The doctor regularly measured my levels to be sure they were within the normal range for a male my age. In other words, I wasn’t taking ‘roids to get big; I was getting control of hormones that were not functioning well. This is how you should look at testosterone therapy – it is a gentle nudge to help you be in normal ranges, not a big push to get you huuu-yge. If you’re like me, you want “normal ranges” of a 27-year-old, not of a 60-year-old. It’s my plan to keep my testosterone where it is now (around 700) no matter what it takes. Right now, the Bulletproof Diet and the other biohacks I’ve written about do that! I’m 43.


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.
I know many of you are clamoring for the “how-to” part of this series (which will go up on Thursday), but before we get to that, it’s important to cover why you should even care about your testosterone levels in the first place, what T is and how it’s made, and how to get properly tested for it. Building a sound foundation before we dive into the nitty gritty details will be highly beneficial.
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.
For example, in February 2017, scientists reported on trials involving men over age 65 who had low testosterone due to aging. Each trial included a different number of men depending on the subject of the research. Roughly half of the participants received testosterone therapy for a year; the rest underwent a placebo treatment. The researchers discovered the following:
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.
I’m currently 64 y.o. After close to 10 years of twice-weekly injections of 20 units of testosterone cypionate my PSA gradually increased from 4.4 to more than 16. My urologist has performed 4 biopsies and one prostate MRI over that time, all of them negative. The last was 15 months ago. Early last year, after my fluctuating PSA reached 16, I discontinued the injections for about 6 months. My PSA dropped back to 6.1, and by the end of that time, my testosterone levels were about 240 but my libido seemed almost non-existent. I resumed the injections at a reduced level, 15 units, and 3 months later, the testosterone level was in the 700 range but the PSA was back to 16. My doctor told me to discontinue the injections pending another biopsy when I’m 65 in June.(I can’t afford another one immediately because of a high insurance deductible and previous family medical bills.) I am now gradually reducing the injections to 10 units once weekly, in hopes of limiting the withdrawal. Am I playing with fire or doing the right thing and have you had other patients with similar histories?
Vitamin D: Recent research suggests a strong link between vitamin D and hormone function—but as much as 40 percent of Americans are estimated to be deficient. That’s where supplements come in: According to a study published in the journal Hormone and Metabolic Research, vitamin D-deficient men who also had low T experienced a roughly 25 percent increase in T levels after supplementing with 3,000 IU of vitamin D3 for one year.
Always worry of side effects i.e. prostate cancer! Also feels like I am doping like a pro-cyclist (hate cheaters) Without it my muscles and joints stiffens so painfully, fuzzy and somewhat depressed, when pushing very hard while exercising the sensations become bizarre and again so incredibly painful — it feels so good after the injection if I had waited too long!

Tailor the above recommendations to your personal needs and lifestyle. If you’re a vegetarian drop the bacon and steak, but keep the whey protein and eggs. If you have an injury that prevents you from heavy weightlifting, move as much as you can in the way that you can. There are no studies out there which can tell you exactly what will happen if you do X and Y, but not Z. And I certainly can’t tell you either. Don’t be afraid of self-education – that’s how I learned all this – and embrace the idea of conducting your own experiment and being your own test subject. Incorporate as many of the recommendations above as you’re comfortable with, consult your doctor, and track your results.


I am now 65 & have had Low-T problems since I was about 60. I took topical Testosterone for a few years until insurance stopped covering it. Then I took injections at a Men's Health-Low-T Clinic. Then I was diagnosed with Prostate Cancer & was told to stop taking Testosterone. I underwent radiation treatment to cure the Prostate cancer, but since there is a theory that taking Testosterone can lead to Prostate cancer, I have chosen not to resume taking it. While I am glad to be free of the cancer, I have been feeling extremely fatigued & tired all the time to the point that doing much of anything like a little yard work would leave me exhausted for days.
Dr. Martin’s Extra Strength Testosterone Booster made our top spot for budget-friendly enhancers. This is a unique and powerful blend of natural herbs that will help you with your energy levels and raise your stamina. Men will also appreciate better results when it comes to building up lean muscle, and the supplement will give your libido a boost, too.
Although it’s rare to see swelling caused by fluid retention, physicians need to be careful when prescribing testosterone to men with compromised kidney or liver function, or some degree of congestive heart failure. It can also increase the oiliness of the skin, so that some men get acne or pimples, but that’s quite uncommon, as are sleep apnea and gynecomastia (breast enlargement).
It may also become a treatment for anemia, bone density and strength problems. In a 2017 study published in the journal of the American Medical Association (JAMA), testosterone treatments corrected anemia in older men with low testosterone levels better than a placebo. Another 2017 study published in JAMA found that older men with low testosterone had increased bone strength and density after treatment when compared with a placebo. 

Hi I just turned 50 , and for the past 6 years I have been going through depression , low energy , insomnia , but my sex drive was not bad, I really did not know what it was , so last month my family doctor asked that I test my testosterone and the result was 7.2 noml/l (208 ngdl. So I was prescribed 2.5g 1% androgel, after two weeks I did not feel a difference , on the box it says that the recommended dose is 5g 1% , so my doctor prescribed the 5g 1 % , its now a week since I started the 5 g ( all together three weeks since I started androgel ) & now I feel great, my mood and energy level is way better, I never had an issue with my libdo , so no difference there. I asked my family doctor to refer me to an endocrinologist, just to get a second opinion but that appointment will happen only after 5 months, huge wait time. I am not worried about all that is said about side effects like prostate cancer , heart issues etc because otherwise I am very healthy and have family history of cancers and heart issues , but what worries me is , will my testes & p.glands stop producing Testosterone because of this external replacement? Something I would not want to happen at 50, because probably with exercise & diet I could try boosting by my T.Level naturally. More over will I become sterile , I have a young wife and we may have more kids. Also the gel application is very uncomfortable since I have young kids in the house I have o take extreme caution. Last was it worth starting TRT without finding out the level of my free testosterone. appreciate your advise. Thanks.

Some of them can benefit dieters or competitive athletes. These individuals often experience significant decreases in their testosterone levels as a result of the restrictive or stressful exercise or diet regimen. It is worth mentioning that many of them can actually benefit healthy and hyper-active individuals (for example, professional weight lifters), but we can’t know that for sure because there aren’t enough studies to back up this claim.
A recent study conducted on trained subjects showed that squats stimulated a greater testosterone response than leg presses.10 Stick with multijoint exercises like squats, bench presses, and deadlifts—the kinds of compound lifts that'll help jack up your testosterone levels. Since machines isolate a muscle you're working (less stabilizer activity), they're not as good a choice compared to free weights.
While testosterone stimulates a man’s sex drive, it also aids in achieving and maintaining an erection. Testosterone alone doesn’t cause an erection, but it stimulates receptors in the brain to produce nitric oxide. Nitric oxide is a molecule that helps trigger a series of chemical reactions necessary for an erection to occur. When testosterone levels are too low, a man may have difficulty achieving an erection prior to sex or having spontaneous erections (for example, during sleep).

The IOM report estimated that a study of whether there is an increased risk of prostate cancer in men on testosterone therapy might require following 5,000 men for three to five years. Before launching such an endeavor, the report recommended more firmly establishing the effectiveness of testosterone-replacement therapy, saying that studies of long-term risks and benefits should be conducted only after short-term efficacy has been proven. That means the male equivalent of the WHI remains far off.


Looking purely at the biochemical numbers, The Endocrine Society* considers low testosterone to be a total testosterone level of less than 300 ng/dl, and I think that’s a reasonable guide. But no one quite agrees on a number. It’s not like diabetes, where if your fasting glucose is above a certain level, they’ll say, “Okay, you’ve got it.” With testosterone, that break point is not quite as clear.
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
Ben has mentioned APOE many times, as in this podcast, with the reference in this transcript as something like 34/44. I’ve always assumed that meant a number of different genes that related to APOE having the homozygous or heterzygous mutations. I’ve only been able to find one rs in my 23andme raw data that seems meaningful to this, rs429358. How do you all figure out your APOE status? Are you getting this from one of the other companies that analyzes part of your raw data for you?
Testosterone may prove to be an effective treatment in female sexual arousal disorders,[52] and is available as a dermal patch. There is no FDA approved androgen preparation for the treatment of androgen insufficiency; however, it has been used off-label to treat low libido and sexual dysfunction in older women. Testosterone may be a treatment for postmenopausal women as long as they are effectively estrogenized.[52]

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. 


AC, I just ran across the thread… definitely start the injections. Should help with levels that low. I’m 36 and have battled low T for 6-7 years. My labs came back to show 90ng/dl when I just turned 30, and I’ve done Testosterone cypionate injections @ 100mg/mL weekly, Testim, Androgel, and Fortesta over the years. I’m actually going to my endocrinologist tomorrow to have new blood work done.
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.
A man with shrinking levels of testosterone actually may lose some body hair. Testosterone replacement therapy comes with a few potential side effects, including acne and breast enlargement. Testosterone patches may cause minor skin irritation. Topical gels may be easier to use, but great care must be taken to avoid transferring testosterone to someone else though skin-to-skin contact.

Hi.i have a simple question…I AM 60 YEARS OLD and my free testosterone is 7… and my regular testosterone is 700+…I really need TRT …and in case yes i need it the doctor said if i start i need to do it for the rest of my life !!! he said is not coming back!!! ..i don’t know is true or not??? With my testosterone levels i need or not to do TRT???..i am going in gym daily and i feel good in general …all my blood results are perfect …///Again if i take the TRT will help me in general ??or is better to not use the “TRT”..Thank you for your time to answer HONEST for my question ..I ask this because i don’t know what to do ..i don’t want to do something wrong???…!!!..ps .if is possible to answer me on my email ..Thank you v v much and GOD BLESS YOU …Chris…R…
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]
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.

An added testosterone benefit of my high fat and balanced protein and carb diet was that it probably helped me lose some body fat (I went from 18% to 12% body fat). Studies show that high fat diets actually contribute to increased body fat loss. And as we discussed earlier, as you lose body fat, your T production ramps up. Virtuous cycle for the win!
But can testosterone replacement therapy help with heart disease? Study results are mixed. Small studies in the early 2000s found that men with heart disease who underwent testosterone therapy saw only slight improvements. Some were able to increase their walking distance by 33 percent. Another study found that hormone therapy only widened healthy arteries but had no effect on angina pain.
BSN Evotest the next ranked testosterone booster and is a unique option in that it’s available in both capsule and powdered drink form. For those who dislike swallowing pills, this will be a better route to go. There are mixed reports on the taste quality of the product, however, this is an individual preference and should not be something that deters you from purchasing it. It mixes fairly well by most reports, so is something that you should be able to easily take with you to the gym for use during the workout session.
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.]
"Some say it's just a part of aging, but that's a misconception," says Jason Hedges, MD, PhD, a urologist at Oregon Health and Science University in Portland. A gradual decline in testosterone can't explain a near-total lack of interest in sex, for example. And for Hedges' patients who are in their 20s, 30s, and early 40s and having erectile problems, other health problems may be a bigger issue than aging.
×