An international consensus document was recently published and provides guidance on the diagnosis, treatment and monitoring of late-onset hypogonadism (LOH) in men. The diagnosis of LOH requires biochemical and clinical components. Controversy in defining the clinical syndrome continues due to the high prevalence of hypogonadal symptoms in the aging male population and the non-specific nature of these symptoms. Further controversy surrounds setting a lower limit of normal testosterone, the limitations of the commonly available total testosterone result in assessing some patients and the unavailability of reliable measures of bioavailable or free testosterone for general clinical use. As with any clinical intervention testosterone treatment should be judged on a balance of risk versus benefit. The traditional benefits of testosterone on sexual function, mood, strength and quality of life remain the primary goals of treatment but possible beneficial effects on other parameters such as bone density, obesity, insulin resistance and angina are emerging and will be reviewed. Potential concerns regarding the effects of testosterone on prostate disease, aggression and polycythaemia will also be addressed. The options available for treatment have increased in recent years with the availability of a number of testosterone preparations which can reliably produce physiological serum concentrations.
If you have low testosterone, your functional medicine or anti-aging physician will help you diagnose it. There are several different hormones your physician should measure, but the most important two are your free testosterone and estrogen levels, because converting too much testosterone to estrogen is a problem that’s different from not making enough testosterone in the first place. In my case, I wasn’t making very much testosterone, and what I was making my body converted to estrogen way too effectively.
The evidence shows that testosterone treatment does not change the strength or rate of urine flow, does not change the ability to empty the bladder, and does not change other symptoms such as frequency or urgency of urination, as assessed by the American Urological Association Symptom Score or the International Prostate Symptom Score. I’ve had a couple of patients over the years who had some worsening of urinary symptoms with testosterone, but that’s rare, even with long-term use.
Estrogen is important in men, but too high of a level has all sorts of negative consequences – ranging from heart attacks to prostate cancer (32 & 33). The balance between testosterone and estrogen (or estradiol) is critical for a man. If the ratio is out and estrogen starts to dominate you run into all sorts of issues – such as breast cell growth, prostate enlargement and of course lower testosterone.
I am 41 and took test for my depression/ansiety, fatigue and ED problem due to the stress I am exposed to in my work.. Now I stopped and I accumulate a lot of fat, ansiety came back and I started to drink alcohol to cool things down, but as U know, its not helping. My question is.. Do you have to stop taking testosterone eventually or can you keep taking it as a supplement in a regular basis along the rest of your live? Cheers from Panama, Central America.
A: Testosterone production declines naturally with age. Low testosterone, or testosterone deficiency (TD), may result from disease or damage to the hypothalamus, pituitary gland, or testicles that inhibits hormone secretion and testosterone production. Treatment involves hormone replacement therapy. The method of delivery is determined by age and duration of deficiency. Oral testosterone, Testred (methyltestosterone), is associated with liver toxicity and liver tumors and so is prescribed sparingly. Transdermal delivery with a testosterone patch is becoming the most common method of treatment for testosterone deficiency in adults. A patch is worn, either on the scrotum or elsewhere on the body, and testosterone is released through the skin at controlled intervals. Patches are typically worn for 12 or 24 hours and can be worn during exercise, bathing, and strenuous activity. Two transdermal patches that are available are Androderm (nonscrotal) and Testoderm (scrotal). The Androderm patch is applied to the abdomen, lower back, thigh, or upper arm and should be applied at the same time every evening between 8 p.m. and midnight. If the patch falls off before noon, replace it with a fresh patch until it is time to reapply a new patch that evening. If the patch falls off after noon, do not replace it until you reapply a new patch that evening. The most common side effects associated with transdermal patch therapy include itching, discomfort, and irritation at the site of application. Some men may experience fluid retention, acne, and temporary abnormal breast development (gynecosmastia). AndroGel and Testim are transdermal gels that are applied once daily to the clean dry skin of the upper arms or abdomen. When used properly, these gels deliver testosterone for 24 hours. The gel must be allowed to dry on the skin before dressing and must be applied at least 6 hours before showering or swimming. Gels cannot be applied to the genitals. AndroGel is available in a metered-dose pump, which allows physicians to adjust the dosage of the medication. Side effects of transdermal gels include adverse reactions at the site of application, acne, headache, and hair loss (alopecia). For more specific information on treatments for low testosterone, consult with your doctor or pharmacist for guidance based on current health condition. Kimberly Hotz, PharmD
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!

In this study, an ethical approval No. 20171008 was obtained from Ethical Committee of Qassim province, Ministry of Health, Saudi Arabia. At the beginning, a written informed consent was taken from a 30-year-old man for participation in this study. The patient came to the King Saud Hospital, Unaizah, Qassim, Saudi Arabia, with abdominal pain. He looked pale and hazy, hence, immediately admitted. A battery of lab tests was ordered by the attending physician. Moreover, abdominal ultrasound imaging was performed. The results of the tests showed high levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), indicating liver injury. Other serum parameters, such as total proteins, albumin, and iron, in addition to the levels of kidney and heart enzymes were all found to be in the normal range. A complete blood count showed normal levels of red blood cells, white blood cells, and platelets. The ultrasound images of the man’s abdomen were all found to be normal as well [Figure 2]. The patient, a sportsman, described that he was taking a testosterone commercial booster product called the Universal Nutrition Animal Stak for the purpose of enhancing his testosterone profile to achieve a better performance and body composition. The attending physician decided to admit the man for 1 week. Some medications were prescribed, and the patient was discharged later after having fully recovered.
I’m a low key,thinker-type, after a test I learned my T hormone was so low I should be rigid. TRT sent my drive into negative overdrive: ambition, cunning, entrepreneurial risk, physcal and psychological risks: drugs,you name it. I was lucky it happened after 50 years of memories ’cause I missd and have problems recalling the last seven years that I was on TRT (5 pumps a day of 1.25mgs). If you’re starting, take a pictoral record at the least of your monthly life ( a flick a month).
However, studies have found that social success among men is actually linked with high testosterone levels. For example, teenage boys who were perceived as socially adept and dominant had higher levels of testosterone than boys that were low on the totem pole. What’s even more interesting is that this same study found that teenage boys who had a history of being anti-social and displaying high physical aggression were found to have lower testosterone levels at age 13 compared with boys with no history of high physical aggression.
Now that we know chronic insulin spikes lead to lower Testosterone production, I hope I haven’t sent you running into the low carb camp! There are a few studies out there showing that long term low carb or ketogenic dieting leads to higher cortisol levels (especially with subjects who are training), and decreased testosterone levels (28 & 29). I have used low carb diets in the past with successful results (winning a national bodybuilding title), however the key is to use cyclical carb re-feeds. If you’re going to go on a low carb diet for whatever reason, be sure to work in a large carb reefed once a week.
AC, I just ran across the thread… definitely start the injections. Should help with levels that low. I’m 36 and have battled low T for 6-7 years. My labs came back to show 90ng/dl when I just turned 30, and I’ve done Testosterone cypionate injections @ 100mg/mL weekly, Testim, Androgel, and Fortesta over the years. I’m actually going to my endocrinologist tomorrow to have new blood work done.

A testosterone booster is a natural supplement used by people (mostly men) to boost their testosterone levels. They work in a few different ways. First, they often impact the hormones related to testosterone and cause more of the hormones to circulate in the blood. They also can block estrogen production, which is commonly called a female sex hormone.
Hi i was jus wondering what supplements should i take now im really impressed with testo fuel comments right now i m talking fish oil , whole food multi ,nutrafol for hair it is basically a dht blocker becoz i m having male pattern baldness which is in half way getting better now with prp and Nutrafol both natural after an intensive research. Is it ok to take testosterone booster when u are on dht blocker supplements anyways im 40yrs old male plz reply it will help me a lot i have bad energy levels,declining muscle mass joint pain weak bones plz help
The aim of treatment for hypogonadism is to normalize serum testosterone levels and abolish symptoms or pathological states that are due to low testosterone levels. The exact target testosterone level is a matter of debate, but current recommendations advocate levels in the mid-lower normal adult range (Nieschlag et al 2005). Truly physiological testosterone replacement would require replication of the diurnal rhythm of serum testosterone levels, but there is no current evidence that this is beneficial (Nieschlag et al 2005).
I am still on T therapy. But here’s what pisses me off: No one tells you that you will be hooked on the drug virtually forever! Don’t ever stop it abruptly! I did and I had a major crash: physically and emotionally. I went into the darkest depression ever…and I was lacking in energy so much that I had to have 4 naps a day…just to get through the day. I was also robbed of any initiative to do anything.
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.

Testosterone is responsible for increased muscle mass. Leaner body mass helps control weight and increases energy. For men with low testosterone, studies that treatment can decrease fat mass and increase muscle size and strength. Some men reported a change in lean body mass but no increase in strength. It’s likely you’ll see the most benefits when you combine testosterone therapy with strength training and exercise.


This post can absolutely change your life, and probably help you avoid some pitfalls. Like shrunken balls. (I am not an expert in the synthetic anabolic testosterone drugs used by bodybuilders — they carry lots of risks but pack a big punch if you want to get swole. Bulletproof is all about having massive clean energy, looking good, and living a very long time…so anabolic steroids aren’t on my roadmap.)


Testosterone may decrease your chances of Alzheimer’s Disease. Several studies have linked low testosterone levels to an increased risk of Alzheimer’s disease.  In a 2010 study by the University of Hong Kong, researchers studied 153 Chinese men who were recruited from social centers. They were at least 55 years and older, lived in the community, and didn’t have dementia. Of those men, 47 had mild cognitive impairment — or problems with clear thinking and memory loss.
“However, the parallels don’t necessarily follow logically, creating a real need to bring more evidence to this area so that physicians and patients would be able to make more  informed decisions based on the best possible evidence,” said Dr. Gill, a professor of medicine and the lead investigator at the Yale study site, the largest site participating in the TTrials, and coauthor of all 4 TTrials. 
There are studies that show Soy consumption in humans leads to lower sperm count, but unfortunately they did not look at testosterone levels in the study (40). This (41) particular study compared the estrogen production of men drinking soy protein to those drinking whey. After two weeks they found the estradiol levels were equal, however soy drinkers had LOWER Testosterone levels and HIGHER cortisol levels (both bad).
Actually he knows exactly what he is talking about. The fact your a doctor gives zero confidence that you have any knowledge in HRT, in fact I believe it where you wonderful doctors that started the larger opioid epedemic the world has ever seen. Make sure if your considering HRT you see a doctor that specializes in it, otherwise you very well could be getting terrible advice by a doctor with no knowledge of the subject as is the case here. Do your research on the doctor, and make sure you are getting a doctor that specializes in HRT. Don’t forget somebody had to finish at the bottom of the class in med school, and based on this doctors comments he probably was one of them. Doctors can be as dangerous as they are helpful; as we have seen quite clearly with the opioid epidemic being experienced in this country, as I mentioned above. This epidemic was caused 100% by doctors in this country. I own several HRT clinics and employ some of the top doctors in the HRT field. Our doctors put our patients health above all else especially above the all mighty dollar. I assure you the comment by this Dr. claiming the post above makes absolutely no sense (I believe it makes no sense to him, because he has zero knowledge on the subject) is dead wrong, and the poster was pretty much right on point with what he said.
Hello I’m 22 years old and for years I’ve been struggling with hypothyroidism and depression. Recently I went to check my blood for low T and was shocked but not surprised at the level (125). That’s terrible for a 22 year old given that’s the time my testosterone is supposed to be the highest. Anyways I’ve been prescribed depo testosterone 200ml bottle. I give myself a shot each week and haven’t really noticed much change. I know I have to give it time, but is there anything else I can do or should be prescribed to help speed up the process?
I need an answer regarding getting testoroene after having your Prostate removed. I had my Prostate removed 3 months ago and my PSA levels are zero. I want to go back on testoroene because I felt great when I was on it before having my prostate taken out. I am 44 years old and I workout 4-5 days a week hard. I am in excellent shape and I didn’t have any symptoms of prostate cancer other then my PSA levels went up.

The doctor regularly measured my levels to be sure they were within the normal range for a male my age. In other words, I wasn’t taking ‘roids to get big; I was getting control of hormones that were not functioning well. This is how you should look at testosterone therapy – it is a gentle nudge to help you be in normal ranges, not a big push to get you huuu-yge. If you’re like me, you want “normal ranges” of a 27-year-old, not of a 60-year-old. It’s my plan to keep my testosterone where it is now (around 700) no matter what it takes. Right now, the Bulletproof Diet and the other biohacks I’ve written about do that! I’m 43.

Testosterone levels generally peak during adolescence and early adulthood. As you get older, your testosterone level gradually declines — typically about 1 percent a year after age 30 or 40. It is important to determine in older men if a low testosterone level is simply due to the decline of normal aging or if it is due to a disease (hypogonadism).

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