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The Keto Kamp Podcast With Ben Azadi

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 analyst.


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 working.
  • 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 Men

  • 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 testosterone.
  • 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 issue.


[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 statistics.
  • 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 libido.


[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 dysfunction.
  • 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 levels.


[17:40] Boosting Testosterone

  • You have to start with the foundations:
    • Exercise
    • Sleep
    • Nutrition
  • 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 constantly exercising.
  • 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 testosterone.
  • There is data on using DHEA as a supplement to increase testosterone.
  • Ralph doesn’t treat himself – always take the guidance of a practitioner.


[23:35] Exercising to Boost Testosterone

  • Ralph does the Big Five:
    • Deadlift
    • Squat
    • Pullup
    • Bench press
    • Rows
  • 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 Eating

  • 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 eating.
  • 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 insulin.
  • Brain function will also improve with time-restrictive eating.


[30:00] Are You Fasting Too Much?

  • You are fasting too much if your thyroid hormone is suppressed.
  • 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 other symptoms.
  • Poor muscle recovery is another issue with fasting too much.


[32:00] The Difference Between Cutting Calories and Time Restrictive Eating

  • 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 meditation.
  • 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 out.
  • 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 weight training.
  • 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 body.
  • 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




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Disclaimer: Disclaimer: This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Ben Azadi disclaim responsibility from any possible adverse effects from the use of information contained herein. Opinions of guests are their own, and this podcast does not accept responsibility of statements made by guests. This podcast does not make any representations or warranties about guests qualifications or credibility. Individuals on this podcast may have a direct or non-direct interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.