Currently available testosterone preparations in common use include intramuscular injections, subcutaneous pellets, buccal tablets, transdermal gels and patches (see Table 2). Oral testosterone is not widely used. Unmodified testosterone taken orally is largely subject to first-pass metabolism by the liver. Oral doses 100 fold greater than physiological testosterone production can be given to achieve adequate serum levels. Methyl testosterone esters have been associated with hepatotoxicity. There has been some use of testosterone undecanoate, which is an esterified derivative of testosterone that is absorbed via the lymphatic system and bypasses the liver. Unfortunately, it produces unpredictable testosterone levels and increases testosterone levels for only a short period after each oral dose (Schurmeyer et al 1983).
The International Journal of Sports Physiology and Performance recently studied tennis players, rugby teams, and wrestlers to find a link between testosterone and competitive outcome. They found that the difference between winning and losing was reflected in testosterone levels! The athletes' own natural testosterone prior to the game was directly related to the outcome after the game -- the higher the testosterone, the more frequently the athlete won.6
“I did a lot of research on Andro400 before I ordered it because I've tried other products in the past and they haven't worked. But with this I could not believe the difference within, literally within a month. I'm 62 years old and since I started taking it I have lost 37 lbs. And I have more energy than I've had in 20 years. It's still coming off, but it's coming off slower now. It was the belly fat. I could get weight off but I could never get the tummy off, and now the tummy's coming off. Libido -- everything's better all the way around.“
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.
The oldest form is an injection, which we still use because it’s inexpensive and because we reliably get good testosterone levels in nearly everybody. The disadvantage is that a man needs to come in every few weeks to get a shot. A roller-coaster effect can also occur as blood testosterone levels peak and then return to baseline. [See “Exogenous vs. endogenous testosterone,” above.]
I was depressed, getting fat, and zero libido. My doc did a full blood work up. My Total Testosterone level was 289 ng/dl. He offered TRT but I declined because I knew, at 53, that if I went on TRT my own testosterone production would shut down and at my age I would have a pretty difficult time kick starting it up again. I researched and researched for about a month. I started on Vitamin D 10,000 iu per day ( I knew this was a safe amount because I tested at 26ng/dl and optimum level is anywhere between 40-80ng/dl. I also took 1,200 mg of magnesium, 9mg of Boron and Vitamin K Complex. Tested again 3 months later and blood work showed I was at 720.
When patients ask about risks, I remind them that they already have testosterone in their system and that the goal of testosterone treatment is to restore its concentration back to what it was 10 or 15 years previously. And the molecule itself that we give is identical to the one that their bodies make naturally, so in theory, everything should be hunky-dory. But in practice, there are always some curveballs.
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Caffeine. Use caffeine moderately. Too much of the jittery juice increases cortisol, which decreases testosterone. Moreover, consuming caffeine late in the day hurts sleep, which lowers testosterone production. But one recent study indicates that caffeine consumed before working out may boost testosterone levels and help you exercise more efficiently. During my experiment I popped a piece of caffeinated gum five minutes before my workouts. Each piece had 100 mg of caffeine, about the same amount in a cup of coffee. That was usually it for my caffeine intake that day.
The final two studies looked directly at soy vs testosterone levels. The first looked at introducing consumption of soya flour on testosterone levels. They found that those who ate the Soy flour lowered their T levels during the study (43). And the second study looked at the consumption of soy protein isolates (powder) in healthy men. They found that testosterone levels decreased upon consumption of soy powder (45).
A: If a health insurance company is providing coverage for a medication, including testosterone replacement therapy, they determine the final cost of the product. Costs will vary from one health insurance plan to another. To determine the costs of the testosterone replacement options, the health insurance plan should be contacted. There are various options for testosterone replacement therapy including gels, injections, patches, and tablets that dissolve under the lip. All of the formulations can be effective and each has advantages and disadvantages. The most appropriate testosterone replacement therapy depends on a variety of factors, including cost, patient preference, and tolerability. Testosterone replacement gels, such as AndroGel and Testim, are very effective and easy to administer. AndroGel and Testim can be easily applied to the skin once daily. However, the gels can be irritating to the skin and AndroGel and Testim are typically quite expensive. Testosterone replacement injections, such as Depo-Testosterone (testosterone cypionate) and Delatestryl (testosterone enanthate), are usually inexpensive. The injections are given only once every one to two weeks. The major disadvantage with injectable testosterone is that testosterone levels may be difficult to control. Levels may be too high after an injection and too low before the following injection. A testosterone replacement patch, such as Androderm, is applied every night and left on for 24 hours. Androderm can be applied to the arm, back or stomach, in an area without too much hair. Androderm can cause irritation of the skin. A testosterone tablet, Striant, is placed under the upper lip against the gums and replaced every 12 hours. Striant molds to the upper gum so that eating and drinking can occur normally. The testosterone tablet can irritate the gums and cause a bitter taste and toothache. People with low testosterone should work with their doctor or healthcare provider to find a safe, effective, and affordable testosterone replacement option for them. 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. Derek Dore, PharmD
In addition to its role as a natural hormone, testosterone is used as a medication, for instance in the treatment of low testosterone levels in men and breast cancer in women. Since testosterone levels decrease as men age, testosterone is sometimes used in older men to counteract this deficiency. It is also used illicitly to enhance physique and performance, for instance in athletes.
Many clinical studies have looked at the effect of testosterone treatment on body composition in hypogonadal men or men with borderline low testosterone levels. Some of these studies specifically examine these changes in older men (Tenover 1992; Morley et al 1993; Urban et al 1995; Sih et al 1997; Snyder et al 1999; Kenny et al 2001; Ferrando et al 2002; Steidle et al 2003; Page et al 2005). The data from studies, on patients from all age groups, are consistent in showing an increase in fat free mass and decrease in fat mass or visceral adiposity with testosterone treatment. A recent meta-analysis of 16 randomized controlled trials of testosterone treatment effects on body composition confirms this pattern (Isidori et al 2005). There have been less consistent results with regard to the effects of testosterone treatment of muscle strength. Some studies have shown an increase in muscle strength (Ferrando et al 2002; Page et al 2005) with testosterone whilst others have not (Snyder et al 1999). Within the same trial some muscle group strengths may improve whilst others do not (Ly et al 2001). It is likely that the differences are partly due to the methodological variations in assessing strength, but it also possible that testosterone has different effects on the various muscle groups. The meta-analysis found trends toward significant improvements in dominant knee and hand grip strength only (Isidori et al 2005).
More can be learned from a large, randomized, placebo-controlled trial of finasteride treatment in 18,800 men aged 55 or more. Finasteride is a 5α-reductase inhibitor which acts to prevent the metabolism of testosterone to dihydrotestosterone (DHT) – the most active androgen in the prostate. The trial showed a greater overall incidence of prostate cancer in the control group, but men treated with finasteride were more likely to have high grade tumors (Thompson et al 2003), suggesting that reduced androgen exposure of the prostate may delay the presentation of prostate cancer and/or promote advanced disease in some other way.
In decades past, this essentially meant that once your body hit a certain age, it no longer kept up with the young at heart. Luckily, today there is a variety of solutions to combat declining testosterone levels, including Test Boosters, dietary supplements which are formulated to help naturally stimulate the body’s production of testosterone. Sounds good, but not sure where to start? We’ve compiled the Top 10 Test Boosters for 2018 to help you make the best choice.
Testosterone is only one of many factors that influence aggression and the effects of previous experience and environmental stimuli have been found to correlate more strongly. A few studies indicate that the testosterone derivative estradiol (one form of estrogen) might play an important role in male aggression. Studies have also found that testosterone facilitates aggression by modulating vasopressin receptors in the hypothalamus.
This paper will aim to review the current evidence of clinical effects of testosterone treatment within an aging male population. As with any other clinical intervention a decision to treat patients with testosterone requires a balance of risk versus benefit. We shall try to facilitate this by examining the effects of testosterone on the various symptoms and organs involved.
Testosterone does a lot more than you’d think, whether we’re talking about male or female biology. It’s the hormone that helps you burn fat, build muscle , and increase your sex drive , and its power doesn’t stop there. Keeping your testosterone levels in a normal range can make you happier, too , and testosterone can even improve your cardiovascular health and decrease your risk of mortality (from all causes!), according to a study of 83,000 older men who underwent testosterone replacement therapy .
At the present time, it is suggested that androgen replacement should take the form of natural testosterone. Some of the effects of testosterone are mediated after conversion to estrogen or dihydrotestosterone by the enzymes aromatase and 5a-reductase enzymes respectively. Other effects occur independently of the traditional action of testosterone via the classical androgen receptor- for example, its action as a vasodilator via a cell membrane action as described previously. It is therefore important that the androgen used to treat hypogonadism is amenable to the action of these metabolizing enzymes and can also mediate the non-androgen receptor actions of testosterone. Use of natural testosterone ensures this and reduces the chance of non-testosterone mediated adverse effects. There are now a number of testosterone preparations which can meet these recommendations and the main factor in deciding between them is patient choice.
Epidemiological evidence supports a link between testosterone and glucose metabolism. Studies in non-diabetic men have found an inverse correlation of total or free testosterone with glucose and insulin levels (Simon et al 1992; Haffner et al 1994) and studies show lower testosterone levels in patients with the metabolic syndrome (Laaksonen et al 2003; Muller et al 2005; Kupelian et al 2006) or diabetes (Barrett-Connor 1992; Andersson et al 1994; Rhoden et al 2005). A study of patients with type 2 diabetes using measurement of serum free testosterone by the gold standard method of equilibrium dialysis, found a 33% prevalence of biochemical hypogonadism (Dhindsa et al 2004). The Barnsley study demonstrated a high prevalence of clinical and biochemical hypogonadism with 19% having total testosterone levels below 8 nmol/l and a further 25% between 8–12 nmol/l (Kapoor, Aldred et al 2007). There are also a number longitudinal studies linking low serum testosterone levels to the future development of the metabolic syndrome (Laaksonen et al 2004) or type 2 diabetes (Haffner et al 1996; Tibblin et al 1996; Stellato et al 2000; Oh et al 2002; Laaksonen et al 2004), indicating a possible role of hypogonadism in the pathogenesis of type 2 diabetes in men. Alternatively, it has been postulated that obesity may be the common link between low testosterone levels and insulin resistance, diabetes and cardiovascular disease (Phillips et al 2003; Kapoor et al 2005). With regard to this hypothesis, study findings vary as to whether the association of testosterone with diabetes occurs independently of obesity (Haffner et al 1996; Laaksonen et al 2003; Rhoden et al 2005).
When it comes to testosterone in the body, most of it is bound testosterone. This means it is testosterone that is bound to either the sex hormone globulin or the protein albumin. The problem is this bound up testosterone goes largely unused by the body and does nothing for you in its bound state. It is the free testosterone that is the testosterone you feel and that makes you manly, this is free flowing in your veins and not bound to anything. This is the kind of testosterone you want, the more the better.
I am 56 and I have been taking 100 mg of Test Cyp IM once a week for the last 4 months. My total T fluctuates between 500 and 1000 and my E2 has been staying under 30 with the help of Arimidex 0.5 mg every 3.5 days. I do not know what my free T is due to the expense but I feel much better than I did. Not great but much better so I will continue. If you are not feeling good on TRT then you should have your E2 checked because it is probably over 30 which will counteract the effects of your free T.
With the exception of increasing my fat and cholesterol intake, my diet wasn’t that unconventional. I didn’t follow a strictly low-carb or Paleo diet because recent research has suggested that a diet high in protein and low in carbs actually causes T levels to decrease. With that said, I was judicious with the carbs. I tried to get most of my carbs from veggies and fruit, but I didn’t freak out if my wife made us spaghetti for dinner.
A: According to the package insert, there are several longer-term side effects that have occurred with testosterone therapy. Testosterone can stimulate the growth of cancerous tissue. Prostate cancer or enlargement of the prostate can develop during prolonged therapy with testosterone, and these conditions are more likely to occur in elderly men. In patients receiving testosterone therapy, tests for prostate cancer should be performed as is current practice. Androgen therapy, such as testosterone, can cause a loss of blood sugar control in patients with diabetes. Close monitoring of blood glucose is recommended. Male patients can experience feminization during prolonged therapy with testosterone. The side effects of feminization include breast soreness and enlargement. These side effects are generally reversible when treatment is stopped. Hair loss resembling male pattern baldness has also occurred. Sexual side effects including decreased ejaculatory volume and low sperm counts have occurred in patients receiving long-term therapy or excessive doses. For more information, please consult with your health care provider and visit //www.everydayhealth.com/drugs/testosterone. Michelle McDermott, PharmD
Men who produce more testosterone are more likely to engage in extramarital sex. 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. 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.
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. 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. Testosterone production is reduced gradually in men starting from the age of 30. 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.
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). 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.
Hi Douglas, this is a great question, thanks for reaching out. Apart from having a solid training plan that’s suited to your current level of fitness, and goals, you can also use a quality Testosterone Booster which could give you the lift you need to get back into the gym. If you find it difficult to swallow tablets, you can always empty the capsule into a glass of water, juice, or coffee to make it easier to take.
I have tried pellets, I went from 5 grams/day gel, to 10 grams, had little change due to work schedule and no energy made it difficult to manage daily. Levels got down to 78 at one point. Testo pellets worked great but it took 10 to make a difference and it brought me up to the 300-400 range. My body rejected 3 pellets and expelled them. Tried axiron, didn’t work, natesto, which the doc never heard off next, a Nasal spray which helped but the bottle ran out 5 days early either by my mistake or dosage problems. Back to 10 grams Testim AG ($360 after deductible) which helps if i could stay consistent but I’m 28. With a job, and health insurance, deductible issues I can not afford 800 dollars a month, 360 after deductible. Recent levels of FSH/LH are .7 and 1.2 (low). Total testosterone 114, free 18.9, and bioavalability at 39.6 (low). I had a MRI of my pituitary gland today, and get results next week. Hoping to start depo T next week as I return to work. If I can recommend anything to anyone, is make sure it’s affordable, you have the time or energy to apply/administer, and understand most people will not understand what you are going through. 2 killers of testosterone are chronic stress and lack of sleep. In 3 years of treatment I wish I came to this man’s article and others and read up prior because I’m on the brink of losing everything I’ve worked for due to hypogonadism. Wish you all results and good health, and thank you for a great article!
Testosterone replacement therapy can successfully treat erectile dysfunction and loss of libido in men with low testosterone from either advancing age or hypogonadism. Although the effects of increased testosterone are more dramatic in hypogonadal men there are also benefits to the libido of men with normal gonadal, also called eugonadal, function. In a 2004 study published in the "Journal of Endocrinology and Metabolism," researchers found that increasing peak testosterone levels to between 400 and 500 percent above baseline in subjects resulted in a significant increase in sexual arousability over placebo subjects.
Overall there is evidence that testosterone treatment increases lean body mass and reduces obesity, particularly visceral obesity, in a variety of populations including aging men. With regard to muscle changes, some studies demonstrate improvements in maximal strength but the results are inconsistent and it has not been demonstrated that these changes lead to clinically important improvements in mobility, endurance or quality of life. Studies are needed to clarify this. Changes in abdominal obesity are particularly important as visceral fat is now recognised as predisposing the metabolic syndrome, diabetes and cardiovascular disease.
We reviewed the ingredient lists of our supplements and cut three that prescribed us an overdose of magnesium. While it’s possible to stay under the 350mg daily limit of supplemental magnesium by taking fewer pills than the manufacturer recommends, we were concerned that any manufacturer would advise you to exceed the recommended safety limit for magnesium intake by almost a third.
Because clomiphene citrate is not approved by the FDA for use in men, little information exists about the long-term effects of taking it (including the risk of developing prostate cancer) or whether it is more effective at boosting testosterone than exogenous formulations. But unlike exogenous testosterone, clomiphene citrate preserves — and possibly enhances — sperm production. That makes drugs like clomiphene citrate one of only a few choices for men with low testosterone who want to father children.
Fifteen home remedies for acne Many home remedies can help people reduce their acne by treating oily skin, killing bacteria, and providing antioxidants. Natural treatments that reduce acne flare-ups include aloe vera gel, honey, and tea tree oil. Learn about 15 natural home remedies and how to use them to improve acne, pimples, and oily skin here. Read now
If men’s brain, muscles, and bones are being affected daily due to low testosterone, and it is what makes men, men, why aren’t we doing more about this serious health problem? Could there be a political correctness crept in the scientific community that is hindering newly invigorated research in this area? I thought that scientific inquiry suppose to go where the evidence leads. It appears that some honest experts are opening their eyes to this truth.
I am 35 and had the non sexual symptoms for awhile now( weight gain/muscle loss, extreme fatigue, lack of clarity/concentration) I got my testosterone levels checked last week and it was 35.4 ng. Not a typo, 35.4. I was told by my dr. That I needed to start TRT right away as low t can effect a lot different things in your body. I did my first injection last night (200mg/ml every 2 weeks) about 8 pm and td now 3:30 am and I’m wide awake and feel extremely motivated to go to the gym and work out. I know each person is different but should I feel like this already, or is it a placebo effect at this point?
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.
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Once your elevate testosterone levels, you will also sharpen your focus, enhance sports performance, and enjoy enormous competitive spirit. You will also soon notice that the lack of motivation is no longer your problem. Being highly motivated and aggressive due to the action of testosterone boosters, you will experience better muscle gain. Whether you are a novice or a professional sportsman, you will quickly reach your sports goals.
Falling in love decreases men's testosterone levels while increasing women's testosterone levels. There has been speculation that these changes in testosterone result in the temporary reduction of differences in behavior between the sexes. However, it is suggested that after the "honeymoon phase" ends—about four years into a relationship—this change in testosterone levels is no longer apparent. Men who produce less testosterone are more likely to be in a relationship or married, and men who produce more testosterone are more likely to divorce; however, causality cannot be determined in this correlation. Marriage or commitment could cause a decrease in testosterone levels. Single men who have not had relationship experience have lower testosterone levels than single men with experience. It is suggested that these single men with prior experience are in a more competitive state than their non-experienced counterparts. Married men who engage in bond-maintenance activities such as spending the day with their spouse/and or child have no different testosterone levels compared to times when they do not engage in such activities. Collectively, these results suggest that the presence of competitive activities rather than bond-maintenance activities are more relevant to changes in testosterone levels.
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.
Vitamin D and zinc are both essential to testosterone production. A year-long study looked at the vitamin D and testosterone levels of 2299 men. It found that men with vitamin D levels above 30 nmol/L had more testosterone and lower levels of sex hormone-binding globulin (SHBG). SHBG binds to hormones so your cells can’t use them, and if you have too much of it, your testosterone levels drop . Men with vitamin D deficiency had lower testosterone and higher SHBG levels.
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. 6β-Hydroxylation and to a lesser extent 16β-hydroxylation are the major transformations. 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. In addition to 6β- and 16β-hydroxytestosterone, 1β-, 2α/β-, 11β-, and 15β-hydroxytestosterone are also formed as minor metabolites. Certain cytochrome P450 enzymes such as CYP2C9 and CYP2C19 can also oxidize testosterone at the C17 position to form androstenedione.
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For the 3rd year in a row, DAA Max claims the #1 spot in the Top 10. A product that stands out in all categories with a formula that has been shown in studies to increase free testosterone levels after just 12 days of consistent use. DAA Max’s feedback over the years has shown that this product is not only potent in terms of elevating testosterone and boosting one’s libido, but at its low price it just can’t be beaten.
DHEA (dehydroepiandrosterone) extract - this is a chemical that used in your body which a ‘hormone precursor’. This means it’s the chemical used by the body to create hormones like oestrogen or testosterone. When taken as supplement it is believed to boost testosterone levels, but DHEA has not been shown to increase testosterone in men. DHEA comes in two form:
The T Trials are a set of seven clinical trials hosted at 12 sites around the country. In the aggregate, 790 men aged 65 or older with low levels of testosterone and associated symptoms participated. First, participants had to qualify for one of the main three trials: the Sexual Function Trial, the Physical Function Trial, or the Vitality Trial. Then, participants could participate in any of the other trials for which they qualified.
I thought your article was informative if researching effects of testosterone on cardiovascular and urological findings. However, it failed to key in on the psychological effects which cause noted behavioral changes. My husband was diagnosed with mildly low testosterone level and a fatty liver. Upon convincing his NP to put him on the topical gel as a first course of treatment he has stated he feels great, no longer foggy, and energetic like never before. Please understand, he was not having any sexual dysfunction but instead decreased energy and increased fatigue. What I also noticed is that he is now acting more dominant and agressive in his behavior. He speaks with the intent that nothing he says matters to him regardless of bluntness or disrespect. He has requested a divorce after 18 years of marriage without any prior indication that this was his intentions blindsiding our entire family and friend network. He recently got a job promotion since being on testosterone therapy and has a grandiose personal about him. He has lost 22 pounds and has decreased communications and contact with loved ones. He is scheduled to return to practitioner for a refill on his gel prescription and we, his family, are hoping that he may be taken off this medication which has drastically changed the man I have known for nearly 20 years. Unfortunately because he is a pilot and travels frequently we can only hope that he has not allowed his mental alertness spill over into his physical needs and allowed for infidelity to occur as he has changed all personal passwords, eliminated me accesss to flight benefits and checking account. We no longer get his schedule and therefore only await his sporadic call/texts to let us know if his whereabouts. He has developed a despiteful attitude towards me in a matter of 3 weeks which weeks. He has been on this medication for almost one month now. Prior to the medication, all was well and happy. This medication has completely changed our lives in a negative way. Perhaps practitioner need to consider the behavioral outcomes as well especially in men in their 40’s who may also be going through a mid life crisis. Take it from my firsthand experience that it is not been considered thoroughly in his case.
Studies also show a consistent negative correlation of testosterone with blood pressure (Barrett-Connor and Khaw 1988; Khaw and Barrett-Connor 1988; Svartberg, von Muhlen, Schirmer et al 2004). Data specific to the ageing male population suggests that this relationship is particularly powerful for systolic hypertension (Fogari et al 2005). Interventional trials have not found a significant effect of testosterone replacement on blood pressure (Kapoor et al 2006).
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.
There have been a number of smaller studies on men receiving testosterone-replacement therapy, and if you look at the results cumulatively, the rate of prostate cancer in these men was about 1% per year. If you look at men who show up for prostate cancer screening, same sort of age population, the rate tends to be about the same. You have to be cautious in comparing studies and combining the results, but there’s no signal in these results that testosterone-replacement therapy creates an unexpectedly high rate of prostate cancer.