Low Energy and Low Testosterone – What’s the Deal and How to Beat It?

Do you feel tired all the time, lack motivation, experience brain fog, and get sleepy during the day? Many medical and lifestyle factors can cause these symptoms, but when we are talking about men, one of those factors can be low testosterone. In fact, low energy and low testosterone can be a significant problem for men as they grow older and their T levels decline.

The hormone testosterone is responsible for many processes, during adolescence and throughout adult life, including maintaining muscle, producing sperm cells, libido, and generating energy. Although declining testosterone levels can have an impact on these and other factors as a part of normal aging, it’s not normal for testosterone to drop so low that fatigue becomes a way of life.

Symptoms of low testosterone
Low energy or fatigue is just one of the symptoms of having low testosterone. Others include:
• Depression
• Irritability
• Anemia
• Hot flushes
• Erectile dysfunction
• Decline in body hair growth
• Decrease in muscle mass
• Development of gynecomastia (man boobs)
• Trouble concentrating
• Loss of bone mass (osteoporosis)

If you are experiencing symptoms of low testosterone, talk to your doctor about having your T levels checked. All it takes is a simple blood test.

How to remedy low energy and low testosterone
If you want to boost your testosterone levels and your energy along with it, you may be tempted to listen to the commercials telling you to jump on board the testosterone replacement therapy (TRT) train. However, testosterone replacement therapy is FDA approved only for men who have low T levels associated with disorders of the pituitary gland, testicles, or brain that cause hypogonadism. The safety and benefits of using TRT for symptoms of low T for aging reasons has not been established. TRT also may increase a man’s risk of suffering a heart attack or stroke.

Instead, you can help battle low energy and low testosterone with natural options. It is recommended you adopt all of these lifestyle tips because they can work in synergy and improve your results.

Get checked out. Talk to your doctor about any medical conditions or medications that could be causing your low energy and low testosterone. Thyroid disease, sleep apnea, depression, insomnia, heart disease, diabetes, and anemia are associated with fatigue and/or low T, as are the following medications: opioids, some antidepressants, statins, ketoconazole, cimetidine, spironolactone, and chemotherapy. Discuss with your doctor lifestyle changes and alternative medications, if needed, to help you overcome the low energy and low testosterone that is affecting your quality of life.

Try natural testosterone supplements. Numerous herbs and nutrients have been shown to help boost testosterone levels naturally on various levels. Those ingredients include L-arginine, avena sativa, beetroot, beta-sitosterol, L-carnitine, L-citrulline, fenugreek, ginkgo biloba, green tea extract, pygeum africanum, resveratrol, tribulus terrestris, vitamin D, and zinc. Rather than take these substances individual, your best bet is to take one supplement that contains all or nearly all of them.

Improve your diet. Kick up your energy and T levels by keeping saturated fat intake low and fruits, vegetables, and other whole natural foods high on your menu. Alcohol consumption should be kept to a minimum: two drinks daily is considered moderation, but less is even better.

Stay hydrated. This is a simple tip that many men overlook, especially if they are exercising, working outdoors, or are elderly. Dehydration can cause fatigue and lower your energy levels. Carry a stainless steel water bottle and drink from it frequently.

Get quality sleep. Seven to eight hours every night is highly recommended. You need sleep to produce testosterone. If you are experiencing sleep apnea, get it treated. Your doctor can order a sleep study if sleep apnea is indicated.

Get help for depression. Depression, low energy and low testosterone often go hand-in-hand, so it’s important to address depression. If you are treated medically for depression, talk to your doctor about medications that are not in the selective serotonin reuptake inhibitor class, as these can interfere with libido and sexual performance.

Exercise. Regular physical activity raises testosterone levels. Be sure to choose activities you enjoy so you’ll be more likely to stick with it. You’ll feel more energized, improve your overall health, enhance muscle strength, and even drop some weight.

Bottom line
If you’re experiencing low energy or fatigue, low testosterone may be a reason. These natural testosterone and energy boosters can alter your life for the better if you’re willing to commit to change. The challenge is out!

References
Bergh SJ, Giraldi A. Sexual dysfunction associated with antidepressant agents. Ugeskr Laeger 2014 May 26; 176(22).
Food and Drug Administration. FDA drug safety communication: FDA cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use. 2018 Feb 26
McHenry J et al. Sex differences in anxiety and depression: role of testosterone. Frontiers in Neuroendocrinology 2014 Jan 35(1): 42-57
Metcalf E. Does working out affect testosterone levels? WebMD 2015

The Power of Probiotics

Extensive research has shown that beneficial bacteria, aka probiotics, can play a significant role in numerous areas of human health. Because these good microorganisms are concentrated in the digestive system, and especially in the intestinal tract, their interactions with food and their impact on all things related to digestion are of most interest.

For example, one of the strengths associated with probiotics is an ability to help balance the healthy bacteria in your digestive system. An imbalance can occur for many reasons, including use of antibiotics, illness, and eating a poor diet, such as one that includes processed meats, sugary beverages, and refined carbohydrates. We could easily be talking about a hot dog or sausage on a white flour bun accompanied by greasy French fries and washed down with a cola. This combination could cause some internal fireworks!

Probiotics can defuse that fire. For example, people who take probiotics have experienced a reduced risk of experiencing diarrhea. Several factors can be involved in diarrhea, including the use of antibiotics and traveling to a different country, but it also can develop if you consume foods that have been left out on a serving table too long or not stored properly. Cases of food poisoning are not uncommon during the summer months because higher temperatures foster more rapid growth of harmful bacteria.

Probiotics are insurance

Taking probiotics is an insurance policy. Even if you try to eat a balanced diet and avoid food additives and other harmful ingredients, it’s a challenge. Holidays and special occasions are prime opportunities to step away from your usual diet. Although the end result may be stomach pain, diarrhea, or other intestinal disturbances, use of probiotics can step in and help restore balance.

In fact, daily use of a wide spectrum probiotic, which is one that contains many different species of beneficial bacteria, is a prudent way to protect your digestive and immune systems every day.

Health benefits of probiotics

If you take probiotics on a regular basis, you can set yourself free from stressing over the detrimental effects of poor dietary choices. That does not mean you can make bad food choices on a continuous basis and expect probiotics to save you! However, if you provide your body with beneficial bacteria daily, you can help create and maintain a healthy intestinal (gut) environment where beneficial bacteria secure the upper hand over disease-causing, system-disrupting microorganisms.

For example:

Heart health. Heart disease is still the number one killer of men in the United States and many other countries, and probiotics can help change that statistic. Studies show probiotics can lower bad cholesterol (LDL) and blood pressure and also raise good cholesterol (HDL). It’s recommended you take at least 10 billion CFUs daily for 8 weeks to experience results.

Digestive disorders. If you suffer from inflammatory bowel disease, which includes ulcerative colitis and Crohn’s disease, or irritable bowel syndrome, then probiotics can be helpful. One study even found that a specific probiotic called E. coli Nissle was as effective as drugs in maintaining remission in ulcerative colitis cases. Symptoms of irritable bowel syndrome can be reduced when using probiotics.

Immune system function. Probiotics can enhance the function of the immune system. One study, for example, showed that probiotics limited damage to the epithelium by certain pathogens and also promoted the restoration of the tissue. In a 2018 Swiss report, the authors noted that probiotics can increase the activity or natural killer cells and other natural antibodies, modulate the secretion of cytokines (molecules that regulate immunity and inflammation), enhance the epithelial barrier in the gut, and help keep out damaging bacteria.

Weight problems. How can microorganisms help with weight loss? Study results suggest probiotics may prevent the absorption of dietary fat in the intestinal tract and help you feel fuller for longer, store less body fat, and burn more calories.

In one study in women, use of Lactobacillus rhamnosus for three months resulted in a 50 percent greater weight loss than among women who did not take the supplement. Another showed that those who took L. gasseri for 12 weeks had an 8.5 percent reduction in belly fat. Given the challenge associated with losing weight, probiotics could offer this benefit along with the other health advantages.

Mental health. Studies in both animals and humans show that probiotic supplements can improve some mental health issues. In a review of 15 human studies, for example, supplementation with various Bifidobacterium and Lactobacillus strains resulted in an improvement in anxiety, depression, obsessive-compulsive disorder, and memory.

In a group of chemical workers, those who ate 100 grams of probiotic yogurt daily experienced improvement in anxiety, depression, stress, and general health when compared with those who took a placebo. In a study of 40 individuals with depression, taking probiotics daily for 8 weeks reduced levels of depression and levels of C-reactive protein (a marker of inflammation) and insulin when compared with individuals who did not take the probiotic.

Bottom line

Are you ready to set yourself free from worry about the damaging effects of some of your dietary choices? Would you like to improve your heart health, boost your immune function, enhance the ability to lose weight, and improve symptoms of digestive problems and depression and anxiety?

Then a daily dose of probiotics may help. A wide spectrum of strains should be present in the supplement you choose (i.e., at least 8 to 10). Declare your independence from worry about digestive health or slipping up on your diet. Always strive to eat organic, all-natural foods and exercise regularly, and complement your efforts with daily probiotic supplementation.

References

Agerholm-Larsen L et al. The effect of a probiotic milk product on plasma cholesterol: a meta-analysis of short-term intervention studies. European Journal of Clinical Nutrition 2000 Nov; 54(11): 856-60

Aronsson L et al. Decreased fat storage by Lactobacillus paracasei is associated with increased levels of angiopoietin-like 4 protein (ANGPTL4). PLoS One 2010 Sep 30; 5(9)

Behm B. Avoid food poisoning during summer picnics. Centers for Disease Control and Prevention 2017 Jul 10

Kadooka Y et al. Effect of Lactobacillus gasseri SBT2055 in fermented milk on abdominal adiposity in adults in randomized controlled trial. British Journal of Nutrition 2013 Nov 14; 110(9): 1696-703

Kiessling G et al. Long-term consumption of fermented dairy products over 6 months increases HDL cholesterol. European Journal of Clinical Nutrition 2002 Sep; 56(9): 843-49

Khalesi S et al. Effect of probiotics on blood pressure: a systematic review and meta-analysis of randomized, controlled trials. Hypertension 2014 Oct; 64(4): 897-903

La Fata G et al. Probiotics and the gut immune system: indirect regulation. Probiotics and Antimicrobial Proteins 2018 Mar; 10(1): 11-21

Moayyedi P et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut 2010 Mar; 59(3): 325-32

Mohammadi AA et al. The effects of probiotics on mental health and hypothalamic-ituitary-adrenal axis: a randomized, double-blind, placebo-controlled trial in petrochemical workers. Nutritional Neuroscience 2016 Nov; 19(9): 387-95

Ogawa A et al. Lactobacillus gasseri SBT2055 suppresses fatty acid release through enlargement of fat emulsion size in vitro and promotes fecal fat excretion in healthy Japanese subjects. Lipids in Health and Disease 2015 Mar 20; 14:20

Resta-Lenert S, Barrett KE. Live probiotics protect intestinal epithelial cells from the effects of infection with enteroinvasive Escherichia coli (EIEC). Gut 2003 Jul; 52(7): 988-97

Sanchez M et al. Effect of Lactobacillus rhamnosus CGMCC1.3724 supplementation on weight loss and maintenance in obese men and women. British Journal of Nutrition 2014 Apr 28; 111(8): 1507-19

Wang H et al. Effect of probiotics on central nervous system functions in animals and humans: a systematic review. Journal of Neurogastroenterology and Motility 2016 Oct 30; 22(4): 589-605

 

Age creeping up on you? Mid-Life Crisis? Let’s Beat It!

Mid-Life Crisis? You’ve Got it Beat!

Mid-life crisis got you feeling apprehensive or a bit down? Struggling with uncertainty about the direction your health is going? Let’s take stock!

It’s mid-year and chances are any New Year’s resolutions you may have made were shelved long ago. That’s okay, it happens to the best of us. But you’re probably still looking for the right combination of healthy choices and moves that will help you maintain a high quality of life over the next few decades—right?

There’s no time like the present to make those moves.

What improvements can you make to your lifestyle right now to restore, maintain, and improve your vitality, health, and mood?  Sound like a tall order? It could be, but it also can be the greatest opportunity and gift you give to yourself and your loved ones.

Let’s face it: getting older can really be a bummer, but it doesn’t have to be. Change your perspective and you change the outcome. If you are willing to make a few healthy alterations in your daily life, you could get to spend more quality time with your partner or spouse, your children and grandchildren, and your friends, and pursue goals you have set in your life—or reach for new dreams you have yet to realize.

Let’s start with diet

When it comes to diet and food options, you can choose from scores of diets and dietary plans, books, and recipes. However, the ones that make the most sense scientifically may not be sexy (although they can improve your performance in the bedroom), but they work. They include the Mediterranean diet and DASH (Dietary Approaches to Stop Hypertension), both of which have been shown to help protect against the number one killer of men and women—heart disease—as well as support brain health and also throw in benefits for bone and digestive health as well.

The foundation of a healthy diet is simple: focus on whole, natural foods (i.e., free of artificial preservatives, flavors, colors, sugars, hormones, pesticides, and steroids), which provide a balance of macronutrients (protein, healthy fats, carbs), and are rich in vitamins, minerals, phytonutrients, and enzymes. This gives you a wealth of foods from which to choose—just keep them whole and natural.

  • Feast on fruits and vegetables, seeds, nuts, whole grains, beans, legumes, and teas.
  • Moderate your intake of fish, poultry, meat, and dairy.
  • Choose healthy fats such as olive oil, sesame oil, and coconut oil.
  • Avoid added sugars, alcohol, and too much salt—switch to herbs and spices instead.
  • Drink plenty of pure water.

Lose extra pounds

Have you added a few extra pounds in recent years?  Time to let them go and welcome in added vitality, less stress on your joints, and a significantly reduced risk of heart disease, stroke, diabetes, erectile dysfunction, prostate cancer, and colon cancer. If you lose 5 to 10 percent of your current weight, you can appreciate these impressive health benefits.

For example, the Diabetes Prevention Program found that individuals who lost 7 percent of their body weight and exercised about one-half hour daily reduced their risk of diabetes by nearly 60 percent. Did you know that every step you take places up to six times your weight in pressure on your feet and knees. So if you weigh 200 pounds, that’s up to 1,200 pounds of pressure on your joints. Ouch!

So what’s the secret to weight loss? No secret…just patience, dedication, and motivation. Some simple weight loss tips:

  • Skip the fad diets and choose an eating program that you can live with. After all, you don’t want to be miserable while losing weight, right? The Mediterranean diet, DASH, and various plant-based diets provide lots of variety and nutrition and can be easy to follow.
  • Chew! Too many people forget to thoroughly chew their food. This will force you to eat more slowly, feel satisfied in a healthy way, and allow you to better digest your food.
  • Increase your physical activity, and be sure to include things that you enjoy. Consider team sports, exercising with a friend, taking up a new activity, joining a gym, or forming an exercise group at work or in your neighborhood.
  • Make food substitutions. Crunchy veggies are better than chips for dipping. Water with lemon beats soda. Cauliflower rice is a better choice than regular rice. Frozen bananas or berries are much lower in calories than ice cream. There are scores of substitutions you can make to reduce calories.
  • Inadequate sleep contributes to weight gain. Be sure to get your 7 to 9 hours of Zzzzs every night.

Quit smoking

If you don’t smoke, you’re ahead of the game! But if you do, it’s time to escape the clutches of this lethal habit. Don’t think just because you’ve been smoking for decades, you can’t experience some significant benefits once you snuff that final cigarette. Within one week of stopping, blood circulation improves. That’s good news on the bedroom front, since a strong erection depends on a good blood supply. Current smokers are nearly three times more likely to have erectile dysfunction than non smokers and former smokers.

After 30 days, your lungs will function more efficiently. You ay cough up mucus, but that means you are clearing out your lungs and reducing the risk of infection. By your one year anniversary of quitting, your risk of heart disease will be half of someone who still smokes. It takes about ten times longer to reduce your risk of lung disease by half that of a smoker. If you are keen on maintaining your vision, then quit smoking, because this habit increases the risk of cataracts and macular degeneration.

To help you kick the habit, devise a plan:

  • Identify a quit date. Choose a time when the stress level in your life is not running high, or you could set yourself up for failure.
  • Establish support. Having a partner, spouse, or friend who can support and encourage you is important. You also could attend a smoking cessation group, listen to stop smoking talks online, or use nicotine patches or similar products.
  • Know your motivations. It helps to write down why you want to quit. Keep that list handy so you can refer to it when you feel tempted to smoke.
  • Find healthy habits. Smoking is a habit as well as an addiction, so you should replace the unhealthy habit with a healthy one. For some it’s going to the gym, joining a sports team, taking up biking or jogging, or adopting a new hobby.

Keep moving

Want to live longer? Adopt the “E” word. Men older than 50 who participated in regular moderate exercise can live about a year longer than their peers who are sedentary, according to the Framingham Heart Study. Kick up the activity to high and you can extend it to about four years. Physical activity improves heart and blood vessel health, enhances brain and cognitive function, helps control blood sugar levels, aids weight loss, improves mood, betters bone strength, and helps sleep.

The exercise formula is BASS: balance, aerobic, strength, stretch. Include activities that promote all of these elements and you will enhance your total health.

  • Balance, incorporate yoga, tai chi, qi gong, or simply practice heel-toe walking.
  • Aerobic activities include walking and jogging, swimming, spinning, jumping rope, and rowing.
  • Strength exercises include lifting weights, using your own body weight, and boxing.
  • Stretching is an activity you should do daily, both before and after exercise, as well as various times during the day. Stretching allows you to stay limber, retain range of motion, and avoid injury.

Keep your eyes on cholesterol

About 14 percent of Americans have cholesterol levels greater than 240 mg/dL, and many more have levels above 200 mg/dL, which is the cutoff point considered to be desirable, according to the National Cholesterol Education Program. If you lower your total cholesterol by 10 percent, you also reduce your risk of dying from heart disease by 15 percent. Many men can reduce cholesterol simply by instituting dietary changes, such as avoiding both saturated and trans fats, eating whole grains, and including more fruits and vegetables in your diet. Both the Mediterranean and DASH diets are healthy plans, as are plant-based models.

Need a few more tips on how to lower cholesterol?

  • Drop excess pounds
  • Increase physical activity
  • Avoid processed foods
  • Consider taking medication. This should be a last resort if lifestyle changes don’t reduce your cholesterol levels to a healthy level

Maintain a healthy blood pressure

If you’d like to stick around for many years to come, keep a watchful eye on your blood pressure. It pays to have a home monitoring device, which are available in drug stores and other retail outlets everywhere. Your healthcare provider will tell you which systolic and diastolic numbers are best for you. Know, however, that experts are not in agreement as to the ideal blood pressure. The American Heart Association and the American College of Cardiology recommend a goal of 130/80 mmHg, which replaced a former recommendation of 140/90 mmHg. However, some other health professionals call for 120/80 mmHg or lower as the goal.

Why focus on blood pressure? When you reduce high blood pressure, you also decrease your risk of stroke by 35 to 40 percent, the incidence of heart failure by more than 50 percent, and the chances of heart attack by 20 to 25 percent.

Ideally you can reduce your blood pressure by making some lifestyle modifications and thus avoid medications altogether. How?

  • Reduce you intake of salt. Check labels on food products, especially processed foods, which can be very high in sodium (salt). Switch to using herbs and spices instead of salt
  • Eat more foods high in potassium. This mineral helps lower blood pressure. Popular choices are avocadoes, bananas, black beans, coconut water, spinach, sweet potatoes, swiss chard, tomatoes, watermelon, and white beans.
  • Practice stress management techniques. That could mean exercise, tai chi, listening to music, dance, meditation, deep breathing, visualization, progressive relaxation, or other methods
  • Drug treatment should be your last resort if lifestyle efforts are not reducing your blood pressure adequately. Discuss the possibilities with your healthcare provider.

Reduce stress

The “fight or flight” response of our ancestors kicked in when they had to escape man-eating animals and other life-threatening situations. They experienced a rush of hormones and chemicals throughout their body, faster heart rate and breathing, a rise in blood pressure, and a burst of energy in the form of glucose in their blood stream. Today we experience the same physical responses to stress, but our stress is more likely to involve rush hour traffic, balancing monthly bills, coping with job crises, and struggling with healthcare costs.

The vast majority of our stress is not life-threatening, yet the body doesn’t discriminate. So when stress is chronic or unresolved, the body keeps the high blood pressure, the high sugar levels, the elevated heart rate, and even greater mental stress. All of these factors contribute to poor overall health as well as a higher risk of heart disease, diabetes, gastrointestinal problems, depression, headaches, obesity, and more.

How do you manage stress? It’s important to incorporate easy, enjoyable ways to cope with stress in your daily life. Here are a few suggestions:

  • Meditation of visualization
  • Yoga, tai chi, qi gong, and similar practices
  • Deep breathing exercises
  • Enjoyable exercise, such as basketball or touch football with friends, dancing, jogging, swimming, hiking, canoeing, tennis, handball
  • Massage
  • Laughter (funny videos, movies, laughter yoga)
  • Sleep/naps (not as an escape, but if you are overtired, a nap can reduce stress levels)
  • Change your perspective. Often it is how we look at things or situations that determines our stress level and thus our response to it. Ask yourself: how important is this situation? Is it truly worthy getting upset over? What can I learn from this situation? Can I get help with this situation?

Imbibe moderately or not at all

Alcohol can be part of socializing, kicking back, and celebrating with family and friends, and it also has some positive health benefits. At the same time, however, alcohol consumption can have a significant negative impact on the body.

Moderation is the key. For men, a moderate amount of alcohol is two drinks daily, which translates into two 12-ounce glasses of beer, two 5-ounce glasses of wine, or two 1.5 ounce shots of liquor.

Consuming more than two drinks daily can increase the risk of hypertension, stroke, arrhythmia, and sudden death. Having up to one drink daily can reduce the risk of Alzheimer’s, but heavy drinking increases the risk to 22 percent when compared with nondrinkers. Drinking alcohol at any level increases the risk of hemorrhagic stroke by two to four times.

Want to reduce or eliminate your alcohol consumption? Here are a few things to watch for:

  • Looks can be deceiving. A wine goblet can make 5 ounces look like next to nothing and so you can be tempted to fill the glass. The amount of liquor in a mixed drink glass may be more than you bargained for. Pay attention to how much alcohol you are actually consuming.
  • Don’t drink alone. People tend to drink more when they are alone. However, don’t drink with individuals who may keep encouraging you to keep up with them!
  • Take a break. If your habit is to drink every day or nearly every day, take a day or two off every week.
  • Get help. If you find it difficult to reduce or quit drinking, talk to a professional about your drinking habits.

Get enough Zzzzzs

Are you getting 7 to 9 hours of sleep every night? That’s the amount recommended by the National Sleep Foundation. If you lack sufficient sleep, your mind and body will rebel in various ways. For example:

  • Weight gain. One reason for this response to sleep deprivation is that it interferes with the hormones that regulate appetite. Another reason may be that you may tend to eat more sugary or high-fat foods when you’re tired so you’ll stay awake.
  • Diabetes risk. Studies show that people who sleep less than five hours a night have a threefold greater risk of developing type 2 diabetes than people who sleep six hours or longer.
  • Heart disease risk. Short-term sleep deprivation is associated with risk factors for heart disease, such as high cholesterol, high blood pressure, and high triglycerides, while long-term lack of sleep may increase the risk of heart disease and stroke.
  • Mental impact. Feeling foggy? You probably know that sleep deprivation can make it difficult to concentrate or remember things, but did you know it also makes you more likely to experience depression and anxiety? A recent review shows that sleep deprivation/insomnia is closely related to depression.

If you’d like to get more shut eye, check out these secrets to better sleep.

Don’t skip health screenings

When was the last time you saw a healthcare professional for a health screening or physical? According to the American Academy of Family Physicians, 55 percent of men questioned had not visited their doctor for a physical exam in the previous year. Yet 40 percent of them had high blood pressure, heart disease, diabetes, cancer, or some other chronic condition.

Nearly 30 percent of men said they “wait as long as possible” before they would go to a doctor if they were experiencing pain or feeling sick. Many men delay or completely avoid a number of health screenings that are strongly recommended on an as-needed basis, yearly, or less often. To see a list of those screenings and when they are recommended, click here and see page 30.

Make a mental note of how many of the screenings you have done and which ones you plan to do. How did you do? If you have any questions about these tests, discuss them with your healthcare provider.

Bottom line

The mid-life crisis is real only if you allow it to be. Congratulate yourself for making it this far. Then take control of the rest of your life and resolve to live it to the fullest and to be the healthiest and most energetic you can be. You owe it to yourself, your family, friends, and to the difference you can make in the world.

Sources

American College of Cardiology. New ACC/AHA high blood pressure guidelines lower definition of hypertension. 2017 Nov 13

Harvard Medical School. A guide to men’s health fifty and forward.

Riemann D et al. Sleep, insomnia, and depression. Neuropsychopharmacology 2019 May 9