Vitamin D3: Vitamin D3 is actually more hormone than it is a vitamin. Vitamin D is taken in by around 10% of our diets and D3 is mostly absorbed from the sun, which can be linked to greater testosterone production. The link between the two is a result from the luteinizing hormone playing its role. Read more about how vitamin D3 effects testosterone — the evidence is staggering.
Studies conducted in rats have indicated that their degree of sexual arousal is sensitive to reductions in testosterone. When testosterone-deprived rats were given medium levels of testosterone, their sexual behaviors (copulation, partner preference, etc.) resumed, but not when given low amounts of the same hormone. Therefore, these mammals may provide a model for studying clinical populations among humans suffering from sexual arousal deficits such as hypoactive sexual desire disorder.[37]
Testosterone, historically believed to be important only for male sexual function, has over the past decades transformed from niche hormone to multi-system player.22 There is increasing recognition of the harmful consequences of hypogonadism (also known as testosterone deficiency) wide spectrum of beneficial health effects of testosterone therapy and.23, 24
The basis for my thinking that T levels could be boosted by cold baths came from a post I wrote a few years ago on the benefits of cold showers. One benefit I found in my research was that they could increase testosterone levels. I mentioned a 1993 study done by the Thrombosis Research Institute in England that found increased T levels after taking a cold shower. Here’s the thing. I can’t find a link to the original source and I can’t find any other studies that support this claim! So without supporting research, I’m unsure of the effects of cold showers on testosterone.
The oldest form is an injection, which we still use because it’s inexpensive and because we reliably get good testosterone levels in nearly everybody. The disadvantage is that a man needs to come in every few weeks to get a shot. A roller-coaster effect can also occur as blood testosterone levels peak and then return to baseline. [See “Exogenous vs. endogenous testosterone,” above.]

I am 45 years old and have been diagnosed with low testosterone levels. In 2014 my levels were 16.5 and in 2016 that dramatically reduced to a score of 10.4. My doctor prescribed me Testo gel which I rub on every morning and have done so for the last 6 weeks. I keep myself fit, gym twice a week and martial arts twice a week and found my energy levels were depleting and didn’t seem to recover quickly the next day. I started to feel exhausted and experienced low libido,lack of motivation and mental focus. I actually thought oh well this is what happens when you get older.

Garlic is a very effective food that has been used for centuries in treating various physical ailments including heart problems and respiratory infections. What most people don’t know is that it is also a potent aphrodisiac and very effective in boosting sperm volume. It contains a compound called allicin which improves blood flow to the male sexual organs, increasing sperm production and semen volume.
“Poor lifestyle can mimic the symptoms of low testosterone and can actually cause low testosterone as well,” says Hodzovic. “The main culprits include lack of sleep, excessive stress, too little or too much exercise and too little or too much body fat. Getting healthy and active and eating a balanced nutritious diet along with enough sleep are the most important things to do.
Despite all the wonderful benefits of testosterone boosters, it will only work as well as you are able to make it work. This means that if you’re living a sloppy lifestyle, then your testosterone booster will produce poor results. Testosterone boosters work best when you make small, healthy changes to your lifestyle and diet that will allow your T-booster to give you its full benefits.
Herein lies the problem.  DHT is an extremely powerful androgen, significantly more potent than testosterone.  Somehow, fenugreek causes increases in muscle mass and libido while reducing DHT.  I often argue on the site that it is not exactly increased testosterone that you want.  You want the blessings of a high testosterone level: physical fitness, libido, and high energy levels.  If fenugreek can bestow these upon you, why do you need the testosterone?
In addition to these effects, DHEA supplementation also increases FREE testosterone levels. As you may or may not know, testosterone is found in the body in both free and bound forms. Free testosterone is the biologically active kind that we want more of in order to improve energy, strength, recovery, and sexual function. Bound testosterone is biologically inactive, due to serum hormone-binding globulin (SHBG).
Overall there is evidence that testosterone treatment increases lean body mass and reduces obesity, particularly visceral obesity, in a variety of populations including aging men. With regard to muscle changes, some studies demonstrate improvements in maximal strength but the results are inconsistent and it has not been demonstrated that these changes lead to clinically important improvements in mobility, endurance or quality of life. Studies are needed to clarify this. Changes in abdominal obesity are particularly important as visceral fat is now recognised as predisposing the metabolic syndrome, diabetes and cardiovascular disease.
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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.
Professional-athlete-turned-biohacker Maximilian Gotzler gave a speech about boosting testosterone at the 2015 Bulletproof Conference. He started by leading the room through the Haka, a Maori war dance that New Zealand’s pro rugby team has made popular. The Pasadena Conference Center trembled as over 100 people shouted and stomped in unison. It was awesome.
A meta-analysis of nine randomized controlled trials [31] evaluated effects of ginger on net changes in blood glucose and lipid concentrations (total cholesterol, triglyceride, low-density lipoprotein cholesterol, high density lipoprotein cholesterol).  In a total of 609 adults with T2DM or hyperlipidemia, ginger supplementation led to significant reductions in plasma levels of total cholesterol, triglycerides, and blood glucose, but non-significant reduction in LDL-c levels.
Vitamin D3 has the ability to naturally boost testosterone levels.  Increasing serum vitamin D levels in the body can help increase testosterone production, allowing you to potentially build muscle at a faster rate. If you don’t live in an area of the world that allows for a good amount of sunlight, you could become deficient and could benefit from a vitamin D supplement.
The brain is also affected by this sexual differentiation;[13] the enzyme aromatase converts testosterone into estradiol that is responsible for masculinization of the brain in male mice. In humans, masculinization of the fetal brain appears, by observation of gender preference in patients with congenital diseases of androgen formation or androgen receptor function, to be associated with functional androgen receptors.[99]
What makes TestoFuel different from other testosterone boosters on the market is that the company is constantly researching and updating the ingredients. So, you know you are getting a product that has been formulated using the latest clinical studies. Unlike most other companies that formulate a product and update it every 3 – 5 years or never at all.
Why do we need magnesium? Magnesium is an essential nutrient in the body that can help decrease the risk of developing osteoporosis, improve insulin sensitivity, and lower the risk of hypertension. This article looks at other health benefits of magnesium, what happens if a person has a deficiency, supplements, and how to include it in the diet. Read now

Studies conducted in rats have indicated that their degree of sexual arousal is sensitive to reductions in testosterone. When testosterone-deprived rats were given medium levels of testosterone, their sexual behaviors (copulation, partner preference, etc.) resumed, but not when given low amounts of the same hormone. Therefore, these mammals may provide a model for studying clinical populations among humans suffering from sexual arousal deficits such as hypoactive sexual desire disorder.[37]
Testosterone is an androgen hormone produced by the adrenal cortex, the testes (in men), and the ovaries (in women). It is often considered the primary male sex hormone. Testosterone stimulates the development of male secondary sex characteristics (like body hair and muscle growth) and is essential in the production of sperm. In women, testosterone plays a role in egg development and ovulation.
Herein lies the problem.  DHT is an extremely powerful androgen, significantly more potent than testosterone.  Somehow, fenugreek causes increases in muscle mass and libido while reducing DHT.  I often argue on the site that it is not exactly increased testosterone that you want.  You want the blessings of a high testosterone level: physical fitness, libido, and high energy levels.  If fenugreek can bestow these upon you, why do you need the testosterone?
“This study establishes testosterone levels at which various physiological functions start to become impaired, which may help provide a rationale for determining which men should be treated with testosterone supplements,” Finkelstein says. “But the biggest surprise was that some of the symptoms routinely attributed to testosterone deficiency are actually partially or almost exclusively caused by the decline in estrogens that is an inseparable result of lower testosterone levels.”

If you are not making muscular gains by using your old BCAA supplement, our Advanced BCAA is the product to use to solve this problem.  Advanced BCAA’s are superior to free form BCAA’s because it is  more absorbable. Advanced BCAA is in peptide form and from predigested whey protein.  This makes it much more effective and beneficial to gaining muscle.  So if you have given up or don’t think BCAA’s work, try our Advanced BCAA powder and you wont be disappointed.


You should also know that a lot of people are deficient in Vitamin D. In the USA & many other western regions in the world, vitamin D deficiency is at epidemic proportions. The best way to increase your D levels is sun exposure. You only need 20-30 minutes of exposure to a large amount of skin (i.e., take your shirt off and go for a walk during the day).
A previous meta-analysis has confirmed that treatment of hypogonadal patients with testosterone improves erections compared to placebo (Jain et al 2000). A number of studies have investigated the effect of testosterone levels on erectile dysfunction in normal young men by inducing a hypogonadal state, for example by using a GnRH analogue, and then replacing testosterone at varying doses to produce levels ranging from low-normal to high (Buena et al 1993; Hirshkowitz et al 1997). These studies have shown no significant effects of testosterone on erectile function. These findings contrast with a similar study conducted in healthy men aged 60–75, showing that free testosterone levels achieved with treatment during the study correlate with overall sexual function, including morning erections, spontaneous erections and libido (Gray et al 2005). This suggests that the men in this older age group are particularly likely to suffer sexual symptoms if their testosterone is low. Furthermore, the severity of erectile dysfunction positively correlates with lower testosterone levels in men with type 2 diabetes (Kapoor, Clarke et al 2007).

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Testosterone is used as a medication for the treatment of males with too little or no natural testosterone production, certain forms of breast cancer,[10] and gender dysphoria in transgender men. This is known as hormone replacement therapy (HRT) or testosterone replacement therapy (TRT), which maintains serum testosterone levels in the normal range. Decline of testosterone production with age has led to interest in androgen replacement therapy.[109] It is unclear if the use of testosterone for low levels due to aging is beneficial or harmful.[110]
Keep more weapons in your arsenal: Occasionally use lifting methods like forced reps, negatives, and dropsets to further stress your body. Personal trainer and fitness journalist Michael Berg explains in "6 Ways to Crank Up Your Testosterone Levels" that going beyond muscular failure with these techniques has been shown to pump up T-levels in study subjects.[16]
Most studies support a link between adult criminality and testosterone, although the relationship is modest if examined separately for each sex. Nearly all studies of juvenile delinquency and testosterone are not significant. Most studies have also found testosterone to be associated with behaviors or personality traits linked with criminality such as antisocial behavior and alcoholism. Many studies have also been done on the relationship between more general aggressive behavior/feelings and testosterone. About half the studies have found a relationship and about half no relationship.[66] However, later it was found out that testosterone activates dominant, aggressive behavior if at the same time a person has high testosterone and low levels of cortisol in the blood. Conversely, a high level of testosterone and high levels of cortisol do not stimulate dominant behavior. Because cortisol inhibits the action of testosterone.[67][68][69][70] This is probably why the results of the experiments were inconsistent.
Statins are some of the most prescribed drugs in the world for reducing cholesterol levels and preventing heart disease. Various studies in the 1990s, including a study published in the ‘European Journal of Clinical Nutrition,’ supported the claim that Fenugreek could help reduce cholesterol levels[2]. One possible explanation is the high fiber content in fenugreek.  A fiber-rich diet has been shown to help reduce the levels of LDL (‘bad’ cholesterol) in your blood. (Note: The validity of the various studies from the 1990s have been questioned though because of small sample sizes[3])
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.
Rest and recovery is just as important as exercise, if not more so. Every time you do an intense workout, give yourself a minimum of 2 days to recuperate afterward, if not more. And don’t mix exercise with sleep hacking. If you’re exercising, get at least 8 hours of sleep every night. Your body uses it to rebuild, and you can throw your hormones out of whack if you don’t rest up properly. Here’s a more in-depth guide to Bulletproof weight training, complete with sample workouts.
Testosterone [Figure 1] is the main male sex hormone. It is responsible for male sexuality and is the main hormone-producing the features associated with masculinity such as substantial muscle mass, facial hair, libido, and sperm production.[1] Besides, the hormone has other vital functions as the basic chemical composition of testosterone is steroidal; and steroids are known to have significant physiological, as well as psychological, effects in male individuals, especially adults.[1] Testosterone production is reduced gradually in men starting from the age of 30.[2] Hence, testosterone blood concentrations slowly diminish as age progresses. As a result, men may experience a number of physiological and psychological events, such as a lack of sex-drive, erectile dysfunction, acute depression, fatigue, low energy levels, and insomnia.[3]

Scientists in Italy found that subjects who consumed roughly 3 grams of D-AA for 12 days observed a 42 percent increase in testosterone levels.[12] The researchers also noted that the D-AA group still had 22 percent more testosterone than the placebo group three days after they stopped supplementing. Conversely, a more recent article published in Nutrition Research found no increase in testosterone levels in resistance-trained males after supplementing with 3 grams of D-AA for 28 days.[13]

Also, due to the intake of these synthetic substances, men start behaving in a very excited way, as well as demonstrate high levels of aggression and even violence. So, the men’s behavior may be antisocial. In addition, the men will experience breast enlargement and testicular shrinkage. The other adverse effects include hypertension, tumor growth, heart attacks and strokes, as well as development of liver disorders. It’s obvious that the numerous dangers of steroid use far outweigh a few benefits which they bring.
Short bursts of timed intense activity — known as high-intensity interval training or HIIT — trigger the body to make more testosterone than less-than-intense aerobic or endurance exercise, says La Puma. Spurts of activity stimulate androgen-sensitive tissue, he explains, which tells the body to make more testosterone. Strength training has also been shown to increase testosterone.
The fact of the matter is the better quality protein you use the better quality muscle gains you will get. The best thing to combine Advanced BCAA’s is to get our Peptopro or Bio serum 1. This will create a protein powder supplement that is far superior than any protein supplement available today. Essentially you will create a super protein powder. Use with a carb powder like our Oatmuscle to really make a muscle growing protein supplement. Finally combine with Heliogen casein at night and this will give your body a great chance for recovery for the next day ..
It seems that adequate testosterone levels are an important influence on sexual symptoms in the aging male and also influence the response of men to PDE-5 inhibitors, the first line treatment for erectile dysfunction in men. Many would now suggest screening for testosterone deficiency in all men presenting with erectile dysfunction (Gore and Rajfer 2004; Shabsigh 2005). This would seem appropriate because, in addition to benefits on sexual function, identification and treatment of hypogonadal men with testosterone could improve other symptoms of hypogonadism and protect against other conditions such as osteoporosis.
This one is another herb that is known to increase semen volume. It has been found that men who consume this herb in the form of a supplement can expect higher sperm count per milliliter of semen, higher semen volume per ejaculation and also better sperm motility. It is also known to have a positive effect on the sex drive and arousal of both men and women.
Want faster recovery and more lean muscle gains?  Advanced BCAA is your answer.  Why?  Because everyone knows that BCAA’s (branched chain amino acids)  are the building blocks of muscle.  You’re not going to grow an ounce of muscle without BCAA’s.  Now BCAA’s can be found in foods like milk and meat, and of course whey protein contains BCAA’s.  However Advanced BCAA’s is a special ultra fast, absorbable form of BCAA that will sky rocket your muscle gains.  It provides the body with BCAA’s in peptide form.  Which means it is digested very fast,  faster than normal BCAA’s that you’ll find on the retail shelf.  Get a BCAA supplement that gives you the best chance for success.  GET ADVANCED BCAA!
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.
Dr. Martin’s Extra Strength Testosterone Booster made our top spot for budget-friendly enhancers. This is a unique and powerful blend of natural herbs that will help you with your energy levels and raise your stamina. Men will also appreciate better results when it comes to building up lean muscle, and the supplement will give your libido a boost, too.
I can report that I saw decreased body fat during my three-month testosterone experiment. I started off with 18% body fat and ended the experiment with 12% body fat. I almost have a six-pack! This is the leanest I’ve ever been in my entire life. The funny thing is, I wasn’t even trying to shed body fat. It just happened. All hail, mighty testosterone!
Travison, T. G., Vesper, H. W., Orwoll, E, Wu, F., Kaufman, J. M., Wang, Y., …Bhasin, S. (2017, April1). Harmonized reference ranges for circulating testosterone levels in men of four cohort studies in the United States and Europe. The Journal of Clinical Endocrinology & Metabolism, 102(4), 1161–1173. Retrieved from https://academic.oup.com/jcem/article/102/4/1161/2884621
If you haven’t hit your twenties yet then you probably can’t imagine losing your interest in sex. I feel you, Holmes.  At 26, I have a healthy appetite now (partially because I consciously work on elevating my T) but it’s nowhere near where it was when I was 17.  I imagine that things will only get worse by the time I’m 35 which is why it’s important to learn what gets your motor firing now.
What are the health benefits of kale? Kale is a leafy green vegetable featured in a variety of meals. With more nutritional value than spinach, kale may help to improve blood glucose, lower the risk of cancer, reduce blood pressure, and prevent asthma. Here, learn about the benefits and risks of consuming kale. We also feature tasty serving suggestions. Read now
Stick to protocols that stress large degrees of muscle mass and are moderate- to high-intensity. Additionally, more seasoned gym-goers may want to incorporate forced repetitions periodically into their programs, as testosterone increases have been observed with this type of training.14 Incorporating other post-failure training techniques such as dropsets or partials may similarly be associated with higher T production.

Miscellaneous: Sleep: (REM sleep) increases nocturnal testosterone levels.[146] Behavior: Dominance challenges can, in some cases, stimulate increased testosterone release in men.[147] Drugs: Natural or man-made antiandrogens including spearmint tea reduce testosterone levels.[148][149][150] Licorice can decrease the production of testosterone and this effect is greater in females.[151]


Around age 30, men’s testosterone levels begin a long, gradual decline. (According to the FDA, normal T range is between 300 to 1,000 nanograms per deciliter (ng/dl) of blood serum. Anything below 300 ng/dl is considered low.) If a blood test confirms you have low T, your doctor may recommend a prescription testosterone supplement or replacement therapy.
Amazing this thread is going after 3 years. Very good indeed. I have low cortisol and my doctor decided to check testosterone. It came back at 5! Not 500, but 5! My doctor did not believe this to be correct. She indicated I would not be able to grow facial hair and that my arm hair would have fell out. She retested. It came back at 23. WTH. So she wanted to start me on Clomid. Well of course my insurance would not cover this. Most pharmacies wanted $300-400 for a 30 day supply. Can’t afford that! The 2 pharmacies that were reasonable cannot get it from their suppliers at this time. So my doctor wants to start weekly injections. I do not know what to think but am trying to find all the information I can on the subject as I am quite nervous. So if anyone else is still reading or comes across this please let me know what you think or your story. it would very much be appreciated. i will be 38 next month and am a little “lost” about all of this. Many thanks! 🙂
Fortunately supplementation of Vitamin D3 has been noted to significantly boost testosterone levels up to 20%.[40,41] This occurs via a reduction in sex-hormone binding globulin (SHBG) and aromatase expression, which limits the breakdown of testosterone into estrogen. It’s also worth mentioning that Vitamin D3 has been shown to raise levels of the anabolic hormone IGF-1.[42,43]
DAA (D-Aspartic Acid): When it comes to potent ingredients, D-Aspartic Acid is probably one the most potent ones currently available for boosting testosterone levels. This ingredient is used by sportsmen and bodybuilders alike to boost performance and gains, while it has also been shown to aid infertile men. DAA works with the brain, which stimulates the release of the luteinizing hormone that produces testosterone and also the secretion of growth hormone. Testosterone Synthesis also increases along with the other effects.
This is the best BCAA supplement ever created.  You see this is not your typical BCAA supplement that all the other supplement companies sell.  Those products are simply free-form amino acids made by some Chinese manufacturer and packaged in the United States.  Free form amino acid supplements have been around since the 1980’s and they have never been proven to be helpful in building muscle mass.  In fact after whey protein came out in the 90’s it really made BCAA amino acids obsolete because whey protein contains over 30% BCAA.  If you want more BCAA’s simply use another scoop of whey protein instead of BCAA powder.  Its cheaper, tastes better, and contains plenty of BCAA plus all the other amino acids.  Ok so now that I have convinced you that free form BCAA’s supplements are pretty much worthless let me tell you about our new Advanced BCAA’s.
Elevated testosterone levels have been demonstrated to increase the growth of body muscles and contribute to better activation of the nervous system, resulting in more power and strength, a better mood, enhanced libido, and many other benefits.[3] Previous researches done on the anabolic role of testosterone and its impact on muscular strength in training-induced adaptations has provided rather conflicting findings, and a positive correlation between testosterone-mediated responses and both functional performance and body composition was found.[4,5] There are a number of naturally occurring substances that can boost testosterone levels in the body. Foods containing such substances are known as testosterone-foods; and they tend to be rich in vitamins, antioxidants, and minerals like zinc, which plays a key role in testosterone production.[2,6-8]
Note that DHT is what causes male pattern baldness so it stands to reason that fenugreek may delay the balding process.  A quick Google search of “fenugreek and baldness” reveals that I am not the only genius struck with this idea.  There are sites out there that claim that a fenugreek+saw palmetto concoction or applying a fenugreek paste can help prevent Mr. Cleanitis.
Smoking doesn’t promote maintaining male hormone levels healthy. The study has shown that smoking deprives the body from zinc. Zinc deficiency is dangerous for men because it is fraught with testosterone deficiency. The matter is that zinc is a kind of structural material for building the testosterone molecules. So, smoking combined with unhealthy diet strikes a blow against normal testosterone production.
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!
D-AA:  D-Aspartic Acid has been known to increase libido and sex drive as well as fertility in infertile men. D-AA was the craze a few years back but the issue found was that after a month of use, the results started to diminish.  Also, if you currently have normal levels of testosterone, D-AA won’t do much good for you in terms of an increase in T-levels. 

We should probably start with the elephant in the room: do these supplements increase testosterone? The answer is probably yes. There are some ingredients that help convince your body to produce more testosterone, but there’s a catch. Testosterone boosters aren’t actually great at boosting; that is, at pushing your testosterone levels above your healthy, normal balance. Boosters typically act more like restorers — helping bring low testosterone levels back to that healthy equilibrium rather than boosting you above normal testosterone levels. Just like how if you have anemia, taking a vitamin B12 supplement can help restore your energy and reduce fatigue, but if your B12 levels are good, a supplement won’t give you super energy levels to stay awake for three days — your body will likely just process (read: pee) out the extra.
The mechanism of age related decreases in serum testosterone levels has also been the subject of investigation. Metabolic clearance declines with age but this effect is less pronounced than a reduction in testosterone production, so the overall effect is to reduce serum testosterone levels. Gonadotrophin levels rise during aging (Feldman et al 2002) and testicular secretory responses to recombinant human chorionic gonadotrophin (hCG) are reduced (Mulligan et al 1999, 2001). This implies that the reduced production may be caused by primary testicular failure but in fact these changes are not adequate to fully explain the fall in testosterone levels. There are changes in the lutenising hormone (LH) production which consist of decreased LH pulse frequency and amplitude, (Veldhuis et al 1992; Pincus et al 1997) although pituitary production of LH in response to pharmacological stimulation with exogenous GnRH analogues is preserved (Mulligan et al 1999). It therefore seems likely that there are changes in endogenous production of GnRH which underlie the changes in LH secretion and have a role in the age related decline in testosterone. Thus the decreases in testosterone levels with aging seem to reflect changes at all levels of the hypothalamic-pituitary-testicular axis. With advancing age there is also a reduction in androgen receptor concentration in some target tissues and this may contribute to the clinical syndrome of LOH (Ono et al 1988; Gallon et al 1989).
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