If you’re an older man with low testosterone and interested in taking testosterone, this decision should be carefully considered with your physician. Your physician will be able to better assess the balance of your conditions and whether hormone replacement could put you at potential risk. It's a bad idea for anybody to engage in hormone supplementation without the supervision of a physician. Just because hormones occur naturally in the body does not mean that they can be taken without negative effects.
One thing that is often overlooked when it comes to testosterone boosters is the dosing. Test boosters aren’t like other supplements where you can just take the one dosing per day and forget about until the next day. As with any supplement, it only stays in your system for 4-8 hours. This means you need to be taking more than one dose per day. 2 doses are better but it still is not enough. If you want to keep your test levels up all day you will need to be taking at least 3 and preferably 4 doses per day to keep your testosterone levels high throughout the day and to keep them from dropping between doses. You should also be sure to take them every day and try to not miss any doses to get the most out of them.
Binge drinking on the other hand does impact Testosterone levels – especially on a short term basis. Two studies (22 & 23) show that large acute quantities of alcohol consumption in a short period led to decreases in Testosterone levels by a whooping 20-23% after 24hours! Note however this is drinking to extreme excess! Likewise, chronic alcohol abuse is known to reduce testosterone more notably (as seen in alcoholics).
Our bodies make testosterone while we sleep. In one study, men who got five hours of sleep a night had testosterone levels 10 to 15 percent lower than when they got a solid eight hours. The study, conducted by the University of Chicago, found that skimping on sleep reduced the men’s T levels by an amount equivalent to aging 10 or more years. While it can be challenging to change your sleep habits, says Natasha Turner, ND, you can “start going to bed 15 minutes earlier each week until you reach your target time.”
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.
You may find this hard to believe, but some common breakfast foods like Kellogg’s corn flakes and Graham crackers were invented 100 years ago to lower male libido. Kellogg and Graham believed that male sexual desire was the root of society’s problems, so they set out to make bland foods that would take away libido (this is absolutely true; look it up). That low fat, grain-based thing absolutely works wonders for lowering testosterone.
Ashwagandha: One of the hottest herbs out there right now, this adaptogen packs a one-two punch. First, it helps the body fight off stress: According to one Indian Journal of Psychological Medicine study, ashwagandha has a cortisol-lowering effect—a major benefit to anyone who wants their body to be more T-friendly. And, second, it can also support your T-boosting training efforts. One Journal of the International Society of Sports Nutrition study, for example, found that men who supplemented with ashwagandha saw significantly greater strength and T gains after eight weeks of resistance training than those who took a placebo.

"I am so thankful to your company. I have lost 50 lbs. and went from a size 38 waist to an unbelievable 30! I am 56 years old, and now with Andro 400, I feel like I am 25 again. I was taking ramipril for high blood pressure and celebrex for my arthritis. Gone!!! My doctor has not seen a transformation like mine ever! Exercise used to be a chore -- now I have the energy to jog, exercise and be intimate with my partner when we share our love for each other. My mood has changed. I don't get stressed out anymore. I'm so happy now. I'm just a completely different man! Thank you, thank you, thank you!"
A couple years ago I was having a problem with my thighs burning when walking up stairs. I noticed the muscles in my legs looking smaller. So I had my doc to check my T levels , and it was under 100. So she started me on testosterone injections weekly 200mg . After several injections I felt great , muscles in legs came back , lots of energy everything good . Leveled out at 3 injections a week 100mg , had a T level of 550 . So I go in for my scheduled injection and they tell me there out of testosterone . I might mention, this is a health care facilility that gives financial assistant if needed. And they have 3 or doctors and a nurse practitioner, which was who I was seeing . So I went on to check back often and got the same reply , were out of supply . So finally after months of the same , I gave up . I started loosing wait and my nerves got bad . Was having panic attacks etc. but I was coming off Prozac at the same time so I blamed it all on that. I was so bad with my nerves I ended up in the ER while on vacation . Doc there put me on a med for stress which I’m still using . After close to a year I checked back with the place I was getting TRT and they were resupplyed with testosterone. So I started back up because of low sex drive and ED. My first injection of 200mg was just short of a Marical , nerves felt great ED gone , had a sex drive , lot of energy . Then after 7 days or so all gone bad nerves started back up . He had me scheduled for anouther injection in 4 weeks 100mg . I went in for injection and after a couple days started feeling a little better . Then same thing as before about 7 days later nerves and everything else as before got worse . 3 weeks later I finally got a appt. with this different doc then I use to have . Told him the problems I was having , which included a horrible down mood , no energy . He decided to start injections every 2 weeks and upped the dose slitley. It’s been 5 days and already noticing ED problem reaccuring . He’s worried about the threat of prostate cancer. And doesn’t want to add any more injection to the schedule. I guess I’m going to have to start seeing the nurse practitioner who seemed to be more liberal and informed about TRT. I feel once a week injection is what it will take to get feeling good again. I’m 57 now with good health . Just need to get my T level on track with a doctor that will listen to how his patient is feeling . My last T level was at 365 . I failed to mention before I started the injections I was on androgel Dailey , 5 pumps a day . Then he gave me the injection of 200mg test . That’s when I felt fantastic for about a week or so . Then down hill . And I wanted to switch because the injection just seem so much better and they are . I noticed a big difference.
February 22, 2018 - Since our last review, the manufacturers of two of our top picks have gone out of business, and some new testosterone boosters have entered the arena. We’ve updated this review to evaluate the current field of testosterone supplements, as well as beef up analysis on what kind of results you can expect from t-boosters. Our only current top pick, Beast Sports Nutrition, is a new player in the industry that contains all four of the ingredients with studies showing a positive effect on testosterone.
If you take a statin (cholesterol lowering medication) and you follow the 30-Day Heart Tune-Up program, there is a good chance you’ll be able to work with your doctor and over time safely stop your statin medication. Statin medications lower cholesterol, and you need cholesterol to make testosterone. Ask your doctor what you can do with lifestyle changes to not need a statin medication. Improving your cholesterol profile is only part of the answer. Many of the risk calculators doctors use look at tobacco use, body weight, blood pressure, blood sugar, and cholesterol. Improve all your risk factors, and often you won’t qualify for a medication!
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.
The problem with testosterone therapy is several reasons you may have to stop taking it.Despite what you hear the chance of enlarged prostate is very real.It happened to me.Also blood too thick only cure by phlebotomy(having blood drawn more often than you will probably want to be harpooned to thin blood.) I didn’t sleep well either(especially as trips to bathroom got more frequent from BPH)then you really need several labs getting estradiol and testosterone levels correct and hcg and arimidex in the mix also (or Clomid) but dht issues are very real and not addressed in most try protocol.finisteride has many bad side effects as does avodart. Testosterone therapy is great for some people but if you’re low normal like I was I wish I would have left well enough alone. Our bodies have a lot more hormones to balance than just testosterone and estradiol and the crash can be a little rough if you have to stop. Be smart and have Clomid,Adex,and hcg on hand just in case.Good luck to all on trt(and those stopping it)
Sexual arousal - boosting testosterone can improve sexual arousal, even if you have normal testosterone levels. Higher levels of testosterone can make it easier for you to get aroused and can boost your sex drive generally. While this doesn’t affect the physical action of your erections, if you are not getting hard because you’re not aroused then boosting testosterone could help.

I have had BPH for years. Am in early 60s and recently had a 12 site prostate biopsy after a very slow rise of PSA to 4.5 (over a period of 10 years). There were two sites with PIN (one with outpouching and one was focal). Have been on various form of test replacement…changing methods periodically from test cyp IM, or SQ, with and without HCG or HCG alone. I want to continue a very low dose of either HCG or Test Cyp (10-20mg twice/week). What are your thoughts?
Consuming high amounts of sugary foods raises your blood glucose levels, which causes your body to release insulin as a response to the raised blood glucose levels. If not managed correctly, the body begins to develop a tolerance to insulin and cannot absorb the sugars in the blood stream as it used to, causing you to become insulin resistant. Being insulin resistant releases cortisol, and as you know, cortisol has extremely negative effects, lowering testosterone by quite a bit.
Zinc is little more of a nice-to-have ingredient than a must-have. It’s on our radar as an ingredient that possibly boosts testosterone levels, and while we couldn’t find enough supporting evidence that taking zinc would increase natural testosterone, low zinc levels have been connected to infertility. A low zinc level is also possibly a sign of hypogonadism. The closest support we found is in a study which found that people recovered from nutritional deficiency-related problems more quickly if they took a zinc supplement than those who did not. Zinc is available in many foods, such as oysters, fortified breakfast cereals, and red meat.
Costs were, in my opinion, very high especially for Axiron. I began reading all the health issues with drugs of this type. I became concerned and stopped using them. I took several over the counter supplements without much success. But recently I purchased from Briland Brands on amazon PaleoTest. I restarted a workout regimen and now feel great both during the workout and after. I can absolutely tell the difference. And it is a fraction of the price of the prescription drugs I took.
A: There are no over-the-counter products approved by the U.S. Food and Drug Administration (FDA) to increase testosterone levels. There are several prescription medication options available. Please consult with your health care provider in regards to your testosterone levels and to determine which treatment option best meets your individual needs. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Kristen Dore, PharmD
Dr. Darryn Willoughby, a professor of health, human performance and recreation and the director of the Exercise and Biochemical Nutrition Laboratory at Baylor University, told us that even in studies where there was an increase in testosterone, it was only around 15–20 percent. “In men with clinically normal testosterone levels, this modest increase will most likely not be anabolic enough to improve exercise performance,” he says. So if you have normal testosterone levels, and are simply trying to get an extra edge in gaining muscle, losing weight, or some extra time in the bedroom — you might see some results from taking a testosterone booster. But really, these will be most useful for men with low testosterone trying to get back to a healthy testosterone range.

Looking at the ingredients and we see that they used a nice dose of D-Aspartic Acid which we have already talked about how much we like that. They also used a good dose of Fenugreek which boosts testosterone and enhances libido as well as Ginseng Extract which is a natural aphrodisiac. They also use Zinc Gluconate which is a solid testosterone booster and also has shown to be a bit of an aphrodisiac itself.
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Some foods, vitamins, and herbs can help boost your testosterone levels. Be sure to talk to your doctor, if you’re concerned about low testosterone. These alternative and natural treatments aren’t proven to be more, or as, effective as traditional testosterone therapy. Some may also interact with any medications you may be taking and cause unintended side effects.


Let’s do a quick review of what I shared in the introduction to this series. August of last year was a tough month for me, primarily because of a huge and grueling project we were in the midst of here on the site. I was stressed out and my sleeping, healthy eating habits, and workout regimen all suffered. At the end of the month I got my testosterone levels tested and found that my total T was 383 ng/dL and my free T was 7.2 pg/mL – close to the average for an 85-100-year-old man.
Men can experience a range of symptoms if testosterone decreases more than it should. Low testosterone, or low T, is diagnosed when levels fall below 300 nanograms per deciliter (ng/dL). A normal range is typically 300–1000 ng/dL, according to the U.S. Food and Drug Administration. A blood test called a serum testosterone test is used to determine your level of circulating testosterone.
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.
Likewise, the amino acids in a protein-rich diet play a big role in both testosterone and muscle growth. As Chris Lockwood, Ph.D., explains, "When combined with training, which increases the sensitivity of androgen receptors, and the consumption of essential amino acids necessary to support protein synthesis, the effects of testosterone on muscle and performance is significantly amplified."[3,4]
My genetic make-up is 47XXY. I was diagnosed in September, 1976, and have been on some kind of T-therapy since – injections, pills, gels, patches, pellets, now back on injections. At this time, now, I inject 1/2cc deep IM, every 7-8 days. I suffered a blood clot between my knee and my groin (right leg) in January, 2017. I am now on Eliquis through June, 2017. My blood has always been quick to coagulate. I’ve read through all of this, and only found mention of blood clots sporadically in relation to T-therapy. I’m 70 yoa, have never had a problem before. Can you give me any info I can pass along to my doctor? Thank you.
Both testosterone and 5α-DHT are metabolized mainly in the liver.[1][155] Approximately 50% of testosterone is metabolized via conjugation into testosterone glucuronide and to a lesser extent testosterone sulfate by glucuronosyltransferases and sulfotransferases, respectively.[1] 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.[1][155][156] Androsterone and etiocholanolone are then glucuronidated and to a lesser extent sulfated similarly to testosterone.[1][155] The conjugates of testosterone and its hepatic metabolites are released from the liver into circulation and excreted in the urine and bile.[1][155][156] Only a small fraction (2%) of testosterone is excreted unchanged in the urine.[155]

In essence, there are two types of testosterone boosters, namely natural and synthetic supplements. Anabolic steroids which are under the synthetic category are known to deliver positive results as well as nasty side effects. It is due to this reason that an increasing number of bodybuilders and athletes are now utilizing safer testosterone boosters.


After 90 days, it seemed like the Andro Gel kind of stopped having it’s effect. Went back to see the doc, and my levels had dropped back to about 198 from high 200’s. Doc said it’s not unusual that the body gets used to it, and maybe I needed to adjust up. I switched to four pumps per day, and I felt immediate effects. Now…there is a period of ultra-horniness, and sometimes, you will feel some of the “roid rage” at some of these levels. It varies from person to person. Generally, if you are an ass, or high strung, this will amplify it. If you are pretty mellow, you may notice that every once in a while you’ll get angry at something that does matter, but again, it’s different person to person.


Testosterone is included in the World Health Organization's list of essential medicines, which are the most important medications needed in a basic health system.[111] It is available as a generic medication.[10] The price depends on the form of testosterone used.[112] It can be administered as a cream or transdermal patch that is applied to the skin, by injection into a muscle, as a tablet that is placed in the cheek, or by ingestion.[10]

Millions of men use testosterone therapy to restore low levels and feel more alert, energetic, mentally sharp, and sexually functional. But it's not that simple. A man's general health also affects his testosterone levels. For instance, being overweight, having diabetes or thyroid problems, and taking certain medications, such as glucocorticoids and other steroids, can affect levels. Therefore, simply having low levels does not always call for taking extra testosterone.


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).
A: Testosterone production declines naturally with age. Low testosterone, or testosterone deficiency (TD), may result from disease or damage to the hypothalamus, pituitary gland, or testicles that inhibits hormone secretion and testosterone production. Treatment involves hormone replacement therapy. The method of delivery is determined by age and duration of deficiency. Oral testosterone, Testred (methyltestosterone), is associated with liver toxicity and liver tumors and so is prescribed sparingly. Transdermal delivery with a testosterone patch is becoming the most common method of treatment for testosterone deficiency in adults. A patch is worn, either on the scrotum or elsewhere on the body, and testosterone is released through the skin at controlled intervals. Patches are typically worn for 12 or 24 hours and can be worn during exercise, bathing, and strenuous activity. Two transdermal patches that are available are Androderm (nonscrotal) and Testoderm (scrotal). The Androderm patch is applied to the abdomen, lower back, thigh, or upper arm and should be applied at the same time every evening between 8 p.m. and midnight. If the patch falls off before noon, replace it with a fresh patch until it is time to reapply a new patch that evening. If the patch falls off after noon, do not replace it until you reapply a new patch that evening. The most common side effects associated with transdermal patch therapy include itching, discomfort, and irritation at the site of application. Some men may experience fluid retention, acne, and temporary abnormal breast development (gynecosmastia). AndroGel and Testim are transdermal gels that are applied once daily to the clean dry skin of the upper arms or abdomen. When used properly, these gels deliver testosterone for 24 hours. The gel must be allowed to dry on the skin before dressing and must be applied at least 6 hours before showering or swimming. Gels cannot be applied to the genitals. AndroGel is available in a metered-dose pump, which allows physicians to adjust the dosage of the medication. Side effects of transdermal gels include adverse reactions at the site of application, acne, headache, and hair loss (alopecia). For more specific information on treatments for low testosterone, consult with your doctor or pharmacist for guidance based on current health condition. Kimberly Hotz, PharmD
This particular product contains the largest dose of D-Aspartic Acid making it a highly effective muscle and strength builder. In addition, TestoFuel contains optimum doses the proven ingredients of Vitamin D, Oyster Extract, Zinc, Magnesium, Vitamin B6, Vitamin K2, Fenugreek and Siberian Ginseng. And you won’t get filler ingredients with this one like you do with many others.
Hoffman, J., Ratamess, N., Kang, J., Magine, G., Faigenbaum, A. & Stout, J. (2006, August). Effect of creatine and beta-alanine supplementation on performance and endocrine responses in strength/power athletes [Abstract]. International Journal of Sport Nutrition and Exercise Metabolism, 16(4), 430–46. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17136944

I am a 67 yo male diagnosed with prostate cancer gleason 6. I have a prescription on bicalutamide 50 mg a day since Nov 2016 and leuprolide 11,5 mg every 3 months. My testicles reduced their size to half it´s original size, my libido is almost zero. I went through a radiotherapy of 45 sessions; my PSA level went from 11.2 to 0.13 on my last test from Sept 2017 and the leuprolide injections are taken away from my prescription by my urologist. I am planning to take TRT with Testosterone mix called SUSTANON 250 mg per week and HCG 5000 IUs twice a month. Give me your thoughts please


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However, if you have normal testosterone levels and are looking for a boost, for strength gaining purposes, then D-Aspartic acid use may prove less fruitful. A study published in Nutrition Research showed that when the booster was given to men who resistance trained four times a week, their body composition and muscle strength was no different to men who took part in resistance training without the aid of D-Aspartic acid.

I have tried pellets, I went from 5 grams/day gel, to 10 grams, had little change due to work schedule and no energy made it difficult to manage daily. Levels got down to 78 at one point. Testo pellets worked great but it took 10 to make a difference and it brought me up to the 300-400 range. My body rejected 3 pellets and expelled them. Tried axiron, didn’t work, natesto, which the doc never heard off next, a Nasal spray which helped but the bottle ran out 5 days early either by my mistake or dosage problems. Back to 10 grams Testim AG ($360 after deductible) which helps if i could stay consistent but I’m 28. With a job, and health insurance, deductible issues I can not afford 800 dollars a month, 360 after deductible. Recent levels of FSH/LH are .7 and 1.2 (low). Total testosterone 114, free 18.9, and bioavalability at 39.6 (low). I had a MRI of my pituitary gland today, and get results next week. Hoping to start depo T next week as I return to work. If I can recommend anything to anyone, is make sure it’s affordable, you have the time or energy to apply/administer, and understand most people will not understand what you are going through. 2 killers of testosterone are chronic stress and lack of sleep. In 3 years of treatment I wish I came to this man’s article and others and read up prior because I’m on the brink of losing everything I’ve worked for due to hypogonadism. Wish you all results and good health, and thank you for a great article!
Transdermal preparations of testosterone utilize the fact that the skin readily absorbs steroid hormones. Initial transdermal preparations took the form of scrotal patches with testosterone loaded on to a membranous patch. Absorption from the scrotal skin was particularly good and physiological levels of testosterone with diurnal variation were reliably attained. The scrotal patches are now rarely used because they require regular shaving or clipping of scrotal hair and because they produce rather high levels of dihydrotestosterone compared to testosterone (Behre et al 1999). Subsequently, non-scrotal patches were developed but the absorptive capacity of non-scrotal skin is much lower, so these patches contain additional chemicals which enhance absorption. The non-scrotal skin patches produce physiological testosterone levels without supraphysiological dihydrotestosterone levels. Unfortunately, the patches produce a high rate of local skin reactions often leading to discontinuation (Parker and Armitage 1999). In the last few years, transdermal testosterone gel preparations have become available. These require daily application by patients and produce steady state physiological testosterone levels within a few days in most patients (Swerdloff et al 2000; Steidle et al 2003). The advantages compared with testosterone patches include invisibility, reduced skin irritation and the ability to adjust dosage, but concerns about transfer to women and children on close skin contact necessitate showering after application or coverage with clothes.
Benefits: Ashwagandha a wonderful herb originating from India is also called the Indian Ginseng because of it’s regard as a powerful aphrodisiac. Ashwagandha roots when consumed it increases sexual powers. These sexual powers include maintaining a stronger erection, longevity, enhanced sexual feeling. It also enhances fertility by increasing sperm count and quality. Ashwaganda works by reducing prolactin and neutralizing free radicals which both leads to increased testosterone levels.

^ Butenandt A, Hanisch G (1935). "Uber die Umwandlung des Dehydroandrosterons in Androstenol-(17)-one-(3) (Testosterone); um Weg zur Darstellung des Testosterons auf Cholesterin (Vorlauf Mitteilung). [The conversion of dehydroandrosterone into androstenol-(17)-one-3 (testosterone); a method for the production of testosterone from cholesterol (preliminary communication)]". Chemische Berichte (in German). 68 (9): 1859–62. doi:10.1002/cber.19350680937.
At the National Population and Family Development Board in Malaysia, men between the ages of 31 and 52 were given two capsules of the herb (E. longifolia) in Andro400 every day for three weeks. They reported erections were stronger and, in some cases, lasted longer. Overall, they felt more virile. Their levels of testosterone doubled within three weeks.5
Popular through the centuries in Ayurvedic healing (a traditional practice of medicine in India) ashwagandha is what is known as an "adaptogen." This means the body may be able to use it to help adapt to stressors. While many people supplement with it for reducing cortisol, anxiety, and fatigue levels, ashwagandha also holds relevance for us here with potential testosterone boosting benefits.[8]
• In a trial of men with anemia, 58% percent were no longer anemic after a year of therapy, compared to 22% who received a placebo. In addition, testosterone therapy was associated with higher hemoglobin levels. Hemoglobin is a protein in the blood that carries oxygen from the lungs to other areas of the body. It also brings carbon dioxide back to the lungs.
Testosterone boosters are formulated for men in most cases, though there are a few brands that are appropriate for women. These are generally for men who want to improve their lean muscle mass, stamina, and energy levels. If you have low testosterone levels, these are great to ward off symptoms like low energy, excessive body fat, and a low sex drive. Some athletes might benefit from these boosters. You should always check with your doctor before adding these supplements or any other supplements to your regimen, particularly if you have chronic health conditions or if you are already taking medications or supplements.

during therapy. It is very hard to find a local endo who is thinking with his head vs complying with old trt programs. I tool clomid in the past to see what it would do and it elevated my t level to 520 in 2 weeks from low 220. Aromason will do same but clomid is more potent. Not sure what the long effect would be since you tend to get bit moody on clomid after 2 months. LH is also being affected in negative way since the lh receptors can burn out to a degree. I will contact the trt clinic in order to start my trt as they have much more experience with these things.
“I did a lot of research on Andro400 before I ordered it because I've tried other products in the past and they haven't worked. But with this I could not believe the difference within, literally within a month. I'm 62 years old and since I started taking it I have lost 37 lbs. And I have more energy than I've had in 20 years. It's still coming off, but it's coming off slower now. It was the belly fat. I could get weight off but I could never get the tummy off, and now the tummy's coming off. Libido -- everything's better all the way around.“

A: If a health insurance company is providing coverage for a medication, including testosterone replacement therapy, they determine the final cost of the product. Costs will vary from one health insurance plan to another. To determine the costs of the testosterone replacement options, the health insurance plan should be contacted. There are various options for testosterone replacement therapy including gels, injections, patches, and tablets that dissolve under the lip. All of the formulations can be effective and each has advantages and disadvantages. The most appropriate testosterone replacement therapy depends on a variety of factors, including cost, patient preference, and tolerability. Testosterone replacement gels, such as AndroGel and Testim, are very effective and easy to administer. AndroGel and Testim can be easily applied to the skin once daily. However, the gels can be irritating to the skin and AndroGel and Testim are typically quite expensive. Testosterone replacement injections, such as Depo-Testosterone (testosterone cypionate) and Delatestryl (testosterone enanthate), are usually inexpensive. The injections are given only once every one to two weeks. The major disadvantage with injectable testosterone is that testosterone levels may be difficult to control. Levels may be too high after an injection and too low before the following injection. A testosterone replacement patch, such as Androderm, is applied every night and left on for 24 hours. Androderm can be applied to the arm, back or stomach, in an area without too much hair. Androderm can cause irritation of the skin. A testosterone tablet, Striant, is placed under the upper lip against the gums and replaced every 12 hours. Striant molds to the upper gum so that eating and drinking can occur normally. The testosterone tablet can irritate the gums and cause a bitter taste and toothache. People with low testosterone should work with their doctor or healthcare provider to find a safe, effective, and affordable testosterone replacement option for them. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Derek Dore, PharmD


The regulation of testosterone production is tightly controlled to maintain normal levels in blood, although levels are usually highest in the morning and fall after that. The hypothalamus and the pituitary gland are important in controlling the amount of testosterone produced by the testes. In response to gonadotrophin-releasing hormone from the hypothalamus, the pituitary gland produces luteinising hormone which travels in the bloodstream to the gonads and stimulates the production and release of testosterone.
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