Hello everyone. First off, thank you Dr. Abraham Morgentaler, for the excellent and refreshing article. I do not intend to spill my guts about symptoms or values on here as it has already been done so many times over. I will say that I am an RN BSN and have been on HRT for going on 6 yrs. I live in Oklahoma and when I first started noticing symptoms I knew something was wrong and began to do research myself. With an initial level of 241 no doctor here at that time, would even consider HRT as I was only 35ish at the time.
Proprietary blends are a growing problem in the supplement industry. This is where mix many ingredients together and list it on the label as a blend. The problem with this is you have no idea how much of each of those ingredients you are getting. Complete transparency is best so the customer knows what they are getting and it also helps limit side-effects.
Ashwagandha is sometimes included in testosterone supplements because of the hypothesis that it improves fertility. However, we couldn’t find sufficient evidence to support this claim (at best, one study found that ashwagandha might improve cardiorespiratory endurance). WebMD advocates caution when taking this herb, as it may interact with immunosuppressants, sedative medications, and thyroid hormone medications.
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
If you're completely inactive, or if you're completely burned out from overly intense training, neither one is going to help your T-levels. And when it comes to nutrition, eating enough—and getting adequate dietary fats—are both essential for healthy testosterone levels, and for general health.[2] In "All About Testosterone," Chris Lockwood, Ph.D., notes that extreme low-calorie dieting and fasting will hinder testosterone levels from staying at their peak, along with better-known villains like chronic stress.
A large number of trials have demonstrated a positive effect of testosterone treatment on bone mineral density (Katznelson et al 1996; Behre et al 1997; Leifke et al 1998; Snyder et al 2000; Zacharin et al 2003; Wang, Cunningham et al 2004; Aminorroaya et al 2005; Benito et al 2005) and bone architecture (Benito et al 2005). These effects are often more impressive in longer trials, which have shown that adequate replacement will lead to near normal bone density but that the full effects may take two years or more (Snyder et al 2000; Wang, Cunningham et al 2004; Aminorroaya et al 2005). Three randomized placebo-controlled trials of testosterone treatment in aging males have been conducted (Snyder et al 1999; Kenny et al 2001; Amory et al 2004). One of these studies concerned men with a mean age of 71 years with two serum testosterone levels less than 12.1nmol/l. After 36 months of intramuscular testosterone treatment or placebo, there were significant increases in vertebral and hip bone mineral density. In this study, there was also a significant decrease in the bone resorption marker urinary deoxypyridinoline with testosterone treatment (Amory et al 2004). The second study contained men with low bioavailable testosterone levels and an average age of 76 years. Testosterone treatment in the form of transdermal patches was given for 1 year. During this trial there was a significant preservation of hip bone mineral density with testosterone treatment but testosterone had no effect on bone mineral density at other sites including the vertebrae. There were no significant alterations in bone turnover markers during testosterone treatment (Kenny et al 2001). The remaining study contained men of average age 73 years. Men were eligible for the study if their serum total testosterone levels were less than 16.5 nmol/L, meaning that the study contained men who would usually be considered eugonadal. The beneficial effects of testosterone on bone density were confined to the men who had lower serum testosterone levels at baseline and were seen only in the vertebrae. There were no significant changes in bone turnover markers. Testosterone in the trial was given via scrotal patches for a 36 month duration (Snyder et al 1999). A recent meta-analysis of the effects on bone density of testosterone treatment in men included data from these studies and two other randomized controlled trials. The findings were that testosterone produces a significant increase of 2.7% in the bone mineral density at the lumber spine but no overall change at the hip (Isidori et al 2005). These results from randomized controlled trials in aging men show much smaller benefits of testosterone treatment on bone density than have been seen in other trials. This could be due to the trials including patients who are not hypogonadal and being too short to allow for the maximal effects of testosterone. The meta-analysis also assessed the data concerning changes of bone formation and resorption markers during testosterone treatment. There was a significant decrease in bone resorption markers but no change in markers of bone formation suggesting that reduction of bone resorption may be the primary mode of action of testosterone in improving bone density (Isidori et al 2005).
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.
Other stereotypical "macho" behaviors can affect testosterone in women, according to a 2015 report in the Proceedings of the National Academy of Sciences. For example, posing in a powerful way increases testosterone in both women and men. The 2015 report showed that having women role-play a position of power — acting like a boss — had the same effect.

NHT works to reach a targeted level of hormones in your body, restoring your body’s natural ability to keep healthy and fit. Hormones are beneficial at any age, but most commonly we administer the therapy to people in their 40’s, when your body naturally begins to slow production of certain hormones. Supplementing these declining hormones can keep your body fit and active for much longer. Bio-identical hormones are made from plants and are identical to the hormones naturally produced by your own body. We never use synthetic hormones, which have been shown to increase your risk of heart disease and diabetes.
Well, this is another area of confusion and great debate, but I don’t think it’s as confusing as it appears to be in the literature. When most doctors learned about testosterone in medical school, they learned about total testosterone, or all the testosterone in the body. But about half of the testosterone that’s circulating in the bloodstream is not available to the cells. It’s tightly bound to a carrier molecule called sex hormone–binding globulin, which we abbreviate as SHBG.
^ 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.
Falling in love decreases men's testosterone levels while increasing women's testosterone levels. There has been speculation that these changes in testosterone result in the temporary reduction of differences in behavior between the sexes.[53] However, it is suggested that after the "honeymoon phase" ends—about four years into a relationship—this change in testosterone levels is no longer apparent.[53] Men who produce less testosterone are more likely to be in a relationship[54] or married,[55] and men who produce more testosterone are more likely to divorce;[55] however, causality cannot be determined in this correlation. Marriage or commitment could cause a decrease in testosterone levels.[56] Single men who have not had relationship experience have lower testosterone levels than single men with experience. It is suggested that these single men with prior experience are in a more competitive state than their non-experienced counterparts.[57] Married men who engage in bond-maintenance activities such as spending the day with their spouse/and or child have no different testosterone levels compared to times when they do not engage in such activities. Collectively, these results suggest that the presence of competitive activities rather than bond-maintenance activities are more relevant to changes in testosterone levels.[58]
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
A: A troche is a small lozenge designed to dissolve in the mouth. Testosterone is available in troche or buccal form. If you are referring to testosterone troche, this product is generally used to treat conditions in men that result from a lack of natural testosterone. Testosterone is vital to maintaining an active and healthy male sex drive. Testosterone deficiency can cause erectile dysfunction. Studies suggest that if erectile dysfunction is associated with a low testosterone level, it can often be treated with prescription testosterone pills. Based on your complete medical history and blood levels of testosterone, your doctor can determine the best treatment option to meet your needs. For more information, please consult with your health care provider and visit //www.everydayhealth.com/drugs/testosterone. Michelle McDermott, PharmD
In my late 40’s I was on Androgel. I lost weight and gained muscle; became healthier over all, brighter outlook, more active, and a harder erection that had a mind of it’s own. Then I went on injectable testosterone. My numbers are normal but my weight is up even after eating less. As well everything else is shelter smelter. I intend to get back to Androgel. (this, of course, is my own personal study)
I definitely enjoyed an increase in muscle mass during my experiment. Despite dropping six percentage points in body fat in three months, my weight stayed about the same; I began the experiment weighing 185 pounds and I ended it weighing the same. The body fat I lost was replaced with muscle. It was fun to see and hear Kate’s reaction when I’d take off my shirt to get into the shower. “Whoa! Your muscles have gotten huge!”
Inaccurate or misinterpreted test results can either falsely diagnose or miss a case of testosterone deficiency. Your testosterone level should be measured between 7 am and 10 am, when it's at its peak. Confirm a low reading with a second test on a different day. It may require multiple measurements and careful interpretation to establish bioavailable testosterone, or the amount of the hormone that is able to have effects on the body. Consider getting a second opinion from an endocrinologist.
If you think you may have Low T symptoms or are suffering from Andropause (Hypogonadism), don't hesitate to contact a Hormone Therapy Physician at one of our male hormone replacement clinics today. You can get tested for Low T with a fast, easy lab test and start treatment right away with a prescription. Find a Testosterone Doctor & Clinics for hormone testing, diagnoses and treatment.
To date, no large, double-blind, randomized controlled studies of a link between testosterone treatment and prostate cancer have been completed. In its 2004 report, the Institute of Medicine (IOM) committee studying the need for clinical trials of testosterone-replacement therapy noted that only 31 placebo-controlled studies had been done in older men, with the largest one enrolling just 108 participants. Most of these studies lasted only six months.

Testosterone is necessary for normal sperm development. It activates genes in Sertoli cells, which promote differentiation of spermatogonia. It regulates acute HPA (hypothalamic–pituitary–adrenal axis) response under dominance challenge.[22] Androgen including testosterone enhances muscle growth. Testosterone also regulates the population of thromboxane A2 receptors on megakaryocytes and platelets and hence platelet aggregation in humans.[23][24]
I was depressed, getting fat, and zero libido. My doc did a full blood work up. My Total Testosterone level was 289 ng/dl. He offered TRT but I declined because I knew, at 53, that if I went on TRT my own testosterone production would shut down and at my age I would have a pretty difficult time kick starting it up again. I researched and researched for about a month. I started on Vitamin D 10,000 iu per day ( I knew this was a safe amount because I tested at 26ng/dl and optimum level is anywhere between 40-80ng/dl. I also took 1,200 mg of magnesium, 9mg of Boron and Vitamin K Complex. Tested again 3 months later and blood work showed I was at 720.
Preliminary research has shown that clomiphene citrate (Clomid), a drug generally prescribed to stimulate ovulation in women struggling with infertility, can foster the production of natural testosterone, termed endogenous testosterone, in men. In a recent prospective study, 36 hypogonadal men took a daily dose of clomiphene citrate for at least three months. Within four to six weeks, all of the men had heightened levels of testosterone; none reported any side effects during the year they were followed.
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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:

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.


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Testosterone is a steroid from the androstane class containing a keto and hydroxyl groups at the three and seventeen positions respectively. It is biosynthesized in several steps from cholesterol and is converted in the liver to inactive metabolites.[5] It exerts its action through binding to and activation of the androgen receptor.[5] In humans and most other vertebrates, testosterone is secreted primarily by the testicles of males and, to a lesser extent, the ovaries of females. On average, in adult males, levels of testosterone are about 7 to 8 times as great as in adult females.[6] As the metabolism of testosterone in males is greater, the daily production is about 20 times greater in men.[7][8] Females are also more sensitive to the hormone.[9]
Testosterone levels peak by early adulthood and drop as you age—about 1% to 2% a year beginning in the 40s. As men reach their 50s and beyond, this may lead to signs and symptoms, such as impotence or changes in sexual desire, depression or anxiety, reduced muscle mass, less energy, weight gain, anemia, and hot flashes. While falling testosterone levels are a normal part of aging, certain conditions can hasten the decline. These include:
The use of anabolic steroids (manufactured androgenic hormones) shuts down the release of luteinising hormone and follicle stimulating hormone secretion from the pituitary gland, which in turn decreases the amount of testosterone and sperm produced within the testes. In men, prolonged exposure to anabolic steroids results in infertility, a decreased sex drive, shrinking of the testes and breast development. Liver damage may result from its prolonged attempts to detoxify the anabolic steroids. Behavioural changes (such as increased irritability) may also be observed. Undesirable reactions also occur in women who take anabolic steroids regularly, as a high concentration of testosterone, either natural or manufactured, can cause masculinisation (virilisation) of women.
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