Thomas M. Gill, MD, Humana Foundation Professor of Medicine at Yale University School of Medicine in New Haven, CT, told EndocrineWeb that these trials were needed because “the pharmaceutical industry did a very good job of promoting testosterone, and there have been suggestions of parallels between age-related decreases in testosterone levels in men, and menopause in older women.”
For years, the recommendation has been to get a testosterone value early in the morning because levels start to drop after 10 or 11 a.m. But the data behind that recommendation were drawn from healthy young men. Two recent studies showed little change in blood testosterone levels in men 40 and older over the course of the day. One reported no change in average testosterone until after 2 p.m. Between 2 and 6 p.m., it went down by 13%, a modest amount, and probably not enough to influence diagnosis. Most guidelines still say it’s important to do the test in the morning, but for men 40 and above, it probably doesn’t matter much, as long as they get their blood drawn before 5 or 6 p.m.
*IMPORTANT TESTOSTERONE TREATMENT WARNING: Who Should Not Enroll in Testosterone Replacement Therapy? Men who have or had prostate cancer or breast cancer should not take testosterone replacement therapy. All men considering treatment should undergo a thorough prostate cancer screening prior to starting any therapy program with a rectal exam and PSA test. *Men who have or have had cardiovascular disease, or are at risk for coronary disease, or have had a history of heart disease may not be candidates for testosterone treatment. Blood testing, thorough physical examination and careful screening by your physician is absolutely essential before considering a hormone therapy program of any kind. Always discuss the potential benefits, uses, side effects and risks of prescription hormones and steroid drugs with your treating physician. Hormone Treatment is for medically qualified candidates only. The FDA has cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use - FDA Testosterone Safety Update
I’ve been on testosterone replacement for over 3 years and at first I did the shots and my mood swings were ridiculous, my skin broke out on my chest and shoulders, and my henatocrit went to 55%. I finally got fed up with doing shots every two weeks and switched to Gel and it’s been so much better. It actually increases my levels which is rare for most men. I do 12.5 mg, three pumps a day, and this keeps My level between 500 and 600. My hematocrit is 48.5 and no mood swings.
In summary it’s important to know that this topic is still hotly debated, and there are a lot of inconsistencies in the data. We do know that soy contains phytoestrogens and does seem to have a lot of affects on the body, including some studies that show decreased Testosterone levels. For that reason (and the fact that it tastes like ass) I avoid it, and I recommend you also avoid it (in particular soy isolates!) if you’re seeking higher testosterone.
Testosterone may improve cognitive ability. Not only have studies shown that there is a link between testosterone levels and Alzheimer’s, they’ve also shown a link between T levels and overall cognitive ability, particularly in older men. One such study performed by Dutch researchers found a direct linear relationship between T levels and cognitive function, while other studies have found a linear relationship between memory loss and T levels. Because of these correlations, many researchers believe testosterone plays a role in preventing brain tissue decay in elderly men. The hormone’s connection to cognition explains why some of the symptoms of low T in men are memory loss, trouble concentrating, and “fogginess.”
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.
Dr. Abraham Morgentaler, an associate professor of surgery at Harvard Medical School and the director of Men’s Health Boston, specializes in treating prostate diseases and male sexual and reproductive difficulties. He has developed particular expertise in treating low testosterone levels. In this interview, Dr. Morgentaler shares his views on current controversies, the treatment strategies he uses with his own patients, and why he thinks experts should reconsider the possible link between testosterone-replacement therapy and prostate cancer.
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.

Smith, R. P., Khanna, A., Coward, R. M., Rajanahally, S., Kovac, J. R., Gonzales, M. A., & Lipshultz, L. I. (2013, September). Factors influencing patient decisions to initiate and discontinue subcutaneous testosterone pellets (Testopel) for treatment of hypogonadism [Abstract]. The Journal of Sexual Medicine, 10(9), 2326–2333. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23859250

Popular through the centuries in Ayurvedic healing (a traditional practice of medicine in India) ashwagandha is what is known as an "adaptogen." This means the body may be able to use it to help adapt to stressors. While many people supplement with it for reducing cortisol, anxiety, and fatigue levels, ashwagandha also holds relevance for us here with potential testosterone boosting benefits.[8]
Ashwagandha: One of the hottest herbs out there right now, this adaptogen packs a one-two punch. First, it helps the body fight off stress: According to one Indian Journal of Psychological Medicine study, ashwagandha has a cortisol-lowering effect—a major benefit to anyone who wants their body to be more T-friendly. And, second, it can also support your T-boosting training efforts. One Journal of the International Society of Sports Nutrition study, for example, found that men who supplemented with ashwagandha saw significantly greater strength and T gains after eight weeks of resistance training than those who took a placebo.
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.
I have been searching quite a while for a testosterone booster that could help me in a few different ways yet not to be too expensive. Over the years, I have experienced a low irritability tolerance(meaning it doesn’t take much to send me “over the top”) and have moods swings due to negative situations. I would like to be more at peace with myself & around others(without trying to fake it).I don’t usually have a lot of energy at work & rely on energy drinks. I also have a lower sex drive due to what I believe is low blood flow. I am 43 years old and am not over weight, but could stand to tone up and lose a little around the waist. If this site is legit, I would like to know your opinion on what I have disclosed & what you recommend.
There are many Supplements: Zinc for starters about 1/3 of Men have to low Zinc. Make shure you get a good chemical form no oxides best are chelates or citrates. Then there is Arginin and L-Citrullin two amino acids that help Blood flow basacly natural viagra. And then there are things like maca(a plant that you can get in powder form) that hightens libido but not like zinc it doesnt highten the testosteron level. My dad takes the combo of these 3 things kosts you about 30-60$ per Month. Dont be lazy do research on the stuff to make shure you get right dosages and good quality Sups
The body’s endocrine system consists of glands that manufacture hormones. The hypothalamus, located in the brain, tells the pituitary gland how much testosterone the body needs. The pituitary gland then sends the message to the testicles. Most testosterone is produced in the testicles, but small amounts come from the adrenal glands, which are located just above the kidneys. In women, the adrenal glands and ovaries produce small amounts of testosterone.
I am a 43 year old and have undergone pituitary sectioning/surgery twice. Since then i have been using the testoterone gel daily for 12 years without any problem. However, i still have pituitary tumor and also diagnosed with colon cancer. I am thinking of stopping the HRT because i felt it is worsening the illness. I would be glad if you could advice me of the risk of stopping the treatment.
One of the few testosterone boosters on the market to feature Eurycoma Longifolia, a patented ingredient that was developed at Massachusetts Institute of Technology (MIT) for the treatment of sexual dysfunction and male fertility, Tongkat Ali supports increased sex drive through multiple pathways, including boosting one’s free testosterone levels. Great as a standalone testosterone booster and a staple in many people’s post cycle after an anabolic cycle.
Hacking your testosterone influences everything from body composition to energy levels to mood. It’s easy to eat more butter; it’s hard to visit a doctor and get tested, but that’s what I recommend: know your levels. If you’re 25, you’ll know what your target is when you’re 35. By the time you’ve noticed symptoms of low testosterone, it’s too late to get your “normal” measurements!
The effects of testosterone in humans and other vertebrates occur by way of multiple mechanisms: by activation of the androgen receptor (directly or as DHT), and by conversion to estradiol and activation of certain estrogen receptors.[113][114] Androgens such as testosterone have also been found to bind to and activate membrane androgen receptors.[115][116][117]
Men on long-term testosterone appear to have a higher risk of cardiovascular problems, like heart attacks, strokes, and deaths from heart disease. For example, in 2010, researchers halted the Testosterone in Older Men study when early results showed that men on hormone treatments had noticeably more heart problems. "In older men, theoretical cardiac side effects become a little more immediate," Dr. Pallais says.
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.
Testosterone may prove to be an effective treatment in female sexual arousal disorders,[52] and is available as a dermal patch. There is no FDA approved androgen preparation for the treatment of androgen insufficiency; however, it has been used off-label to treat low libido and sexual dysfunction in older women. Testosterone may be a treatment for postmenopausal women as long as they are effectively estrogenized.[52]
As a urologist, I tend to see men because they have sexual complaints. The primary hallmark of low testosterone is low sexual desire or libido, but another can be erectile dysfunction, and any man who complains of erectile dysfunction should get his testosterone level checked. Men may experience other symptoms, such as more difficulty achieving an orgasm, less-intense orgasms, a smaller amount of fluid from ejaculation, and a feeling of numbness in the penis when they see or experience something that would normally be arousing.
I read several comments about blood clots. The issue was more than likely caused by estrogen overload and the measurement of ultra sensitive estradiol would prove it. I would wager that given T without anastrozole and having belly fat, that aromatase enzyme converted T to estrogen and that is why clots developed and why they felt worse instead of better. That is my opinion.

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.
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.
How do you boost testosterone naturally? Testosterone is a male sex hormone. Low levels can cause changes to the distribution of body fat and muscle strength. Testosterone reduces with age, but people can boost it with lifestyle changes, including diet and exercise. Adequate sleep, nutritional supplements, and stress reduction may also help. Learn more here. Read now
Your diet is the best source of zinc; along with protein-rich foods like meats and fish, other good dietary sources of zinc include raw milk, raw cheese, beans, and yogurt or kefir made from raw milk. It can be difficult to obtain enough dietary zinc if you're a vegetarian, and also for meat-eaters as well, largely because of conventional farming methods that rely heavily on chemical fertilizers and pesticides. These chemicals deplete the soil of nutrients ... nutrients like zinc that must be absorbed by plants in order to be passed on to you.
The changes in average serum testosterone levels with aging mean that the proportion of men fulfilling a biochemically defined diagnosis of hypogonadism increases with aging. Twenty percent of men aged over 60 have total testosterone levels below the normal range and the figure rises to 50% in those aged over 80. The figures concerning free testosterone are even higher as would be expected in view of the concurrent decrease in SHBG levels (Harman et al 2001).
It’s worth emphasizing that these supplements are totally legit. They’re NOT steroids. Meaning, only the natural and harmless ingredients have been used to make these products, which can help the guys dealing with the low testosterone problems, such as low energy, fatigue, muscle loss, irritability, and similar. Usually, the guys tend to start experience these problems in their late 20s and in some cases in their early 30s.

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.
If your levels are indeed low, there are a number of synthetic and bioidentical testosterone products on the market, as well as DHEA, which is the most abundant androgen precursor prohormone in the human body, meaning that it is the largest raw material your body uses to produce other vital hormones, including testosterone in men and estrogen in women.
This product is to be taken once daily on an empty stomach. Is there a particular time frame when food can be eaten? If I were to take this in the morning right when I wake up and then eat breakfast an hour later, is that fine? Also, mostly the only time of day my stomach is usually empty is right before going to bed. If it is taken at this time, will this affect sleep at all?
“She” being the key word. I had to quit a female doc because even though my level was down to 200, she thought I just needed more vitamin D! When I tried that and came back a few weeks later and told her there was no change in how I felt she refused to order another blood test, and after that wouldn’t even see me. I would never trust a female doctor with testosterone replacement therapy, as they all seem to have the same shit attitude from what my friends have told me, they treat it like it’s not a real thing even though you better bow down and kiss their asses when it comes to breast cancer and menopause.
Studies of the effects on cognition of testosterone treatment in non-cognitively impaired eugonadal and hypogonadal ageing males have shown varying results, with some showing beneficial effects on spatial cognition (Janowsky et al 1994; Cherrier et al 2001), verbal memory (Cherrier et al 2001) and working memory (Janowsky et al 2000), and others showing no effects (Sih et al 1997; Kenny et al 2002). Other trials have examined the effects of testosterone treatment in older men with Alzheimer’s disease or cognitive decline. Results have been promising, with two studies showing beneficial effects of testosterone treatment on spatial and verbal memory (Cherrier et al 2005b) and cognitive assessments including visual-spatial memory (Tan and Pu 2003), and a recent randomized controlled trial comparing placebo versus testosterone versus testosterone and an aromatase inhibitor suggesting that testosterone treatment improves spatial memory directly and verbal memory after conversion to estrogen (Cherrier et al 2005a). Not all studies have shown positive results (Kenny et al 2004; Lu et al 2005), and variations could be due to the different measures of cognitive abilities that were used and the cognitive state of men at baseline. The data from clinical trials offers evidence that testosterone may be beneficial for certain elements of cognitive function in the aging male with or without cognitive decline. Larger studies are needed to confirm and clarify these effects.

The potential downside of this positive feedback loop, Coates argues, is that testosterone levels can eventually surge past optimal levels and have the opposite effect – leading to overconfidence and poor decision-making. When this happens to animals, Coates, observed, they “go out in the open, pick too many fights [and] patrol areas that are too large…Risk taking becomes risky behaviour.”
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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.
Using steroids eventually trains your body to realize that it doesn’t have to produce as much testosterone to reach its equilibrium, so to reach the same highs you’ll need to take more steroids, and when you stop taking them, your body will need to readjust — you’ll be living with low testosterone for a while (and you’ll need to see a doctor if your body doesn’t readjust on its own). Forcing your body to stay above your natural testosterone, even if you’re naturally low, can create this kind of dependency which ultimately decreases the amount of testosterone your body will produce on its own.

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]


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I am 51 male. I have had low T for a few years now. I was using Testim for a few years, but I hated the smell and mostly feared getting thus stuff on the kids. The reason I stopped with all that nasty gel is because my T levels weren’t improving. So, why bother using anything that is not working, so I stopped. Apparently I am one of those men who do not absorb the gel very well. My T levels dropped from a low of around 200 on a 800+ scale to under 100 after I stopped using the gel.
Hypogonadism is highly prevalent amongst men with diabetes mellitus type 2 or symptoms of the metabolic syndrome, including insulin resistance, impaired glucose regulation, obesity, and hypertension.1,6,13,14,17,18 Low testosterone in many men with diabetes remains undiagnosed and untreated, and current guidelines recommend measurement of testosterone levels in such patients and, equally, that such chronic diseases should be investigated and treated in men with hypogonadism.1,6 It is not yet fully known whether diabetes is a cause or a consequence of low testosterone, and the full effects of testosterone administration on glycemic control in hypogonadal men with diabetes are unclear. However, there are indications that treating hypogonadism may have benefits on metabolic status in men with diabetes, and there is evidence that testosterone replacement therapy has a beneficial effect on risk factors for diabetes such as central obesity, insulin sensitivity, glucose control and blood lipid profiles in hypogonadal men with type 2 diabetes.14,19,20

When testosterone and endorphins in ejaculated semen meet the cervical wall after sexual intercourse, females receive a spike in testosterone, endorphin, and oxytocin levels, and males after orgasm during copulation experience an increase in endorphins and a marked increase in oxytocin levels. This adds to the hospitable physiological environment in the female internal reproductive tract for conceiving, and later for nurturing the conceptus in the pre-embryonic stages, and stimulates feelings of love, desire, and paternal care in the male (this is the only time male oxytocin levels rival a female's).[citation needed]


Benefits: Tongkat Ali works by stimulating the pituitary glands and hypothalamus glands to produce natural testosterone past it’s peak. It also blocks excessive cortisol production. Cortisol turns excessive testosterone into estrogen. Ingredients in the Tongkat ali allows the body to produce testosterone at a steady rate to increase free testosterone while lowering cortisol.
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.
There is a large body of evidence linking the onset and/or progression of cardiovascular disease to low testosterone levels in men. It is now apparent that an increased cardiovascular risk and accelerated development of atherosclerosis occurs not only in elderly men or men with obesity or type 2 diabetes mellitus, but also in non-obese men with hypogonadism.14 Current best evidence from systematic review of randomized controlled trials suggests that testosterone use in hypogonadal men is relatively safe in terms of cardiovascular health and do not produce unfavorable elevations in blood pressure or glycemic control, and does not adversely effect lipid profiles.4,15 

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.]
Before a boy is even born, testosterone is working to form male genitals. During puberty, testosterone is responsible for the development of male attributes like a deeper voice, beard, and body hair. It also promotes muscle mass and sex drive. Testosterone production surges during adolescence and peaks in the late teens or early 20s. After age 30, it’s natural for testosterone levels to drop by about one percent each year.
February 22, 2018 - Since our last review, the manufacturers of two of our top picks have gone out of business, and some new testosterone boosters have entered the arena. We’ve updated this review to evaluate the current field of testosterone supplements, as well as beef up analysis on what kind of results you can expect from t-boosters. Our only current top pick, Beast Sports Nutrition, is a new player in the industry that contains all four of the ingredients with studies showing a positive effect on testosterone.
A study out of the University of Mary Hardin-Baylor in Belton, Texas, examined the effects of fenugreek supplementation on strength and body composition in resistance-trained men. Researchers found that while both the placebo and fenugreek groups significantly increased their strength during the first four weeks, only the fenugreek group saw significant increases in strength after eight weeks of training and supplementation.[5]
One study showed that six months of zinc supplementation among slightly zinc-deficient elderly men doubled serum levels of testosterone. And another eight-week trial found that college football players who took a nightly zinc supplement showed increased T-levels and increased leg strength that was 250 percent greater than a placebo! Holy quads, Batman! Research has also shown deficiencies in zinc to be a risk factor for infertility caused by low testosterone levels.
Cross-sectional studies have found a positive association between serum testosterone and some measures of cognitive ability in men (Barrett-Connor, Goodman-Gruen et al 1999; Yaffe et al 2002). Longitudinal studies have found that free testosterone levels correlate positively with future cognitive abilities and reduced rate of cognitive decline (Moffat et al 2002) and that, compared with controls, testosterone levels are reduced in men with Alzheimer’s disease at least 10 years prior to diagnosis (Moffat et al 2004). Studies of the effects of induced androgen deficiency in patients with prostate cancer have shown that profoundly lowering testosterone leads to worsening cognitive functions (Almeida et al 2004; Salminen et al 2004) and increased levels of serum amyloid (Gandy et al 2001; Almeida et al 2004), which is central to the pathogenesis of Alzheimer’s disease (Parihar and Hemnani 2004). Furthermore, testosterone reduces amyloid-induced hippocampal neurotoxity in vitro (Pike 2001) as well as exhibiting other neuroprotective effects (Pouliot et al 1996). The epidemiological and experimental data propose a potential role of testosterone in protecting cognitive function and preventing Alzheimer’s disease.
Testosterone increases dominance and the desire for power. The link between testosterone and dominance has been demonstrated in numerous studies. T motivates men to gain and maintain social status. The desire for dominance can be a bad thing if it leads to criminal behavior, but it’s also what fuels the climb for success, motivates men to resist oppression and buck authority, and may even help you with the ladies…
At the present time, it is suggested that androgen replacement should take the form of natural testosterone. Some of the effects of testosterone are mediated after conversion to estrogen or dihydrotestosterone by the enzymes aromatase and 5a-reductase enzymes respectively. Other effects occur independently of the traditional action of testosterone via the classical androgen receptor- for example, its action as a vasodilator via a cell membrane action as described previously. It is therefore important that the androgen used to treat hypogonadism is amenable to the action of these metabolizing enzymes and can also mediate the non-androgen receptor actions of testosterone. Use of natural testosterone ensures this and reduces the chance of non-testosterone mediated adverse effects. There are now a number of testosterone preparations which can meet these recommendations and the main factor in deciding between them is patient choice.
In contrast to steroids, testosterone boosters have a fully different mechanism of action. They are the products which contain the natural ingredients only. These ingredients act by stimulating the man’s body to synthesize own testosterone. So, testosterone levels grow naturally without negative health effects associated with the intake of steroids.
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