Natural Sildenafil & Testosterone Alternatives: Pedalium Murex & Paederia Foetida +150% Testosterone and +200% Erectile Function. Plus: Icariin, Aromatase & Stronger Bones. Probiotics, Phytosterols & Thyroid Activity.

If the Aliens have seen these Bugarash apocalypse pilgrims, they have probably turned tail and fled ;-)

I guess the SuppVersity figure of the week was a date "12/21/2012", I mean this is a once in a life-time event! Or do you really believe there will be another chance for mankind to be snatched from the jaws of extinction?

Ok, enough of the sarcasm, the world is still there and the SuppVersity is still operating, so let's get to the not so short On Short Notice items for today.

If there had been more room in the headline I would probably have labeled it "Endocrine Special" and I guess once you have gone through the posts, you will agree that this would certainly have made sense.

• Traditional treatment of osteopenia with Epimedium brevicornum works, 'cause it's a potent aromatase promoter (Yang. 2012) -- When a group of researchers from the Chengdu Institute of Biology, Chinese Academy of Sciences and the School of Chinese Pharmacy, Chengdu University of Traditional Chinese Medicine in Chengdu, China, set out to investigate the mechanism behind the anti-osteoporotic effects of the dried leave extract from Epimedium brevicornum, they already suspected that it would probably be related to some sort of endocrine modulation.
  
  

  

  Figure 1: In vitro effect of Forskolin and Icariin on aromatase expression in KGN cells (Yang. 2012)

  With estrogen deficiency being the major cause of osteoporosis, a disease which does by the way affect over 200 million people worldwide (Riggs. 1998), being their the most likely mechanism behind the bone building and bone mineral density (BMD) protective effects, it was obvious to study, whether there was some sort of interaction between the extract and the data in figure 1 shows that Yang et al. were right to do so (note: the cell line used in the study was a KGN granulosa cell that's closely associated with the developing female oocyte, so effects could vary from one tissue to the other)
  
  Now all that certainly sounds as if this was bad stuff no sane male human being should be taking. Luckily, for many of you, my fellow men, who may have been exposed to Epimidium / Icariin from various supplements, this is not the case. Why? Simply because estrogen is not the enemy and Epimidium has not only been found to have anti-aging effects (whole extracts; Yan. 2009), it also prevents neurotoxicity from beta-amyloid plague the key feature of Alzheimer's and similar diseases (Zeng. 2010; listen to Thursday's Science Round-Up for other amyloid beta inhibitors / protectant's) and the neurotoxic effects of excess corticosteroids (Liu. 2011). In addition, Epimidium pubescen flavenoids have been shown to reverse the negative effects even passive exposure to cigarette smoke may have on the bone mineral density of male rats (Gao. 2012) and Icariin the common denominator in all of the members of the Epimidium family exerts direct proliferative and thus pro-fertility effects on the sertoli cells in male rodents (Nan. 2012).
  
  

  

  Table 1: Analysis of Chinese Epimidium species (MDida. 2010)

  Ah, and last but not least the beneficial effect Horny Goat Weed (likewise one of the members of the Epimidium family) has on male libido are likely partly a result of the increased aromatase activity, as well. If it works for you, your estrogen levels are probably pretty low to begin with (this reasoning is based on the profound beneficial effects of estrogen on male libido in men expressing little to no aromatase enzyme; Carani. 1999).

• Pedalium murex Linn. fruits may not be as potent acute libido and erectile performance enhancers as sildenafil, but the effects accumulate and persist just as its unique testosterone boosting effects (Sharma. 2012) -- In case taking a potential proestrogenic compound like Horny Goat is nothing you feel would do anything good for your libido, you may want to use some Pedalium murex Linn. in traditional Indian medicinea herb that has been used in traditional Indian medicine for centuries to treat male sexual dysfunction and impotency.
  

  

  Figure 2: Effects of different doses of an ethanolic extract from Pedalium murex (P.m.) and Sildenafil citrate (5mgkg) on penile erection scores and post ejaculatory interval (time it takes to be able to have sex again) exrpessed relative to saline treated control (based on Sharma. 2012)

  As the data in figure 2 shows, its effects on erectile performance are slightly less pronounced than those of sildenafil citrate, but at an appropriate dosage and after some time, it will probably do its job sufficiently for most men with respective problems. What's really exiting though, is that the data in figure 3 clearly shows that it does so not by simple nitric oxide effects (P. murex at 10 mg/
  ml exhibited a relative nitric oxide release of 15.3 mM as compared to a nitric oxide release of 39.3472.7 mM with sildenafil citrate), but probably (also) by boosting testosterone levels. 
  
  

  

  Figure 3: Serum testosterone levels during and after Pedalium murex or Sildenafil citrate administration expressed relative to saline control (Sharma. 2012)

  Since the testosterone levels remained elevated for 14 days after the treatment was seized these observations make P. murex a potential candidate for the next best natty test booster.to be powered by advertisement lines like "up to 125% increase in testosterone that last for more than 2 weeks" even when you take some time off. I guess, the only serious downside here is the close relation of P. murex to the notoriously useless Tribulus, which does also contain furostanol glycosides. Luckily Magnle and Jolley found another potentially active ingredient in P. murex fruit. The compound goes by the name diosgenin and appears to be a direct precursor for the synthesis of sex hormones including testosterone (Mangle. 1998).
  
  Since I don't think you will have to wait very long until the first major players in the supplement business will jump on this bandwagon - you know that a single rodent study is enough to make fortune until people realize that this stuff does not work, at all - you will probably soon be able to test it on yourself. In case you intend to do that, you should certainly look for a standardized ethanolic extract with ~20%+ of diosgenin (that was the content of the extract Sharma et al. used) and a serving size of 16.2mg/kg per body weight, the HED of the 100mg/kg group (that would be 1,300mg /day of the extract for an 80kg adult).

• Paederia foetida Linn. (P. foetida) yet another Indian libido and testosterone boosting herb (Soni. 2012) -- If you like the appeal of exclusiveness a climbing plant found in the Central and Eastern Himalayas, at elevations of up to 5000 ft, you may prefer the an ethanol extract of Paederia foetida Linn. (P. foetida) leaves over the previously discussed Pedalium murex fruit extract.
  
  

  

  Figure 4: Penile erection index and testosterone levels of rats after 15 and 28 days on P. foetida, data expressed relative to saline control (Soni. 2012)

  According to a recent study from the same group of Indian scientists (yet a different lead author), the effects of P. foetida and P. murex are in fact virtually identical. While the general protocol was very similar (in this done on rat, not mice) the positive control was not Sildenafil citrate, as in the previously mentioned experiment, but an intramuscular injection of 0.5 mg/kg body weight of testosterone suspension in arachis oil twice a week. It's actually a pity the scientists didn't measure the actual testosterone levels in the animals in the testosterone group. I would be curious how the 2.5x increase in the high dose group (200mg/kg, human equivalent ~2,600mg/day) would compare. When it comes to the erection quality, it did at least easily top the results of injectable testosterone (see figure 4), which is yet allegedly not the best erection booster, anyway. And if we went by the data on body weight and the weight of the testes, seminal vesicles, prostate glands and epididymis, it even appears to be more anabolic than testosterone; after all the body weight gain in the PF groups were 15%. 23% and 34% higher than in the control group and comparable if not higher to those that were induced by testosterone (+29%).
  
  And for all the supplement producers and fans of stacks it may be important to know that the leaves of P. foetida, which is also used as carminative, antiinflammatory, astringent, spasmolytic, antidiarrhoeal, diuretic and antilithic do contain a whole host of well- and lesser known compounds, e.g. iridoid glycosides, sitosterol, stigmasterol, campesterol, ursolic acid, hentriacontane, hentriacontanol, ceryl alcohol, palmitic acid and methyl mercaptan, but no diosgenin. So Ayurvedabol (TM) or whatever name ending on -bol, -drol or -ripp-off has not been used by the creepy competition, already, could benefit from having both Paederia foetida and Pedalium murex in it ;-)

• Combination of probiotics and phytosterols ramps up thyroid function and (re-)establishes a healthy lipid profile (Awaisheh. 2012) -- While I could offer you a minimum of two additional libido enhancing, potentially pro-anabolic testosterone booster, I know that not all of you are into these products (am I right ladies?), so I thought it prudent to close this installment of On Short Notice with a study on thyroid metabolism, which could be is of interested for all of you.
  
  
  Which phytosterols are there and where can I find them? The major phytosterols in the human diet are sitosterol (high in nuts, amaranth, avocados, grape leaves), stigmasterol (high in coriander, chocolate and soy), campesterol (high in various vegetable oils, spec. conola / rapeseed) and brassicasterol (high in cabbage, broccoli, other brassica, but also coriander, seafood and rapeseed oil).
  Contrary to some previous studies and anecdotal reports on the Internet, a recent paper by scientists from the Department of Food Science at the Al-Balqa Applied University, in Salt, Jordan, suggest that phytosterols don't have thyroid inhibiting, but promoting effects.
  
  In their latest study Awaisheh et al. investigated the effects of a probiotic stack containing two strains of each of Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus gasseri, and Lactobacillus reuteri and a phytosterol supplement on the lipid metabolism in rodents. Their results show that the addition of the phytosterol supplement promoted the already pronounced effects the probiotics had on the hypercholesterolemia of the rodents who were fed with a high-fat-high-cholesterol basal diet for 8 weeks. In addition, the phytosterols, yet not the probiotics alone, elevated the levels of serum total thyroxine (TT4), total triiodothyronine (TT3), and free triiodothyronin (fT3), which could have exerted additional benefits on the non-measured triglyceride levels.
  
  These results do actually come as a surprise and I would like to see more research - specifically in human trials - before I would buy products from producers who seize the scientists suggestion that this renders probiotics and phytosterols potential candidates for "functional foods" - I mean, let's be honest ever since the first "functional foods" hit the market people have been getting sicker: Do you really believe that's because they don't eat the "good" cholesterol lowering margarine instead of their beloved Kerrygold butter? I don't think so.

That's it for today.. well, aside from the promise to include the other testosterone and libido boosting herb studies in another SuppVersity post and a selection of the latest  SuppVersity Facebook News, of course:

• Iron deficiency makes H Pylori go on a rampage - Iron deficiency enhances H. pylori virulence and increases risk of gastric cancer (read more)
• Danish folk medicine for depression? Not really, but there are a couple of promising natural MAO-A inhibitors the Danes have been using for centuries (read more)
• Strength training equally heart healthy as aerobics - 6-weeks of strength training show particular beneficial effects in African American men (read more)

Since I it's still pretty early and I am certainly not going to the city, before the shops close and all the people who believed they wouldn't need Christmas presents this year, since the world would *put whatever apocalyptic catastrophe you like here*, have gone home, I may be adding some more news later. Until then, I hope you have some fun with what's already there and are looking forward for the 2nd installment of the "Making HIIT a Hit" series that will be published tomorrow.

References:

• Awaisheh SS, Khalifeh MS, Al-Ruwaili MA, Khalil OM, Al-Ameri OH, Al-Groom R. Effect of supplementation of probiotics and phytosterols alone or in combination on serum and hepatic lipid profiles and thyroid hormones of hypercholesterolemic rats. J Dairy Sci. 2012 Nov 22.
• Carani C, Rochira V, Faustini-Fustini M, Balestrieri A, Granata AR. Role of oestrogen in male sexual behaviour: insights from the natural model of aromatase deficiency. Clin Endocrinol (Oxf). 1999 Oct;51(4):517-24.
• Gao SG, Liu H, Li KH, Liu WH, Xu M, Jiang W, Wei LC, Zhang FJ, Tian J, Xiao WF, Yang Y, Song Y, Lei GH. Effect of Epimedium pubescen flavonoid on bone mineral density and biomechanical properties of femoral distal end and femoral diaphysis of passively smoking male rats. J Orthop Sci. 2012 May;17(3):281-8.
• Liu B, Zhang H, Xu C, Yang G, Tao J, Huang J, Wu J, Duan X, Cao Y, Dong J. Neuroprotective effects of icariin on corticosterone-induced apoptosis in primary cultured rat hippocampal neurons. Brain Res. 2011 Feb 23;1375:59-67. 
• Mangle MS, Jolley CI. HPTLC studies on Tribulus terrestris (Chota ghokru) and Pedalium murex (Bada ghokru). Indian Drugs. 1998; 35:189–194.
• MDidea Extracts Professional. Horny Goat Weed or Epimedium Herb: Botanical Origin, Archeology, Traditional and Pharmacological findings of Epimedium species, fractions and isolated components. 08th, Oct. 2010. < http://www.mdidea.net/products/herbextract/icariin/data10.html > retrieved on 12/21/2012. 
• Nan Y, Zhang X, Yang G, Xie J, Lu Z, Wang W, Ni X, Cao X, Ma J, Wang Z. Icariin stimulates the proliferation of rat Sertoli cells in an ERK1/2-dependent manner in vitro. Andrologia. 2012 Nov 7.
• Riggs BL, Khosla S, Melton LJ 3rd. A unitary model for involutional osteoporosis: estrogen deficiency causes both type I and type II osteoporosis in postmenopausal women and contributes to bone loss in aging men. J Bone Miner Res. 1998 May;13(5):763-73. 
• Sharma V, Thakur M, Dixit VK. A comparative study of ethanolic extracts of Pedalium murex Linn. fruits and sildenafil citrate on sexual behaviors and serum testosterone level in male rats during and after treatment. J Ethnopharmacol. 2012 Aug 30;143(1):201-6.
• Soni DK, Sharma V, Chauhan NS, Dixit VK. Effect of ethanolic extract of Paederia foetida Linn. leaves on sexual behavior and spermatogenesis in male rats
• Yan S, Wu B, Lin Z, Jin H, Huang J, Yang Y, Zhang X, Shen Z, Zhang W. Metabonomic characterization of aging and investigation on the anti-aging effects of total flavones of Epimedium. Mol Biosyst. 2009 Oct;5(10):1204-13.
• Zeng KW, Ko H, Yang HO, Wang XM. Icariin attenuates β-amyloid-induced neurotoxicity by inhibition of tau protein hyperphosphorylation in PC12 cells. Neuropharmacology. 2010 Nov;59(6):542-50.

Adelfo Cerame - Road to The Wheelchair Nationals '12: Eggs, Chocolate Milk and Wheelchair Bodybuilding

Image 1: It's just a Halloween costume, but one that is absolutely fitting - in every sense.

I am honestly not sure on what note to introduce this week's installment of Adelfo's increasingly popular contest prep log - a funny or rather a dead serious one? I mean, even in the introduction to his very first post I have pointed out how inspiring not only his work ethic, but also his whole constructive attitude is. I mean look at him in his Halloween costume, what may look somewhat hilarious at first sight, is in fact dead serious (and you will realize that at least after reading the current installment of the contest prep series) - if you asked me, I would not be able to name someone else who would be more suited for the role of Thor, the hammer-wielding god associated with thunder, lightning, storms, oak trees, strength and the protection of mankind... and the fact that my Thor is sitting in a wheelchair, does just add to the freaky awesomeness of someone, I am proud to be call a friend.

Short-Term Protein Shortage and Other Obstacles

Wow it’s already November, Thor is back from Valhalla (cf. image 1) and the second months of my contest preperation for the 2012 Wheelchair Nationals begins. Things have gone quite well so Contrary to what you would expect, my strength and performance been increasing - I have been increasing my lifts by 5-10 pounds every week. The switch to escalating density training (cf. "Things Start to Escalate") is already paying off. I am getting stronger which each cycle - each week, a rep or two or a few pounds more on all major moves. 

Video 1: Click on the image to view Adelfo pump out an intense biceps + triceps EDT cycle (video by Adelfo Cerame, 2011)

EDT - a strong argument against superfluous body fat

While my strength is exploding, my waist is doing the exact opposite: It seems like I’m leaning out real fast - current waist circumference 30". Jeans which usually only fit, when I was way more into previous contest preps fit like a glove - now, more than 3 months out! I know that this would scare the hell out of many of my "colleagues" who would probably be afraid that they were losing too much muscle, but form me, it's a good thing. I don't feel that my arms, chest or back got flat (quite the opposite) and with Thanksgiving and Christmas just around the corner, being leaner will actually benefit me when I use those holidays for my designated cheat/carb load days. It’s always fun to have cheat and re-feed days when you’re lean and mean, because you can feel and moreover see (at least when you are back at the gym) how those carbs replenish your muscle ... but I’ll talk more on that on another segment when I do get leaner and actually start carb loading again.

A note by Dr. Andro: It is when you are "lean and mean", as Adelfo artistically put it, when you benefit (and even need) refeeds the most. With your insulin sensitivity maxed out and your adipose tissues almost empty, little aromatase converting your valuable testosterone into estrogen etc. this is the best time for an intermittent (high carb) overfeed that will set the anti-catabolic + protein synthetic machinery into overdrive and convince your body that he can, with a clear conscious, spend those last few triglycerides he has still held back for "the real bad times" in the course of your next intermittent fasts ;-)

Thor is back in the gym - not doing Hammer curls, though ;-)

Since pictures, and even more videos, usually say more than a thousand words and because I suppose that you are curious what exactly I am doing at the gym that produces these outstanding changes, I shot another video tonight (cf. video 1). It's a biceps + triceps EDT block [comment Dr. Andro: You can find the best exercises for biceps, triceps and all other body parts in the SuppVersity EMG Series]. The same fundamental concept as with the other body parts: You have 20 minutes, in the course of which you have to complete as many cycles of two given exercises as you can. Personally, I usually do 2-3 EDT block exercises every training session; and mostly, I end my workouts on a biceps and triceps block… well, you know, this is just my favorite ;-)

The calorie spiral starts turning

As I mentioned last week, this is going to be my first week with a slight caloric deficit. For the first month I stayed within my caloric maintenance just to see if my body would lean out or make any improvements. This month I’m going to drop down to 1900 calories/day, which would equal a 350 kcal deficit, which isn’t that much but things are going to well, currently that anything more than that would be plainout stupid. After all, I have repeatedly hinted at the advantage of being able to gradually drop your calories, whenever it becomes necessary in my previous blogposts... my whole contest prep is built around this idea - start early lean down gradually, but consistently and avoid the flattening crash at the end of the prep that cost so many aspiring bodybuilders their procard.

Recipe of the Week: Yet to be named Porky Potato Post Workout Meal: As you see, I have not forgotten last week's promise to have a recipe of the week in each and every of the upcoming installments of my contest prep log. This week's recipe is actually so brand new that I have yet to come up with a catchy name for it. It's easy to prepare and for me it is a post workout meal.

Image 2: Yet to be named Porky Potato Post Workout Meal

Ingredients:

• 2 lean pork loin chops (about 4 oz each)
• 4 oz sweet potato
• 6 baby carrots
• ½ cup cottage cheese
• 1 medium banana (about 3 oz)
• 1 tbs. honey

Macros: 48g protein/ 65g carbs/ 17g fat

A quick tip: Pork is naturally salty, so I don’t even season it with salt; I just use garlic, pepper and spices. And the banana and honey over the cottage cheese makes for a great dessert after the meal!

When you drastically cut calories, be that at the beginning or the end of your prep, this is like... juicing, when you are still a complete beginner... or like premature ejaculation, if you like that comparison, better. Drop your calories too low and you are done. There is nothing you can do anymore, when your body stops responding. So I'm going to drop as much body fat as I can with my 1900 calories and when I realize I'm hitting a wall, it will be time to drop down to 1800. And so on…

"If being able to buy a month worth supply of eggs for $25 ain't an argument for not investing another $60 into protein powder, what then? "

What is every bodybuilder's worst nightmare? Correct! Running out of protein. And guess what happened to me this very week? Correct! I ran out of protein. And since I don’t get paid till’ this Friday, this wasn't going to change for the rest of the week. I usually use protein to fortify my foods and include it as a drink with my whole food meals to help me reach my daily macros for protein. As I was browsing around through my local grocery store thinking about what other sources of protein I could possibly use - one that has a decent amino acid profile and is yet economical and won't turn me into an eunuch (so no soy, obviously ;-), my eyes fell on a five dozen eggs (for all mathematical geniuses out there, five dozen = 5x12 = 60) for $8 and some change! What better way to get your protein than from eggs? So instead of using a protein shake, I just popped a couple of these bad boys throughout my feeding hours to help me reach my macros for protein (I just take out the yolk if I would be missing my fat macros, otherwise)… that did actually work so well, that I am considering to to this in the future, as well. After all, the 5-dozen eggs lasted a little over a week.

Image 3: 5 dozen eggs for $8? And a gallon of chocolate milk for $4? Bodybuilder what else can you ask for? The protein supplements will have to take a back seat, for now.

I also started using low fat chocolate milk as my post workout shake (low fat, to avoid the slowing effect of the fat on protein & carb digestion). I was reading an article that Dr. Andro posted a while back (cf. table 2) about how chocolate milk was just as good a PWO shake as any other, so I figured" why not?" - I ran out of protein anyway.

And since we’re on the topic of budgeting and being economical, I decided to cut most of the raw meats out of my diet and stick to conventional cuts for the majority of my prep. In order to eat raw, the sources have to be the best quality such as grass-fed or cage-free, and along with quality (unfortunately) comes an expensive price. To me, who was not born with a silver spoon in his mouth, it just makes sense to spend $7 on 7 pieces of chicken breast, rather than $7 on 1 piece of grass-fed NY steak. I will still do raw milk and cheeses (and raw eggs from time to time) though. Fortunately, the place where I get my raw milk and cheeses hooks me up. And in case you are now thinking to yourselves: "Man that goes completely against his quality over quantity mantra", let me tell you this: Yes, I am downgrading the quality of my meats, but I still eat whole “nutrient dense” foods, I train everyday, and keep my calories and macronutrients in check, and right now that’s all that matters.

Competitive Wheelchair Bodybuilding

Image 4: Jason Greer took 2nd at the 1st 2011 IFBB Pro Wheelchair Championchips. Be honest, guys. If there is anything freaky about Jason, that it is his freakin' awesome physique and I am happy that RX Muscle covered the show pretty extensively and would love to see Dave Palumbo and the rest of the team vocer the NPC Wheelchair Nationals, as well (note: this is my = Dr. Andro's comment).

Now let's get to a much less depressing topic: Wheelchair Bodybuilding! For those of you that may not know, there is a small and growing community of bodybuilders that are in wheelchairs. We train and diet just as hard as our able body counter parts... well, I guess minus the legs ;-). We don’t roll on stage for pity claps, most of us train and diet hard and put our bodies through the grind of training and dieting year round. We look at ourselves as serious athletes in a sport we love to compete in.

The disabilities of the competitors range from multiple sclerosis over cerebral palsy, spina bifida to spinal cord injuries such as paraplegics and quadriplegics. The type of disability and level of injury eventually determine wheelchair bodybuilder's mobility and function: For wheelchair bodybuilders, who were injured above the waistline, for example, it is particularly hard to build their abdominal muscles. Other wheelchair bodybuilders have limited function on all four limbs, so they have to work twice as hard just to train and build muscle. Some can do certain exercises, others can’t. It just all depends on the disability and injury level. For those of who want to know more about us, I've compiled a few links:

• Biographic information on many of the currently competing wheelchair bodybuilders
• Weelchair Bodybuilding on Facebook
• Natural Wheelchair Bodybuilding on Facebook

For those of you that may be reading this and are in chairs and curious about competing or those of you who are interested in going to a show, here are the three major wheelchair bodybuilding competitions I know of...

• the NPC Wheelchair Nationals in Florida - taking place every march,
• the NPC USA’s in New Orleans - taking place in June, and
• the INBF Natural Buckeye in Ohio, which just started a wheelchair division last year. 

There are other shows and organizations that have wheelchair classes, but most of the time the competition is slim or - even worse ! - competition is just you against yourself and that’s no fun! In my first competition I was the only competitor and I hated the fact that I took first place by default! Lol. I’d rather lose to someone than take a 1st place trophy because I was the only competitor... but hey you know, neither of this is going to happen at the Nationals in Florida and if you want to know why, come back next week ;-)

T-Gel with or Without an Aromatase Inhibitor? If You Are Healthy & Lean and Want to Stay This Way, There is Only One Answer: T-Gel Without Aromatase Inhibitor!

Don't let her talk you into participating in studies that risk your manliness ;-)

Would you be willing to participate in a study, where you could end up without testosterone? No? Well me neither... strangely Joel S. Finkelstein et al. were able to find 198 healthy men between 20 and 50 years who were stupid enough to participate in an experiment, where they were randomized to placebo, or testosterone gel (1.25, 2.5, 5, or 10g per day) while being on gosererelin acetate, which did suppress their natural testosterone production.

With additional 202 subjects receiving an identical "treatment", but in this case alongside a whoppy dose of the aromatase inhibitor anastrazol as a bonus, the study design leaves us with plenty of groups and tons of subjects. To "determine the relative degree of testosterone deficiency, estradiol defi­ciency, or both at which undesirable changes in body composition, strength, and sexual function begin to occur." (Finkelstein 2013)

Yep, that is the study you don't not want to be part of, but....

I bet you will still be interested in the results. Am I right? Ok, let's see then. In men receiving goserelin acetate (kills the natural testosterone production) and 0 g (pla­cebo), 1.25 g, 2.5 g, 5 g, or 10 g of testosterone gel daily (cohort 1), the mean testosterone levels were

• 0g testosterone: 44±13 ng per deciliter, 
• 1.25g testosterone: 191±78 ng per deci­liter
• 2.5g testosterone: 337±173 ng per deciliter, 
• 5g testosterone 470±201 ng per, and
• 10g testosterone 805±355 ng per deciliter

With 1.4 pg per milliliter, 7.9±2.9 pg per mil­liliter, 11.9±5.7 pg per milliliter, 18.2±10.2 pg per milliliter, and 33.3±15.3 pg per milliliter the estrogen levels of all participants were all well within the normal range (<55pg/ml).

Update: As Dr. Crisler (www.allthingsmale.com) just told me the accuracy of the information about estrogen may be questionable, because the essay the scientists used is not reliable in adult men. Instead, he suggest you use a "sensitive" essay like LabCorp (#500108), which uses the "cutting edge" LC/MS technology, Mayo Clinic's "Enhanced Estradiol" (#81816) or LabCorp's "Sensitive Estradiol (#140244), which is less expensive and thus probably a good choice for those without insurance. Dr. Crisler also pointed out that the wide variations you see in T-levels are actually a "very good thing, since this more closely mimics the serum profile of young healthy men". I do not deny that, but I still thought that it was wise to point out that the difference between 805ng/dl and 924ng/dl is absolutely non-significant when you have a range of ±521ng/dl.

Now the latter was obviously true for the guys on the aromatase inhibitor as well, with 1-2pg/ml their levels were however pathologically low and considering the high standard deviations, their T-levels were not that much higher:

Figure 1: Testosterone (ng/dl) and estrogen (pg/ml x10) in healthy men on 0, 1.25, 2.5, 5 and 10g (T0-T10) of testosterone gel with and without an additional aromatase inhibitor (Finkelstein. 2013)

"In men who also received anastrozole (cohort 2), the corresponding mean testosterone levels were 41±13 ng per deciliter, 231±171 ng per deciliter, 367±248 ng per deciliter, 485±240 ng per deci­liter, and 924±521 ng per deciliter and the corresponding mean estradiol levels were 1.0±0.4 pg per milliliter, 1.2±0.4 pg per milliliter, 2.0±2.3 pg per milliliter, 2.1±1.9 pg per millili­ter, and 2.8±1.8 pg per milliliter." (Finkelstein 2003)

[*please note the high (up to 50%!) standard deviations which tell you that the response to transdermal testosterone may vary profoundly from one men to another]

If you take a closer look at the data in Figure 1 and keep in mind that I had to multiply the estrogen levels by x10 in order to fit them into the same graph, it becomes all the more evident that the men in the non-AI group all had normal (<55pg/ml) estrogen levels. Their peers in the anastrazole group, on the other hand, had basically no estrogen at all and correspondingly high testosterone to estrogen ratios. In the worst case (yep, that is something bad!), namely 10g of t-gel + A,I the latter was as high as 335, which is almost 12x higher than in the 2.5g testosterone group without anastrazole (cohort 1).

No T, but tons of body fat

Apropos, cohort 1, in this group of men those who received the anti-androgen goserelin alongside a low(ish) doses of T-gel, i.e. either 0 g, 1.25 g, or 2.5 g of testosterone, daily, had significantly higher body fat levels and those in the 0 and 1.25g of T-gel significantly lower levels of lean mass compared to their peers in the 5g T-gel per day group.

Just a reminder: The testosterone level of the guys in the 5g group was only 470ng/dl and thus still rock bottom - the age adjusted normal levels for men are after all (I highlighted the group, where most of the subjects were in):

• 

  Effects of high and low testosterone on body composition (learn more)

  14-15 yr: 33-585 ng/dL
• 16-17 yr: 185-886 ng/dL
• 18-39 yr: 400-1080 ng/dL
• 40-59 yr: 350-890 ng/dL
• > 60 yr: 350-720 ng/dL

Those on the highest dose of T-gel (10g) ended up at the top (remember the standard deviations) of the normal range for testosterone and right in the happy medium for estrogen (normal range is 14-55pg/ml). These guys  experienced a significant decrease in body fat and increases in tigh muscle area and leg press strength.

Interestingly, both the decrease and increase in body in response to high and low testosterone levels occurred almost exclusively in the "benign" subcutaneous adipose tissue. The intra-abdominal­ fat area, on the other hand did not change significantly in any group. If we follow the standard interpretation of the health effects of the different body fat stores, the conclusion would thus be that low T is not so much of a problem, after all it's all "healthy fat" that you will gain... to bad that too much of that "healthy fat" will make you just as insulin resistance as the visceral fat - it just takes longer for the negative effects to occur.

Now what did the AI do?

Suggested read explaining why the annihilation of E2 has negative effects on your body comp: "Estrogen, Friend or Foe of Muscle Hypertrophy? Plus: Are You 'SERMing' Away Your Satellite Cells?" | more

I know, the most intriguing question has not been answered yet: What was the role of anastrazole in all this? And how did the subjects in cohort 2 fare compared to their "high" (remember even the 10g guys had normal estrogen levels) estrogen counterparts. Well,...

"In cohort 2, the percentage of body fat increased in all groups when the aromatization of testosterone to estradiol was inhibited. The magni­tudes of these increases were similar with doses of 0 g, 1.25 g, 2.5 g, and 5 g of testosterone daily, a finding that suggests a predominantly estro­genic effect" (Finkelstein. 2013)

Yep, I deliberately quoted this, because I know that you've been brain-washed to believe the opposite would happen. The big bad estrogen is what keeps you lean... good that you have been taking natural AIs for years, right? Well, no obviously not. Probably rather the reason that you still don't have the cover-model look you are aspiring.

---

Did you know that (a) the endogenous production of estrogens has significant protective effects on your heard cardiovascular health (Sudhir. 1999) and that (b) aromatase is neuroprotective and low levels of it have been associated with the occurance + progression of neurological diseases such as dementia, Alzheimer's and Parkinsons as well as an inability to recover from mechanic (trauma) or chemical (intlammation) damage to the brain (Azcoitia. 2001)? No? Well, let's hope that this is because you've never heard it and not because you've been abusing AIs for the past decade ;-)

So, to use an AI or not - is that even a question? A direct comparison of all the data from cohort 1 (no aromatase inhibitor) and cohort 2 (using anastrazole), informs us that

"The cohort–testosterone dose interaction was significant for the percentage of body fat (P = 0.001), intraabdominal­fat area (P = 0.021), subcutaneous ­fat area (P = 0.029), sexual desire (P = 0.045), and erectile function (P = 0.032)" (Finkelstein. 2013)

Or, to put it another way: The study shows us that estradiol exerts an inde­pendent effect on body fat, sexual desire and erectile function. So you better don't ignore the real world implications you are about to suffer, when you put too much faith in hearsay instead of looking at your actual blood levels:

"In the groups that received testosterone, inhibi­tion of estrogen synthesis (cohort 2), as com­pared with intact estrogen synthesis (cohort 1), was associated with significant increases in the percentage of body fat (P<0.001), subcutaneous­ fat area (P<0.001), and intraabdominal­fat area (P = 0.002) and with significant decreases in sexual desire (P<0.001) and erectile function (P = 0.022)" (Finkelstein. 2013)

Yes, you heard the scientists right. Suppressing your estrogen levels is going to make you fat, rob you of your sexual desire and render you unable to perform the deed.

At the same time it had no beneficial effect on the increases in lean body mass or strength or any other positive outcome the subjects got from using T-gel. On the contrary, the low estrogen levels on in the 10g T-gel group did actually blunt reduce the lean mass gains and the fat loss the men in cohort 1 (no anastrozole) experienced, when they used 10g of T-gel per day was effectively reversed by the AI.

Figure 2: Fat gain, lower lean mass gain, less sexual desire & lower sexual function (not shown) and the list goes on... there really is nothing remotely beneficial about low estrogen (figures from Finkelstein. 2013).

It should thus be absolutely obvious that the only reason you should use an aromatase inhibitor with your testosterone replacement therapy is blood work that indicates that you have serious issues with over-aromatization. In many cases those can be reduced if not solved by (a) reducing inflammation and (b) getting rid of your belly.

To deliberately annihilate your estrogen levels, on the other hand, is simply stupid - irrespective of whether you are on TRT or not and even if you don't care about the negative long-term effects on your brain and heart health.

References:

• Azcoitia I, Sierra A, Veiga S, Honda S, Harada N, Garcia-Segura LM. Brain aromatase is neuroprotective. J Neurobiol. 2001 Jun 15;47(4):318-29.
• Sudhir K, Komesaroff PA. Clinical review 110: Cardiovascular actions of estrogens in men. J Clin Endocrinol Metab. 1999 Oct;84(10):3411-5. Review.

Adelfo Cerame - Pre-Contest-Prep: Back Training 101!

Image 1: An impressive back of which Adelfo feels it really lacks behind. Read more about how he is going to tackle this problem area, this week.

Time is flying by, only 2 weeks and Adelfo will start the hot phase of his contest preparation for the Wheelchair Nationals 2012 in Palm Beach Gardens, FL. From the last installment of the series, you will probably remember that he is using this time to streamline his raw-foods intermittent fasting diet regimen, which - he hinted at that in the last installment already, has not hampered his training progress the least. Currently at 149.5lbs with a body fat percentage of 13.4% he is hitting the gym more motivated than anytime before, as you will read and see in today's installment of Adelfo's exclusive contest-prep log, here at the SuppVersity.

If you want success, you have to constantly reinvent your diet

I already mentioned in the last installment of this series that I felt like the introduction of more and more raw foods into my diet had really helped with both strength as well as size gains in the gym. So, before I delve a little into my current training modalities, I thought I'd share a few additional thoughts on my current nutritional regimen with you.

Image 2: Adelfo's latest preworkout goodness for you to copy: Raw Kiwi Strawberry PreWorkout Shake - 20g protein, 44g carbs, 5g fiber, 28g; 508kcal of muscle building all natural foods, free of artificial flavors and sweeteners, yet 100% delicious!

Although everything seems to be working just fine at the moment, I am already planning ahead. When I start my prep, I will add a protein shake (50g) right after my workout, and then have the rest of my PWO meal when I get home... I just weighed myself today. 149.5 pounds, that's what the scale is telling me and what my current calculations are based on. I estimate my initial caloric needs at about 2,250 calories per day and given the amount of food I am slamming down at the moment, the addition of a protein shake immediately after my workout will help me to get up to those 2,250 calories as a reasonable starting point for my contest prep. While this may be my first prep on an intermittent fast, I figure that  

... whether you fast intermittently or not, you got to start a every diet with a reasonably high caloric intake...

If you do not lose weight as fast as you want to you can still cut back on calories. If, on the other hand, you are losing weight much to fast, chances are your will already have lost valuable muscle tissue, when you realize that you need to add in that additional protein shake that preserves lean tissue and revitalizes your metabolism. The occasional hunger pangs, I have been experiencing in the course of the last week are an early warning sign, I am not going to ignore.

Building a huge back sometimes forces you back to the drawing board

Image 3: Trying to build a killer back like the "Governator", but no clue which exercises will work? Then you better check out the SuppVersity EMG Serie with The Best Back Exercises of Witdh and Thickness.

I already mentioned in the SuppVersity Student Spotlight that I like it fast and heavy (I am speaking of training here, guys ;-) Currently, however, I am experimenting with some sort of heavy/light alternating training pattern, which looks like that:

• Monday: Chest/Triceps (heavy day)
  5 chest exercises & 2 Triceps exercises
• Tuesday: Back/Biceps (heavy day)
  5 back exercises & 2 biceps exercises
• Wednesday: Rest (not so heavy day ;-)
• Thursday: Triceps/Chest (volume / higher reps)
  5 triceps exercises & 2 chest exercises
• Friday: Biceps/ Back (volume / higher reps)
  5 biceps exercises & 2 back exercises
• Saturday: Shoulders (volume / higher reps)
  the only exercise I go really heavy on are shoulder presses

I consider my back one of my weakest body parts, so I've expanded my back training exercises. I used to do different variation of lat pulldowns, in the past, mainly because I was limited due to my mobility. Similarly, many gyms have machines I could not use until, after a lot of hard work, my core and trunk muscles got stronger and I began to feel a lot more confident to just try and experiment with new exercises, machines, grips, etc.

Video 1: Adelfo training back 2 weeks before the hot phase of his contest preparation is about to begin.

I guess, if you have not already been, Adelfo did now get you interested in "How on earth can you train in a wheelchair, at all?"... if you want to see a part of his current routine, i.e.

• seated rows - underhand grip
• wheelchair pullups
• seated rows - overhand grip

I suggest you click on the video to the left and enjoy a lesson in "how to train your back properly" - if the expression picture perfect form had not been out there for quite some time, someone probably would have come up with it after seeing this video ;-)

Currently, I do most of my back exercises on cables and machines, especially the hammer strength machines - those are my favorites. I also do body weight exercises for my back, such as pull ups and chin ups (see video 1). I use machines and cables because I am not able to transfer onto a T-bar row or do any type of standing or bent-over rows, so I try to just mimic those exercises as much as I can through machines. I train my back twice a week usually on Tuesdays and Fridays. I combine my back exercises with biceps.

Image 4: Next time he will be posing in front of the American flag, it will be with a procard in his hands ;-)

I usually like to train real heavy on Mondays and Tuesdays, because that's when I feel the strongest after my Sunday refeeds, so I end up training back real heavy once and with a higher volume and/or higher reps, the other day. That being said, I still try to lift as heavy as I can even within the higher rep-ranges.

On heavy days my set/ rep range are 4-5 sets of 5 reps (not including warmup sets) I try to increase the weight on every set whether it be just a 5 pound increase each set, just as long as I am trying to better my last set. On my volume/ higher rep days, my rep ranges are 4-5 sets of 8-12 reps.

I usually start off with exercises for thickness, so I always do row exercises first...

• seated row machine - I use this to mimic the T-bar rows
• seated row machine - this is a different variation that has a lower under hand grip and I use this to mimic some what of a bent over row where you have an under hand grip
• seated high rows on the hammer strength machine - one of my favorites, I can go real heavy and get a real good squeeze on my back
• single arm cable rows  - on a cable machine, I tie myself to the opposite end, while I have somebody pull the cable for me, and with a under hand grip I can do single arm rows, I know its hard to explain but I will eventually get video of it, couldn't do it today because there were a lot of people occupying "my" machines ;-)

Image 4: Leaning back slightly
(135° vs. 180°) on lat pull-downs
increases the activation.

The exercises I feel contribute more to the width of my back are

• wide grip lat pulldowns - I tie a weight belt around my chair so that I can lift heavy without getting lifted off my chair
• under hand grip lat pulldowns and wide grip behind the neck lat pulldowns
• close grip pulldowns - I use the V-bar
• wheelchair pull ups and wheelchair chin ups

As any reasonable trainee would do, I obviously don't do every exercise in every workout. For me it depends on how I feel the very day and which exercises I actually can do - as I mentioned I need a helping hand on some of the moves ;-)

I guess that's it for this weeks, folks. I am already looking forward to next Thursday, where - I can guarantee that - Dr. Andro and I will have some more interesting stuff for you to read, watch and think about. Until then, those of you interested in more information on diet and exercise science should check out both, the SuppVersity EMG Series and Dr. Andro's latest "baby", his Intermittent Thoughts on Intermittent Fasting... but, with all that reading, don't forget to hit the gym! 

Adelfo Cerame - Pre-Contest-Prep Experimentation Time: Initial Impressions of RAW Intermittent Fasting

Image 1: Adelfo Cerame, your man at the Wheelchair Nationals 2012 in the first week of his pre-contest experimentation phase (Adelfo Cerame, Sept. 2011)

Just about a month to go, until Adelfo will start the acute phase of his preparation for the Wheelchair Nationals 2012 in Palm Beach Gardens, FL. So just about the right time some serious pre-contest-prep experimentation with raw foods on an intermittent fast. As you remember from last week's student spotlight that was kind of a teaser to this series, this is going to be Adelfo's first contest prep without OCD-like 3-4h feeding schedules. And it will - at least to my knowledge - be the first meticulously documented raw foods contest prep of a promising candidate for the thought after procard that is going to be awarded to the winner of the over the overall (all classes) in March 2012 in sunny Florida.

If you read some or all of my Intermittent Thoughts on Intermittent Fasting, listened to my interview with Carl Lenore on raw milk or read the respective article on the SuppVersity, I assume you will be similarly excited to hear right from Adelfo, how this stomach, training intensity and overall feeling have been on his first week on the combination of uncustomary feeding schedules, raw eggs, meats, milk and honey ....

Experimentation Time - Raw Foods + Intermittent Fasting = ???

Even though I will not start the strict phase of my contest prep until October, 1st, I plan to use the weeks to come to play and experiment with intermittent fasting (IF) before I literally put all my raw eggs into the intermittent fasting basket in the weeks to come. I have already begun to incorporate raw foods into my nutrition over the last few months, and must say that I have been very pleased with the results. The things I liked most, however, were...

Image 2: Looks like Adelfo is right: the raw foods obviously helped him to keep the fat off during the off season (photo by Adelfo Cerame, Sept. 2011)

• the efficiency of not having to cook meals or prepare meals the night before - just being able to put food on the plate and eat (less prep time) is a novel and appreciable convenience for me
• a noticeable increase in strength and performance at the gym
• an unexpectedly prompt increase in arm size (I have already put on a whole inch! from 16" to 17")
• the ability to stay fairly lean in these last weeks of the off-season - I can still see parts of my abdominal muscles, although I did not really pay attention to my caloric intake
  

One thing that I have also noticed is an improvement in my "internal functions" - most prominently digestion and sexual function... when you get a spinal cord injury, a lot of your internal functions are disrupted or damaged. Ranging from bowel and bladder control to sexual function - things change overnight.

Breaking the Fast Raw Foods Style

Image 3: Adelfo Cerame's magic pre-workout formula: raw milk; 3 organic eggs; 1 tbs. raw honey; 1 tbs. raw coconut oil; no propriety blends, e-numbers, artificial sweeteners or colorings folks, just plain good old healthy whole raw foods and above all, it does not take longer to prepare than your average whey protein shake ;-)

Prior to raw foods eating, I was able to improve my digestion and bowel frequency by increasing my intake of fibrous foods and being particularly keen about what to eat and what to avoid. The incorporation of more and more raw foods into my diet did yet improve my digestion and bowel program way beyond what I had been able to achieve with processed foods and supplements alone. It may be difficult to understand for a non-paraplegic, but staying in the bathroom "forever" is a serious and enervating issue most paraplegics and quadriplegics have. And as far as sexual function is concerned, I was still able to get erections before, yet not without the help of E.D. medications. Rotating more and more raw foods into my diet, helped with that issue tremendously. Even without the help of E.D. meds., I have now longer and stronger erections than before.

If you consider not having to cook all your meals "convenient", then not having to worry about prepping your meals or to think about what you will be eating within the next three hours is pure luxury. 

The practical benefits aside, I was positively surprised that, at least in the course of this first week of intermittent fasting, I did not notice any loss in strength or energy. Lethargy or a lack of motivation, problems that are supposed to occur especially in the initial phase of intermittent fasting were not an issue, at all. The only actual "problem" (if you would like to call it thus, when you are on a diet) was that I found it really hard to fulfill my daily caloric needs with the 3 meals, I could squeeze into my feeding window.

If you are interested in some more information on dos and donts, as well as the science behind and around intermittent fasting make sure to follow both the weekly updates of Adelfo's contest prep documentation, as well as my Intermittent Thoughts on Intermittent Fasting series on the SuppVersity
(img hardwaresphere)

If you read the third part of the Intermittent Thoughts on Intermittent Fasting series, you will be familiar with the female athletes from the Ramadan study by Memari et al. having similar problems, i.e. they did not meet their exercise-related caloric demands on their fasting protocol. Other than Adelfo, who is well aware that putative (or I should say "perceived") overeating in the feeding window is a necessity, the ladies in that study were yet not able (or unwilling?) to nourish their bodies appropriately - the unfortunate result, I already mentioned that in my analysis of the study, were fat gain and a significant YoYo-effect, when they eventually broke the fast. So, if your goal is to lose fat, not muscle, and you decide to go on an intermittent fast, make sure you copy Adelfo's rational approach to intermittent fasting instead of turning the whole thing into yet another anorexic low-calorie diet.

Whole Raw Foods - Convenient, Healthier and Cheaper than 1001 Supplements

What I'm also really excited about is that, in this first week, the combination of intermittent fasting and raw food eating turned out to be really economical. Something, I suppose you would not have expected!? I remember having to spend loads of money on foods and protein powders just to make sure that I could eat my 6-7 meals a day. Now, all I have to worry about are 3 meals pre-workout, post-workout and another meal before i go to sleep. And the money I save on the boatloads of protein powders I used to buy is better spend in some quality whole-foods, anyhow.

Image 4: This is what a real post-workout meal should look like ;-)

I assume that some of you have difficulties to imagine how a sample meal plan could look like, so here is an example:

• pre-workout = breaking the fast @ 2:30 pm: shake with raw milk; 3 organic eggs; 1 tbs. raw honey; 1 tbs. raw coconut oil
• post-workout meal @ 6:40 pm: 8 oz steak, large yam, handful of pineapples & carrots, 1 tbs. raw honey & coconut water
  
  
• before bed @10 pm: 1 c. raw milk, 2 eggs, 1 tbs. coconut oil, 25g protein powder

If you want to know how things are working out for Adelfo, don't forget to come back next Thursday for the next installment of this series featuring more information about Adelfo's diet, the first progress chart for you to follow his weight, body fat % and muscular development and a sneak peak on how our man at the 2012 wheelchair nationals trains. Until then, feel free to share Adelfo's reports via Facebook, and to leave your appreciations, comments and questions in the comments area of this page.

Now Its Official: Propecia Drug Finasteride Kills Male Libido Permanently

Image 1: Chemical structure of finasteride

Other than the FDA some European medicine and health care agencies, such as the Swedish Medical Products Agency and the Medicines and Healthcare Products Regulatory Agency of the United Kingdom already had the guts to declare in their patient informations that "persistence of erectile dysfunction after discontinuation of treatment with Propecia has been reported in post-marketing use." While this was obviously no reason for the all-mighty FDA to correct or re-evaluate their own documents, two it did intrigue Michael S. Irwig and Swapna Kolukula, two US scientists from Washington and Baltimore, respectively.

In their study (Irwig. 2011), the scientists conducted standardized interviews with 71 otherwise healthy men (age: 21–46y), who experienced permanent (>3 months) sexual side effects after temporary use of Finasteride. Their reports are staggering:

94% developed low libido, 92% developed erectile dysfunction, 92% developed decreased arousal, and 69% developed problems with orgasm. The mean number of sexual episodes per month dropped and the total sexual dysfunction score increased for before and after finasteride use according to the Arizona Sexual Experience Scale (P < 0.0001 for both).

These sexual side effects occurred after a "mean duration of finasteride use [of] 28 months" and they were persistent up to the interview date. For the study population this meant that they had already been suffering 40 months, on average, when the interviews took place; and chances are that many of them will suffer the consequences of an insufficient (or should I say incompetent or corrupted?) drug approval process and consequent indoctrination of medical practitioners for the rest of their lives.

Note: After receiving some critical feedback via facebook, I feel that it is necessary to point out that the result of the study may not be misinterpreted as "Every Finasteride user will experience persistent decreases in libido, erectile disfunction etc.", but as "In those percentage of Finasteride users, where such side effects occur, they can potentially be permanent." So the news is neither that Finasteride will cause these effects in each and every user, nor that it may cause such side effects (that is in fact mentioned in the package insert, I suppose), but that IF side effects occur, it is possible that they are persistent.