Can a carnivore diet increase testosterone levels? Or is that just a claim wrapped in red meat?
Hi, I’m Dr. Eric Westman, and welcome to my channel, where I review and debunk nutritional misinformation online. In this video, we’re going to hear from one of the prominent carnivore influencers, a physician, and see what he says about testosterone levels. Be sure to wait till the end to hear my final thoughts.
Introduction
Dr. Anthony Chaffee: “I did carnivore for 3 weeks, lost 13 pounds the first week, felt okay, then after that, felt great. I’m wondering how long it would take for significant testosterone levels to increase.” It’s individual, but I regularly test people first when they come in, try to get them on a carnivore diet, and then check them again 6 to 8 weeks later. Typically, I see a significant improvement in testosterone in that time.
Dr. Eric Westman: Who are we listening to? Always consider the source. This is Dr. Anthony Chaffee. I met Dr. Chaffee this summer for the first time. He is super intelligent. He’s a former professional rugby player, a physician, and is now promoting the carnivore diet.
I can say that he is super smart, has done his homework about biochemistry, and is promoting a diet that he thinks is really safe and effective. And now we’re talking about testosterone. What does the diet that he promotes do to testosterone?
Hearing what he said, I wonder how many people he’s monitored testosterone on. But we’re going to take it in and learn from his experience using a carnivore diet, which is a subset of a ketogenic, low-carb, adequate-protein, high-fat diet, and see what his experience has been from people testing testosterone levels.
Ensuring Accuracy of Testosterone Testing
Dr. Anthony Chaffee: It’s very important how you take testosterone – and all your tests, really – but testosterone in particular. You need to take it first thing in the morning, because you get your hit of testosterone first thing in the morning, like when you wake up or just before you wake up. Then it spikes up and goes down.
If you test your testosterone in the afternoon or midday, it’s going to be lower than if you had checked it first thing in the morning. Check it between 8 and 9 a.m., fasting from the night before, 9:00 p.m. Only drink water after that. Only drink water in the morning – no coffee, tea, cigarettes, heroin, anything. No food in the morning until after your blood test. No medications either until after your blood test. And then no exercise, stress, or sexual activity for 48 hours before you take your blood test. All those things can affect how your testosterone levels come out and all your other blood tests as well.
Dr. Eric Westman: Wow. I thought back on my training, and I really didn’t get much training in measuring testosterone and replacing testosterone levels, regardless of what diet someone was doing. I’m trained as an internal medicine specialist in the U.S., then went into obesity medicine as a specialty using a keto diet as the method I’m most comfortable with, before pills, shots, and meal replacement programs. If the diet clicks, that’s what I use.
I went back and reviewed some information about testosterone as a hormone. It will go down in men over time. If you compare levels in the blood to normal levels, it’s common for it to go down over time, a natural reduction, at least for carb eaters, because that’s what the normal range is. It’s based on those who eat carbohydrates. Then I looked at some guidelines about replacing testosterone. Even now, 30 years after my initial training, there’s not a whole lot of great data. The American College of Physicians, in a position statement in the last 5 years, said that unless testosterone levels are really low and someone has a problem with sexual function and cares about it, there’s really no evidence that replacing testosterone is worth doing.
I like that, because if someone’s not symptomatic, you don’t want to just check a blood level and try to get it back into a normal range. You always want to ask someone how they’re feeling. That’s a problem with thyroid measurements too – just checking the blood doesn’t tell you the thyroid function. So just checking the blood level of testosterone probably suffers from the same issues. It doesn’t tell you what’s going on inside the cells. You would want to ask someone about their libido, their sexual desire, and sexual function. I’m reassured that I haven’t missed out on a big area of checking testosterone and replacing it.
Now, I do know there are people who are a fringe from mainstream medicine, where they give back hormones thinking that if we can recreate the hormone status of youth, we will live longer. There are longevity groups that prescribe not only testosterone for men but estrogen and progesterone for women and bioidentical hormones. I’m not well-versed in that. If you’re working with someone who does understand that, great.
But here, the carnivore diet is seen as a kind of panacea to fix everything. There are not a whole lot of publications about changes, and no publication I’m aware of comparing carnivore to a different type of diet. That’s going to be important before we have any comparative information to say you should do this diet or another.
But Dr. Chaffee is going to give the experience that he’s had from his own clinical practice.
Getting off Testosterone Replacement Treatments
Dr. Anthony Chaffee: “I’ve been carnivore for 2 months and the doctor took me off testosterone because of high red blood cells. My testosterone is 174. I’m getting hot flashes and fatigue. Should I get a new PCP?” When I have patients on carnivore, after 3 to 6 months, sometimes even earlier, they can significantly improve their testosterone levels just on their own without going on any sort of testosterone.
It could very well be that your body can make a recovery if you’re very low and you’re symptomatic. That’s probably a bit inappropriate to take you off that quickly. It should have had sort of a weaning dose.
It also depends on why you’re on testosterone. Was there some sort of injury to your testicles that you’re not really able to produce testosterone properly? Or was this just that you were having sort of lower levels associated with aging and wanted to get up to more youthful levels?
Dr. Eric Westman: So this question has to do with someone who’s been given testosterone by the doctor, now does a carnivore diet, and one of the side effects of too much testosterone is increased red blood cells. Here the doctor, I think rightly, said, “Let’s reduce the testosterone instead of getting off that carnivore diet.”
The question really is: how do you handle the testosterone replacement once you do a carnivore type of diet? I think monitoring and adjusting as a general theme here is a good way to think about it. And then mentioning that there are different reasons people would be on testosterone – the natural reduction of aging, for example.
If you had a reduction in sexual function, libido is a legitimate use of this, with monitoring. After that, there are other reasons you would be on testosterone. Someone in the comments mentioned a genetic problem. So there may be a genetic issue. There may be some injury where the testicles aren’t able to produce testosterone, that sort of thing.
I guess the main point here is that testosterone, and any shot or hormone replacement, may have side effects, and you want to monitor those side effects when you change a diet, even toward a keto or carnivore diet.
Choosing What’s Best For You
Dr. Anthony Chaffee: What happened? How do you feel? They should know. But that’s usually what return appointments are. It’s like, “Okay, let’s do this, and I’ll see you again in a month and see how you’re doing.” That’s usually a good way to do it. But you need to go back and tell them that there’s a problem, and then just say, “Hey, look, maybe go on a more graduated reduction, because this has gone too far the other way.”
I think in time, unless you’ve had an actual injury that will stop you from being able to make testosterone properly, you will probably start making normal amounts of testosterone again. That’s what most people do. But it could be that your body’s not able to do that, in which case you might need to take something long term.
I think that’s maybe a bit overkill – taking you off completely just because your red blood cells went up a bit. Especially if your testosterone levels were normal. If you’re too high, sure, bring it down. But testosterone level 174 is not normal. That’s quite low, actually.
I would go back and talk to them. If they’re not approachable and not wanting to hear it, then get a second opinion. It’s definitely your right to do that. It’s your body. It’s your life. It’s your health. If someone’s not really helping you, then you’re allowed to go to someone else and ask their opinion as well. That’s fair.
Dr. Eric Westman: I guess that was the end of it.
What we’ve been hearing is the question and answers by a carnivore influencer, a physician who treats people online, maybe in person. I met Dr. Chaffee. I think he’s a brilliant physician. But it’s hard to know the number of people that he’s seen with testosterone levels. I don’t know if this is real data.
I went down and read all the comments so far, and there were five people who put in the comments that their testosterone went up after going on a carnivore diet. There was one person who said the carnivore diet made their testosterone go down, but it was still in the normal range. So I’m left with five to one.
Then the question is, does it functionally matter to have this kind of change? Are you having more libido? Are you having more sexual function that you want, for example? It’s hard to tease that out as a doctor in a clinic.
I always wonder about the people who don’t come back, the people I don’t hear from, the people who didn’t find the keto or carnivore diet something they wanted to do. There may have been side effects. And so this is one reason for a systematic evaluation called a study, why you would want a study to look at different diets and their effect on testosterone, thyroid, or any other hormonal system for that matter.
Conclusion
Dr. Eric Westman: In general, I think Dr. Chaffee is a great source of information. The carnivore diet is a subset of a keto diet that I’ve been using in my clinic for over 20 years now, if you include the research we’ve done. It’s interesting.
I don’t fully subscribe to an online program with doctors giving advice without knowing all the information. Maybe I’m old school, but people come in and tell me in person something they may not have been able to tell me in a one-line little question. So beware of advice with such little information learned from the person giving the advice.
Good video on balance. I’m learning about testosterone and realize now I have not missed out on a big “we should measure testosterone and replace it if it’s not right.” The American College of Physicians, which is a rather conservative group, says that it’s a good thing to do if people are symptomatic and have low testosterone levels.
It’s something worth checking and being aware of but not to worry about if you’re happy with that testosterone system.
Watch the full video here.
Speaker Bio
Eric Westman, MD, MHS, is an Associate Professor of Medicine at Duke University, the Medical Director of Adapt Your Life Academy and the founder of the Duke Keto Medicine Clinic in Durham, North Carolina. He is board-certified in Internal Medicine and Obesity Medicine and has a master’s degree in clinical research. As a past President of the Obesity Medicine Association and a Fellow of the Obesity Society, Dr. Westman was named “Bariatrician of the Year” for his work in advancing the field of obesity medicine. He is a best-selling author of several books relating to ketogenic diets as well as co-author on over 100 peer-reviewed publications related to ketogenic diets, type 2 diabetes, obesity, smoking cessation, and more. He is an internationally recognized expert on the therapeutic use of dietary carbohydrate restriction and has helped thousands of people in his clinic and far beyond, by way of his famous “Page 4” food list.
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