Rational Wellness Podcast Episode 019: Male Health with Dr. Mike Carragher

Dr. Mike Carragher discusses male hormonal health with Dr. Ben Weitz. Symptoms of low testosterone include low energy, low libido, not sleeping well, gaining fat, having trouble gaining muscle, etc. Hypogonadism is not based solely on testosterone levels, but also on symptoms.  Dr. Carragher mentioned that we have seen a 15% drop in testosterone levels in the US in the last two generations.  This is at least partially related to endocrine disruptors in the environment. Dr. Carragher said that he likes to look at free or bioavailable testosterone levels. If free testosterone is low, then he will recommend improving their diet and exercising in a way that will elevate testosterone levels, but in his experience, this is not usually enough without supplementing with testosterone. If it’s a younger guy who is interested in preserving his fertility, he will recommend either clomiphene citrate (Clomid) or HCG, both of which are drugs that stimulate your testes to produce more testosterone and they don’t make sperm counts go down or interfere with fertility.  Dr. Carragher discussed that in order to stimulate your body to produce more testosterone or growth hormone, you should do heavy weight training and high intensity anaerobic exercise, like sprinting or interval training.  He recommends a 20 minute workout 3-4 times per week with high intensity interval training alternating with walking.

I asked about the patient who perhaps is overweight (fat cells secrete estrogen) and who eats a poor diet and get exposed to pesticides and other estrogenic substances, who use personal care products with sodium laurel sulfate and other estrogenic substances, who perhaps have a fatty liver that is unable to filter out toxins appropriately, and if you put them on testosterone, they will likely aromatize some it into estrogen. How do you deal with that? Dr. Carragher said that estrogen that is given to me is actually very helpful for most men, though this is very different than testosterone that is produced peripherally. Dr. Carragher says that if you optimize their hormones with testosterone and perhaps DHEA and thyroid, they will drop fat very quickly. I asked about using nutrients as part of an estrogen detox program? Dr. Carragher said that if he has a patient with gynecomastia, he may use an aromatase inhibitor (an estrogen blocker), such as Arimidex, for a few months.

I asked if Dr. Carragher typically uses injectable testosterone or testosterone gel? He said he loves lipoderm cream, which is very well absorbed. Or he will use injections, esp. if they are concerned about transference to kids or women.  He does not like gels like Androgel, since they are very low in potency and are not formulated well and it is very hard to get appreciable levels in men with these gels.

I told Dr. Carragher about my experience dealing with professional and amateur bodybuilders and saw extreme versions of abuse of testosterone and of anabolic steroids, including guys in their 20’s and 30’s who had heart attacks or whom needed kidney transplants.  And recently I have seen men as patients who come into my office having been prescribed testosterone replacement, but who look like bodybuilders due to very large muscles, and it is clear to me that this is being done for aesthetics and not just for replacement.  Dr. Carragher said that he makes it clear to his patients that he is not in favor of creating bodybuilders. He is trying to help his a patient prevent chronic diseases and the abuse of testosterone will create chronic diseases. The heart has the largest amount of testosterone receptors of any organ in the body.  If you give a patient with the right amount of testosterone, it improves the heart.  But if you give a patient three times the testosterone that they need, the heart will hypertrophy and they’ll get dilated cardiomyopathy and they can die of congestive heart failure.

I asked if Dr. Carragher would give testosterone to a patient with a history of prostate cancer or with an elevated PSA if they have a need for testosterone? He said yes, that he would consider using it, but he would make sure that his urologist goes along with it. He mentioned that Dr. Abraham Morgenthal, one of the foremost experts on prostate cancer and testosterone, is conducting a study using testosterone with patients with active prostate cancer and the preliminary results are that their prostate cancer is growing at a slower rate.

To contact Dr. Carragher or to make an appointment to see him, go to his website,  https://thebodywellusa.com/  or email him at DrMike@the bodywellusa.com or call his office at 323-874-9355

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