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Testosterone Replacement Therapy: Testosterone Injections …

Posted: October 12, 2017 at 11:55 pm

Many men with low testosterone report improved energy levels, sex drive, and mood after testosterone treatment. If testosterone is low, why not replace it?

Not so fast. A low testosterone level by itself doesn’t need treatment. Testosterone replacement therapy can have side effects, and the long-term risks and benefits aren’t known. Only men with symptoms of low testosterone and blood levels that confirm this as the cause of symptoms should consider testosterone replacement. Talking with your doctor is the only way to know if testosterone therapy is right for you.

The symptoms of low testosterone are sometimes obvious, but they also can be subtle. Testosterone levels decline naturally in men as they age over decades. But certain conditions can also lead to an abnormally low level. Symptoms of low testosterone include:

If a man has symptoms of low testosterone and tests show he has an abnormally low testosterone level, a doctor may suggest treatment. For millions of men who have low testosterone levels but no symptoms, no treatment is currently recommended. It is has also not been approved for treating men with low levels because of aging.

Testosterone replacement therapy is available in several forms. All can improve testosterone levels:

Why not a simple testosterone pill? Oral testosterone is available. However, some experts believe oral testosterone can have negative effects on the liver. Using other methods, such as skin patches, gels, orally disintegrating tablets, or injections, bypasses the liver and gets testosterone into the blood directly.

What can you expect from testosterone treatment? It’s impossible to predict, because every man is different. Many men report improvement in energy level, sex drive, and quality of erections. Testosterone also increases bone density, muscle mass, and insulin sensitivity in some men.

Men also often report an improvement in mood from testosterone replacement. Whether these effects are barely noticeable, or a major boost, is highly individualized.

Karen Herbst, MD, PhD, an endocrinologist at University of California-San Diego, specializes in testosterone deficiency. She estimates about one in 10 men are “ecstatic” about their response to testosterone therapy, while about the same number “don’t notice much.” The majority have generally positive, but varying responses to testosterone replacement.

Testosterone replacement therapy side effects most often include rash, itching, or irritation at the site where the testosterone is applied.

However, there is also evidence of an increased risk of heart attack or stroke associated with testosterone use. Experts emphasize that the benefits and risks of long-term testosterone therapy are unknown, because large clinical trials haven’t yet been done.

There are a few health conditions that experts believe testosterone therapy can worsen:

It will be years before large clinical trials bring any answers on the long-term benefits and risks of testosterone therapy. As with any medicine, the decision on whether the possible benefits outweigh any risks is up to you and your doctor.

Isn’t taking testosterone replacement basically the same as taking steroids, like athletes that “dope”? It’s true that anabolic steroids used by some bodybuilders and athletes contain testosterone or chemicals that act like testosterone.

The difference is that doses used in testosterone replacement only achieve physiologic (natural) levels of hormone in the blood. The testosterone forms some athletes use illegally are in much higher doses, and often combined (“stacked”) with other substances that boost the overall muscle-building (anabolic) effect.

SOURCES: “Androderm Side Effects.”

Swerdloff, R. Journal of Clinical Endocrinology & Metabolism, 2000.

Wilson, J. American Journal of Medicine, 1980.

Bhasin, S. Journal of Clinical Endocrinology and Metabolism, 2006.

Karen Herbst, MD, PhD, assistant professor in medicine, University of California, San Diego.

News release, FDA.

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Testosterone Replacement Therapy: Testosterone Injections …

How To Lose Weight Fast and Safely –

Posted: October 12, 2017 at 11:55 pm

You want to drop pounds, now. And you want to do it safely. But how?

First, keep in mind that many experts say its best to lose weight gradually. Its more likely to stay off. If you shed pounds too fast, youll lose muscle, bone, and water instead of fat, says the Academy of Nutrition and Dietetics.

The academys advice: Aim to lose 1-2 pounds per week, and avoid fad diets or products that make promises that sound too good to be true. Its best to base your weight loss on changes you can stick with over time.

For faster results, youll need to work with a doctor, to make sure that you stay healthy and get the nutrients that you need.

Youve probably heard the saying, calories in, calories out; as in, you just need to burn more calories than you eat and drink.

But its not that simple, as many people can tell you from their own experience.

Your metabolism — how well your body turns calories into fuel — also matters. And if you cut too many calories, its bad for you. You slow down your metabolism, and that can make you fall short on some nutrients.

There are many ways you can do this, without cutting calories too much. You could:

Whatever method you use, youll need to favor good-for-you foods like vegetables, fruits, whole grains, and lean protein so you keep up good nutrition. Working with a dietitian is a good idea, so you make a plan that covers those needs.

Many apps can help you track your eating. Since you probably have your smartphone with you all the time, you can use it to keep up with your plan. Or keep a pen-and-paper food journal of what you ate and when.

Youll also want to have people on your side to help you stay motivated and to cheer you on. So ask your family and friends to support your efforts to lose weight.

You might also want to join a weight loss group where you can talk about how its going with people who can relate. Or talk with someone you know whos lost weight in a healthy way. Their encouragement is contagious, in a good way!

At the most basic level, food is fuel. It gives you energy to do things. But very few people eat just for that reason. Its at every social gathering. And its where a lot of us turn when we have a rough day.

Youll need to know what makes you want to eat when youre not hungry, and have a plan for those moments.

The first step is finding out what your triggers are. Is it stress, anger, anxiety, or depression in a certain part of your life? Or is food your main reward when something good happens?

Next, try to notice when those feelings come up, and have a plan ready to do something else instead of eating. Could you take a walk? Text a friend?

Lastly, reward yourself for making a different choice. Just dont use food as the reward.

You dont have to go vegan, gluten-free, or quit any particular food group to lose weight. In fact, youre more likely to keep the pounds off for good if its something you can live with for the long term.

But it does make sense to cut way down on, or totally cut out, empty calories.

Limit added sugars. These are the sugars in cookies, cakes, sugar-sweetened drinks, and other items — not the sugars that are naturally in fruits, for instance. Sugary foods often have a lot of calories but few nutrients. Aim to spend less than 10% of your daily calories on added sugars.

Be choosy about carbs. You can decide which ones you eat, and how much. Look for those that are low on the glycemic index (for instance, asparagus is lower on the glycemic index than a potato) or lower in carbs per serving than others. Whole grains are better choices than processed items, because processing removes key nutrients such as fiber, iron, and B vitamins. They may be added back, such as in enriched bread.

Include protein. Its satisfying and will help keep up your muscles. There are vegetarian and vegan sources (nuts, beans, and soy are a few), as well as lean meat, poultry, fish, and dairy.

Most Americans get enough protein but could choose to get it from leaner sources, so you may already have plenty in your diet. Your exact protein needs depend on your age, gender, and how active you are.

Make friends with good fats. Small amounts of fat can help you feel full and less like youre on a diet. The better choices are those in fish, nuts, and seeds, and olive oil or coconut oils. Those have unsaturated fats — polyunsaturated or monounsaturated fats, specifically.

Fill up on fiber. You can get that from vegetables, whole grains, fruits — any plant food will have fiber. Some have more than others. Top sources include artichokes, green peas, broccoli, lentils, and lima beans. Among fruits, raspberries lead the list.

Eat more often. If you eat 5-6 times a day, it could keep hunger at bay. You could split your calories equally across all of those mini-meals, or make some bigger than others. You will need to plan portions so that you dont end up eating more than you bargained for.

What About Meal Replacements? These products will control your calories. Theyre convenient and take the guesswork out of dieting.

Again, though, youll need to change your eating habits to keep the weight off if you go off the meal replacements.

Watch your drinks. One easy way to lose weight quickly is to cut out liquid calories, such as soda, juice, and alcohol. Replace them with zero-calorie drinks like lemon water, unsweetened tea, or black coffee.

Diet drinks will save you calories, compared with sugary beverages. But if you then reach for a cookie or other treat because youre still hungry or you think you saved enough calories for it, that plan backfires.

You might think that fasting is a quick way to drop pounds. But experts dont recommend it, because its not a long-term solution. Its better to have an eating plan that you can stick to over time and fits into your lifestyle.

All fasts arent the same. Some involve skipping all food. There are also fasts where you eat every other day. There hasnt been a lot of research on how well off-and-on fasting works in the long run.

During the first days of your fast, you may feel hungry and grumpy. You may also get constipated. And you wont have the energy to do much, physically. Drink lots of water and take a daily multivitamin. You should also tell your doctor, especially if you take medications that will probably need to be adjusted.

Remember that if you do fast, youll still need to change your eating habits once your fast ends.

No matter how you kick-start your weight loss, the best way to keep it off is with long-lasting lifestyle changes, like a healthy eating plan and physical activity. If youre not sure where to start, how many calories to cut, or how to do it safely, you might want to consult a registered dietitian.

WebMD Medical Reference Reviewed by Christine Mikstas, RD, LD on February 28, 2017


Caroline Apovian, MD, Nutrition and Weight Management Center, Boston Medical Center.

Monica Auslander, registered dietitian, Essence Nutrition, Miami.

Alison Borkowska, PhD, WeightNot.

Jewels Lett, registered dietitian.

Jessica Levings, Balanced Pantry.

Dana Simpler, MD, Mercy Medical Center.

Adrienne Youdim, MD.

Robert Ziltzer, MD, Scottsdale Weight Loss Center.

International Journal of Behavioral Medicine: The association between rate of initial weight loss and long-term success in obesity treatment: does slow and steady win the race?

Obesity Reviews: Lessons from obesity management programmes: greater initial weight loss improves long-term maintenance.

Academy of Nutrition and Dietetics: Staying Away from Fad Diets.

CDC: Losing Weight.

National Heart, Lung, and Blood Institute: Healthy Eating Plan.

Mayo Clinic: Chart of High-Fiber Foods.

USDA: All About the Protein Foods Group.

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How To Lose Weight Fast and Safely –

Detox Diets: Do They Work? Are They Healthy?

Posted: October 12, 2017 at 11:52 pm

The Promise

They’re popular, but they aren’t proven to do what they say they’ll do: flush toxins out of your system. In fact, they may be risky and even backfire.

Still thinking about it? You should know this first.

That depends on the particular detox diet you’re following. There are many of them. Some involve fasting, or just drinking liquids. Others allow some foods, like fruits and vegetables. They typically are short diets — they’re not a way of eating you can stick with in the long run.

You’ll be hungry and may feel weak. Whether or not a detox diet is safe depends on the plan and how long you stay on it.

Most people dont feel good on low-calorie, nutrient-poor diets. Potential side effects include low energy, low blood sugar, muscle aches, fatigue, feeling dizzy or lightheaded, and nausea.

If the idea of detoxing appeals, you might try “clean” eating that focuses on vegetables, fruits, whole grains, and lean protein — basically, whole foods without a lot of processing. That’s good for you and more likely to give you results that last, especially if you make exercise a habit.

Limitations: You’re going to go without a lot of the foods you usually eat. Detox diets are typically very rigid and involve eating the same few things over and over.

Cooking and shopping: Depends on the detox plan you’re following. Because there’s not a lot you’re allowed to eat, you won’t have a long shopping list and prep work should be minimal.

Packaged foods or meals: Some detox plans recommend herbs, pills, powders, enemas, and other forms of colon cleansing. Methods vary and often include products that are only available from the authors web site.

In-person meetings? No.

Exercise : Not required, and you may not have the energy for it, because you’re not getting that many calories.

Costs: Besides your grocery shopping, a detox diet may also call for some supplements and other products, which vary in cost.

Support: None, except for resources you may find online.

Does It Work?

If your goal is weight loss, a detox diet might help you drop a few pounds, but youll likely just gain it back. In the end, you havent accomplished anything, and its certainly not a healthy approach.

If your goal is to detox your system, dont waste your time or money. Your body is an expert at getting rid of toxins no matter what you eat. Toxins dont build up in your liver, kidneys, or any other part of your body, and youre not going to get rid of them with the latest detox wonder. Especially avoid diets that promise to detox your liver with supplements or cleanse whatever the diet determines needs washing out.

The only type of detox diet that is worthwhile is one that limits processed, high-fat, and sugary foods, and replaces them with more whole foods likefruits and vegetables. That clean-eating approach is your best bet to getting your body in tip-top shape.

Is It Good for Certain Conditions?

Not only are detox diets not good for people with certain medical conditions, they could be harmful. There is no research showing they improve blood pressure or cholesterol or have a positive effect on the heart. For people with diabetes, they may be quite dangerous. Any diet that severely restricts what you eat could lead to dangerously low blood sugar if you take medicine for diabetes.

The exception would be a detox diet that just focuses on clean-eating. This approach would be great for anyone living with high cholesterol, high blood pressure, diabetes, and even heart disease.

The Final Word

Weve heard a great deal about detox diets in recent years. But its all hype with no health benefits. There are many ways to get your body clean and healthy. This isnt one of them.

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Detox Diets: Do They Work? Are They Healthy?

Fad Diets: Why They Don’t Work & What To Do Instead

Posted: October 12, 2017 at 11:52 pm

If you’ve followed a fad diet, you have plenty of company. But have you been able to stay on these deprivation diets for a long time? And if you did lose weight, did the pounds stay off once you went back to your usual way of eating?

Fad diets don’t help you keep off the weight in the long term. So what does work? The best diet is not a diet at all, but a way of life that includes food you enjoy, exercise, and healthy habits.

Here’s some simple, straightforward advice.

Just as a car needs the proper gasoline to make it run, a body needs a healthy diet to develop properly. That means the right balance of protein, carbohydrates, and fat — as well as a host of other nutrients.

When you go on a fad diet and exclude necessary nutrients, you’re putting yourself at risk for becoming ill. Getting too little of any nutrient may not cause an immediate problem. But if it’s lacking for a long time, you may find you have health problems.

Food servings have grown larger and larger over the years. And fast-food restaurants aren’t the only places you’ll find supersized meals. Researchers have noted that from 1970 through the 1990s, portion sizes of hamburgers, burritos, tacos, french fries, sodas, ice cream, pie, cookies, and salty snacks increased — whether the foods were eaten at home or at restaurants.

What does a healthy serving size look like?

Here are some simple tricks to scale back your portions (and calories):

If you need more information on weight loss and dieting, talk to your health care provider or a registered dietitian. Ask your doctor about your “ideal” weight and the number of calories you must eat to lose pounds and maintain an ideal weight.

Also, ask friends, family, or co-workers to join you as you work to change your eating habits and pare down your weight. Sticking to a weight loss plan is much easier when you have someone to support you.


Nielsen, S. Journal of the American Medical Association, Jan. 22-29, 2003.

Young, L. American Journal of Public Health, February 2002.

Academy of Nutrition and Dietetics: “Eat Right Nutrition Tips.”

CDC: “Physical Activity for Everyone.”

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Fad Diets: Why They Don’t Work & What To Do Instead


Posted: October 12, 2017 at 9:47 am

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Posted: October 9, 2017 at 10:50 pm

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Posted: October 6, 2017 at 10:47 am

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Posted: October 6, 2017 at 10:46 am

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Can I diet while breastfeeding?

Posted: October 5, 2017 at 9:51 pm

By Kelly Bonyata, IBCLC

Yes! Nursing mothers can lose weight safely if they follow some basic guidelines.

Wait until your baby is two months old before dietingIts best not to do anything consciously to lose weight until after the second month. This gives your body enough time to successfully establish a healthy milk supply that is less likely to be adversely affected if your caloric intake is restricted. Breastfeeding your baby, on average, burns 200-500 calories per day (above what you needed to maintain your pre-pregnancy weight) so keep in mind that even without a weight loss program you are burning extra calories.

Breastfeed without restrictionResearch tells us that both more frequent breastfeeding and breastfeeding longer than six months increases maternal weight loss.

Eat at least 1500-1800 calories per dayWhile nursing, you should not consume less than 1500-1800 calories per day, and most women should stay at the high end of this range. Some mothers will require much more than this, but studies show that going below this number may put supply at risk.

Keep weight loss at less than 1.5 pounds per weekMost moms can safely lose up to 1.5 pounds per week or 6 pounds per month after the second month and not affect milk supply or babys well being. One study has suggested that short-term weight loss of 2.2 pounds (1 kg) per week is not a problem (in this study, moms dieted for 11 days).

Decrease the calories graduallyA sudden drop in calories can reduce milk supply. Some moms notice this during an illness, although dehydration and/or medication use could also be a factor in reduced milk supply when mom is sick. It has been hypothesized that a sudden calorie decrease can cause moms body to go into starvation mode and cut nonessential resources such as milk production.

Avoid quick-fix solutionsLiquid diets, low-carb diets, fad diets, weight loss medication, etc. are not recommended while breastfeeding.

Make dietary changes decrease your fat intake to 20-25% or less of total calories; keep your protein intake up to prevent loss of muscle mass (Recommended Intake of protein for nursing mothers is 65 grams/day for the first 6 months and 62 grams/day between 6 and 12 months).

Spread your calorie intake out instead of 2-3 meals, eat 3 smaller meals with snacks between. Your body will be less likely to go into starvation mode if you are eating small amounts throughout the day.

Exercise moderately so that you burn more fat while keeping lean muscle mass. Resistance/weight training is a good way to build muscle mass. A person with more muscle mass burns more calories, even when resting.

Weight Watchers and Body for Life are generally considered to be fine for breastfeeding mothers. Weight Watchers has a program specifically aimed at nursing mothers. As always, avoid cutting calories too abruptly or losing weight too quickly.

See Low carb diets and breastfeeding.

See Herbal weight loss products and breastfeeding.


@ other websites

Lovelady CA, et al. Weight change during lactation does not alter the concentrations of chlorinated organic contaminants in breast milk of women with low exposure. J Hum Lact 1999 Dec;15(4):307-15. The results of this study suggest that moderate weight loss (4.1 kg/9 lbs between 4 and 20 weeks postpartum) in lactating women with low exposure to environmental contaminants does not increase contaminant concentration in breast milk.

McCrory MA. Does dieting during lactation put infant growth at risk? Nutr Rev 2001 Jan;59(1 Pt 1):18-21. For some women, postpartum retention of weight gained during pregnancy may contribute to obesity. A recent 10-week randomized intervention showed that infants of initially overweight, lactating mothers who exercised and dieted to lose an average of 0.5 kg/week grew normally.

Lovelady CA, et al. The effect of weight loss in overweight, lactating women on the growth of their infants. N Engl J Med 2000 Feb 17;342(7):449-53. This study found that weight loss of approximately 0.5 kg (1.1 pound) per week between 4 and 14 weeks post partum in overweight women who are exclusively breast-feeding does not affect the growth of their infants.

McCrory MA, et al. Randomized trial of the short-term effects of dieting compared with dieting plus aerobic exercise on lactation performance (link is to full article). Am J Clin Nutr 1999 May;69(5):959-67. This study found that short-term weight loss (approximately 1 kg/2.2 pounds per week) through a combination of dieting and aerobic exercise appears safe for breast-feeding mothers and is preferable to weight loss achieved primarily by dieting because the latter reduces maternal lean body mass. Longer-term studies are needed to confirm these findings.

Dewey KG. Effects of maternal caloric restriction and exercise during lactation (link is to full article). J Nutr 1998 Feb;128(2 Suppl):386S-389S. Studies suggest that, for women who are not underweight initially, lactation is not adversely affected by moderate rates of weight loss (no more than 2 kg/4.4 pounds per month) achieved by either caloric restriction or exercise. A short period of more rapid weight loss is not harmful to lactation. It is unknown, however, whether there are risks associated with longer periods of rapid weight loss.

Journal search on dieting and exercise during lactation

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Can I diet while breastfeeding?

Physician’s Plan Weight Loss | Physicians Plan Weight Loss …

Posted: October 5, 2017 at 9:51 pm

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There is a critical ingredient in our recipe for sustainable weight loss that makes Physicians Plan Weight Loss patients truly successful. It is our highly trained staff and physicians who take the time to truly know each patient. From our weight loss coaches to our clinical providers, every member of the Physicians Plan Weight Loss team is fully invested in your success.

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Physician’s Plan Weight Loss | Physicians Plan Weight Loss …

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