Moderate-HighGBS: 81 (High Risk)nutrition

Male Testosterone Optimization

Developer: Abraham Morgentaler, Jay Campbell, functional medicine

Natural optimization 3-6 months, TRT ongoing with monitoring

Protocol Overview

Evidence-based protocol to naturally optimize testosterone or use TRT (testosterone replacement therapy) safely. Addresses lifestyle factors and supportive supplements before or alongside TRT.

Conditions Treated

Low testosterone

andropause

erectile dysfunction

low libido

fatigue

Protocol Steps

Testing: Total testosterone (AM fasted), free testosterone, estradiol (sensitive assay), SHBG, LH, FSH, prolactin, thyroid, vitamin D, CBC, metabolic panel, PSA (baseline if >40)

Lifestyle optimization: Sleep 7-9 hours (testosterone rises during sleep), stress management (cortisol lowers T), avoid endocrine disruptors (plastics, pesticides), maintain healthy weight (obesity lowers T)

Diet: Adequate calories (calorie restriction lowers T), sufficient healthy fats (30-40% calories), cholesterol (T made from cholesterol), zinc-rich foods (oysters, red meat), cruciferous vegetables (DIM for estrogen metabolism), limit alcohol

Exercise: Heavy resistance training (compound lifts: squats, deadlifts, bench press) 3-4x/week, avoid excessive endurance training (marathon running lowers T), adequate recovery

Supplements for natural optimization: Vitamin D3 4000-5000 IU (maintain 50-80 ng/ml), zinc 30mg + copper 2mg, magnesium 400mg, boron 6-9mg, vitamin K2 MK-7 180mcg, ashwagandha KSM-66 600mg 2x/day (shown to raise T), DHEA 25-50mg if DHEA-S low, fadogia agrestis 600mg (emerging evidence), tongkat ali 200-400mg

TRT if needed (total T <350-400 ng/dL with symptoms): Testosterone cypionate or enanthate IM injection 100-200mg/week (split into 2 doses 3.5 days apart for stable levels), OR transdermal gel daily, OR subcutaneous pellets every 3-4 months

Aromatase management: DIM 200mg daily or anastrozole 0.25-0.5mg 2x/week if estradiol >40-50 pg/ml (high estrogen on TRT causes issues)

HCG: 500 IU 2x/week if fertility desired or to maintain testicular function on TRT

Monitor on TRT: Testosterone (trough before injection), estradiol, hematocrit (TRT raises RBC - donate blood if hematocrit >52%), PSA, lipids every 3-6 months

Avoid: Testosterone suppression from opioids, excessive alcohol, marijuana (lowers T), soy isoflavones

Key Resources

Testosterone Optimization Therapy by Jay Campbell, Abraham Morgentaler's books, Examine.com for supplement evidence, TRT clinics

Contraindications & Risks

TRT: Prostate cancer (controversial), polycythemia, sleep apnea (may worsen), fertility (suppresses without HCG), heart disease (individualize)

Important Notes

Testosterone declines 1% per year after 30. Low T epidemic (environmental factors, obesity, endocrine disruptors). Symptoms: fatigue, low libido, erectile dysfunction, depression, muscle loss, fat gain, brain fog. Total T <300 ng/dL clearly low, 300-500 gray zone (treat based on symptoms). Old fear of prostate cancer largely debunked - Morgentaler's research. TRT doesn't cause cancer in men without cancer. Free T more important than total. SHBG binds T (high SHBG lowers free T). Injection 2x/week better than 1x/week (stable levels). Estradiol management important - some conversion to estrogen is healthy (<40 pg/ml), too high causes issues. HCG preserves fertility and testicular size. Natural optimization works for some - vitamin D, zinc, ashwagandha, sleep, resistance training. TRT is life-changing for those who need it. Work with knowledgeable provider (many mainstream docs underdose).

Also Effective For

Chronic Fatigue / Fibromyalgia

Key Supplements & Herbs in This Protocol

Supplements

Copper Boron

Herbs

Ashwagandha

Withania somnifera

Critical Safety Warning

This protocol is documented for educational purposes only. The Gabriel Bullshit Score (GBS) of 81 reflects significant institutional response and controversy. Some alternative health protocols have resulted in serious harm or death.

Always consult with qualified healthcare professionals before beginning any treatment. Do not delay or forego proven medical care.

Quick Overview

Evidence LevelModerate-High

GBS Score81 / 100

Categorynutrition

DeveloperAbraham Morgentaler, Jay Campbell, functional medicine

DurationNatural optimization 3-6 months, TRT ongoing with monitoring

About GBS Score

The Gabriel Bullshit Score reflects the magnitude of institutional response, controversy, and documented concerns. Higher scores indicate greater institutional pushback, not necessarily inefficacy. This is a research tool, not medical advice.