How To Optimize Hormone Health For Longevity | Dr. Mark Hyman

You will find your health diminished. You'll have low energy, low motivation, low concentration, low cognitive function, low libido, low sexual function and erectile dysfunction. Not so great. Hormones are things that are often overlooked. They're misunderstood and often cause so much stress for people because they are not optimized. Whether it's your sex hormones, whether it's thyroid hormones, whether it's growth hormones, we're gonna talk about all of it. Today we're gonna focus on sex hormones, particularly in things that relate to sex hormones and a little bit about adrenal hormones, but they're kind of connected 'cause everything is connected when it comes to the body, particularly around hormones. So what should you know if you're a guy? I'm gonna go through men and I'm gonna go through women. I'm gonna start with the guys first 'cause they're a bit more straightforward. The first thing you should know is your testosterone. And your testosterone is something that's not just good to look at if you're 90 years old and you know, are having trouble or if you're 70 or 60. these are hormones that are things that you should know about your health all through your life spectrum. And I've seen 30-year-olds with the hormone levels of a 90-year-old. They go, well, and by the way, what's normal, right? If you look at a normal range of hormones, depending on which lab you look at, the reference range is like 200 to 1,000. Show is having a level of 250, the same as having a level of 950. Obviously not. And how do they come to those ranges? Well, they come to those ranges by looking at the average in a population. which is if you have an unhealthy population, the average is bad, right? So you want to be optimal. Now, we typically say for a male, you should have a testosterone level over 500, but probably it should be more like 6, 7, 8, even 900. And hormone levels are really important because they determine so much about your health. Hormones, particularly testosterone, is important for building muscle, for motivation, for cognitive function, for energy, for focus. And if your You don't have adequate levels of testosterone, by the way, also for sexual function, for libido, for erections, for all the things that are important in life. And if you don't have adequate levels of testosterone, you will find your health diminished. You'll have low energy, low motivation, low concentration, low cognitive function, low libido, low sexual function, and erectile dysfunction. Not so great. So how do you measure hormones? We look at both the total testosterone and also the free testosterone. and we also look at estrogen levels and we look at also brain hormone levels like FSH and LH, and we look at something called sex hormone binding globulin. So we don't just look at one thing, we look at the whole pattern of what's going on with your hormonal health. And we can tell a lot. For example, some guys, you know, this is really common in America where you see guys with big bellies, right? Pretty much the norm. If you have a big belly, what's going on there? You have visceral fat or visceral adipose tissue or VAT. or belly fat, right? And it's not like normal fat. It's actually producing all sorts of bad things, including inflammation, including oxidative stress. It screws up your brain chemistry. It makes you hungry. It prevents you from burning fat. It makes you gain more weight. It makes you more insulin resistance. It creates a vicious cycle. But one of the things that happens is you actually tend to shift your hormone production to more estrogen. so when you see men, for example, who have big bellies, they often have loss of hair on their body or they have, you know, no soft, more soft skin, right? So what's going on there? Well, they're having high estrogen and low testosterone. And, and so basically, the bigger your belly, the lower your testosterone. It's easy test. You just look in the mirror. But it's better to know your numbers and check your blood. Now, when you have low testosterone, what can you do about it? If you have low total, low free testosterone, if you have high estrogen levels, what can you do? Well, it's important to understand that these things can be managed through lifestyle, right? Cutting out the sugar and starch, increasing fat. Where does cholesterol, I mean, where did your testosterone come from? It comes from fat. Cholesterol is the building block of all your steroid hormones. Steroid hormones are not just, you know, obviously, cortisone or, or anabolic hormones, but all your sex hormones are made from cholesterol. So if you have low fat in your diet and low saturated fat, you actually tend to have lower sex hormones. And so you can boost the quality of fat in your diet, you can cut out the starch and sugar, and other things that also help. Alcohol is not good. So alcohol also increases estrogen levels. It poisons your liver so you can't metabolize it. And by the way, yes, men have estrogen. They just have lower levels than women. And yes, women have testosterone, just lower levels than men. So the testosterone levels go down, estrogen levels go up with alcohol. And so there's a lot of things you can do like changing your diet and stopping drinking or reducing drinking. But you also can exercise large muscle groups like the large muscles like your glute muscles, your hamstrings, your quads, heavy weight lifting with lower body muscles is a great way to boost your testosterone and also your growth hormone. We'll talk about that in a minute. So having a proper exercise routine is really important. Also, environmental chemicals can affect your hormones. So reducing your exposure to environmental chemicals, really important. It's important to understand, you know, again, looking at the numbers, you've got to understand not what's the normal level, but what is the optimal level for where you are. Like, I, you know, I am 63 years old, but I don't want the hormone levels of a 95 year old who's unhealthy. I want the hormone levels of a young 40 or 50 or even 30 year old. So I want my hormones around 800. 600, 700. And that's where I get them by using a comprehensive approach. You just have to know what to do because everything we do influences our hormones. So getting your testosterone straight is really important for men for all the reasons I just mentioned. We also look at other hormones including DHEA sulfate. This is a hormone that looks at your adrenal function. Adrenal function is connected to your sex hormones but often as we're under stress, as we age, our DHEA levels go down. and we tend to age faster. We tend to have more fatigue. We tend to have less libido. We tend to have other issues. So checking your DHEA level is really important because that tells you where you are in the stress response and also what you can do about it. And then you can boost your DHEA by lifestyle factors we talked about. You can actually take DHEA. It's a supplement. It's a hormone. It sells as a supplement. And we also look at, in addition to that, we look at IGF-1, which is an add-on test of function health panel. IGF-1 measures your basic level of something called insulin-like growth factor one. And that is important because it's an indirect reflection of your growth hormone. As we age, our growth hormone goes down. We tend to repair things less well. We tend to rebuild tissues less well. So you want to make sure we have adequate growth hormone. Now, you don't want it too high because too high can mean insulin resistance. It can mean more inflammation. It can be a sign of, you know, more issues, you know, potentially that cause cancer. So we want to keep our growth hormone levels in a good level, not too high, not too low. So, but, but again, things like strength training and exercise and certain supplements like arginine can actually help naturally build growth hormone. There's peptides we can use. There's all sorts of things that can be used to optimize your hormone levels and your growth hormone levels to fix your adrenals. And if your adrenals are shot, like with a DHEA low, there's lots of things you can do. We've talked about a lot on the podcast, but, you know, all sorts of ways to regulate your stress response from meditation to yoga to breath work to, you know, hanging out with friends, to being in nature, the list goes on. But it's important to understand that you have power over these numbers. They're not just you're not just a passive recipient of whatever numbers you got. They're highly modifiable because your entire biology is the result we call your phenotype is a result of your lifestyle washing over every cell in your body every minute. So every thought you have, every bite of food you take, every exercise you do or don't do, how much sleep you get, and all influences everything all the time. So we have tremendous power at any moment. What else should we be paying attention to as a man? Well, PSA tests are important and they're not perfect, but it can be elevated if you have a large prostate, but it can also be a sign of cancer. So it's important to see what's going on with your PSA, and it's something we screen as part of the panel. And we also look at not just the total PSA, but the free PSA, which gives us a better indicator of whether or not you are having a higher likelihood of having early prostate cancer and something you can track over time. And often with PSA, people can have normal PSA and still have prostate cancer. But what we see often is a a change in the number over time. So it's the rate of increase. So let's say your number is one, but it goes to, let's say four is considered abnormal. Let's say it goes to two. Well, one to two is a big jump, right? That means something may be going on or if it goes two to four. So it doesn't have to be abnormal, but it can still be an indicator over time of how to pick up early signs of prostate cancer. And it's one of the major cancers in men that kills so many people. So I think that's important to know. So you get a big comprehensive view of what's going with your hormones, and then you can intervene with various lifestyle factors and you can actually see changes over time and then we can recheck and see how you're doing. So that's the guys. What about for women? What about hormones for women? Well, I think it's, it's unfortunate, but women have to suffer a lot more hormonal chaos than men for a lot of reasons. Their hormones are changing all the time with menstrual cycles, with menopause, with puberty. They're much more sensitive to environmental toxins and how those impact hormonal function. They're much more affected by stress. They're much more affected by alcohol, by dietary changes, by lack of exercise, by smoking. All these things mess sexed hormones. So it's important for me to understand what their hormones are doing, how they're affecting them, why they feel what they feel. And we see, you know, incredible array of hormonal disorders in women that cause so much suffering. It really isn't necessary. It's, you know, women should not have screwed up hormones that cause all sorts of symptoms like PMS or fibroids or PCOS, which is polycystic ovarian syndrome, or infertility, or menopausal symptoms or menstrual cramps. I mean, these are, these are things that, that are not a design flaw in humans. It's because of how we're living and what we're doing, and then we have agency over. So, you know, I've written a lot about this. I used to be a doctor at Kenya Ranch and I basically that was my whole population was women between like 30 and 60. So I got a really good sense of what's going on and was measuring a lot of hormonal tests and could see changes over time. You know, think about it, 75% of women have some PMS symptoms, which is nuts. Why is that something women have to suffer from? It's not. And I had a patient recently who had severe menstrual cramps and things were really out of balance for her. and she didn't really realize what was going on. And there's ways to fix that. So we were able to fix it for her, change her diet, adjust a few things, and she has no more menstrual cramps. So the body has an incredible capacity to repair and heal. We just have to know how to activate it. So one of the tests we look at for women, a few of the same ones, but also different ones, we look at estrogen, we look at progesterone, we look at also testosterone, we look at DHA sulfate, we also look at pituitary hormones like FSH, LH, sex hormone binding globulin. and a few others I'll talk about in a minute. So that gives us a really complete picture of what's going on. So we can tell, for example, if women are having something called estrogen dominance, this is a really common condition in the world because a lot of things we do cause us to produce too much estrogen in relation to our progesterone, particularly in menstruating women and even postmenopausal, by the way, postmenopausal women can have high estrogen levels. And what causes high estrogen levels? Well, Sugar and starch, okay, they're the problem. We know that from, if you listen to me, you know, that's kind of basically the problem for everything. So, too much sugar and starch raise insulin, which causes more fat deposition, more fat leads to more estrogen production because there's something in your fat cells called aromatase, which actually causes your sex hormones to turn into estrogen. That's what happens to men too. Their estrogen gets converted, I mean, testosterone gets converted to estrogen. So, when you have too much fat tissue, particularly belly fat, you get higher levels of estrogen. If you drink alcohol, it poisons your liver and you get higher levels of estrogen. If you don't exercise, you may have higher levels. If your gut is not healthy and you don't have enough of the healthy bacteria in your gut and fiber, you might increase your estrogen levels by recirculating estrogen that you excrete from your liver into your body and raising your estrogen levels. It can be because of stress. Cortisol will increase estrogen levels. Certain environmental toxins will do that as well. There's a lot of things called xenoestrogens, which are environmental toxins like all the plastics and pesticides and petrochemical toxins all can screw up your estrogen levels. So we have, we really need to understand that our hormones as women, I'm not a woman, obviously, but women's hormones are highly variable, change over their life cycle and are highly influenced by our lifestyle and what we do. So we have tremendous agency over changing those things and figuring out what to do about it. So knowing your numbers is really important when it comes to this. see, for example, if I want to know if a woman is having like estrogen imbalance and they may be having heavy bleeding, they may be having clots, they may be having menstrual cramps, they might be having fibroids or maybe all these issues. And I know that may be as high estrogens. I want to check their estrogen and progesterone ratio. If they have high estrogen and, and low progesterone relatively, that's a problem. I also can look at the other numbers like LH and FSH. This is common if you have a woman with PCOS. which is really common. It's a cause of infertility, but we'll see with those women a high level of LH and FSH being low. So the ratio of LH to FSH goes up and that's a clue that there's this problem of PCOS. So we can tell a lot from these numbers, from the patterns in the numbers. We also look at something called prolactin, both in men and women, and this is a pituitary tumor that has a broad impact on our health and is influenced by many factors. And we've actually found people with tumors in their pituitary that are benign tumors, but they actually produce prolactin and that can cause all sorts of health and metabolic effects. So it's important to kind of get a picture of these numbers. We also looked for women also at the IGF-1 for the same reasons. And we also look at another test that's unique to women called anti-mullerian hormone. Anti-mullerian hormone is a great indicator of your fertility. The higher the number, the more fertile you are, the lower the number, the less fertile you are. So a lot of women wanting to know their fertility status can actually get this test. Also, we also check testosterone. because just as we check estrogen in men, we also check testosterone in women. And a lot of women tend to have low libido or low sexual function or decreased arousal or lower orgasms. And that all can be because of hormonal effects and often treat people directly with hormonal therapy with this or with other things that boost testosterone. But it's fixable. And sometimes, you know, lifestyle can be very effective, as we mentioned. And sometimes you need bioidentical hormones, both for men and women. So I will prescribe hormones for men, testosterone. I will prescribe combination of hormones for women, estrogen, progesterone, testosterone, depending on what they need. But it's very personalized and it's very individualized. So in the guide that you get with your function report, you actually get to know, you know, what are the things you can do about these numbers, but it's really about finding the nuances. And then there's a lot of supplements that can help both with men and women. Men can, there's a lot of great supplements that help with libido and sexual function. Also for women, same thing. A lot of women women can take herbs to help with regulating estrogen, progesterone imbalances with various kinds of hormonal disorders. For example, Chase Berry is great for PMS and there's other other therapies we use, but it's a combination of things. In a perfect world, look, I'd be seeing millions of patients, billions of patients ideally. I've had so much experience, but the truth is I'm just one doctor and the conventional healthcare system is already buckling under the weight of so many sick people. who aren't able to access good access to health care. In fact, you know, there's, I think, over 100,000 physicians shortage, nursing shortages, and we have so many sick people in America, six out of 10 have chronic illness, 93% are metabolically unhealthy, 75% are overweight, 1 in 2 have diabetes. I know it's depressing, right? But here's the deal. Most of those things are entirely preventable or even reversible using a comprehensive approach that deals with the root causes, addresses the lifestyle factors, and are things that you can do on your own. need a doctor. Now, based on this thinking around knowing your numbers and why I believe it's so important to democratize healthcare, I helped co-found a company called Function Health, which is a revolutionary way to understand and manage your own health that starts with a comprehensive set of over 100 lab tests. They're delivered to you in an easy to understand dashboard that tracks your numbers over time and gives you clear insights, actionable insights about every biomarker tested, what it means, what the reference ranges are conventionally, what the optimal reference ranges how to actually use the things that are at your disposal, lifestyle, supplements, things that you can access yourself that actually don't require a doctor. And health happens not in the doctor's office, it happens where we live, eat, work, play, and pray. I always say, I can't cure diabetes in my office. It's cured in the kitchen, in the grocery store, on the farm, or the restaurants, right? So all these are important insights that you should have about your body. So we're building function to democratize much of what I do and give you the keys to your own health and put control back in your hands. It's the most powerful approach to help I've seen in my career as a doctor. And it's, I think, the most crucial step you can take for your health and, and to own your health and become the CEO of your own health. Now, the wait list for function is open. We have over 11, 000 people that have already gone through. It's live across the United States. We're inviting new members to join a wait list every day. and if you're interested in taking control of your health, get your spot on the wait list right now. Go to functionhealth.com It's really empowering to know what's going on and often people just don't feel right or they have this or that symptom and they don't really know what's going on and the doctor doesn't quite know how to deal with it. And that's really the purpose of function is to let you know what's going on under the hood, to give you the tools and the knowledge you need to be able to fix it. So it's really a very comprehensive approach that will leave you feeling empowered and understanding what to do to help yourself live a long, healthy life. You know, I think one of my missions in life is to end needless suffering for millions of people. There's certain things you can't fix, right? There's a natural disaster, a war, you know, house falls on you or something like the wicked witch of the West. What can you do? But. But most of the things people suffer from are optional. It's needless suffering, and it has to do with not having the right information. about what's going on in your body and not knowing what to do about it. And that's really the purpose of function and functional health is to give you the knowledge and the roadmap. So I'm super excited about it. Like I said, I I can see millions of patients if I had a perfect life, but that's not how the world works. I can't do that. With function Health, I feel like we're trying to democratize much of what I do, offering you the keys.