I started with the shots. Wowee! the effect was like night and day. For two years I was like a teenager. But then I noticed some REALLY risky (Health) behavior ( and memory gaps) and bad decisions with long-term implications(i.e judgement). So I tried stopping TRT (four years on the pumps),within four months, mood swings like menopause: snarly with co workers (not good in nursing), grumpy with everyone, switch from jovial to downcast in an instant (I’m male). Had to go back on and do an 18 mth taper, coupled with exercise. No TRT, makes exercise SO hard to do. Muscles seem so much more aware of stiffness.

The medical conditions that cause excess testosterone are rare, argues Drincic. "Many people mistake the symptoms of anabolic steroid abuse with symptoms of high testosterone,” he says. Anabolic steroids, which are sometimes abused by athletes and body builders, are synthetic versions of the male hormone testosterone. They can cause behavior and mood changes that include rage, paranoia, irritability, and poor judgment.

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.
After years of low libido,ED and just general lack of energy I found a urogist will to look at my symptoms. Turned out my testosterone level was 135 so I started on testosterone. Had a great improvement on everything I was having issues plus just a lot happier. My Dr. did PSA every 6 months and my PSA over almost 2 years went from 1.16 to 1.67, still pretty low for 56YOA He wanted to do a biopsy and he found 1 out of 12 cores 60%, GS3X3. I had an MRI and found a .5cm cancer, clean margins, perfectly round and dead center of the prostate.I’m doing active surviellance and the DR wants to start me on Finasteride and continue TRT. I like to believe that the years of low testosterone help the cancer to develope and the twice yearly testing of PSA by the doctor because of therapy caught it very early.I’m not too sure about TRT and Finasteride together.
There is a negative correlation of testosterone levels with plasminogen activator inhibitor-1 (PAI-1) (Glueck et al 1993; Phillips 1993), which is a major prothrombotic factor and known to be associated with progression of atherosclerosis, as well as other prothrombotic factors fibrinogen, α2-antiplasmin and factor VII (Bonithon-Kopp et al 1988; Glueck et al 1993; Phillips 1993; De Pergola et al 1997). There is a positive correlation with tissue plasminogen activator (tPA) which is one of the major fibrinolytic agents (Glueck et al 1993). Interventional trials have shown a neutral effect of physiological testosterone replacement on the major clotting factors (Smith et al 2005) but supraphysiological androgen administration can produce a temporary mild pro-coagulant effect (Anderson et al 1995).
Finally, there's the question of prostate cancer risk. Research over the past few decades has shown little evidence of a link between testosterone replacement therapy and prostate cancer. However, the question has not been entirely laid to rest. Eisenberg recommends that his testosterone replacement therapy patients get a PSA test once or twice a year to check for possible signs of concern.
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.
The FDA approved testosterone therapy only for men having a low testosterone (hypogonadism) as the result of a diagnosed medical condition (ie, genetic defects), or as a side effect of cancer chemotherapy.3 However, testosterone frequently has been prescribed off-label to men who have had no diagnosed medical condition, other than an age-related decrease in circulating testosterone, also known as “low T”.
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:
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]
CrazyBulk USA earned runner-up status, coming in closely behind our first pick. If your goal is bulking, cutting, and maximum strength, these 100 percent legal steroid-alternative testosterone enhancers are what you are looking for. You can bulk up with these safe and legal supplements without worrying about a prescription or getting in trouble with the law.
Every vitamin, mineral, and ingredient that affects the human body can be taken in enough quantities that they are harmful, or toxic, even the ones that — at lower levels — are beneficial or necessary. Unfortunately, testosterone boosters contain a lot of ingredients that are not well understood. This means in addition to not being able to confirm whether certain ingredients increase testosterone, the scientific and medical communities also don’t know at what levels many ingredients become toxic. On the up side, you might need to eat several pounds of a particular leafy plant before it becomes harmful. On the down side, it could be significantly less that pushes you over your body’s limit. We simply don’t know how little or how much the human body can tolerate. We recommend keeping your doctor in the loop when you add any supplement with unproven ingredients into your diet — they’ll be able to help you find and track any undesired side-effects that these ingredients might cause.
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
Before assessing the evidence of testosterone’s action in the aging male it is important to note certain methodological considerations which are common to the interpretation of any clinical trial of testosterone replacement. Many interventional trials of the effects of testosterone on human health and disease have been conducted. There is considerable heterogenicity in terms of study design and these differences have a potential to significantly affect the results seen in various studies. Gonadal status at baseline and the testosterone level produced by testosterone treatment in the study are of particular importance because the effects of altering testosterone from subphysiological to physiological levels may be different from those of altering physiological levels to supraphysiological. Another important factor is the length of treatment. Randomised controlled trials of testosterone have ranged from one to thirty-six months in duration (Isidori et al 2005) although some uncontrolled studies have lasted up to 42 months. Many effects of testosterone are thought to fully develop in the first few months of treatment but effects on bone, for example, have been shown to continue over two years or more (Snyder et al 2000; Wang, Cunningham et al 2004).
There are a lot of test booster blends out there. A lot of them are junk. I have tried to cover the most effective herbs above. As always, I recommend doing your own research and experiment to see if you notice an effect. If you would like one easy herbal solution I recommend starting with Mike Mahlers Aggressive Strength product purely because I have solid anecdotal evidence of its effectiveness. But again, supplements should be seen purely as that - a supplement to a healthy diet, plenty of sleep, hard training with adequate rest.

Testosterone may strengthen your heart. Research on testosterone’s relation to heart health is split. Some scientists have found that men with higher testosterone levels have an increased risk of heart disease, while recent studies have shown that men with below-normal T levels are more at risk for heart problems. The research is still on-going, but many doctors find the evidence compelling that optimal testosterone levels can help prevent cardiovascular disease.
I am 41 and took test for my depression/ansiety, fatigue and ED problem due to the stress I am exposed to in my work.. Now I stopped and I accumulate a lot of fat, ansiety came back and I started to drink alcohol to cool things down, but as U know, its not helping. My question is.. Do you have to stop taking testosterone eventually or can you keep taking it as a supplement in a regular basis along the rest of your live? Cheers from Panama, Central America.
The testicles produce an enzyme called 11ßHSD-1 which protects your testosterone molecules from the effects cortisol.  During times of prolonged stress and chronically elevated cortisol, there simply is too much cortisol for 11ßHSD-1 to handle.  This results in testosterone molecules being destroyed inside the gonads before they even enter the bloodstream (8, 9).
D-AA:  D-Aspartic Acid has been known to increase libido and sex drive as well as fertility in infertile men. D-AA was the craze a few years back but the issue found was that after a month of use, the results started to diminish.  Also, if you currently have normal levels of testosterone, D-AA won’t do much good for you in terms of an increase in T-levels. 
The mineral zinc is important for testosterone production, and supplementing your diet for as little as six weeks has been shown to cause a marked improvement in testosterone among men with low levels.1 Likewise, research has shown that restricting dietary sources of zinc leads to a significant decrease in testosterone, while zinc supplementation increases it2 -- and even protects men from exercised-induced reductions in testosterone levels.3
This is one of the most controversial recommendations I make, but it shouldn’t be. It’s no different than using thyroid medication. If your levels are low, and the other techniques here don’t work, use TRT. You will like your life again. If your levels are low, bioidentical testosterone will make you live longer and better, provided you use it right.

Beast Sports Nutrition - Super Test has all four of our dream ingredients: magnesium, fenugreek, longjack, and zinc. These ingredients have all been demonstrated to help increase natural testosterone levels, with plenty of scientific research to support them (done on humans too, and not just rats). By combining all four ingredients, Super Test has the best chance of helping to increase your testosterone levels, and thereby helping you gain muscle or have a more active sex life.
The content here is for information purposes only. By delivering the information contained herein is does not mean preventing, diagnosing, mitigating, treating or curing any type of medical condition or disease. When beginning any natural supplementation regiment or integrative treatment, the advice of professionally licensed healthcare providers is advisable to seek.
There are pills in the United States for testosterone supplementation, but their use is strongly discouraged because they cause significant liver toxicity. A safe oral formulation called testosterone undecanoate is available in Canada and in Europe, but not in the United States. What’s quite exciting is that an injectable version of testosterone undecanoate (Nebido) was submitted to the FDA for approval in August 2007. (It’s already approved in many other countries.) It lasts for 12 weeks, so a patient could come in and get a shot about four times a year. [Editor’s note: In December 2009, the brand name of the drug in the United States was changed to Aveed. As of January 2011, it was still awaiting FDA approval.]
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.

The regular intake of testosterone boosters is known for the high level of safety comparing to the hormone injections and the use of illegal steroids. But still to protect yourself against any possible adverse reactions, you should remember that the supplementation can’t be continuous. The breaks from time to time are required. Such an approach to the use of boosters is healthy and best-working if you aspire to enhance own hormone production without any harm.
Boron, a mineral, keeps the cell walls of plants strong. Eating dried fruits and nuts gives you abundant amounts of boron. You can also take boron supplements. It's important to keep your daily boron intake at less than 20 mg, however, according to a current factsheet available from the U.S. National Library of Medicine. High doses of boron can cause serious side effects such as skin inflammation and peeling, irritability, tremors or depression.
I am a 43 year old and have undergone pituitary sectioning/surgery twice. Since then i have been using the testoterone gel daily for 12 years without any problem. However, i still have pituitary tumor and also diagnosed with colon cancer. I am thinking of stopping the HRT because i felt it is worsening the illness. I would be glad if you could advice me of the risk of stopping the treatment.
In many of the studies we found, those who saw the most improvement in health, testosterone, or muscle gain were those with existing nutrient or vitamin deficiencies. This means that some gains may be due more to dietary changes and generally restoring nutrient and vitamin levels than any one magic ingredient, but also that making sure your diet includes healthy amounts of nutrients should be your first step.

The contents displayed within this public group(s), such as text, graphics, and other material (“Content”) are intended for educational purposes only. The Content is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in a public group(s).
I am 41 and took test for my depression/ansiety, fatigue and ED problem due to the stress I am exposed to in my work.. Now I stopped and I accumulate a lot of fat, ansiety came back and I started to drink alcohol to cool things down, but as U know, its not helping. My question is.. Do you have to stop taking testosterone eventually or can you keep taking it as a supplement in a regular basis along the rest of your live? Cheers from Panama, Central America.
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).
Keep in mind that you can use virtually any type of equipment you want for this – an elliptical machine, a treadmill, swimming, even sprinting outdoors (although you will need to do this very carefully to avoid injury) -- as long as you're pushing yourself as hard as you can for 30 seconds. But do be sure to stretch properly and start slowly to avoid injury. Start with two or three repetitions and work your way up, don't expect to do all eight repetitions the first time you try this, especially if you are out of shape.
In summary it’s important to know that this topic is still hotly debated, and there are a lot of inconsistencies in the data. We do know that soy contains phytoestrogens and does seem to have a lot of affects on the body, including some studies that show decreased Testosterone levels. For that reason (and the fact that it tastes like ass) I avoid it, and I recommend you also avoid it (in particular soy isolates!) if you’re seeking higher testosterone.
Produced primarily by the testicles, testosterone is the hormone responsible for developing male sexual traits and maintaining muscle mass, bone density and red blood cell levels. Testosterone levels peak in adolescence and early adulthood then begin to decline with age, typically at a rate of 1 to 2 percent per year after age 30. Testosterone levels influence physical, emotional and sexual well being, with higher testosterone generally having a favorable effect on attitude and performance. Though increasing testosterone can have benefits, changes to testosterone levels can affect hormonal production elsewhere in the endocrine system, so consult a doctor prior to attempting to raise your testosterone.

The all-new True Grit Test Booster is scientifically engineered to deliver the most powerful testosterone-boosting ingredients on the market today. This powerful 3-in-1 formula offers the benefits of both free and total testosterone boost as well as cortisol balance. Using powerful clinically studied key ingredients, True Grit Test Booster works with the body to naturally increase testosterone levels while staying within the normal healthy range

Before we go any further, know that fenugreek is an herb of Asian origin, commonly used in Indian cuisine.  The Indians have been consuming it as an aphrodisiac and an herbal cure-all for centuries which might explain why that waiter in your local Indian restaurant is always smiling. As it turns out, there is actually some validity to the purported claims.


12)  Use Aswaghanda and Collagen Protein:  This adaptogenic herb has been shown to reduce stress hormone, increase DHEA and boost testosterone levels.  You can take the Cortisol Defense to help you get restorative sleep at night which will support your testosterone.  In addition, I personally enjoy using the Organic Bone Broth Collagen in addition to the Amino Strong for a post weight training shake.  This protein powder has all the benefits of collagen protein and it has 500 mg of high potency ashwagandha in each serving!
It also had a purpose. It turns out posing in powerful stances causes your testosterone to increase within 20 minutes [13,14]. In those two studies, power posing for just a few minutes also dropped cortisol and boosted confidence. It’s a great way to start your day, or to give yourself an edge before a job interview or a big presentation. They don’t call it “warrior pose” for nothing!

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Findings that improvements in serum glucose, serum insulin, insulin resistance or glycemic control, in men treated with testosterone are accompanied by reduced measures of central obesity, are in line with other studies showing a specific effect of testosterone in reducing central or visceral obesity (Rebuffe-Scrive et al 1991; Marin, Holmang et al 1992). Furthermore, studies that have shown neutral effects of testosterone on glucose metabolism have not measured (Corrales et al 2004), or shown neutral effects (Lee et al 2005) (Tripathy et al 1998; Bhasin et al 2005) on central obesity. Given the known association of visceral obesity with insulin resistance, it is possible that testosterone treatment of hypogonadal men acts to improve insulin resistance and diabetes through an effect in reducing central obesity. This effect can be explained by the action of testosterone in inhibiting lipoprotein lipase and thereby reducing triglyceride uptake into adipocytes (Sorva et al 1988), an action which seems to occur preferentially in visceral fat (Marin et al 1995; Marin et al 1996). Visceral fat is thought to be more responsive to hormonal changes due to a greater concentration of androgen receptors and increased vascularity compared with subcutaneous fat (Bjorntorp 1996). Further explanation of the links between hypogonadism and obesity is offered by the hypogonadal-obesity-adipocytokine cycle hypothesis (see Figure 1). In this model, increases in body fat lead to increases in aromatase levels, in addition to insulin resistance, adverse lipid profiles and increased leptin levels. Increased action of aromatase in metabolizing testosterone to estrogen, reduces testosterone levels which induces further accumulation of visceral fat. Higher leptin levels and possibly other factors, act at the pituitary to suppress gonadotrophin release and exacerbate hypogonadism (Cohen 1999; Kapoor et al 2005). Leptin has also been shown to reduce testosterone secretion from rodent testes in vitro (Tena-Sempere et al 1999). A full review of the relationship between testosterone, insulin resistance and diabetes can be found elsewhere (Kapoor et al 2005; Jones 2007).

Short bursts of timed intense activity — known as high-intensity interval training or HIIT — trigger the body to make more testosterone than less-than-intense aerobic or endurance exercise, says La Puma. Spurts of activity stimulate androgen-sensitive tissue, he explains, which tells the body to make more testosterone. Strength training has also been shown to increase testosterone.

Studies conducted in rats have indicated that their degree of sexual arousal is sensitive to reductions in testosterone. When testosterone-deprived rats were given medium levels of testosterone, their sexual behaviors (copulation, partner preference, etc.) resumed, but not when given low amounts of the same hormone. Therefore, these mammals may provide a model for studying clinical populations among humans suffering from sexual arousal deficits such as hypoactive sexual desire disorder.[37]
Total levels of testosterone in the body are 264 to 916 ng/dL in men age 19 to 39 years,[169] while mean testosterone levels in adult men have been reported as 630 ng/dL.[170] Levels of testosterone in men decline with age.[169] In women, mean levels of total testosterone have been reported to be 32.6 ng/dL.[171][172] In women with hyperandrogenism, mean levels of total testosterone have been reported to be 62.1 ng/dL.[171][172]
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
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Men who start using the gels have to come back in to have their testosterone levels measured again to make sure they’re absorbing the right amount. Our target is the mid to upper range of normal, which usually means around 500 to 600 ng/dl. The concentration of testosterone in the blood actually goes up quite quickly, within a few doses. I usually measure it after two weeks, though symptoms may not change for a month or two.
If you haven’t hit your twenties yet then you probably can’t imagine losing your interest in sex. I feel you, Holmes.  At 26, I have a healthy appetite now (partially because I consciously work on elevating my T) but it’s nowhere near where it was when I was 17.  I imagine that things will only get worse by the time I’m 35 which is why it’s important to learn what gets your motor firing now.
Male sex characteristics greatly depend on testosterone synthesis in your body. If you keep the levels of this hormone normal, you will prevent sexual potency issues. Accordingly, the elevation of testosterone levels helps combat the impairment of erectile function. The levels of this hormone also affect male fertility. If these levels grow, fertility improves. Aging has a negative impact on testosterone secretion. Such hormonal imbalance is inevitable and permanent. But it’s still possible to positively change the situation and stimulate hormone production by using the high-quality testosterone boosters.
The hypogonadal-obesity-adipocytokine cycle hypothesis. Adipose tissue contains the enzyme aromatase which metabolises testosterone to oestrogen. This results in reduced testosterone levels, which increase the action of lipoprotein lipase and increase fat mass, thus increasing aromatisation of testosterone and completing the cycle. Visceral fat also promotes lower testosterone levels by reducing pituitary LH pulse amplitude via leptin and/or other factors. In vitro studies have shown that leptin also inhibits testosterone production directly at the testes. Visceral adiposity could also provide the link between testosterone and insulin resistance (Jones 2007).
I started with the shots. Wowee! the effect was like night and day. For two years I was like a teenager. But then I noticed some REALLY risky (Health) behavior ( and memory gaps) and bad decisions with long-term implications(i.e judgement). So I tried stopping TRT (four years on the pumps),within four months, mood swings like menopause: snarly with co workers (not good in nursing), grumpy with everyone, switch from jovial to downcast in an instant (I’m male). Had to go back on and do an 18 mth taper, coupled with exercise. No TRT, makes exercise SO hard to do. Muscles seem so much more aware of stiffness.
“Our hypothesis was that testosterone would be good for the coronary arteries because we thought that by repleting testosterone to healthy levels there would be an improvement in the cholesterol panel and atherosclerosis burden. But what we found was the opposite, that atherosclerosis actually progresses faster under the influence of testosterone.”
‘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.
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.
A testicular action was linked to circulating blood fractions – now understood to be a family of androgenic hormones – in the early work on castration and testicular transplantation in fowl by Arnold Adolph Berthold (1803–1861).[181] Research on the action of testosterone received a brief boost in 1889, when the Harvard professor Charles-Édouard Brown-Séquard (1817–1894), then in Paris, self-injected subcutaneously a "rejuvenating elixir" consisting of an extract of dog and guinea pig testicle. He reported in The Lancet that his vigor and feeling of well-being were markedly restored but the effects were transient,[182] and Brown-Séquard's hopes for the compound were dashed. Suffering the ridicule of his colleagues, he abandoned his work on the mechanisms and effects of androgens in human beings.
I am 51 male. I have had low T for a few years now. I was using Testim for a few years, but I hated the smell and mostly feared getting thus stuff on the kids. The reason I stopped with all that nasty gel is because my T levels weren’t improving. So, why bother using anything that is not working, so I stopped. Apparently I am one of those men who do not absorb the gel very well. My T levels dropped from a low of around 200 on a 800+ scale to under 100 after I stopped using the gel.
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.
Some foods, vitamins, and herbs can help boost your testosterone levels. Be sure to talk to your doctor, if you’re concerned about low testosterone. These alternative and natural treatments aren’t proven to be more, or as, effective as traditional testosterone therapy. Some may also interact with any medications you may be taking and cause unintended side effects.
Shilajit in its natural state has no chemical definition. In order to yield a consistent and efficacious form of shilajit, the shilajit is obtained from carefully selected rocks and is put through a patented technology where it is purified and standardized. This form of shilajit is now assured of optimal levels of bioactive components such as fulvic acid and dibenzo-pyrones, and is known as the patented PrimaVie.
The body’s endocrine system consists of glands that manufacture hormones. The hypothalamus, located in the brain, tells the pituitary gland how much testosterone the body needs. The pituitary gland then sends the message to the testicles. Most testosterone is produced in the testicles, but small amounts come from the adrenal glands, which are located just above the kidneys. In women, the adrenal glands and ovaries produce small amounts of testosterone.
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.
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