DHT blockers
- Mild topical options include caffeine and ketoconazole
- Finasteride and dutasteride work systemically but can have more side effects
- DHT is important for overall male health, so completely blocking it may not be ideal
Prostate Health (2:04:01)
Key points on prostate health:
- Low-dose daily tadalafil (2.5-5mg) may benefit prostate health
- Monitor PSA levels, with normal ranges varying by age
- Be aware that 5-alpha reductase inhibitors like finasteride can affect PSA readings
Lifestyle Factors Impacting Hormones (1:53:48)
Dr. Gillett discusses various lifestyle factors that can impact hormone levels:
- Cannabis: Smoked cannabis can decrease testosterone and increase prolactin
- Nicotine: Can negatively impact hormones, especially at higher doses
- Alcohol: Increases aromatase activity, converting testosterone to estrogen
- Cycling: Prolonged pressure on the perineum can impact pelvic floor health
- Diet: Adequate healthy fats are important for hormone production
Environmental Factors (2:17:25)
Dr. Gillett addresses concerns about environmental toxins:
- BPA and phthalates can act as xenoestrogens, potentially disrupting hormone balance
- He recommends avoiding BPA-containing plastics when possible
- Testing water quality and using filters can help reduce exposure
Conclusion
This comprehensive discussion with Dr. Kyle Gillett provides a wealth of information on male hormone optimization. Key takeaways include the importance of lifestyle foundations like sleep, nutrition, and stress management, as well as targeted supplement use when appropriate. For those considering more aggressive interventions like TRT, close medical supervision is crucial. The episode emphasizes a holistic approach to hormone health, considering factors ranging from exercise and diet to environmental exposures. By implementing these evidence-based strategies, men can work towards optimizing their hormones safely and effectively at any age.
