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!
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Changes in body composition are seen with aging. In general terms, aging males are prone to loss of muscle mass and a gain in fat mass, especially in the form of visceral or central fat. An epidemiological study of community dwelling men aged between 24 and 85 years has confirmed that total and free testosterone levels are inversely correlated with waist circumference and that testosterone levels are specifically related to this measure of central obesity rather than general obesity (Svartberg, von Muhlen, Sundsfjord et al 2004). Prospective studies show that testosterone levels predict future development of central obesity (Khaw and Barrett-Connor 1992; Tsai et al 2000). Reductions in free testosterone also correlate with age related declines in fat free mass (muscle mass) and muscle strength (Baumgartner et al 1999; Roy et al 2002). Studies in hypogonadal men confirm an increase in fat mass and decrease in fat free mass versus comparable eugonadal men (Katznelson et al 1998). Taken together, the epidemiological data suggest that a hypogonadal state promotes loss of muscle mass and a gain in fat mass, particularly visceral fat and therefore mimics the changes of ‘normal’ aging.
By passing this bill, the Congress has amended the Controlled Substances Act to include Androstenedione supplements such as 4 Androstenediol, 5 Androstenediol, etc. The original Anabolic Steroid Control Act was passed in 1990 creating a list of anabolic steroids that would be classified as "Schedule III" substances and put in the same category as drugs such as heroin and cocaine. Now, with the passage of Senate Bill 2195 (the Anabolic Steroid Control Act of 2004), they have added Androstenedione supplements to the Controlled Substances Act.

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Sugar is to testosterone what kryptonite is to Superman. Eliminating sugar is probably the single most powerful way to increase your performance, in part because sugar absolutely devastates your testosterone levels (but all carbs do not, especially under heavy training.) In one study of 74 men, a 75g dose of sugar – about the equivalent of a bottle of soda – decreased serum testosterone by 25% in under an hour, and levels stayed low for at least 2 hours [7]. On top of that, 15% of the men who started with normal testosterone dipped into the hypogonadal range after they ate sugar – that’s the range in which doctors diagnose men’s testes and women’s ovaries as failing. When you do eat carbs, stick to Bulletproof ones like sweet potatoes and squash. My recommendations for types of carbs and how often to eat them are here.
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.

You may be interested in boosting your testosterone levels if your doctor says you have low levels, or hypogonadism, or need testosterone replacement therapy for other conditions. If you have normal testosterone levels, increasing your testosterone levels may not give any additional benefits. The increased benefits mentioned below have only been researched in people with low testosterone levels.
In accordance with sperm competition theory, testosterone levels are shown to increase as a response to previously neutral stimuli when conditioned to become sexual in male rats.[40] This reaction engages penile reflexes (such as erection and ejaculation) that aid in sperm competition when more than one male is present in mating encounters, allowing for more production of successful sperm and a higher chance of reproduction.
“I'm having great results. Everybody is seeing a difference. People say, “You look good! Did you lose weight? What are you taking?” I'm 59, and I'm bringing my belt down a couple different notches. I couldn't break 180 lbs for nothing, no matter what I tried. Now it's 175 lbs. and she's going from there. I was just doing it for the belly -- no matter what I just couldn't get rid of the belly (until now). And I'm not as tired as I used to be.“

In addition to conjugation and the 17-ketosteroid pathway, testosterone can also be hydroxylated and oxidized in the liver by cytochrome P450 enzymes, including CYP3A4, CYP3A5, CYP2C9, CYP2C19, and CYP2D6.[159] 6β-Hydroxylation and to a lesser extent 16β-hydroxylation are the major transformations.[159] The 6β-hydroxylation of testosterone is catalyzed mainly by CYP3A4 and to a lesser extent CYP3A5 and is responsible for 75 to 80% of cytochrome P450-mediated testosterone metabolism.[159] In addition to 6β- and 16β-hydroxytestosterone, 1β-, 2α/β-, 11β-, and 15β-hydroxytestosterone are also formed as minor metabolites.[159][160] Certain cytochrome P450 enzymes such as CYP2C9 and CYP2C19 can also oxidize testosterone at the C17 position to form androstenedione.[159]
Cruciferous vegetables like broccoli are rich in indoles, anti-cancer compounds that indirectly boost testosterone production by breaking down and flushing the system of excess estrogen, which inhibits the production of male sex hormones. As men age, their estrogen levels gradually rise, while testosterone levels fall. Indoles can help strike the balance. In one study, supplementing with indole-3-carbinol from cruciferous vegetables for just 7 days cut the estrogen hormone estradiol in half for men. Another study found indole supplementation significant increased urinary excretion of estrogens among men.
Low Testosterone has a big impact on men. Some males suffer debilitating symptoms when their bodies produce insufficient levels of testosterone, resulting in a condition called hypogonadism. Hypogonadism is the decreased functionality of the testes in producing an adequate amount of testosterone. Hypogonadism is not permanent, and can be treated with hormone replacement therapy, specifically Low Testosterone Therapy.
This is one of the most controversial recommendations I make, but it shouldn’t be. It’s no different than using thyroid medication. If your levels are low, and the other techniques here don’t work, use TRT. You will like your life again. If your levels are low, bioidentical testosterone will make you live longer and better, provided you use it right.
A large number of side-effects have been attributed to testosterone. In our clinical experience, the incidence of significant adverse effects with treatment producing physiological testosterone levels is low, and many side effects attributed to testosterone are mainly relevant to supraphysiological replacement. Some adverse effects are specific to a given mode of delivery and have already been described. Potential adverse effects concerning the prostate have also been discussed and require appropriate monitoring of symptoms, PSA and digital rectal examination. Other tumors which may be androgen responsive include cancer of the breast and primary liver tumors, and these are both contraindications to testosterone treatment
Started HRT in my early 50’s as I had all the low-T symptoms and Type 2 Diabetes, which was hammering my body. My total T was about 100 (not sure about Free at that point). First started with Androgel, and was getting decent symptomatic improvement, but didn’t like the residue from the cream, and traveling with the creams was a problem. I’ve gone to pellet implants for the past 7 years. Every 4-5 months, very happy with results to date.

Finally, we looked at the proprietary blends of our remaining boosters, and dug into their ingredient lists. Supplements frequently include ingredients known for their “folk-lore” value; they’re believed to work, even when there isn’t any scientific background to prove it. Though we didn’t ding points if an ingredient wasn’t proven to be good (just so long as it wasn’t proven to be bad), we didn’t want to include any ingredient with evidence of causing harm.
We should probably start with the elephant in the room: do these supplements increase testosterone? The answer is probably yes. There are some ingredients that help convince your body to produce more testosterone, but there’s a catch. Testosterone boosters aren’t actually great at boosting; that is, at pushing your testosterone levels above your healthy, normal balance. Boosters typically act more like restorers — helping bring low testosterone levels back to that healthy equilibrium rather than boosting you above normal testosterone levels. Just like how if you have anemia, taking a vitamin B12 supplement can help restore your energy and reduce fatigue, but if your B12 levels are good, a supplement won’t give you super energy levels to stay awake for three days — your body will likely just process (read: pee) out the extra.
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

Testosterone may strengthen your heart. Research on testosterone’s relation to heart health is split. Some scientists have found that men with higher testosterone levels have an increased risk of heart disease, while recent studies have shown that men with below-normal T levels are more at risk for heart problems. The research is still on-going, but many doctors find the evidence compelling that optimal testosterone levels can help prevent cardiovascular disease.

Such sort of injuries varies in severity and extent of damage markedly from one person to the other and withdrawal of the drug/supplement coupled with proper medical attention suffice in terms of alleviating the symptoms.[8,12] This was observed in the present case. However, the liver injury observed here may not be confidently linked to product consumption as the subject later reported that the following recovery he consumed two more courses of the booster with no side effects. Tests performed following hospital discharge, and repeated use of the product showed AST and ALT to be slightly high, whereas the rest of the blood parameters tested appeared to be normal. The AST/ALT ratio is considered to be a very important parameter for the evaluation of liver diseases, such as non-alcoholic fatty liver disease,[13] though it is rarely considered alone. Overall, the evidence was inconclusive in the present work in terms of linking the use of a testosterone booster with liver injury. However, even though a single case report cannot establish causality with statistical power.[13] Further research on the usage of a commercial testosterone booster within large populations for a long period is necessary to investigate whether the symptoms shown in the present case were significantly present in other athletes consuming the same commercial product or not. To guarantee an optimal outcome with no severe side effects, further research is warranted to confirm the present findings and determine whether the effects observed in this case report would be statistically significant in larger samples.

Tribulus terrestris is an ingredient commonly presented as improving testosterone levels, but has not been found to be more effective than a placebo or possess any testosterone increasing properties. WebMD cautions that it interferes with Lithium and diabetes medications, and in general, not enough is known about tribulus terrestris to recommend a dosage for anyone.
Testosterone belongs to a class of male hormones called androgens, which are sometimes called steroids or anabolic steroids. In men, testosterone is produced mainly in the testes, with a small amount made in the adrenal glands. The brain's hypothalamus and pituitary gland control testosterone production. The hypothalamus instructs the pituitary gland on how much testosterone to produce, and the pituitary gland passes the message on to the testes. These communications happen through chemicals and hormones in the bloodstream.
Testosterone replacement therapy is currently only FDA approved for men who have been diagnosed with hypogonadism, but it’s also prescribed off-label for older men who take it in hopes that it will improve their libido. The use of testosterone therapy is increasingly common in the United States, with more than 2 million men receiving the therapy. Not every man benefits from taking testosterone supplements. Testosterone is available in different forms, including topicals such as gels, creams, and patches; injections; and pellets that are surgically placed directly beneath the skin. (7)