Why Can’t I Ever Seem to Keep the Weight Off When I Diet?

Dieting. It works!

Well…sort of.

You’ve tried dieting.  It works most of the time. Restrict what you’re eating and you’ll usually lose weight. Sometimes very quickly.

Juice cleanse du jour, Master Cleanse, The Biggest Loser, Fat Flush, The Zone, Atkins, Weight Watchers, Sugar Busters, South Beach, High Fat/Low Carb, Mediterranean. The list goes on.  They could open a bookstore devoted to diet books alone there have been so many. And the truth is, most of them DO work. Short-term.

But as time goes on, dieting becomes more difficult.  The same diet you did a few years ago doesn’t work as well the second, or third, or fourth go-around.  Or even if you’re not “dieting,” maybe you’re eating better than you ever have before. And you’re exercising more frequently and with more intensity than ever.


Well there’s a very good explanation. And it has to do with hormones.

You see, hormones play a large part in how your body responds physically as you grow older. As you age, your body produces less of the fat burning, energy producing hormones like thyroid, testosterone, estrogen, DHEA and growth hormones and tends to produce more of your fat storing hormones like cortisol and insulin. This result is overall weight gain and that dreaded fat around the middle that becomes so difficult to lose.

And one of the big problems with short-term, restrictive type diets is that they can increase the hormones you want to keep low (the fat storing ones) and decrease the hormones you want nice and high (the fat burning ones). So you’re often left in worse shape than when you started!

Optimizing your hormones can turn this around. Getting levels of key hormones back to where they were before they started declining (or rising, in the case of the potentially harmful ones) helps your body lose weight, burn fat, and increase your muscle density.


So where can you start? Begin by getting your hormone levels checked by a physician who specializes in Age Management & Hormonal Optimization.  And lose the weight. Safely. Sustainably.

Get the body and vigor that you had during your 20s and 30s back. Look and feel better than you ever have before.

Is Testosterone Going to Give Me A Heart Attack?

testosterone dr. mike carragher. hormones age management









Poor testosterone!

Many patients have been asking me recently about news reports mentioning a study that linked testosterone to an increase in heart attacks in men.  “Testosterone prescriptions linked to heart attack” was the headline in the Los Angeles Times on January 29, 2014.

Yikes!  Of course this headline grabbed my attention.

The news reports stem from an article published in the journal Plos One, titled ‘Increased Risk of Non-Fatal Myocardial Infarction Following Testosterone Therapy Prescription in Men.’

So I looked closer at the study.

Before I talk about the serious flaws in the study, the first thing I should mention is this: Testosterone therapy is not to be taken lightly.  With all the popularity of testosterone therapy these days, there are many doctors recklessly prescribing it without properly screening patients.  There are “Low T” clinics sprouting up in strip malls across the country.  This is has been, and continues to be, unsettling to me.  Testosterone (or any hormone therapy) should be properly prescribed and and monitored by a hormone specialist.  If you think you may benefit from testosterone, see a hormone specialist who will comprehensively evaluate you.  He or she should be well versed in the benefits and risks of therapy and the treatment of possible side effects for you to have optimal benefits from the therapy.

Now, as for the Plos One study, here are the important problems:


This is an observational study. These are the ones that typically make news headlines, as one can observe any outcome and draw erroneous conclusions from it. It is not a randomized trial.  Most of the randomized, controlled studies on testosterone demonstrate considerable cardiovascular protection (more later).  If you manipulate the data of any study long enough, you can get it show anything that you want.


The study did not assess testosterone levels of patients before and during therapy. It looked at men who filled a prescription for testosterone. Not even whether or not they took it, or took it correctly.  Without proper assessment of testosterone levels, it is impossible to tell if a patient is a good candidate for therapy or if they are tolerating the therapy well.  And without knowing if the men took their testosterone, or took it correctly, you need to be very wary of conclusions drawn. This is very basic stuff when if comes to research studies.


The biggest problem with this study has to do with the “control group.” The authors compared the groups of men who were prescribed testosterone therapy to men who were prescribed a class of drugs called PDE5 inhibitors.  You’ve heard of these drugs before by their brand names: Viagra and Cialis.  The authors  observed a lower risk of heart disease in the PDE5 inhibitor group. PDE5 inhibitors are drugs typically used to treat men with erectile dysfunction.  The authors state they used this group “as comparison” to the testosterone group so there would theoretically be an increase in sexual activity in both groups.

But they ignored an important fact!  PDE5 inhibitors have significant positive effects on the cardiovascular system. Two PDE5 inhibitors have even recently been approved for treatment of idiopathic pulmonary hypertension because of their ability to relax blood vessels. And a new study in the Journal of Cardiovascular Pharmacology and Therapeutics states that PDE5 inhibitors have potential as cardiovascular drugs in patients with coronary artery disease and in heart failure patients.

If PDE5 inhibitors can decrease the risk of heart disease and relax blood vessels in men with heart disease, how can the authors of this study possibly think that men on PDE5 inhibitors would be a good control group against the men placed on testosterone?

They can’t!

The results of the Plos One study run counter to an overwhelming amount of literature over 25 years that supports the use of testosterone as an important therapy that can lower cholesterol and blood sugar levels, reduce body fat and increase lean muscle mass.  These are all factors that reduce the risk of heart disease.

A new review article published in December 2013 in the Journal of the American Heart Association (JAHA) provides a comprehensive review of the clinical literature looking at associations between testosterone and cardiovascular disease. Over 100 studies were reviewed, and the authors concluded that low levels of testosterone are associated with increased rates of overall mortality, cardiovascular-related mortality, and higher rates of obesity and diabetes. And the severity of disease correlated with the degree of testosterone deficiency. Testosterone has been shown to relax coronary arteries and improve ability of patients with congestive heart failure to exercise. Testosterone lowers blood sugar in diabetics and lowers body mass index (BMI) in obese patients. Finally, studies have associated lower testosterone levels with thicker walls of major arteries, increasing risk of atherosclerosis. All of these factors point to the conclusion that optimal testosterone levels decrease the risk of cardiovascular disease.

The results of the current study, despite all the media coverage, are essentially meaningless. Testosterone therapy can be an excellent way to help men to improve their quality of life and decrease their risk of multiple diseases.  This is shown in the overwhelming majority of studies.

Again, be wary of news headlines.  Consult with a hormone specialist.

Show your doctor this blog post, especially if he or she tells you testosterone is going to increase your risk for heart attack.  The truth is, you probably know more than he or she does about this study after reading this.

Do you feel FATigued?

It’s the most common health problem over 40. You’ve got fat around your middle and you’re tired all the time. To top it off you may have

• A foggy brain

• Low moods

• And no libido

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  • When using a statin drug may be helpful and when it’s not
  • What MCT Oil and pastured butter have in common
  • Why anti-depressants and birth control pills are not the answer in peri-menopause and menopause
  • What “jumping the canyon” means and how it helps with cravings

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Melatonin: The Sleep Hormone (and So Much More!)

Do you wish you could sleep more soundly and feel more rested?

Sleep disturbances and insomnia are frequent complaints I hear about from my patients.  So I though it would be useful to talk about a hormone that most people are deficient in as they age and can have a profound effect on quality and quantity of sleep: melatonin.

You may already be thinking, “Yeah, yeah, I tried melatonin. It didn’t work for me.” Or, “Melatonin gave me nightmares.”  Or, “Melatonin doesn’t work as well as Ambien.”  My clinical experience has shown me that melatonin, when used correctly, is extremely effective. There is evidence that melatonin may have a role in the biologic regulation of not only circadian rhythms and sleep but also mood, reproduction, tumor growth, and aging.

But first, we need to talk about the small gland in the center of the brain that produces melatonin.

Melatonin, which is a hormone, is secreted by the pineal gland, a small gland located in the center of the brain.  Three centuries ago, the French philosopher René Descartes described the pineal gland as “the seat of the soul.”  The pineal gland controls energy production and usage in the body through the effects of melatonin as well as other substances.  The pineal gland tells our body where it should use energy, to make antibodies, hormones or certain enzymes.  Melatonin has the ability to regulate circadian rhythms and has important effects on reproductive function of many animals.

The light-transducing ability of the pineal gland has led some to call the pineal the “third eye.” It is frequently referred to as the “master endocrine gland.”  Sort of a conductor to the orchestra that is the body.

Melatonin production increases when light input to the retina is low, and decreases when more light reaches the eye.  Studies show that melatonin is converted to ramelteon, which causes sleep onset to be faster and increases the duration of sleep.  Meaning you fall asleep faster and stay asleep longer.  Studies also show that ramelteon does not have the withdrawal effects or dependence associated with other sleep aids such as Ambien or Lunesta.

It is one of the first hormones that declines in humans as we get older, beginning as early as puberty.  This may explain why, as a child and teen, you could probably sleep for 8-12 hours per night soundly, even if there were a marching band next to your bed.

Personally, when I use melatonin I sleep more soundly, and rarely wake up during the night.  And if I do wake up, I fall back asleep easily.  I wake up feeling rested and refreshed.

Melatonin: Not just for sleeping anymore

Beyond sleep, melatonin has may benefits, including important anti-aging benefits. Here’s a list of some of melatonin’s benefits beyond sleep:

  • Lifespan: Preclinical studies have shown that melatonin increases the lifespan of animals by up to 20%.
  • Antioxidant power: Melatonin is an extremely powerful antioxidant.  It plays a vital role in the body’s defense against numerous cell-damaging free radicals.  Melatonin has 200% more antioxidant power than vitamin E and is superior to glutathione as well as vitamin C in reducing oxidative damage or “rusting” of cells.
  • Osteoporosis: Research from animal models has showed that melatonin has beneficial effects on bone repair and bone density.
  • Alzheimer’s Disease: Melatonin has a neuroprotective effect, reducing oxidative damage to brain cells.  It can also help delay the onset of Alzheimer’s disease by protecting the brain against the development of the beta-amyloid plaques that are the hallmark of Alzheimer’s.
  • Cancer: Research shows that melatonin has anticarcinogenic properties – meaning it can prevent the growth of cancer cells as well as interfere with cancer cell multiplication and growth.
  • Immunity: Melatonin can activate T-helper cells to protect the body from foreign invaders and immune-related diseases.
  • Cholesterol: Studies show that melatonin can decrease total and LDL cholesterol and increase HDL cholesterol.
  • Heart Disease: Animal models show that melatonin helps protect against heart muscle injury, reducing the amound to damage done by heart attacks as well and improve heart muscle function after heart attacks.

How to use melatonin correctly

Much of the reason many have a poor response to melatonin is threefold, in my opinion.

Firstly, many take either too little or too much.  Some people require as little as 1 mg, while others require up to 25 mg to receive the same benefit. That’s a huge range!  Having the dose that is right for you is key.

Secondly, much of the commercially available, over-the-counter melatonin is manufactured in China and may contain contaminants; the quality control can be very poor if you are not getting your melatonin from a reputable source.  I don’t know about you, but for me, if I am taking a supplement or nutraceutical, especially a hormone, I am going to get the best quality I can.

Thirdly, many take melatonin when they need other hormones as well.  Many symptoms are multi-causal.  So while melatonin may be part of the problem, it may also be human growth hormone (HGH), testosterone, thyroid, progesterone, or others that are the problem as well.

So when I prescribe melatonin as part of an Age Management protocol,  I do so after measuring all the key hormones that may be playing a role. Then, I use only the highest quality manufactured pharmaceutical-grade melatonin, or I have a compounding pharmacy formulate 100% pure melatonin. I start at a low dose, based upon my patient’s weight, age, and symptoms, and titrate upward as needed to receive the greatest benefit.  It my patient is not having any effect, I increase the dose.  If they are experiencing morning sleepiness or headache, I decrease the dose accordingly.  I use the highest dose tolerable since I believe the benefits of melatonin are so great.

Melatonin’s effects are best when used as part of a comprehensive Age Management Program, with all hormones optimized.  Your hormones work together, much like a great symphony, with each hormone playing an important part.  Melatonin is no exception.

For more information, or to book an evaluation, please email me at drmike@thebodywellusa.com or call (323) 874-9355.  We have customized Age Management Programs for clients who live all over the world, requiring only one visit annually to our clinic.

How To Optimize Human Growth Hormone (HGH) Levels Without Expensive Pharmaceutical HGH

There are ways to increase your HGH levels other than expensive pharmaceutical HGH.  And no, we’re not talking about buying a cheap knock-off product from the back door of your gym, risky HGH from China or other sources, or ordering the newest pills or under-the-tongue sprays from late night TV.

What Is HGH and What Does It Do?

Human Growth Hormone (HGH), aka somatropin, is a hormone that is secreted by a small gland at the base of the brain called the pituitary.  It works on several different body tissues to promote healthy metabolism.  HGH is an essential hormone in childhood to ensure proper growth and development; without HGH, you’d be a dwarf. HGH levels start to decline gradually from about age 21 onward.  It is widely believed that many of the changes associated with aging are due largely to this decline in HGH.

Much of the work of HGH is done by a related hormone called Insulin Growth Factor-1 (IGF-1).  After HGH is secreted by the pituitary gland, it travels to the liver (and some other tissues) and is converted to IGF-1.  The easiest way to assess HGH’s level in your body is by measuring the IGF-1 level in your blood.

What Are the Symptoms of HGH Deficiency?

  • Increased body fat, especially around the waist
  • Anxiety and depression
  • High LDL “bad” cholesterol & high triglycerides
  • Decreased sexual function and interest
  • Fatigue
  • Feelings of being isolated from other people
  • Greater sensitivity to heat and cold
  • Less muscle (lean body mass)
  • Less strength, stamina and ability to exercise without taking a rest
  • Reduced bone density

HGH and Body Fat: A Vicious Cycle

Part of the reason so many adults are HGH deficient is because of their percentage body fat.  Body fat inhibits HGH secretion from the pituitary gland, so the higher percentage body fat you have, the less your body secretes HGH.  Making matters worse, since HGH helps maintain and improve strength and energy, it becomes even more difficult to lose weight as your body fat increases.

HGH also helps regulate the secretion of insulin, the fat storing hormone.  As you are aging, HGH levels typically decline and insulin levels typically rise if you are eating a diet high in carbohydrates and refined foods.  So you begin to store more fat without any change in diet or physical activity.  This is part of the reason you could basically eat whatever you wanted as a young person without gaining weight – you probably had high HGH and low insulin, an ideal mix for keeping fat off.

Benefits of HGH

People who take HGH for Age Management swear by it.  Here’s a list of the benefits of modulating HGH/IGF-1:

  • Improved general energy levels
  • Decreased total body fat
  • Increased lean body mass
  • Enhanced skin thickness and elasticity
  • Improved healing time and reduced infection rates after surgery
  • Increased bone mineral density
  • Improved cholesterol profile
  • Improved exercise capacity
  • Decreased recovery time between workouts
  • Improved mood, coping skills, and overall well-being

So Why Aren’t We All Taking It?

The biggest barrier to HGH supplementation is cost.  HGH is very expensive and therefore typically available only to people who can afford it.  Also, most doctors don’t know how to evaluate patients accurately for HGH deficiency.  It is important you be evaluated by a physician experienced in Age Management and optimizing HGH levels.

These are lots of products on the market that claim to raise HGH levels: pills, creams, sprays and powders.  These were designed to take advantage of the fact that most people can’t afford pharmaceutical-grade injectable HGH.  But buyer beware!  The above list of benefits of HGH were observed using pharmaceutical, injectable HGH.  None of these benefits have been objectively measure with the use of pills, creams, sprays or powders.

How We Help Our Clients Raise HGH Levels and Minimize Cost

In my clinic in Los Angeles, The Body Well, we evaluate our clients for Growth Hormone Deficiency and measure blood levels.  For most of my patients, we begin raising their HGH production by optimizing their other hormones, and teaching them how to eat, exercise and change their lifestyles in ways that optimize their own bodies’ HGH production. There are specific ways of eating, exercising, and living that optimize HGH secretion from the pituitary. These include:

  • Low carbohydrate eating
  • Minimally processed foods
  • Good quality saturated fats
  • Good quality protein sources
  • High Intensity Interval Training (HIIT) based upon precisely measured aerobic and anaerobic thresholds
  • An intelligently designed weight lifting program
  • Parasympathetic-enhancing activities to ensure adequate rest
  • A sleep program for enhanced hormonal production
  • Avoiding foods and supplements that interfere with HGH production
  • Optimizing other hormones

After about 6-12 weeks, we re-measure HGH/IGF-1 levels and almost always see rises in their HGH/IGF-1 levels.  These are usually significant enough that our clients can avoid having to pay for pharmaceutical HGH, or at the very least minimize their dosing to a level that is much more affordable.

For more information, or to book an evaluation, please email me at drmike@thebodywellusa.com or call (323) 874-9355.  We have customized Age Management Programs for clients who live all over the world, requiring only one visit annually to our clinic.