First, it’s important to note that these tactics and practices to boost testosterone naturally probably won’t work with men who have hypoandrogenism. If the glands and cells responsible for producing testosterone are damaged or defective, no amount of eggs or sleep will help you raise testosterone levels. You’ll likely need to use testosterone replacement therapy to get your T levels to a healthy place.
My biggest symptom was fatigue. Interestingly, I had and have no problem with erections at all. Granted, I wasn’t getting spontaneous erections like when I was a teenager and into my late 20’s, but that was a good thing as getting an erection whenever and having no way to relieve it can get annoying. Anyway, my biggest concern with low T was/is energy levels and loss of muscle mass.
I am a 67 yo male diagnosed with prostate cancer gleason 6. I have a prescription on bicalutamide 50 mg a day since Nov 2016 and leuprolide 11,5 mg every 3 months. My testicles reduced their size to half it´s original size, my libido is almost zero. I went through a radiotherapy of 45 sessions; my PSA level went from 11.2 to 0.13 on my last test from Sept 2017 and the leuprolide injections are taken away from my prescription by my urologist. I am planning to take TRT with Testosterone mix called SUSTANON 250 mg per week and HCG 5000 IUs twice a month. Give me your thoughts please
Bottom line: testosterone boosters aren’t right for a lot of people. We dive deep into ingredient research below, but typically, testosterone boosters contain at least one (and often three or more) different ingredients that each impact your circulatory system — both the heart and blood. If you’re taking any kind of blood-thinner medication, or you have a history of heart disease, these supplements can get really dangerous, really quickly. The simple fact of the matter is that hormones are tricky things to mess with, and a doctor should be your first port of call to help you safely achieve your goals — whether they’re related to fitness, weight, or libido.
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.
DHEA (dehydroepiandrosterone) extract - this is a chemical that used in your body which a ‘hormone precursor’. This means it’s the chemical used by the body to create hormones like oestrogen or testosterone. When taken as supplement it is believed to boost testosterone levels, but DHEA has not been shown to increase testosterone in men. DHEA comes in two form:
If you do take DAA I recommend cycling it (i.e. 5 days on, 2 off, over 4 weeks then 4 weeks off). And taking it with an aromatase inhibitor (which ensures the aspartic acid doesn’t get converted to estrogen). Especially as more studies are coming out showing the increase in testosterone is limited to a week or two before it drops back to normal levels.
Testosterone plays a role in certain behaviors, including aggression and dominance. It also helps to spark competitiveness and boost self-esteem. Just as sexual activity can affect testosterone levels, taking part in competitive activities can cause a man’s testosterone levels to rise or fall. Low testosterone may result in a loss of confidence and lack of motivation. It can also lower a man’s ability to concentrate or cause feelings of sadness. Low testosterone can cause sleep disturbances and lack of energy.

"I'm 53 years old and my passion is surfing the oceans worldwide – big waves. Since taking Andro400, I'm now down to my ideal weight – from 185 to 175 now which is probably a net 15 pound loss, taking into account that the increased muscle I have now is heavier than the fat it replaced. My energy level is up. I feel strong and more physically fit in general. Also, from surfing I have been injured many times – for example I've broken my neck and pelvis among other things. Taking Andro400, I have much less pain overall – and I've been able to take less pain medication and anti-inflammatory drugs.”
Both testosterone and 5α-DHT are metabolized mainly in the liver.[1][155] Approximately 50% of testosterone is metabolized via conjugation into testosterone glucuronide and to a lesser extent testosterone sulfate by glucuronosyltransferases and sulfotransferases, respectively.[1] An additional 40% of testosterone is metabolized in equal proportions into the 17-ketosteroids androsterone and etiocholanolone via the combined actions of 5α- and 5β-reductases, 3α-hydroxysteroid dehydrogenase, and 17β-HSD, in that order.[1][155][156] Androsterone and etiocholanolone are then glucuronidated and to a lesser extent sulfated similarly to testosterone.[1][155] The conjugates of testosterone and its hepatic metabolites are released from the liver into circulation and excreted in the urine and bile.[1][155][156] Only a small fraction (2%) of testosterone is excreted unchanged in the urine.[155]
A: Androderm comes in the form of a transdermal patch and is used for testosterone replacement therapy in patients who have insufficient levels of testosterone. Testosterone is a hormone produced in the body that plays a key role in many physiological processes in men. In some men, however, the body does not produce enough of the hormone, resulting in a variety of symptoms including decreased libido, erectile dysfunction, muscle loss, anemia and depression, among others. Androderm helps treat these symptoms and raise low testosterone levels by delivering therapeutic amounts of the hormone, which are absorbed through the skin. According to the prescribing information for Androderm, depression was a reported side effect of the medication. Other common side effects of Androderm include itching and redness at the application site, prostate abnormalities, headache, and burning or hardening of the skin at the application site. Less common side effects of Androderm include reduced libido (sex drive), fatigue, high blood pressure, anxiety, confusion, increased appetite, and body pain. For more specific information, consult with your doctor for guidance based on your health status and current medications, particularly before taking any action. Your physician can determine if your dosage of the medication needs to be adjusted or if an alternative medication should be considered. Lori Poulin, PharmD
Test1fy comes in with one of the most unique formulas containing ingredients that not only support testosterone increases and lean mass gains, but also help in increasing hunger making it the perfect addition to anyone’s natural bulking stack. It is overall a well rounded and potent formula making it perfect for anyone, from newbie to the seasoned veteran.

BCAA peptides are the building blocks of muscle.  Your body cannot make BCAA’s.  You have to eat them.  One easy way of course is food and things like whey protein powder.  That is why whey protein works so well because it contains BCAA’s at high levels.  Advanced BCAA is 50% BCAA in peptide form!!  Peptides are digested faster and more efficiently than whole foods and normal protein powders.  This means more muscle building and recovery support!!

If you're a man who's experiencing symptoms such as decreased sex drive, erectile dysfunction, depressed mood, and difficulties with concentration and memory, and you think low testosterone may be to blame, you can have your levels tested. Since testosterone levels fluctuate throughout the day, you'll probably need more than a blood test to get a true picture of your levels.
In order to discuss the biochemical diagnosis of hypogonadism it is necessary to outline the usual carriage of testosterone in the blood. Total serum testosterone consists of free testosterone (2%–3%), testosterone bound to sex hormone binding globulin (SHBG) (45%) and testosterone bound to other proteins (mainly albumin −50%) (Dunn et al 1981). Testosterone binds only loosely to albumin and so this testosterone as well as free testosterone is available to tissues and is termed bioavailable testosterone. Testosterone bound to SHBG is tightly bound and is biologically inactive. Bioavailable and free testosterone are known to correlate better than total testosterone with clinical sequelae of androgenization such as bone mineral density and muscle strength (Khosla et al 1998; Roy et al 2002). There is diurnal variation in serum testosterone levels with peak levels seen in the morning following sleep, which can be maintained into the seventh decade (Diver et al 2003). Samples should always be taken in the morning before 11 am to allow for standardization.
We also have epidemiologic studies, like the Physicians’ Health Study, the Baltimore Longitudinal Study of Aging, and the Massachusetts Male Aging Study, that include tens of thousands of men who are followed for 5, 10, 15, or even 20 years. At the end of the study period, the researchers see who developed prostate cancer and who didn’t. They can then look at blood samples taken at the start of the study to see if, for example, the group that got prostate cancer had a higher level of testosterone over all. About 500,000 men have been entered in some 20 trials of this type around the world. Not one of those studies has shown a definitive correlation between prostate cancer and total testosterone. Three or four have shown weak associations, but none of those have been confirmed in subsequent studies.
Before assessing the evidence of testosterone’s action in the aging male it is important to note certain methodological considerations which are common to the interpretation of any clinical trial of testosterone replacement. Many interventional trials of the effects of testosterone on human health and disease have been conducted. There is considerable heterogenicity in terms of study design and these differences have a potential to significantly affect the results seen in various studies. Gonadal status at baseline and the testosterone level produced by testosterone treatment in the study are of particular importance because the effects of altering testosterone from subphysiological to physiological levels may be different from those of altering physiological levels to supraphysiological. Another important factor is the length of treatment. Randomised controlled trials of testosterone have ranged from one to thirty-six months in duration (Isidori et al 2005) although some uncontrolled studies have lasted up to 42 months. Many effects of testosterone are thought to fully develop in the first few months of treatment but effects on bone, for example, have been shown to continue over two years or more (Snyder et al 2000; Wang, Cunningham et al 2004).
Testosterone booster products obtained from trusted sources and administered as per the recommendations of the manufacturer may still present some health risks. The present case provided weak evidence of causality between acute liver injury and a commercial testosterone booster. To guarantee an optimal outcome with no severe side effects, further research is warranted to confirm the present findings and determine whether the effects observed in this case report would be statistically significant in larger samples.
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.
^ Jump up to: a b Travison TG, Vesper HW, Orwoll E, Wu F, Kaufman JM, Wang Y, Lapauw B, Fiers T, Matsumoto AM, Bhasin S (April 2017). "Harmonized Reference Ranges for Circulating Testosterone Levels in Men of Four Cohort Studies in the United States and Europe". The Journal of Clinical Endocrinology and Metabolism. 102 (4): 1161–1173. doi:10.1210/jc.2016-2935. PMC 5460736. PMID 28324103.
When many people think of someone with a high level of testosterone, they may picture a man loaded with strength, sexual prowess, and machismo. But while high-T has been correlated with all those things, it’s also been correlated with aggression, sexual misconduct, and violence. One of testosterone’s most common uses—as a performance-enhancing steroid—illustrates both sides of the hormone. Injecting steroids can be a quick way for athletes to dramatically improve performance, but the side effects can also be extreme, and can include excessive body hair growth, sexual dysfunction, and the hard-to-corral anger known as “roid rage.”

The overweight men participated in one German study. The first group of the participants used a placebo for one year. The second group of the participants consumed vitamin D3. All the participants aspired to shed excessive weight. Those men who took this vitamin lost up to 6 kg of unwanted weight. Also, they got the additional bonus; that is, the increase in testosterone production by about 25%.4

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.
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.

Sleep apnea is another frequently listed contraindication to testosterone treatment. There have been a few reports of the development, or worsening, of sleep apnea during testosterone therapy (Matsumoto et al 1985) but sleep apnea is actually associated with lower serum testosterone levels (Luboshitzky et al 2002). The reduction in fat mass during treatment with testosterone could potentially be beneficial for sleep apnea, so many specialists will still consider patients for treatment with appropriate monitoring. It is wise to take a clinical history for sleep apnea during testosterone treatment in all men and perform sleep studies in those who develop symptoms.


There are no studies showing its effects on healthy males, but it has been shown to drastically improve testosterone in infertile males (ref 77). It's also packed full of minerals, so is a great superfood nevertheless. I use the Sunfoods brand. Make sure you buy from a quality brand, as there are a lot of poor shilajit products out there, also some have been shown to be high in heavy metals. 
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.
Testosterone is the main hormone associated with muscle mass, strength gains, and libido. But that's far from the only thing it does in the body. As Chris Lockwood, Ph.D., explains in the article "All About Testosterone," it impacts everything from mood and memory to bone health—but yes, to be clear, it also makes muscles bigger and stronger, and helps increase endurance and athletic performance.

Use natural grooming products. Most grooming products these days contain parabens, another type of xenoestrogen. And by most, I mean more than 75% of all products. To reduce my exposure as much as possible, I became a hippy during my experiment and started using all natural, paraben-free grooming products. You can find most of these items at most health food stores:


Overall, few patients have a compelling contraindication to testosterone treatment. The majority of men with late onset hypogonadism can be safely treated with testosterone but all will require monitoring of prostate parameters HDL cholesterol, hematocrit and psychological state. It is also wise to monitor symptoms of sleep apnea. Other specific concerns may be raised by the mode of delivery such as local side effects from transdermal testosterone.
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.
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.]

Disclaimer. We do not claim that we have got the approval from Food and Drug Administration when offering our products and services on this website. We do not try to position the testosterone booster supplements the information on which we give on this website as the professional treatment alternative. Also, we do not appeal to the users to practice self-treatment by using the content here. We only publish the content that the authors provide to us. Therefore, these articles may not express our opinion, only the opinion of the article writers. In addition, take into consideration that the content writers are not the healthcare practitioners. Hence, it follows that the writers’ opinions should not be perceived as medical advice. We emphasize that the diet pills intake should be a decision taken based on the recommendations of the real healthcare practitioner since only the doctor can make a diagnosis and prescribe any treatment. We cooperate with the affiliated websites which can publish their content on this website for advertising purposes. Consequently, we do not have any bearing upon trademarks, service marks, logos, and brand names that come from the affiliated websites. Moreover, the content provided by the advertising partners is subject to amendments and deletion at the content owners’ own discretion.
While steroids like DHEA can be used to boost testosterone, if used in the wrong dosages or by people who don’t need them they can raise T-levels far beyond the normal range, which is what causes accelerated muscle gain. According to Dr. Emil Hodzovic, who is a competitive bodybuilder as well as a doctor with Medichecks, steroids come with “a set of risks, including liver damage, hormone imbalance, high blood pressure, and a higher risk of a stroke or heart attack”.
According to a study in the International Journal of Reproductive BioMedicine, D-Aspartic acid increases testosterone levels in some animals. However, studies that have looked at its effects on humans are inconclusive and mainly of poor quality. The paper says there is an urgent need for more research on this chemical, which occurs naturally in some human tissues.
What is your opinion of using depo-testosterone injections on women? I am 44 and have had a complete hyserectomy. My OB/GYN was injecting the hormone when I complained of low libido. Unfortunately, the doctor was asked to leave the practice and his replacement refuses to use the injections on me. Any thoughts or suggestions would be greatly appreciated.

While steroids like DHEA can be used to boost testosterone, if used in the wrong dosages or by people who don’t need them they can raise T-levels far beyond the normal range, which is what causes accelerated muscle gain. According to Dr. Emil Hodzovic, who is a competitive bodybuilder as well as a doctor with Medichecks, steroids come with “a set of risks, including liver damage, hormone imbalance, high blood pressure, and a higher risk of a stroke or heart attack”.
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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.

Ginger is also often found in joint support supplements. There is little well-designed research, however, ginger was reported to have some effectiveness for relieving joint pain of osteoarthritis (OA) and rheumatoid arthritis probably due to its anti-inflammatory [17,18,21] and anti-oxidant activity [17,18]. In a meta-analysis of five trials (593 patients) ginger was found to be modestly efficacious and reasonably safe for treatment of OA and was able to reduce pain and disability [32].


There are positive correlations between positive orgasm experience in women and testosterone levels where relaxation was a key perception of the experience. There is no correlation between testosterone and men's perceptions of their orgasm experience, and also no correlation between higher testosterone levels and greater sexual assertiveness in either sex.[34]
A4M, which stands for “The American Academy of Anti-Aging Medicine” is dedicated to the advancement of tools, technology, and transformations in healthcare that can detect, treat, and prevent diseases associated with aging. They promote the research of practices and protocols that have the potential to optimize the human aging process. The organization is also dedicated to educating healthcare professionals and practitioners, scientists, and members of the public on biomedical sciences, breakthrough technologies, and medical protocols through our advanced education entity: Metabolic Medical Institute (MMI). Their event in Vegas each year is, in my opinion, well worth checking out.
In accordance with sperm competition theory, testosterone levels are shown to increase as a response to previously neutral stimuli when conditioned to become sexual in male rats.[40] This reaction engages penile reflexes (such as erection and ejaculation) that aid in sperm competition when more than one male is present in mating encounters, allowing for more production of successful sperm and a higher chance of reproduction.
How to Get Rid of Loose Skin After Weight Loss The Ultimate Shoulder Workout: The Best Shoulder Exercises for Big Delts The Ultimate Arms Workout: The Best Arm Exercises for Big Guns The Best Chest Workouts for Building Awesome Pecs (According to Science) How to Build Muscle and Lose Fat…at the Same Time The Ultimate Back Workout: The Best Back Exercises for a Thick, Wide Back

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I have used Androgel for 7 years with Testosterone levels between 650 and 900. PSA remained just under 3.0. 2 pumps per day. A year ago I increased my pumps to 4 per day and within a few months my Testosterone was 1,100 BUT my PSA shot up to 5.2. Last April, I totally stopped Androgel and within 2 months my Testosterone was under 20 (really) and PSA was virtually zero. Libido also fell from “strong” to “zero”. After 5 months of no Androgel, I resumed it in September at 2 pumps per day and now my Testosterone has improved to almost 600 and my PSA is just under 3.0. Am having my 3 month check-up with my Urologist tomorrow.
Magnesium comes with a strict upper cap. Excess magnesium is hard on your kidneys, and can lead to kidney failure. The NIH recommends that men consume 400-420 mg of magnesium daily, but that they should not exceed 350 mg of supplemental magnesium per day. Because while it’s rare for people to chronically overdose on magnesium through diet (you’d have to eat a lot of almonds and spinach, for example), overdose by supplement is far more common.
If you're looking for a miracle pill, this one is NOT one either. But if you're looking for a supplement that works as good as any out there in the market for an unbelievable price, please buy this product. It works after a short period of consistently taking the product and the results are noticeable in the gym as well as on your person. Whether you buy this as a training supplement or a male vitality enhancer, you won't be disappointed.
Androgens may modulate the physiology of vaginal tissue and contribute to female genital sexual arousal.[48] Women's level of testosterone is higher when measured pre-intercourse vs pre-cuddling, as well as post-intercourse vs post-cuddling.[49] There is a time lag effect when testosterone is administered, on genital arousal in women. In addition, a continuous increase in vaginal sexual arousal may result in higher genital sensations and sexual appetitive behaviors.[50]
I have been on both pills and gel.While the pills were much more convenient, the gel seems to work better for me. I feel more focused and clear of mind with gel therapy. I’ve also noticed more sexual interest (closer to levels when younger – now 65) and get ‘harder’ when I do get an erection. The therapy has been good for me emotionally and physically. I’ll stay on it until and if negative signs/symptoms arise.
Unlike women, who experience a rapid drop in hormone levels at menopause, men experience a more gradual decrease of testosterone levels over time. The older the man, the more likely he is to experience below-normal testosterone levels. Men with testosterone levels below 300 ng/dL may experience some degree of low T symptoms. Your doctor can conduct a blood test and recommend treatment if needed. They can discuss the potential benefits and risks of testosterone medication, as well.
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. 
Workouts lasting longer than about an hour may begin to spike cortisol levels and subsequently decrease testosterone. Additionally, research has demonstrated that a shorter rest period between sets (1 minute versus 3 minutes) elicited higher acute hormonal responses following a bout of resistance training.11 To maximize your testosterone response, keep your rest periods short and total workout time to 60 minutes or fewer.
MuscleTech Pro Series Alpha Test claims you’ll be able to see increases in free testosterone levels in as few as seven days. Its formula is supported by potent ingredients such as Fenugreek, Shilajit, and Boron Citrate. The formulation can also help increase lean muscle mass, strength, as well as overall performance and maintains a peak testosterone-to-cortisol ratio.
Based on my research, I guess fenugreek is kind of a crapshoot, a toss-up, a gamble, a coin toss, a roulette spin of sorts, you get the idea.  There are a lot of conflicting reports on whether it increases or decreases testosterone levels, but it seems like the libido-improvement is consistent.  The vast majority of men report positive effects from fenugreek so go ahead and give it a shot.
While I do have a pretty manly mustache, I’m not a doctor or a medical expert. I’m a guy with a law degree he’s never used who blogs about manliness. What I’m about to share shouldn’t be taken as a substitute for qualified medical expertise. It’s simply my experience and views on the subject. Before you make any changes in lifestyle or diet, talk to your doctor or healthcare provider. Be smart.
I am 50 yrs old. I tried to go the route my urologist provide of 50mgs of injectable test weekly. No man can live on that dose. For the past five years I have self administered injectable cyponate at the rate of 250 mgs to 750 mgs weekly. Non stop , no breaks. I have polycythemia from these injections. I give blood every 8 weeks to combat this. I have administered 10 X the recommended dose with no bad side effects. I get full blood work done yearly. Doctors are so scared they will get sued if something happens that they wont give you enough. Its a shame.
Ghlissi, Z., Atheymen, R., Boujbiha, M. A., Sahnoun, Z., Makni Ayedi, F., Zeghal, K., ... Hakim, A. (2013, December). Antioxidant and androgenic effects of dietary ginger on reproductive function of male diabetic rats [Abstract]. International Journal of Food Sciences and Nutrition, 64 (8), 974–978. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23862759
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.

While researchers in Brisbane, Australia, found that while Testofen (“a standardized [fenugreek] extract and mineral formulation”) significantly improved the sexual arousal, orgasm, and the general quality of life of participants, it did not remarkably increase testosterone above normal levels. Participants who took Testofen were more satisfied with their energy, well-being, and muscle strength than those who took the placebo.
When it comes to testosterone in the body, most of it is bound testosterone. This means it is testosterone that is bound to either the sex hormone globulin or the protein albumin. The problem is this bound up testosterone goes largely unused by the body and does nothing for you in its bound state. It is the free testosterone that is the testosterone you feel and that makes you manly, this is free flowing in your veins and not bound to anything. This is the kind of testosterone you want, the more the better.
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.
Epidemiological evidence supports a link between testosterone and glucose metabolism. Studies in non-diabetic men have found an inverse correlation of total or free testosterone with glucose and insulin levels (Simon et al 1992; Haffner et al 1994) and studies show lower testosterone levels in patients with the metabolic syndrome (Laaksonen et al 2003; Muller et al 2005; Kupelian et al 2006) or diabetes (Barrett-Connor 1992; Andersson et al 1994; Rhoden et al 2005). A study of patients with type 2 diabetes using measurement of serum free testosterone by the gold standard method of equilibrium dialysis, found a 33% prevalence of biochemical hypogonadism (Dhindsa et al 2004). The Barnsley study demonstrated a high prevalence of clinical and biochemical hypogonadism with 19% having total testosterone levels below 8 nmol/l and a further 25% between 8–12 nmol/l (Kapoor, Aldred et al 2007). There are also a number longitudinal studies linking low serum testosterone levels to the future development of the metabolic syndrome (Laaksonen et al 2004) or type 2 diabetes (Haffner et al 1996; Tibblin et al 1996; Stellato et al 2000; Oh et al 2002; Laaksonen et al 2004), indicating a possible role of hypogonadism in the pathogenesis of type 2 diabetes in men. Alternatively, it has been postulated that obesity may be the common link between low testosterone levels and insulin resistance, diabetes and cardiovascular disease (Phillips et al 2003; Kapoor et al 2005). With regard to this hypothesis, study findings vary as to whether the association of testosterone with diabetes occurs independently of obesity (Haffner et al 1996; Laaksonen et al 2003; Rhoden et al 2005).
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