New Approaches in Testosterone Treatment: Fertility, Mood, BPH and Beyond: Episode Rerun

In this episode, Dr. Kate Kresge revisits her conversation with Dr. Eric Yarnell, a naturopathic physician focused on men's health, urology, and botanical medicine. Dr. Yarnell makes a case that changes how you think about low testosterone: in most men, it's a signal that something else needs attention, not the disease itself. He explains why you can't test testosterone on its own, how male factors are often overlooked in fertility workups, where environmental chemicals fit in, and how herbal medicine, nutrition, and gut health can support prostate and hormonal health. If you care for men, this one will sharpen both your labs and your treatment plans.

3 Key Takeaways

• Low testosterone is often a symptom. Dr. Yarnell estimates that only a minority of men with low testosterone have primary testicular failure; for most, it's secondary to issues like rising blood sugar, and testosterone alone won't fix the root cause. (Tajar 2010)
• Test the whole system, carefully. Guidelines recommend confirming low testosterone with repeat fasting morning total testosterone, and checking free testosterone when SHBG may be altered. (Bhasin 2018)
• Male fertility deserves its own workup. Sperm concentration among men unselected for fertility in North America, Europe, Australia, and New Zealand declined by more than 50% between 1973 and 201, which is why Dr. Yarnell starts with a semen analysis and an exposure history. (Levine 2017)

Guest: Dr. Eric Yarnell is the president of Northwest Naturopathic Urology, focusing on men's health, urology, and nephrology, and a professor in the Department of Botanical Medicine at Bastyr University. He is the author of numerous texts, including Natural Approach to Urology, Natural Approach to Prostate Conditions, Natural Approach to Gastroenterology, and Naturopathic Nephrology.

Clinical FAQ

What should a testosterone workup include?

Dr. Yarnell looks beyond total testosterone to free testosterone, free and weakly bound testosterone, SHBG, albumin, LH, and estrogens, because testosterone "exists in a system." (Bhasin 2018)

How do environmental chemicals affect male fertility?

He discusses PCBs, pesticides, herbicides, and PFAS, how exposures can be assessed, and practical ways to reduce them, while cautioning against extreme "detox" diets. (Mínguez-Alarcón 2023)

How does gut health connect to the prostate?

Dr. Yarnell explains how diet and gut health may influence prostate conditions, and how he uses nutrition and botanicals to support patients with BPH.

Timestamps

02:49 – Testosterone misconceptions, symptoms, and tests

12:14 – Rethinking fertility treatment and sperm analysis

16:14 – Fertility and chemical exposure

19:39 – Chemical detox approaches

22:01 – Detox diets debunked

23:45 – Herbal medicine for men's health

34:55 – The power of nutrition and lifestyle changes

44:54 – The frontier of gastrointestinal health

53:11 – Diet and natural approaches for leaky gut

56:12 – Empowering your health journey

Ready to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript helps clinicians bring supplement dispensing, lab ordering, and patient education into one centralized workflow. For more practitioner education on supplements, nutrition, and evidence-informed clinical care, visit Fullscript Academy at academy.fullscript.com.

Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine.