The understanding is that mainstream medical research takes about 20 years to make it into clinical practice, specialists included (unless it’s blockbuster drug research, in which case it seems to make it to doctors’ offices overnight…).  That means that current research I comment on won’t be used appropriately for at least another 2 decades.  While I consider this completely inappropriate because, as a physician, it is my responsibility to my patients to stay current to some degree, it is a reality.

However, there is an occasional glimpse of the sun through the clouds when mainstream medical practioners try to apply functional medicine concepts in limited aspects.  Probiotics are a key one–106 years in the medical literature and some docs are starting to recommend Florastor in limited situations.  Unfortunately, Florastor can work great to lower the risk of antibiotic associated diarrhea, but is not considered a probiotic to restore normal flora in the gut.  So, great idea for mainstream medicine, but inappropriate application.

Strangely, I see the same thing with checking testosterone levels.  I’ve seen more and more of this over the years, and some clinics even hang their hats on the idea of testosterone checking and supplementation (usually as pellets implanted under the skin of the glut region).  But it seems so out of context with the rest of the bloodwork checked that I just scratch my head in wonder.

Why?  Several reasons.  First, checking testosterone in the blood is not my favorite method.  Salivary testing is much easier and checks the levels of unbound, active hormone in the body, which blood testing does NOT do (it checks the protein bound, inactive levels). 

Next, if the levels are low, their is never a question as to why they are low; it’s just replacement with creams, pills, injections or pellets.  Which–by the way, can really screw up the way your body works.  It would not be the first time I’ve seen a male patient with low testosterone pushed into sterility from exogenous testosterone use.

In functional medicine, we would ask WHY are the levels low and address that aspect of the issue.  Many times, it can be an adrenal issue.  A chunk of a male’s circulating testosterone is actually derived from the adrenal gland (on the range of 5%) and we need to evaluate and support adrenal function via supplementation, exercise and stress mangement. 

Toxicity from the environment can contribute greatly.  The principal agent are the phthalates, which are well known to produce a feminizing effect on the male.  So avoid things with that “new car” or “new shower curtain” smell as much as possible.

James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.