How to Optimize Your Hormones for Health & Vitality | Dr. Kyle Gillett

Gillett emphasizes that long‑term hormone optimization depends far more on consistent lifestyle than on drugs or supplements. His “big six” are: (1) diet, with minimal ultra‑processed foods and appropriate caloric intake; (2) exercise, especially resistance training plus zone‑2 cardio; (3) stress optimization to keep cortisol in check, ideally as a household or family unit; (4) sleep optimization for mitochondrial and hormone health; (5) sunlight and outdoor exposure, including natural heat/cold; and (6) spirit, meaning some form of spiritual or existential grounding, which measurably affects mental and physical health.

Evidence from human and animal studies shows that caloric restriction improves testosterone primarily in obese or metabolically unhealthy individuals. In lean, young, healthy men, sustained caloric restriction generally lowers testosterone. Intermittent fasting is not inherently magical for fat loss—calories in vs. calories out still governs weight—but fasting can improve growth hormone output and metabolic markers when properly applied. Choice of approach should depend on body composition and metabolic status, not trends.

DHT is a potent androgen critical for motivation, effort feeling good, and cardiovascular and sexual function, but excess DHT activity in scalp follicles drives male‑pattern baldness. 5‑alpha‑reductase inhibitors (finasteride, dutasteride, saw palmetto, high‑dose curcumin/bioperine) can protect hair and prostate but may lower mood, libido, and neurosteroid‑driven calmness and sleep. Effects are usually reversible if stopped in time. Gillett prefers local approaches (e.g., topical or mesotherapy dutasteride to the scalp) when possible, and warns that widespread use of systemic 5‑AR inhibitors is often unnecessary and can create “post‑finasteride”–like syndromes.

Women typically have more total testosterone than estradiol (in different units) and far more DHEA, and these androgens are crucial for libido, motivation, body composition, and wellbeing. PCOS is common (10–20% prevalence) yet underdiagnosed; it presents with androgen excess (acne, hirsutism, hair thinning), insulin resistance (high fasting insulin, HOMA‑IR >2), and/or menstrual irregularities. Tools like metformin, myo‑/D‑chiro‑inositol, DIM, body‑fat reduction, and carefully chosen contraceptives can improve PCOS, but oral contraceptives also raise SHBG and lower free androgens, blunting libido and cyclical attraction effects.

For clinically hypogonadal men, Gillett favors low, steady doses of injectable testosterone (often ~100–120 mg/week split 2–3 times) rather than large, infrequent injections that cause peaks, side effects (thick blood, anxiety), and crashes. Topical or oral undecanoate can work for some but have practical limits. He generally avoids routine aromatase inhibitors because low estrogen harms mood, connective tissue, and libido; he prefers lifestyle and mild supplements (e.g., calcium D‑glucarate, DIM in select cases). TRT increases sleep apnea risk in a dose‑dependent manner, for both low‑T and normal‑T users, so screening and sleep monitoring are critical.