Be All That You Can Be
An Interview With Dr Jonathan Wright
Jonathan Wright, MD, is well known to readers of Life Enhancement by virtue of his knowledge and enthusiasm for subjects dear to our hearts. Dr Wright is widely acclaimed as one of the leading alternative and life extension physicians practicing in the United States today. In his role as medical director of the Tahoma Clinic in Renton, Washington, he has treated thousands of patients using innovative, natural therapies, including nutrient supplements, botanicals, natural hormones, and glandular extracts. Among his most recent books are the bestseller Natural Hormone Replacement for Women Over 45 and the soon-to-be bestseller [if men are as wise as women] Maximize Your Vitality and Potency for Men Over 40. Dr Wright has also written monthly columns for Prevention and Let's Live magazines. Since 1982 he, along with Dr Alan Gaby, has taught health care practitioners at his annual four-day intensive seminar, entitled "Nutritional Therapy in Medical Practice."
Despite his innovative and outstanding accomplishments in natural medicine, Dr Wright was made infamous to those outside the natural medicine field by the FDA, which in 1992 raided his clinic at gunpoint and arrested his B vitamins! Not surprisingly, one of his favorite sayings is, "Let's outlive the FDA!" In this exclusive interview with Life Enhancement's Will Block, he discusses his new vitality and potency formulation for men.
LE: In your new book, Maximize Your Vitality and Potency for Men Over 40, coauthored with Lane Lenard, PhD - which I had a wonderful time reading - there is a great deal of emphasis put on testosterone, the hormone that makes men what they are. You have chosen to formulate a vitality and potency product. Wouldn't testosterone, the real thing, achieve the best results?
DR WRIGHT: Testosterone is a prescription drug, which requires professional health care supervision. But as with everything, it's not the entire story. My formulation is designed to help us keep our own internally produced testosterone levels up and to keep sexual functioning going. Research increasingly shows that testosterone is just as important an anti-aging factor for men as estrogen and progesterone are anti-aging factors for women. For example, there is research showing that women who take replacement hormones after menopause drastically cut their risk for such things as Alzheimer's and senile dementia.
Rodin's The Kiss
So far, parallel research has not been done in men. However, from my clinical observations, testosterone replacement improves mental function in older men. Their alertness, mood, and even memory are enhanced. Since testosterone is by prescription, my formulation (which is not testosterone) is designed to do every supplemental thing we can to maintain, improve, and restore testosterone levels in men, thus forestalling age-related testosterone-deficiency syndrome. At the very least, we can put off the time when we might need the testosterone prescription. There's research to show that, if we improve testosterone levels, we may help improve both cardiovascular and sexual function.
LE: Many people believe testosterone leads to violence or other antisocial attitudes.
DR WRIGHT: The few studies that have been done using testosterone itself don't appear to support that claim. "Testosterone" aggression and violence appear to result mostly from taking artificial molecules mistakenly labeled as testosterone by their patent medicine producers. These include such things as methyltestosterone and the diverse group of patent medicines loosely labeled "anabolic steroids," such as Durabolin® and so forth. When the natural testosterone molecule itself is looked at, its ability to produce violent or aggressive behavior is decidedly less.
LE: Do men experience the equivalent of menopause?
My formula is designed to do every supplemental thing we can to maintain, improve, and restore testosterone levels in men.
DR WRIGHT: There are studies cited in our book that show that male hormone levels, specifically testosterone levels, decline with age, but certainly not as abruptly as women's do. However, the decline of free, bioavailable testosterone is a bit more rapid than that of total testosterone. And, of course, there are differences in the rate of testosterone decline from man to man. I have worked with men in their 40s whose total testosterone levels and free testosterone levels are too low, but this isn't usual, and it more often affects older men.
LE: Other than supplementing with the hormone testosterone, what else can we do to help slow aging?
DR WRIGHT: Good diet and exercise should be at the foundation level. We need to make sure that the food in our diets is as whole, unprocessed, and unrefined as possible. There's that famous Danish study showing that male organic farmers in their 40s had significantly higher sperm counts than college students in their 20s (college students who were unlikely to be eating organic foods).
So basic diet always comes first. Then there's exercise, which has been shown to help improve many glandular functions. Beyond that - and, one hopes, some good mental health too - there definitely are many supplemental items that can further improve sexual function and possibly increase a man's level not only of total testosterone but also of free testosterone. While the specific nutrients in my product are targeted primarily at men in their 40s and older, there are some studies showing improved function and performance even in men in their 30s.
Testosterone replacement improves mental function in older men. Alertness, mood, and even memory are positively enhanced.
LE: Is there a direct health benefit attributed to sexuality?
DR WRIGHT: You may recall a recent, well-publicized study showing that folks who have sex twice a week had the best levels of secretory IGA, whereas folks who had sex less often than twice a week had definitely lower levels. Secretory IGA is one of very many components of the immune system that help to prevent infection.What the study suggests is that, even if we happen to be 83 years old, sexual activity twice a week is going to do more than just be fun, it's going to help our immune systems stay stronger.
LE: Interesting. There was a correlative study published in the British Medical Journal (see Orgasm and Longevity - March 1998), and done in Wales, in which researchers actually tried to compute the correspondence between the frequency of sexual intercourse and the risk of death for men. They found that there was a direct correspondence: the greater the frequency of intercourse, the lower the mortality rate (all else being equal).
Sex is one of the best things in the world, and it's certainly reflective of a well-operating, goal-seeking, happy, satisfied person. It seems inconceivable to me that somebody could be truly happy without sex. And helping men achieve sexual fulfillment is just what your formulation is designed to do. How did you come up with the idea for this formulation?
There's research to show that, if we improve testosterone levels, we may help improve both cardiovascular and sexual function.
DR WRIGHT: It was a natural consequence of having coauthored Maximize Your Vitality and Potency with Dr Lane Lenard. Plus, I was already familiar with formulations on the health-food store shelves. None of these formulations contained all the items, at the research-warranted levels, that I wanted to offer. Having looked at the studies and sifted through the evidence, it naturally occurred to me that we ought to put them all in one formula.
LE: Let's go through these ingredients, talking about their benefits or their contributions to the goal of the formulation, sexual fulfillment. Let's start with L-arginine.
DR WRIGHT: L-arginine has certainly had a great deal more publicity since the role of nitric oxide, or NO (found in many areas of the body) was discovered. This amino acid is the immediate precursor to the nitric oxide molecule and is a general dilator of blood vessels as well as a local dilator in the vessels of the penis. Also, studies show L-arginine to be of significant value in congestive heart failure; helping to achieve better dilation of the general circulatory system reduces the workload of the heart.
But getting back to sexual function, more L-arginine circulating in the bloodstream means more that is available to be turned into nitric oxide to maintain the blood flow to the penis. And although human studies on nitric oxide and male sexual function are very few, they do show, sure enough, that a good percentage of men have marked improvement in their ability to achieve and maintain erections. Men who were taking notes in their diaries said, yes, the erections were harder and longer-lasting and so forth when they were using L-arginine. The two studies I have in mind used 2,800 mg and 2,500 mg of arginine, respectively. We use 2,800 mg.
There are studies cited in our book that show that male hormone levels, specifically testosterone levels, decline with age.
Not only does L-arginine help dilate the vessels of the penis, but studies done 30 years ago report that it improves sperm count in men.
LE: We've seen one report in the Journal of Urology that found a doubling of sperm count in just a few weeks. What about choline? What is its role in this formulation?
DR WRIGHT: Choline is one of the precursors of acetylcholine, which is one of the major neurotransmitters throughout our nervous systems. We include choline because not all of us get very much of it from dietary sources, so we'll have an additional source to make the acetylcholine neurotransmitter. Of course, in the various neuropathways involved in sex, we all know that "it starts in the brain," and then the nerves fire themselves down to the appropriate locations. Several of those nerve transmissions from the brain to the sex organs use acetylcholine, of which, again, choline is a major precursor. Acetylcholine also helps release the enzyme that helps to produce nitric oxide. But that aspect has not been demonstrated in a controlled human trial.
LE: What about ginkgo biloba? Does it have an effect on nitric oxide?
Men said, yes, the erections were harder and longer-lasting when they were using L-arginine.
DR WRIGHT: Ginkgo was the subject of just one human study that we could find, but it was a very interesting one in that the men were tested with - something I'm sure we would all run away from unless we were part of the study - a penile clamp, a clamp that measures actual blood flow to and from the penis.
DR WRIGHT: The work involved 60 men, all of whom had problems with erections and impotence. They were refractory - didn't respond - to a medical treatment called papaverine injection. The study entailed placing a ring-shaped structure around the male organ to measure the blood flow in and out. When ginkgo was taken for six months, this penile clamp technique showed that there was a significantly increased blood flow. This objective measurement found that 30 men out of the 60 regained erectile function. And of the other 30 men, who didn't regain erectile function with ginkgo biloba, 15 had some improvement, 12 were no longer refractory to the injections - they worked - and only three were without benefit.
LE: Impressive. I saw a scientific abstract showing ginkgo to be 84% effective for antidepressant-induced sexual dysfunction caused predominantly by selective serotonin reuptake inhibitors. It was found effective for both men and women. Ginkgo biloba generally had a positive effect on all four phases of the sexual response cycle: desire, excitement (erection and lubrication), orgasm, and resolution (afterglow).
While the specific nutrients are primarily targeted at men in their 40s and older, there are some studies showing improved function and performance in men even in their 30s.
Then there is literature supporting ginkgo's ability to increase the releasability and sensitivity of nitric oxide synthase, the key enzyme for producing nitric oxide. Atherosclerosis, an age-related disease, inhibits nitric oxide synthase, helping to explain the lessening impact of arginine on older men in one study. It may be that ginkgo biloba can be helpful in that regard, as anecdotal reports suggest. What about ginseng?
DR WRIGHT: In Chinese medicine, ginseng is used for members of both sexes when the effects of aging are felt. Considered a general rejuvenator for many functions, it was thought of as a stimulant for sexual activity, or, in younger women, for fertility. In a lab study with rats, ginseng - albeit a lot of ginseng - increased serum testosterone levels.
As you were saying about ginkgo, other studies showed that ginseng helped with the release of nitric oxide and improved the blood flow to the male organ. None of the studies actually gave a mechanism, but one has to respect a roughly 5,000-year medical tradition in China that says use it for this reason. Ginseng has been shown to improve neurotransmitter activity in the brain, and, as we know, sexual activity starts there.
LE: It's useful to point out that Viagra®, the drug that has garnered all the press excitement, doesn't help libido, meaning sexual motivation. Are there other items in your formulation that deal specifically with libido? Nerve transmissions from the brain to the sex organs use acetylcholine, of which choline is a major precursor.
DR WRIGHT: Probably yohimbe. Folk tradition in West Africa involves the use of yohimbe for what were reported by early explorers as ceremonial orgies. These involved the use of a lot of yohimbe bark. From these traditions, the chances are very good that yohimbe does something for libido. Yohimbe works through alpha-adrenergic blocking, which prevents the emptying of blood from the penis, thus helping erections. However, we haven't seen any controlled scientific studies supporting its effects on libido.
LE: What about South America's muira puama, another of these legendary items?
DR WRIGHT: There was a study done in France at 1-1 1/2 g/day, and while the protocol was loose and subjective, better than half the men with low libido reported increases in sexual desire. Also, 50% noted improvement in erectile function. Because this was not placebo-controlled, one has to say it was a preliminary study. Plus there are strong anecdotal reports for muira puama improving libido, so I thought it should be included in the formulation. Also called "potency bark," it is very safe to use.
LE: What about Urtica dioica, also known as stinging nettle? Ginseng has been shown to improve neuro-transmitter activity in the brain, and, as we know, sexual activity starts there.
DR WRIGHT: Stinging nettle is interesting because of its effect on the protein sex-hormone-binding globulin (SHBG), which circulates in the bloodstream. SHBG actually binds a large majority of these sex hormones, including testosterone for men and estrogen, progesterone, etc., for women. In men, SHBG binding prevents testosterone from being utilized, by preventing it from stimulating testosterone receptors.
Remember that "free testosterone" means not bound to SHBG. "Total testosterone" is the sum of the free and SHBG-bound testosterone. Well, for reasons that nobody has explained yet, SHBG increases with age, sopping up more of a man's testosterone. So a man can have what looks like normal total testosterone, yet be deficient in free testosterone.
Stinging nettle has the unique capability of displacing testosterone from the SHBG and getting more of it into the free testosterone state. In other words, the Urtica bounces the testosterone off the bench and puts it onto the playing field.
LE: Since stinging nettle makes more testosterone available, its use for benign prostatic hypertrophy (BPH) is puzzling. If you believe the manufacturers of synthetic patented drugs - such as Proscar® (finasteride) - that have been devised to inhibit the conversion of testosterone into dihydrotestosterone (DHT), stinging nettle should increase BPH rather than reduce it.
New Jonathan Wright book. Available from Life Enhancement.
DR WRIGHT: Currently there are two major theories in this area. One is that testosterone transformed to DHT is the bad stuff, and it makes the prostate enlarge. Drugs called 5-alpha reductase inhibitors, such as Proscar, are designed to block the transformation of testosterone to DHT.
The other theory, though, more popular in Europe, holds otherwise. Instead, it is the transformation of testosterone into the estrogen estradiol by an enzyme called aromatase that causes prostate enlargement. To drive that point home, French researcher Dr B de Lignieres has treated men with enlarged prostates with DHT itself, the stuff that is supposed to enlarge the prostate, and he has found that men's prostates actually got smaller, not larger.
LE: Interesting. Why is Withania somnifera (also called ashwagandha) used?
DR WRIGHT: This is fascinating, because ashwagandha in the Indian Ayurvedic tradition occupies the same position of value that ginseng does in the Chinese tradition. And yet, ashwagandha is much less known than ginseng, despite that same lengthy tradition. Ashwagandha (see the book) refers to the smell and strength of a stallion. And it alludes to what the Ayurvedic tradition has said, namely that ashwagandha has aphrodisiac properties.
In the one study that I could find, which was actually sent to me courtesy of Kerry Bone, who does the botanical column in my newsletter, Nutrition and Healing, a double-blind study was conducted with 101 men in their 50s. Some took ashwagandha, some took placebos. Ashwagandha users had increases in hemoglobin (red cell count) and hair melanin content (which means a bit less gray hair), less decrease in fingernail calcium, and decreased cholesterol. Surprisingly, they found a significant increase in seated stature. This is the height from our tailbone to the top of our heads when seated. Somehow the men taking ashwagandha had a significant increase in their seated stature. Now we can only speculate on that. Does it somehow improve the height of the spinal disks? It's probably not going to improve the height of the bone.
The chances are very good that yohimbe does something for libido.
After I read this, I thought, if for nothing else but to keep my spine from collapsing, I'd go take some ashwagandha. But to get around to the sexual aspect, over 70% of the men taking ashwagandha reported an improvement in sexual performance.
LE: That's amazing. A few years ago I worked with a racehorse breeder in Pennsylvania, in the Main Line area, who claimed that L-arginine not only made his horses stronger and faster, it made them more responsive and able to leave the starting gate more quickly. He also found that the horses receiving arginine displayed an almost coltlike quality, enjoying movement as if for the first time. Which leads us right into the next item, which is the Avena sativa, or wild oats.
DR WRIGHT: There are no formal studies using Avena sativa on human males to see if it actually does increase their ability to go "sow their wild oats." Yet I've made clinical observations, particularly with men in their 20s and 30s who had low testosterone levels for their age and for whom Avena sativa resulted in increased testosterone levels. So although those weren't controlled trials, they were clinical anecdotes that support Avena's effect on sexual function.
LE: What about magnesium and potassium? There are strong anecdotal reports for muira puama improving libido. Also called "potency bark," it is very safe to use.
DR WRIGHT: What have those essential minerals to do with sexual function? The explanation is in the aspartate form of each of them. Prior to the Kefauver amendments to one of the innumerable FDA laws, one of the major patent medicine manufacturers was actually putting money into the study of potassium aspartate and magnesium aspartate together, called generically potassium-magnesium aspartate, and given the trade name Spartase®.
Use of potassium-magnesium aspartate, as opposed to placebo, improved energy and lessened fatigue. Following the Kefauver legislation, the cost of getting a drug approved went from $0.25 million to $25 million within one year. So they just dropped it because they couldn't patent the stuff. We're using it because we reason that an improvement in energy is bound to help our sexual function.
LE: Especially, as I suspect, because many people engage in sex later in the day, when fatigue is more likely.
DR WRIGHT: So the key is not the magnesium and potassium per se, but the aspartate form. Ayurvedic tradition says that ashwagandha has aphrodisiac properties.
LE: Those papers appeared in "status" medical journals such as JAMA.
DR WRIGHT: They were cranking up for a big product introduction before Congress changed the law.
LE: Lastly we have selenium, copper, and zinc.
DR WRIGHT: Selenium is in the formulation because of the L-arginine, which may for some people cause activation of latent herpes. And that's not real neat. While it won't happen to everyone, there is a risk in a small percentage of people, and selenium helps inhibit the replication of herpes and other retroviruses. Studies of the molecular genetics of retroviruses (and herpes is one of these) have found that they make a selenium protein that acts as if it were a birth control pill for the herpes virus.
I've made clinical observations, particularly with men in their 20s and 30s with low testosterone levels for their age, for whom Avena sativa resulted in increased testosterone levels.
It's also possible to balance L-arginine with L-lysine, helping to achieve the same thing. So if folks want an extra measure of insurance against activating herpes, they can take some L-lysine, which does not interfere with the body's utilization of L-arginine for nitric oxide. L-lysine has been shown to inhibit the stimulation of the herpes virus by L-arginine.
Just to be clear, L-arginine cannot cause herpes if we don't already have it, but it does have a small chance of "reactivating" it, which (if it's a problem) can be stopped with selenium or L-lysine, among other things.
Zinc is one of the major elements in keeping our prostates from enlarging. And a lot of men don't get enough zinc in their diets. I theorize - this is not backed by anyone's controlled study - that we probably will function better without enlarged prostates. Taking zinc over a long period of time will lead to copper depletion, so copper is included too.
LE: Zinc is also involved in sperm production.
DR WRIGHT: That too. So if we're thinking of more sperm, both L-arginine and zinc will help.
Use of potassium-magnesium aspartate, as opposed to placebo, improved energy and lessened fatigue.
LE: And the particular forms?
DR WRIGHT: The sebacate form of copper has been found to be the best transporter for that mineral across lipid membranes, which surround every cell. The picolinate and citrate forms of zinc have been shown to be the best-absorbed forms.
LE: It is very exciting to me that this excellent formulation for vitality and potency is now available. And congratulations on your book! We will carry it and refer anyone who's really serious about testosterone to your clinic. In conclusion, is there anything else you'd like our readers to know?
DR WRIGHT: Since you've asked, how about a shameless plug? Get our book Maximize Your Vitality and Potency for Men Over 40, capture the ideas, and put them to use in order to improve your life. Then get Natural Hormone Replacement for Women Over 45 for the woman in your life (if she needs it, of course).
But remember that some of the ingredients have been shown to improve sexual function in men under 40 years old, too. So even if a reader himself and his lady aren't over 40 or 45, the formulation should help them both have a more enjoyable time together.