I just started TRT gel. On the first day I noticed an improvement in my awareness/energy level. This is now day three and I feel much better. Before I was tired and lacked the mental clarity I now feel. I have not yet noticed and increase in my libido but I think it is improving. Probably need the stimulation from my fiancé and more time to get my T levels up. Before I started the gel, total T levels were 450, and then 500+. I went to an Integrative MD who suggested Free T. That level was low and my SBGH was 100 (high). I then went to an NP who ordered the Free T. She referred me to an Endocrinologist. She along with her Attending interviewed me and decided to prescribe. They asked if I wanted the gel or the injections. I opted for the gel. I will wait and see how the gel works. So far so good.

There are three ways to increase testosterone activity naturally with simple lifestyle choices. The first is to increase total testosterone production. Second is to increase the amount of free and active testosterone that can stimulate testosterone receptors. The third is to unblock testosterone receptors, opening them up for testosterone stimulation.
Ten healthy men aged around 24 years old spent 1 week sleeping for 8 hours per night at home, they then spent the next 11 nights in a lab. They slept for 10 hours per night for 3 nights, followed by 8 nights of restricted sleep, when they slept for only 5 hours. Doctors checked their blood every 15 to 30 minutes during the last night that they slept 10 hours, as well as on the sleep-restricted session.
Both Beast Sports’ Super Test and iSatori’s ISA-Test contain a proprietary blend, which means they don’t disclose the amount of each and every ingredient in the mix. This is only a problem if there is an ingredient tucked into a proprietary blend for which we need to know an amount, like magnesium and zinc. While none of the ingredients in Beast Sports’s proprietary blend raised any red flags, iSatori’s blend contains melatonin, a hormone that helps regulate sleep. Melatonin is an ingredient that has a hard upper limit — Healthline suggests at most 10mg for an adult — and even lower doses can interact poorly with many medications. Since we can’t confirm whether the amount of melatonin in iSatori’s proprietary blend is under 10mg, we cut iSatori.

Finally, we looked at the proprietary blends of our remaining boosters, and dug into their ingredient lists. Supplements frequently include ingredients known for their “folk-lore” value; they’re believed to work, even when there isn’t any scientific background to prove it. Though we didn’t ding points if an ingredient wasn’t proven to be good (just so long as it wasn’t proven to be bad), we didn’t want to include any ingredient with evidence of causing harm.
This has become a common practice despite an Institute of Medicine (IOM) report issued in 2003, indicating insufficient evidence of any benefit derived from testosterone hormone therapy to address expected symptoms of male aging.4  These studies, and 2 others (to be presented in a separate EW research brief) come on the heels of research on the efficacy of prescribing testosterone5 that appeared in the NEJM last year.
My energy level have increased and my muscle mass has also increased, so I have positive results. As I said before I didn’t have a problem with achieving erections or maintaining, but with these injections I am now getting quite a good deal more spontaneous erections, and then when I do get one it does feels harder and stronger. The stronger and harder aspect is great, but the more often spontaneous is a bit annoying. 🙂
My energy level have increased and my muscle mass has also increased, so I have positive results. As I said before I didn’t have a problem with achieving erections or maintaining, but with these injections I am now getting quite a good deal more spontaneous erections, and then when I do get one it does feels harder and stronger. The stronger and harder aspect is great, but the more often spontaneous is a bit annoying. 🙂
Conflicting results have been obtained concerning the importance of testosterone in maintaining cardiovascular health.[29][30] Nevertheless, maintaining normal testosterone levels in elderly men has been shown to improve many parameters that are thought to reduce cardiovascular disease risk, such as increased lean body mass, decreased visceral fat mass, decreased total cholesterol, and glycemic control.[31]
Another point I’d like to make for people worried about a link between high testosterone and prostate cancer is that it just doesn’t make sense. Prostate cancer becomes more prevalent in men as they age, and that’s also when their testosterone levels decline. We almost never see it in men in their peak testosterone years, in their 20s for instance. We know from autopsy studies that 8% of men in their 20s already have tiny prostate cancers, so if testosterone really made prostate cancer grow so rapidly — we used to talk about it like it was pouring gasoline on a fire — we should see some appreciable rate of prostate cancer in men in their 20s. We don’t. So, I’m no longer worried that giving testosterone to men will make their hidden cancer grow, because I’m convinced that it doesn’t happen.
This is one of the most controversial recommendations I make, but it shouldn’t be. It’s no different than using thyroid medication. If your levels are low, and the other techniques here don’t work, use TRT. You will like your life again. If your levels are low, bioidentical testosterone will make you live longer and better, provided you use it right.
^ Jump up to: a b Sapienza P, Zingales L, Maestripieri D (September 2009). "Gender differences in financial risk aversion and career choices are affected by testosterone". Proceedings of the National Academy of Sciences of the United States of America. 106 (36): 15268–73. Bibcode:2009PNAS..10615268S. doi:10.1073/pnas.0907352106. PMC 2741240. PMID 19706398.
Exercise boosts testosterone in two important ways. First, specific types of exercise actually cause our body to produce more testosterone. We’ll talk more about those in a bit. Second, exercise helps to increase muscle mass and decrease body fat. As we’ve discussed previously, adipose tissue converts testosterone into estrogen. The less fat we get, the more T we have.
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]
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).
6., 7. JK, Udani, George AA, Musthapa M, Pakdaman MN, and Abas A. "Effects of a Proprietary Freeze-Dried Water Extract of Eurycoma Longifolia (Physta) and Polygonum minus on Sexual Performance and Well-Being in Men: A Randomized, Double-Blind, Placebo-Controlled Study." National Center for Biotechnology Information. U.S. National Library of Medicine, 12 Jan. 2014.

Testosterone may fight depression. If you’ve been battling the black dog of depression, it may be because of low testosterone levels. Researchers have found that men suffering from depression typically have deficient testosterone levels. While scientists haven’t been able to figure out whether it’s low testosterone that causes depression or if depression causes low T levels, preliminary research has shown that some men suffering depression report improvement in mood and other factors of depression after undergoing doctor-directed testosterone treatments.
It goes without saying that what you eat significantly influences your hormone balance and body composition. This is nothing new. There are countless athletes and bodybuilders who are paying a close attention to what they eat for a reason. For example, if you consume a lot of so-called junk food, then you inevitably end up with a poor nutritional profile. In plain English, you can forget about a six-pack and the high testosterone.
Dr. Resnick and colleagues assessed 788 participants in the cognitive function arm of the TTrials but focused on the 493 participants who were classified as having age-associated memory impairment with a confirmation of both subjective and objective indicators of cognitive decline. The authors detected no significant effect after 1 year of testosterone treatment on either the primary outcome of verbal memory, as measured by delayed paragraph recall or on any of the secondary outcomes of visual memory, executive function, and spatial ability.1

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]
Jeff- I read your post and I can relate to your problem. Perhaps you’ve already received some help but I can tell you this much. I recovered from prostate cancer about 2 yrs ago. My oncologist is also a graduate of Harvard like the doc that wrote this article. He put me on Axiron about 8 months ago after I complained to him of symptoms similar to you. He has no concerns that the T will cause me to get prostate cancer again. I do my 4 month check ups and have my T tested at that time along with my PSA. Everything is normal so far. My T count was initially 50 and now I am in the low 300 range. The Axiron has gotten me back to normal and then some!! I’m 58 and I told him at my last appt that I feel like I’m 40.
A: According to the NIH, normal values for testosterone levels in men can range from 300 to 1,200ng/dL. There can be many different causes of low testosterone including age, diseases, accidents, and medications. Symptoms of low testosterone may include: loss of sex drive, erectile dysfunction, depressed mood, and difficulty concentrating. Low testosterone levels may also bring around body changes including: hair loss, decrease in blood cells possibly leading to anemia, fragile bones, and a decrease in muscle mass. There are different testosterone replacement therapies including patches, such as Androderm; gels, such as Androgel and Testim; and injections, such as testosterone cypionate. Only your health care provider can decide if and what kind of testosterone replacement therapy is appropriate for you. Testosterone replacement therapy is not right for everyone. Patient with certain prostate issues or breast cancer should not take testosterone. For more specific information, consult with your doctor for guidance based on your health status and current medications, particularly before taking any action. Kristen Dore, PharmD
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.”
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.[53] 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.[53] Men who produce less testosterone are more likely to be in a relationship[54] or married,[55] and men who produce more testosterone are more likely to divorce;[55] however, causality cannot be determined in this correlation. Marriage or commitment could cause a decrease in testosterone levels.[56] 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.[57] 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.[58]

Hello – Has anybody here had their hair fall out after significantly increasing their T level? In 90 days of Clomiphene Citrate use my Total Testosterone went from 290 to 1100. and my Free T went from 50 to 202. Yes, it went way up! CC works. I have no idea why anybody would bother with gels and shots without giving this a chance. It costs almost nothing. so cheap.
I’m a 70 year old male. Here’s my brief story, I was exhausted all the time after an encounter with H-Py-Lori. After may tests it was found out that my T-count was at about 250. I was put on a testosterone cream replacement therapy. Before I knew it, at about month I was at 1500 count. This was at 4 cream applications a day. The doctor took me down to twice/two applications a day, now I was at 600. I felt great at both levels.
When I was using the gel my testicles also shrank a bit, but not anywhere near this amount. And when I stopped using the gel they plumbed back up again to their former size. It took some time but their size came back. This may be an issue for the younger guys, but I think most older guys can easily handle this as no big deal, because overall it’s not.
The general recommendation is that men 50 and older who are candidates for testosterone therapy should have a DRE and a PSA test. If either is abnormal, the man should be evaluated further for prostate cancer, which is what we do with everybody whether they have low testosterone or not. That means a biopsy. But if all of those results are normal, then we can initiate testosterone therapy. The monitoring that needs to happen for men who begin testosterone therapy is really very simple: DRE, PSA, and a blood test for hematocrit or hemoglobin, once or twice in the first year and then yearly after that, which is pretty much what we recommend for most men over age 50 anyway.
Since 2004, Andro400 has been the leader among natural testosterone boosters with a proven track record of successfully helping tens of thousands of customers increase their testosterone safely without side effects. Andro400 contains only the most highly researched and time-tested ingredients proven to naturally increase T levels. Enjoyed by men (and women) of all ages and results are backed by the industry's leading Satisfaction Guarantee.
In essence, there are two types of testosterone boosters, namely natural and synthetic supplements. Anabolic steroids which are under the synthetic category are known to deliver positive results as well as nasty side effects. It is due to this reason that an increasing number of bodybuilders and athletes are now utilizing safer testosterone boosters.

Before assessing the evidence of testosterone’s action in the aging male it is important to note certain methodological considerations which are common to the interpretation of any clinical trial of testosterone replacement. Many interventional trials of the effects of testosterone on human health and disease have been conducted. There is considerable heterogenicity in terms of study design and these differences have a potential to significantly affect the results seen in various studies. Gonadal status at baseline and the testosterone level produced by testosterone treatment in the study are of particular importance because the effects of altering testosterone from subphysiological to physiological levels may be different from those of altering physiological levels to supraphysiological. Another important factor is the length of treatment. Randomised controlled trials of testosterone have ranged from one to thirty-six months in duration (Isidori et al 2005) although some uncontrolled studies have lasted up to 42 months. Many effects of testosterone are thought to fully develop in the first few months of treatment but effects on bone, for example, have been shown to continue over two years or more (Snyder et al 2000; Wang, Cunningham et al 2004).
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.
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).[3] 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.[3]
Treatment is not necessary if your levels fall within the normal range. Testosterone replacement therapy is primarily beneficial for men with low testosterone levels. Don’t purchase testosterone without a prescription. See your doctor if you think you might have low levels of testosterone. A blood test can determine your testosterone levels and help diagnose underlying conditions.
Exercise is the original testosterone booster, and it’s one of the most powerful full-body hacks around. Men see a sharp increase in both testosterone and human growth hormone (HGH) after lifting weights, and the boost is greater with shorter rest time between sets (1 minute rest outperforms 3 minutes rest) [9]. With the shorter rest time, women also get a large boost in HGH.
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.
The one side effect that no one talks about is psychological for me. Because I am 67 years old and suddenly look, feel and act 37 I only want to be around younger people. I have no use associating with people my own age. I have nothing in common and even look different. This year at my class reunion was a glaring example…..no doubt I looked younger than anyone, but it is sooo much more than just very that. My customers are young, all my girlfriends and associates. This all has a large effect on my mind. It’s hard to grasp suddenly looking and acting 30 years younger than your friends. My mind is so confused about how old I really am. I do a lot of adrenalin sports for my age snow ski, wake-surf, wake-board, scuba dive and it is no doubt just a matter of time till I get hurt doing these wild sports. In my mind I’m 37 so I think it’s all normal. This whole experience has been incredible and very positive with the only one psychological effect and no other physical side effect.
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.

In a recent study of male workers, men with low testosterone levels had an increased chance of severe erectile dysfunction (Kratzik et al 2005), although such a link had not been found previously (Rhoden et al 2002). Certainly erectile dysfunction is considered part of the clinical syndrome of hypogonadism, and questions regarding erectile dysfunction form part of the clinical assessment of patients with hypogonadism (Morley et al 2000; Moore et al 2004).
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.
Recently, a panel with cooperation from international andrology and urology societies, published specific recommendations with regard to the diagnosis of Late-onset Hypogonadism (Nieschlag et al 2005). These are summarized in the following text. It is advised that at least two serum testosterone measurements, taken before 11 am on different mornings, are necessary to confirm the diagnosis. The second sample should also include measurement of gonadotrophin and prolactin levels, which may indicate the need for further investigations for pituitary disease. Patients with serum total testosterone consistently below 8 nmol/l invariably demonstrate the clinical syndrome of hypogonadism and are likely to benefit from treatment. Patients with serum total testosterone in the range 8–12 nmol/l often have symptoms attributable to hypogonadism and it may be decided to offer either a clinical trial of testosterone treatment or to make further efforts to define serum bioavailable or free testosterone and then reconsider treatment. Patients with serum total testosterone persistently above 12 nmol/l do not have hypogonadism and symptoms are likely to be due to other disease states or ageing per se so testosterone treatment is not indicated.
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.
More specifically, saw palmetto is frequently used to suppress prostate growth and combat abnormal urine flow that results from an enlarged prostate. The reason it is believed that saw palmetto can combat prostate hyperplasia is based on some research indicating it may block an enzyme (5-alpha-reductase) that converts testosterone into dihydrotestosterone (DHT).[21]
Male hypogonadism becomes more common with increasing age and is currently an under-treated condition. The diagnosis of hypogonadism in the aging male requires a combination of symptoms and low serum testosterone levels. The currently available testosterone preparations can produce consistent physiological testosterone levels and provide for patient preference.
12. We keep you informed with a FREE eNewsletter – a $19.95 value. Every month, we send a short science-backed newsletter updating you on the latest research on Testosterone and your health. In addition, we email once-a-week “T-Tips” which are brief, to-the-point tips to help you see better results. This is a $19.95 value absolutely FREE to our customers!
Natural testosterone boosters also help to increase the amount of free testosterone in the body. There are a couple of different ingredients they use that help with this. One of these ingredients is stinging nettle. Stinging nettle is actually able to bind to the globulin in place of testosterone, therefore leaving more free testosterone in the body that is unbound.
With the help of the three main ingredients, you have the ability to naturally raise your free testosterone levels giving you an increase in strength, muscle mass, stamina, and libido.  NutriSuppz Ultra Test aims to help you sleep better, burn fat easier, and feel energized, and have improved mental alertness.  Another perk of NutriSuppz Ultra Test is that it is a fully transparent profile with no proprietary blends—allowing you to know exactly what you are getting in each dose.
Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 1 Mar 2019), Cerner Multum™ (updated 1 Mar 2019), Wolters Kluwer™ (updated 28 Feb 2019) and others. Refer to our editorial policy for content sources and attributions.
More recently, a study from 2015 noted that consuming 600mg daily of standardized fenugreek extract for eight weeks increased free testosterone levels compared to placebo. The test group also experience an increase the the number of repetitions the could perform in the leg press before reaching failure. And, to top it off, subjects receiving the fenugreek supplement dropped body fat without losing strength.
Testosterone may help you woo a woman. In the animal kingdom, higher testosterone levels have long been shown to be associated with a male’s dominance in the competition for mates. But a recent study has shown this is true for human males as well. When a pair of men were instructed to compete for the affection of an attractive female undergraduate, the men’s assertiveness, ability to control the conversation, and ultimately, their chances of having the woman say she “clicked” with them most, were positively associated with their pre-competition testosterone levels. So there is truth to the idea that men with swagger get the girl, and this self-assuredness may be partly rooted in T.
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.
In summary, low testosterone levels are linked to the presence of numerous cardiovascular risk factors. Testosterone treatment acts to improve some of these factors, but effects may vary according to pre- and post-treatment testosterone levels, as well as other factors. There is little data from trials specific to aging males. Appropriately-powered randomized controlled trials, with cardiovascular disease primary endpoints, are needed to clarify the situation, but in the meantime the balance of evidence is that testosterone has either neutral or beneficial effects on the risk of cardiovascular disease in men. It is particularly important to define the effect of testosterone treatment on cardiovascular disease in view of its potential use as an anti-anginal agent.

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Testosterone therapy improves body composition (increase in lean body mass, decrease in fat mass) in men with hypogonadism.1 There is a supplementary improvement in muscle strength and physical function. The benefits of testosterone treatment on body composition have consistently been demonstrated in clinical studies of testosterone therapy in hypogonadal men or men with borderline low testosterone levels,1,6,8,12,13 and confirmed by systematic reviews or meta-analyses of randomized controlled trials.4,5,6,13
There is a polymorphic CAG repeat sequence in the androgen receptor gene, which codes for a variable number of glutamine amino acids in the part of the receptor affecting gene transcription. A receptor with a short CAG sequence produces greater activity when androgens attach, and men with shorter CAG polymorphisms exhibit androgenic traits, such as preserved bone density (Zitzmann et al 2001) and prostate growth during testosterone treatment (Zitzmann et al 2003). Indirect evidence of the importance of androgens in the development of prostate cancer is provided by case control study findings of a shorter, more active CAG repeat sequence in the androgen receptor gene of patients with prostate cancer compared with controls (Hsing et al 2000, 2002).
Another way to look at it is like this: Women are only capable of building a small amount of muscle without the use of performance enhancers, regardless of how hard they train or how rigid their meal plan is. When women reach their physical peak and are unable to move any further than that point, it’s because of their naturally low levels of testosterone.
When I first started TRT, my physician prescribed a cream that you rub into your skin. The cream version of TRT is not too convenient, because if someone touches you while you have the cream on, the testosterone can rub off on him/her. This can be really bad around kids or pregnant women. If you’re sleeping next to someone, the cream can get on the sheets and transfer over that way, too. The cream can be annoying, but it works. There’s also a gel version called AndroGel; I skipped it because it doesn’t absorb as well as the cream does.
Recently, a panel with cooperation from international andrology and urology societies, published specific recommendations with regard to the diagnosis of Late-onset Hypogonadism (Nieschlag et al 2005). These are summarized in the following text. It is advised that at least two serum testosterone measurements, taken before 11 am on different mornings, are necessary to confirm the diagnosis. The second sample should also include measurement of gonadotrophin and prolactin levels, which may indicate the need for further investigations for pituitary disease. Patients with serum total testosterone consistently below 8 nmol/l invariably demonstrate the clinical syndrome of hypogonadism and are likely to benefit from treatment. Patients with serum total testosterone in the range 8–12 nmol/l often have symptoms attributable to hypogonadism and it may be decided to offer either a clinical trial of testosterone treatment or to make further efforts to define serum bioavailable or free testosterone and then reconsider treatment. Patients with serum total testosterone persistently above 12 nmol/l do not have hypogonadism and symptoms are likely to be due to other disease states or ageing per se so testosterone treatment is not indicated.
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