Feb 24, 2020
On today's show, we have a naturopathic physician,
acupuncturist, and functional medicine practitioner specializing in
integrative urology, men’s health, and nutrigenomics, Dr. Ralph
Esposito. His precise and personalized style utilizes a systems
biology and precision medicine approach to medicine.
In addition to advising as a peer reviewer for medical journals,
he has authored several medical textbook chapters. He has designed
education modules for health professionals specifically on
urological conditions, male and female hormone dysfunction,
hypogonadism, exercise, men’s health, and sexual dysfunction.
Dr. Esposito has trained under Dr. Peter D’Adamo, the originator
of Opus23®, at the Center of Excellence in Generative Medicine at
the University of Bridgeport, and NYU Integrative and Functional
Urology Center. He holds a position as an adjunct professor at New
York University, where he lectures on integrative medicine.
Currently, Dr. Esposito serves as a medical consultant and research
In this episode, Dr. Esposito opens the show by diving deep into
his background. Then, he reveals what may be causing low
testosterone levels in men and common ways to test for the issues.
Dr. Esposito describes ways in which men can raise their
testosterone levels, including exercise, sleep, and nutrition. Stay
tuned as Dr. Esposito names the best exercises to boost
testosterone – plus, he gives his take on time restrictive eating
and ways to tell if you are overdoing it.
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[00:20] About Dr. Ralph Esposito
- Esposito watched as his father became medically disabled and
heavily medicated. The threat of a family history of chronic
disease was a major contributing factor to why he chose to pursue
naturopathic medicine when conventional medicine alone was not
- Ralph credits Dr. Geo Espinosa for his mentorship and for
allowing him to work with him at the NYU integrative and functional
urology center for almost seven years.
- Esposito continued his work with Dr. Espinosa in research,
writing, and education modules. This experience led him to his
current position as a medical consultant and research analyst for
medical practice in New York.
[03:45] The Culprits of Low Testosterone Levels in
- Is the brain sending a message to the testes to make
testosterone? If they get the message, are they making the
testosterone? What is the body doing with the testosterone
afterward? Once you figure out these answers, then you can figure
out the underlying cause.
- Sleep deprivation and chronic stressors can contribute to low
- A lot of athletes can have issues in the testes and the brain
after years of trauma.
- It’s not so black and white what could be causing the
[07:40] Testing Male Hormones
- Ralph will test for various male hormones – including the
thyroid hormone. Without the thyroid hormone, you will not be able
to produce testosterone.
- Physicians are misreading labs because they do not understand
- How are your hormone levels changing over time?
- Heavy metals can impair libido. Dr. Ralph’s patients will come
to them with heavy metals and complaints about a lack of
[12:00] Using Drugs to Test Testosterone
- Drugs are the last option. Clomiphene is an estrogen modulator
– it blocks the estrogen receptors in the brain. If their
testosterone does not go up, there is an issue in the testes.
[15:30] High Estrogen and Low Testosterone
- High estrogen and low testosterone are signs of metabolic
- Environmental toxins can cause this. In the past week, Dr.
Ralph has read four articles about how the environment is
disrupting our health.
- The most common reason for high estrogen is high insulin
[17:40] Boosting Testosterone
- You have to start with the foundations:
- Putting ice on your testes will not increase the levels. You
could potentially damage them.
- If you’re not sleeping seven hours, then you are not releasing
the proper hormones. Plus, you won’t be able to recover.
- Exercise is a stressor. Sleep is essential when you are
- A high carb diet is a sure proof way to damage your
testosterone levels. Insulin is a proinflammatory.
- Exercise will help your body efficiently produce
- There is data on using DHEA as a supplement to increase
- Ralph doesn’t treat himself – always take the guidance of a
[23:35] Exercising to Boost Testosterone
- Ralph does the Big Five:
- Bench press
- Work out your back, legs, and chest.
- Duration and frequency will release cortisol. Marathon runners
are in a catabolic state. They are breaking down a lot more than
they are building up.
- Sprinting is also a great exercise.
[27:00] The Benefits of Time-Restrictive
- Time-restrictive feeding is only eating within certain windows.
Intermittent fasting is going multiple days without food.
- Gut rest is the most significant benefit to time-restrictive
- Bacteria will thrive in a fasted state.
- The gut rest will allow you to heal. The cell turnover rate is
very fast in the gut.
- Time-restrictive eating will also make you more sensitive to
- Brain function will also improve with time-restrictive
[30:00] Are You Fasting Too Much?
- You are fasting too much if your thyroid hormone is
- Low motivation to exercise and low libido are issues. You could
be stressing your system.
- Cold fingers and feet, weak hair, thinning eyebrow hair are
- Poor muscle recovery is another issue with fasting too
[32:00] The Difference Between Cutting Calories and Time
- Caloric restriction is the idea behind most diets.
- Fasting has a completely different impact.
- Food is sending a message to the body.
- You can change the messaging in your body by exercising and
- Food is influential to our biology.
- Calories matter, but they aren’t as important.
[36:00] About Dr. Ralph’s Lifestyle
- Ralph exercises in the afternoon and eats after he works
- If Dr. Ralph works out in the morning, he eats after the
workout and starts his unfed time.
- Ralph is doing a CrossFit type of training and traditional
- Ralph moves every single day – he never sits on the couch for
an entire day.
[41:35] What To Do If You Plateaued
- Diversify your diet.
- There’s a lot to learn about our microbiome. Your diet within
48 hours can diversify your biome and the response in your
- Don’t eat the same stuff all the time.
- Your lifestyle should also switch.
- There’s never a time you should diversify your sleep. However,
there are times that you should utilize sleep restriction therapy.
Do not wake up later to get extra hours of sleep – it will throw
your rhythm off.
- “If we are unable to adapt, then we will be unable to
survive.” -Dr. Ralph
AND MUCH MORE!
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