The general recommendation is that men 50 and older who are candidates for testosterone therapy should have a DRE and a PSA test. If either is abnormal, the man should be evaluated further for prostate cancer, which is what we do with everybody whether they have low testosterone or not. That means a biopsy. But if all of those results are normal, then we can initiate testosterone therapy. The monitoring that needs to happen for men who begin testosterone therapy is really very simple: DRE, PSA, and a blood test for hematocrit or hemoglobin, once or twice in the first year and then yearly after that, which is pretty much what we recommend for most men over age 50 anyway.
Before assessing the evidence of testosterone’s action in the aging male it is important to note certain methodological considerations which are common to the interpretation of any clinical trial of testosterone replacement. Many interventional trials of the effects of testosterone on human health and disease have been conducted. There is considerable heterogenicity in terms of study design and these differences have a potential to significantly affect the results seen in various studies. Gonadal status at baseline and the testosterone level produced by testosterone treatment in the study are of particular importance because the effects of altering testosterone from subphysiological to physiological levels may be different from those of altering physiological levels to supraphysiological. Another important factor is the length of treatment. Randomised controlled trials of testosterone have ranged from one to thirty-six months in duration (Isidori et al 2005) although some uncontrolled studies have lasted up to 42 months. Many effects of testosterone are thought to fully develop in the first few months of treatment but effects on bone, for example, have been shown to continue over two years or more (Snyder et al 2000; Wang, Cunningham et al 2004).
Saw palmetto: Uses, dosage, and side effects Saw palmetto is an extract from the berries of a type of palm tree. The berries have traditionally been used to ease urinary and reproductive problems. The extract is now used in herbal remedies to stabilize testosterone. Learn about its use, its effectiveness, the science behind the claims, and any side effects. Read now
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The mechanism of age related decreases in serum testosterone levels has also been the subject of investigation. Metabolic clearance declines with age but this effect is less pronounced than a reduction in testosterone production, so the overall effect is to reduce serum testosterone levels. Gonadotrophin levels rise during aging (Feldman et al 2002) and testicular secretory responses to recombinant human chorionic gonadotrophin (hCG) are reduced (Mulligan et al 1999, 2001). This implies that the reduced production may be caused by primary testicular failure but in fact these changes are not adequate to fully explain the fall in testosterone levels. There are changes in the lutenising hormone (LH) production which consist of decreased LH pulse frequency and amplitude, (Veldhuis et al 1992; Pincus et al 1997) although pituitary production of LH in response to pharmacological stimulation with exogenous GnRH analogues is preserved (Mulligan et al 1999). It therefore seems likely that there are changes in endogenous production of GnRH which underlie the changes in LH secretion and have a role in the age related decline in testosterone. Thus the decreases in testosterone levels with aging seem to reflect changes at all levels of the hypothalamic-pituitary-testicular axis. With advancing age there is also a reduction in androgen receptor concentration in some target tissues and this may contribute to the clinical syndrome of LOH (Ono et al 1988; Gallon et al 1989).

Androgens may modulate the physiology of vaginal tissue and contribute to female genital sexual arousal.[48] Women's level of testosterone is higher when measured pre-intercourse vs pre-cuddling, as well as post-intercourse vs post-cuddling.[49] There is a time lag effect when testosterone is administered, on genital arousal in women. In addition, a continuous increase in vaginal sexual arousal may result in higher genital sensations and sexual appetitive behaviors.[50]


As with a number of treatments or medicines that have been around for a long, long time, it hasn’t been scrutinized like a new drug would be. And although they’ve been discussed, there aren’t any large-scale, randomized controlled clinical trials of testosterone-replacement therapy under way. [See “A male equivalent to the Women’s Health Initiative?” below.]
“What on earth do you mean?” Well, I don’t literally mean taking it to the compound. What I mean to say is that you should be incorporating the three most important compound exercises into your routine: bench press, squats, and deadlifts. In case you didn’t know, by training large muscle groups your body releases more testosterone. When you do these three lifts, and perform them properly, then you’ll reap the benefits of not only muscle gains, but also that of an increased release of testosterone and growth hormone.
This has become a common practice despite an Institute of Medicine (IOM) report issued in 2003, indicating insufficient evidence of any benefit derived from testosterone hormone therapy to address expected symptoms of male aging.4  These studies, and 2 others (to be presented in a separate EW research brief) come on the heels of research on the efficacy of prescribing testosterone5 that appeared in the NEJM last year.
Men on long-term testosterone appear to have a higher risk of cardiovascular problems, like heart attacks, strokes, and deaths from heart disease. For example, in 2010, researchers halted the Testosterone in Older Men study when early results showed that men on hormone treatments had noticeably more heart problems. "In older men, theoretical cardiac side effects become a little more immediate," Dr. Pallais says.
If your levels are indeed low, there are a number of synthetic and bioidentical testosterone products on the market, as well as DHEA, which is the most abundant androgen precursor prohormone in the human body, meaning that it is the largest raw material your body uses to produce other vital hormones, including testosterone in men and estrogen in women.
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When I was using the gel my testicles also shrank a bit, but not anywhere near this amount. And when I stopped using the gel they plumbed back up again to their former size. It took some time but their size came back. This may be an issue for the younger guys, but I think most older guys can easily handle this as no big deal, because overall it’s not.
Sprinting has been shown numerous times that it has positive effects on testosterone levels. One 2011 study (ref 84) looked at weightlifters who performed 4x35m sprints twice a week. In contrast to the control group (who continued lifting but did not sprint), it was found that “After the 4-week training program, total testosterone and the total testosterone/cortisol ratio increased significantly in the (sprinters) EXP group”.
The other problem researchers run into when studying the benefits of testosterone is distinguishing between “cause” and “effect.” Is it T that’s providing all these great health benefits or does simply being healthy give you optimal levels of testosterone? It’s tricky because in some instances the answer is “both.” Testosterone (like all hormones) often plays a part in a “virtuous cycle” that regulates a whole host of  processes in our bodies — as you increase T, you get healthier; as you get healthier, your T levels rise. It can also play a part in a “vicious cycle” — as your T levels go down, your health suffers; as your health suffers, your T levels decrease even more.
Next, while testosterone levels do decline with age, this may simply be because the older that men get, the less they take care of themselves – they stop exercising, start putting on weight, and don’t pay as much attention to their diet. A recent study suggests that age-related T decline is not inevitable, and that if you keep living a healthy lifestyle, you can maintain healthy testosterone levels. So if you’re an older guy, try to do all you can as far as lifestyle changes before you get on the prescription T. I don’t mean doing a little cardio a few times a week, using the machines at the gym, and eating “pretty” healthy. Follow the guidelines above, and see what happens first.
Get out of here with your quackery nonsense. No one likes trolls that want to push diet and weight loss pills as a serious solution to low t and ED. Anyone who reads your comment will waste at least 20 seconds of their life. What’s worse, they might listen to you instead of getting real medical advice that might actually help with an issue that is devastating to their lifestyle. And btw, before you decide to respond to this with more quackery, testimonials or fake research, know that I am a pharmaceutical scientist and won’t fall for your bogus statements
Vitamin D is arguably the most important vitamin when it comes to testosterone. A study published in the Journal of Clinical Endocrinology examined the relationship between vitamin D supplementation and testosterone levels in men. The authors found that participants with higher levels of vitamin D had significantly higher levels of free testosterone compared to those with insufficient levels of vitamin D.8 Based on these study results, it appears vitamin D has a strong relationship with testosterone levels.
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There is a dirty little secret about testosterone cream that almost no one knows, and I’m going to share it here. Please don’t abuse it. If you take a vanishingly small dose of testosterone cream and apply it to your labia and the vulva (or your partner’s), you will witness a form of vasodilation rarely seen no matter how good you are in bed. It has a profound local effect and will produce a night you won’t forget for years.

Your first step should be to see your doctor. If you think you have low testosterone, we cannot stress enough that you should proceed with caution and talk to a medical professional — taking a booster can definitely do more harm than good. Low testosterone can be a symptom of more serious problems, like a pituitary disorder or a side-effect of medication, and a booster can mask the root cause. A doctor will be able to evaluate your testosterone levels with a simple blood test, and if you both decide a booster is the way to go, give the ingredients of any supplement a once-over to make sure that they’re not at risk of making your personal health situation worse.


Both Beast Sports’ Super Test and iSatori’s ISA-Test contain a proprietary blend, which means they don’t disclose the amount of each and every ingredient in the mix. This is only a problem if there is an ingredient tucked into a proprietary blend for which we need to know an amount, like magnesium and zinc. While none of the ingredients in Beast Sports’s proprietary blend raised any red flags, iSatori’s blend contains melatonin, a hormone that helps regulate sleep. Melatonin is an ingredient that has a hard upper limit — Healthline suggests at most 10mg for an adult — and even lower doses can interact poorly with many medications. Since we can’t confirm whether the amount of melatonin in iSatori’s proprietary blend is under 10mg, we cut iSatori.
Regardless of the method of testosterone treatment chosen, patients will require regular monitoring during the first year of treatment in order to monitor clinical response to testosterone, testosterone levels and adverse effects, including prostate cancer (see Table 2). It is recommended that patients should be reviewed at least every three months during this time. Once treatment has been established, less frequent review is appropriate but the care of the patient should be the responsibility of an appropriately trained specialist with sufficient experience of managing patients treated with testosterone.
If you do take DAA I recommend cycling it (i.e. 5 days on, 2 off, over 4 weeks then 4 weeks off). And taking it with an aromatase inhibitor (which ensures the aspartic acid doesn’t get converted to estrogen). Especially as more studies are coming out showing the increase in testosterone is limited to a week or two before it drops back to normal levels.
Studies have shown that testosterone-replacement therapy may offer a wide range of benefits for men with hypogonadism, including improved libido, mood, cognition, muscle mass, bone density, and red blood cell production. But little consensus exists on what constitutes low testosterone, when testosterone supplementation makes sense, or what risks patients face. Much of the current debate focuses on the long-held belief that testosterone may stimulate prostate cancer.

Herein lies the problem.  DHT is an extremely powerful androgen, significantly more potent than testosterone.  Somehow, fenugreek causes increases in muscle mass and libido while reducing DHT.  I often argue on the site that it is not exactly increased testosterone that you want.  You want the blessings of a high testosterone level: physical fitness, libido, and high energy levels.  If fenugreek can bestow these upon you, why do you need the testosterone?


Fenugreek, in the form of a capsule, testofen, or Fenugreek tea could do the trick. The fact that fenugreek increases libido is not mythology; it is backed by a clinical study which showed the libido of men aged 25-52 increased by 25%[1] on average when taking fenugreek extract for six weeks.  According to Lee Myer, of www.peaktestosterone.com fame, fenugreek will help you achieve orgasm as well, so if this is an issue for you, fenugreek may be the answer.  It’s a frustrating problem to have.
Cognitive abilities differ between males and females and these differences are present from childhood. In broad terms, girls have stronger verbal skills than boys who tend to have stronger skills related to spatial ability (Linn and Petersen 1985). It is thought that the actions of sex hormones have a role in these differences. Reviewing different cognitive strengths of male versus female humans is not within the scope of this article but the idea that cognition could be altered by testosterone deserves attention.
Fenugreek is an enigma, deep-fried in a mystery, and wrapped in secrecy. It can actually LOWER your testosterone levels while simultaneously increasing your libido and athletic performance, 2 effects that correlate with elevated testosterone levels.  Strange.  This is the first supplement I have come across that might have the opposite of the desired effect, and yet be worth taking anyway.
Despite all the wonderful benefits of testosterone boosters, it will only work as well as you are able to make it work. This means that if you’re living a sloppy lifestyle, then your testosterone booster will produce poor results. Testosterone boosters work best when you make small, healthy changes to your lifestyle and diet that will allow your T-booster to give you its full benefits.
When patients ask about risks, I remind them that they already have testosterone in their system and that the goal of testosterone treatment is to restore its concentration back to what it was 10 or 15 years previously. And the molecule itself that we give is identical to the one that their bodies make naturally, so in theory, everything should be hunky-dory. But in practice, there are always some curveballs.
Avoid stressful situations – It is actually that simple. If you can avoid stressful situations, then you can significantly improve your overall testosterone production. Why is that? Well, you should know that stress makes our bodies to produce cortisol that is a notorious and well-known testosterone killer. So, what can you do about it? Well, you should definitely try deep breathing, meditating, exercising, and other lifestyle changes that can help you deal with the stressful situations the right way.
show that total testosterone levels increase after exercising, especially after resistance training. Low testosterone levels can affect your sex drive and your mood. The good news is that exercise improves mood and stimulates brain chemicals to help you feel happier and more confident. Exercise also boosts energy and endurance, and helps you to sleep better. Fitness experts recommend 30 minutes of exercise every day.
Some studies have looked at testosterone therapy and cognition. Although the findings weren’t definitive, there was some evidence of cognitive improvement. Other studies have shown that it improves mood. Testosterone therapy has also been shown to be effective in the treatment of osteoporosis and in increasing muscle bulk and strength. [See “Testosterone’s impact on brain, bone, and muscle,” above.]

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My energy level have increased and my muscle mass has also increased, so I have positive results. As I said before I didn’t have a problem with achieving erections or maintaining, but with these injections I am now getting quite a good deal more spontaneous erections, and then when I do get one it does feels harder and stronger. The stronger and harder aspect is great, but the more often spontaneous is a bit annoying. 🙂
The diagnosis of late-onset hypogonadism requires the combination of low serum testosterone levels with symptoms of hypogonadism. Questionnaires are available which check for the symptoms of hypogonadism. These have been validated for the assessment of aging patients with hypogonadism (Morley et al 2000; Moore et al 2004) but have a low specificity. In view of the overlap in symptoms between hypogonadism, aging and other medical conditions it is wise to use a formal method of symptom assessment which can be used to monitor the effects of testosterone replacement.
For this reason, after the 2008 financial market meltdown, some commentators put the blame for the crash on the male-dominated profession, arguing that men take too many risks, and the economy would do better and be more stable if it was run by women. Of course, risk-taking does come with inherent risk, but it has also been responsible for the lion’s share of society’s progress and innovation since the dawn of time. Financial markets would likely not exist – period – without testosterone-driven risk-taking.

In fact, high cortisol deals a crushing blow to testosterone in two ways. During, long-lasting stress, high amounts of cortisol release very often and have a direct negative influence on T levels. Thus, cortisol inhibits testosterone synthesis in the testes and hypothalamus. In addition, the production of cortisol is impossible without cholesterol. But testosterone synthesis also demands cholesterol. Since during stress cholesterol is first of all used for making cortisol, T levels simply plummet.


In summary it’s important to know that this topic is still hotly debated, and there are a lot of inconsistencies in the data. We do know that soy contains phytoestrogens and does seem to have a lot of affects on the body, including some studies that show decreased Testosterone levels. For that reason (and the fact that it tastes like ass) I avoid it, and I recommend you also avoid it (in particular soy isolates!) if you’re seeking higher testosterone.
If your need is greater though, there are other legal options to consider. DHEA is a precursor steroid hormone that is only available on prescription in the UK, but if taken under close supervision it can have dramatic effects. It must be taken under supervision though because too high a dose can cause mood changes and aggression — roid rage, in other words — as well as all the other unwanted by-products of too much testosterone.
"Boy, I'm doing fine, you can't imagine! I play basketball 6 days a week all winter. I'm 63 years old. I play with 19-year-olds, and I hold my own every day. And Andro400 helps a lot. I'm quick as a cat -- it's amazing! I absolutely know the difference. I'm having a blast, and I appreciate your product. It works wonderfully! You can’t imagine what I can do at my age -- and you help. That ain't no kiddin!"

"Some say it's just a part of aging, but that's a misconception," says Jason Hedges, MD, PhD, a urologist at Oregon Health and Science University in Portland. A gradual decline in testosterone can't explain a near-total lack of interest in sex, for example. And for Hedges' patients who are in their 20s, 30s, and early 40s and having erectile problems, other health problems may be a bigger issue than aging.
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