In order to discuss the biochemical diagnosis of hypogonadism it is necessary to outline the usual carriage of testosterone in the blood. Total serum testosterone consists of free testosterone (2%–3%), testosterone bound to sex hormone binding globulin (SHBG) (45%) and testosterone bound to other proteins (mainly albumin −50%) (Dunn et al 1981). Testosterone binds only loosely to albumin and so this testosterone as well as free testosterone is available to tissues and is termed bioavailable testosterone. Testosterone bound to SHBG is tightly bound and is biologically inactive. Bioavailable and free testosterone are known to correlate better than total testosterone with clinical sequelae of androgenization such as bone mineral density and muscle strength (Khosla et al 1998; Roy et al 2002). There is diurnal variation in serum testosterone levels with peak levels seen in the morning following sleep, which can be maintained into the seventh decade (Diver et al 2003). Samples should always be taken in the morning before 11 am to allow for standardization.
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.

My entire presentation was focused on 32 different ways to increase testosterone naturally, with no injections or hormone replacement protocols required. I'm not against bioidentical hormone replacement therapy (BHRT), but I do think one should explore as many natural alternatives as possible first. Or, for even more bang for the buck, pair BHRT with the tactics you'll discover in this episode.
Stick to protocols that stress large degrees of muscle mass and are moderate- to high-intensity. Additionally, more seasoned gym-goers may want to incorporate forced repetitions periodically into their programs, as testosterone increases have been observed with this type of training.14 Incorporating other post-failure training techniques such as dropsets or partials may similarly be associated with higher T production.
Hi i was jus wondering what supplements should i take now im really impressed with testo fuel comments right now i m talking fish oil , whole food multi ,nutrafol for hair it is basically a dht blocker becoz i m having male pattern baldness which is in half way getting better now with prp and Nutrafol both natural after an intensive research. Is it ok to take testosterone booster when u are on dht blocker supplements anyways im 40yrs old male plz reply it will help me a lot i have bad energy levels,declining muscle mass joint pain weak bones plz help
I’ve been reading all these comments and replies here. This was a great article and if it does anything, it should stimulate you to talk to your physician. Your Dr. can take blood and have it annylized, then prescribe the proper direction to take. A lot of people here have been giving free advice, but who knows your system best? Am I going to take advice from someone who doesn’t know anything other than the symptoms I present? I’m not, but what if I’m allergic?

While testosterone stimulates a man’s sex drive, it also aids in achieving and maintaining an erection. Testosterone alone doesn’t cause an erection, but it stimulates receptors in the brain to produce nitric oxide. Nitric oxide is a molecule that helps trigger a series of chemical reactions necessary for an erection to occur. When testosterone levels are too low, a man may have difficulty achieving an erection prior to sex or having spontaneous erections (for example, during sleep).

Discussing the clinical utility of these findings, Dr. Budoff told EndocrineWeb, “in the short-term, I am going to check my patients for atherosclerosis before instituting testosterone therapy. We still need a definitive study to show whether or not heart attacks are increased by supplemental testosterone, but advancing atherosclerosis is not a good thing. These results should make us more cautious about whom we treat and what doses we use.”
6., 7. JK, Udani, George AA, Musthapa M, Pakdaman MN, and Abas A. "Effects of a Proprietary Freeze-Dried Water Extract of Eurycoma Longifolia (Physta) and Polygonum minus on Sexual Performance and Well-Being in Men: A Randomized, Double-Blind, Placebo-Controlled Study." National Center for Biotechnology Information. U.S. National Library of Medicine, 12 Jan. 2014.
The aim of treatment for hypogonadism is to normalize serum testosterone levels and abolish symptoms or pathological states that are due to low testosterone levels. The exact target testosterone level is a matter of debate, but current recommendations advocate levels in the mid-lower normal adult range (Nieschlag et al 2005). Truly physiological testosterone replacement would require replication of the diurnal rhythm of serum testosterone levels, but there is no current evidence that this is beneficial (Nieschlag et al 2005).

^ Southren AL, Gordon GG, Tochimoto S, Pinzon G, Lane DR, Stypulkowski W (May 1967). "Mean plasma concentration, metabolic clearance and basal plasma production rates of testosterone in normal young men and women using a constant infusion procedure: effect of time of day and plasma concentration on the metabolic clearance rate of testosterone". The Journal of Clinical Endocrinology and Metabolism. 27 (5): 686–94. doi:10.1210/jcem-27-5-686. PMID 6025472.


It’s perhaps no coincidence that Giacomo Casanova, who was said to eat 50 oysters for breakfast each morning, reportedly bed half of Europe. After all, oysters are brimming with zinc, a mineral that elevates testosterone while simultaneously boosting growth factor hormone—both of which enhance muscle growth and physical performance (in and out of the bedroom).
Unfortunately, in the modern world, stresses and emotional exhaustion lie in wait for men at every step. Nowadays, burnout is a constant state for many men. Of course, this causes great harm to the men’s health. Stresses drain of vitality and affect emotional state. Besides, they are also very dangerous for the nervous system. The nature is wise. And the body of a man who is not subject to stress can produce more testosterone.
I need an answer regarding getting testoroene after having your Prostate removed. I had my Prostate removed 3 months ago and my PSA levels are zero. I want to go back on testoroene because I felt great when I was on it before having my prostate taken out. I am 44 years old and I workout 4-5 days a week hard. I am in excellent shape and I didn’t have any symptoms of prostate cancer other then my PSA levels went up.
Hi Douglas, this is a great question, thanks for reaching out. Apart from having a solid training plan that’s suited to your current level of fitness, and goals, you can also use a quality Testosterone Booster which could give you the lift you need to get back into the gym. If you find it difficult to swallow tablets, you can always empty the capsule into a glass of water, juice, or coffee to make it easier to take.

Camacho EM1, Huhtaniemi IT, O'Neill TW, Finn JD, Pye SR, Lee DM, Tajar A, Bartfai G, Boonen S, Casanueva FF, Forti G, Giwercman A, Han TS, Kula K, Keevil B, Lean ME, Pendleton N, Punab M, Vanderschueren D, Wu FC; EMAS Group. “Age-associated changes in hypothalamic-pituitary-testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study.” Eur J Endocrinol. 2013 Feb 20;168(3):445-55. doi: 10.1530/EJE-12-0890. Print 2013 Mar.
So much to say, take a look at excelmale.com. it is a resource for men like us that give answers, science and dialogue which addresses our questions. It’s a great resource for men like us. Also, I would say to eliminate blue light before bed from tv and pc screens. Simply use blue light blocking glasses or F.lux from the play store. Also get outside in the sun in the AM. The goal is to restore the circadian rhythm which impacts hormone productiion.

• 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.
The rise in testosterone levels during competition predicted aggression in males but not in females.[90] Subjects who interacted with hand guns and an experimental game showed rise in testosterone and aggression.[91] Natural selection might have evolved males to be more sensitive to competitive and status challenge situations and that the interacting roles of testosterone are the essential ingredient for aggressive behaviour in these situations.[92] Testosterone produces aggression by activating subcortical areas in the brain, which may also be inhibited or suppressed by social norms or familial situations while still manifesting in diverse intensities and ways through thoughts, anger, verbal aggression, competition, dominance and physical violence.[93] Testosterone mediates attraction to cruel and violent cues in men by promoting extended viewing of violent stimuli.[94] Testosterone specific structural brain characteristic can predict aggressive behaviour in individuals.[95]
"I went from 230 pounds down to 192. When my son got married, I went for the suit fitting, and I was a size 48. When I went back to do the final fitting, I was a 44! I want to keep getting it for the weight loss; I lost 4 inches around my belly, and I want to get rid of the rest of the weight around my belly. I’m 57, and my wife says I look like I’m back in my 30s. I have more energy for sure, and I’m going to participate in one of those Savage races where they have the obstacle courses with one of our kids."
In summary, low testosterone levels are linked to the presence of numerous cardiovascular risk factors. Testosterone treatment acts to improve some of these factors, but effects may vary according to pre- and post-treatment testosterone levels, as well as other factors. There is little data from trials specific to aging males. Appropriately-powered randomized controlled trials, with cardiovascular disease primary endpoints, are needed to clarify the situation, but in the meantime the balance of evidence is that testosterone has either neutral or beneficial effects on the risk of cardiovascular disease in men. It is particularly important to define the effect of testosterone treatment on cardiovascular disease in view of its potential use as an anti-anginal agent.
Hello – Has anybody here had their hair fall out after significantly increasing their T level? In 90 days of Clomiphene Citrate use my Total Testosterone went from 290 to 1100. and my Free T went from 50 to 202. Yes, it went way up! CC works. I have no idea why anybody would bother with gels and shots without giving this a chance. It costs almost nothing. so cheap.
As with cognitive effects, previous studies examining CVD changes following testosterone treatment have been conflicting and inconclusive. Dr. Budoff and his research team used coronary computed tomographic angiography (CCTA) to assess 138 men, including 73 treated with testosterone and 65 receiving placebo, for changes in coronary artery plaque volume after 1 year.

In fact, studies on vegetarian and low-fat diets both show reduced testosterone levels of about 12 percent. Where higher fat diets of at least 40 percent of calories, with a higher intake of saturated fat, show increased testosterone levels. Why? It’s not rocket science. After all, cholesterol makes up the building blocks from which testosterone is formed; without it, the hormone simply can’t synthesize. Organic eggs are one of the best dietary sources. In addition to essential fatty acids, a whole egg is rich in aspartic acid, an amino acid that triggers production of testosterone.

2009 had heart attack, placed coronary stent, everything okay. Put on statins to keep lipid levels down to prevent further artery blockage. One year later developed Peyronie’s disease, low sex drive, fatigue, testicles withdrawn and hurting. Testosterone level was 85. Diagnosed with hypogonadism. Started Androgel, felt normal after a couple of weeks. I believe statins is the cause of my low T, you need lipids for hormone transport. Androgel could only bring my T level in the 250 range. Switched to Axiron (better, less messy), and my T level stays around 500 range. I get samples of Testim every now and then, it has a manly woody fragrance that women like. At present, I’m feeling a little fatigue, and mild dehydration. My lab work is always normal, except my red blood cells is always on the high side, almost abnormal. Next week I am going to donate some blood, to bring my RBC count down, and see if that will help.
Saw palmetto and testosterone facts Testosterone is the primary male sex hormone. Boosting its levels can have many effects, such as promoting muscle growth and improving libido. Saw palmetto, a plant resembling the leaves of a palm tree, may boost testosterone levels and offer other health benefits. Learn more about saw palmetto and testosterone here. Read now

According to a study in the International Journal of Reproductive BioMedicine, D-Aspartic acid increases testosterone levels in some animals. However, studies that have looked at its effects on humans are inconclusive and mainly of poor quality. The paper says there is an urgent need for more research on this chemical, which occurs naturally in some human tissues.


There is increasing interest in the group of patients who fail to respond to treatment with PDE-5 inhibitors and have low serum testosterone levels. Evidence from placebo-controlled trials in this group of men shows that testosterone treatment added to PDE-5 inhibitors improves erectile function compared to PDE-5 inhibitors alone (Aversa et al 2003; Shabsigh et al 2004).

Testosterone therapy improves body composition (increase in lean body mass, decrease in fat mass) in men with hypogonadism.1 There is a supplementary improvement in muscle strength and physical function. The benefits of testosterone treatment on body composition have consistently been demonstrated in clinical studies of testosterone therapy in hypogonadal men or men with borderline low testosterone levels,1,6,8,12,13 and confirmed by systematic reviews or meta-analyses of randomized controlled trials.4,5,6,13


My biggest symptom was fatigue. Interestingly, I had and have no problem with erections at all. Granted, I wasn’t getting spontaneous erections like when I was a teenager and into my late 20’s, but that was a good thing as getting an erection whenever and having no way to relieve it can get annoying. Anyway, my biggest concern with low T was/is energy levels and loss of muscle mass.

Women also feel the effects of testosterone imbalance. Common knowledge holds that testosterone is just for men, but that’s not true. Low testosterone in women results in a wide variety of hard to diagnose symptoms: fatigue, anxiety, sleeplessness, depression, and weight gain are some common symptoms. These effects are commonly seen after menopause, but hormone imbalances can happen at any age. Properly balancing the body’s natural testosterone and estrogen levels prevents these symptoms.
As with cognitive effects, previous studies examining CVD changes following testosterone treatment have been conflicting and inconclusive. Dr. Budoff and his research team used coronary computed tomographic angiography (CCTA) to assess 138 men, including 73 treated with testosterone and 65 receiving placebo, for changes in coronary artery plaque volume after 1 year.
Looking for ingredients that work in the realm of supplements can be like finding a needle in a haystack. Testosterone boosters, like all dietary supplements, are not approved by the Food and Drug Administration prior to marketing. This lack of oversight dates back to the 1994 Dietary Supplement Health and Education Act (DSHEA), which stipulated that purveyors of supplements weren’t required to prove the safety of their products or the veracity of what’s on the labels to the FDA before listing them for sale. Often, there isn’t a lot of scientific backing behind an ingredient, or research has been done solely on animals, not humans.
Sleep apnea is another frequently listed contraindication to testosterone treatment. There have been a few reports of the development, or worsening, of sleep apnea during testosterone therapy (Matsumoto et al 1985) but sleep apnea is actually associated with lower serum testosterone levels (Luboshitzky et al 2002). The reduction in fat mass during treatment with testosterone could potentially be beneficial for sleep apnea, so many specialists will still consider patients for treatment with appropriate monitoring. It is wise to take a clinical history for sleep apnea during testosterone treatment in all men and perform sleep studies in those who develop symptoms.

I am now 65 & have had Low-T problems since I was about 60. I took topical Testosterone for a few years until insurance stopped covering it. Then I took injections at a Men's Health-Low-T Clinic. Then I was diagnosed with Prostate Cancer & was told to stop taking Testosterone. I underwent radiation treatment to cure the Prostate cancer, but since there is a theory that taking Testosterone can lead to Prostate cancer, I have chosen not to resume taking it. While I am glad to be free of the cancer, I have been feeling extremely fatigued & tired all the time to the point that doing much of anything like a little yard work would leave me exhausted for days.
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Another point I’d like to make for people worried about a link between high testosterone and prostate cancer is that it just doesn’t make sense. Prostate cancer becomes more prevalent in men as they age, and that’s also when their testosterone levels decline. We almost never see it in men in their peak testosterone years, in their 20s for instance. We know from autopsy studies that 8% of men in their 20s already have tiny prostate cancers, so if testosterone really made prostate cancer grow so rapidly — we used to talk about it like it was pouring gasoline on a fire — we should see some appreciable rate of prostate cancer in men in their 20s. We don’t. So, I’m no longer worried that giving testosterone to men will make their hidden cancer grow, because I’m convinced that it doesn’t happen.
Trials of testosterone treatment in men with type 2 diabetes have also taken place. A recent randomized controlled crossover trial assessed the effects of intramuscular testosterone replacement to achieve levels within the physiological range, compared with placebo injections in 24 men with diabetes, hypogonadism and a mean age of 64 years (Kapoor et al 2006). Ten of these men were insulin treated. Testosterone treatment led to a significant reduction in glycated hemoglobin (HbA1C) and fasting glucose compared to placebo. Testosterone also produced a significant reduction in insulin resistance, measured by the homeostatic model assessment (HOMA), in the fourteen non-insulin treated patients. It is not possible to measure insulin resistance in patients treated with insulin but five out of ten of these patients had a reduction of insulin dose during the study. Other significant changes during testosterone treatment in this trial were reduced total cholesterol, waist circumference and waist-hip ratio. Similarly, a placebo-controlled but non-blinded trial in 24 men with visceral obesity, diabetes, hypogonadism and mean age 57 years found that three months of oral testosterone treatment led to significant reductions in HbA1C, fasting glucose, post-prandial glucose, weight, fat mass and waist-hip ratio (Boyanov et al 2003). In contrast, an uncontrolled study of 150 mg intramuscular testosterone given to 10 patients, average age 64 years, with diabetes and hypogonadism found no significant change in diabetes control, fasting glucose or insulin levels (Corrales et al 2004). Another uncontrolled study showed no beneficial effect of testosterone treatment on insulin resistance, measured by HOMA and ‘minimal model’ of area under acute insulin response curves, in 11 patients with type 2 diabetes aged between 33 and 73 years (Lee et al 2005). Body mass index was within the normal range in this population and there was no change in waist-hip ratio or weight during testosterone treatment. Baseline testosterone levels were in the low-normal range and patients received a relatively small dose of 100 mg intramuscular testosterone every three weeks. A good increase in testosterone levels during the trial is described but it is not stated at which time during the three week cycle the testosterone levels were tested, so the lack of response could reflect an insufficient overall testosterone dose in the trial period.
I was born with a rare genetic disorder called Klinefelter’s syndrome. My parents actually were known about my condition prior to birth. I’m 25 years old and have been on TRT since 8th grade. It’s a permanent part of life and essential to ultimate happiness, motivation, and the pursuit of bigger and better things. I currently face problems at this time in life due to the endocrinologists. It seems when I bring a problem or question to them, they don’t take charge and figure it out. There all pushed off to the side and left for no one; so now I’ve gotten rid of them and I’m in pursuit of a doctor who will improve the quality of my life. Also with my last doctor I was able to retrieve enough testosterone to perform my out ethical experiment with Testosterone. I injected myself every 5 days for a period of 3 months at the dosage of .75ml. The outcome was amazing. My mind, body, and spirit were one. The energy was phenomenal and in demand. I was able to pursue my endeavors with the energy provided, I was able to think about running and exercising and then put that thought into action. I took extensive notes in the form of a journal to create the ultimate needed dosage for myself. The only reason it ended in three months, was due to no more medicine. It had to be done. Now I’m off to find a doctor to work with me.
• 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.
Findings that improvements in serum glucose, serum insulin, insulin resistance or glycemic control, in men treated with testosterone are accompanied by reduced measures of central obesity, are in line with other studies showing a specific effect of testosterone in reducing central or visceral obesity (Rebuffe-Scrive et al 1991; Marin, Holmang et al 1992). Furthermore, studies that have shown neutral effects of testosterone on glucose metabolism have not measured (Corrales et al 2004), or shown neutral effects (Lee et al 2005) (Tripathy et al 1998; Bhasin et al 2005) on central obesity. Given the known association of visceral obesity with insulin resistance, it is possible that testosterone treatment of hypogonadal men acts to improve insulin resistance and diabetes through an effect in reducing central obesity. This effect can be explained by the action of testosterone in inhibiting lipoprotein lipase and thereby reducing triglyceride uptake into adipocytes (Sorva et al 1988), an action which seems to occur preferentially in visceral fat (Marin et al 1995; Marin et al 1996). Visceral fat is thought to be more responsive to hormonal changes due to a greater concentration of androgen receptors and increased vascularity compared with subcutaneous fat (Bjorntorp 1996). Further explanation of the links between hypogonadism and obesity is offered by the hypogonadal-obesity-adipocytokine cycle hypothesis (see Figure 1). In this model, increases in body fat lead to increases in aromatase levels, in addition to insulin resistance, adverse lipid profiles and increased leptin levels. Increased action of aromatase in metabolizing testosterone to estrogen, reduces testosterone levels which induces further accumulation of visceral fat. Higher leptin levels and possibly other factors, act at the pituitary to suppress gonadotrophin release and exacerbate hypogonadism (Cohen 1999; Kapoor et al 2005). Leptin has also been shown to reduce testosterone secretion from rodent testes in vitro (Tena-Sempere et al 1999). A full review of the relationship between testosterone, insulin resistance and diabetes can be found elsewhere (Kapoor et al 2005; Jones 2007).
Actually he knows exactly what he is talking about. The fact your a doctor gives zero confidence that you have any knowledge in HRT, in fact I believe it where you wonderful doctors that started the larger opioid epedemic the world has ever seen. Make sure if your considering HRT you see a doctor that specializes in it, otherwise you very well could be getting terrible advice by a doctor with no knowledge of the subject as is the case here. Do your research on the doctor, and make sure you are getting a doctor that specializes in HRT. Don’t forget somebody had to finish at the bottom of the class in med school, and based on this doctors comments he probably was one of them. Doctors can be as dangerous as they are helpful; as we have seen quite clearly with the opioid epidemic being experienced in this country, as I mentioned above. This epidemic was caused 100% by doctors in this country. I own several HRT clinics and employ some of the top doctors in the HRT field. Our doctors put our patients health above all else especially above the all mighty dollar. I assure you the comment by this Dr. claiming the post above makes absolutely no sense (I believe it makes no sense to him, because he has zero knowledge on the subject) is dead wrong, and the poster was pretty much right on point with what he said.

Men who take Testosterone report a surge in their sex drive and frequency of sex. They are better able to work out, build muscle mass and strength. The fat around their belly melts away as they lose weight and trim their waists. Men who enroll in a comprehensive Testosterone Replacement program which includes diet, nutrition and exercise - feel better, sleep better and look better. They have their edge back along with a restored enthusiasm for daily living, pursuing relationships and living life.


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.
If a man's testosterone looks below the normal range, there is a good chance he could end up on hormone supplements—often indefinitely. "There is a bit of a testosterone trap," Dr. Pallais says. "Men get started on testosterone replacement and they feel better, but then it's hard to come off of it. On treatment, the body stops making testosterone. Men can often feel a big difference when they stop therapy because their body's testosterone production has not yet recovered."
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