Does Ketogenic Diet & Red Light Therapy Improve Testosterone and Estrogen?

This article is based on an interview with Dr Kelly Gibas, a Functional Medicine Certified Practitioner (CFMP) and Licensed Professional Clinical Counselor (LPCC), as well as the founder of Bristlecone Medical. The conversation covers her research on the ketogenic diet and the preliminary results, as well as red light therapy devices and the potential to increase testosterone levels in men. 

You can access her clinical trials and research projects here. Now let’s look at the summary of her discovery. 

Reasons for Red Light Therapy Research

Dr Kelly Gibas specializes in metabolic syndrome, diabetes, polycystic ovary syndrome (PCOS), and associated mental health issues such as depression, anxiety, dysthymia, and postural orthostatic tachycardia syndrome (POTS). 

According to Dr Kelly, it is remarkable that red light therapy is a non-invasive modulator of metabolism that is affordable for the public and has verified clinical use. This contrasts with the usual "Band-Aid" drugs that alleviate symptoms superficially but have no effect on deeper issues. With the use of red light devices, which provide the correct frequency, power and luminance, metabolism is heightened and energy production (ATP) is increased due to organic changes in the action of the mitochondria.

How Red Light Therapy Amplifies the Effects of a Ketogenic Diet

By turning on the red light, the effects of being on a ketogenic diet are amplified and the body's ability to use both sugar and fat for fuel is enhanced.

Mitochondrial Substrate Selection

An important component of metabolic pathology is an inflexible approach to mitochondrial substrate selection. Cells are unable to change their fuel selections to match the changing energy needs. In a healthy organism, an alternating pattern of glucose and fat oxidation is typically seen, as the mitochondria are responsible for carbon combustion transitions between the two energy sources. The communication and collaboration between the two substrates allow the mitochondria to pick the most suitable fuel for a particular physiological state, thereby avoiding both high and low blood sugar levels.

During the time of hunting and gathering, human physiology was capable of adjusting to sudden changes in energy requirements. This usually involved a period of fasting before the refill of energy supplies. This flexibility has been identified as a movement between two primary nutrient sensing pathways, mTOR (growth) and AMPK (breakdown). In today's world, though, there is a continuous influx of fuel sources, causing a condition of metabolic insensitivity or inflexibility. This is caused by an over-activation of mTOR and the disruption of nutrient sensing, with an inability to switch between substrates and a lack of energy balance.

When long-term over-nourishment occurs, the competition between sources of energy intensifies, leading to a lack of collaboration and leaving mitochondria in a state of uncertainty where all three major fuels are constantly being oxidized. This produces metabolic obstruction.

COX Enzyme

The mitochondria of the cell can see a boost in their functions with the presence of red light, which enhances the action of cytochrome oxidase (COX) in the electron transport chain by targeting its luminance on the cellular metabolic machinery.

Insulin regulates the fluctuation between glucose, fatty acids and amino acids, however, resistance to its action can result in abnormal nutrient distribution. This usually happens early on in the development of the disease. The COX enzyme helps metabolism by binding high-energy electrons (products of digestion) with oxygen to form water. This is crucial in the production of ATP energy. However, if the COX enzyme is not in sync with the flow of electrons, the high-energy particles can escape the metabolic pathway and form hazardous free radicals or ROS (reactive oxygen species) instead of being changed into water.

The COX enzyme is regulated by red light, which allows for greater flexibility and encourages healthy fat burning.

The ketogenic diet has the opposite effect of an overfed phenotype. The body responds to dietary ketosis as if it were fasting, due to the activation of AMPK. This activation increases metabolic flexibility, decreases the burning of carbon and assists in eliminating metabolic blockages.

A combination of red light therapy and the ketogenic diet is beneficial for human health.

The Connection Between Red Light Therapy and Ketogenic Diet in Terms of Hormones

Early findings demonstrate that red light therapy, when serum ketones are higher than 0.5 mmol/L, can lead to more normal production of primary sex hormones in both genders. In addition, serum progesterone was found to be higher in pre- and postmenopausal women, which was accompanied by an improved synthesis of adrenal DHEA.

Progesterone amounts increased for both postmenopausal and pre-menopausal women in both groups; however, the keto group showed a greater change. The initial results point towards the zona reticularis of the adrenal cortex boosting the production of DHEA and progesterone resulting from PBM providing energetic, regulatory help to the adrenal mitochondria.

Significance of the Female Results of Increased Progesterone

The utilization of red light therapy in conjunction with a ketogenic diet has been found to adjust the modifications to steroidogenesis that are caused by stress. This is done by controlling pivotal mitochondrial enzymes and pathways, which results in decreased activation of the HPA axis. Additionally, there will be drops in glucose and insulin levels along with an increase in the production of DHEA and progesterone.

The adrenal glands are responsible for the production of cortisol, adrenaline, and DHEA (dehydioepiandrosterone). DHEA is an essential steroid hormone for the metabolism of cholesterol, which produces progesterone, estrogen, and testosterone. As people age, the levels of DHEA and sex hormones decrease due to the reduction in mitochondrial activity. This decrease in DHEA and sex steroids has a significant effect on peri- and postmenopausal women.

The sex hormone progesterone is produced both in the ovaries and from DHEA by the cells of the zona reticularis, which is situated in the innermost layer of the adrenal cortex. When DHEA levels are low, it can lead to the dual conditions of estrogen dominance and adrenal insufficiency that are commonly seen in middle-aged and postmenopausal women. As a woman's ovulatory cycle diminishes, she has to depend on the adrenal glands to produce DHEA in order to preserve progesterone levels and guard against estrogen dominance.

Adrenal insufficiency is an ailment caused by excessive stress, which impedes the adrenal glands from producing the needed levels of steroid hormones. The mitochondria manufacture pregnenolone, derived from cholesterol, as the building block of steroidogenesis; as cortisol secretion heightens due to prolonged stress, the production of DHEA and progesterone will decrease.

It had been previously thought that the "pregnenolone steal" was the cause of clinical changes that are seen in the early and mid-stage of stress progression; an increase in cortisol levels and a decrease in DHEA/progesterone. However, research has demonstrated that pregnenolone is not reduced in availability, but rather cortisol synthesis and secretion is inhibited through stress signaling pathways, causing the pathophysiological changes associated with stress.

Studies have demonstrated that excess glucose and insulin in the body can lead to a decrease in the production of DHEA and progesterone in humans. Additionally, cell-culture experiments suggest that with chronic inflammation, the zona reticularis reduces DHEA production in the presence of high ACTH. The levels of cortisol, DHEA, progesterone, estrogen, and testosterone are controlled by signalling molecules and enzyme activation.

In order to control inflammatory stress and keep DHEA production healthy, while at the same time dampening the HPA axis, red light therapy and nutritional ketosis can be employed.

Benefits of the Ketogenic Diet to Women’s Health 

Research carried out on a group of women showed they had an increase of 17% in estradiol levels. It’s obvious that estrogen is a controlling factor in female metabolism, influencing how fuel is processed in both the brain and body. A decrease in 17B-estradiol (E2), which happens in menopause, is linked to an increased risk of developing late-onset Alzheimer's disease (LOAD) in women.

The production of 17B-estradiol (E2) by the ovaries in females is indicative of youthful hormone regulation; E2 is the factor controlling the female menstrual cycle, allowing for the proper release of the corpus luteum. This corpus luteum is responsible for the production of progesterone, which is necessary for the decidualization of the endometrium and proper maintenance of the uterine lining. If E2 is not expressed in adequate amounts, ovulatory menstrual cycles become a rarity; as a result of the lack of corpus luteum, the synthesis of progesterone diminishes greatly. This decline in progesterone leads to estrogen dominance, thereby increasing the chance of developing sex-related cancers in the breast, ovary and colon.

Lipid hormones, such as sex steroids, can pass through the blood-brain barrier to modify the nuclear DNA and consequently regulate cerebral metabolism. 17B-estradiol is particularly powerful in terms of transcriptional abilities and can help to even out energy levels, avoiding any sudden deficits. Additionally, both testosterone and 17B-estradiol work together to increase the amount of ATP in the mitochondria, resulting in better glucose metabolism in the brain.

By influencing the Ventromedial Nuclei of the hypothalamus, peripheral E2 assists women in avoiding fatness, insulin opposition, and T2DM by harmonizing energy use with caloric consumption. A decrease in the exterior production of 17β-estradiol, progesterone, and testosterone are emblematic of growing older and sickness.

The Impact of Red Light Therapy and Keto Diet on Testosterone Balance

It has been demonstrated in recent research that by following a ketogenic diet over a period of 12 weeks, testosterone levels in males can be augmented through increased availability of cholesterol and DHEA. Additionally, evidence suggests that red light therapy can further advance the production of testosterone from DHEA by enhancing mitochondrial synthesis.

According to the findings from the 12-week intervention, all of the male participants experienced an enhancement in their testosterone levels. This corresponds with past studies which have revealed that red light therapy and the ketogenic diet are able to increase testosterone levels internally.

Testosterone in male individuals can be converted to estradiol (E2) in an adaptive manner; yet, having healthy amounts of testosterone can offer a hormonal issue to the production of E2, thus permitting the testosterone/estrogen ratio to stay in equilibrium to prevent the manifestation of estrogen dominance symptoms like an enlarged prostate.

The presence of testosterone in males is akin to that of progesterone; a satisfactory amount of testosterone reduces the growth-stimulating effects of E2.

How to Treat Hormone Imbalance in Men and Women

Inflammation can be combated by using red light therapy and a ketogenic diet.

The combination of Photobiomodulation (PBM) at frequencies of red (660nm) and near-infrared (NIR) (850nm) and the oxidation of ketone bodies possess the singular capacity to suppress the secretion of ACTH and impede the HPA axis. Selecting fat as fuel initiates AMPK and boosts the epinephrine pathway in the adrenal medulla, which is an adaptive response to stress; as mentioned before, red light therapy enhances beta-oxidation in the mitochondria.

It has been observed in cell-culture research that, in lengthy periods of inflammation, the zona reticularis reduces DHEA production when there is an increase in ACTH. Inflammation has a major impact on the fluctuating balance between cortisol and the production of DHEA, progesterone, estrogen, and testosterone.

Research conducted on T2DM patients with high cortisol levels and low DHEA revealed an impaired enzyme responsible for creating DHEA in the zona reticularis. After half a year of a diet concentrating on reducing glucose and insulin, the enzyme activity was restored, and cortisol, DHEA, and progesterone levels returned to normal.

Patient Stories that Stood Out During the Research

Throughout the time we spent working with patients over the course of 12 weeks, we encountered several stories that were incredibly motivating. Two patients, in particular, were particularly impressive.

A female who was going through the perimenopause stage expressed how her sexual appetite had drastically risen and had a beneficial impact on her long-term relationship with her partner.

A 30-year-old diabetic with obesity and a deep ulcer on the lower leg that did not seem to heal using conventional means—with the help of red light therapy and a diet that kept serum ketones higher than 0.5 mmol/L—the ulcer decreased both in size and depth.

Other Patient Populations That Would Benefit from Red Light Therapy

It is my conviction that red light therapy and a medically-supervised ketogenic regimen are very effective in forestalling diabetic ulcers and amputations of the lower limbs.

Long-term diabetes sufferers often have amputations of their lower limbs as a result of diabetic ulcers. The occurrence of diabetic foot wounds and amputations of the lower limbs is on the rise, seeing an earlier onset of T2DM.

Damage to the vasculature can lead to diabetic ulcers, and these unhealed wounds present a major health hazard. The five-year survival rate after amputation in diabetics shows the urgent need to stop these ulcers from occurring, identify them early, and develop effective treatments.

Research has demonstrated that Photobiomodulation (PBM) boosts circulation and noticeably raises the delivery of nutrients to the skin via increased perfusion. This indicates that the improvement in blood flow is joined with an augmentation in trophic components brought to the skin.

Importance of Non-Invasive Treatment 

It is important to discover treatments for ailments that are organic, non-aggressive, and do not involve medication. Two novel approaches to healthcare, red light therapy and ketogenic diets, are initiating a shift away from traditional reactionary medicine and toward a focus on preventive maintenance of both lifespan and healthspan. 

Optimized care at reasonable prices is a requirement that must be met. Recent studies demonstrate that a lot of people with complete insurance coverage don't stick to medical instructions; medications are not taken, and visits are neglected. This carelessness on the part of those that are fully insured, combined with those who are underinsured, puts a mounting strain on the system as chronic diseases quickly worsen and require end-stage care.

Non-chemical and non-invasive forms of healing provide options that are both preventative and cost-effective/available to the general public; such as red light therapy. These natural remedies can be done in the patient's house and applied in a dose-dependent manner focused on prevention.

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