Overall, few patients have a compelling contraindication to testosterone treatment. The majority of men with late onset hypogonadism can be safely treated with testosterone but all will require monitoring of prostate parameters HDL cholesterol, hematocrit and psychological state. It is also wise to monitor symptoms of sleep apnea. Other specific concerns may be raised by the mode of delivery such as local side effects from transdermal testosterone.
Shilajit in its natural state has no chemical definition. In order to yield a consistent and efficacious form of shilajit, the shilajit is obtained from carefully selected rocks and is put through a patented technology where it is purified and standardized. This form of shilajit is now assured of optimal levels of bioactive components such as fulvic acid and dibenzo-pyrones, and is known as the patented PrimaVie.
Some people can get away with more of a barebones approach to boosting their testosterone levels. MET-Rx Tribulus 750 has been around for years and has been used by many to help get their testosterone levels back within the normal range. The product has been laboratory tested and has been deemed safe for use by athletes, bodybuilders, and gym rats alike.
For example, testosterone can increase the hematocrit, the percentage of red blood cells in the bloodstream. If the hematocrit goes up too high, we worry about the blood becoming too viscous or thick, possibly predisposing someone to stroke or clotting events. Although, frankly, in a review that I wrote in the New England Journal of Medicine* where we reviewed as much of this as we could, we found no cases of stroke or severe clotting related to testosterone therapy. Nevertheless, the risk exists, so we want to be careful about giving testosterone to men who already have a high hematocrit, such as those with chronic obstructive pulmonary disease, or those who have a red-blood-cell disorder.
Other side effects include increased risk of heart problems in older men with poor mobility, according to a 2009 study at Boston Medical Center. A 2017 study published in JAMA found that treatments increase coronary artery plaque volume. Additionally, the Food and Drug Administration (FDA) requires manufactures to include a notice on the labeling that states taking testosterone treatments can lead to possible increased risk of heart attacks and strokes. The FDA recommends that patients using testosterone should seek medical attention right away if they have these symptoms:
When the body cannot produce enough testosterone on its own, the term is called hypogonadism. Testosterone boosters do not give the user actual testosterone (like with steroids), rather, they kickstart the production of this very important hormone. For that reason, it’s important to find a potent formulation that has one or multiple key ingredients in it.
The bones and the brain are two important tissues in humans where the primary effect of testosterone is by way of aromatization to estradiol. In the bones, estradiol accelerates ossification of cartilage into bone, leading to closure of the epiphyses and conclusion of growth. In the central nervous system, testosterone is aromatized to estradiol. Estradiol rather than testosterone serves as the most important feedback signal to the hypothalamus (especially affecting LH secretion). In many mammals, prenatal or perinatal "masculinization" of the sexually dimorphic areas of the brain by estradiol derived from testosterone programs later male sexual behavior.
Currently available testosterone preparations in common use include intramuscular injections, subcutaneous pellets, buccal tablets, transdermal gels and patches (see Table 2). Oral testosterone is not widely used. Unmodified testosterone taken orally is largely subject to first-pass metabolism by the liver. Oral doses 100 fold greater than physiological testosterone production can be given to achieve adequate serum levels. Methyl testosterone esters have been associated with hepatotoxicity. There has been some use of testosterone undecanoate, which is an esterified derivative of testosterone that is absorbed via the lymphatic system and bypasses the liver. Unfortunately, it produces unpredictable testosterone levels and increases testosterone levels for only a short period after each oral dose (Schurmeyer et al 1983).
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.
Elevated testosterone levels have been demonstrated to increase the growth of body muscles and contribute to better activation of the nervous system, resulting in more power and strength, a better mood, enhanced libido, and many other benefits. Previous researches done on the anabolic role of testosterone and its impact on muscular strength in training-induced adaptations has provided rather conflicting findings, and a positive correlation between testosterone-mediated responses and both functional performance and body composition was found.[4,5] There are a number of naturally occurring substances that can boost testosterone levels in the body. Foods containing such substances are known as testosterone-foods; and they tend to be rich in vitamins, antioxidants, and minerals like zinc, which plays a key role in testosterone production.[2,6-8]
Both testosterone and 5α-DHT are metabolized mainly in the liver. Approximately 50% of testosterone is metabolized via conjugation into testosterone glucuronide and to a lesser extent testosterone sulfate by glucuronosyltransferases and sulfotransferases, respectively. An additional 40% of testosterone is metabolized in equal proportions into the 17-ketosteroids androsterone and etiocholanolone via the combined actions of 5α- and 5β-reductases, 3α-hydroxysteroid dehydrogenase, and 17β-HSD, in that order. Androsterone and etiocholanolone are then glucuronidated and to a lesser extent sulfated similarly to testosterone. The conjugates of testosterone and its hepatic metabolites are released from the liver into circulation and excreted in the urine and bile. Only a small fraction (2%) of testosterone is excreted unchanged in the urine.
Hooper, D. R., Kraemer, W. J., Saenz, C., Schill, K. E., Focht, B. C., Volek, J. S. … Maresh, C. M. (2017, July). The presence of symptoms of testosterone deficiency in the exercise-hypogonadal male condition and the role of nutrition [Abstract]. European Journal of Applied Physiology, 117(7), 1349–1357. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28470410
And the ads have been working: The number of prescriptions written for testosterone have skyrocketed by more than 300 percent since 2001, reaching 7.2 million in 2013, according to a report published in 2016. Another study, published in JAMA in 2017, found that between 2009 and 2013, testosterone testing and treatment rose substantially in areas of the U.S. where such ads were very common.
This evidence, together with the beneficial effects of testosterone replacement on central obesity and diabetes, raises the question whether testosterone treatment could be beneficial in preventing or treating atherosclerosis. No trial of sufficient size or duration has investigated the effect of testosterone replacement in primary or secondary prevention cardiovascular disease. The absence of such data leads us to examine the relationship of testosterone to other cardiovascular risk factors, such as adverse lipid parameters, blood pressure, endothelial dysfunction, coagulation factors, inflammatory markers and cytokines. This analysis can supply evidence of the likely effects of testosterone on overall cardiovascular risk. This has limitations, however, including the potential for diverging effects of testosterone on the various factors involved and the resultant impossibility of accurately predicting the relative impact of such changes.
A study out of the University of Mary Hardin-Baylor in Belton, Texas, examined the effects of fenugreek supplementation on strength and body composition in resistance-trained men. Researchers found that while both the placebo and fenugreek groups significantly increased their strength during the first four weeks, only the fenugreek group saw significant increases in strength after eight weeks of training and supplementation.
The maximum hormone concentration in the blood is reported immediately after the workout. And the effect lasts throughout the day. However, it’s important to ensure that your physical activity is moderate. The matter is that too much high-intensity exercise can give an undesirable result. But even if for any reason you can’t attend a gym, it’s not a problem. Just move as much as possible during the day. Even simple walking will be of great benefit.
I think we’ll also find out in five years that there very well may be general health benefits of having normal testosterone compared to low testosterone. There are growing data for all-cause mortality that men who have low testosterone die earlier than those who have normal testosterone. A study by the Veterans Administration reported about a year ago showed low testosterone levels were associated with a dramatically increased mortality rate. It’s hard to know why that is, but I think we’ll be focused on that in the coming years.
Finally, there's the question of prostate cancer risk. Research over the past few decades has shown little evidence of a link between testosterone replacement therapy and prostate cancer. However, the question has not been entirely laid to rest. Eisenberg recommends that his testosterone replacement therapy patients get a PSA test once or twice a year to check for possible signs of concern.
I read several comments about blood clots. The issue was more than likely caused by estrogen overload and the measurement of ultra sensitive estradiol would prove it. I would wager that given T without anastrozole and having belly fat, that aromatase enzyme converted T to estrogen and that is why clots developed and why they felt worse instead of better. That is my opinion.
I had been on testosterone cyperonate 250-300 mg every 2 weeeksfor one year when diagnosed as having hypercythemic. I was cut of treatments immediately. Scanned from head to toe side to side. All clear. My urologist refuses to resume any HRT as my total testosterone is 701 immunoassay. However, he never mentions my Free % T value of 1.3. The labs range is 1.6-2.9. SHGB =70.6. Albumin 4.1. Is not the Free T we should be concerned with? Do I not need to go “Uologist Hunting”????
The doctor regularly measured my levels to be sure they were within the normal range for a male my age. In other words, I wasn’t taking ‘roids to get big; I was getting control of hormones that were not functioning well. This is how you should look at testosterone therapy – it is a gentle nudge to help you be in normal ranges, not a big push to get you huuu-yge. If you’re like me, you want “normal ranges” of a 27-year-old, not of a 60-year-old. It’s my plan to keep my testosterone where it is now (around 700) no matter what it takes. Right now, the Bulletproof Diet and the other biohacks I’ve written about do that! I’m 43.
More can be learned from a large, randomized, placebo-controlled trial of finasteride treatment in 18,800 men aged 55 or more. Finasteride is a 5α-reductase inhibitor which acts to prevent the metabolism of testosterone to dihydrotestosterone (DHT) – the most active androgen in the prostate. The trial showed a greater overall incidence of prostate cancer in the control group, but men treated with finasteride were more likely to have high grade tumors (Thompson et al 2003), suggesting that reduced androgen exposure of the prostate may delay the presentation of prostate cancer and/or promote advanced disease in some other way.
The potential downside of this positive feedback loop, Coates argues, is that testosterone levels can eventually surge past optimal levels and have the opposite effect – leading to overconfidence and poor decision-making. When this happens to animals, Coates, observed, they “go out in the open, pick too many fights [and] patrol areas that are too large…Risk taking becomes risky behaviour.”
More specifically, saw palmetto is frequently used to suppress prostate growth and combat abnormal urine flow that results from an enlarged prostate. The reason it is believed that saw palmetto can combat prostate hyperplasia is based on some research indicating it may block an enzyme (5-alpha-reductase) that converts testosterone into dihydrotestosterone (DHT).
However, testosterone is only one of many factors that aid in adequate erections. Research is inconclusive regarding the role of testosterone replacement in the treatment of erectile dysfunction. In a review of studies that looked at the benefit of testosterone in men with erection difficulties, showed no improvement with testosterone treatment. Many times, other health problems play a role in erectile difficulties. These can include:
The TTrials were funded by the National Institutes of Health, and consist of 7 integrated, placebo-controlled, randomized clinical trials evaluating the short-term efficacy of testosterone treatment in older men with low circulating levels of the hormone. The benefits of testosterone were evaluated in 7 clinically relevant medical concerns and at least preliminary evidence of efficacy in sexual function, physical function, vitality, cognition, anemia, bone health, and cardiovascular health.
Known as the "male hormone," testosterone is produced primarily by the testicles. "Beginning around age 30, testosterone levels begin to decline naturally and continue to do so as a man ages," says Holly Lucille, ND, RN, a naturopathic doctor, educator, and author, "sometimes leading to low testosterone symptoms such as depressed moods, decreased sex drive, erectile dysfunction, and difficulties with concentration and memory.”