In addition to weightlifting, studies have shown that HIIT workouts can also help boost testosterone levels. For those of you who don’t know, HIIT stands for high-intensity interval training. It calls for short, intense bursts of exercise, followed by a less-intense recovery period. You repeat with the intense/less-intense cycle several times throughout the workout. In addition to increasing T, HIIT has been shown to improve athletic conditioning and fat metabolism, as well as increase muscle strength.
My preference is to start men on testosterone, for a couple of reasons. First, if a man has successful return of his own erections, it’s like a home run for him. He doesn’t have to take a pill in anticipation of having sex. He can have sex whenever he wants. Second, the benefits of testosterone-replacement therapy often go way beyond erectile dysfunction. That may be what brought the patient into the office originally, but then he comes back saying how much better he feels in general, how much more energetic and motivated he is, how his drives on the golf course seem to be going farther, and how his mood is better.
Epidemiological evidence supports a link between testosterone and glucose metabolism. Studies in non-diabetic men have found an inverse correlation of total or free testosterone with glucose and insulin levels (Simon et al 1992; Haffner et al 1994) and studies show lower testosterone levels in patients with the metabolic syndrome (Laaksonen et al 2003; Muller et al 2005; Kupelian et al 2006) or diabetes (Barrett-Connor 1992; Andersson et al 1994; Rhoden et al 2005). A study of patients with type 2 diabetes using measurement of serum free testosterone by the gold standard method of equilibrium dialysis, found a 33% prevalence of biochemical hypogonadism (Dhindsa et al 2004). The Barnsley study demonstrated a high prevalence of clinical and biochemical hypogonadism with 19% having total testosterone levels below 8 nmol/l and a further 25% between 8–12 nmol/l (Kapoor, Aldred et al 2007). There are also a number longitudinal studies linking low serum testosterone levels to the future development of the metabolic syndrome (Laaksonen et al 2004) or type 2 diabetes (Haffner et al 1996; Tibblin et al 1996; Stellato et al 2000; Oh et al 2002; Laaksonen et al 2004), indicating a possible role of hypogonadism in the pathogenesis of type 2 diabetes in men. Alternatively, it has been postulated that obesity may be the common link between low testosterone levels and insulin resistance, diabetes and cardiovascular disease (Phillips et al 2003; Kapoor et al 2005). With regard to this hypothesis, study findings vary as to whether the association of testosterone with diabetes occurs independently of obesity (Haffner et al 1996; Laaksonen et al 2003; Rhoden et al 2005).
There are two ways that we determine whether somebody has low testosterone. One is a blood test and the other is by characteristic symptoms and signs, and the correlation between those two methods is far from perfect. Generally men with the lowest testosterone have the most symptoms and men with highest testosterone have the least. But there are some men who have low levels of testosterone in their blood and have no symptoms.
Testosterone is only one of many factors that influence aggression and the effects of previous experience and environmental stimuli have been found to correlate more strongly. A few studies indicate that the testosterone derivative estradiol (one form of estrogen) might play an important role in male aggression.[66][71][72][73] Studies have also found that testosterone facilitates aggression by modulating vasopressin receptors in the hypothalamus.[74]

The first period occurs between 4 and 6 weeks of the gestation. Examples include genital virilisation such as midline fusion, phallic urethra, scrotal thinning and rugation, and phallic enlargement; although the role of testosterone is far smaller than that of dihydrotestosterone. There is also development of the prostate gland and seminal vesicles.
Erectile dysfunction is a common finding in the aging male. A prevalence of over 70% was found in men older than 70 in a recent cross-sectional study (Ponholzer et al 2005). Treatment with phosphodiesterase-5 (PDE-5) inhibitors is proven to be effective for the majority of men but some do not respond (Shabsigh and Anastasiadis 2003). The condition is multi-factorial, with contributions from emotional, vascular, neurological and pharmacological factors. The concept of erectile dysfunction as a vascular disease is particularly interesting in view of the evidence presented above, linking testosterone to atherosclerosis and describing its action as a vasodilator.
Free testosterone (T) is transported into the cytoplasm of target tissue cells, where it can bind to the androgen receptor, or can be reduced to 5α-dihydrotestosterone (DHT) by the cytoplasmic enzyme 5α-reductase. DHT binds to the same androgen receptor even more strongly than testosterone, so that its androgenic potency is about 5 times that of T.[118] The T-receptor or DHT-receptor complex undergoes a structural change that allows it to move into the cell nucleus and bind directly to specific nucleotide sequences of the chromosomal DNA. The areas of binding are called hormone response elements (HREs), and influence transcriptional activity of certain genes, producing the androgen effects.
And remember, saturated fats work best (along with monounsaturated fats – olive oil, almonds, avocados etc.). In fact higher intakes of polyunsaturated fats (canola oil, sunflower oil, soybean oil, safflower oil, margarine etc.) are linked to LOWER testosterone levels (14 & 15). I explore the dangers of PUFA's in a lot more detail in this article - PUFA's: The Worst Thing For Your Health That You Eat Everyday.
However, if you have normal testosterone levels and are looking for a boost, for strength gaining purposes, then D-Aspartic acid use may prove less fruitful. A study published in Nutrition Research showed that when the booster was given to men who resistance trained four times a week, their body composition and muscle strength was no different to men who took part in resistance training without the aid of D-Aspartic acid.
Tongkat ali (a.k.a. Longjack, a.k.a. Eurycoma Longifolia) is a foundational compound of Ayurveda, commonly used as an aphrodisiac. Similar to DHEA, longjack has been found to be effective in both men and women for improving libido, total and free testosterone concentrations as well as muscle mass and strength in men and women! And, unlike many of the other old world herbs commonly touted as natural testosterone boosters, longjack actually has a fair amount of human research denoting its benefits.

Once your elevate testosterone levels, you will also sharpen your focus, enhance sports performance, and enjoy enormous competitive spirit. You will also soon notice that the lack of motivation is no longer your problem. Being highly motivated and aggressive due to the action of testosterone boosters, you will experience better muscle gain. Whether you are a novice or a professional sportsman, you will quickly reach your sports goals.
Research shows that bone density increases with testosterone treatment as long as the dose is high enough. on the effect of testosterone on bone density found increases in spinal and hip bone density. Another of females transitioning into males found that testosterone increased bone mineral density. But it’s unknown if testosterone can help with reducing fracture risk.
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]
The most commonly used testosterone preparation in the United States — and the one I start almost everyone off with — is a topical gel. There are two brands: AndroGel and Testim. The gel comes in miniature tubes or in a special dispenser, and you rub it on your shoulders or upper arms once a day. Based on my experience, it tends to be absorbed to good levels in about 80% to 85% of men, but that leaves a substantial number who don’t absorb enough for it to have a positive effect. [For specifics on various formulations, see table below.]

The use of these supplements can help to burn fat and build muscles. As a result, the health and strength of your muscles and bones improve that ultimately leads to a strong and healthy body. Another prominent feature of Testosterone Booster is that it can help to elevate mood and energy. These supplements contains a powerful blend of natural herbs. These natural herbs have healthful properties. Thus, you can have the energy and stamina to perform your best in the gym. Furthermore, these supplements will also help you to increase your productivity at work because of your improved energy levels.


The mechanism of age related decreases in serum testosterone levels has also been the subject of investigation. Metabolic clearance declines with age but this effect is less pronounced than a reduction in testosterone production, so the overall effect is to reduce serum testosterone levels. Gonadotrophin levels rise during aging (Feldman et al 2002) and testicular secretory responses to recombinant human chorionic gonadotrophin (hCG) are reduced (Mulligan et al 1999, 2001). This implies that the reduced production may be caused by primary testicular failure but in fact these changes are not adequate to fully explain the fall in testosterone levels. There are changes in the lutenising hormone (LH) production which consist of decreased LH pulse frequency and amplitude, (Veldhuis et al 1992; Pincus et al 1997) although pituitary production of LH in response to pharmacological stimulation with exogenous GnRH analogues is preserved (Mulligan et al 1999). It therefore seems likely that there are changes in endogenous production of GnRH which underlie the changes in LH secretion and have a role in the age related decline in testosterone. Thus the decreases in testosterone levels with aging seem to reflect changes at all levels of the hypothalamic-pituitary-testicular axis. With advancing age there is also a reduction in androgen receptor concentration in some target tissues and this may contribute to the clinical syndrome of LOH (Ono et al 1988; Gallon et al 1989).

With ingredients like Fenugreek, Ashwagandha, Shilajit, and Boron Citrate, you can expect to see some increases in lean muscle mass thanks to the hike in free and total testosterone levels as well as its ability to suppress cortisol, a natural hormone that can reduce the body’s ability to use fat stores as energy. True GRIT Test Booster does not contain proprietary blends, so you can actually see the exact dosage you are getting from each ingredient listed.
While steroids like DHEA can be used to boost testosterone, if used in the wrong dosages or by people who don’t need them they can raise T-levels far beyond the normal range, which is what causes accelerated muscle gain. According to Dr. Emil Hodzovic, who is a competitive bodybuilder as well as a doctor with Medichecks, steroids come with “a set of risks, including liver damage, hormone imbalance, high blood pressure, and a higher risk of a stroke or heart attack”.

Forged Methyl EAA stands out as it has a special concentrated derivative of D-Aspartic Acid (DAA) which is touted as being 50 times more effective than normal DAA. The formula is so strong that Transform supplements had to put an estrogen blocker as when your testosterone levels get boosted very high, your body will start to convert it to estrogen. It comes with a hefty price tag but many users have considered it to be hands down the strongest on the market.
I think that the importance of testosterone for cardiovascular health is going to be increasingly recognized. In the past, because men die of heart attacks more often than women and men have more testosterone, the fear has been that testosterone causes heart problems. But every single study of whether testosterone is bad for the heart has been negative, and what people haven’t pointed out in most of those negative studies is that there may be a beneficial effect.
6)  Take Cold Showers:  Cold showers have been known to stimulate and boost testosterone production and improve metabolism, detoxification and brain function.  Start your shower with warm/hot water and turn it to cold for the last 30-60 seconds while pumping your muscles and creating a big shiver as your muscles contract.  That will help to boost internal heat and boost testosterone production.  This article will help you.
With the exception of increasing my fat and cholesterol intake, my diet wasn’t that unconventional. I didn’t follow a strictly low-carb or Paleo diet because recent research has suggested that a diet high in protein and low in carbs actually causes T levels to decrease. With that said, I was judicious with the carbs. I tried to get most of my carbs from veggies and fruit, but I didn’t freak out if my wife made us spaghetti for dinner.

If you’re an older man with low testosterone and interested in taking testosterone, this decision should be carefully considered with your physician. Your physician will be able to better assess the balance of your conditions and whether hormone replacement could put you at potential risk. It's a bad idea for anybody to engage in hormone supplementation without the supervision of a physician. Just because hormones occur naturally in the body does not mean that they can be taken without negative effects.
Cholesterol is the building block of testosterone, and eating healthy fats, including saturated fats, helps your body make “good” cholesterol while also supporting healthy hormone balance. Give your body a dose of healthy fats and proteins by consuming moderate amounts of meats from hormone-free animals, grassfed cattle, and wild-caught fish. Nosh on healthy-fat sources such as olives, nuts, seeds, avocados, and coconut oil.
In the hepatic 17-ketosteroid pathway of testosterone metabolism, testosterone is converted in the liver by 5α-reductase and 5β-reductase into 5α-DHT and the inactive 5β-DHT, respectively.[1][155] Then, 5α-DHT and 5β-DHT are converted by 3α-HSD into 3α-androstanediol and 3α-etiocholanediol, respectively.[1][155] Subsequently, 3α-androstanediol and 3α-etiocholanediol are converted by 17β-HSD into androsterone and etiocholanolone, which is followed by their conjugation and excretion.[1][155] 3β-Androstanediol and 3β-etiocholanediol can also be formed in this pathway when 5α-DHT and 5β-DHT are acted upon by 3β-HSD instead of 3α-HSD, respectively, and they can then be transformed into epiandrosterone and epietiocholanolone, respectively.[157][158] A small portion of approximately 3% of testosterone is reversibly converted in the liver into androstenedione by 17β-HSD.[156]
Levels of testosterone naturally decrease with age, but exactly what level constitutes "low T," or hypogonadism, is controversial, Harvard Medical School said. Testosterone levels vary wildly, and can even differ depending on the time of day they're measured (levels tend to be lower in the evenings). The National Institutes of Health includes the following as possible symptoms of low testosterone:
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.
Men who produce more testosterone are more likely to engage in extramarital sex.[55] Testosterone levels do not rely on physical presence of a partner; testosterone levels of men engaging in same-city and long-distance relationships are similar.[54] Physical presence may be required for women who are in relationships for the testosterone–partner interaction, where same-city partnered women have lower testosterone levels than long-distance partnered women.[59]
‘Testosterone boosting’ products  - found online, or in health food or body-building shops, these products claim to boost testosterone levels if you buy them. The majority of these products will not have the effect you want and are not worth spending money on. Any of these products that do have a real effect may have a form of prescription medication in which is both dangerous and illegal.

Miscellaneous: Sleep: (REM sleep) increases nocturnal testosterone levels.[146] Behavior: Dominance challenges can, in some cases, stimulate increased testosterone release in men.[147] Drugs: Natural or man-made antiandrogens including spearmint tea reduce testosterone levels.[148][149][150] Licorice can decrease the production of testosterone and this effect is greater in females.[151]
One preliminary study by researchers from Tikrit University showed high statistically significant increase of serum hormones (p< 0.01) in infertile men [9]. After 30 week treatment serum testosterone has increased by 17,7%, serum luteinizing hormone by 43,2% and serum follicle-stimulating hormone by 17,6%; dosage of ginger used was not disclosed [9]. It is suggested that improved testosterone production is because ginger was shown to be effective in decreasing SDF (sperm DNA Fragmentation) in infertile men [22]. SDF is negatively correlated with testosterone levels [23].
• 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.
First, it’s important to note that these tactics and practices to boost testosterone naturally probably won’t work with men who have hypoandrogenism. If the glands and cells responsible for producing testosterone are damaged or defective, no amount of eggs or sleep will help you raise testosterone levels. You’ll likely need to use testosterone replacement therapy to get your T levels to a healthy place.
46 year old whose suffered with low libido and all the related symptoms for over a decade. Finally had the courage to have a frank talk with dr. and urologist. Testosterone level 165, free testos level 3.6. Re-doing blood work again just to be sure in the next week or so, and will post updates then as things progress. Normal ranges are 300-1200 and 6 to 12.
Researchers found that the simple act ‘expressing power through open, expansive postures’ (i.e. standing up straight and proud) can increase Testosterone and decrease cortisol (58), along with improving feelings of power and tolerance for risk. Easy! Your mother was right – don’t slouch. This could be a handy trick before making a speech or going on a date!
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.
One thing that is often overlooked when it comes to testosterone boosters is the dosing. Test boosters aren’t like other supplements where you can just take the one dosing per day and forget about until the next day. As with any supplement, it only stays in your system for 4-8 hours. This means you need to be taking more than one dose per day. 2 doses are better but it still is not enough. If you want to keep your test levels up all day you will need to be taking at least 3 and preferably 4 doses per day to keep your testosterone levels high throughout the day and to keep them from dropping between doses. You should also be sure to take them every day and try to not miss any doses to get the most out of them.

Cardiovascular disease, and its underlying pathological process atherosclerosis, is an important cause of morbidity and mortality in the developed and developing world. Coronary heart disease in particular is the commonest cause of death worldwide (AHA 2002; MacKay and Mensah 2004). As well as increasing with age, this disease is more common in the male versus female population internationally, which has led to interest in the potential role of sex hormones in modulating risk of development of atherosclerosis. Concerns about the potential adverse effects of testosterone treatment on cardiovascular disease have previously contributed to caution in prescribing testosterone to those who have, or who are at risk of, cardiovascular disease. Contrary to fears of the potential adverse effects of testosterone on cardiovascular disease, there are over forty epidemiological studies which have examined the relationship of testosterone levels to the presence or development of coronary heart disease, and none have shown a positive correlation. Many of these studies have found the presence of coronary heart disease to be associated with low testosterone levels (Reviews: Jones, Jones et al 2003; Jones et al 2005).
With the help of the three main ingredients, you have the ability to naturally raise your free testosterone levels giving you an increase in strength, muscle mass, stamina, and libido.  NutriSuppz Ultra Test aims to help you sleep better, burn fat easier, and feel energized, and have improved mental alertness.  Another perk of NutriSuppz Ultra Test is that it is a fully transparent profile with no proprietary blends—allowing you to know exactly what you are getting in each dose.
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.
When looking for a solid natural testosterone booster, you’ll want one that has the ability to increase natural testosterone levels, increase muscular strength, improve performance and stamina, and help pack on lean muscle mass.  With a mix of key ingredients like D-AA, Tribulus, Fenugreek, and DIM, Evlution’s booster aims to take your training to the next level.  It can also help improve your sleep which is vital in allowing the body to recover from intense sessions in the gym.

Bodybuilding.com sells science-backed testosterone support from top brands so you can continue to crush your goals. Our customer reviews will give you a snapshot of how each of these products works on real people living real lives, so you can make the best decision for your body. Ready to feel powerful again? Let’s find the test booster that’s right for you.


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.
“Poor lifestyle can mimic the symptoms of low testosterone and can actually cause low testosterone as well,” says Hodzovic. “The main culprits include lack of sleep, excessive stress, too little or too much exercise and too little or too much body fat. Getting healthy and active and eating a balanced nutritious diet along with enough sleep are the most important things to do.
Sportsmen are permitted to use the boosters to trigger the mechanism of testosterone synthesis in the body. These products won a wide popularity among the sportsmen. The matter is that the supplements work by substantially enhancing sports performance, reviving strength, boosting endurance, coping with excessive stress levels, and decreasing time necessary for recovery after exhausting exercises.
Testosterone levels naturally rise in response to sexual arousal and activity. Men with higher levels of testosterone usually have greater sexual activity. Older men need more testosterone for libido and erectile function. But it’s important to note that erectile dysfunction is often due to other conditions or medications rather than low testosterone levels.
It seems that adequate testosterone levels are an important influence on sexual symptoms in the aging male and also influence the response of men to PDE-5 inhibitors, the first line treatment for erectile dysfunction in men. Many would now suggest screening for testosterone deficiency in all men presenting with erectile dysfunction (Gore and Rajfer 2004; Shabsigh 2005). This would seem appropriate because, in addition to benefits on sexual function, identification and treatment of hypogonadal men with testosterone could improve other symptoms of hypogonadism and protect against other conditions such as osteoporosis.
Androgens may modulate the physiology of vaginal tissue and contribute to female genital sexual arousal.[48] Women's level of testosterone is higher when measured pre-intercourse vs pre-cuddling, as well as post-intercourse vs post-cuddling.[49] There is a time lag effect when testosterone is administered, on genital arousal in women. In addition, a continuous increase in vaginal sexual arousal may result in higher genital sensations and sexual appetitive behaviors.[50]

Hypogonadism is highly prevalent amongst men with diabetes mellitus type 2 or symptoms of the metabolic syndrome, including insulin resistance, impaired glucose regulation, obesity, and hypertension.1,6,13,14,17,18 Low testosterone in many men with diabetes remains undiagnosed and untreated, and current guidelines recommend measurement of testosterone levels in such patients and, equally, that such chronic diseases should be investigated and treated in men with hypogonadism.1,6 It is not yet fully known whether diabetes is a cause or a consequence of low testosterone, and the full effects of testosterone administration on glycemic control in hypogonadal men with diabetes are unclear. However, there are indications that treating hypogonadism may have benefits on metabolic status in men with diabetes, and there is evidence that testosterone replacement therapy has a beneficial effect on risk factors for diabetes such as central obesity, insulin sensitivity, glucose control and blood lipid profiles in hypogonadal men with type 2 diabetes.14,19,20


Vitamin D, a steroid hormone, is essential for the healthy development of the nucleus of the sperm cell, and helps maintain semen quality and sperm count. Vitamin D also increases levels of testosterone, which may boost libido. In one study, overweight men who were given vitamin D supplements had a significant increase in testosterone levels after one year.5
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.
After 90 days, it seemed like the Andro Gel kind of stopped having it’s effect. Went back to see the doc, and my levels had dropped back to about 198 from high 200’s. Doc said it’s not unusual that the body gets used to it, and maybe I needed to adjust up. I switched to four pumps per day, and I felt immediate effects. Now…there is a period of ultra-horniness, and sometimes, you will feel some of the “roid rage” at some of these levels. It varies from person to person. Generally, if you are an ass, or high strung, this will amplify it. If you are pretty mellow, you may notice that every once in a while you’ll get angry at something that does matter, but again, it’s different person to person.
I started testosterone therapy in January 25th 2014. Original Levels 206 total and 3.5 free. Now I am 1350 total and 125 free. I can honestly say I have felt no different. Still just as tired, Sexual interest is very high as it was before therapy. I am over weight with a fat belly. My biggest complaint is feeling tired. That has not changed. My weight increased a .little since beginning therapy. Who knows??
The researchers found that men who received hormone treatment experienced an increase in bone strength and density. Strength increases were greater in the spine than they were in the hip. However, as with other T Trials, more research needs to be done. A larger study over many years would need to be performed to determine whether testosterone could decrease risk of bone fracture.

That said, keep in mind that using leucine as a free form amino acid can be highly counterproductive as when free form amino acids are artificially administrated, they rapidly enter your circulation while disrupting insulin function, and impairing your body's glycemic control. Food-based leucine is really the ideal form that can benefit your muscles without side effects.
Hacking your testosterone influences everything from body composition to energy levels to mood. It’s easy to eat more butter; it’s hard to visit a doctor and get tested, but that’s what I recommend: know your levels. If you’re 25, you’ll know what your target is when you’re 35. By the time you’ve noticed symptoms of low testosterone, it’s too late to get your “normal” measurements!
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.
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