If Your Doctor Tells You You’re Normal, Say “That’s Not Good Enough!”

Do you want to be “NORMAL” or do you want to be:





I know what the answer is for me. And I bet it’s the same answer for you.

One of the most frequent questions I get from clients is “I went to see my regular doctor and he told me my hormone levels are normal.  We checked everything and he said everything is fine.  So why do I feel so lousy? Why am I so tired? Why is my sleep so poor? Why is my sex drive lower than it used to be? Why does my recovery from exercise take so long? Why am I so irritable?”

Well, the answer to this depends on what you define as normal.

How is “normal” defined?

In general, most doctors consider normal levels to be those ranges revealed in a blood test that the lab designates to a certain hormone. For example, if you’re getting your testosterone levels tested, a normal total testosterone value is often used. The “normal” range for testosterone is roughly between 300 to 1200 ng/dL (nanograms per deciliter). If you fall anywhere in this range, you’re told your level is normal.

Here’s where the problems start.

Problem 1: The Gap

That’s a pretty big gap between the two numbers! It says that someone who has a level of 300 ng/dL is essentially the same as someone who has a level of 1200 ng/dL. It doesn’t say anything about what is normal FOR YOU.  Nor does it consider that your level may have been 3 or 4 times higher a few years ago. You may have symptoms because your level should be higher than it is even though your level falls in the “normal” range.  Normal for you may not be the same as normal for me. We are all different, and this should be acknowledged.

Problem 2: Who is defining “normal?”

Second, who comes up with the “normal” range?  These ranges were calculated in the past by taking the testosterone levels of a sampling of guys with ages ranging anywhere from about 19 to 90. Their health and fitness levels varied anywhere from fit to obese. The healthy 19 year old levels were more on the high end of the chart, while the older guys were at the lower end. So, it was concluded by the powers that be that it is “normal” for older men to have much lower testosterone levels than younger guys. But do you want to be compared with any old (or young) guy? Regardless of any underlying medical problems they may have? I don’t! I want my hormone levels to be compared with healthy, optimally performing men, or even more importantly with ME and how I feel.

Optimal hormone levels are the levels associated with the highest quality of life, the lowest incidence of symptoms, the lowest risk of degenerative disease, and the best health outcomes. That’s where I want my levels to be.

Problem 3: Your doctor needs to be checking the right hormones

Your doctor should be looking at the right hormone levels in the first place.  Sadly, they’re often not.  Testosterone is a perfect example. Most doctors look at total testosterone, when they should be looking at free testosterone, which is the testosterone that is actually available to do all the things you want it to do in your body.  I see many patients with high total testosterone levels (“My doctor says my level is great…”) and low free testosterone levels (“…so why do I feel so lousy?”). It’s important the right levels are being looked at in the first place!

So who should you go to for lab testing and to discuss your hormone levels?

It may be challenging for you to discuss normal versus optimal hormone levels with your regular doctor, as he or she may not be familiar with or has not researched enough to give you the best advice. That’s why when having your hormone levels tested, it’s important for you to find a physician that specializes in hormone optimization in order to be better informed and treated for any hormonal deficiencies. And most traditional doctors do not have the time to sit down with you for an hour or more to come up with a comprehensive individual treatment plan specific to your needs.

Just as you should see an orthopedist to fix an injured shoulder or a cardiologist for heart issues, you should see a physician who specializes in hormonal optimization to evaluate and treat you.  And since traditional endocrinologists specialize in treating hormonal diseases, you are better off seeing an Age Management Medicine physician to advise and comprehensively treat you when you’re not diseased, but are suffering from the signs and symptoms of hormonal decline.

Hormones do not act alone

Lastly, there are so many different hormones in your body. Each does not exist in a vacuum. They play together like instruments in an orchestra, working together to create an amazing you. They should be comprehensively addressed, along with looking at nutrition, exercise and lifestyle, since all of these contribute to your overall hormonal health.  Your body and health cannot be summed up or improved by testing one or two numbers.

Optimizing hormone levels can help you look and feel better as well as rejuvenate tissue and help you feel more youthful and vigorous.

So if you’re being told by your doctor that “normal” for your age is fatigue, low sex drive, depression, increased body fat, loss of muscle mass and poor quality of sleep, turn around and run.

You deserve better.

For an evaluation with Dr. Carragher, please call (323) 874-9355 or email drmike@thebodywellusa.com

Sermorelin: A More Affordable Alternative to Human Growth Hormone (HGH)

We all age. It’s part of life.

But most of us hope that as we age, we can maintain the highest quality of life possible. That we can keep as much of the energy, strength, and and appearance we enjoy in youth.  At the same time, most of us hope to be spared the impairment that comes with chronic, degenerative diseases.  Hormones are key players in our ability to feel and look young – as well as stave off the degenerative diseases of aging.

You see, as we age, hormone levels change. Typically, the hormones we like at high levels – fat burning, energy producing hormones – will fall.  And the hormones we like at low levels – fat storing, energy depleting hormones – tend to rise.  With this change, we look and feel older. Hormones often fall into a deficiency range, below the levels associated with the best health outcomes.  This is when intervention with hormone optimization (through diet, the right amount and kind of exercise, sleep, lifestyle modifications, and hormone supplementation) can be extremely beneficial.

Human Growth Hormone (HGH) is one of these hormones.  Unfortunately, it isn’t available to everyone who needs it, largely due to its price tag.

There is now a less expensive alternative.  I’ll talk about that. But first, I’d like to talk a bit about HGH.

What Is HGH and What Does It Do?

Human Growth Hormone (HGH) 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-Like 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.  IGF-1 travels to body tissues where it stimulates cell growth and proliferation. The easiest way to assess the HGH 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
  • Sleep disturbances/insomnia
  • Anxiety and depression
  • High LDL “bad” cholesterol & high triglycerides
  • Decreased sexual function and interest
  • Fatigue
  • Greater sensitivity to heat and cold
  • Decreased muscle mass (lean body mass)
  • Less strength, stamina and ability to exercise without taking a rest
  • Loss of bone density

Why Is Human Growth Hormone So Sought After?

Growth hormone replacement therapy using HGH has been used by many Age Management practitioners as one of the most effective ways to treat Adult Onset Growth Hormone Deficiency, which often occurs with aging.  Its beneficial effects have made it one of the best ways to treat age-related decline.

Benefits of much sought-after HGH include:

  • Improved energy levels
  • Decreased body fat
  • Increased lean body mass
  • Enhanced skin thickness and elasticity
  • Increased collagen production
  • Improved sleep
  • 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 and overall well-being

Sounds pretty good, right?

So Why Aren’t We All Taking It?

The biggest barrier to pharmaceutical HGH use 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 and monitor patients accurately for HGH deficiency.  It is important you be evaluated by a physician experienced in Age Management and optimizing HGH levels.  Too much can be as dangerous as too little, so it’s important to be monitored by an experienced physician as well.

There 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 measured with the use of pills, creams, sprays or powders.

Sermorelin: A Lower Cost Alternative to HGH

One medication alternative to HGH is the use of Growth Hormone Releasing Factor 1–29 NH2-acetate, or Sermorelin, which has recently become available to physicians for use in Age Management Medicine.  Sermorelin is an analog (similar molecule) of naturally occurring Growth Hormone-Releasing Hormone (GHRH) whose activity also declines during aging.  Unlike injectable HGH that causes production of the bioactive hormone IGF-1 from the liver, sermorelin simulates your own pituitary gland to increase production and secretion of your own body’s HGH.  Then the secreted HGH travels to the liver to cause production of IGF-1 so it can do its work for your body.

So basically, instead of injecting HGH, you inject sermorelin, which causes your body to secrete more of its own HGH.  

One of the advantages of using sermorelin is that the cost is significantly less than HGH.

How is Sermorelin Used?

Sermorelin is administered by an injection under the skin with a tiny needle once daily prior to bedtime, just like HGH. The time of injection is important because sermorelin complements the stimulation which naturally occurs during sleep and thereby facilitates the nighttime release of HGH that is characteristic of youth. 

How Will You Know It’s Working?

Patients usually report improved sleep quality within the first few weeks of therapy.  This usually comes along with improved mood and increased energy levels. After 3-6 months of therapy, most people report noticeable body changes like increased muscle tone and a leaner physique.  

Like most peptide hormones, sermorelin takes about 6 months before full effects are noticed.  Like HGH, sermoerlin is metabolized quickly and therefore requires daily dosing. Its action causes a chain reaction that results in elevated and sustained HGH and growth factor levels.  So it does take some time to become optimal and see the benefits you’re looking to achieve.  

Do You Need To Take It Forever?

In many instances, no.  Sermorelin has an ongoing effect in which HGH levels can be sustained after the last injection.  Initially, like HGH, it needs to be injected every day.  But once optimal results are achieved, you can often be switched to a maintenance protocol eliminating the need for daily injections and further reducing the cost of therapy.

How Do You Get Started?

The starting place for any hormonal optimization program is a thorough evaluation including a blood draw to measure current levels and see if you are a candidate for therapy.  Hormones do not exist in a vacuum, so a complete hormonal profile should be obtained.  As well, diet, medical history, exercise, lifestyle factors and supplementation should all be taken into account before a protocol is initiated.  By addressing these other factors, dosing can be kept to a minimum. 

I strongly recommend an evaluation by a physician specializing in Age Management Medicine to determine a program best suited for your goals and to be sure you receive appropriate and responsible recommendations and monitoring.  

You owe it to yourself to proactively take charge of your health before disease and decline take charge of you.

Will You Be Ready If a Major Earthquake Strikes?

While I usually write to you about hormones or other topics directly related to Age Management Medicine, today I feel compelled to write about something very different.  Disaster preparedness.  Specifically earthquake preparedness, since much of my practice serves clients in California.

Last weekend I was at a medical conference where a presentation on disaster preparedness was aimed at doctors and our roles post disaster.  The data shocked me.

According to seismologists, California has more than a 99% chance of having a magnitude 6.7 or greater earthquake in the next 30 years.  The southern extension of the San Andreas Fault, which extends from Monterey County to the Salton Sea, is now capable of an 8.1 or greater magnitude earthquake.  According to Thomas Jordan, Director of the Southern California Earthquake Center, the San Andreas Fault is “locked and loaded.”

This means “The Big One” In California could happen anywhere between the next 10 minutes and the next 30 years.

The earthquake in Northern Japan on March 11, 2011 was 9.0 on the Richter Scale.  Ten days later, nearly 900,000 households were still without water and 250,000 households were without power. The estimated economic cost was US$235 billion dollars. Staggering statistics.

Despite the fact that there were some key differences, we learned some valuable lessons from that earthquake. One of the biggest lessons learned is that basic supplies shortages will affect areas far from the epicenter. Many of the things we take forgranted (food, water, shelter, transportation, communication) can be gone in a moment if a major earthquake hits.

Preparedness is Key

There are a number of suggestions that I’d like to pass along to you:

1. Have enough water.  1 gallon of water/day per person for drinking.  Store enough water for 30 days.  Also have a water purification kit or unscented liquid bleach (eight drops per gallon when water is first stored)

2. Maintain canned/non-perishable food supply (and a manual can opener) . Ideally, 2000 calories of food/day per person.  Canned beans, protein bars, canned meat, canned vegetables.  As with water, food may not be readily available for an extended period after a significant disaster.  Make your food supply count and emphasize nutrient dense choices.

3. Maintain a one month supply of critical medications. Pharmacy services as well as transportation of pharmaceuticals (and other goods) will very likely be disrupted.  Experts encourage you to have a 30 day supply of any necessary, life saving medications available.  Make sure you check the expiration dates and rotate your stored supply as necessary.

4. Create an earthquake kit or box containing, at the minimum:

  • First aid kit and handbook
  • Comfortable/practical change of clothes
  • Sturdy shoes
  • Blankets or sleeping bags
  • Portable radio and flashlight, with spare batteries
  • Extra pair of eyeglasses
  • Extra set of house and car keys
  • Toilet paper, toiletries and feminine hygiene items
  • Cash in small bills and small change
  • Small tool kit
  • Books, deck of cards, games

While this list may seem simple, most people don’t have even these basics on hand. Take some time this weekend to talk to your loved ones about a preparedness plan and to stock these necessities.

You can purchase self-contained earthquake kits online: http://www.earthquakestore.com/emergency-deluxe-kits.php

Here are some additional resources for more information and access to disaster preparedness information.  You and your loved ones are worth the investment of a bit of forethought when it comes to being prepared.



Leptin: The New Big Boss in Town









There’s a new kid on the hormone block and he’s kind of a big deal.

Even though we’ve only known about him for a very short while, he’s actually been controlling things behind the scenes this whole time.

The hormone we’re talking about is leptin.

Discovered in 1994, leptin is the major hormone that ultimately influences all other hormones in our body, and virtually controls all functions of the hypothalamus – the organ previously considered the grand master in charge of our hormonal output.

Leptin’s primary job is to tell the hypothalamus that you’ve got enough energy stored in your fat stores, and thus don’t need to eat or store more of it. It’s a close relation to insulin, your fat storage hormone, and the two are constantly in a dance together.

As such, leptin coordinates our hormonal, metabolic, and behavioral responses to starvation. Even though we’re not consciously aware of it, leptin is telling us how much to eat, how much of what we just ate to store as body fat, and how much to move or not move our bodies. It profoundly affects our emotions, cravings, and behavior and it determines how much fat is stored under the skin and around our organs.

Like I said, it’s kind of a big deal.

When your leptin levels are in balance, you feel good, you have appropriate appetite and good energy levels, and your weight is healthy and stable. When your leptin levels are too high, your appetite increases disproportionately, you energy levels tank, and your body goes into “starvation” mode, stashing away more and more fat for the rainy day that never comes.

There can be two reasons for leptin being out of balance:

1) leptin deficiency – there is simply not enough leptin to tell your brain you’ve stored enough fat

Or, what is much more common:

2) leptin resistance – there’s plenty of leptin circulating in your blood, but your hypothalamus isn’t getting the message, so your brain thinks you’re starving and responds appropriately

Much like insulin, chronically high leptin levels increase inflammation and, over time, lead to degenerative disease.

Here’s the kicker: the only thing that influences leptin levels is your diet. And in fact, no other hormonal imbalance in your body can be restored without leptin functioning properly.  Bio-identical hormones can help, but we must also work to maintain optimal endogenous hormonal balance – and managing leptin levels is key to doing so.

Here are 14 indicators that you may be resistant to this all-important hormone:

  1. Being overweight
  2. Fatigue after meals
  3. Presence of love handles
  4. High blood pressure
  5. Craving comfort foods
  6. Feeling consistently anxious or stressed out
  7. Feeling hungry all the time or at off hours in the night
  8. Having osteoporosis
  9. Being unable to lose weight or keep weight off
  10. Regularly craving coffee or other stimulants
  11. High fasting triglycerides
  12. Tendency to snack after meals
  13. Having problems falling or staying asleep
  14. No change in the way your body looks no matter how much you exercise

The take away?

There is no pill, exercise, or injection you can take that will ultimately get you to your health goals without also taking your diet into consideration. This is why nutritional optimization is a cornerstone of The Carragher Method, The Body Well’s Age Management Program, and it’s why we get the results we do.

Interested in optimizing your hormones and feeling like you did in your 20s no matter how old you are?  Contact us at (323) 874-9355 or email me at doctormike@thebodywellusa.com

3 Things You Need to Know About Inflammation: Cause. Effect. Prevention.

What Is Inflammation?

At some point in your life, you’ve probably had some sort of injury. You’ve either fallen, ending up with a scrape or bruise, or you’ve somehow cut yourself, I’m sure. You’ve also likely had some sort of infectious invader, like a bacteria or virus. And, it’s quite possible you’ve had a foreign body like a splinter or a bee sting.

Each of these assaults on your body triggers a physiological response called inflammation. Acute inflammation, to be precise. Basically, inflammation is a response that your body has to injury or insult. It’s a protective response your body initiates to eliminate the cause of cell injury, remove dead or dying cells and tissues, and begin the process of repair.  The acute inflammatory response is normally limited and self controlled – meaning, once the repair process if complete, the inflammation ends.

This is a good thing, right?  Well, it is good in the sense that it is necessary to heal.

But there is another kind of inflammation that happens in your body. And it’s not a good thing. This other type of inflammation is chronic, low-grade, and can cause progressive and serious injury to your body’s cells and tissues.  Worse still, it can be systemic, meaning it happens all over damaging tissues in multiple organ systems.

We have identified through research that your body has some of this chronic, low-grade inflammation present all the time.  But the degree of this inflammation is what makes it worse for you.  Meaning the more of this chronic inflammation you have, the more it damages your tissues and organ systems. It can also increase and intensify and cause a number of different problems as you age. Chronic inflammation has been linked to just about every degenerative disease, including:

  • Heart disease
  • Insulin resistance and Diabetes
  • Cancer
  • Stroke
  • Muscle loss
  • Alzheimer’s Disease
  • Osteopenia and Osteoporosis
  • Hypertension
  • Arthritis

So the next logical question you may have is: What causes chronic inflammation?

We have identified a number of causes of chronic, low-grade inflammation. The good news is, many of them you can eliminate. Here are some of them:

  • Suboptimal hormone levels
  • Oxidized LDL (“bad” cholesterol)
  • Weight gain and obesity
  • Many dietary factors
  • Lack of exercise or too much exercise
  • Smoking
  • Stress (mental or prolonged physical)
  • Periodontal disease

So How can I prevent low grade inflammation from happening, or at least keep it at bay?

Since many of the causes of chronic inflammation can be linked to your diet, exercise and lifestyle choices, the solutions can be found here as well.

  • Learn how and what to eat
  • Learn the right type and amount of exercise for your body
  • Improved self-care, and decreasing bad habits.

It’s a little bit easier said than done, but with the right information, you can profoundly decrease inflammation and improve not only the way you feel now, but decrease you risk for degeneration and disease down the road.