A4M, which stands for “The American Academy of Anti-Aging Medicine” is dedicated to the advancement of tools, technology, and transformations in healthcare that can detect, treat, and prevent diseases associated with aging. They promote the research of practices and protocols that have the potential to optimize the human aging process. The organization is also dedicated to educating healthcare professionals and practitioners, scientists, and members of the public on biomedical sciences, breakthrough technologies, and medical protocols through our advanced education entity: Metabolic Medical Institute (MMI). Their event in Vegas each year is, in my opinion, well worth checking out.
Our bodies make testosterone while we sleep. In one study, men who got five hours of sleep a night had testosterone levels 10 to 15 percent lower than when they got a solid eight hours. The study, conducted by the University of Chicago, found that skimping on sleep reduced the men’s T levels by an amount equivalent to aging 10 or more years. While it can be challenging to change your sleep habits, says Natasha Turner, ND, you can “start going to bed 15 minutes earlier each week until you reach your target time.”
Overall, it seems that both estrogen and testosterone are important for normal bone growth and maintenance. Deficiency or failure of action of the sex hormones is associated with osteoporosis and minimal trauma fractures. Estrogen in males is produced via metabolism of testosterone by aromatase and it is therefore important that androgens used for the treatment of hypogonadism be amenable to the action of aromatase to yield maximal positive effects on bone. There is data showing that testosterone treatment increases bone mineral density in aging males but that these benefits are confined to hypogonadal men. The magnitude of this improvement is greater in the spine than in the hip and further studies are warranted to confirm or refute any differential effects of testosterone at these important sites. Improvements seen in randomized controlled trials to date may underestimate true positive effects due to relatively short duration and/or baseline characteristics of the patients involved. There is no data as yet to confirm that the improvement in bone density with testosterone treatment reduces fractures in men and this is an important area for future study.
Andy – If you take testosterone, your hypothalamus will notice an abundance of testosterone in your system and will instruct your pituitary gland not to send LH and FSH to your testicles. If you’re testicles are not receiving these two hormones, they will stop making testosterone. If you quit testosterone call turkey, you will likely fall back to your baseline level fairly quickly. There is a protocol however to get back to your normal production much quicker should you choose to quit therapy.
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.
If you’re an older man with low testosterone and interested in taking testosterone, this decision should be carefully considered with your physician. Your physician will be able to better assess the balance of your conditions and whether hormone replacement could put you at potential risk. It's a bad idea for anybody to engage in hormone supplementation without the supervision of a physician. Just because hormones occur naturally in the body does not mean that they can be taken without negative effects.
The sexual hormone can encourage fair behavior. For the study, subjects took part in a behavioral experiment where the distribution of a real amount of money was decided. The rules allowed both fair and unfair offers. The negotiating partner could subsequently accept or decline the offer. The fairer the offer, the less probable a refusal by the negotiating partner. If no agreement was reached, neither party earned anything. Test subjects with an artificially enhanced testosterone level generally made better, fairer offers than those who received placebos, thus reducing the risk of a rejection of their offer to a minimum. Two later studies have empirically confirmed these results.[75][76][77] However men with high testosterone were significantly 27% less generous in an ultimatum game.[78] The Annual NY Academy of Sciences has also found anabolic steroid use which increase testosterone to be higher in teenagers, and this was associated with increased violence.[79] Studies have also found administered testosterone to increase verbal aggression and anger in some participants.[80]
Both testosterone and 5α-DHT are metabolized mainly in the liver.[1][155] Approximately 50% of testosterone is metabolized via conjugation into testosterone glucuronide and to a lesser extent testosterone sulfate by glucuronosyltransferases and sulfotransferases, respectively.[1] An additional 40% of testosterone is metabolized in equal proportions into the 17-ketosteroids androsterone and etiocholanolone via the combined actions of 5α- and 5β-reductases, 3α-hydroxysteroid dehydrogenase, and 17β-HSD, in that order.[1][155][156] Androsterone and etiocholanolone are then glucuronidated and to a lesser extent sulfated similarly to testosterone.[1][155] The conjugates of testosterone and its hepatic metabolites are released from the liver into circulation and excreted in the urine and bile.[1][155][156] Only a small fraction (2%) of testosterone is excreted unchanged in the urine.[155]

I’m 56 and 5 years ago dropped to 270 with all the side effects listed for low test. After trying shots and not liking the roller coaster effect, I switched to gels. Androgel and Axiron had too low a dosage and far too messy. They need to not call them gels but liquids. If it pours like water it’s a liquid. My doctor recommended a compounding Pharmacy that made a cream and it was perfect. It had a click dispenser that looked like a deoderant that would pre-measure the dosage and I could rub it on my arms and shoulders or on my neck, really anywhere not covered in hair but the thinner the skin the better. It dried instantly so I could get dressed in a couple minutes. My totals never got out of the 400’s until I started the 150mg daily cream dosage, then they hovered around 700. The down side was Insurance didn’t cover it and I had to pay $50 a month vs free shots from the doctors office or $10 for the so-called gels. Bad news is it has now doubled in price due to new Federal production regs on compounding Pharms. Now, I am going back on the shots which I now have to buy the vile for $125 for 10 doses and have to take it to my doctor to administer it every 2wks while I am looking into bioidentical pellet implants.

For facts sake I am 51yr old male and I am fat. I do have a large and muscular fat, but I also have a good amount of at on top of that. My body shape is not the typical huge “beer belly” gut that is hard and dangerous, rather, I am fat all over proportionally, but still considered obese. The fat on my body and around my middle is quite soft compared to male friends who have those large and hard bellies. Still, my doctor and reading indicate that fat has an effect on T potentially lowering the overall level that my T would be if I lost a good amount of that fat.

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.


Two of the immediate metabolites of testosterone, 5α-DHT and estradiol, are biologically important and can be formed both in the liver and in extrahepatic tissues.[155] Approximately 5 to 7% of testosterone is converted by 5α-reductase into 5α-DHT, with circulating levels of 5α-DHT about 10% of those of testosterone, and approximately 0.3% of testosterone is converted into estradiol by aromatase.[2][155][161][162] 5α-Reductase is highly expressed in the male reproductive organs (including the prostate gland, seminal vesicles, and epididymides),[163] skin, hair follicles, and brain[164] and aromatase is highly expressed in adipose tissue, bone, and the brain.[165][166] As much as 90% of testosterone is converted into 5α-DHT in so-called androgenic tissues with high 5α-reductase expression,[156] and due to the several-fold greater potency of 5α-DHT as an AR agonist relative to testosterone,[167] it has been estimated that the effects of testosterone are potentiated 2- to 3-fold in such tissues.[168]
The effect excess testosterone has on the body depends on both age and sex. It is unlikely that adult men will develop a disorder in which they produce too much testosterone and it is often difficult to spot that an adult male has too much testosterone. More obviously, young children with too much testosterone may enter a false growth spurt and show signs of early puberty and young girls may experience abnormal changes to their genitalia. In both males and females, too much testosterone can lead to precocious puberty and result in infertility. 

Testosterone plays a role in certain behaviors, including aggression and dominance. It also helps to spark competitiveness and boost self-esteem. Just as sexual activity can affect testosterone levels, taking part in competitive activities can cause a man’s testosterone levels to rise or fall. Low testosterone may result in a loss of confidence and lack of motivation. It can also lower a man’s ability to concentrate or cause feelings of sadness. Low testosterone can cause sleep disturbances and lack of energy.
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.
AC, I just ran across the thread… definitely start the injections. Should help with levels that low. I’m 36 and have battled low T for 6-7 years. My labs came back to show 90ng/dl when I just turned 30, and I’ve done Testosterone cypionate injections @ 100mg/mL weekly, Testim, Androgel, and Fortesta over the years. I’m actually going to my endocrinologist tomorrow to have new blood work done.

Bikinis, models, nuts … Is there anything Brazilian that’s not sexy? Selenium is a trace mineral found in Brazil nuts that plays an important role in hormone health. You only need a tiny bit for healthy sperm, but a tiny deficiency can be catastrophic for reproductive health. In one study, men who had lower testosterone and were infertile also had significantly lower selenium levels than the fertile group. Supplementing with the mineral improved chances of successful conception by 56 percent. And a second study that included 69 infertile men with low levels of the mineral, found selenium supplementation could significantly improve sub-par sperm motility associated with testosterone deficiency. Moreover, 11 percent of the men successfully impregnated their partners during the trial!
Then in 2017, Melville carried out another study on DAA.[4] This time he recruited 22 men in a randomized, double-blind fashion and had them consume either a placebo or 6g of DAA. After 12 weeks of supplementation, researchers observed that DAA had no significant impact on resting levels of either free or total testosterone. Any improvements in strength or hypertrophy were similar to those in the placebo group.
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By passing this bill, the Congress has amended the Controlled Substances Act to include Androstenedione supplements such as 4 Androstenediol, 5 Androstenediol, etc. The original Anabolic Steroid Control Act was passed in 1990 creating a list of anabolic steroids that would be classified as "Schedule III" substances and put in the same category as drugs such as heroin and cocaine. Now, with the passage of Senate Bill 2195 (the Anabolic Steroid Control Act of 2004), they have added Androstenedione supplements to the Controlled Substances Act.
Discussing the clinical utility of these findings, Dr. Budoff told EndocrineWeb, “in the short-term, I am going to check my patients for atherosclerosis before instituting testosterone therapy. We still need a definitive study to show whether or not heart attacks are increased by supplemental testosterone, but advancing atherosclerosis is not a good thing. These results should make us more cautious about whom we treat and what doses we use.”
The T Trials will serve as a prelude to lengthier and more robust trials in the future. More results from the T Trials are now coming in and overall results were mixed, with testosterone replacement associated with some benefits and some risks. More research needs to be done to figure out the balance of these potential benefits and risks as well as the precise clinical utility of testosterone treatment.
As a nurse I am very concerned with following my labs as most of these places don’t actually follow my labs. I also happen to have the side effect of polycythemia and donate 2-3 times a year for this reason. At one point I asked my doctor who referred me to a urologist. At the time I was on 150mg IM with half a dose or 0.5mL twice weekly to avoid the “roller coaster”. Anyways, I went there so I could get some concrete answers as to why I was having low T, this doctor all but threw me out of his office stating that “they” are making me dependent on T. As a professional in the medical field I was highly offended, he didn’t even speak with me about anything at all, I had no chance to ask what was going on, if my dosing was correct or if there was anything else I needed to do. He kicked me out and said he wasn’t even charging for the visit. Absolutely applaud. So to those who have found a Dr. that actually listens and works with your individual issues, kuddos. To the rest of us I highly recommend that you research as much as possible before using out of state clinics.

Estrogen is important in men, but too high of a level has all sorts of negative consequences – ranging from heart attacks to prostate cancer (32 & 33). The balance between testosterone and estrogen (or estradiol) is critical for a man. If the ratio is out and estrogen starts to dominate you run into all sorts of issues – such as breast cell growth, prostate enlargement and of course lower testosterone.
Men who have prostate cancer or breast cancer should not take testosterone replacement therapy. Nor should men who have severe urinary tract problems, untreated severe sleep apnea or uncontrolled heart failure. All men considering testosterone replacement therapy should undergo a thorough prostate cancer screening -- a rectal exam and PSA test -- prior to starting this therapy.
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