Men can experience a range of symptoms if testosterone decreases more than it should. Low testosterone, or low T, is diagnosed when levels fall below 300 nanograms per deciliter (ng/dL). A normal range is typically 300–1000 ng/dL, according to the U.S. Food and Drug Administration. A blood test called a serum testosterone test is used to determine your level of circulating testosterone.
Most men report being able to lose body fat and gain lean muscle more easily when they take testosterone boosters. These supplements can also raise a man’s mood and make him feel more confident. You might notice that your libido gets a boost, too. They make workouts more effective and, in some cases, easier. Testosterone boosters are also great for men with low testosterone levels, as they will combat the low energy and fatigue that go along with low levels. Other supplements to consider are energy-boosting supplements and pre-workout supplements.
Fenugreek is often found in Indian, Turkish, and Persian cuisine. Multiple studies have found it to improve testosterone levels, and in particular, sexual performance. Scientists at Babu Banarasi Das University and King George’s Medical University in India have found that fenugreek improved testosterone levels. Testosterone levels increased for 90% of the volunteers, sperm morphology (the size and shape of sperm) improved for 14.6%, and more than 50% of volunteers experienced improvements in mental alertness, mood, and libido.
Travison, T. G., Vesper, H. W., Orwoll, E, Wu, F., Kaufman, J. M., Wang, Y., …Bhasin, S. (2017, April1). Harmonized reference ranges for circulating testosterone levels in men of four cohort studies in the United States and Europe. The Journal of Clinical Endocrinology & Metabolism, 102(4), 1161–1173. Retrieved from https://academic.oup.com/jcem/article/102/4/1161/2884621
After various studies in animals had shown anabolic (muscle building) properties among the various Fenugreek benefits, a study was conducted on men undergoing resistance training. During the study the participants trained in a supervised manner 4 times a week for 8 weeks. Although the levels of DHT (Dihydrotestosterone) were reduced in those taking the Fenugreek supplement, other hormonal markers were not affected[4]. Another study further supported those findings, while also reporting that those taking the supplement witnessed an additional 2kg of fat loss and 2kg more muscle mass gain over the same period[5]. Impressive results indeed.
A couple years ago I was having a problem with my thighs burning when walking up stairs. I noticed the muscles in my legs looking smaller. So I had my doc to check my T levels , and it was under 100. So she started me on testosterone injections weekly 200mg . After several injections I felt great , muscles in legs came back , lots of energy everything good . Leveled out at 3 injections a week 100mg , had a T level of 550 . So I go in for my scheduled injection and they tell me there out of testosterone . I might mention, this is a health care facilility that gives financial assistant if needed. And they have 3 or doctors and a nurse practitioner, which was who I was seeing . So I went on to check back often and got the same reply , were out of supply . So finally after months of the same , I gave up . I started loosing wait and my nerves got bad . Was having panic attacks etc. but I was coming off Prozac at the same time so I blamed it all on that. I was so bad with my nerves I ended up in the ER while on vacation . Doc there put me on a med for stress which I’m still using . After close to a year I checked back with the place I was getting TRT and they were resupplyed with testosterone. So I started back up because of low sex drive and ED. My first injection of 200mg was just short of a Marical , nerves felt great ED gone , had a sex drive , lot of energy . Then after 7 days or so all gone bad nerves started back up . He had me scheduled for anouther injection in 4 weeks 100mg . I went in for injection and after a couple days started feeling a little better . Then same thing as before about 7 days later nerves and everything else as before got worse . 3 weeks later I finally got a appt. with this different doc then I use to have . Told him the problems I was having , which included a horrible down mood , no energy . He decided to start injections every 2 weeks and upped the dose slitley. It’s been 5 days and already noticing ED problem reaccuring . He’s worried about the threat of prostate cancer. And doesn’t want to add any more injection to the schedule. I guess I’m going to have to start seeing the nurse practitioner who seemed to be more liberal and informed about TRT. I feel once a week injection is what it will take to get feeling good again. I’m 57 now with good health . Just need to get my T level on track with a doctor that will listen to how his patient is feeling . My last T level was at 365 . I failed to mention before I started the injections I was on androgel Dailey , 5 pumps a day . Then he gave me the injection of 200mg test . That’s when I felt fantastic for about a week or so . Then down hill . And I wanted to switch because the injection just seem so much better and they are . I noticed a big difference.
In 2003, an Institute of Medicine panel concluded that there was insufficient evidence supporting the benefits of testosterone in older men and recommended further research. Consequently, in 2010, the National Institute of Aging, which is part of the NIH, launched the Testosterone Trials (T Trials) to figure out whether testosterone can help with symptoms associated with low levels of testosterone secondary to older age (i.e., symptomatic hypogonadism).
Xenoestrogen is a chemical that imitates estrogen in the human body. When men are exposed to too much of this estrogen-imitating chemical, T levels drop significantly. The problem is xenoestrogen is freaking everywhere — plastics, shampoos, gasoline, cows, toothpaste. You name it and chances are there are xenoestrogen in it. The ubiquitous nature of this chemical in our modern world is one reason some endocrinologists believe that testosterone levels are lower in men today than in decades past. It’s also a reason doctors say the number of boys born with hypospadias — a birth defect in which the opening of the urethra is on the underside of the penis and not at the tip — has doubled.  Note to expecting parents: make sure mom stays away from xenoestrogens during the pregnancy.

When females have a higher baseline level of testosterone, they have higher increases in sexual arousal levels but smaller increases in testosterone, indicating a ceiling effect on testosterone levels in females. Sexual thoughts also change the level of testosterone but not level of cortisol in the female body, and hormonal contraceptives may affect the variation in testosterone response to sexual thoughts.[51]
A: Testosterone is the male androgen, or sex hormone. It controls too many things to list here. While it does help regulate mood, sex drive, and metabolism, it does this by working in tandem with other hormones in your body. It's produced by the male testes and the adrenal glands. For more information, go to //www.everydayhealth.com/drugs/testosterone. Matt Curley, PharmD
Testosterone [Figure 1] is the main male sex hormone. It is responsible for male sexuality and is the main hormone-producing the features associated with masculinity such as substantial muscle mass, facial hair, libido, and sperm production.[1] Besides, the hormone has other vital functions as the basic chemical composition of testosterone is steroidal; and steroids are known to have significant physiological, as well as psychological, effects in male individuals, especially adults.[1] Testosterone production is reduced gradually in men starting from the age of 30.[2] Hence, testosterone blood concentrations slowly diminish as age progresses. As a result, men may experience a number of physiological and psychological events, such as a lack of sex-drive, erectile dysfunction, acute depression, fatigue, low energy levels, and insomnia.[3]
A number of research groups have tried to further define the relationship of testosterone and body composition by artificial alteration of testosterone levels in eugonadal populations. Induction of a hypogonadal state in healthy men (Mauras et al 1998) or men with prostate cancer (Smith et al 2001) using a gonadotrophin-releasing-hormone (GnRH) analogue was shown to produce increases in fat mass and decreased fat free mass. Another experimental approach in healthy men featured suppression of endogenous testosterone production with a GnRH analogue, followed by treatment with different doses of weekly intramuscular testosterone esters for 20 weeks. Initially the experiments involved men aged 18–35 years (Bhasin et al 2001) but subsequently the study was repeated with a similar protocol in men aged 60–75 years (Bhasin et al 2005). The different doses given were shown to produce a range of serum concentrations from subphysiological to supraphysiological (Bhasin et al 2001). A given testosterone dose produced higher serum concentrations of testosterone in the older age group (Bhasin et al 2005). Subphysiological dosing of testosterone produced a gain in fat mass and loss of fat free mass during the study. There were sequential decreases in fat mass and increases in fat free mass with each increase of testosterone dose. These changes in body composition were seen in physiological and supraphysiological treatment doses. The trend was similar in younger versus older men but the gain of fat mass at the lowest testosterone dose was less prominent in older patients (Bhasin et al 2001; Bhasin et al 2005). With regard to muscle function, the investigators showed dose dependent increases in leg strength and power with testosterone treatment in young and older men but there was no improvement in fatigability (Storer et al 2003; Bhasin et al 2005).
Many endocrinologists are sounding the alarm about the damaging effects that come with exposure to common household chemicals. Called “endocrine disruptors,” these chemicals interfere with our body’s hormone system and cause problems like weight gain and learning disabilities. One type of endocrine disruptor is particularly bad news for our testosterone levels.

Testosterone is indisputably the king of hormones when it comes to the gym. While it’s responsible for reproductive development, it’s better known for its major role in promoting muscle growth, increasing bone density, and even how body fat is distributed. Testosterone levels are also a huge influencer in terms of overall health and emotional state. With age, however, natural testosterone production naturally declines, leading to higher levels of body fat and more difficulty building muscle, not to mention a decrease in libido.
Most studies support a link between adult criminality and testosterone, although the relationship is modest if examined separately for each sex. Nearly all studies of juvenile delinquency and testosterone are not significant. Most studies have also found testosterone to be associated with behaviors or personality traits linked with criminality such as antisocial behavior and alcoholism. Many studies have also been done on the relationship between more general aggressive behavior/feelings and testosterone. About half the studies have found a relationship and about half no relationship.[66] However, later it was found out that testosterone activates dominant, aggressive behavior if at the same time a person has high testosterone and low levels of cortisol in the blood. Conversely, a high level of testosterone and high levels of cortisol do not stimulate dominant behavior. Because cortisol inhibits the action of testosterone.[67][68][69][70] This is probably why the results of the experiments were inconsistent.

I have had BPH for years. Am in early 60s and recently had a 12 site prostate biopsy after a very slow rise of PSA to 4.5 (over a period of 10 years). There were two sites with PIN (one with outpouching and one was focal). Have been on various form of test replacement…changing methods periodically from test cyp IM, or SQ, with and without HCG or HCG alone. I want to continue a very low dose of either HCG or Test Cyp (10-20mg twice/week). What are your thoughts?
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That said, a group of researchers at the National University of Malaysia did a systemic literature review of longjack, looking for clinical research that demonstrated a relationship between the shrub and testosterone levels. Of 150 articles, only 11 met their inclusion criteria — involving humans and scientifically rigorous. However, of those 11 studies, seven “revealed remarkable association” between using longjack and improving male sexual health, while the remaining four “failed to demonstrate sufficient effects.” The team concluded that longjack looks “promising” when it comes to raising low testosterone, and that there is convincing evidence that it works.
ZMA (unnecessary). So when I researched how to increase testosterone, a supplement called ZMA kept popping up. It’s a blend of zinc, magnesium, and vitamin B6. The purported benefits of ZMA include better and deeper sleep which indirectly is supposed to increase testosterone. Zinc and magnesium are necessary minerals in testosterone production, so a mega-dose should be useful, right? Well, no. I bought some and took it during the duration of experiment. I should have done some more research before I made the purchase. While one study in 1998 showed increased strength among athletes taking ZMA, two recent studies (study 1, study 2) have shown that it has absolutely no effect on total or free testosterone levels. Crap. My advice, unless you have a zinc and magnesium deficiency, no need to waste your money on this.
When I told people that I was doing an experiment to increase my testosterone, the question that people would invariably ask in hushed tones was, “So, did it, you know, improve your sex life?” Honestly, I didn’t see too much change. I had a robust and healthy sex life before the experiment and continued to do so afterwards. I guess I was a bit more randier than usual, but not much. I’d imagine if you had been suffering from low T for a long time and took steps to increase it, you’d likely see improvement in the bedroom department.
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There are many Supplements: Zinc for starters about 1/3 of Men have to low Zinc. Make shure you get a good chemical form no oxides best are chelates or citrates. Then there is Arginin and L-Citrullin two amino acids that help Blood flow basacly natural viagra. And then there are things like maca(a plant that you can get in powder form) that hightens libido but not like zinc it doesnt highten the testosteron level. My dad takes the combo of these 3 things kosts you about 30-60$ per Month. Dont be lazy do research on the stuff to make shure you get right dosages and good quality Sups
I have been on TRT for over 8 years now. I feel GREAT! I read all these studies, hear in the news, and see all these dumb lawsuit commercials about testosterone causing cardiovascular events, blood clots and many other things. If anyone takes the time to do the due diligence and read the studies the picture becomes very clear. Unless you monitor all the other hormones, specifically, Estradiol, DHT, Pregenolone, Total Testosterone, Free Direct Testosterone, and DHEAS you are playing a deadly game. The reason is you must give something to control the pathways of T conversion into estradiol and or DHT. The vast majority of the studies used nothing to control those pathways and they gave men way, way more T than they needed to start with. They also gave forms of T that are not acceptable. Especially the oral version.
As you cut these dietary troublemakers from your meals, you need to replace them with healthy substitutes like vegetables and healthy fats (including natural saturated fats!). Your body prefers the carbohydrates in micronutrient-dense vegetables rather than grains and sugars because it slows the conversion to simple sugars like glucose, and decreases your insulin level. When you cut grains and sugar from your meals, you typically will need to radically increase the amount of vegetables you eat, as well as make sure you are also consuming protein and healthy fats regularly.

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Get out of here with your quackery nonsense. No one likes trolls that want to push diet and weight loss pills as a serious solution to low t and ED. Anyone who reads your comment will waste at least 20 seconds of their life. What’s worse, they might listen to you instead of getting real medical advice that might actually help with an issue that is devastating to their lifestyle. And btw, before you decide to respond to this with more quackery, testimonials or fake research, know that I am a pharmaceutical scientist and won’t fall for your bogus statements
Feeling low energy, lack of enthusiasm, but not so much on the sexual side, seems okay. At age 63 started an exercise program. nothing seem to help bring me back, so had my blood test at age 64. 150. 6 months later 165. My doctor started me on testosterone patches after a heart and prostate exam. Now two months into program, now using the gel, there seems little change. Disappointed. I am guess my next blood test will show less than 200. I am disappointed sufficiently to decide not to continue the program. I mean, the drugs cost $500 a month, although my cost is less. I guess my question is if I quit the program, will my body return to its normal, or will it be worse. i can live with a low normal, but less would not not be acceptable.
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
Hormonal Imbalance can affect your personal and work relationships. Some of the most noticeable symptoms prompting patient's to seek out medical care are a complete lack of energy and sheer fatigue, loss of sex drive, erectile dysfunction or soft erections, loss of lean muscle mass and bone strength, rapid weight gain, excessive adipose fatty tissue, disturbed sleep patterns, depression, moodiness, social withdrawal, reduced ability to recover from workouts, flabby muscles, lack of strength and endurance.
A related issue is the potential use of testosterone as a coronary vasodilator and anti-anginal agent. Testosterone has been shown to act as a vasodilator of coronary arteries at physiological concentrations during angiography (Webb, McNeill et al 1999). Furthermore men given a testosterone injection prior to exercise testing showed improved performance, as assessed by ST changes compared to placebo (Rosano et al 1999; Webb, Adamson et al 1999). Administration of one to three months of testosterone treatment has also been shown to improve symptoms of angina and exercise test performance (Wu and Weng 1993; English et al 2000; Malkin, Pugh, Morris et al 2004). Longer term studies are underway. It is thought that testosterone improves angina due its vasodilatory action, which occurs independently of the androgen receptor, via blockade of L-type calcium channels at the cell membrane of the vascular smooth muscle in an action similar to the dihydropyridine calcium-channel blockers such as nifedipine (Hall et al 2006).
The other problem researchers run into when studying the benefits of testosterone is distinguishing between “cause” and “effect.” Is it T that’s providing all these great health benefits or does simply being healthy give you optimal levels of testosterone? It’s tricky because in some instances the answer is “both.” Testosterone (like all hormones) often plays a part in a “virtuous cycle” that regulates a whole host of  processes in our bodies — as you increase T, you get healthier; as you get healthier, your T levels rise. It can also play a part in a “vicious cycle” — as your T levels go down, your health suffers; as your health suffers, your T levels decrease even more.
"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."
Ashwagandha: One of the hottest herbs out there right now, this adaptogen packs a one-two punch. First, it helps the body fight off stress: According to one Indian Journal of Psychological Medicine study, ashwagandha has a cortisol-lowering effect—a major benefit to anyone who wants their body to be more T-friendly. And, second, it can also support your T-boosting training efforts. One Journal of the International Society of Sports Nutrition study, for example, found that men who supplemented with ashwagandha saw significantly greater strength and T gains after eight weeks of resistance training than those who took a placebo.
Today we take a look at some of the physical and psychological benefits that come with having optimal testosterone levels (I’ll talk about what “optimal” means regarding T later this week). You probably know about some of the benefits already, but some of the ones I discuss may surprise you. When appropriate, I’ll report any health benefits that I experienced during my own 90-day testosterone boosting experiment.

Anabolic–androgenic steroids (AASs) are synthetic derivatives of testosterone that are commonly used among athletes aged 18–40 years, but many reports have demonstrated the presence of numerous toxic and hormonal effects as a result of long-term use of an AAS.[9] Testosterone-foods act as natural libido boosters. Due to the growing interest in herbal ingredients and other dietary supplements worldwide, the use of testosterone boosters is becoming more and more mainstream among athletes, but several side effects were documented. Hence, this study established to help in the assessment of the side effects and health risks which could occur among athletes consuming testosterone boosters.
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.”
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.

The biggest change I made to my diet was increasing my fat and cholesterol intake. There’s a reason why old school strong men would drink raw eggs — studies have suggested that higher fat and cholesterol consumption results in increased levels of total T; men eating low-fat diets typically have decreased testosterone levels. The emphasis on increasing fat and cholesterol consumption meant I got to eat like Ron Swanson for three months — bacon and eggs and steak was pretty much the staple of my diet.


Testosterone is included in the World Health Organization's list of essential medicines, which are the most important medications needed in a basic health system.[111] It is available as a generic medication.[10] The price depends on the form of testosterone used.[112] It can be administered as a cream or transdermal patch that is applied to the skin, by injection into a muscle, as a tablet that is placed in the cheek, or by ingestion.[10]
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.
One study looking at alcohol consumption found that increasing alcohol consumption led to a higher level of free & total testosterone compared to a non-drinking control group (20). Drinking did however lower SHBG testosterone levels, though this type of testosterone is bound to a protein meaning our bodies cannot use it to build muscle or increase our mood.
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).

My last injection was November 2017 and i decided to rest for a quarter and see what the impact is. My energy and muscle tone has definitely dropped but I don’t have back acne, sour sweat and I sleep better. In my case anyway I feel like my T is being regulated lower. I turn up the heat and T , my body turns up the aircon which suppresses the T. I can’t find any discussion on correlation between temperature/climate and T anywhere but given that we all live in climate controlled environments now seems worthy of some study.
Herbalists have used _Trifolium pratense_, red clover, to treat menopausal symptoms like hot flashes. The mechanisms underlying these effects remain unknown. Testosterone decreases hot flashes in some postmenopausal women, so red clover may work in this way. A 2015 paper in the Avicenna Journal of Phytomedicine reviewed the literature testing this idea.
If you are serious about losing weight, you have got to strictly limit the amount of processed sugar in your diet, as evidence is mounting that excess sugar, and fructose in particular, is the primary driving factor in the obesity epidemic. So cutting soda from your diet is essential, as is limiting fructose found in processed foods, fruit juice, excessive fruit and so-called "healthy" sweeteners like agave.
It could be said that testosterone is what makes men, men. It gives them their characteristic deep voices, large muscles, and facial and body hair, distinguishing them from women. It stimulates the growth of the genitals at puberty, plays a role in sperm production, fuels libido, and contributes to normal erections. It also fosters the production of red blood cells, boosts mood, and aids cognition.
“I'm having great results. Everybody is seeing a difference. People say, “You look good! Did you lose weight? What are you taking?” I'm 59, and I'm bringing my belt down a couple different notches. I couldn't break 180 lbs for nothing, no matter what I tried. Now it's 175 lbs. and she's going from there. I was just doing it for the belly -- no matter what I just couldn't get rid of the belly (until now). And I'm not as tired as I used to be.“
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).
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