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
NHT works to reach a targeted level of hormones in your body, restoring your body’s natural ability to keep healthy and fit. Hormones are beneficial at any age, but most commonly we administer the therapy to people in their 40’s, when your body naturally begins to slow production of certain hormones. Supplementing these declining hormones can keep your body fit and active for much longer. Bio-identical hormones are made from plants and are identical to the hormones naturally produced by your own body. We never use synthetic hormones, which have been shown to increase your risk of heart disease and diabetes.
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.
I’ve had low testo in the winter for the last 10 years, with the lowest values around april (live in the north). But last year (in september) I started using vitamine D (10 000 IU) and K2 (180 mcg), combined with magnesium (200 mg malate) and zinc (25 mg malate and piccolinate) every night, and since then I no longer have low testo in the winter, and is feeling like I do in the summer and have normal testo levels. This combo may work for other people as well. And the risk for dangerous side effects is probabaly neglectable. But it takes a couple of weeks before it kicks in.
Aromatase inhibitors can boost testosterone on their own, but they can also complement other testosterone boosters. If you take a supplement that increases testosterone without inhibiting the aromatase enzyme (through hypothalamic stimulation, for instance), you may find yourself with more estradiol than you need, a situation that taking an aromatase inhibitor may remedy.
The maximum hormone concentration in the blood is reported immediately after the workout. And the effect lasts throughout the day. However, it’s important to ensure that your physical activity is moderate. The matter is that too much high-intensity exercise can give an undesirable result. But even if for any reason you can’t attend a gym, it’s not a problem. Just move as much as possible during the day. Even simple walking will be of great benefit.
Findings that improvements in serum glucose, serum insulin, insulin resistance or glycemic control, in men treated with testosterone are accompanied by reduced measures of central obesity, are in line with other studies showing a specific effect of testosterone in reducing central or visceral obesity (Rebuffe-Scrive et al 1991; Marin, Holmang et al 1992). Furthermore, studies that have shown neutral effects of testosterone on glucose metabolism have not measured (Corrales et al 2004), or shown neutral effects (Lee et al 2005) (Tripathy et al 1998; Bhasin et al 2005) on central obesity. Given the known association of visceral obesity with insulin resistance, it is possible that testosterone treatment of hypogonadal men acts to improve insulin resistance and diabetes through an effect in reducing central obesity. This effect can be explained by the action of testosterone in inhibiting lipoprotein lipase and thereby reducing triglyceride uptake into adipocytes (Sorva et al 1988), an action which seems to occur preferentially in visceral fat (Marin et al 1995; Marin et al 1996). Visceral fat is thought to be more responsive to hormonal changes due to a greater concentration of androgen receptors and increased vascularity compared with subcutaneous fat (Bjorntorp 1996). Further explanation of the links between hypogonadism and obesity is offered by the hypogonadal-obesity-adipocytokine cycle hypothesis (see Figure 1). In this model, increases in body fat lead to increases in aromatase levels, in addition to insulin resistance, adverse lipid profiles and increased leptin levels. Increased action of aromatase in metabolizing testosterone to estrogen, reduces testosterone levels which induces further accumulation of visceral fat. Higher leptin levels and possibly other factors, act at the pituitary to suppress gonadotrophin release and exacerbate hypogonadism (Cohen 1999; Kapoor et al 2005). Leptin has also been shown to reduce testosterone secretion from rodent testes in vitro (Tena-Sempere et al 1999). A full review of the relationship between testosterone, insulin resistance and diabetes can be found elsewhere (Kapoor et al 2005; Jones 2007).

Levels of testosterone naturally decrease with age, but exactly what level constitutes "low T," or hypogonadism, is controversial, Harvard Medical School said. Testosterone levels vary wildly, and can even differ depending on the time of day they're measured (levels tend to be lower in the evenings). The National Institutes of Health includes the following as possible symptoms of low testosterone:
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
Great product. I'm a 41 yearold and found myself with low energy constantly. Since taking these pills I'm more energized and don't get home from work and just sit around the house anymore. Bonus the wife has been loving the extra benefit that they are giving us. I never thought I had a problem in that area but since I started taking these I've noticed a way longer lasting performance time.

Don’t waste your time with the gel, the Injectable is far superior. Also most will be given 200 mg cypionate per week, you can actually go much higher and feel a lot better and if combined with good resistance training and cardio achieve a very good figure and low fat percentage . There was actually a study overseas that said men could benefit with TRT at 600mg per week, although you will never see that happen with American doctors .
I am generally dubious about supplement claims & have tried a few other Testosterone boosters which had no effect I could tell. Being desperate to find something to help me feel better, I ordered Dr Martin's T Booster. It arrived on May 14th and after the first day I felt better & noticeably had more energy. I don't have that tired dead feeling every morning now when trying to get out of bed. I am able to do some work & physical activities without being exhausted to the point of being sick. I have been taking Dr Martin's T-Booster for 8 days now. While I am not out running marathons yet, I am feeling much better & hope to continue getting better as I keep taking it
Lose some weight – It goes without saying that being overweight is unhealthy for more than one reason. As your weight increases, your testosterone levels decrease inevitably. The good news is that as soon as you start losing weight, you can reverse this process and your testosterone levels will begin rising again. Could you think of a better reason to exercise regularly?

Sportsmen are permitted to use the boosters to trigger the mechanism of testosterone synthesis in the body. These products won a wide popularity among the sportsmen. The matter is that the supplements work by substantially enhancing sports performance, reviving strength, boosting endurance, coping with excessive stress levels, and decreasing time necessary for recovery after exhausting exercises.


Exercise boosts testosterone in two important ways. First, specific types of exercise actually cause our body to produce more testosterone. We’ll talk more about those in a bit. Second, exercise helps to increase muscle mass and decrease body fat. As we’ve discussed previously, adipose tissue converts testosterone into estrogen. The less fat we get, the more T we have.
When I told people that I was doing an experiment to increase my testosterone, the question that people would invariably ask in hushed tones was, “So, did it, you know, improve your sex life?” Honestly, I didn’t see too much change. I had a robust and healthy sex life before the experiment and continued to do so afterwards. I guess I was a bit more randier than usual, but not much. I’d imagine if you had been suffering from low T for a long time and took steps to increase it, you’d likely see improvement in the bedroom department.
If low T is your initial concern, lifestyle changes may help. “Dietary and exercise changes, particularly limiting sugars, especially fructose, eating healthy saturated fats, and engaging in high-intensity exercises may relieve symptoms of low testosterone," Lucille says. "Strength training, reducing stress, and optimizing vitamin D levels can also be very effective at boosting testosterone levels naturally."
First is quality, Advanced BCAA’s are made from whey protein isolate. Typical free form amino acids are made from human hair and other not so favorable sources. In addition many free form amino acids are made in China. Secondly is the “form” the amino acids are in. Advanced BCAA’s are in peptide form. Meaning they are in di and trip peptide form. The body ABSORBS amino acids in di and trip peptide form, through the intestinal wall and into the blood stream. It is still not known whether free form amino acids are absorbed by the body. Keep in mind that free form amino acids supplements have been around since the 80’s. They have never been proved to help muscle recovery and grow. Di and tri peptides have been proven to be beneficial for muscle recovery.
Ginger (also known as Zingiber officinale, family: Zingiberaceae) has been widely consumed as a dietary spice, delicacy, and as a traditional oriental medicine. The rhizome can be used fresh, dried or powdered. Ginger is often applied for treating nausea due to caused by morning sickness during pregnancy, chemotherapy and seasickness. The ginger rhizome also contains several biologically active compounds such as gingerol, shogaols, gingerdiol and gingerdione [22].

I was born with a rare genetic disorder called Klinefelter’s syndrome. My parents actually were known about my condition prior to birth. I’m 25 years old and have been on TRT since 8th grade. It’s a permanent part of life and essential to ultimate happiness, motivation, and the pursuit of bigger and better things. I currently face problems at this time in life due to the endocrinologists. It seems when I bring a problem or question to them, they don’t take charge and figure it out. There all pushed off to the side and left for no one; so now I’ve gotten rid of them and I’m in pursuit of a doctor who will improve the quality of my life. Also with my last doctor I was able to retrieve enough testosterone to perform my out ethical experiment with Testosterone. I injected myself every 5 days for a period of 3 months at the dosage of .75ml. The outcome was amazing. My mind, body, and spirit were one. The energy was phenomenal and in demand. I was able to pursue my endeavors with the energy provided, I was able to think about running and exercising and then put that thought into action. I took extensive notes in the form of a journal to create the ultimate needed dosage for myself. The only reason it ended in three months, was due to no more medicine. It had to be done. Now I’m off to find a doctor to work with me.
I’ve also got a thyroid nodule (benign), and should have it burned out very soon. So I’ve been battling a little more than low T for several years to say the least… a lot of the symptoms of low T can overlap with hyper and/or hypothyroidism… I highly recommend having your TSH, T4 and T3 levels checked along with your Testosterone for anyone experiencing symptoms.
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.
“About 2 weeks after starting Andro400, I noticed my belly fat disappearing. Now, after only one month, I've lost about ten pounds all in my mid section. What a miracle! I have more energy and don't have to hold my gut in any longer. I'm more relaxed and my libido has increased 5 fold! I'm 58 years old and beginning to feel like a teenager again! Your product has delivered exactly as advertised. I'm elated!”
Testosterone replacement therapy can successfully treat erectile dysfunction and loss of libido in men with low testosterone from either advancing age or hypogonadism. Although the effects of increased testosterone are more dramatic in hypogonadal men there are also benefits to the libido of men with normal gonadal, also called eugonadal, function. In a 2004 study published in the "Journal of Endocrinology and Metabolism," researchers found that increasing peak testosterone levels to between 400 and 500 percent above baseline in subjects resulted in a significant increase in sexual arousability over placebo subjects.
In 2002, the federally sponsored Women’s Health Initiative (WHI) stopped its hormone replacement therapy (HRT) trial (estrogen plus progestin), which included more than 16,000 women, three years early because those taking the pills had an increased risk of developing breast cancer and blood clots, and an increased risk of suffering a stroke or heart attack than those taking a placebo. The findings ran counter to the long-held belief that HRT could preserve health — and trim heart-disease risk in women.
Testosterone is a hormone that is produced primarily in the testicles for men and the ovaries and adrenal glands for women. This hormone is essential to the development of male growth and masculine characteristics. For women, testosterone comes in much smaller amounts. Testosterone production increases about 30 times more during adolescence and early adulthood. After early adulthood, it’s natural for levels to drop slightly each year. Your body may see a one percent decline after you’re 30 years old.
Another recent development is the production of adhesive tablets which are applied twice daily to the buccal mucosa on the gum above the incisor teeth. The tablets gradually release testosterone into the systemic venous circulation and steady state physiological concentrations are achieved in most patients within two days (Ross et al 2004). Some patients do not like the feeling of the tablet in the mouth or find that there is an abnormal taste in the mouth, but local adverse effects are usually mild and transient (Wang, Swerdloff et al 2004).
If you have low testosterone and are prescribed testosterone therapy by your doctor, it does not increase your risk for getting prostate cancer. However, in some patients with existing prostate cancer, adding testosterone hormone therapy can make the cancer grow faster. Men with low testosterone levels are actually more likely to get prostate cancer than men with normal prostate levels. You need to discuss these details with your physician and make the best decision for you.
It could be said that testosterone is what makes men, men. It gives them their characteristic deep voices, large muscles, and facial and body hair, distinguishing them from women. It stimulates the growth of the genitals at puberty, plays a role in sperm production, fuels libido, and contributes to normal erections. It also fosters the production of red blood cells, boosts mood, and aids cognition.
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.
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.
There have been case reports of development of prostate cancer in patients during treatment with testosterone, including one case series of twenty patients (Gaylis et al 2005). It is not known whether this reflects an increase in incidence, as prostate cancer is very common and because the monitoring for cancer in patients treated with testosterone is greater. Randomized controlled trials of testosterone treatment have found a low incidence of prostate cancer and they do not provide evidence of a link between testosterone treatment and the development of prostate cancer (Rhoden and Morgentaler 2004). More large scale clinical trials of longer durations of testosterone replacement are required to confirm that testosterone treatment does not cause prostate cancer. Overall, it is not known whether testosterone treatment of aging males with hypogonadism increases the risk of prostate cancer, but monitoring for the condition is clearly vital. This should take the form of PSA blood test and rectal examination every three months for the first year of treatment and yearly thereafter (Nieschlag et al 2005). Age adjusted PSA reference ranges should be used to identify men who require further assessment. The concept of PSA velocity is also important and refers to the rate of increase in PSA per year. Patients with abnormal rectal examination suggestive of prostate cancer, PSA above the age specific reference range or a PSA velocity greater than 0.75 ng/ml/yr should be referred to a urologist for consideration of prostate biopsy.
Fifteen home remedies for acne Many home remedies can help people reduce their acne by treating oily skin, killing bacteria, and providing antioxidants. Natural treatments that reduce acne flare-ups include aloe vera gel, honey, and tea tree oil. Learn about 15 natural home remedies and how to use them to improve acne, pimples, and oily skin here. Read now
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
Testosterone begins with cholesterol. In fact, every single sex hormone you make you synthesize from cholesterol – that’s one reason a “heart healthy” low-fat, low-cholesterol diet limits your performance. Fat and cholesterol don’t make you fat. They give your body the building blocks to create abundant testosterone and other sex hormones, which actually makes you lose weight and build muscle, especially if your current testosterone levels are low [1].
My question is in two parts, I am looking for energy and some muscle build but only do push ups and sit ups so not looking for massive results. I am diabetic and I am wanting to get a testosterone booster to have more energy for daily use not so much for help in the bedroom but I would not mind if it helps out. Would I be able to take it not just for a certain product but any testosterone booster? The other question is does it help with any form of muscle growth, again not anything big but some? I would appreciate any advice or information you can give me.

Ashwagandha is shown to be effective at reducing cortisol which in turn helps with testosterone production. There are also numerous studies showing the effects on improving testosterone in infertile men (ref 80).  If you are using the Aggressive Strength product you don't need to supplement with ashwagandha as it's included in the test booster formula. Likewise if you're using Tian Chi (my daily herb drink).

A large number of trials have shown the positive effects of testosterone treatment on markers of bone formation and increased bone density in hypogonadal men treated with testosterone.1,4,6,8,13 Not surprisingly, the effects may take several years to fully develop. At present no data on the role of testosterone in preventing fracture in men with hypogonadism are available.
Recently, a panel with cooperation from international andrology and urology societies, published specific recommendations with regard to the diagnosis of Late-onset Hypogonadism (Nieschlag et al 2005). These are summarized in the following text. It is advised that at least two serum testosterone measurements, taken before 11 am on different mornings, are necessary to confirm the diagnosis. The second sample should also include measurement of gonadotrophin and prolactin levels, which may indicate the need for further investigations for pituitary disease. Patients with serum total testosterone consistently below 8 nmol/l invariably demonstrate the clinical syndrome of hypogonadism and are likely to benefit from treatment. Patients with serum total testosterone in the range 8–12 nmol/l often have symptoms attributable to hypogonadism and it may be decided to offer either a clinical trial of testosterone treatment or to make further efforts to define serum bioavailable or free testosterone and then reconsider treatment. Patients with serum total testosterone persistently above 12 nmol/l do not have hypogonadism and symptoms are likely to be due to other disease states or ageing per se so testosterone treatment is not indicated.

Ben has mentioned APOE many times, as in this podcast, with the reference in this transcript as something like 34/44. I’ve always assumed that meant a number of different genes that related to APOE having the homozygous or heterzygous mutations. I’ve only been able to find one rs in my 23andme raw data that seems meaningful to this, rs429358. How do you all figure out your APOE status? Are you getting this from one of the other companies that analyzes part of your raw data for you?
What are the side effects of testosterone pellets? Testosterone is the male sex hormone, and its levels in the body decline steadily with age. Many people wish to supplement it when they are deficient. Testosterone pellets can be a convenient form of testosterone replacement therapy, but they can cause side effects, such as fluid retention and acne. Learn more here. Read now
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.
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.

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.

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It goes without saying that what you eat significantly influences your hormone balance and body composition. This is nothing new. There are countless athletes and bodybuilders who are paying a close attention to what they eat for a reason. For example, if you consume a lot of so-called junk food, then you inevitably end up with a poor nutritional profile. In plain English, you can forget about a six-pack and the high testosterone.
Fatherhood decreases testosterone levels in men, suggesting that the emotions and behavior tied to decreased testosterone promote paternal care. In humans and other species that utilize allomaternal care, paternal investment in offspring is beneficial to said offspring's survival because it allows the parental dyad to raise multiple children simultaneously. This increases the reproductive fitness of the parents, because their offspring are more likely to survive and reproduce. Paternal care increases offspring survival due to increased access to higher quality food and reduced physical and immunological threats.[60] This is particularly beneficial for humans since offspring are dependent on parents for extended periods of time and mothers have relatively short inter-birth intervals.[61] While extent of paternal care varies between cultures, higher investment in direct child care has been seen to be correlated with lower average testosterone levels as well as temporary fluctuations.[62] For instance, fluctuation in testosterone levels when a child is in distress has been found to be indicative of fathering styles. If a father's testosterone levels decrease in response to hearing their baby cry, it is an indication of empathizing with the baby. This is associated with increased nurturing behavior and better outcomes for the infant.[63]
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.
One study looking at alcohol consumption found that increasing alcohol consumption led to a higher level of free & total testosterone compared to a non-drinking control group (20). Drinking did however lower SHBG testosterone levels, though this type of testosterone is bound to a protein meaning our bodies cannot use it to build muscle or increase our mood.
Testosterone is necessary for normal sperm development. It activates genes in Sertoli cells, which promote differentiation of spermatogonia. It regulates acute HPA (hypothalamic–pituitary–adrenal axis) response under dominance challenge.[22] Androgen including testosterone enhances muscle growth. Testosterone also regulates the population of thromboxane A2 receptors on megakaryocytes and platelets and hence platelet aggregation in humans.[23][24]
When the body cannot produce enough testosterone on its own, the term is called hypogonadism.  Testosterone boosters do not give the user actual testosterone (like with steroids), rather, they kickstart the production of this very important hormone.  For that reason, it’s important to find a potent formulation that has one or multiple key ingredients in it.

Let’s first start off by saying, there is no comparison of natural testosterone boosters to synthetic.  When referring to synthetic, we’re talking anabolic steroids.  At that point, you’re comparing apples and oranges.  Which is best—natural or synthetic?  Synthetic.  It is much easier to put on quality muscle mass while using anabolics than it is using a natural testosterone booster.  One is basically giving you synthetic testosterone while the other is giving you a minor boost in natural testosterone production.  However, not only are there side effects to the use of anabolics, but they are also illegal in the United States unless used under a doctor’s supervision with a prescription.
Zaima, N., Kinoshita, S., Hieda, N., Kugo, H., Narisawa, K., Yamamoto, A., ... Moriyama, T. (2016, September). Effect of dietary fish oil on mouse testosterone level and the distribution of eicosapentaenoic acid-containing phosphatidylcholine in testicular interstitium. Biochemistry and Biophysics Reports, 7, 259–265. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613343/
For the 3rd year in a row, DAA Max claims the #1 spot in the Top 10. A product that stands out in all categories with a formula that has been shown in studies to increase free testosterone levels after just 12 days of consistent use. DAA Max’s feedback over the years has shown that this product is not only potent in terms of elevating testosterone and boosting one’s libido, but at its low price it just can’t be beaten.

It goes without saying that what you eat significantly influences your hormone balance and body composition. This is nothing new. There are countless athletes and bodybuilders who are paying a close attention to what they eat for a reason. For example, if you consume a lot of so-called junk food, then you inevitably end up with a poor nutritional profile. In plain English, you can forget about a six-pack and the high testosterone.

Zinc: Another potent ingredient to add to any testosterone booster is zinc. This study shows how zinc is able to prevent a decline in testosterone levels during intense and hard workouts performed by wrestlers. Researchers found that the group who was administered with a placebo had a reduction in testosterone, as opposed to the group who were supplemented with zinc. The placebo group had a notable drop in their testosterone count during this process. Zinc has also been shown to increase the number of free testosterone and lower SHBG.

There have been case reports of development of prostate cancer in patients during treatment with testosterone, including one case series of twenty patients (Gaylis et al 2005). It is not known whether this reflects an increase in incidence, as prostate cancer is very common and because the monitoring for cancer in patients treated with testosterone is greater. Randomized controlled trials of testosterone treatment have found a low incidence of prostate cancer and they do not provide evidence of a link between testosterone treatment and the development of prostate cancer (Rhoden and Morgentaler 2004). More large scale clinical trials of longer durations of testosterone replacement are required to confirm that testosterone treatment does not cause prostate cancer. Overall, it is not known whether testosterone treatment of aging males with hypogonadism increases the risk of prostate cancer, but monitoring for the condition is clearly vital. This should take the form of PSA blood test and rectal examination every three months for the first year of treatment and yearly thereafter (Nieschlag et al 2005). Age adjusted PSA reference ranges should be used to identify men who require further assessment. The concept of PSA velocity is also important and refers to the rate of increase in PSA per year. Patients with abnormal rectal examination suggestive of prostate cancer, PSA above the age specific reference range or a PSA velocity greater than 0.75 ng/ml/yr should be referred to a urologist for consideration of prostate biopsy.
For example, in February 2017, scientists reported on trials involving men over age 65 who had low testosterone due to aging. Each trial included a different number of men depending on the subject of the research. Roughly half of the participants received testosterone therapy for a year; the rest underwent a placebo treatment. The researchers discovered the following:

The reliable measurement of serum free testosterone requires equilibrium dialysis. This is not appropriate for clinical use as it is very time consuming and therefore expensive. The amount of bioavailable testosterone can be measured as a percentage of the total testosterone after precipitation of the SHBG bound fraction using ammonium sulphate. The bioavailable testosterone is then calculated from the total testosterone level. This method has an excellent correlation with free testosterone (Tremblay and Dube 1974) but is not widely available for clinical use. In most clinical situations the available tests are total testosterone and SHBG which are both easily and reliably measured. Total testosterone is appropriate for the diagnosis of overt male hypogonadism where testosterone levels are very low and also in excluding hypogonadism in patients with normal/high-normal testosterone levels. With increasing age, a greater number of men have total testosterone levels just below the normal range or in the low-normal range. In these patients total testosterone can be an unreliable indicator of hypogonadal status. There are a number of formulae that calculate an estimated bioavailable or free testosterone level using the SHBG and total testosterone levels. Some of these have been shown to correlate well with laboratory measures and there is evidence that they more reliably indicate hypogonadism than total testosterone in cases of borderline biochemical hypogonadism (Vermeulen et al 1971; Morris et al 2004). It is important that such tests are validated for use in patient populations relevant to the patient under consideration.

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