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.
Benefits: Maca roots originates from the mountains of Peru. For a long time, natives have been using Maca roots as not only a food supply but for it’s properties for increasing sexual potency. It has been prove to improve erectile dysfunctions, libido and sperm production. Maca roots stimulate semen volume, sperm count and sperm motility, which makes Maca a powerful Aphrodisiac.
Vitamin D3 has the ability to naturally boost testosterone levels.  Increasing serum vitamin D levels in the body can help increase testosterone production, allowing you to potentially build muscle at a faster rate. If you don’t live in an area of the world that allows for a good amount of sunlight, you could become deficient and could benefit from a vitamin D supplement.
In the last few years, a lot of men and women have switched over to a pellet that goes under your skin. This is probably the best way to take testosterone now. The pellet is life-changing for both men and women (the dose for women is much lower than it is for men). Women, you won’t get bulky and grow a beard when you take testosterone to achieve normal levels, but you will probably lean out a little without losing your curves, and your energy and sex drive will be amazing. Female bodybuilders who experience weird scary side effects are taking anabolic steroids.
It goes without saying that a healthy diet, quality sleep, productive lifestyle, and regular exercises can contribute to the overall increase of testosterone. However, it is also true that these activities are very often not enough for guys who have the problems with naturally low testosterone levels. This situation also includes people who want to boost their existing testosterone levels.
A study in the European Journal of Clinical Nutrition that showed drops in cholesterol levels also highlighted the benefits of Fenugreek in controlling glucose levels (this is in fact what the trial was intended to test). When you eat, your glucose levels spike. Fenugreek helps stimulate insulin release to slow down the absorption of sugars in your intestinal tract. Fenugreek might help control blood sugar levels in diabetics.  Furthermore, high glucose levels create a poor environment for testosterone production.  This is why Tim Ferris, in his testosterone diet, advises against consuming sweets and simple starches when you are trying to increase T levels.
I started doing prostate biopsies before putting men on testosterone therapy because the fear had always been that a hidden cancer might grow due to increased testosterone. It was also believed that low testosterone was protective. Well, we found prostate cancer in one of the first men with low testosterone we biopsied, even though his PSA level and digital rectal exam (DRE) were normal. As we did more of these, we found more and more cases, about one out of seven, despite normal DRE and normal PSA. When we had data for 77 men and the cancer rate was about the same, 14%, the Journal of the American Medical Association published our findings. At the time, that rate of prostate cancer in men with normal PSA was several times higher than anything published previously, and it approximated the risk of men who had an elevated PSA or an abnormal DRE. That was in 1996.
Overall there is evidence that testosterone treatment increases lean body mass and reduces obesity, particularly visceral obesity, in a variety of populations including aging men. With regard to muscle changes, some studies demonstrate improvements in maximal strength but the results are inconsistent and it has not been demonstrated that these changes lead to clinically important improvements in mobility, endurance or quality of life. Studies are needed to clarify this. Changes in abdominal obesity are particularly important as visceral fat is now recognised as predisposing the metabolic syndrome, diabetes and cardiovascular disease.
I just started TRT gel. On the first day I noticed an improvement in my awareness/energy level. This is now day three and I feel much better. Before I was tired and lacked the mental clarity I now feel. I have not yet noticed and increase in my libido but I think it is improving. Probably need the stimulation from my fiancé and more time to get my T levels up. Before I started the gel, total T levels were 450, and then 500+. I went to an Integrative MD who suggested Free T. That level was low and my SBGH was 100 (high). I then went to an NP who ordered the Free T. She referred me to an Endocrinologist. She along with her Attending interviewed me and decided to prescribe. They asked if I wanted the gel or the injections. I opted for the gel. I will wait and see how the gel works. So far so good.
Vitamin C (unnecessary). I don’t know where I first heard about vitamin C’s supposed T-boosting benefits, but it’s one of those things you see all over the internet when you Google “how to increase testosterone.” Without trying to find the research that backs up that claim, I took a vitamin C supplement during my experiment. I later found some research that suggests that vitamin C does increase testosterone levels in diabetic mice, but because I wasn’t diabetic (nor a mouse), I’m not sure how much the vitamin C helped. I’ve actually stopped taking vitamin C supplements. I’m likely getting more than enough with my diet. Unless you have diabetes, you probably won’t see much benefit from this supplement. Don’t waste your money.

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).

Alphamax XT’s testosterone boosting formula is so potent that they had to include an estrogen blocker in the formula. User’s have reported that the product’s effects rivals a hardcore pre-workout in terms of aggression and intensity. When the workout is done user’s have also been reporting accelerated muscle recovery, fat loss, and increased muscle definition.
Afrisham, R., Sadejh-Nejadi, S., SoliemaniFar, O., Kooti, W., Ashtary-Larky, D., Alamiri, F., … Khaneh-Keshi, A. (2016, November 24). Salivary testosterone levels under psychological stress and its relationship with rumination and five personality traits in medical students. Psychiatry Investigations, 13(6), 637–643. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5128352/
Known as the "male hormone," testosterone is produced primarily by the testicles. "Beginning around age 30, testosterone levels begin to decline naturally and continue to do so as a man ages," says Holly Lucille, ND, RN, a naturopathic doctor, educator, and author, "sometimes leading to low testosterone symptoms such as depressed moods, decreased sex drive, erectile dysfunction, and difficulties with concentration and memory.”

Testosterone is responsible for increased muscle mass. Leaner body mass helps control weight and increases energy. For men with low testosterone, studies that treatment can decrease fat mass and increase muscle size and strength. Some men reported a change in lean body mass but no increase in strength. It’s likely you’ll see the most benefits when you combine testosterone therapy with strength training and exercise.
For years, the recommendation has been to get a testosterone value early in the morning because levels start to drop after 10 or 11 a.m. But the data behind that recommendation were drawn from healthy young men. Two recent studies showed little change in blood testosterone levels in men 40 and older over the course of the day. One reported no change in average testosterone until after 2 p.m. Between 2 and 6 p.m., it went down by 13%, a modest amount, and probably not enough to influence diagnosis. Most guidelines still say it’s important to do the test in the morning, but for men 40 and above, it probably doesn’t matter much, as long as they get their blood drawn before 5 or 6 p.m.

Testosterone improves not just your sex drive, but it also enhances exercise drive, energy for work, mental sharpness, muscle repair, and revs your metabolism to help with weight control. Although improving testosterone levels has not yet been shown to increase lifespan, having a healthy testosterone level improves quality of life for both men and women.
I’m a 49yr old who had a testosterone level of below 300 . I have been on AndroGel for over one year now. The first three months my levels were running between 500 and 600.in the fourth month my level spiked to over 1200 and cut my doctor cut my dosage back to half. my levels fell back to below normal and have since remained that way even though I have been put on the normal dosage again. It seems as though my body has stopped responding to the andro gel.
Some of the effects of testosterone treatment are well recognised and it seems clear that testosterone treatment for aging hypogonadal men can be expected to increase lean body mass, decrease visceral fat mass, increase bone mineral density and decrease total cholesterol. Beneficial effects have been seen in many trials on other parameters such as glycemic control in diabetes, erectile dysfunction, cardiovascular risk factors, angina, mood and cognition. These potentially important effects require confirmation in larger clinical trials. Indeed, it is apparent that longer duration randomized controlled trials of testosterone treatment in large numbers of men are needed to confirm the effects of testosterone on many aspects of aging male health including cardiovascular health, psychiatric health, prostate cancer and functional capacity. In the absence of such studies, it is necessary to balance risk and benefit on the best available data. At the present time the data supports the treatment of hypogonadal men with testosterone to normalize testosterone levels and improve symptoms. Most men with hypogonadism do not have a contraindication to treatment, but it is important to monitor for adverse consequences including prostate complications and polycythemia.
In males, testosterone is synthesized primarily in Leydig cells. The number of Leydig cells in turn is regulated by luteinizing hormone (LH) and follicle-stimulating hormone (FSH). In addition, the amount of testosterone produced by existing Leydig cells is under the control of LH, which regulates the expression of 17β-hydroxysteroid dehydrogenase.[132]
For this reason, after the 2008 financial market meltdown, some commentators put the blame for the crash on the male-dominated profession, arguing that men take too many risks, and the economy would do better and be more stable if it was run by women. Of course, risk-taking does come with inherent risk, but it has also been responsible for the lion’s share of society’s progress and innovation since the dawn of time. Financial markets would likely not exist – period – without testosterone-driven risk-taking.
Another study in 2015 by Melville and friends gave subjects either three or six grams of DAA per day for a 14 days (2 weeks). Researchers noted that the 3g dose of D-aspartic acid did not result in any meaningful changes in testosterone levels (or any other anabolic hormones for that matter).[3] However, the group of men receiving 6g per day experienced a significant reduction in both total testosterone and free testosterone levels, with no concurrent change in other hormones tested.[3]
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At the present time, it is suggested that androgen replacement should take the form of natural testosterone. Some of the effects of testosterone are mediated after conversion to estrogen or dihydrotestosterone by the enzymes aromatase and 5a-reductase enzymes respectively. Other effects occur independently of the traditional action of testosterone via the classical androgen receptor- for example, its action as a vasodilator via a cell membrane action as described previously. It is therefore important that the androgen used to treat hypogonadism is amenable to the action of these metabolizing enzymes and can also mediate the non-androgen receptor actions of testosterone. Use of natural testosterone ensures this and reduces the chance of non-testosterone mediated adverse effects. There are now a number of testosterone preparations which can meet these recommendations and the main factor in deciding between them is patient choice.
"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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