I’ve had low testo in the winter for the last 10 years, with the lowest values around april (live in the north). But last year (in september) I started using vitamine D (10 000 IU) and K2 (180 mcg), combined with magnesium (200 mg malate) and zinc (25 mg malate and piccolinate) every night, and since then I no longer have low testo in the winter, and is feeling like I do in the summer and have normal testo levels. This combo may work for other people as well. And the risk for dangerous side effects is probabaly neglectable. But it takes a couple of weeks before it kicks in.
In this podcast, I will review the key biomarkers for achieving peak male health, along with the most potent and effective practices for optimizing biological variables for men's fertility and longevity. I will also unveil a host of little-known biohacks proven to enhance or restore peak testosterone and drive, along with how to practically implement a blend of ancestral wisdom and modern science to amplify sexual performance.
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Sportsmen are permitted to use the boosters to trigger the mechanism of testosterone synthesis in the body. These products won a wide popularity among the sportsmen. The matter is that the supplements work by substantially enhancing sports performance, reviving strength, boosting endurance, coping with excessive stress levels, and decreasing time necessary for recovery after exhausting exercises.
Hello everyone. First off, thank you Dr. Abraham Morgentaler, for the excellent and refreshing article. I do not intend to spill my guts about symptoms or values on here as it has already been done so many times over. I will say that I am an RN BSN and have been on HRT for going on 6 yrs. I live in Oklahoma and when I first started noticing symptoms I knew something was wrong and began to do research myself. With an initial level of 241 no doctor here at that time, would even consider HRT as I was only 35ish at the time.

“Life for the winner is more glorious. It enters the next round of competition with already elevated testosterone levels, and this androgenic priming gives it an edge that increases its chances of winning yet again. Through this process an animal can be drawn into a positive-feedback loop, in which victory leads to raised testosterone levels which in turn leads to further victory.”

Male hypogonadism is a clinical syndrome caused by a lack of androgens or their action. Causes of hypogonadism may reflect abnormalities of the hypothalamus, pituitary, testes or target tissues. Increases in the amount of testosterone converted to estrogen under the action of the enzyme aromatase may also contribute to hypogonadism. Most aspects of the clinical syndrome are unrelated to the location of the cause. A greater factor in the production of a clinical syndrome is the age of onset. The development of hypogonadism with aging is known as late-onset hypogonadism and is characterised by loss of vitality, fatigue, loss of libido, erectile dysfunction, somnolence, depression and poor concentration. Hypogonadal ageing men also gain fat mass and lose bone mass, muscle mass and strength.


61y/o with 18month progressive lethargy, depressed mood, no sex drive, no erections. Doc put me on cymbalta (slept even more than 14hrs daily) then on Wellbutrin. All the time I was pushing for T testing. Came back low in March of this year and put on IM cypionate 100mg q3 weeks. Even I knew that was too low and infrequent. Nonetheless, that how it’s been since April. Finally got urology consult in Shreveport and got a level done at that time. Was 127 just two weeks after last injection. He is going to bump me up to 300mg q2 weeks and do a level 2 days after first injection and 1 day before next shot. Since I’m getting care thru VA, it’s a waiting game. Saw urologist last week. Prob won’t see testostosterone in mail for another week or two. I’m excited to feel like living again, not sleeping all the time, and perhaps some nooky now and then . Appreciated this article arm subsequent posts and personal trials. Would love to find a competent and assertive urologist in my area of Louisiana. I’m around Monroe….so if you know one, let me know!
Testosterone is a sex hormone that plays important roles in the body. In men, it’s thought to regulate sex drive (libido), bone mass, fat distribution, muscle mass and strength, and the production of red blood cells and sperm. A small amount of circulating testosterone is converted to estradiol, a form of estrogen. As men age, they often make less testosterone, and so they produce less estradiol as well. Thus, changes often attributed to testosterone deficiency might be partly or entirely due to the accompanying decline in estradiol.
Hi i was jus wondering what supplements should i take now im really impressed with testo fuel comments right now i m talking fish oil , whole food multi ,nutrafol for hair it is basically a dht blocker becoz i m having male pattern baldness which is in half way getting better now with prp and Nutrafol both natural after an intensive research. Is it ok to take testosterone booster when u are on dht blocker supplements anyways im 40yrs old male plz reply it will help me a lot i have bad energy levels,declining muscle mass joint pain weak bones plz help
Everytime you add Testosterone to your system, be it naturally through producing in the testis, injected, oral, or dermal you will receive a spike in your blood levels. Estrogen is mainly created in men by an action of an enzyme called Aromatase. Aromatase floats around and binds to Testosterone and converts it to Estrogen. When you spike your T your E will follow in this way. The obvious and detrimental effects to many of the already estrogen dominant hypogonadal men will be inappropriate over stimulation of the estrogen receptors in the body. Gynecomastia, fluid retention, weight gain, brain fog, erratic emotions, depression, ect. Higher levels of Estrogen cause SHBG to be created. SHBG binds to Testosterone and transports it to the liver for disposal. On top of this Estrogen can bind to your androgen receptors causing Testosterone to float around with no where to go. If you are taking shots or gel or cream and feel little to no effect even though it’s technically raised your T blood ranges, you now have an multiple answers for why you little to nothing or feel even worse. This has been known for years that you must be prepared to control Estrogen. An Aromatase Inhibitor (AI) or anti estrogen medication (Clomiphene, Tamoxifen) is needed to stop the estrogen from getting out of control. By taking an Aromatase inhibitor and monitoring your E2 levels you can easily control Estrogen, Aromatase, and SHBG from getting out of hand and free up those blocked androgen receptors so you can now reap the benefits of elevating T to a healthy level. If your Doctor is not testing your E2(aka Estrogen, Estradiol) levels before and during talks and administration of TRT or will never prescribe an AI then you shouldn’t be following his advice at all and will be harmed by Testosterone usage. This may sound complicated but in the end it’s simple. Elevate Testosterone. Control Estrogen. Only two medications needed. Don’t settle.
But if somebody fails testosterone therapy, meaning that their erections aren’t any better, I’ve said, “Well, let’s stop the testosterone and try one of the PDE5, or phosphodiesterase type 5, inhibitors — sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).” A lot of patients then say, “Well, actually, I’d like to stay on the testosterone. True, it’s not helping my erections, but I’m more turned on, and I’m getting these other benefits.” So we often continue the testosterone and add a PDE5 inhibitor.
Other side effects include increased risk of heart problems in older men with poor mobility, according to a 2009 study at Boston Medical Center. A 2017 study published in JAMA found that treatments increase coronary artery plaque volume. Additionally, the Food and Drug Administration (FDA) requires manufactures to include a notice on the labeling that states taking testosterone treatments can lead to possible increased risk of heart attacks and strokes. The FDA recommends that patients using testosterone should seek medical attention right away if they have these symptoms:
Get some sun – I know many people say you should avoid the sun like a vampire unless you want to get skin cancer but we actually do need some sunlight. This is because the sun is the best source of vitamin D which plays a huge role in testosterone production and other bodily functions. Keep your sun exposure in moderation but do not avoid it altogether.
“I'll be totally honest I tried a different product, and I wasn't happy with the different product and so I've been without any supplement for some time now, and I can really feel the difference. And I had fantastic results with the Andro400 Max. Probably lost 35 pounds. And more impressive than that was the inches I lost off of my belly and my waist. The increased energy is fantastic, and the mood enhancement is really good. I'm very impressed with it. You guys are considerably cheaper than the other brand. I get 2 bottles a month from you guys and that's even $15 less than the GNC product.”
In the hepatic 17-ketosteroid pathway of testosterone metabolism, testosterone is converted in the liver by 5α-reductase and 5β-reductase into 5α-DHT and the inactive 5β-DHT, respectively.[1][155] Then, 5α-DHT and 5β-DHT are converted by 3α-HSD into 3α-androstanediol and 3α-etiocholanediol, respectively.[1][155] Subsequently, 3α-androstanediol and 3α-etiocholanediol are converted by 17β-HSD into androsterone and etiocholanolone, which is followed by their conjugation and excretion.[1][155] 3β-Androstanediol and 3β-etiocholanediol can also be formed in this pathway when 5α-DHT and 5β-DHT are acted upon by 3β-HSD instead of 3α-HSD, respectively, and they can then be transformed into epiandrosterone and epietiocholanolone, respectively.[157][158] A small portion of approximately 3% of testosterone is reversibly converted in the liver into androstenedione by 17β-HSD.[156]
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.
In a placebo-controlled study, 27 Division II football players received either a placebo or a ZMA supplement for a total of seven weeks during their scheduled spring practice. At the end of the seven weeks, the players taking the ZMA supplement had a 30 percent increase in testosterone, while the placebo group had a 10 percent decrease. The ZMA group also saw an 11.6 percent increase in strength, compared to only 4.6 percent in the placebo group.[7]
I turned 50 and noticed I had low energy and no desire to workout. I decided to try a testosterone enhancer. I bought these and upon taking them I felt immediate results. I then ordered 3 more bottles on the spot. It is truly amazing how much of a difference it has made in my strength and endurance. Not to mention stamina. I never would've guessed that anything would have such a noticeable positive effect on strength and energy. I am so impressed.
Despite all the wonderful benefits of testosterone boosters, it will only work as well as you are able to make it work. This means that if you’re living a sloppy lifestyle, then your testosterone booster will produce poor results. Testosterone boosters work best when you make small, healthy changes to your lifestyle and diet that will allow your T-booster to give you its full benefits.
In this study, an ethical approval No. 20171008 was obtained from Ethical Committee of Qassim province, Ministry of Health, Saudi Arabia. At the beginning, a written informed consent was taken from a 30-year-old man for participation in this study. The patient came to the King Saud Hospital, Unaizah, Qassim, Saudi Arabia, with abdominal pain. He looked pale and hazy, hence, immediately admitted. A battery of lab tests was ordered by the attending physician. Moreover, abdominal ultrasound imaging was performed. The results of the tests showed high levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), indicating liver injury. Other serum parameters, such as total proteins, albumin, and iron, in addition to the levels of kidney and heart enzymes were all found to be in the normal range. A complete blood count showed normal levels of red blood cells, white blood cells, and platelets. The ultrasound images of the man’s abdomen were all found to be normal as well [Figure 2]. The patient, a sportsman, described that he was taking a testosterone commercial booster product called the Universal Nutrition Animal Stak for the purpose of enhancing his testosterone profile to achieve a better performance and body composition. The attending physician decided to admit the man for 1 week. Some medications were prescribed, and the patient was discharged later after having fully recovered.
Testosterone is included in the World Health Organization's list of essential medicines, which are the most important medications needed in a basic health system.[111] It is available as a generic medication.[10] The price depends on the form of testosterone used.[112] It can be administered as a cream or transdermal patch that is applied to the skin, by injection into a muscle, as a tablet that is placed in the cheek, or by ingestion.[10]
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!

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.

NHT works to reach a targeted level of hormones in your body, restoring your body’s natural ability to keep healthy and fit. Hormones are beneficial at any age, but most commonly we administer the therapy to people in their 40’s, when your body naturally begins to slow production of certain hormones. Supplementing these declining hormones can keep your body fit and active for much longer. Bio-identical hormones are made from plants and are identical to the hormones naturally produced by your own body. We never use synthetic hormones, which have been shown to increase your risk of heart disease and diabetes.


Low testosterone levels may contribute to decreased sex drive, erectile dysfunction, fragile bones, and other health issues. Having low testosterone levels may also indicate an underlying medical condition. See your doctor if you suspect you have low testosterone. A simple blood test is all it takes to check if your testosterone falls within the normal range.
Studies of the effects on cognition of testosterone treatment in non-cognitively impaired eugonadal and hypogonadal ageing males have shown varying results, with some showing beneficial effects on spatial cognition (Janowsky et al 1994; Cherrier et al 2001), verbal memory (Cherrier et al 2001) and working memory (Janowsky et al 2000), and others showing no effects (Sih et al 1997; Kenny et al 2002). Other trials have examined the effects of testosterone treatment in older men with Alzheimer’s disease or cognitive decline. Results have been promising, with two studies showing beneficial effects of testosterone treatment on spatial and verbal memory (Cherrier et al 2005b) and cognitive assessments including visual-spatial memory (Tan and Pu 2003), and a recent randomized controlled trial comparing placebo versus testosterone versus testosterone and an aromatase inhibitor suggesting that testosterone treatment improves spatial memory directly and verbal memory after conversion to estrogen (Cherrier et al 2005a). Not all studies have shown positive results (Kenny et al 2004; Lu et al 2005), and variations could be due to the different measures of cognitive abilities that were used and the cognitive state of men at baseline. The data from clinical trials offers evidence that testosterone may be beneficial for certain elements of cognitive function in the aging male with or without cognitive decline. Larger studies are needed to confirm and clarify these effects.

“I'll be totally honest I tried a different product, and I wasn't happy with the different product and so I've been without any supplement for some time now, and I can really feel the difference. And I had fantastic results with the Andro400 Max. Probably lost 35 pounds. And more impressive than that was the inches I lost off of my belly and my waist. The increased energy is fantastic, and the mood enhancement is really good. I'm very impressed with it. You guys are considerably cheaper than the other brand. I get 2 bottles a month from you guys and that's even $15 less than the GNC product.”

Japanese Knotweed (a.k.a Hu Zhang or Polygonum cuspidatum) is highlighted by WebMD as needing more evidence to rate its effectiveness in a number of different areas: like treating constipation and liver or heart disease. They also warn that it can interact poorly with medications that are changed and broken down by the liver, and those that slow blood clotting (anticoagulants and antiplatelets).


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
Benefits: Ashwagandha a wonderful herb originating from India is also called the Indian Ginseng because of it’s regard as a powerful aphrodisiac. Ashwagandha roots when consumed it increases sexual powers. These sexual powers include maintaining a stronger erection, longevity, enhanced sexual feeling. It also enhances fertility by increasing sperm count and quality. Ashwaganda works by reducing prolactin and neutralizing free radicals which both leads to increased testosterone levels.

Clinical trials of the effect of testosterone on glucose metabolism in men have occurred in diabetic and non-diabetic populations. Data specific to aging males is not available. A series of studies investigated the effects of testosterone or dihydrotestosterone given for 6 weeks or 3 months to middle aged, non-diabetic obese men (Marin, Holmang et al 1992; Marin, Krotkiewski et al 1992; Marin et al 1993). It was found that physiological treatment doses led to improved insulin resistance, as measured by the gold standard technique using a euglycemic clamp and/or serum glucose and insulin responses during glucose tolerance test. These improvements were associated with decreased central obesity, measured by computered tomography (CT) or waist-hip ratio, without reduced total fat mass. Insulin resistance improved more with testosterone than dihydrotestosterone treatment and beneficial effects were greater in men with lower baseline testosterone levels. Increasing testosterone levels into the supraphysiological range lead to decreased glucose tolerance.
Testosterone levels naturally rise in response to sexual arousal and activity. Men with higher levels of testosterone usually have greater sexual activity. Older men need more testosterone for libido and erectile function. But it’s important to note that erectile dysfunction is often due to other conditions or medications rather than low testosterone levels.
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
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.
Health information accessed through www.centracare.com is not intended to be a substitute for professional medical advice, diagnosis or treatment. We strive to present reliable, up-to-date health information on our web site and “For the Health of It” blog. However, this information is not intended for the purpose of diagnosing or prescribing. Please contact your health care provider if you have any concerns or questions about specific content that may affect your health. Log in to MyChart to send a secure message to your provider.
The diagnosis of late-onset hypogonadism requires the combination of low serum testosterone levels with symptoms of hypogonadism. Questionnaires are available which check for the symptoms of hypogonadism. These have been validated for the assessment of aging patients with hypogonadism (Morley et al 2000; Moore et al 2004) but have a low specificity. In view of the overlap in symptoms between hypogonadism, aging and other medical conditions it is wise to use a formal method of symptom assessment which can be used to monitor the effects of testosterone replacement.
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).
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 [1], and increase your sex drive [2], and its power doesn’t stop there. Keeping your testosterone levels in a normal range can make you happier, too [3], 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 [4].
Testosterone boosters are a class of herbal supplements aimed at naturally increasing your testosterone levels. Usually, they contain micronutrients that men are commonly deficient in, such as zinc, and which have been connected in research to healthy testosterone levels. They also may contain adaptogens, which are a class of supplement that are thought to help the body adapt to stress, or ingredients which have been connected to improved sleep. Sleep restriction has been shown to reduce testosterone in healthy young men, and as Chris Lockwood, Ph.D., notes, disturbed sleep is a common symptom of low T-levels.[1]

I have been on testosterone injections for about six months now. My urologist has me taking 50mg a week. I noticed that when I take the injection my normal resting heart rate is about 61 beats a minute, on the day of the injection it goes up to about 84 BPM. I also notice a tightness in my chest/esophagus area for about 24-48 hours and than it subsides. I have also noticed it appears to make my eyes water on the day of the injection. I have gotten off the injections because that is the obvious thing to do, but the dillema is than my personal life with the wife suffers. I am in great shape and work out all the time. Is there anything you can recommended I do to mitigate the increased blood pressure and increased heart beat? My last blood test showed normal except my estrogen was right at the recommended max but still with in limits. Any advice would be appreciated.

Type 2 diabetes is an important condition in terms of morbidity and mortality, and the prevalence is increasing in the developed and developing world. The prevalence also increases with age. Insulin resistance is a primary pathological feature of type 2 diabetes and predates the onset of diabetes by many years, during which time raised serum insulin levels compensate and maintain normoglycemia. Insulin resistance and/or impaired glucose tolerance are also part of the metabolic syndrome which also comprises an abnormal serum lipid profile, central obesity and hypertension. The metabolic syndrome can be considered to be a pre-diabetic condition and is itself linked to cardiovascular mortality. Table 1 shows the three commonly used definitions of the metabolic syndrome as per WHO, NCEPIII and IDF respectively (WHO 1999; NCEPIII 2001; Zimmet et al 2005).


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.

Professional-athlete-turned-biohacker Maximilian Gotzler gave a speech about boosting testosterone at the 2015 Bulletproof Conference. He started by leading the room through the Haka, a Maori war dance that New Zealand’s pro rugby team has made popular. The Pasadena Conference Center trembled as over 100 people shouted and stomped in unison. It was awesome.

Of course, testosterone’s primary function is to bring about secondary sexual characteristics in men. A healthy dose of testosterone is shown to treat conditions such as impotence. Men with fertility issues benefit from increased levels of testosterone in the body. The aging process slows down the rate of testosterone production by the adrenals and testes. It is irreversible and one of the only means to mediate the effects of low testosterone concentration is to include testosterone boosting agents in your regimen.

Hormonal Imbalance can affect your personal and work relationships. Some of the most noticeable symptoms prompting patient's to seek out medical care are a complete lack of energy and sheer fatigue, loss of sex drive, erectile dysfunction or soft erections, loss of lean muscle mass and bone strength, rapid weight gain, excessive adipose fatty tissue, disturbed sleep patterns, depression, moodiness, social withdrawal, reduced ability to recover from workouts, flabby muscles, lack of strength and endurance.


   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
These berries are known to improve your overall stamina and mood. But that’s not all, they also keep temperatures in the scrotum at the optimum level. The scrotum contains the testes which produce sperm. Higher temperatures tend to hamper the sperm production and decrease the volume that is released in a man’s ejaculate. They also promote sperm production by improving blood circulation and protecting against free radical damage.
Hacking your testosterone influences everything from body composition to energy levels to mood. It’s easy to eat more butter; it’s hard to visit a doctor and get tested, but that’s what I recommend: know your levels. If you’re 25, you’ll know what your target is when you’re 35. By the time you’ve noticed symptoms of low testosterone, it’s too late to get your “normal” measurements!
There are the testosterone deficiency signs, such as loss of sexual desire, erectile dysfunction, impaired fertility, chronic fatigue, etc. But it’s not always possible to understand which medical condition caused the decrease in testosterone levels. For example, if you always feel exhausted and have no sexual desire, it may provide evidence of depression.
We scoured the database of the National Center for Biotechnology Information (part of the U.S. National Library of Science) for articles. Of the many ingredients marketed as boosting testosterone levels, we only found four backed by multiple articles based on human testing. For the best chance of boosting testosterone levels, a supplement needs to contain magnesium, fenugreek, and longjack — and some zinc wouldn’t go astray, either.
A number of epidemiological studies have found that bone mineral density in the aging male population is positively associated with endogenous androgen levels (Murphy et al 1993; Ongphiphadhanakul et al 1995; Rucker et al 2004). Testosterone levels in young men have been shown to correlate with bone size, indicating a role in determination of peak bone mass and protection from future osteoporosis (Lorentzon et al 2005). Male hypogonadism has been shown to be a risk factor for hip fracture (Jackson et al 1992) and a recent study showed a high prevalence of hypogonadism in a group of male patients with average age 75 years presenting with minimal trauma fractures compared to stroke victims who acted as controls (Leifke et al 2005). Estrogen is a well known determinant of bone density in women and some investigators have found serum estrogen to be a strong determinant of male bone density (Khosla et al 1998; Khosla et al 2001). Serum estrogen was also found to correlate better than testosterone with peak bone mass (Khosla et al 2001) but this is in contradiction of a more recent study showing a negative correlation of estrogen with peak bone size (Lorentzon et al 2005). Men with aromatase deficiency (Carani et al 1997) or defunctioning estrogen receptor mutations (Smith et al 1994) have been found to have abnormally low bone density despite normal or high testosterone levels which further emphasizes the important influence of estrogen on male bone density.
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