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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
There have been case reports of development of prostate cancer in patients during treatment with testosterone, including one case series of twenty patients (Gaylis et al 2005). It is not known whether this reflects an increase in incidence, as prostate cancer is very common and because the monitoring for cancer in patients treated with testosterone is greater. Randomized controlled trials of testosterone treatment have found a low incidence of prostate cancer and they do not provide evidence of a link between testosterone treatment and the development of prostate cancer (Rhoden and Morgentaler 2004). More large scale clinical trials of longer durations of testosterone replacement are required to confirm that testosterone treatment does not cause prostate cancer. Overall, it is not known whether testosterone treatment of aging males with hypogonadism increases the risk of prostate cancer, but monitoring for the condition is clearly vital. This should take the form of PSA blood test and rectal examination every three months for the first year of treatment and yearly thereafter (Nieschlag et al 2005). Age adjusted PSA reference ranges should be used to identify men who require further assessment. The concept of PSA velocity is also important and refers to the rate of increase in PSA per year. Patients with abnormal rectal examination suggestive of prostate cancer, PSA above the age specific reference range or a PSA velocity greater than 0.75 ng/ml/yr should be referred to a urologist for consideration of prostate biopsy.
I am 35 and had the non sexual symptoms for awhile now( weight gain/muscle loss, extreme fatigue, lack of clarity/concentration) I got my testosterone levels checked last week and it was 35.4 ng. Not a typo, 35.4. I was told by my dr. That I needed to start TRT right away as low t can effect a lot different things in your body. I did my first injection last night (200mg/ml every 2 weeks) about 8 pm and td now 3:30 am and I’m wide awake and feel extremely motivated to go to the gym and work out. I know each person is different but should I feel like this already, or is it a placebo effect at this point?

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).
The body’s endocrine system consists of glands that manufacture hormones. The hypothalamus, located in the brain, tells the pituitary gland how much testosterone the body needs. The pituitary gland then sends the message to the testicles. Most testosterone is produced in the testicles, but small amounts come from the adrenal glands, which are located just above the kidneys. In women, the adrenal glands and ovaries produce small amounts of testosterone.
Clinical trials of the effect of testosterone on glucose metabolism in men have occurred in diabetic and non-diabetic populations. Data specific to aging males is not available. A series of studies investigated the effects of testosterone or dihydrotestosterone given for 6 weeks or 3 months to middle aged, non-diabetic obese men (Marin, Holmang et al 1992; Marin, Krotkiewski et al 1992; Marin et al 1993). It was found that physiological treatment doses led to improved insulin resistance, as measured by the gold standard technique using a euglycemic clamp and/or serum glucose and insulin responses during glucose tolerance test. These improvements were associated with decreased central obesity, measured by computered tomography (CT) or waist-hip ratio, without reduced total fat mass. Insulin resistance improved more with testosterone than dihydrotestosterone treatment and beneficial effects were greater in men with lower baseline testosterone levels. Increasing testosterone levels into the supraphysiological range lead to decreased glucose tolerance.
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.
TestosteroneTherapy.org Provides Information, News & Reviews regarding Testosterone Replacement Therapy for Men & Women including Testosterone Injections like Depo-Testosterone, Cypionate, Enanthate and Propionate, Steroid Hormone Creams, Androgen Gels, HCG Injections, Estrogen and Progesterone Therapy, Natural Boosters, Supplements and Patches to Regain Energy, Boost Sex Drive, Build Muscle, Lose Weight and Treat Hormonal Imbalance. Visit a Low T Center To Start a TRT Treatment program at a Hormone Clinic for Low T, Andropause, ED (Erectile Dysfunction) or Menopause Symptoms. Anti-Aging Treatment Centers and Hormone Replacement for Men & Women.
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But if somebody fails testosterone therapy, meaning that their erections aren’t any better, I’ve said, “Well, let’s stop the testosterone and try one of the PDE5, or phosphodiesterase type 5, inhibitors — sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).” A lot of patients then say, “Well, actually, I’d like to stay on the testosterone. True, it’s not helping my erections, but I’m more turned on, and I’m getting these other benefits.” So we often continue the testosterone and add a PDE5 inhibitor.
I can report that I saw decreased body fat during my three-month testosterone experiment. I started off with 18% body fat and ended the experiment with 12% body fat. I almost have a six-pack! This is the leanest I’ve ever been in my entire life. The funny thing is, I wasn’t even trying to shed body fat. It just happened. All hail, mighty testosterone!
"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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