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.
Sleep apnea is another frequently listed contraindication to testosterone treatment. There have been a few reports of the development, or worsening, of sleep apnea during testosterone therapy (Matsumoto et al 1985) but sleep apnea is actually associated with lower serum testosterone levels (Luboshitzky et al 2002). The reduction in fat mass during treatment with testosterone could potentially be beneficial for sleep apnea, so many specialists will still consider patients for treatment with appropriate monitoring. It is wise to take a clinical history for sleep apnea during testosterone treatment in all men and perform sleep studies in those who develop symptoms.
While I do have a pretty manly mustache, I’m not a doctor or a medical expert. I’m a guy with a law degree he’s never used who blogs about manliness. What I’m about to share shouldn’t be taken as a substitute for qualified medical expertise. It’s simply my experience and views on the subject. Before you make any changes in lifestyle or diet, talk to your doctor or healthcare provider. Be smart.

Epidemiological studies suggest that many significant clinical findings and important disease states are linked to low testosterone levels. These include osteoporosis (Campion and Maricic 2003), Alzheimer’s disease (Moffat et al 2004), frailty, obesity (Svartberg, von Muhlen, Sundsfjord et al 2004), diabetes (Barrett-Connor 1992), hypercholesterolemia (Haffner et al 1993; Van Pottelbergh et al 2003), hypertension (Phillips et al 1993), cardiac failure (Tappler and Katz 1979; Kontoleon et al 2003) and ischemic heart disease (Barrett-Connor and Khaw 1988). The extent to which testosterone deficiency is involved in the pathogenesis of these conditions, or to which testosterone supplementation could be useful in their treatment is an area of great interest with many unanswered questions.
I was born with a rare genetic disorder called Klinefelter’s syndrome. My parents actually were known about my condition prior to birth. I’m 25 years old and have been on TRT since 8th grade. It’s a permanent part of life and essential to ultimate happiness, motivation, and the pursuit of bigger and better things. I currently face problems at this time in life due to the endocrinologists. It seems when I bring a problem or question to them, they don’t take charge and figure it out. There all pushed off to the side and left for no one; so now I’ve gotten rid of them and I’m in pursuit of a doctor who will improve the quality of my life. Also with my last doctor I was able to retrieve enough testosterone to perform my out ethical experiment with Testosterone. I injected myself every 5 days for a period of 3 months at the dosage of .75ml. The outcome was amazing. My mind, body, and spirit were one. The energy was phenomenal and in demand. I was able to pursue my endeavors with the energy provided, I was able to think about running and exercising and then put that thought into action. I took extensive notes in the form of a journal to create the ultimate needed dosage for myself. The only reason it ended in three months, was due to no more medicine. It had to be done. Now I’m off to find a doctor to work with me.

For men with low blood testosterone levels, the benefits of hormone replacement therapy usually outweigh potential risks. However, for most other men it's a shared decision with your doctor. It offers men who feel lousy a chance to feel better, but that quick fix could distract attention from unknown long-term hazards. "I can't tell you for certain that this raises your personal risk of heart problems and prostate cancer, or that it doesn't," Dr. Pallais says.
Cross-sectional studies conducted at the time of diagnosis of BPH have failed to show consistent differences in testosterone levels between patients and controls. A prospective study also failed to demonstrate a correlation between testosterone and the development of BPH (Gann et al 1995). Clinical trials have shown that testosterone treatment of hypogonadal men does cause growth of the prostate, but only to the size seen in normal men, and also causes a small increase in prostate specific antigen (PSA) within the normal range (Rhoden and Morgentaler 2005). Despite growth of the prostate a number of studies have failed to detect any adverse effects on symptoms of urinary obstruction or physiological measurements such as flow rates and residual volumes (Snyder et al 1999; Kenny et al 2000, 2001). Despite the lack of evidence linking symptoms of BPH to testosterone treatment, it remains important to monitor for any new or deteriorating problems when commencing patients on testosterone treatment, as the small growth of prostate tissue may adversely affect a certain subset of individuals.
In males, the testosterone test can help find the reason for sexual problems, like reduced sex drive or erectile dysfunction. If you’re having a hard time getting your partner pregnant, the test can tell if your blood testosterone level is low. It can also screen for problems with the hypothalamus or pituitary gland. This controls how much testosterone your body makes.

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There are no studies showing its effects on healthy males, but it has been shown to drastically improve testosterone in infertile males (ref 77). It's also packed full of minerals, so is a great superfood nevertheless. I use the Sunfoods brand. Make sure you buy from a quality brand, as there are a lot of poor shilajit products out there, also some have been shown to be high in heavy metals. 
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How is it that women for many years have had HRT available and it is common place and acceptable for them? Men are expected to just have a decline and when they start to look into this, immediately they are looked at as they just want to do steroids. This is not the case for any of the comments I have read. I too simply like having my levels where they should be and if taken for this reason should be common place just as it is for estrogen replacement in women.
As a urologist, I tend to see men because they have sexual complaints. The primary hallmark of low testosterone is low sexual desire or libido, but another can be erectile dysfunction, and any man who complains of erectile dysfunction should get his testosterone level checked. Men may experience other symptoms, such as more difficulty achieving an orgasm, less-intense orgasms, a smaller amount of fluid from ejaculation, and a feeling of numbness in the penis when they see or experience something that would normally be arousing.
I can report that I saw decreased body fat during my three-month testosterone experiment. I started off with 18% body fat and ended the experiment with 12% body fat. I almost have a six-pack! This is the leanest I’ve ever been in my entire life. The funny thing is, I wasn’t even trying to shed body fat. It just happened. All hail, mighty testosterone!

According to a study in the International Journal of Reproductive BioMedicine, D-Aspartic acid increases testosterone levels in some animals. However, studies that have looked at its effects on humans are inconclusive and mainly of poor quality. The paper says there is an urgent need for more research on this chemical, which occurs naturally in some human tissues.
The largest amounts of testosterone (>95%) are produced by the testes in men,[2] while the adrenal glands account for most of the remainder. Testosterone is also synthesized in far smaller total quantities in women by the adrenal glands, thecal cells of the ovaries, and, during pregnancy, by the placenta.[130] In the testes, testosterone is produced by the Leydig cells.[131] The male generative glands also contain Sertoli cells, which require testosterone for spermatogenesis. Like most hormones, testosterone is supplied to target tissues in the blood where much of it is transported bound to a specific plasma protein, sex hormone-binding globulin (SHBG).
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.
Glad to be heard. I have been using 10 times the recommended prescription dose of injectable test over the course of 6 years. Yes, 10 times the recommended dose. I use 250 at the lowest and 1000 mgs a week and sometimes 1200 mgs weekly. I am 50 years old. I look better than 90% of the 25 year olds I see in the gym. I have had zero issues. Acne a little , testicle shrinkage maybe 15%. No big deal. My sex drive is on fire. I bench pressed 340 pound today. I weigh 195 pounds and lean and muscles defined and hard as a rock. Doctors in the USA have no clue what they are doing. They read literature and have no experience or facts about test. They prescribe 50 mgs a week. Way short of what we as men need. Everyone is different, but 250mgs weekly is what we need typically. Injectable is the way to go. Gels are a weak joke. My doctor basically told me he was scared to prescribe more than 50 mgs weekly for fear of being sued if something went wrong. I found my own source and have been on top of the world for 6 years. Father died of prostate cancer. Mine prostate is fine. Prostate cancer from test is another example of ignorance in medical field. I am living proof that one can inject 10 times the recommended rate for the better part of a decade with no probs. I do hope the medical field catches up with the times and stops relying on archaic info.
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Another study in 2015 by Melville and friends gave subjects either three or six grams of DAA per day for a 14 days (2 weeks). Researchers noted that the 3g dose of D-aspartic acid did not result in any meaningful changes in testosterone levels (or any other anabolic hormones for that matter).[3] However, the group of men receiving 6g per day experienced a significant reduction in both total testosterone and free testosterone levels, with no concurrent change in other hormones tested.[3]
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.
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??

I’m telling you all of this because no matter who you are, keeping your testosterone levels balanced is more important now than ever before. Modern living has not been kind to our hormones. In American men, serum testosterone levels have declined by about 1% each year for the past 30 years [5], and you can make a few educated guesses about why. Hormone-disrupting chemicals are more prevalent than ever before, physical activity is less and less common, veganism is popular (I was a raw vegan for a while), and many doctors insist on pushing a low-fat, low-cholesterol diet for health (by the way, the concept of a low-fat diet began in the mid-70s, shortly before the nationwide testosterone decline. It could be a coincidence, but I doubt it).

The TTrials were funded by the National Institutes of Health, and consist of 7 integrated, placebo-controlled, randomized clinical trials evaluating the short-term efficacy of testosterone treatment in older men with low circulating levels of the hormone. The benefits of testosterone were evaluated in 7 clinically relevant medical concerns and at least preliminary evidence of efficacy in sexual function, physical function, vitality, cognition, anemia, bone health, and cardiovascular health.
There is a dirty little secret about testosterone cream that almost no one knows, and I’m going to share it here. Please don’t abuse it. If you take a vanishingly small dose of testosterone cream and apply it to your labia and the vulva (or your partner’s), you will witness a form of vasodilation rarely seen no matter how good you are in bed. It has a profound local effect and will produce a night you won’t forget for years.

More specifically, saw palmetto is frequently used to suppress prostate growth and combat abnormal urine flow that results from an enlarged prostate. The reason it is believed that saw palmetto can combat prostate hyperplasia is based on some research indicating it may block an enzyme (5-alpha-reductase) that converts testosterone into dihydrotestosterone (DHT).[21]
If you're a man who's experiencing symptoms such as decreased sex drive, erectile dysfunction, depressed mood, and difficulties with concentration and memory, and you think low testosterone may be to blame, you can have your levels tested. Since testosterone levels fluctuate throughout the day, you'll probably need more than a blood test to get a true picture of your levels.
The authors reported statistically significant increases in both noncalcified and total coronary artery plaque in patients receiving testosterone treatment. Participants’ coronary artery calcium scores, another measure of calcified plaque, were not significantly affected by testosterone treatment. Although these results are potentially a cause for concern, additional studies are required to determine the clinical relevance of this increase in plaque volume.
The unsexy truth is that increasing T naturally simply comes down to making some long-term changes in your diet and lifestyle. As you’ll see, what I did to increase T largely boils down to eating better, exercising smarter, and getting more sleep. That’s pretty much it. But as with most things in life, the devil is in the details, so I’ll share with you exactly what I did and provide research that explains why the things I did helped boost my testosterone.

^ Jump up to: a b Sapienza P, Zingales L, Maestripieri D (September 2009). "Gender differences in financial risk aversion and career choices are affected by testosterone". Proceedings of the National Academy of Sciences of the United States of America. 106 (36): 15268–73. Bibcode:2009PNAS..10615268S. doi:10.1073/pnas.0907352106. PMC 2741240. PMID 19706398.
For men with low blood testosterone levels, the benefits of hormone replacement therapy usually outweigh potential risks. However, for most other men it's a shared decision with your doctor. It offers men who feel lousy a chance to feel better, but that quick fix could distract attention from unknown long-term hazards. "I can't tell you for certain that this raises your personal risk of heart problems and prostate cancer, or that it doesn't," Dr. Pallais says.
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