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Improved Sleep and Testosterone Levels

May 20, 2010 Written by JP    [Font too small?]

The key to being a great patient being a meticulous detective. How long do you spend at a typical doctor’s appointment? 15 minutes? 30 minutes? An hour if you’re lucky? Now compare that to the number of waking hours you spend with yourself. The fact of the matter is that you know infinitely more about yourself than any physician can ever know. If you pay close attention to what’s going on with your body, mind and surroundings you can be a tremendous resource in assisting your health care team to determine what’s right and what’s wrong with you.

Great patients also bring information to the table. They don’t just visit a doctor and expect answers. Rather, there should be a two-way exchange of information. This past week I found several health items on Twitter that I personally plan to share with my own health care providers.

Dr. Michael Eades is one of my mentors in the field of integrative medicine. I can always count on him to post entertaining, thought-provoking health information and more on his Twitter page. A few days ago he stated that, “Virulently malignant brain tumor in woman successfully treated with a ketogenic diet”. This piqued my interest. To the uninitiated, a ketogenic diet is a very low carbohydrate, very high fat diet that is sometimes used to manage treatment-resistant epilepsy. The case study Dr. Eades alludes to appears in a recent edition of the journal Nutrition and Metabolism. The paper describes an unexpectedly rapid recovery in a 65-year-old woman with a rare and deadly form of brain cancer (glioblastoma multiforme or GBM). The patient in question received standard treatment in addition to a low calorie, ketogenic diet. “After two months treatment, the patients body weight was reduced by about 20% and no discernible brain tumor tissue was detected”. The authors of the paper went on to add that, “rapid regression of GBM is rare in older patients following … standard therapy alone, the response observed in this case could result in part from the action of the calorie restricted ketogenic diet”. (1,2,3)

Speaking of the brain, I just discovered some very encouraging news for all of you coffee lovers out there courtesy of Rick McGuire, one of my favorite health sources on Twitter, and the Journal of Alzheimer’s Disease. Here are some of the finer points contained in a newly published review of studies entitled, “Therapeutic Opportunities for Caffeine in Alzheimer’s Disease and Other Neurodegenerative Diseases”:

  • “It appears that caffeine cannot be considered a ‘pure’ cognitive enhancer. Its indirect action on arousal, mood and concentration contributes in large part to its cognitive enhancing properties.”
  • “Results indicate a surprising ability of moderate caffeine intake (the human equivalent of 500 mg caffeine or 5 cups of coffee per day) to protect against or treat AD in a mouse model for the disease and a therapeutic potential for caffeine against AD in humans”
  • “The studies reviewed provide strong evidence that caffeine may represent a promising therapeutic tool in Parkinson’s disease, thus being the first compound to restore both motor and non-motor early symptoms of PD together with its neuroprotective potential” (4,5,6,7,8)

Symptomatic Androgen (Testosterone) Deficiency Increases with Age

Source: Journal of Clinical Endocrinology & Metabolism Vol. 92  (link)

Orna Izakson, a naturopathic doctor from Portland, Oregon shares a steady flow of natural health tips and wisdom on Twitter as well. On Monday she tweeted about how “dropping testosterone levels as men age may manifest as poor sleep”. I don’t know about you but that’s not the first culprit I think of when considering causes of sleep inadequacy. However researchers from the University of Montreal suspect this hormonal connection may be a common cause of sleep disturbance in aging men. The author of the research, Zoran Sekerovic, explains that, “With age, there is neuronal loss and the synchronization of cerebral activity isn’t as good, which is why there is a loss of deep sleep. Because deep sleep requires great synchronization”. If further investigations support these findings, then replacing testosterone in older men may become a standard treatment for related sleep disorders. In the meantime, losing excess body weight may be the safest and cheapest option for accomplishing this goal naturally. A new trial published in the International Journal of Obesity concluded that losing 10% of excessive body weight can increase plasma testosterone levels and, not surprisingly, improve erectile function and sexual desire as well. (9,10,11)

When I look at the breadth of information contained in today’s column it makes me feel very hopeful. Today, my friends on Twitter have presented real-world information about: a) using high levels of dietary fat to overcome a dreaded variety of cancer; b) drinking coffee to enhance brain function and discourage the incidence of neurodegenerative diseases; c) losing weight to bolster testosterone levels and, possibly, improving sleep quality. However, all of these natural options only exist in practical terms if you and your physicians are aware of them.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


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Posted in Food and Drink, Memory, Men's Health

13 Comments & Updates to “Improved Sleep and Testosterone Levels”

  1. Mark Says:


    Is there a natural way to boost testosterone levels in the body? Can it come from foods or should one look to supplementing?

  2. Anonymous Says:

    Quality sleep does not only help testosterone level but in general health body system. If you have enough sleep, that can give you a renewed energy for another day.

  3. JP Says:


    I think non-supplemental approaches should be tried first – aside from a multivitamin/mineral. On the top of my list is to:

    + Eat a diet that’s rich in healthy fats, protein and low in carbohydrates. I wouldn’t be concerned about natural sources of cholesterol or saturated fat.

    + I would try to emphasize nutrient-dense, whole foods and minimize my exposure to dietary phytoestrogens.

    + Aerobic and resistance exercise would also be high on my priority list.

    + At the bare minimum, I’d take a high-potency multi-vitamin/mineral to ensure optimal levels of key nutrients such as magnesium, Vitamin D and zinc.

    + I would practice daily stress management. Excess cortisol can adversely impact hormonal status.

    + As stated in the column, losing excess weight can be helpful.

    + I’d also make sure to get adequate sleep.

    + Last but not least … I would maintain a healthy and vigorous sex life.

    If several months of this kind of lifestyle didn’t yield satisfactory results, I would consider consulting with a physician who’s trained in the judicious use of testosterone replacement therapy. But I’d only do so if I was clearly out of the normal range.

    Be well!


  4. JP Says:


    Agreed. 🙂

    Be well!


  5. liverock Says:

    Vitamin D levels have recently been shown to increase T levels.


    Interesting about the Ketone diet and brain cancer. The ketonic diet appears to also help others with neurodegeneration problems including childhood epilepsy and ALS.



    I think the brain mitochondria favours burning fat rather than
    carbohydrates in some people. A few people I know with CFS reckon that they do better on the Keto diet with increased energy.

  6. JP Says:

    Thank you for adding those excellent points, Liverock! 🙂

    Here’s another example of the potential of the ketogenic diet:


    Be well!


  7. JP Says:

    Update: L-Theanine, a component of green tea, improves sleep quality …


    J Am Coll Nutr. 2015 Mar 11:1-12.

    In Search of a Safe Natural Sleep Aid.

    Sleep deprivation is associated with an elevated risk of various diseases and leads to a poor quality of life and negative socioeconomic consequences. Sleep inducers such as drugs and herbal medicines may often lead to dependence and other side effects. l-Theanine (γ-glutamylethylamide), an amino acid naturally found abundant in tea leaves, has anxiolytic effects via the induction of α brain waves without additive and other side effects associated with conventional sleep inducers. Anxiolysis is required for the initiation of high-quality sleep. In this study, we review the mechanism(s), safety, and efficacy of l-theanine. Collectively, sleep studies based on an actigraph, the obstructive sleep apnea (OSA) sleep inventory questionnaire, wakeup after sleep onset (WASO) and automatic nervous system (ANS) assessment, sympathetic and parasympathetic nerve activities, and a pediatric sleep questionnaire (PSQ) suggest that the administration of 200 mg of l-theanine before bed may support improved sleep quality not by sedation but through anxiolysis. Because l-theanine does not induce daytime drowsiness, it may be useful at any time of the day. The no observable adverse effect level (NOAEL) for the oral administration of l-theanine was determined to be above 2000 mg/kg bw/day. Key teaching points: Sleep deprivation-associated morbidity is an increasing public health concern posing a substantial socioeconomic burden. Chronic sleep disorders may seriously affect quality of life and may be etiological factors in a number of chronic diseases such as depression, obesity, diabetes, and cardiovascular diseases. Most sleep inducers are sedatives and are often associated with addiction and other side effects. l-Theanine promotes relaxation without drowsiness. Unlike conventional sleep inducers, l-theanine is not a sedative but promotes good quality of sleep through anxiolysis. This review suggests that l-theanine is a safe natural sleep aid.

    Be well!


  8. JP Says:

    Update: Sleep apnea is linked to lower testosterone levels and overweight in men …


    Clin Respir J. 2014 Apr 14.

    Fatigue and serum testosterone in obstructive sleep apnea patients.

    INTRODUCTION: Obstructive sleep apnea (OSA)-related fatigue is a common understudied symptom. Fatigue is associated with low serum testosterone level in non-OSA patients. No data are available about this association in OSA patients.

    OBJECTIVES: To investigate in adult obese males affected by OSA, the relationship between fatigue and serum testosterone in order to identify predictors for OSA-related fatigue.

    METHODS: Fifteen OSA patients and 15 control subjects participated. The parameters analyzed were serum testosterone morning concentration, polysomnography parameters, daytime sleepiness (Epworth Sleepiness Scale) and fatigue (Multidimensional Fatigue Inventory). Regression test was applied in order to show predictors of fatigue. Kruskal-Wallis test followed by post-hoc analysis was performed to test for differences between controls and OSA subgroups for testosterone, fatigue components and sleepiness.

    RESULTS: Mean testosterone level was 3.55 ± 0.7 ng/mL in the OSA group, significantly lower than in controls (4.26 ± 1.1 ng/mL, P = 0.049). An inverse correlation was found between testosterone and fatigue scores (P < 0.01). Furthermore, a statistically significant difference was found between the control group and the severe OSA subgroup for general fatigue, physical fatigue, reduced activity and mental fatigue. However, no significant differences were found between controls and mild OSA. Among all variables, testosterone was the only independent significant predictor of physical fatigue (t = -2.56, P = 0.033, R = 0.978, R2  = 0.958) and reduced activity (t = -4.41, P = 0.002, R = 0.966, R2  = 0.934) in the OSA patients. CONCLUSIONS: OSA-related fatigue was strongly associated with serum testosterone, together with OSA severity. Be well! JP

  9. Rebeka Says:

    I always wake up in the midlde of the night if I’ve been drinking the night before. Alcohol metabolizes into sugar, and a sugar rush in the middle of the night probably isn’t so good for sleep.

  10. JP Says:

    Hi Rebeka,

    That makes sense. This might be the reason why:


    Alcohol. 2015 Jun;49(4):299-310.

    Alcohol disrupts sleep homeostasis.

    Alcohol is a potent somnogen and one of the most commonly used “over the counter” sleep aids. In healthy non-alcoholics, acute alcohol decreases sleep latency, consolidates and increases the quality (delta power) and quantity of NREM sleep during the first half of the night. However, sleep is disrupted during the second half. Alcoholics, both during drinking periods and during abstinences, suffer from a multitude of sleep disruptions manifested by profound insomnia, excessive daytime sleepiness, and altered sleep architecture. Furthermore, subjective and objective indicators of sleep disturbances are predictors of relapse. Finally, within the USA, it is estimated that societal costs of alcohol-related sleep disorders exceeds $18 billion. Thus, although alcohol-associated sleep problems have significant economic and clinical consequences, very little is known about how and where alcohol acts to affect sleep. In this review, we have described our attempts to unravel the mechanism of alcohol-induced sleep disruptions. We have conducted a series of experiments using two different species, rats and mice, as animal models. We performed microdialysis, immunohistochemical, pharmacological, sleep deprivation and lesion studies which suggest that the sleep-promoting effects of alcohol may be mediated via alcohol’s action on the mediators of sleep homeostasis: adenosine (AD) and the wake-promoting cholinergic neurons of the basal forebrain (BF). Alcohol, via its action on AD uptake, increases extracellular AD resulting in the inhibition of BF wake-promoting neurons. Since binge alcohol consumption is a highly prevalent pattern of alcohol consumption and disrupts sleep, we examined the effects of binge drinking on sleep-wakefulness. Our results suggest that disrupted sleep homeostasis may be the primary cause of sleep disruption observed following binge drinking. Finally, we have also shown that sleep disruptions observed during acute withdrawal, are caused due to impaired sleep homeostasis. In conclusion, we suggest that alcohol may disrupt sleep homeostasis to cause sleep disruptions.

    Be well!


  11. JP Says:

    Updated 1/26/16:


    Aging Male. 2016 Jan 20:1-9.

    Testofen, a specialised Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen decrease, increases testosterone levels and improves sexual function in healthy aging males in a double-blind randomised clinical study.

    This study examined the effect of Testofen, a specialised Trigonella foenum-graecum seed extract on the symptoms of possible androgen deficiency, sexual function and serum androgen concentrations in healthy aging males. This was a double-blind, randomised, placebo-controlled trial involving 120 healthy men aged between 43 and 70 years of age. The active treatment was standardised Trigonella foenum-graecum seed extract at a dose of 600 mg/day for 12 weeks. The primary outcome measure was the change in the Aging Male Symptom questionnaire (AMS), a measure of possible androgen deficiency symptoms; secondary outcome measures were sexual function and serum testosterone. There was a significant decrease in AMS score over time and between the active and placebo groups. Sexual function improved, including number of morning erections and frequency of sexual activity. Both total serum testosterone and free testosterone increased compared to placebo after 12 weeks of active treatment. Trigonella foenum-graecum seed extract is a safe and effective treatment for reducing symptoms of possible androgen deficiency, improves sexual function and increases serum testosterone in healthy middle-aged and older men.

    Be well!


  12. JP Says:

    Updated 06/25/17:


    Altern Ther Health Med. 2017 Jul;23(4):16-24.

    Alternative Therapy for Patients With Obstructive Sleep Apnea/Hypopnea Syndrome: A 1-year, Single-blind, Randomized Trial of Tui Na.

    Context • Obstructive sleep apnea/hypopnea syndrome (OSAHS) is among the most prevalent of sleep-related breathing disorders. No long-term follow-up studies have documented the continued success of lifestyle changes in treatment; oral appliances have an approximate 50% success rate; compliance with continuous positive airway pressure is poor, ranging from 50% to 89%; and the success rate of upper-airway surgery is only 66.4%. Therefore, some OSAHS patients seek alternative treatments.

    Objectives • The study intended to examine the efficacy of traditional Chinese therapeutic massage (tui na) for patients with OSAHS.

    Design • The research team designed a prospective study.

    Setting • The study took place at the outpatient clinic of the sleep center at the Kaohsiung Chang Gung Memorial Hospital (Kaohsiung, Taiwan), an academic tertiary medical center.

    Participants • Participants were 31 patients with moderate to severe OSAHS. Intervention • Each participant received a tui na treatment at multiple acupoints 2 ×/wk for 10 wk for approximately 15 min/session.

    Outcome Measures • At baseline and 3 mo after treatment, participants completed subjective measures, including (1) quality of life using a 36-item, short-form health survey (SF-36); (2) subjective snoring intensity indicated by bed-partners using a 0-10 visual analog scale (VAS); and (3) excessive daytime sleepiness (EDS) status, using a Chinese version of the Epworth Sleepiness Scale (CESS). The research team completed objective measures, including (1) polysomnography, (2) body mass index, and (3) neck circumference.

    Results • Twenty patients completed the full course of treatment. The apnea/hypopnea index per hour decreased from 43.8 ± 26.9 to 37.8 ± 31.7 after the treatments, with P = .049 (paired t test). The arousal index and rapid eye movement stage of sleep improved significantly. Statistically significant improvements were observed for the SF-36 on the score for the physical component summary, for its subscale for general health, for the mental component summary, and for 2 of its subscales: vitality and mental health. The VAS and the CESS showed that snoring intensity and EDS decreased significantly, respectively. No major complications occurred.

    Conclusions • Tui na is a feasible and safe treatment for patients with OSAHS. It can improve the quality of life, sleep architecture, snoring intensity, and EDS in patients with moderate-to-severe OSAHS. In the future, a controlled study should be considered to further investigate the effects of tui na for OSAHS.

    Be well!


  13. JP Says:

    Updated 04/08/18:


    World J Mens Health. 2018 Mar 22.

    Efficacy and Safety of a Mixed Extract of Trigonella foenum-graecum Seed and Lespedeza cuneata in the Treatment of Testosterone Deficiency Syndrome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

    PURPOSE: The aim of this study was to investigate the efficacy and safety of a mixed extract of Trigonella foenum-graecum seed and Lespedeza cuneata (TFGL) for the treatment of testosterone deficiency syndrome (TDS).

    MATERIALS AND METHODS: Patients were instructed to take a placebo or 200 mg TFGL capsule twice per day for 8 weeks. The primary efficacy variable was the change from baseline in the Aging Males’ Symptoms scale (AMS), as well as levels of serum total and free testosterone. Secondary efficacy measurements included changes from baseline in the number of ‘yes’ answers on the Androgen Deficiency in the Aging Male (ADAM) questionnaire, levels of serum total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride, all domain scores of the International Index of Erectile Function (IIEF), perceived stress scale-10 (PSS-10), as well as changes in body composition.

    RESULTS: The TFGL group exhibited a significant improvement in the AMS scores at 8 weeks, total testosterone at 8 weeks, and free testosterone at 4 and 8 weeks. At 4 weeks, 25% of the TFGL group changed to negative in terms of ADAM scores and 34.1% of the TFGL group had negative scores at the end of the study. The TFGL group exhibited a significant improvement in total cholesterol, HDL-C, LDL-C, triglyceride, IIEF scores, and PSS-10 scores at 8 weeks.

    CONCLUSIONS: The mixed extract of TFGL resulted in significant improvements in symptoms of TDS, as measured by the AMS, ADAM, PSS-10 and testosterone levels.

    Be well!


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