The most commonly used testosterone preparation in the United States — and the one I start almost everyone off with — is a topical gel. There are two brands: AndroGel and Testim. The gel comes in miniature tubes or in a special dispenser, and you rub it on your shoulders or upper arms once a day. Based on my experience, it tends to be absorbed to good levels in about 80% to 85% of men, but that leaves a substantial number who don’t absorb enough for it to have a positive effect. [For specifics on various formulations, see table below.]
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Herbalists have used _Trifolium pratense_, red clover, to treat menopausal symptoms like hot flashes. The mechanisms underlying these effects remain unknown. Testosterone decreases hot flashes in some postmenopausal women, so red clover may work in this way. A 2015 paper in the Avicenna Journal of Phytomedicine reviewed the literature testing this idea.
A: A troche is a small lozenge designed to dissolve in the mouth. Testosterone is available in troche or buccal form. If you are referring to testosterone troche, this product is generally used to treat conditions in men that result from a lack of natural testosterone. Testosterone is vital to maintaining an active and healthy male sex drive. Testosterone deficiency can cause erectile dysfunction. Studies suggest that if erectile dysfunction is associated with a low testosterone level, it can often be treated with prescription testosterone pills. Based on your complete medical history and blood levels of testosterone, your doctor can determine the best treatment option to meet your needs. For more information, please consult with your health care provider and visit //www.everydayhealth.com/drugs/testosterone. Michelle McDermott, PharmD
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]
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.
if you’re a physician, you’re the real one who’s playing doctor. Stop prescribing low T treatment and let your patients go to a real doctor and not continue suffering. A simple picture of how hormones are created and their pathways will make you understand that E follows T, when we increase T, E2 will follow which negates all the positive effects of treatment. Without understanding this, you better leave the patient alone.
Grape seed extract is another ingredient with not enough research to suggest a dosage. Grape seed extract can interact with drugs like “blood thinners, NSAID painkillers (like aspirin, Advil, and Aleve), certain heart medicines, cancer treatments, and others.” If this sounds like you (or if you ever pop an Advil to clear off a headache), you’ll need to speak with a doctor to make sure this supplement is safe to take.
Testosterone causes prostate cancer. Since the 1940s, it was commonly believed in the medical field that high testosterone levels were the cause of prostate cancer in men. Doctors reached this conclusion because two scientists in 1941 noticed that prostate cancer regressed in a patient after they castrated him and his T levels subsequently declined. This conclusion was based on the results from a single patient!
Vitamin D3. Vitamin D3 actually isn’t a vitamin, it’s a hormone — a really important hormone that provides a whole host of health benefits. Our bodies can naturally make vitamin D from the sun, but recent studies have shown that many Westerners are vitamin D3 deprived because we’re spending less and less time outdoors. When we do decide to venture outside, we slather our bodies with sunscreen, which prevents the sun reaching our skin to kick-off vitamin D3 production. If you’re not getting enough sun, you may have a vitamin D3 deficiency, which may contribute to low T levels. If you think you need more vitamin D3, supplement it with a pill. Studies have shown that men who take this supplement see a boost in their testosterone levels. Because I have a darker complexion — which makes me prone to Vitamin D3 deficiency — I took 4,000 IU of vitamin D3 in the morning.
Caffeine: While caffeine can’t ramp up testosterone directly, it can help you put in the quality work in the gym that will spike your T. One International Journal of Sports Nutrition and Exercise Metabolism study, for instance, found that athletes who consumed caffeine before training lifted more—and experienced a greater subsequent lift in testosterone—than those who took a placebo.
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.
Our bodies need zinc to make testosterone. Zinc also blocks the action of aromatase, the enzyme that converts testosterone to estrogen. Oysters offer the highest amount of zinc per serving of any food. Just six oysters contain about 500 percent of the mineral’s recommended daily allowance (RDA). Other zinc-rich foods include lean meats and spinach.
Also, for those with abnormal fatigue. It’s being found too often that hypogonadism is pared with another abnormality of the endocrine system called Hypothyroidism which causes intense fatigue and even alzheimer like cognitive disruption. Both the Testis and Thyroid need to receive signaling hormones from the Pituitary to function correctly and the Pituitary relies heavily on the Hypothalamus. Simple blood tests can check all of those. It is important you find out the reason you have low Testosterone!

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.
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.
We reviewed the ingredient lists of our supplements and cut three that prescribed us an overdose of magnesium. While it’s possible to stay under the 350mg daily limit of supplemental magnesium by taking fewer pills than the manufacturer recommends, we were concerned that any manufacturer would advise you to exceed the recommended safety limit for magnesium intake by almost a third.
The hypogonadal-obesity-adipocytokine cycle hypothesis. Adipose tissue contains the enzyme aromatase which metabolises testosterone to oestrogen. This results in reduced testosterone levels, which increase the action of lipoprotein lipase and increase fat mass, thus increasing aromatisation of testosterone and completing the cycle. Visceral fat also promotes lower testosterone levels by reducing pituitary LH pulse amplitude via leptin and/or other factors. In vitro studies have shown that leptin also inhibits testosterone production directly at the testes. Visceral adiposity could also provide the link between testosterone and insulin resistance (Jones 2007).
I have had BPH for years. Am in early 60s and recently had a 12 site prostate biopsy after a very slow rise of PSA to 4.5 (over a period of 10 years). There were two sites with PIN (one with outpouching and one was focal). Have been on various form of test replacement…changing methods periodically from test cyp IM, or SQ, with and without HCG or HCG alone. I want to continue a very low dose of either HCG or Test Cyp (10-20mg twice/week). What are your thoughts?
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.
Epidemiological studies suggest that many significant clinical findings and important disease states are linked to low testosterone levels. These include osteoporosis (Campion and Maricic 2003), Alzheimer’s disease (Moffat et al 2004), frailty, obesity (Svartberg, von Muhlen, Sundsfjord et al 2004), diabetes (Barrett-Connor 1992), hypercholesterolemia (Haffner et al 1993; Van Pottelbergh et al 2003), hypertension (Phillips et al 1993), cardiac failure (Tappler and Katz 1979; Kontoleon et al 2003) and ischemic heart disease (Barrett-Connor and Khaw 1988). The extent to which testosterone deficiency is involved in the pathogenesis of these conditions, or to which testosterone supplementation could be useful in their treatment is an area of great interest with many unanswered questions.

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.
The same study showed that drinking did, however, lower semen count and quality. And I want to remind you – this is an article  on improving testosterone levels, not general health as there are a lot of studies that show drinking leads to an assortment of health issues. This acute spike in Testosterone could be due to the effect alcohol has on libido, and also the energy influx in the liver?

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.


We required all of our testosterone boosters to have magnesium, but gave preference to magnesium aspartate, citrate, lactate, and chloride. These forms have been found to be more easily absorbed than magnesium oxide and sulfate. (On the other hand, it didn’t count if the supplement had magnesium stearate, which is used to make pills not stick together.)
Zinc deficiency also negatively affects testosterone levels, according a 2014 article in the Journal of Plant Biochemistry and Physiology. The authors of this review note that zinc supplementation can increase circulating testosterone in some populations. In fact, daily supplementation with typical doses may double testosterone within a few months.

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.
Also, for those with abnormal fatigue. It’s being found too often that hypogonadism is pared with another abnormality of the endocrine system called Hypothyroidism which causes intense fatigue and even alzheimer like cognitive disruption. Both the Testis and Thyroid need to receive signaling hormones from the Pituitary to function correctly and the Pituitary relies heavily on the Hypothalamus. Simple blood tests can check all of those. It is important you find out the reason you have low Testosterone!
My favorite overall tool to manage stress is EFT (Emotional Freedom Technique), which is like acupuncture without the needles. It's a handy, free tool for unloading emotional baggage quickly and painlessly, and so easy that even children can learn it. Other common stress-reduction tools with a high success rate include prayer, meditation, laughter and yoga, for example. Learning relaxation skills, such as deep breathing and positive visualization, which is the "language" of the subconscious.
Because clomiphene citrate is not approved by the FDA for use in men, little information exists about the long-term effects of taking it (including the risk of developing prostate cancer) or whether it is more effective at boosting testosterone than exogenous formulations. But unlike exogenous testosterone, clomiphene citrate preserves — and possibly enhances — sperm production. That makes drugs like clomiphene citrate one of only a few choices for men with low testosterone who want to father children.
Any supplement can have side effects, and testosterone pills or powder are no exception. Talk to your doctor before beginning any new regimen to be sure it is right for you. Side effects can include sleep apnea, ankle swelling, prostate growth, increased urination, acne, and an increased risk of developing a blood clot, which can be serious or even deadly.
The content here is for information purposes only. By delivering the information contained herein is does not mean preventing, diagnosing, mitigating, treating or curing any type of medical condition or disease. When beginning any natural supplementation regiment or integrative treatment, the advice of professionally licensed healthcare providers is advisable to seek.

i have been on T therapy for 32 years now after being diagnosed with Klinefelters. Recently my pharmacy had been non responsive to my request to refill and they flat out refused/declined the request from my doctor which was T powder mixed with a cream base that you place on the shoulder. I asked if I could purchase it with cash and they told me that the FDA is not approving this usage anymore but did not provide an option. Completely out now for close to a week and have been working for five weeks trying to get again. Now what to do, I’m having all kinds of weird feelings including anxiety to the max, nervous, irritable, muscle cramps/pains … I guess they just don’t care that we cannot get something our bodies have adjusted too for many years. Strange thing is I think I have found a compounding pharmacy in Houston Texas that will fill this Rx. I’m not sure how one can do this and another cannot especially if they have compounding capabilities. Now I’m wondering if I can get thru this and stop taking it alltogether however I already know I’m seeing signs of being forgetful, lack of energy and foggy brain. I wonder if this will ever stop. The really bad thing is that I’m traveling for work and cannot get into my doctor’s office. This whole process is not great. I can only imagine what a person must feel taking hard drugs then not getting any all at once.
In high-fat high-furctose fed rats, ginger neutralized diet induced impairment in glucose regulation, dyslipidemia, and oxidative stress [28]. This observed anti-diabetic activity of ginger powder is credited to two active components: 6-paradol and 6-shogaol [29]. They both exhibit potent activity in stimulating glucose utilization by 3T3-L1 adipocytes and C2C12 myotubes. In the high-fat diet mouse model, 6-paradol decreased blood glucose, cholesterol and body weight.
Sitting for long stretches of time increases the odds of illness and untimely death. Here are some simple tricks to get yourself out of your chair: While you're on the phone, stand up and walk around. When watching TV, stand and pace during commercials. Instead of sitting at your makeup table, stand up. In general, try to get on your feet every 30 minutes.
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