Narrator:
Coming up on this episode of The Doctor’s Farmacy.

Dr. Mark Hyman:
All your sex hormones are made from fat. They’re made from cholesterol in fact. The building block for all sex hormones is cholesterol.
Hey everybody, it’s Dr. Mark Hyman. Welcome to The Doctor’s Farmacy. That’s Farmacy with an F, a place for conversations that matter. And today we have a special feature called Health Bites, where I’m bringing you little steps that can improve your health over time. Today we’re going to talk about sex and sex drive and what messes it up and how to increase it. So listen up. This is a topic that’s interesting to all of us. First, I want to just say the biggest killer of sex drive is something you might not think about, but ultimately it’s sugar. Of course it’s sugar because all I talk about is sugar. But it is the driver of much of what’s wrong with our health and even our sex life. So how does this all work? We’re going to talk about how hormones work, about insulin, cortisol, testosterone, growth hormone, leptin, a lot of things that relate to sex drive.
I’m also going to give you a few additional and very interesting tips that you might not have heard about before about what increases libido and also what other things in your lifestyle kill your sex drive and what things you can do to improve it. So stay tuned. Here we go. How does sugar play a role in messing up our hormones? Well, we know very clearly that insulin resistance, this phenomenon I’ve talked about for decades, which is where we start to accumulate fat around our organs, belly fat, is driven by sugar and starch in our diet. And that sugar and starch does a number of things. Besides just pour on the pounds and increase inflammation, it has effects in both women and men that are really bad for sex. For women, high levels of insulin and insulin resistance lead to dysfunctions in your hormones by causing higher levels of androgens, particularly DHCA and other androgens, androstenedione that lead to hair loss on your head and hair growth on your face and acne.
It’s not a lot of fun, and that’s definitely a buzz kill. And also it affects your overall mood, energy, and libido. In men, something happens, it’s quite different actually, what you see is a real drop in testosterone levels. This drop in testosterone levels is sort of inversely related to your insulin resistance. The more insulin resistant you are, the more belly fat you have, the more body fat you get, the more estrogen you make, the less testosterone you make. And you end up having very low testosterone, which has a huge effect on libido. So if you really want to keep going for a long time and have a great sex life, you’ve got to cut out the starch of sugar and it’s going to affect every other area of your life as well. So not only does it affect your sex life, but it affects your cardiovascular risk, your risk for cancer, dementia, and many, many other things.
So big deal. Make sure you’re not insulin resistant because that screws up sex hormones for both men and women and leads to impaired sexual drive and function. Also, by the way, what happens is you decreased blood flow. The more insulin resistance you have, the more vasculitides you have, the reduction in blood flow leads to decreased function in your sex organs, both in male and female sex organs. So it’s really important to keep your blood flowing if you want to keep going, if you know what I mean. Now, leptin is interesting. Leptin is another hormone that we see go up and it’s not directly correlated with sex drive, but it increases when you are more insulin resistant. So leptin is the break on your appetite. But what happens is it doesn’t work so much because of the insulin resistance and leptin keeps going up and that causes you to have more hunger and more leptin resistance. And it’s just a vicious cycle.
The other hormone that really is a big factor in sex drive and function is cortisol. Nobody wants to be making out when you’re super stressed. And cortisol has a number of effects that are quite harmful, including increasing insulin resistance. It prevents erections in men and reduces libido. And so you basically know that when you’re stressed out, you don’t want to make out. So it’s better to learn how to reduce cortisol through various lifestyle strategies, including obviously things like meditation, yoga, breath work, getting your mind right, your beliefs, your attitudes. There’s a lot of work we’ve done in that on the podcast, but it’s really important to learn how to navigate stress in your life and not be overtaken by it, because a lot of the stress that we have is what happens in our minds. It’s not necessarily what’s happening to us, and that’s something we have control over.
There’s also some interesting data about low fat diets as a big factor. Low fat diets were promoted for years as a way to lose weight. They clearly don’t work. In fact, large trials, reviews of all the literature show that when you compare low fat diets to low carbohydrate diets, the low fat diets always lose. And when I say carbohydrates, I mean starch and sugar. Now why is fat important? Because all your sex hormones are made from fat. They’re made from cholesterol in fact. All the sex hormones, the building block for all of them is cholesterol. So if you’re really dramatically reducing your cholesterol with aggressive use of statins, that also can affect your hormone levels too because they’re all connected. So eating more fat, and particularly in men, particularly eating more saturated fat, increases your testosterone levels. Also, environmental toxins are real endocrine disruptors and they definitely drive our sexual dysfunction.
And the toxins that we know, we call xenoestrogens or xenobiotics. They disrupt hormone function for both men and women. They’ve been linked to various kinds of birth defects, fertility issues, decreased sperm count, changes in birth rates due to the effect of these environmental toxins. And also it can make you a little nuts. If you ever remember Alice in Wonderland, mercury is something that they used to create these felt hats. And the Mad Hatter and the Mad Hatters in history were because the hat makers used mercury to stiffen the felt in the hats, which led them to be crazy or mad. Lead also has very negative effects on our mood and cognitive function and behavior. So it’s really important. Also, we want to avoid hormones in our food. There’s a lot of hormones in dairy naturally occurring, but also added in growth hormone. There’s also a lot of hormones in meat when they conventionally grow them and raise them through injecting estrogen pellets in their ears and other things that they do.
So I think it’s not something you really want to do, it’s not something you want to be eating and you want to avoid those things. Sugar, as I mentioned, was a big problem. But also, diet drinks are not the answer either because they lead to increased craving for sweets, they increase insulin resistance, they increase diabetes, obesity. It’s quite interesting to see that these non-caloric compounds have information and that affect your hormones and metabolism and insulin levels, and that actually adds to the risk of obesity and diabetes. All right, so what do we know about how to activate your sexual drive? Well, the first thing is that there’s a lot of things you can do to fix it. First is your diet. And diet plays such a role in our overall health, including our sexual function. So eating a healthy whole foods, phytonutrient rich, low glycemic, good fat, fiber rich diet is going to make a huge difference in your overall health and in your sexual drive and function.
And it normalizes your hormone levels as well. Another thing that’s really powerful is exercise. Exercise not only discharges stress and improves insulin sensitivity, but strength training in particular, particularly in men, actually increases testosterone levels. And men and women both have testosterone and they both need testosterone for sexual desire and function. So getting those levels up is really important. So strength training can be helpful for both men and women in terms of desire and function as well. So also interval training helps with reducing cortisol, boosting growth hormone, improving testosterone. There’s a lot of ways you can work out to help you feel better. Also, a number of supplements can be very helpful. A multivitamin mineral is really important. Your sex hormones require these nutrients to function properly. Vitamin D, zinc and omega-3 fat’s really, really important. And then the other thing is that sometimes even herbs can be helpful.
So ashwagandha, there’s a number of different products out there. Libido stem for men and libido stem for women contains a number of different herbs that have been formulated to actually improve sexual desire and function. Also, alcohol is probably one of the worst things. It definitely always has been taught that the more alcohol you drink, the desire goes up but the ability goes down. Who said that? I think William Shakespeare. It provokes the desire but takes away the performance. So it’s kind of a double edged sword. A glass of wine may be okay, but be careful of alcohol. And stress. Learn how to manage your stress response because that plays a big role. There’s some interesting things coming down the pike. Peptides are an interesting new innovation in both low sexual desire and function in both men and women. And there’s a particular peptide called PT-141 that’s available on the market that can be prescribed by doctors that has been shown to increase sexual desire and it works through a pathway called alpha-MSH.
But these [inaudible 00:09:47] receptors seem to regulate sexual desire and function and they can be a great adjunct to anybody who’s looking to up their ante on their sex drive and performance. So that’s a lot of information about sex and sex drive and what screws it up and what helps it. I hope it’s been helpful for you. And that’s it for today’s Health Bite. And so if you like this little podcast bite, share it with your friends and family on social media. Leave a comment, what you use to help your libido and sex drive and function. And we’ll see you next time on the Doctor’s Farmacy.

Narrator:
Hi everyone. I hope you enjoyed this week’s episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you’re looking for help in your journey, seek out a qualified medical practitioner. If you’re looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It’s important that you have someone in your corner who’s trained, who’s a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.

More than just a basic necessity, water is the universal solvent and elixir of life. Making up about 60 percent of the human body, water’s importance transcends just hydration: playing a pivotal role in every body function, from nutrient assimilation and energy production to detoxification and cellular health.

However, toxins in our drinking water can compromise these functions, causing core imbalances that result in accelerated aging and health problems ranging from increased cancer risk and reproductive problems to thyroid issues and high cholesterol.

Recognizing the gravity of this issue, the Biden-Harris administration recently pledged more than $50 billion in funding to upgrade America’s water infrastructure in every state. The funding aims to expand access to clean drinking water, replace lead pipes, improve wastewater and sanitation infrastructure, and remove toxic “forever chemicals” like PFAS. 

Yet, there’s still a long journey ahead (with additional headwinds from over-exploitation and climate change). So it’s crucial to understand the toxins lurking in our water in the meantime—and learn how to avoid them.

Tap Water Toxins: A Closer Look

Tap water is one of the main sources of exposure to environmental toxins including the following:

PFAS: The “Forever Chemicals”
The Environmental Protection Agency estimates that more than 200 million Americans are exposed to toxic “forever chemicals” known as PFAS through their water systems. These chemicals, used in products like Teflon and Scotchgard, are linked to a myriad of health issues, including cancer, weakened immunity, thyroid problems, reproductive issues, low birth weight, and endocrine disruption.

Heavy Metals: Silent Neurotoxins
With up to ten million lead service lines still in use throughout the country, a staggering 56 percent of the population is exposed to levels of lead in tap water that put adults and children at risk for lead-associated cognitive impairment and behavioral problems—including significantly lower IQ scores and lower cognitive functioning in adulthood. In fact, a study published by the American Academy of Neurology found that higher community exposure to lead was equivalent to two to six years of aging. Thirty nine percent of the US population has lead levels over 2 micrograms per deciliter which makes them at greater risk of heart attack, stroke, and death than those with high cholesterol.

Other metals contaminating our drinking water can include mercury, linked to Alzheimer’s, Parkinson’s, hypertension, and thyroid cancer; arsenic, linked to cardiovascular disease and increased cancer risks; and chromium-6, linked to cancer, liver damage, and reproductive problems.

Microplastics and Nanoplastics: The Invisible Threat
While microplastics are generally more abundant in bottled water than tap water (just a liter of bottled water can contain hundreds of thousands of nanoplastics), microplastics can also make their way into tap water sources from surface run-off, industrial pollution, and degraded plastic waste—posing risks to heart health, disrupting hormones, and attracting and concentrating adjacent heavy metals and pollutants in water such as polychlorinated biphenyls (PCBs).

Fluoride: A Double-Edged Sword
Although mass fluoridation of our water supply has been shown clinically effective for dental health and cavity prevention, we also have evidence to suggest that excessive exposure to fluoride can harm both the body and the brain. Studies show a link between fluoride exposure and hypothyroidism, and it also accumulates in the pineal gland (where melatonin is released), leading to disturbances in sleep and sleep cycle regulation.

The Limitations of Standard Water Filters
It’s a common misconception that a standard water pitcher filter can remove all harmful toxins. Brands like Brita may improve taste and remove chlorine, but they fall short in filtering out PFAS, heavy metals, fluoride, and microplastics.

Empowering Yourself: Steps to Clean Water

1. Identify Your Water’s Toxins

• Use the Environmental Working Group’s Tap Water Database to discover contaminants in your local water by searching your zip code or utility grid.
• Search online for your local municipality’s water quality reports for up-to-date information.

2. Invest in High-Quality Filtration

• Consider a reverse osmosis system, like the AquaTru Under Sink or AquaTru Carafe, which effectively remove a broad range of contaminants.
• Remember to replace the filters as needed and add trace minerals back into the water to compensate for those lost during filtration.

3. Opt for Certified Filters

• Look for filters certified by NSF International or the Water Quality Association.
• The EWG’s guide to water filters also offers a comprehensive overview of various filters, detailing the toxins they remove, pros and cons, and pricing.

4. Choose Safer Containers

• Avoid bottled water whenever possible to reduce microplastic exposure.
• Instead, use stainless steel water bottles like Hydro Flask or Klean Kanteen for safer hydration.

Clean water is a cornerstone of health and longevity. By taking proactive steps to ensure the purity of your drinking water, you’re not just quenching thirst—you’re nurturing your body’s future.

References

1. Heidari, S., Mostafaei, S., Razazian, N. et al. The effect of lead exposure on IQ test scores in children under 12 years: a systematic review and meta-analysis of case-control studies. Syst Rev 11, 106 (2022). https://doi.org/10.1186/s13643-022-01963-y

2. Haena Lee et al. ,Childhood lead exposure is associated with lower cognitive functioning at older ages. Sci. Adv. 8 (2022) doi:10.1126/sciadv.abn5164

are associated with cognitive decline, cardiovascular disease, and an increased risk of cancer.

3. Menke A, Muntner P, Batuman V, Silbergeld EK, Guallar E. Blood lead below 0.48 micromol/L (10 microg/dL) and mortality among US adults. Circulation. 2006;114(13):1388-1394. doi:10.1161/CIRCULATIONAHA.106.628321

4. Marfella R, Prattichizzo F, Sardu C, et al. Microplastics and Nanoplastics in Atheromas and Cardiovascular Events. N Engl J Med. 2024;390(10):900-910. doi:10.1056/NEJMoa2309822

5. Qian N, Gao X, Lang X, et al. Rapid single-particle chemical imaging of nanoplastics by SRS microscopy. Proc Natl Acad Sci U S A. 2024;121(3):e2300582121. doi:10.1073/pnas.2300582121

6. Iamandii I, De Pasquale L, Giannone ME, et al. Does fluoride exposure affect thyroid function? A systematic review and dose-response meta-analysis. Environ Res. 2024;242:117759. doi:10.1016/j.envres.2023.117759

7. Malin, A.J., Bose, S., Busgang, S.A. et al. Fluoride exposure and sleep patterns among older adolescents in the United States: a cross-sectional study of NHANES 2015–2016.Environ Health 18, 106 (2019). https://doi.org/10.1186/s12940-019-0546-7

Fish is a surefire way to up your nutrition game. Benefits may include supporting brain function, helping with inflammation and heart health support. Fatty fish, in particular (think salmon, herring, mackerel, tuna and sardines) are rich in omega-3 fatty acids, a type of unsaturated fatty acid. These omega 3 fatty acids help support cells throughout your body and help them function as they should.

But since not everyone likes fish, fish oil is a good alternative with many health benefits. Keep reading to learn more about the benefits of fish oil and how to incorporate it into your diet.

What Is Fish Oil?

Since our body can’t make omega-3 fatty acids from scratch, they must come from our diet.^[1]

For non-fish lovers, this is where fish oil comes in, as it helps prevent omega-3 deficiency. It is extracted from the tissue of fatty cold-water fish and is rich in two forms of omega-3 fatty acids:

• Docosahexaenoic acid (DHA)
• Eicosatetraenoic acid (EPA)

The other type of omega-3, alpha-linolenic acid (ALA), is found in plant sources, such as walnuts, flaxseed and some leafy greens.

Fish Oil Benefits 

While some supplements leave consumers to sink or swim, there’s nothing fishy about fish oil. Research has linked this mighty supplement to a hefty amount of health benefits, such as:

Heart health

It’s no wonder the American Heart Association recommends at least two servings of fish per week.^[2] Fish oil may help reduce the risk of developing heart disease by contributing to these many functions of the heart:

• Supporting a healthy blood pressure^[3]
• Promoting healthy triglycerides levels^[4]
• Promoting better cholesterol
• Reducing the risk of developing an irregular heartbeat (arrhythmias)

Fish oil may be especially helpful for people who have already had a cardiovascular event, such as a heart attack. For example, a meta-analysis of 17 studies found that fish oil may help prevent recurring episodes and death from heart disease.^[5]

Brain performance and function

Did you know that 50 to 60 percent of the brain’s weight is lipids (fat)? Since 35 percent of that number makes up omega-3s, it makes sense that fish oil’s brain benefits are mind-blowing.

Research has found that omega-3s increase blood flow in the brain. They also promote memory and learning and support cognitive functioning.^[6]

Fish oil may also play a vital role in cognitive health, according to some studies. This includes autism, attention deficit hyperactivity disorder (ADHD) and depression.^[7]

Support Sleep

If you’ve been tossing and turning at night, you’ll be happy to know that fish oil may help improve sleep. DHA may help provide sleep-boosting benefits. A trial of 84 participants found that those who regularly consumed DHA-rich oil had higher-quality sleep. They also took less time to fall asleep.^[8]

How to Add Fish Oil to Your Diet

When it comes to adding omega-3s into your diet, don’t limit yourself to one food category. Omega-3s make up a large variety of foods, such as fruits and vegetables, plant-based sources and animal protein.

Try these options to add more fish oil or omega-3s into your diet:

• Fish and other seafood: Fish is an obvious choice when it comes to omega-3s. After all, they put the “fish” in “fish oil.” But while fatty fish is the best option, you can also cast a wider net to include other types of seafood. For example, shellfish (oysters, mussels and scallops) typically contain all three kinds of omega-3 fatty acids: EPA, DHA and ALA.^[9]
• Eggs: The nutritional profile of eggs is even more impressive for its high concentration of omega-3s. Pastured eggs are the recommended option. A 50-gram pastured egg, for example, contains 330 mg of omega-3.^[10] They have three times as much omega-3 fatty acids as caged hens.^[11]
• Grass-fed beef and lamb: Animals on land may not contain as many omega-3s as fish, but they still help keep people’s omega-3 levels afloat. For example, there are about 24.1 mg of DPA in 100 grams grass-fed beef. Whenever possible, opt for grass-fed beef over grain-fed beef. It has a higher concentration of omega-3 fatty acids.^[12]
• Plant-based sourcesPlant forms of omega-3s include flax seeds, walnuts, chia seeds, hemp seeds, edamame, seaweed and algae. Leafy green vegetables contain a small amount. Keep in mind, though, that these plant sources mainly contain ALA, which is rich in antioxidants.
• Supplements: There are plenty of fish in the sea when it comes to omega-3 supplements. A few options include fish oil, krill oil, cod liver oil and algal oil. Bulletproof’s Omega Krill Complex is one of the best fish oil supplements around. Each lemon-flavored capsule (great for reducing those dreaded fishy burps!) contains a powerful blend of wild-caught omega-3 krill oil, Norwegian herring roe oil and fish oil.

How much fish oil should I take?

There is no conclusive recommendation on how much fish oil to take. However, research suggests healthy adults should aim for 250–500 mg of EPA and DHA combined each day. The amount will vary for other populations, such as the elderly, children and those with heart issues.

Fish oil is a great alternative for those who want to reap the benefits of omega-3s without eating lots of fish. The omega-3s in fish oil, DHA and EPA, have been linked to several health benefits. Fish and seafood, animal protein and plant-based foods are all sources of fatty acids to incorporate into your diet. If nothing else, give fish oil supplements a try. Other forms of omega-3 supplements include krill oil, cod liver oil and algal oil.

Ever wondered what gives some seafood a red hue? Or what makes flamingos’ feathers pink? Enter astaxanthin. It’s a carotene that gives color (pigment) to fish such as salmon, lobster and shrimp.^[1] This is not the same as beta-carotene, another pigment from the carotene family. Beta-carotene gives fruits and vegetables like carrots and sweet potatoes their orange coloring.

As a potent antioxidant, astaxanthin has several potential health benefits. These include protection from skin damage due to UV exposure, neuroprotection and reduced biomarkers of inflammation.^[2]

Read on to learn what makes this carotene so special, see foods high in astaxanthin and get the scoop on supplements.

What Is Astaxanthin?

Let’s take a deep dive into the definition of astaxanthin.

Astaxanthin is a red carotenoid pigment that provides natural coloring to marine plants and species. Living organisms, such as salmon, lobster, crab and crawfish, don’t produce astaxanthin. Instead, they get this red hue from microalgae and yeast — two food sources that contain astaxanthin.^[3]

Some animals develop their pigment through the food chain. For example, the pink coloring of flamingos traces back to their diets, which comprise large amounts of algae and brine shrimp.

Astaxanthin Benefits

You won’t turn fiery red or blush pink from eating too many astaxanthin-rich foods. But you will reap several health benefits, such as:

• High in antioxidants: As one of nature’s most powerful antioxidants, astaxanthin has been hailed as the “king of antioxidants.” This may protect the body from oxidative stress. In simple terms, oxidative stress occurs when there are too many free radicals in the body and not enough antioxidants to neutralize them. Free radicals can come from toxins in the environment, cigarette smoke and ultraviolet light.^[4]
• Promotes healthy skin: Vitamins A, C and E get a lot of attention when it comes to healthy, radiant skin. But none of these contain the same sheer antioxidant power of astaxanthin. Studies have found that astaxanthin is 6,000 times more potent than vitamin C and 100 times more potent than vitamin E.^[5]
  This has fantastic benefits for the skin. A meta-analysis of 11 randomized, placebo-controlled, double-blind studies found that astaxanthin may improve wrinkles, increase hydration and protect against UV damage.^[6]
• Supports brain health:Dealing with oxidative stress over long periods can wreak havoc on the body. For example, it may cause cell damage, premature aging and the development of cancer and diabetes. Oxidative stress can also tamper with a person’s cognitive performance. This is because it can increase the risk of neurodegenerative disorders, such as Alzheimer’s disease. Astaxanthin acts as antioxidant to reduce oxidative stress and the effects of inflammation in the brain.^[7]

Other astaxanthin benefits include:

• Supports heart health
• Supports eye health
• May promote athletic performance
• Immune health support
• Joint comfort and health

Ways to Incorporate Astaxanthin in Your Diet

Adding astaxanthin into your diet through food and supplements is a lot easier — and tastier — than eating the microalgae fish eat.

Astaxanthin in Food

While there are many natural sources of astaxanthin, the most obvious choices are the ones found under the sea. For example, there is about 4.5 mg of astaxanthin in four ounces of salmon.^[8]

When it comes to astaxanthin-rich foods, the redder the better. Here are the best astaxanthin-rich foods to add to your diet:

• Sockeye salmon
• Crawfish
• Krill
• Lobster
• Shrimp
• Crab
• Crawfish
• Krill
• Algae
• Trout

Astaxanthin in Supplements

If you’re not a fan of seafood, no worries. Astaxanthin supplements can help. Many supplements extract astaxanthin from a particular type of microalgae. This microalgae is known as Haematococcus pluvialis. Krill oil, a type of supplement that provides omega-3 fatty acids ALA, EPA and DHA, is another source of astaxanthin.

Bulletproof’s Omega Krill Complex is a standout option that has 2 mg of astaxanthin in each capsule to support the heart, skin, eyes and brain. And since each capsule is lemon-flavored, you get all the benefits you love minus the fishy taste.

At this point, you might be wondering, “how much astaxanthin should I take?” While there are no recommended guidelines, research has found that a safe dosage is between 2 and 24 mg per day.^[9]

Astaxanthin is a carotene that gives fish and other organisms their red color. But astaxanthin does more than impart color onto seafood and other living organisms. It’s also one of nature’s most powerful sources of antioxidants that has a whole slew of impressive health benefits. This includes improved brain health, skin and prevention of free radicals. It even surpasses other carotenoids for its ability to protect the body from oxidative stress.

Seafood is a great and delicious way to increase astaxanthin in your diet. But, eating too much fish could increase your risk of mercury poisoning.^[10] Astaxanthin supplements can help safely fill the nutritional gap.