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Is my testosterone normal?

Hi John,
Can you please take a look at my recent blood results from Kaiser. I don’t trust them when they tell me I’m in a normal range. I would really like your opinion.
Testosterone 308 ng/dl
FSH 4.7 mIU/mL
LH 3.0 mIU/mL

Thank you 🙂
Mark

Dear Mark,

Very complex question actually.  There is a certain amount of disagreement over what “normal” or “optimal ranges” for hormones are, particularly in men.  I will give you my opinion about the tests.

Normal FSH range in adult men is usually reported at 5-15 mIU/ml.  Yours at 4.7 is low, even by this broad range.  In men, FSH or Follicle Stimulating Hormone, is critical for sperm production.

Normal LH range in men is usually reported as 2-14 mIU/ml.   This again, is a pretty broad range.  Your level is 3.0, so it is barely in the lowest end of “normal” range.  LH, or luteinizing Hormone, stimulates the Leydig cells where there is testosterone production.  This is controlled by GnRH, Gonadotropin Releasing Hormone, from the hypothalamus.  There is a test using GnRH to stimulate LH release see where the problem is.

Normal testosterone range is usually reported as 300-1,000 ng/dl. Your level is 308.  This is obviously at the very lowest level of “normal”.

While many general practitioners would be fine with these levels, any reproductive specialist and many good mens doctors would be quite concerned.

This group of tests would be consistent with hypostimulation, or low hormonal pulsing, from the pituitary gland leading to marginal sperm production and low testosterone levels which can affect every aspect of male health.  These problems would include, but not be limited to, low libido or sex drive, low sperm count, weight gain, irritability, erectile dysfunction, infertility, difficulty in gaining or holding muscle mass, fatigue, cardiovascular problems, diabetes, etc.

In reproductive medicine, and many other conditions that I treat, this hypothalamic-pituitary communication is faulty.  In reproductive medicine this is looked at a lot along with adrenal and thyroid function which are controlled by the hypothalamic/pituitary system.

Greatly simplified example. The hypothalmus is the control center (think any movie with lots of dials and screens being monitored like a nuclear facility). The control room (hypothalamus) is constantly measuring temperature, nervous system activity, hormone levels etc.

The hypothalamus has a closed loop with the pituitary where it sends very small messages like GnRH.  The pituitary then sends out chemical messages to the various  glands to increase or decrease the hormonal output from the specific glands.  TSH or thyroid stimulating hormone stimulates the production of  thyroid hormones.  FSH, to stimulate the ovarian follicles in women and spermatogenesis in men.  LH to stimulate follicle release and corpus luteum production (for increased pregesterone.) Many others.

So, the key is find out where in this complex system the problem is.  In Chinese Medicine it is actually dramatically easier than with biomedical testing, although the testing is very cool.  We have many ways to balance the HPA (hypothalamus/pituitary/adrenal) axis.

In biomedicine the focus is on hyperstimulating various systems with pharmaceuticals which will have side effects. In TCM we assist the body to regain homeostasis or balance so that it can do it’s job properly.

In my opinion, based on my historical knowledge of your lifestyle, your particular test results arise primarily from:
-irregular and unnatural circadian rhythms as a result of your shift work schedule, which will dramatically affect HPA axis.
-relationship issues leading to neurohormone imbalance
-under exposure to “male” activities which would stimulate testosterone production
-over exposure to other types of life activities/events which will inhibit testosterone production.

Be well,

– Dr. John Nieters, L.Ac. DAOM, FABORM

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KPFA 94.1 About Health 2pm

Dr. John Nieters will be a guest on KPFA’s “About Health” hosted by Joy Moore. Special show focusing on alternative health care resources.
http://www.kpfa.org/about-health
Subscribe to the about health podcast:
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July 2011 Treating Autoimmune Diseases

In This Issue (Get QiMail delivered to your inbox )
– Treating Autoimmune Diseases with Acupuncture and Oriental Medicine
– Acupuncture for Rheumatoid Arthritis
– 6 Nutrients to Support Your Immune System
– News, Events and Gratitude

Treating Autoimmune Diseases with Acupuncture and Oriental Medicine
Autoimmune diseases are a group of disorders in which the immune system attacks the body and destroys or alters tissues. There are more than eighty serious chronic illnesses in this category including rheumatoid arthritis, type 1 diabetes, lupus, thyroid disease, inflammatory bowel disease, Addison’s disease, pernicious anemia, celiac disease, multiple sclerosis, myasthenia gravis and Guillain–Barré syndrome. According to the American Autoimmune Related Diseases Association (AARDA) twenty percent of the population suffers from autoimmune disorders. Each disease appears uncommon on an individual basis but, as a group, the disorders make up the fourth-largest cause of disability among women. 

Due to the complexity of treating autoimmune disorders, integrative medicine solutions including acupuncture and Oriental medicine have received much attention as successful therapies in their treatment particularly for use in providing pain relief, regulating the immune system, managing symptoms and improving overall quality of life.

What Causes Autoimmune Disease?
Under normal conditions, an immune response cannot be triggered against the cells of one’s own body. In certain cases, however, immune cells make a mistake and attack the very cells that they are meant to protect. This can lead to a variety of autoimmune diseases which encompass a broad category of over 100 diseases in which the person’s immune system attacks his or her own tissue.

The exact mechanisms causing these changes are not completely understood, but bacteria, viruses, toxins, and some drugs may play a role in triggering an autoimmune process in someone who already has a genetic (inherited) predisposition to develop such a disorder. It is theorized that the inflammation initiated by these agents, toxic or infectious, somehow provokes in the body a “sensitization” (autoimmune reaction) in the involved tissues.

As the disease develops vague symptoms start to appear, such as joint and muscle pain, general muscle weakness, possible rashes or low-grade fever, trouble concentrating, or weight loss. The following symptoms may point toward something being wrong: numbness and tingling in hands and feet, dry eyes, hair loss, shortness of breath, heart palpitations, or repeated miscarriages can also be caused by an autoimmune response.

How Acupuncture Treats Autoimmune Disorders
According to Oriental medicine, autoimmune disorders occur when there is imbalance within the body. Imbalance can come from an excess or deficiency of yin and yang that disrupts the flow of Qi, or vital energy, through the body. Acupuncture is used to help the body restore balance, treating the root of the disorder, while specifically addressing the symptoms that are unique to each individual. 

Clinical research has shown that acupuncture causes physical responses in nerve cells, the pituitary gland, and parts of the brain. These responses can cause the body to release proteins, hormones, and brain chemicals that control a number of body functions. It is proposed that, by these actions, acupuncture affects blood pressure, body temperature and the immune system.

In addition to acupuncture, your treatment program to manage your autoimmune disorder may involve a combination of therapies including stress reducing exercises, moderate physical activity, herbal medicine and nutritional support.

Learn more about how acupuncture and Oriental medicine can be safely and effectively incorporated into treating autoimmune disorders, call for a consultation today!

Acupuncture for Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disorder that can affect many different joints and, in some people, other parts of the body as well, including the blood, the lungs, and the heart. Inflammation of the joint lining, called the synovium, can cause pain, stiffness, swelling, warmth, and redness. The affected joint may also lose its shape, resulting in loss of normal movement. Rheumatoid arthritis can last a long time and can be a disease of flares (active symptoms) and remissions (few to no symptoms). 

According to Oriental medical theory, arthritis arises when the cyclical flow of Qi in the meridians becomes blocked. This blockage is called, “bi” type pain and is widely studied and successfully treated using a combination of acupuncture and/or Chinese herbs.

Acupuncture and Oriental Medicine have been found to be extremely effective at treating the pain and inflammation associated with all types of arthritis. The acupuncture points and herbs that are used depend on if the blockage of Qi (arthritis) is caused by the pathogen wind, cold, damp or damp-heat. 

Call today to learn how acupuncture and Oriental medicine can be incorporated into your treatment plan for rheumatoid arthritis!

6 Nutrients to Support Your Immune System
A class of plant chemicals known as bioflavonoids has been found to dramatically reduce inflammation and improve symptoms associated with autoimmune disorders. Here are six that can be found in everyday foods.

Carotenoids – A family of plant pigments that include beta-carotene. A lack of carotenoids in the diet is thought to promote inflammation. Good sources of carotenoids include apricots, carrots, pumpkin, sweet potato, spinach, kale, butternut squash, and collard greens.

Fiber – A healthy and active colon can decrease food sensitivity, which, in turn, can lighten the burden on your immune system. For maximum autoimmune health, increase the fiber in your diet. 

Flavonoids – Found in green and black teas both catechins and theaflavins are beneficial in autoimmune disease.

Ginger – Recent studies show that ginger reduces inflammation by inhibiting prostaglandin and suppresses the immune system’s production of pro-inflammatory cytokines and chemokines, reducing disease severity in patients with rheumatoid arthritis.

Omega-3 – These essential fatty acids found in cold water fish such as salmon or mackerel and flaxseed oil can counter the formation of chemicals that cause inflammation. 

Quercetin – Found naturally in certain foods quercetin can reduce allergic reactions and decrease inflammation. Foods rich in quercetin include apples (skin on), berries, red grapes, red onions, capers, and black tea.

News and Events
Thanks readers of Alameda Magazine for voting John “Best Acupuncturist” in Alameda. We are delighted by this honor.

– We will always accommodate established patients for urgent care drop-in visits during business hours.

– Tune-in to The Medicine Men and The Balancing Point radio shows podcast in iTunes, or live in the Bay Area, www.medicinemenradio.com or www.thebalancingpoint.net

– Special 1 hour episodes of The Balancing Point radio in July on Mondays KEST 1450 AM 9-10am, tune-in!

– Thanks to MN for her recent review of John’s work on yelp (if you don’t know yelp.com, it is a great resource for finding about about your community): “I started going to John for my back pain about 2 months ago, and with first appointment, it significantly improved and after like 2 or 3rd appt, the pain was completely gone. His approach is very comprehensive and I feel very comfortable with John, who is warm and very kind. I am about 5 months pregnant now, but he knows how to treat pregnant woman, so there is no need to worry about. Every time I go to the appointment, I feel so much better, and I highly recommend him for anyone who has health issues. ”

– On September 25th, John will teach at the Colorado School of Traditional Chinese Medicine in Denver. He will teach a 1/2 day on his Integrative Diabetes Protocol and a 1/2 day on the modern clinical applications of the Pi Wei Lun classic. If you are in the Denver area, we hope to see you there. http://www.cstcm.edu/pda/all

– Please join us on Facebook “Alameda Acupuncture – Dr. John Nieters, L.Ac.” (http://www.facebook.com/pages/Alameda-Acupuncture-Dr-John-Nieters-LAc/126245057390177) Upcoming events are listed and links to information about Chinese Medicine and podcast updates.

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Coffee vs. Green Tea

Hi John,
I live in the San Francisco Bay Area (peninsula) and am a big fan of yours. I attended your presentation on Alzheimer’s at the new living expo and have been listening to your weekly radio show on a regular basis. Your knowledge and ability to present information in a clear, caring and understandable manner is refreshing and greatly appreciated.

My recollection and I could be wrong is that during the presentation you recommended against drinking coffee and advocated drinking green tea; while I am a big fan of green tea due to the presence of its polyphenols which have neuroprotective properties, I always felt that coffee also had some major benefits. Recently another study has confirmed the benefits of coffee in relation to Alzheimer’s; seehttp://www.sciencedaily.com/releases/2011/06/110621093301.htm . In addition, there is one study I know of regarding the benefits of coffee for those with prostate cancer that I think is interesting ; seehttp://www.nytimes.com/2011/05/24/health/research/24prevention.html . I also read where coffee is the primary source of antioxidants in the American diet (this would seem like a good trivia question) and this seems to me more a statement about the poor diet of Americans than anything else.

Based on the research on Alzheimer’s I was wondering if you still believe that one should not consume coffee.

Regards,

Allan

Dear Allan,
One of the difficult things to communicate in a seminar of the type that we did was that there is absolutely no “right” diet or group of supplements for everyone.  Although I mention that fact at the beginning of the seminar, it is difficult to hold this in the face of some supplements and activities being communicated as generally “good” or “bad”.

One of the most significant differences between Classical Chinese Medicine and Western Biomedicine is in understanding qualitative vs. quantitative measures and understandings.

Biomedicine is brilliant in quantitative measures.  Chinese Medicine has immense wisdom in seeing and treating based on qualitative measures.

Statistics give us great tools, but no individual is a statistic and cannot be identified statistically, and treatments of individuals should rarely be based on statistical information unless that statistical information is overwhelmingly positive in one direction. For example, according to studies done by the company making a particular statin drug, if 250 people take a particular Statin drug it should prevent one cardiovascular event over a 5 year period.  This information is used to suggest that most if not all people should go on statins.  We also see that 15% of women who go on statin drugs complain of severe muscle pain and weakness.  Of those women, 56% show muscle damage if the muscle is biopsied.  So,  what to do.  Who will be helped and who will be harmed?

In Chinese Medicine it is all about the individual.  For example; we know statistically that about a third of people given Ginseng will have an increase in blood pressure.  This is not a problem for us, as it is very easy to identify the people who are likely to be affected before we give them the herb, so we don’t give them ginseng.

This same principle holds true in Chinese Medicine for ALL elements of diet, herbal medicine, sleep timing,  exercise frequency, and even optimal frequency for sexual activities.  It is all based on the individual.

Coffee is an antioxidant miracle.  It has an extremely high ORAC score for antioxidant content.  Antioxidant activity is very important in Alzheimer’s prevention.  Coffee has dramatic effects on blood sugar and glycemic activity.  Glycemic activity is one of the most important aspects of Alzheimer’s prevention. People are more likely to exercise longer and at greater intensity while on coffee, which is good for many, but not for all.   I like coffee for it’s very beneficial effects on the the Liver (of most people).  I do not like it for my patients with cardiac arrhythmias and certain blood flow irregularities.  I believe, that like all things, some people do better on coffee, while some people are better without coffee, for Alzheimer’s prevention.

In Chinese Medicine, green tea is cooling, coffee is heating in an artificial heating way.  This would be one of my most simple distinctions in deciding between the two substances for my patients.  From there I would look at a whole host of other factors in making a recommendation.  Also critical to me is quality of sleep and/or ability to relax.  If coffee affects these deleteriously, as it often does, I would see that as over-riding or negating the positive potential .

Another point to remember; as much as I enjoy reading and quoting studies, most are not accurate.  Only about 50% stand up to further scrutiny.  And that is just in terms of whether they accurately answer the question asked.  Even more important is that most studies don’t ask the right questions, so the reported results can be very misleading.

A good example is the NIH sponsored study done at Harvard.  The (published) question was “Does the herb Dang Gui relieve menopausal symptoms”. Seems straightforward.  However in the methodology, because of massive unintentional biomedical bias, the assumption used in the study was that menopausal symptoms could only be relieved by raising estrogen levels.

The study indicated that Dang Gui dramatically relieved menopausal symptoms.  It did not however increase estrogen levels.  So the study was reported as a “negative study” even though it actually did lower symptoms and that was the very question being asked.  So they proved that Dang gui did not lower menopausal symptoms while proving that it did actually lower the symptoms.  Hmmmmm.  This type of bias is rampant.

– Dr. John Nieters, L.Ac. DAOM, FABORM

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June 2011 Acupuncture for Diabetes

In This Issue (Get QiMail delivered to your inbox )
– Treating Diabetes with Acupuncture and Oriental Medicine
– Five Areas Diabetics Should Monitor Carefully
– News, Events and Gratitude!

Treating Diabetes with Acupuncture and Oriental Medicine
It is estimated that 25.8 million men, women and children in the United States have diabetes. Diabetes is a disease in which the body does not produce or properly use insulin, a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. According to the Centers for Disease Control and Prevention the risk for death is approximately twice that of persons of similar age without diabetes. 

The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles. Complications of diabetes include heart disease, hypertension, eye problems, kidney disease, nervous system disease, periodontal disease, amputation, fatigue, depression, and complications during pregnancy.

In order to manage diabetes, it is essential for people to make healthy lifestyle choices in diet, exercise, and other health habits. Another important factor when treating diabetes is creating a support team of health care professionals. This support team may include your primary doctor, an eye doctor, nurses, a dietitian, and a licensed acupuncturist.

Diabetes according to Oriental Medicine
According to Traditional Oriental Medicine, diabetes is caused by an imbalance of the cyclical flow of Qi within the meridians and organ systems.

This particular imbalance produces heat that depletes the body’s fluids and Qi causing symptoms such as: 

Fatigue
Lethargy
Unexplained Weight Loss
Excessive Thirst (Polydipsia)
Excessive Urination (Polyuria)
Excessive Eating (Polyphagia)
Poor Wound Healing
Infections
Irritability
Blurry Vision

How Acupuncture and Oriental Medicine Treats Diabetes
In treating diabetes, Oriental medicine offers a way to address each patient individually to eliminate the symptoms associated with diabetes and reduce the need for insulin. A variety of techniques may be used during treatment including acupuncture, herbal medicine, bodywork, lifestyle/dietary recommendations and energetic exercises. The treatment for diabetes focuses on regulating the circulation of blood and Qi and balancing the organ systems to improve pancreatic function and address internal heat and the depletion of fluids. When treating diabetes, acupuncture and Oriental medicine can assist the body to regain its normal healthy functioning. 

To add acupuncture and Oriental medicine to your arsenal when fighting diabetes and learn more about how acupuncture and Oriental medicine can improve your health and well being call for a consultation today!

Five Areas Diabetics Should Monitor Carefully
There are a lot of complications caused by diabetes that require extra attention. If you have diabetes make sure you monitor these five areas on a regular basis.

Blood Sugar
Understand how diabetes changes how food affects your body. Know the signs of low blood sugar. Have a plan in place to correct your blood sugar levels when necessary. 

Heart Health
Diabetics have a higher risk of heart attacks and stroke. Optimal cholesterol and blood pressure goals are lower for diabetics.

Infections
Due to higher blood sugar levels bacteria grow and infections develop more quickly. Treating infections early on can prevent serious complications later.

Feet
Diabetics may suffer from neuropathy, or nerve death in their feet and can get an injury or serious infection without feeling it. 

Exercise
Exercise has been shown to decrease blood sugars and improve insulin resistance, the main issue in those with type II diabetes.

News, Events and Gratitude!
– Thanks readers of Alameda Magazine for voting John “Best Acupuncturist” in Alameda. We are delighted by this honor.

– We will always accommodate established patients for urgent care drop-in visits during business hours.

– We had a great time meeting everyone who came out to the New Living Expo 2011 and to the World Qigong Congress to hear John’s talks.

– Tune-in to The Medicine Men and The Balancing Point radio shows podcast in iTunes, or live in the Bay Area, www.medicinemenradio.com or www.thebalancingpoint.net

– Special 1 hour episodes of The Balancing Point radio in May and June on Mondays KEST 1450 AM 9-10am, tune-in!

– Thanks to MN for her May review of John’s work on yelp (if you don’t know yelp.com, it is a great resource for finding about about your community): “I started going to John for my back pain about 2 months ago, and with first appointment, it significantly improved and after like 2 or 3rd appt, the pain was completely gone. His approach is very comprehensive and I feel very comfortable with John, who is warm and very kind. I am about 5 months pregnant now, but he knows how to treat pregnant woman, so there is no need to worry about. Every time I go to the appointment, I feel so much better, and I highly recommend him for anyone who has health issues. ”

– On September 25th, John will teach at the Colorado School of Traditional Chinese Medicine in Denver. He will teach a 1/2 day on his Integrative Diabetes Protocol and a 1/2 day on the modern clinical applications of the Pi Wei Lun classic. If you are in the Denver area, we hope to see you there. http://www.cstcm.edu/pda/all

– Please join us on Facebook “Alameda Acupuncture – Dr. John Nieters, L.Ac.” (http://www.facebook.com/pages/Alameda-Acupuncture-Dr-John-Nieters-LAc/126245057390177) Upcoming events are listed and links to information about Chinese Medicine and podcast updates.

Posted in Qi Mail | Comments Off on June 2011 Acupuncture for Diabetes
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