Weight Loss at Innovative Men’s Clinic

At Innovative Men’s Clinic, our patients come to us with a multitude of health concerns, from fatigue and sexual function to sleep and body weight. The signs and symptoms of low testosterone are many and can affect any system in the human organism.

Weight gain is one of the most ubiquitous complaints that men have when they come to us as new patients. We have routinely worked with patients to improve hormonal balances that help with metabolism and weight loss, and have been known to give a lot of dietary advice as well. However, many of our patients aren’t aware that we have much more structured weight loss plans as well!

Why being overweight is bad for you / why overweight people should lose weight

While you may hear that being overweight causes many illnesses, in reality being overweight is a symptom of problems that also lead to other illnesses. That may be a small distinction, but the idea is that the things that lead to weight loss also improve and/or prevent many of the illnesses associated with being overweight. Here are just a few reasons to lose weight:

• Being overweight is associated with an increased risk for various types of cancer.
• Losing weight improves cardiovascular health, blood pressure, and cholesterol levels.
• Losing weight prevents and/or improves diabetes and metabolic syndrome
• Losing weight improves overall happiness from increased physical ability/decreased physical disability, improved self image and confidence, more energy, and many other general wellness improvements.
• Losing weight can help improve knee and joint problems, sleep apnea, fertility and sexual problems, memory and risk for Alzheimer’s, and countless other conditions.
• In general, if it is associated with aging, losing weight will likely improve it.

Our Programs

We have three main options for medically supervised weight loss programs. They all involve various levels of personal effort on the part of the patient. The most basic level is the testosterone treatment with dietary counseling. This method involves referrals to dietary information, such as The Primal Blueprint, a book by Mark Sisson, or other Paleo/Ancestral inspired lifestyles. This method requires the most work for the patient, leaving dietary habits,meal planning, shopping and all associated tasks in the hands of the patient. This method works well for people with the time to do a lot of reading and research on their own. It’s also the most gradual method for losing weight, as this is not a “diet” per se. Rather, this is a different way of eating. It is a lifestyle change that along with hormone balancing, can be very effective at building muscle and losing fat. Many patients report that the weight shown on their scale doesn’t really change much, but as a result of gaining muscle and losing fat, their clothes fit much better or they have to go down a few sizes in the waist.

Next is the HCG diet. HCG is Human Chorionic Gonadotropin. At Innovative, we have modified this diet because we don’t feel that limiting one’s nutritional intake to 500 calories per day is a very good idea. HCG is also part of the Testosterone therapy. In the HCG diet, HCG’s main purpose is to stimulate a little bit of testosterone production with the aim of preserving muscle mass which could otherwise be lost on a 500 calorie per day diet. However, with testosterone therapy that includes HCG, we have done several steps better in the hormone and muscle retention (or gain) direction. With a 1000 calorie per day diet, fat loss is still quite dramatic. Like the self-guided Primal Blueprint or other Paleo/Ancestral lifestyle changes, the IMC HCT with Testosterone weight loss program is also self-guided. It follows the HCG diet food lists but adds more of them so that you get adequate amounts of vitamins, minerals, protein, and healthy fats.

Our flagship weight loss program is relatively new to IMC. We are very proud offer the Ideal Protein medically supervised diet. Several men on the Innovative Men staff have lost very impressive amounts in a short amount of time without losing muscle and without any undesirable effects. Ideal Protein provides dieters with continual education as well as weekly consultation and meal plans. Ideal Protein is far more than just a diet. Learning how to maintain a stable weight after dieting is the ultimate goal, and the four-phase Ideal Protein approach has a proven track record internationally. Ideal Protein is being offered at our Federal Way and Bellevue offices. Each office as a Weight Loss Coach that patients meet with on a weekly basis. The coaches help keep patients motivated and educated. Ideal Protein isn’t just a diet. The four-phase approach is a way to transition from a medical weight loss regimen to a new lifestyle way of eating that promotes healthy weight maintenance so that patients don’t “gain it all back.’ Much more information can be had at the link in the previous paragraph.

Though we are called Innovative Men’s Clinic, we offer Ideal Protein coaching to female patients, as well! We welcome our male patients to refer their female friends and family! In addition to the Federal Way and Bellevue IMC locations, Ideal Protein is also offered by Dr. Katie Disharoon in conjunction with the PROTECT® Women’s Hormone Therapy program at Washington Women’s Anti-Aging in Downtown Seattle. For more information, or if you are interested in losing the weight today, go to

Contact us  and book your risk-free visit today!

PROTECT- Hormone Clinic for Women

Bio-identical Hormones for Women- Doesn’t She Deserve The Best?

Like the changing of the seasons, a woman’s body experiences transitions throughout her day, her month and her lifetime thanks to hormones her body produces. When every aspect of this system is working as it should, it’s truly a beautiful interplay of biochemistry. From the thyroid to the adrenal glands, the ovaries to the brain — there’s a myriad of organs at play in the production, regulation and response to a woman’s hormones.

Thanks to increasing awareness around the importance of hormones, women are now more aware than ever of the important role they play in their health and well-being. The consensus is that it’s not enough for these hormones to be simply balanced but also optimized. This is the concept behind the exciting new PROTECT Hormone Program. At PROTECT, we believe women deserve attention and treatments that are as unique as they are.

At PROTECT, we offer personalized assessments which allow us to offer treatments which are specifically tailored to a woman’s needs — no matter what stage of life she’s in. We use bioidentical hormones, which means they are safe, reliable and endlessly customizable to her needs.

Curious if the woman in your life might benefit from the services offered at Protect? Here few conditions that can be improved through the PROTECT Program:
• Hot flashes
• Fatigue
• Brain fog
• Insomnia
• Difficulty with Weight
• Low libido

Dr-Katie-Disharoon-PROTECT-Hormone-programDr. Katie Disharoon, specializes in helping women find optimal wellness. Using natural, plant-based therapies she is able to gently bring the hormonal system into balance which means more energy, healthier skin, easier weight loss and increased libido. As a Naturopathic Doctor (ND) Dr. Disharoon is trained in both traditional and Western medicine, giving her the most effective tools to help her patients thrive.

Call PROTECT to set up your initial assessment with Dr. Disharoon today! (206) 457-5518

Does Viagra Cause Melanoma

Joshua Moninger, ND
Clinical Director

You may have seen in the news recently stories like one published on June 4th, 2014 by CBS news entitled Viagra may increase melanoma risk, study finds. Keep in mind; this is not a good article. This article starts off by stating, “The little blue pill used by men to boost bedroom performance may be detrimental in the great outdoors, according to new research. The study, published in JAMA Internal Medicine, found sildenafil, commonly known as Viagra, may increase a man’s risk for melanoma by as much as 84 percent.” In fact, you will not find that “84%” statistic anywhere in the original study (click here).

The original study describes some very technical biochemistry as the reason for suspecting that drugs like sildenafil (the active ingredient in Viagra) “…may be associated with an increased risk of developing melanoma.” This is different than causing melanoma. When the study was done, Levitra, Cialis, and Stendra were not yet on the market in the US. The theory is that drugs like Viagra, Levitra, and Cialis, which are called Phosphodiesterase 5A Inhibitors (PDE5i’s), can mimic an effect of a genetic mutation called BRAF that downregulates PDE5A levels. In plain terms, The study suggests that Viagra may in theory do the same thing that the gene for melanoma does, by the same mechanism.

But the statistics aren’t as clear as the CBS News and other articles may have us believe. The original study was an observational study that used surveys taken as part of the Health Professionals’ Follow-up Study (HPFS), an ongoing study where men submit answers to questionnaires every 2 years. This study looked at a period from 2000 to 2010 and correlated Viagra use with new diagnoses of melanoma.

The study also very clearly states that “Those using sildenafil were more likely to be older and obese, have family history of melanoma, and take physical examinations (they check their skin for suspicious moles), but were exposed to less sun light as adults (age 25-59 years).” What this means is that erectile dysfunction, and therefore use of drugs like Viagra, is more common in men who also have a family history of melanoma and are more likely to be less healthy overall. This makes sense when we interpret the study as a correlation between Viagra and melanoma, and not a cause and effect relationship. Correlation can also be described as coincidence. In other words, two things that tend to go together don’t necessarily cause each other. They could be different results of the same issue.

One article by the Harvard Health Blog eloquently states the flaws in the conventional interpretation by some other news outlets. It does an excellent job of properly interpreting the study, stating that the absolute increase from 4.3 cases of melanoma per 1000 patients not using Viagra to 8.6 cases of melanoma per 1000 patients who were using Viagra is only a 0.43% increase. Statistics are supposed to make data interpretation more meaningful, but in many cases, statistics can be used to manipulate data into suggesting different things. What the original study actually shows is that there were 70 cases of melanoma per 113,515 person years in the group that had never used Viagra and 9 cases of melanoma per 5774 person years in the group that had used Viagra.   A person year takes into account that the study analyzed data over a 10 year time period. This comes out to 0.6 cases per 1000 person hours for non-users vs. 1.6 cases of melanoma per 1000 person hours in the Viagra group. This is an increase of just one tenth of a percent. Even if it is statistically significant, in the real world it is far too soon to make such a claim, especially considering that users of Viagra type medications are more likely to have a family history of melanoma and be less healthy overall than non-users.

Should you worry about melanoma if you’re taking medications for erectile dysfunction? Everyone should be cautions when it comes to melanoma. If you have a family history, it doesn’t matter if you are taking Viagra or not. The only conclusions that can be taken from this study are that more research needs to be done to establish a true connection. At this point, all that can be said is that melanoma was seen slightly more often in users of Viagra than in non-users.  The relationship could be pure coincidence, and the study also showed absolutely no connection at all between Viagra use and any other type of cancer. We suggest all people, especially those with a family history of skin cancer, protect themselves from excess sun exposure and do routine self-checks and doctor checks to identify suspicious moles that could be cancerous.


We can answer your questions about Viagra and Melanoma health risks.

Please call the IMC location nearest to you.

Dispelling the Myth that Testosterone Causes Prostate Cancer

Testosterone and Prostate Cancer -Dispelling the Myth that Testosterone Causes Prostate Cancer

One of the more common concerns that many of our new patients have when they first come to Innovative Men’s Clinic for treatment, especially if they have a family history of prostate cancer or other non-cancerous prostate problems, is that being treated with testosterone will increase their chances of having prostate disease in the future. Some have even heard that testosterone actually causes prostate cancer. To make matters worse, these sentiments are often shared with patients by their primary care physicians. The myth that testosterone replacement therapy causes prostate cancer has been deeply rooted in the western medical paradigm for over sixty years.

Where does this myth come from?
In the article Testosterone Replacement Therapy and Prostate Risks: Where’s the Beef? By Abraham Morgentaler, MD, the author writes that more than 60 years ago, researchers studied the effects of castration on people with prostate cancer. They observed that the cancer regressed. Since the testicles were removed, no more testosterone was present. They concluded that since removing testosterone led to regression of prostate cancer that the cause of the cancer must have been the testosterone. The same effect was observed in patients who underwent pharmacological lowering of serum testosterone.

However, we now know that there is a lot more to this. If you’re a testosterone patient at Innovative Men’s Clinic, you may recall being told that the male body produced estrogen by converting testosterone directly into estradiol. Men need some estrogen, but they don’t have ovaries to produce it. Instead, an enzyme called Aromatase converts testosterone into estradiol, a potent estrogen. Normally, as life progresses, the amount of estrogen is kept at a particular level, but when a man with low testosterone has his levels brought to an optimal level very suddenly, the activity of Aromatase can result in drastically high estrogen (estradiol) levels. Well, guess what; Estradiol excess has been linked to prostate cancer in more recent studies like this one (click here). This is just one possible effect of increased estradiol levels in men. Many others can occur, and this is why testosterone patients at Innovative Men’s Clinic take the aromatase inhibitor, Anastrozole (Arimidex). By using this medication along with testosterone, the estradiol levels can be kept to optimal levels for a male patient, especially when blood testing is performed as often as it is at IMC.

So, let us review. Physical or chemical castration results in almost no testosterone, and prostate cancer regresses in individuals who have undergone such castration. However, we can now say that since testosterone was nearly absent, and since men get their estradiol by converting testosterone into estradiol, that there was not enough testosterone present to create the offending estradiol. No testosterone = no estradiol. No estradiol = regression of cancer.

Dr. Edward Friedman has written a book called The New Testosterone Treatment; How You and Your Doctor Can Fight Breast Cancer, Prostate Cancer, and Alzheimer’s.    In it, he uses the latest research to explain what he calls The Hormone Receptor Model for how prostate (and breast) cancer emerge, and he does so in a language that most people can understand. By understanding the different testosterone and estrogen receptors and their role in prostate cancer, he has determined that prostate cancer can actually be treated with testosterone therapy so long as the estradiol is kept to a minimal level.

There is still a lot of outdated research out there linking testosterone to prostate cancer, but the use of anastrozole to inhibit the aromatase enzyme and thus the overproduction of estradiol is a relatively new practice. To this day the physicians at IMC receive new patients who have been on testosterone therapy elsewhere, either through their primary care doctor, a urologist, an endocrinologist, or a competing “Low-T” clinic, who have not been prescribed anastrozole to control estradiol or even had their estradiol blood levels checked. At IMC we view this practice as irresponsible, but the point is, there are doctors and clinics who are not administering testosterone therapy appropriately, and when it isn’t done appropriately, side effects emerge, possibly including prostate cancer. This contributes to the myth that testosterone causes prostate cancer and other problems. Fortunately there is plenty of research showing that when testosterone therapy is done correctly, the risk of prostate cancer and other potential effects is nearly eliminated.

Ask yourself, how many teenaged post-pubescent boys do you know with prostate problems? It’s fairly well known that teenaged boys have very high amounts of testosterone, yet they don’t have prostate issues. They also have naturally low levels of estradiol.

As men age, even without an improperly administered testosterone treatment where estradiol is not controlled, men tend to be exposed to and/or produce more estradiol than they should. This increase, along with a decrease in the protective testosterone, is part of why prostate cancer is on the rise (after all, most men who suffer from prostate cancer were never on testosterone replacement therapy).

We encourage you to read more on this topic. It is very important that our patients and potential future patients be comfortable with testosterone treatment, so don’t just take our word for it. Please click the links included in this writing. The previously mentioned study and book, along with the links that follow, are all excellent sources for understanding the latest and best research in the area of prostate cancer and the busted myths surrounding the link between testosterone and prostate cancer.

Destroying the Myth About Testosterone Replacement and Prostate Cancer also by Abraham Morgentaler, MD

Testosterone Therapy Doesn’t Boost Prostate Cancer Risk , Study Finds by Linda Thrasybule, MyHealthNewsDaily contributor.

Ten things you can do to limit chemical estrogen exposure are: By Poliquin Group™ Editorial Staff

10 Ways To Lower Estrogen Toxic Load  By Poliquin Group™ Editorial Staff

An Innovative and Comprehensive Approach to Premature Ejaculation

Premature Ejaculation (PE), also known as early ejaculation, is a very common condition in men that can be very frustrating for couples and can even threaten relationships. It has been estimated that up to one-third of men struggle with this condition on a regular basis.
The clinical definition is an ejaculation that occurs sooner than 2 minutes after vaginal penetration AND includes one of the following:

  • an inability to control the ejaculation when desired
  • causes stress in a relationship

The average normal ejaculation time from penetration has been found to be a little over 6 minutes. While the clinical definition is practical for studies the most helpful definition in reality is any ejaculation that is sooner than you or your partner would like. For instance, one couple may be completely satisfied with 5 minutes of penetration, whereas another couple may need 20 minutes to be satisfied.

What causes premature ejaculation?

The causes of the condition vary widely and are often multiple in origins. Some men have what’s called primary PE, meaning that they have struggled with the condition since the onset of their sexual lives; others have secondary PE with onset later in life.

It’s often found that premature ejaculation (PE) may be situational, either occurring only with certain partners or at certain times. Whenever it occurs, it can be distressing to men. The most important aspect of PE, regardless of when it started, is psychological. Unfortunately, this can be the most difficult component to treat. Some psychological contributors to PE include anxiety and being hyper-aroused. In both cases the nervous system is in a heightened state, and in both cases, calming the nervous system will help increase the orgasm threshold and allow an increased time until orgasm. In general, most of the non-pharmacologic approaches will have very mild effects individually, but when combining several of these, the benefits are cumulative and thus will have a more appreciable effect in helping you to last longer.

Hormone dysregulation (i.e. low testosterone) is a major factor contributing to premature ejaculation. In fact, many men have had suboptimal testosterone since puberty, which predisposes them to premature ejaculation.

With modern medicine we are now learning that testosterone increases amount of serotonin in the brain. Low serotonin is associated with premature ejaculation. This is why long term use of SSRI-type anti-depressants (Selective Serotonin Reuptake Inhibitors which slow down the breakdown/recycling of serotonin) can be helpful for some guys. Unfortunately SSRI medications have a long list of side effects including decreased sex drive and fatigue, making them a less desirable option for treating PE. In addition, one reason serotonin is low in the first place is likely from low testosterone or another hormone imbalance such as thyroid dysregulation.

Internet porn and masturbation can also cause premature ejaculation. According to some studies, porn consumption increases your dopamine production which can cause faster ejaculations. Plus, many men masturbate simply to “get off” in the shortest time possible. This trains your body to ejaculate more quickly when you’re in any sexual situation.  Pornography also causes many people to have unrealistic expectations of what sex is supposed to be like. Think about this: A 5 minute film isn’t going to sell well. Thus, adult films are made to be an entertaining length. Unfortunately, various tricks including Trimix and other medications (see below) and cutting/editing film techniques creates what appears to be an unrealistically long lasting sexual encounter between the actors.

Multifaceted Approach:

There are several angles from which to approach the treatment of PE, and often the best results require a combination of several different treatments. Having many options to choose from also helps provide customized treatments that will work for individual patients.

In general, treatments for four main aspects of PE should be incorporated; Pharmaceuticals, Nutritional Supplements, Psychology, and Techniques.


Breathing: Breathing can help calm an excited/anxious nervous system.

Anxiety: Breathing can help with relaxing the nervous system. Just like during meditation, which often incorporates mindful breathing to quiet the brain, slow, steady, deep breaths during sex can help to calm the nervous system, including the nerves in the penis. DON’T hold your breath or take shallow, fast breaths. These have the opposite effect.

Hyper-arousal: Focusing on the breath has the additional benefit of distracting your thoughts. By thinking about your breathing more, you’re thinking less about sex, which can decrease arousal and allow you to last longer. In addition, beliefs in sex can affect arousal. If it’s a “big deal” you’re more likely to be hyper aroused than if it’s a “normal” part of life (which it is). Having sex more often can help normalize it and reduce your hyper-arousal to a normal level.

A simple exercise to do while masturbation is as follows:
1) Put one hand on your belly and feel your belly rise and fall as you breathe deeply and slowly
2) Consciously keep your pelvic muscles as relaxed as possible.
3) If you get close to orgasm, slow down or stop until sensitivity decreases. Allow yourself at least 15 minutes to do this practice.

PC Muscle Relaxation: The PC or Pelvic muscles described below play an important role in ejaculation. They help to propel semen through and out of the penis. By consciously keeping them relaxed, ejaculation can be delayed until you’re ready. This does take practice, just like any other muscle control, but the above exercise incorporates this practice.

PC Muscle Contraction: Just like the PC muscle can be contracted to prevent urination, it can be contracted to prevent ejaculation. Just before the “point of no return” is reached, squeezing this muscle as firmly as possible can prevent ejaculation, even if orgasm (ejaculation and orgasm are actually separate phenomena that happen to occur simultaneously) occurs. If you hold back ejaculation, you’ll be more likely to maintain your erection and be able to continue. Sensitivity is also reduced for a time allowing one to continue intercourse until the sensitivity is regained. Sometimes, however, the untrained PC muscle is not strong enough to hold back. As such, this technique also requires practice. You can find detailed exercises online, but the best and simplest is the Kegel. Kegel can be incorporated into the exercise above.

Change positions: Changing positions interrupts intercourse and can allow the sensitivity of the penis to be reduced for a short time. Different positions can also result in more or less sensitivity. For example, the traditional missionary position tends to result in greater penile sensitivity while female on top positions can help a man last longer. Other positions can be explored and much information is available online.

Edging Techniques: Edging techniques can be a powerful way to retrain your ejaculatory mechanism to take longer. Edging is beyond the scope of this article but there is loads of information on it on the internet, both for self-training and with your partner to prolong your foreplay.

NLP: Neurolinguistic programming is famous for improving many psychological conditions including the psychological aspects of PE. NLP is beyond the scope of this article, but you should know that it is a powerful tool. Much more can be learned about NLP via a simple google search.


5HTP: The supplement 5-Hydroxytryptophan (5HTP) is an important precursor to the production of serotonin in the brain. Providing the precursor to serotonin results in increased production of serotonin, a neurotransmitter with many functions. A deficiency in serotonin has been associated with premature ejaculation, and many men have experienced improvements in PE by supplementing 5HTP. It is available over-the-counter from most supplement and health food stores. It also can have the effect of improving mood and the ability to relax.


The pharmaceutical approach is what Innovative Men’s Clinic excels at. It has two main benefits: It takes the worry out of things allowing the man to forget about the problem (which itself can reduce anxiety as mentioned in the previous section) and it is very simple to do (unlike some of the techniques discussed later that require some discipline and work).

Dextromethorphan 50mg/Acetaminophen 325mg/Sildenafil 50mg:
Dextromethorphan is a cough suppressant (the DM in Robitussin). A side effect of taking cough suppressants with dextromathorphan is a delay or inability to ejaculate. However, when premature ejaculation is an issue, it can be used to “delay” ejaculation to a more desirable duration.

Acetaminophen is an OTC pain relieving medication (the medication found in Tylenol) that can slightly reduce the sensitivity of the nerves in the penis. By itself, acetaminophen is not likely to result in drastic improvements in PE but when combined with dextromethorphan and other items listed in this article, desirable results can be achieved. Acetaminophen is Absolutely Contraindicated with Alcoholic Beverages! Taking Acetaminophen with alcohol in your system can cause significant damage to your liver.

If ED is an accompanying problem, Dextromethorphan and Acetaminophen can be combined with Sildenafil, the drug found in Viagra. It can also be combined with Tadalafil (Cialis), Vardenafil (Levitra), Avanafil (Stendra), or any other PDE5i medication. It is an arousal-dependent medication that can improve the firmness and duration of an erection. This has two main benefits; More confidence in your erection (and thus your performance) and a quicker recovery time after ejaculation, should you still be interested in continuing your sexual activity. When combined with Dextromethorphan and Acetaminophen, several issues are addressed at once.

Micro-injection Trimix for Premature Ejaculation:
The microinjection is applied completely painlessly just prior to sexual intercourse. Trim acts locally at the penis by opening up the blood vessels and thus allowing you to maintain an erection even after ejaculating.

The ability to maintain the erection after ejaculation reduces anxiety associated with sexual intercourse and the subconscious fear that can cause men to under-perform. Over time patients typically become less concerned with their PE. You may begin to prolong your ejaculation time more easily due to the decreased performance anxiety because even if you do ejaculate early you’ll still have an erection.

Eventually this approach gives you the ability to manage your ejaculation time on your own. It also helps you to practice the other methods listed below without having to worry about failing. We have been using this unique approach with patients for several years and have found remarkable and reliable results. It is very safe when done correctly, and the physicians at Innovative provide thorough instructions to all their patients who wish to use this technique.

How to Deal With Premature Ejaculation:

Part of the problem is that there are unrealistic expectations in modern society. The easy access to internet porn has many men to believe that they need to last for an hour or more. The truth is women should be able to orgasm in a short time too. We’re genetically programmed to be able to get the deed done quickly before a threat or other interruption occurs. The whole point, from an evolutionary perspective at least, is to reproduce. If it takes too long, reproduction is less likely.

If we’re smart, we’ll spend more time in foreplay. For most women, sex is mostly in the mind. Sure, physical arousal plays a big role too, but if you take the time to really get her aroused, she should orgasm within minutes or even seconds of penetration. Even bringing her to orgasm before intercourse will help her be more satisfied, and many woman can have additional orgasms after penetration. In short, it’s well worth your time to be patient and focus on her arousal during foreplay with lots of massage, caressing, kissing, and of course, manual and/or oral stimulation. This way, if you do ejaculate in a very short time after penetration, it’s OK, because your partner will already be satisfied. While reproduction may be the evolutionary goal, modern humans are blessed with the ability to enjoy sex, and as such, enjoyment should be the goal, and there are many ways to do that other than through penetration alone.

If you are struggling with PE don’t wait any longer. Call (425) 455-1700 or make an appointment online with an Innovative Men’s Clinic doctor to discuss a treatment program tailor fit to you. Click HERE to contact the Innovative Men’s Clinic nearest you!

Androgen (Testosterone) Receptors: The Other Half of the Story

Supplementing Testosterone is a great way to increase libido, improve sexual performance, improve sleep and energy, increase strength and muscle mass, improve confidence and drive, and to prevent many of the chronic diseases of aging, such as diabetes, dementia, cardiovascular disease, and many others.

But having the hormone in your system is only part of the equation. Your body still needs to be able to USE it. Treating Low Testosterone with a Testosterone Replacement Therapy is a great start, and at Innovative Men’s Clinic, we excel at providing testosterone replacement therapy in a way that prevents the side effects associated with elevated estrogen levels or decreased Luteinizing Hormone signaling. However, there is a lot that you, the patient, can do to maximize the benefits that you get out of the treatment. The more sensitive you are to testosterone, the more benefit you’ll experience. Testosterone is a signaling hormone (as are most hormones). But if there aren’t enough “ears” to listen for the signal, then the signal doesn’t have as much effect. The “ears” are called receptors, and we can improve the number and sensitivity of them to make better use of the testosterone you have in your body as a result of your testosterone therapy.

Androgen receptors in different parts of the body respond differently to the signal that testosterone provides. When testosterone binds to a receptor, it triggers the cell to function in a way that creates masculinizing effects within that cell. If the receptor is on a brain cell, the result can be more confidence, a more even-keeled temperament, better mood, and an increased sex drive. If the cell is a bicep muscle cell, the signal will result in increased muscle protein building. If the cell is in the lining of an artery, it may do a better job of releasing nitric oxide (see our October blog post, Nitric Oxide and its effects on erectile dysfunction).

In short, if you don’t have enough androgen receptors, your testosterone supplementation will be much less effective. Treating a testosterone deficiency is just the first step. So what can a man do???

The amount of scientific literature on the internet regarding testosterone receptors is disappointing, but there is some, and there is great anecdotal evidence as well. The following is a list of things that can help you get the most out of your testosterone supplementation (or your own testosterone if you’re not currently on a testosterone therapy).

DO lift weights. Repeated sessions of resistance exercise (weight training) increase the density of androgen receptors in the muscles.  Even mild exercise increases the activity of dihydrotestosterone (DHT) in the hippocampus (part of the brain), which then stimulates androgen receptor activity in the rest of the brain.

DO supplement L-Carnitine. A study by William J. Kramer conducted with L-Carnitine back in 2006-2008 showed that after 21 days of supplementation with L-Carnitine there was a significant increase in the amount of androgen receptors during rest. In addition, after exercise the group of which supplemented with L-Carnitine had an even greater amount of androgen receptor activity and protein synthesis than the placebo group. Increased protein synthesis is an indicator of increased testosterone activity. The increase in androgen receptors promoted faster recovery and tissue regeneration following exercise.

DO supplement Iodine. Every cell in your body requires iodine for various functions, but even with iodized salt, iodine deficiency is extremely common. This includes the testosterone receptors on and inside the cells. ?Part of the problem is that lighter halogens which are toxic (fluoride, bromide, and chlorine) are capable of out-competing iodine for the receptors that are supposed to accept iodine. However, the lighter halogens are not functional.? ?People are inadvertently consuming fluoride, bromide, and chlorine virtually every day (toothpaste, water supply, conventional food, etc), but the average intake of iodine is quite low. To unblock those receptors we need to out-compete the toxic halides and replace them with high doses of iodine. This can sometimes cause a detoxification process that may result in headaches and other flu-like symptoms for a period of time.

DO eat well. Pumpkin seeds are high in zinc. Zinc has been shown to increase testosterone receptors to make the most out of increased testosterone levels. Also, eating grass fed, organic red meat two to three times per week will also provide sufficient zinc. Beef is also a good source of complete protein. In general, high carbohydrate foods that stimulate insulin will suppress growth hormone. Growth hormone will increase testosterone receptors, so we don’t want to suppress it with insulin! Therefore, a low carbohydrate, high protein and high healthy fat diet will result in better growth hormone levels and thus improved testosterone receptor activity. Diets such as the Primal Blueprint or other various takes on the paleo diet are the best for hormone and hormone receptor expression.

DO make sure your estrogen levels are not elevated. Estrogen and testosterone often compete with one another, and the levels of each can contribute to the regulation of the receptors for each. In other words, estrogen can contribute to lowering testosterone receptors and thus your sensitivity to testosterone treatment. Patients with elevated estrogen often report little or no effect from the testosterone treatment. Getting estrogen under control will help allow testosterone receptors to flourish.

For more information, our doctors are always willing to speak with you about diet and lifestyle for the purpose of improving hormone receptors and all other aspects of natural health. Innovative Mens Clinic doctors are experienced in many areas of health and wellness, including diet, exercise, herbal and nutritional supplements, natural sleep medicine, sexual function, functional medicine, and many other areas that assist patients on their path to healthier lives.

For more information, call our clinic Bellevue (425) 455-1700

An untreated epidemic- low testosterone in men

Low testosterone levels in men are an untreated epidemic and many doctors are clueless about the problem.

Most doctors have only seen a handful of testosterone lab results and the tests they tend to order are too basic for such an important problem.

They think if you don’t have ED (erectile dysfunction) then there is no way you could have low testosterone levels.

There are many myths about low testosterone. The truth is that men in the United States 20 years ago had much higher testosterone levels on average than men today.

Aging is one factor that can increase your chances of having low testosterone since testosterone levels tend to decline with age (just like many things tend to decline with age) but we are seeing men at all ages having lower testosterone levels than we would expect (and want for optimal health).

Testosterone Declining More Than Expected – Travison et al.

In one study of 1,532 men in 2002, Travison et al. show a massive decline in Massachusetts’s men’s testosterone levels over the past 20 years that is not related to “normal” aging or other health and lifestyle factors that can effect testosterone levels.

We do know that environmental pollution can decrease testosterone levels and that the higher your testosterone levels the lower your risk of death by ALL causes.

In a study of 3,942 men, the risk of death by ANY cause was decreased in men with higher testosterone AND growth hormone (igf-1) levels. IGF-1 is one of the blood markers we use to evaluate growth hormone levels. So the higher your growth hormone and testosterone levels the longer you’ll live! (Steroids Journal, 2012)

HPA Axis for Testosterone Control in the Body

Environmental pollution is likely to increase as the world becomes more crowded and new chemicals are created with little understanding of their long-term consequences. The body has a complex system to control testosterone levels and this system can be affected many different ways.

What is aging?

Many doctors consider low testosterone part of “normal aging”, but what is aging? There are a number of factors that influence how we age, including nutrition, lifestyle, exercise, AND hormone levels. In women, menopause is very obvious. You’re menstruating and then you’re not menstruating.

After a woman goes through menopause many things change. Her risk of stroke increases. Her ability to become pregnant ceases. Her risk of osteoporosis increases along with increased risks for certain cancers. Thus, there is a very clear point in woman’s life when things shift and this can lead to many problems including divorce!

In women, we will get to men soon, before menopause there is a monthly cycle. During this monthly cycle hormones are increases and decreases as part of a monthly rhythm. Each hormone has many different effects in the female body. For example, estrogen rises during days 1-25 of a monthly cycle and estrogen helps to increase mental clarity. In addition, progesterone rises in the second half of the cycle and helps increase the feeling of mental calm. Thus, if certain hormones drop too low you get PMS.

So imagine what happens after menopause with almost NO estrogen and progesterone! This can lead to many different marital problems such as feeling more distanced, low libido, and feelings of being misunderstood. And I digress.

For MEN, there is something similar that happens as we age called andropause. Andropause is the male version of menopause but is much more insidious (happens slowly over time) and it can happen slowly enough that you only notice it after several years or someone else points out there you seem different. Some guys seem to hit a breaking point where their low testosterone level seems to catch up with them and they all of a sudden start having symptoms, such as erectile dysfunction.

Stress increases cortisol levels in the body. Cortisol is part of the “fight or flight” system and if cortisol remains elevated due to ongoing stressors this can further suppress testosterone levels. I have had a number of men come to our clinic that report their low testosterone symptoms started after a stressful event.

The grumpy old man syndrome is an example of how important adequate testosterone is for brain function. It is like PMS for men but it is ALL the time! Interestingly, the men in the movie “Grumpy Old Men” are chasing after a woman. The grumpy part is realistic but since most older men who are experience grumpiness as a result of low testosterone tend a have lower libidos.

Testosterone has an affect on brain function and low testosterone increases your risk of getting Alzheimer’s disease.

I have had a number of patients with low testosterone who say their libido is great but they have all the other symptoms of low testosterone. While it is certainly possible they have a “healthy” libido (sex drive) it very likely that their drive is less than when they were 25 years old. When you’re 25 years old your testosterone production is at its peak. The fact that the decline happens so slowly is part of why guys may notice the decline in their libido less. When I ask how their libido compares to when they were 25 years old the response is usually that it is now less. It is all relative.

The solution to fixing the problem of low testosterone in the individual is generally quite simple. We use a combination of medications that increase your natural production of testosterone while adding additional testosterone in the form of a cream or injection along with medication that reduces the conversion of testosterone to estrogen if needed. Most guys are unaware that they naturally produce a little estrogen. The only problem is when they produce too much.

This approach to testosterone therapy is used widely in Florida and Southern California at men’s health spas and tends to get the best results with the least amount of work required by the patient so they can focus on living their life to fullest and we take care of ensuring good results with the treatment.

The first year of treatment we typically do about 5 very comprehensive lab tests and after the first year we only need to do labs every 6 months for most patients. The cost of testosterone therapy is about $200 per month and is priceless for most men with low testosterone, which based on new research is most men over 35 years of age.

I personally have seen thousands of comprehensive hormone evaluations are we routinely order these tests for our patients in order to increase safety as well as benefits of the treatment. On our standard follow up labs for testosterone therapy we check about 30 different markers.

Nitric Oxide and its Effects on Erectile Performance

Decreased Nitric oxide production is one of the common causes of erectile dysfunction.  At the Innovative Men’s Clinic we offer powerful nitric oxide promoters such as L-Arginine.

Men are interested in the best ways to boost Nitric Oxide naturally, largely because they are marketed for male sexual performance enhancement and exercise performance enhancement. In fact, erectile dysfunction treatments like Viagra, Levitra, and Cialis work to help your nitric oxide stick around and accumulate in the penis to provide stronger erections!

Nitric Oxide – (NO) has many functions in the body but the focus of this article is nitric oxides’s function as a signaling molecule that relaxes the small muscles in our blood vessels, allowing increased blood flow through the vessel (in other words, NO is a vasodilator). In the case of the penis, when nitric oxide levels in the penis increase the penile blood also increases and can lead to an erection. Sexual arousal signals this release of nitric oxider. That should give you all some motivation!

For our bodies to produce nitric Oxide, various nutrients and precursors are necessary. This includes nitrates, which are found in many foods, particularly green, leafy vegetables. We also get nitric oxide from an enzyme called nitric oxide synthase (NOS), whose function is enhanced by adequate testosterone levels. This is where the supplement L-arginine comes in. L-arginine can be converted into nitric oxide by the enzyme, NOS. In the example we used earlier, arousal plus more L-arginine in the penis results in more nitric oxide in the penile blood vessels and subsequently better erections. Of course, arousal is also an important aspect of obtaining a satisfying erection (perhaps the most important) and that requires healthy testosterone and estrogen balance.

Testosterone plays a very important role in hundreds of bodily functions, and nitric oxide production is one of them. Testosterone helps maintain the health of blood vessels (decreased inflammation and atherosclerosis – in fact, low testosterone promotes hardening of the arteries), which allows more efficient nitric oxide production and release from the blood vessel walls and thus better vasodilation, blood flow, and in the case of the penis, a firmer erection. Arteries coated in atherosclerotic plaques can’t release nitric oxide very well at all.  As mentioned previously, testosterone also supports the NOS enzyme that produces nitric oxide.

Exercise is another major contributor to improving nitric oxice production. Nitric oxide is needed in all of our tissues that require extra oxygen during exercise, and thus exercise promotes and “exercises” the nitric oxide production systems. Of course, testosterone helps people feel like exercising, and it helps maximize the benefits of exercise, including nitric oxide production.

That all may be a bit more than what most guys want to know about nitric oxide and L-arginine, but there are many other reasons to promote nitric oxide production in your body. It is imperative to cardiovascular, muscular and brain function. You may have heard that the penis is a barometer for cardiovascular health, and this is absolutely true! Often, it is erectile problems that are the first sign of cardiovascular disease. Anything that improves true erectile health such as green a NO enhancing diet, hormone balancing, and exercise (I am not talking about pharmaceuticals here) will also improve cardiovascular health.

Beyond its function as a vasodilator, nitric oxide is also an important player in our immune system. It acts as a free radical oxidant to destroy viruses and bacteria and it triggers inflammation. You might have read about free radical oxidants and inflammation before. They are both normal parts of healing and fighting infection, but in certain circumstances they can become problematic. We need free radical oxidation and inflammation to heal after injuries and fight infections, but if the process gets out of hand it becomes uncomfortable and can lead to more serious illness.

As such, if you’re taking high doses of L-arginine you’ll likely benefit from better blood flow, better erections, and a better “pump” at the gym, but if you’re taking too much and you’ll cause oxidative stress. The best way to avoid this is to get enough dietary antioxidants to balance out the oxidative potential from nitric oxide. Nature has provided a simple solution to this problem by including high amounts of antioxidants in foods that are high in nitrates. L-arginine as a supplement is a modern invention and breaks this rule (lots of nitric oxide and no antioxidants). There is the risk that people who take L-arginine long-term can deplete the levels of the antioxidant component of the vitamin E family. The solution here is to add a good quality mixed vitamin E (mixed tocopherols) supplement to take alongside the L-Arginine.

This article is just the tip of the iceberg when it comes to nitric oxide. The doctors at Innovative Men’s Clinic© can provide a comprehensive plan for improving nitric oxide levels, but to make a long story short, the best way to boost nitric oxide naturally is to get lots of green, leafy vegetables, carrots, and beets in the your diet, plenty of exercise, and to obtain optimal testosterone levels that are in balance with other hormones. It makes sense that some guys have went out of their way and tried DIY for improving erectile dysfunction before seeing a doctor, since L-arginine can be a good erectile dysfunction – ED treatment for some mild cases. Testosterone is a very important player in the nitric oxide system, as well as hundreds of other bodily functions, but should be done under the strict supervision of a licensed physician.

“If you are of the 40% of men that experiences erectile dysfunction, or if you have been experiencing increased fatigue, weakness, decrease in muscle, or decreased mental clarity, then schedule an appointment and for only $99 you can speak with one a licensed physician to discuss the treatment option that is best for you. We look forward to treating you!”  Bellevue (425) 455-1700

Innovative Men’s Clinic©

The Causes of Low Testosterone, part one

The cause of low testosterone is an important question. This article is just a quick overview of some of the causes of low testosterone.

For example, a prolactin producing tumor in the brain can cause low testosterone. Certain medical conditions can mimic this tumor as well, such as low thyroid.

We check for elevated prolactin levels using a special lab test that uses blood to measure prolactin levels. We always look for the cause of low in testosterone in our patients.

These are other rare conditions that we are on the look out for such as neuroendocrine tumors and POEMS Syndrome. Low testosterone is often caused by other treatments such as pain medications and medications for high blood pressure. Always ask your doctor before changing any of your medications.

There are numerous ways to increase testosterone levels. In fact, just by reducing estradiol levels we can increase testosterone levels. Testosterone is the main source of estrogen in a man’s body. Testosterone converts to estrogen through the aromatase enzyme, which concentrates in fat cells. Men with blood sugar regulation problems are at increased risk of over-converting their testosterone to estrogen.1,2

The conversion of testosterone to estrogen tends to increase as men age and this happens as testosterone levels decline. Prostate cancer is more correlated with increases in estrogen than testosterone.3 Ever notice how men tend to get more sensitive as they get older? There are safer ways to get in touch with your feminine side.

Obesity tends to occur with insulin resistance and the aromatase enzyme concentrates in fat tissue. Obesity increases the risk of cardiovascular disease and erectile dysfunction. Obesity and insulin resistance can cause a downward spiral in a man’s health that can be difficult to reverse without medical treatment using a holistic approach.

Testosterone is essential for blood sugar regulation. Blood sugar regulation problems increase the conversion of testosterone to estrogen. The estrogen is part of a negative feedback loop in the hormone control center in the brain, the pituitary. Estrogen decreases the signal from the brain to the testicles, luteinizing hormone (LH), causing testosterone levels to decrease.

As your testosterone levels decrease muscle converts to fatty tissue and blood sugar regulation problems increase.4 As you can see, this is a downward spiral that is becoming an epidemic in this country. Not all men with obesity appear to have low testosterone but further studies are needed to better assess androgen deficiencies and obesity.

Pollution can cause low testosterone.5,6 There are numerous endocrine disrupting chemicals in our environment such as phthalates.7,8 A wide variety of consumer products, including cosmetics, personal-care products, children’s toys, food packaging, and cleaning and building materials are all known to contain phthalates. Phthalate products can be measured in your urine and help determine your exposure. Heavy metals can impair the enzymes involved in hormone synthesis and these can also be measured in urine.

Stress can cause low testosterone.9 I heard that ever since the September 11th, 2001 terrorist attacks stress levels in the United States have increased significantly. Stress increases the production of stress hormones such as cortisol. This can lead to a pregnenolone steal which takes away precursors from other hormones decreasing their production. Dihydroepiandrosterone (DHEA) is a major hormone precursor in our bodies and it is also an androgen. DHEA is produced in the adrenal glands and deficiency can lead to testosterone deficiency. Thus, supporting the adrenal gland health with nutritional supplements can be helpful.

I hope you found this quick overview helpful. Men with low testosterone need supervised treatment with an experienced physician. We can help you feel better quick and and help you determine the cause of your low testosterone.

Thanks to Dr. Conan Jones for his help writing this article.



  1. Male partial hypogonadotrophic hypogonadism with gynaecomastia and metabolic syndrome. J Coll Physicians Surg Pak. 2012 Feb;22(2):105-7. doi: 02.2012/JCPSP.105107.Ahsan T, Banu Z.
  2. Aromatase up-regulation, insulin and raised intracellular oestrogens in men, induce adiposity, metabolic syndrome and prostate disease, via aberrant ER-a and GPER signalling. Williams G. Mol Cell Endocrinol. 2012 Apr 4;351(2):269-78. doi: 10.1016/j.mce.2011.12.017. Epub 2012 Jan 5.
  3. Increased endogenous estrogen synthesis leads to the sequential induction of prostatic inflammation (prostatitis) and prostatic pre-malignancy. Ellem SJ, Wang H, Poutanen M, Risbridger GP. Am J Pathol. 2009 Sep;175(3):1187-99. doi: 10.2353/ajpath.2009.081107. Epub 2009 Aug 21.
  4. Cardiovascular risks of androgen deprivation therapy.Ribeiro AF, Camara C, Segre CA, Srougi M, Serrano CV Jr. Arq Bras Cardiol. 2010 Sep;95(3):412-5.
  5. Can endocrine disruptors influence neuroplasticity in the aging brain?Neurotoxicology. 2007 Sep;28(5):938-50. Epub 2007 Feb 4.
  6. Endocrine-Disrupting Chemicals: Associated Disorders and Mechanisms of Action Sam De Coster and Nicolas van Larebeke* Environ Public Health. 2012; 2012: 713696. Published online 2012 September 6. doi: 10.1155/2012/713696 PMCID: PMC3443608
  7. Phthalate excretion pattern and testicular function: a study of 881 healthy Danish men. Joensen UN, Frederiksen H, Jensen MB, Lauritsen MP, Olesen IA, Lassen TH, Andersson AM, Jørgensen N. Environ Health Perspect. 2012 Oct;120(10):1397-403. doi: 10.1289/ehp.1205113. Epub 2012 Jul 23.
  8. Cumulative risk assessment of phthalate exposure of Danish children and adolescents using the hazard index approach. Søeborg T, Frederiksen H, Andersson AM. Int J Androl. 2012 Jun;35(3):245-52. doi: 10.1111/j.1365-2605.2011.01240.x. Epub 2012 Feb 9.
  9. Psychological stress and the function of male gonads. Józków P, Medras M. Endokrynol Pol. 2012;63(1):44-9.

The Benefits of magnesium

Magnesium (Mg) deficiency is a big problem in the United States. Likely due to poor farming practices and erosion, the food we eat has become depleted in magnesium.1

There are epidemic rates of high blood pressure in the United States and the fact that magnesium helps relax blood vessels make magnesium a very important mineral.

Imagine how many fatal heart attacks and other diseases could be delayed or prevented with this simple and inexpensive mineral. The problem is that when you take it as a supplement it is likely to cause more loose stools and even diarrhea.

“Aging is very often associated with Mg inadequacy and with increased incidence of many chronic diseases, with muscle loss and sarcopenia, altered immune responses, and vascular and metabolic conditions, such as atherosclerosis, diabetes and the cardiometabolic syndrome. The most common cause of Mg deficit in the elderly population is dietary Mg deficiency, although secondary Mg deficit in aging may also results from many different mechanisms.”2

Magnesium & prostate cancer

Prostate cancer risk increases as men age and research has shown that magnesium levels effect prostate cancer risks. A 2011 study, conducted at Vanderbilt University Medical Center, concluded that, “Low blood Mg levels and a high Ca/Mg ratio were significantly associated with high-grade prostate cancer. These findings suggest Mg affects prostate cancer risk perhaps through interacting with Ca.”3

Acid Reflux & Magnesium

Proton pump inhibitors (PPI) have been linked to decreased magnesium. If you take a drug that decreases your stomach acid production then you will have less acid in your stomach to digest your food. In some cases, acid reflux is actually caused by low stomach acid in the stomach. Yes! If you produce too little stomach acid it can actually cause the sphincter muscle that prevents acid reflux to weaken.

A 2009 review published in The Netherlands Journal of Medicine found that, “While awaiting additional studies, we suggest that magnesium loss in proton-pump inhibitor users should be considered in the differential diagnosis of hypo-magnesaemia of any age. This newly recognized side effect may not even be extremely rare once prescribers become aware of its existence.”4 Meaning, most doctors are totally unaware that low magnesium can be caused be anti-acid reflux treatments.

Magnesium at the hospital

One in ten people in the hospital have low magnesium levels in their bodies and there is no easy lab test for low magnesium. “Magnesium deficiency is a common problem in hospital patients, with a prevalence of about 10%. There are no readily available and easy methods to assess magnesium status.”5 Magnesium use in hospitals is rare despite the evidence for its need.

Lab testing for low magnesium

Measuring magnesium in the blood can be helpful but may tell little about how much magnesium is being transported into the cells. Some people appear to have a problem where there cells don’t transport magnesium into the inner cell space optimally.

Researchers at the Kidney Research Centre (University of Ottawa), agree that, “Much research is still needed to clarify the exact mechanisms of Mg(2+) regulation in the cardiovascular system and the implications of aberrant transcellular Mg(2+) transport in the pathogenesis of cardiovascular disease.”6 Meaning, some people are unable to transport magnesium into their cells effectively.

Magnesium IV after a stroke

In a recent study, published this year in the journal of Clinical Neurology and Neurosurgery, researchers founds that magnesium given by IV after stroke improved the outcome. “Patients receiving MgSO(4) showed significant recovery compared with the group of patients receiving placebo.”7

Magnesium may prolong life

In another 2012 article, published in Clinical Interventions In Aging, “The International Space Station provides an extraordinary facility to study the accelerated aging process in microgravity, which could be triggered by significant reductions in magnesium (Mg) ion levels with, in turn, elevations of catecholamines and vicious cycles between the two.”8

“With space flight there are significant reductions of serum Mg (P < 0.0001) that have been shown in large studies of astronauts and cosmonauts. The loss of the functional capacity of the cardiovascular system with space flight is over ten times faster than the course of aging on Earth. Mg is an antioxidant and calcium blocker and in space there is oxidative stress, insulin resistance, and inflammatory conditions with evidence in experimental animals of significant endothelial injuries and damage to mitochondria.”

The author, William J. Rowe, MD, concludes, “The aging process is associated with progressive shortening of telomeres, repetitive DNA sequences, and proteins that cap and protect the ends of chromosomes. Telomerase can elongate pre-existing telomeres to maintain length and chromosome stability. Low telomerase triggers increased catecholamines while the sensitivity of telomere synthesis to Mg ions is primarily seen for the longer elongation products.”

“Mg stabilizes DNA and promotes DNA replication and transcription, whereas low Mg might accelerate cellular senescence by reducing DNA stability, protein synthesis, and function of mitochondria. Telomerase, in binding to short DNAs, is Mg dependent. On Earth, in humans, a year might be required to detect changes in telomeres, but in space there is a predictably much shorter duration required for detection, which is therefore more reasonable in time and cost. Before and after a space mission, telomere lengths and telomerase enzyme activity can be determined and compared with age-matched control rats on Earth. The effect of Mg supplementation, both on maintaining telomere length and extending the life span, can be evaluated. Similar studies in astronauts would be fruitful.”



  1. Evidence of decreasing mineral density in wheat grain over the last 160 years. Fan MS, Zhao FJ, Fairweather-Tait SJ, Poulton PR, Dunham SJ, McGrath SP. J Trace Elem Med Biol. 2008;22(4):315-24. Epub 2008 Sep 17.
  2. Magnesium and aging. Barbagallo M, Dominguez LJ. Curr Pharm Des. 2010;16(7):832-9.
  3. Blood magnesium, and the interaction with calcium, on the risk of high-grade prostate cancer. Dai Q, Motley SS, Smith JA Jr, Concepcion R, Barocas D, Byerly S, Fowke JH. PLoS One. 2011 Apr 25;6(4):e18237.
  4. Hypomagnesaemia due to use of proton pump inhibitors – a review. M.T. Kuipers, H.D. Thang, A.B. Arntzenius. Neth J Med. 2009 May;67(5):169-72.
  5. Magnesium metabolism and its disorders. Swaminathan R. Clin Biochem Rev. 2003 May;24(2):47-66.
  6. Vascular Biology of Magnesium: Implications in Cardiovascular Disease. Tayze T. Antunes Ph.D., Glaucia Callera Ph.D., Rhian M. Touyz M.D., Ph.D. Magnesium in Human Health and Disease. Nutrition and Health 2013, pp 205-220
  7. Evaluation of the intravenous magnesium sulfate effect in clinical improvement of patients with acute ischemic stroke. Afshari D, Moradian N, Rezaei M. Clin Neurol Neurosurg. 2012 Jun 30. [Epub ahead of print]
  8. Correcting magnesium deficiencies may prolong life. Rowe WJ. Clin Interv Aging. 2012;7:51-4. Epub 2012 Feb 16.