This evidence, together with the beneficial effects of testosterone replacement on central obesity and diabetes, raises the question whether testosterone treatment could be beneficial in preventing or treating atherosclerosis. No trial of sufficient size or duration has investigated the effect of testosterone replacement in primary or secondary prevention cardiovascular disease. The absence of such data leads us to examine the relationship of testosterone to other cardiovascular risk factors, such as adverse lipid parameters, blood pressure, endothelial dysfunction, coagulation factors, inflammatory markers and cytokines. This analysis can supply evidence of the likely effects of testosterone on overall cardiovascular risk. This has limitations, however, including the potential for diverging effects of testosterone on the various factors involved and the resultant impossibility of accurately predicting the relative impact of such changes.
Thanks for reaching out, looks like you’re in a difficult situation here, but don’t worry, you can turn it around. For starters I would focus on getting your stress under control, this has a direct impact on your T-levels. Then look at your diet. Try to eat healthy fats, along with good carbs, and proteins. I’d recommend cutting down on anything containing sugar – again it’s testosterone worst nightmare. If you really want to kick it up a gear, and it sounds as if you do, we recommend using testofuel.com – its’ by far the best natural testosterone booster on the market – you won’t be disappointed! Good luck my friend.

So much to say, take a look at excelmale.com. it is a resource for men like us that give answers, science and dialogue which addresses our questions. It’s a great resource for men like us. Also, I would say to eliminate blue light before bed from tv and pc screens. Simply use blue light blocking glasses or F.lux from the play store. Also get outside in the sun in the AM. The goal is to restore the circadian rhythm which impacts hormone productiion.
There is a negative correlation of testosterone levels with plasminogen activator inhibitor-1 (PAI-1) (Glueck et al 1993; Phillips 1993), which is a major prothrombotic factor and known to be associated with progression of atherosclerosis, as well as other prothrombotic factors fibrinogen, α2-antiplasmin and factor VII (Bonithon-Kopp et al 1988; Glueck et al 1993; Phillips 1993; De Pergola et al 1997). There is a positive correlation with tissue plasminogen activator (tPA) which is one of the major fibrinolytic agents (Glueck et al 1993). Interventional trials have shown a neutral effect of physiological testosterone replacement on the major clotting factors (Smith et al 2005) but supraphysiological androgen administration can produce a temporary mild pro-coagulant effect (Anderson et al 1995).

A loophole in FDA regulations allows pharmaceutical marketers to urge men to talk to their doctors if they have certain "possible signs" of testosterone deficiency. "Virtually everybody asks about this now because the direct-to-consumer marketing is so aggressive," says Dr. Michael O'Leary, a urologist at Harvard-affiliated Brigham and Women's Hospital. "Tons of men who would never have asked me about it before started to do so when they saw ads that say 'Do you feel tired?'"
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.[66][71][72][73] Studies have also found that testosterone facilitates aggression by modulating vasopressin receptors in the hypothalamus.[74]
One more thing that I have experienced from getting injected T is that my testicles have shrunk and they have shrunk quite a good amount. I would say that my testicles are about half the size they were just 4 months ago. This is a result that many men get when they get T injections. I have a buddy who also gets injections and his testicles have shrunk a good amount as well. It’s not a bid deal overall as I am 51yrs old and things like that are not bother. However, I do miss feeling/having larger testicles when I catch a glimpse in the mirror or “adjust” my private parts and I can feel less there. 🙂
There are positive correlations between positive orgasm experience in women and testosterone levels where relaxation was a key perception of the experience. There is no correlation between testosterone and men's perceptions of their orgasm experience, and also no correlation between higher testosterone levels and greater sexual assertiveness in either sex.[34]
The biggest problem with supplementing your testosterone levels is it can shut off your own natural production and it can also permanently lower your sperm count. Taking testosterone boosters may also leave you open to some of the other unwanted side effects, like acne, male pattern baldness, mood swings and aggressive behaviour. To give yourself the best possible chance of avoiding these side effects, you need to see an expert before going for boosters.
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.
Overall, few patients have a compelling contraindication to testosterone treatment. The majority of men with late onset hypogonadism can be safely treated with testosterone but all will require monitoring of prostate parameters HDL cholesterol, hematocrit and psychological state. It is also wise to monitor symptoms of sleep apnea. Other specific concerns may be raised by the mode of delivery such as local side effects from transdermal testosterone.
I highly recommend using a great essential amino acid mix post-exercise in order to boost testosterone.  These essential amino acids and especially the concentrated branched chain amino acids leucine, isoleucine and valine stimulate muscle protein synthesis.  Getting these amino acids in the post-workout window dramatically boosts testosterone production (14).  I like using our Amino Strong and will often recommend a scoop pre-workout and post-workout for the best muscle building, testosterone boosting benefits.
A sedentary lifestyle is another scourge for modern civilization. And this is a serious danger for men. After all, if physical activity is minimal, the testosterone levels will decrease steadily. And in this situation, strength training exercises are a proven method for raising testosterone. Thus, sports exercises always helped raise the levels of male sex hormone. As a result, the testosterone levels elevate after every workout.
Our Testosterone Therapy Doctors, Urologists and Endocrine Physicians have successfully treated over 25,000 patients. Our Testosterone Therapy Centers utilize the most progressive hormone treatment protocols backed up with training from the Mayo Clinic®, Cenegenics® Clinic and Cleveland Clinic®. Fill out the Quick Info Request Form to speak to a Testosterone Specialist and to receive the best pricing for Testosterone Injections and other hormone replacement medications like HCG and HGH Human Growth Hormone.
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.
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.
Another benefit of the increased muscle mass was that I got stronger. My bench press, squat, and deadlift all enjoyed significant gains during my experiment. It’s great to be able to bench press 225 pounds again for 5 sets of 5 like I used to in high school, and I’m on track to beat my maxes on the bench and squat that my 18-year-old self set over 12 years ago.
The potential downside of this positive feedback loop, Coates argues, is that testosterone levels can eventually surge past optimal levels and have the opposite effect – leading to overconfidence and poor decision-making. When this happens to animals, Coates, observed, they “go out in the open, pick too many fights [and] patrol areas that are too large…Risk taking becomes risky behaviour.”
Let’s first start off by saying, there is no comparison of natural testosterone boosters to synthetic.  When referring to synthetic, we’re talking anabolic steroids.  At that point, you’re comparing apples and oranges.  Which is best—natural or synthetic?  Synthetic.  It is much easier to put on quality muscle mass while using anabolics than it is using a natural testosterone booster.  One is basically giving you synthetic testosterone while the other is giving you a minor boost in natural testosterone production.  However, not only are there side effects to the use of anabolics, but they are also illegal in the United States unless used under a doctor’s supervision with a prescription.
The results of these studies indicate that testosterone treatment in older men with low testosterone may proffer some benefits. However, testosterone treatments may also entail risks. The exact trade-off is unknown. Larger and longer studies need to be performed to clarify the effects of testosterone on heart health, bone health, disability, and more.
If your levels are indeed low, there are a number of synthetic and bioidentical testosterone products on the market, as well as DHEA, which is the most abundant androgen precursor prohormone in the human body, meaning that it is the largest raw material your body uses to produce other vital hormones, including testosterone in men and estrogen in women.

A large number of side-effects have been attributed to testosterone. In our clinical experience, the incidence of significant adverse effects with treatment producing physiological testosterone levels is low, and many side effects attributed to testosterone are mainly relevant to supraphysiological replacement. Some adverse effects are specific to a given mode of delivery and have already been described. Potential adverse effects concerning the prostate have also been discussed and require appropriate monitoring of symptoms, PSA and digital rectal examination. Other tumors which may be androgen responsive include cancer of the breast and primary liver tumors, and these are both contraindications to testosterone treatment
The mineral zinc is important for testosterone production, and supplementing your diet for as little as six weeks has been shown to cause a marked improvement in testosterone among men with low levels.1 Likewise, research has shown that restricting dietary sources of zinc leads to a significant decrease in testosterone, while zinc supplementation increases it2 -- and even protects men from exercised-induced reductions in testosterone levels.3

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My question is in two parts, I am looking for energy and some muscle build but only do push ups and sit ups so not looking for massive results. I am diabetic and I am wanting to get a testosterone booster to have more energy for daily use not so much for help in the bedroom but I would not mind if it helps out. Would I be able to take it not just for a certain product but any testosterone booster? The other question is does it help with any form of muscle growth, again not anything big but some? I would appreciate any advice or information you can give me.
TestoRush is a decent natural testosterone booster with decent ingredients. It’s not nearly as potent as some other higher ranked supplements on this site, and, in reading every review we could find from customers, it appears there’s some negativity towards the company. Read this full TestoRush review and find out how it measures up to other boosters we’ve reviewed. READ THE REVIEW
Why the difference? The discrepancy in findings between these studies is likely due to the initial training status and base testosterone levels of the subjects. While more research is warranted on this ingredient, D-AA is one of several ingredients suggested to be effective in boosting test levels, especially for older men whose natural testosterone levels have declined due to the natural course of aging.
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?
In males, testosterone is synthesized primarily in Leydig cells. The number of Leydig cells in turn is regulated by luteinizing hormone (LH) and follicle-stimulating hormone (FSH). In addition, the amount of testosterone produced by existing Leydig cells is under the control of LH, which regulates the expression of 17β-hydroxysteroid dehydrogenase.[132]

Testosterone is a key hormone as it relates to both sexual drive and muscle growth. Testosterone boosters are meant to increase testosterone levels in the blood. Now while most healthy men under the age of 65 may not need a testosterone boosting supplement, it is true that testosterone levels decrease as we get older. That could lead to a host of things from a loss in muscle mass to problems performing in the bedroom. There are natural testosterone booster, however, and you should consider those to minimize potential side effects.
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Changes in body composition are seen with aging. In general terms, aging males are prone to loss of muscle mass and a gain in fat mass, especially in the form of visceral or central fat. An epidemiological study of community dwelling men aged between 24 and 85 years has confirmed that total and free testosterone levels are inversely correlated with waist circumference and that testosterone levels are specifically related to this measure of central obesity rather than general obesity (Svartberg, von Muhlen, Sundsfjord et al 2004). Prospective studies show that testosterone levels predict future development of central obesity (Khaw and Barrett-Connor 1992; Tsai et al 2000). Reductions in free testosterone also correlate with age related declines in fat free mass (muscle mass) and muscle strength (Baumgartner et al 1999; Roy et al 2002). Studies in hypogonadal men confirm an increase in fat mass and decrease in fat free mass versus comparable eugonadal men (Katznelson et al 1998). Taken together, the epidemiological data suggest that a hypogonadal state promotes loss of muscle mass and a gain in fat mass, particularly visceral fat and therefore mimics the changes of ‘normal’ aging.
The biologically available part of total testosterone is called free testosterone, and it’s readily available to the cells. Almost every lab has a blood test to measure free testosterone. Even though it’s only a small fraction of the total, the free testosterone level is a pretty good indicator of low testosterone. It’s not perfect, but the correlation is greater than with total testosterone.

Unfortunately, in the modern world, stresses and emotional exhaustion lie in wait for men at every step. Nowadays, burnout is a constant state for many men. Of course, this causes great harm to the men’s health. Stresses drain of vitality and affect emotional state. Besides, they are also very dangerous for the nervous system. The nature is wise. And the body of a man who is not subject to stress can produce more testosterone.
In fact, high cortisol deals a crushing blow to testosterone in two ways. During, long-lasting stress, high amounts of cortisol release very often and have a direct negative influence on T levels. Thus, cortisol inhibits testosterone synthesis in the testes and hypothalamus. In addition, the production of cortisol is impossible without cholesterol. But testosterone synthesis also demands cholesterol. Since during stress cholesterol is first of all used for making cortisol, T levels simply plummet.
“She” being the key word. I had to quit a female doc because even though my level was down to 200, she thought I just needed more vitamin D! When I tried that and came back a few weeks later and told her there was no change in how I felt she refused to order another blood test, and after that wouldn’t even see me. I would never trust a female doctor with testosterone replacement therapy, as they all seem to have the same shit attitude from what my friends have told me, they treat it like it’s not a real thing even though you better bow down and kiss their asses when it comes to breast cancer and menopause.

From there, you’ll want to adjust how you train, since certain activities provide an especially powerful stimulus for testosterone. Research published in the journal Sports Medicine found that in order to experience a strong testosterone response from exercise, your workouts should be high in volume and produce a metabolic response. Churn through many exercises, sets, and reps, and focus on intense bursts of exercise with short rest periods.


The chemical synthesis of testosterone from cholesterol was achieved in August that year by Butenandt and Hanisch.[187] Only a week later, the Ciba group in Zurich, Leopold Ruzicka (1887–1976) and A. Wettstein, published their synthesis of testosterone.[188] These independent partial syntheses of testosterone from a cholesterol base earned both Butenandt and Ruzicka the joint 1939 Nobel Prize in Chemistry.[186][189] Testosterone was identified as 17β-hydroxyandrost-4-en-3-one (C19H28O2), a solid polycyclic alcohol with a hydroxyl group at the 17th carbon atom. This also made it obvious that additional modifications on the synthesized testosterone could be made, i.e., esterification and alkylation.
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. 
Tarig Elraiyah, Mohamad Bassam Sonbol, Zhen Wang, Tagwa Khairalseed, Noor Asi, Chaitanya Undavalli, Mohammad Nabhan, Osama Altayar, Larry Prokop, Victor M. Montori, Mohammad Hassan Murad; The Benefits and Harms of Systemic Dehydroepiandrosterone (DHEA) in Postmenopausal Women With Normal Adrenal Function: A Systematic Review and Meta-analysis, The Journal of Clinical Endocrinology & Metabolism, Volume 99, Issue 10, 1 October 2014, Pages 3536–3542, https://doi.org/10.1210/jc.2014-2261

The body’s endocrine system consists of glands that manufacture hormones. The hypothalamus, located in the brain, tells the pituitary gland how much testosterone the body needs. The pituitary gland then sends the message to the testicles. Most testosterone is produced in the testicles, but small amounts come from the adrenal glands, which are located just above the kidneys. In women, the adrenal glands and ovaries produce small amounts of testosterone.
It has also been found that college graduates with higher levels of T (men and women alike) are more likely to go into riskier careers. Another study discovered that among financial traders, a trader’s morning level of testosterone accurately predicted his day’s profitability – higher levels of T mean he’s more likely to take risks that day and score big.
Pine Pollen is an androgen, meaning in theory it can raise testosterone levels – effectively making it a naturally derived source of testosterone. Read more about this on the links below. But like I said I started taking it for a few weeks and did notice a bit more ‘up and go’ so to speak, but it did only last a few weeks. I have tried cycling it but haven’t noticed the same effects as I had when I initially started with it. I’m still experimenting and will keep this page updated. Therefore I recommend doing your own research.
Since then, multiple studies have found no link between high testosterone levels and increasing your chances of developing prostate cancer. However — and this is a BIG however — if you already have prostate cancer, increased levels of testosterone may exacerbate the problem. It’s best to wait until after you treat your prostate cancer before you begin any T-boosting regimens. Tread carefully and talk with your doctor.
Much like female hormone replacement, you should never, never ever use conjugated equine estrogen and synthetic progestins. Those two coupled together are evil twins. It is not hormone replacement that is the issue in men or women. The issue is the type of hormone used and doctors not knowing what they are doing. I always use bio-identical hormones. Synthetics are not the proper administration of any hormone program.
Leafy green vegetables such as spinach are rich sources of folic acid. Low levels of folate can give rise to distorted sperm shapes such as ones with two heads or two tails. The sperm are also at an increased risk of chromosomal abnormalities. This means that firstly your sperm will find it difficult to reach an egg and even if it does reach an egg, it will not be able to fertilize it. Furthermore, even if these sperms are able to fertilize an egg, the chances of birth defects are quite high in such cases.

Testosterone is observed in most vertebrates. Testosterone and the classical nuclear androgen receptor first appeared in gnathostomes (jawed vertebrates).[193] Agnathans (jawless vertebrates) such as lampreys do not produce testosterone but instead use androstenedione as a male sex hormone.[194] Fish make a slightly different form called 11-ketotestosterone.[195] Its counterpart in insects is ecdysone.[196] The presence of these ubiquitous steroids in a wide range of animals suggest that sex hormones have an ancient evolutionary history.[197]

When females have a higher baseline level of testosterone, they have higher increases in sexual arousal levels but smaller increases in testosterone, indicating a ceiling effect on testosterone levels in females. Sexual thoughts also change the level of testosterone but not level of cortisol in the female body, and hormonal contraceptives may affect the variation in testosterone response to sexual thoughts.[51]
There are a lot of test booster blends out there. A lot of them are junk. I have tried to cover the most effective herbs above. As always, I recommend doing your own research and experiment to see if you notice an effect. If you would like one easy herbal solution I recommend starting with Mike Mahlers Aggressive Strength product purely because I have solid anecdotal evidence of its effectiveness. But again, supplements should be seen purely as that - a supplement to a healthy diet, plenty of sleep, hard training with adequate rest.
There are several supplements on the market claiming to be natural testosterone boosters. I get these sorts of things in the mail all time. The companies that produce these products claim that the herbs (typically stinging nettle and tribulus) in their pills increase free testosterone by reducing SHBG. They also throw in some B vitamins for “increased energy and vitality.”
Another effect that can limit treatment is polycythemia, which occurs due to various stimulatory effects of testosterone on erythropoiesis (Zitzmann and Nieschlag 2004). Polycythemia is known to produce increased rates of cerebral ischemia and there have been reports of stroke during testosterone induced polycythaemia (Krauss et al 1991). It is necessary to monitor hematocrit during testosterone treatment, and hematocrit greater than 50% should prompt either a reduction of dose if testosterone levels are high or high-normal, or cessation of treatment if levels are low-normal. On the other hand, late onset hypogonadism frequently results in anemia which will then normalize during physiological testosterone replacement.
during therapy. It is very hard to find a local endo who is thinking with his head vs complying with old trt programs. I tool clomid in the past to see what it would do and it elevated my t level to 520 in 2 weeks from low 220. Aromason will do same but clomid is more potent. Not sure what the long effect would be since you tend to get bit moody on clomid after 2 months. LH is also being affected in negative way since the lh receptors can burn out to a degree. I will contact the trt clinic in order to start my trt as they have much more experience with these things.
The hormone testosterone plays a major role in a man’s life. “We’re literally better at who we are if our T levels are thriving,” says Chad Howse, co-author of The Man Diet: A Proven Guide to More Energy, Increased Virility, and Higher Testosterone Levels. T affects just about everything, from a man’s appearance to his physical and emotional health.
There is increasing interest in the group of patients who fail to respond to treatment with PDE-5 inhibitors and have low serum testosterone levels. Evidence from placebo-controlled trials in this group of men shows that testosterone treatment added to PDE-5 inhibitors improves erectile function compared to PDE-5 inhibitors alone (Aversa et al 2003; Shabsigh et al 2004).
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.

Sergeant Steel is arguably the strongest testosterone booster on the market as it combines 16 effectively dosed ingredients that support testosterone increases and estrogen reduction. It’s not often that you come across a product that combines all of the top ingredients and provides you with their proper dosages. Users have been reporting strong increases in libido, strength, sense of well being, muscle hardness, and improved recovery. If you are looking for a no-holds barred test booster, look no further than Sergeant Steel.
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.[66][71][72][73] Studies have also found that testosterone facilitates aggression by modulating vasopressin receptors in the hypothalamus.[74]
“I'm 55 years old and hitting the ball further than I've ever hit, and I'm not getting tired going 18 holes! And when I play softball I'm hitting the ball further. I work for the DWP in LA and it's a very physically demanding job. Andro400 really helps because we work 16 hour days a lot. I was turning down a lot of overtime, but when I started taking Andro400, it got me through the day. I really notice a difference – even my wife did. It really works!”
"I am only 10 weeks into taking your product and I have lost 12 pounds and three inches from my waist. Normally I scoff at radio or TV ads promising results like this. But in this case, my results have far exceeded my expectations. My energy level has increased and my appetite has decreased! All this without any extra exercise program. Thanks from a very satisfied customer!"
I noticed that you say that those that have prostate cancer should not have testosterone replacement therapy, Why-in light of the studies that say that there is no danger from testosterone therapy to one that had/has prostate cancer? If this is your opinion do you have any suggestions as to what I should do about my symptoms? Does testosterone replacement therapy actually do anything?

Have you ever wondered why? When we are under stress, our body produces cortisol that is bad for our testosterone levels. This particular component blocks the production of testosterone. In addition, if there is a lack of Z’s then this is the bad news for your testosterone. You should know that the huge amounts of testosterone are produced during our sleep. Every guy knows that the “morning wood” comes only after a good night sleep.
Benefits: Maca roots originates from the mountains of Peru. For a long time, natives have been using Maca roots as not only a food supply but for it’s properties for increasing sexual potency. It has been prove to improve erectile dysfunctions, libido and sperm production. Maca roots stimulate semen volume, sperm count and sperm motility, which makes Maca a powerful Aphrodisiac.

I have been on Testosterone and semorilin for 3 years now and just wanted to talk on what for me is the BIGGEST side effect NO ONE talks about. In those 3 years I have seen my body transformed in every way. I have such DRIVE and AMBITION I can’t believe it I look and act 30 years younger. I have a GF 25 years younger than me and she can’t keep up! I am very sexually active especially for my age.
Stress less – I know this is easier said than done but if you can reduce your stress levels it will help your testosterone production. This is because stress makes your body produce cortisol which has many negative effects on the body including being a testosterone killer. Try meditating, exercising, deep breathing and other lifestyle changes to keep stress down and cortisol in check.
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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).
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