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.
The second theory is similar and is known as "evolutionary neuroandrogenic (ENA) theory of male aggression".[82][83] Testosterone and other androgens have evolved to masculinize a brain in order to be competitive even to the point of risking harm to the person and others. By doing so, individuals with masculinized brains as a result of pre-natal and adult life testosterone and androgens enhance their resource acquiring abilities in order to survive, attract and copulate with mates as much as possible.[82] The masculinization of the brain is not just mediated by testosterone levels at the adult stage, but also testosterone exposure in the womb as a fetus. Higher pre-natal testosterone indicated by a low digit ratio as well as adult testosterone levels increased risk of fouls or aggression among male players in a soccer game.[84] Studies have also found higher pre-natal testosterone or lower digit ratio to be correlated with higher aggression in males.[85][86][87][88][89]

“I did a lot of research on Andro400 before I ordered it because I've tried other products in the past and they haven't worked. But with this I could not believe the difference within, literally within a month. I'm 62 years old and since I started taking it I have lost 37 lbs. And I have more energy than I've had in 20 years. It's still coming off, but it's coming off slower now. It was the belly fat. I could get weight off but I could never get the tummy off, and now the tummy's coming off. Libido -- everything's better all the way around.“


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.
The contents displayed within this public group(s), such as text, graphics, and other material (“Content”) are intended for educational purposes only. The Content is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in a public group(s).
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.
Hallie Levine is an award-winning magazine and freelance writer who contributes to Consumer Reports on health and fitness topics. Her work has been published in Health, Prevention, Reader's Digest, and Parents, among others. She's a mom to three kids and a fat but feisty black Labrador retriever named Ivry. In her (nonexistent) spare time, she likes to read, swim, and run marathons.
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.
Testosterone booster supplements are supplements that are used to either increase the amount of testosterone in someone’s body or increase the amount that can be used by the body without being converted into a different type of hormone. While it is a male sex hormone, women also produce some testosterone. People with low testosterone levels and some athletes choose to use testosterone booster supplements to increase their muscle mass, reduce their fat stores, strengthen their bones, and improve their sex drives, particularly as they approach middle age.
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].
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.
Rest and recovery is just as important as exercise, if not more so. Every time you do an intense workout, give yourself a minimum of 2 days to recuperate afterward, if not more. And don’t mix exercise with sleep hacking. If you’re exercising, get at least 8 hours of sleep every night. Your body uses it to rebuild, and you can throw your hormones out of whack if you don’t rest up properly. Here’s a more in-depth guide to Bulletproof weight training, complete with sample workouts.
Alterations in mood and depression are a symptom of, but not confined to, hypogonadism.1,6 Outcomes in clinical trials of the effect of testosterone treatment on mood have varied. However, there is evidence that testosterone treatment results in improvements in mood, particularly in older men with hypogonadism.7,8Similarly, although there is an established association between measures of cognitive ability and serum levels of testosterone, the benefits of testosterone treatment on cognition are less clearly established, with some studies reporting improvements in some measures of cognitive function and others failing to detect benefits.6,9-11 Although a potential role for testosterone in protecting cognitive function and preventing Alzheimer’s disease has been proposed by some researchers, confirmation from appropriately-designed clinical trials is awaited.
In summary, low testosterone levels are linked to the presence of numerous cardiovascular risk factors. Testosterone treatment acts to improve some of these factors, but effects may vary according to pre- and post-treatment testosterone levels, as well as other factors. There is little data from trials specific to aging males. Appropriately-powered randomized controlled trials, with cardiovascular disease primary endpoints, are needed to clarify the situation, but in the meantime the balance of evidence is that testosterone has either neutral or beneficial effects on the risk of cardiovascular disease in men. It is particularly important to define the effect of testosterone treatment on cardiovascular disease in view of its potential use as an anti-anginal agent.
A: There are no over-the-counter products approved by the U.S. Food and Drug Administration (FDA) to increase testosterone levels. There are several prescription medication options available. Please consult with your health care provider in regards to your testosterone levels and to determine which treatment option best meets your individual needs. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Kristen Dore, PharmD
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 testosterone deficiency occurs during fetal development, then male characteristics may not completely develop. If testosterone deficiency occurs during puberty, a boy’s growth may slow and no growth spurt will be seen. The child may have reduced development of pubic hair, growth of the penis and testes, and deepening of the voice. Around the time of puberty, boys with too little testosterone may also have less than normal strength and endurance, and their arms and legs may continue to grow out of proportion with the rest of their body.

The T Trials are a set of seven clinical trials hosted at 12 sites around the country. In the aggregate, 790 men aged 65 or older with low levels of testosterone and associated symptoms participated. First, participants had to qualify for one of the main three trials: the Sexual Function Trial, the Physical Function Trial, or the Vitality Trial. Then, participants could participate in any of the other trials for which they qualified.
Testosterone boosters are used by many athletes worldwide to achieve a significant muscle mass increase within a short period of time.[1] However; one cannot be completely confident in terms of the quality and efficacy of such products because of several reasons, such as the possibility of bad storage conditions and originating from an unreliable source. Over the years, some consumers of testosterone boosters have complained of kidney and liver abnormalities that could be linked to their use of boosters.[10] Cases of erroneous product administration have occurred in the past as athletes may not follow the instructions on the label fully, which can lead to many side effects.[11] In the present case, a man was admitted to a hospital because of a severe abdominal pain. The pain was later found to be caused by liver injury. The diagnosis confirmed that the levels of the key hepatic enzymes were markedly elevated. The medical complications observed were found to have occurred following the consumption of two courses of a commercial testosterone booster. According to researchers based in the US, about 13% of the annual cases of acute liver failure are attributable to idiosyncratic drug- and/or supplement-induced liver injury.[12] Marked increase in the levels of ALT, AST, and gamma-glutamyl transferase was observed after consuming the first course of the commercial testosterone booster, and they started to decline after the 2nd and 3rd course. This abruptly increases the levels of liver enzymes after the first course may be attributed to the interruption effect of commercial testosterone booster on liver function as a result of the effects of its ingredients.
“I see people who've been doing things in the gym and they've never been told that it can shut off your own production and it can also irreversibly lower your sperm count,” says Roked. “These are all quite serious issues that even though they may be rare if it happened to you it would cause a big impact on your life, so I'd say it's always best to do things with a specialist, but also for anyone it's not a great idea to take things that aren't needed."
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.
There are two keys to incorporating fat in your diet: getting enough fat, and getting the right kinds of it. A study from 1984 (done, no doubt, with Big Brother watching) looked at 30 healthy men who switched from eating 40% fat (much of it saturated) to 25% fat (much of it unsaturated), with more protein and carbs to make up the difference in calories. After 6 weeks, their average serum testosterone, free testosterone, and 4-androstenedione (an important hormone for testosterone synthesis) all dropped significantly [6]. I think getting 40% of your calories from fat is too little – I recommend 50-70% of calories from fat, or even more in some cases.

Statins are some of the most prescribed drugs in the world for reducing cholesterol levels and preventing heart disease. Various studies in the 1990s, including a study published in the ‘European Journal of Clinical Nutrition,’ supported the claim that Fenugreek could help reduce cholesterol levels[2]. One possible explanation is the high fiber content in fenugreek.  A fiber-rich diet has been shown to help reduce the levels of LDL (‘bad’ cholesterol) in your blood. (Note: The validity of the various studies from the 1990s have been questioned though because of small sample sizes[3])


Cardiovascular disease, and its underlying pathological process atherosclerosis, is an important cause of morbidity and mortality in the developed and developing world. Coronary heart disease in particular is the commonest cause of death worldwide (AHA 2002; MacKay and Mensah 2004). As well as increasing with age, this disease is more common in the male versus female population internationally, which has led to interest in the potential role of sex hormones in modulating risk of development of atherosclerosis. Concerns about the potential adverse effects of testosterone treatment on cardiovascular disease have previously contributed to caution in prescribing testosterone to those who have, or who are at risk of, cardiovascular disease. Contrary to fears of the potential adverse effects of testosterone on cardiovascular disease, there are over forty epidemiological studies which have examined the relationship of testosterone levels to the presence or development of coronary heart disease, and none have shown a positive correlation. Many of these studies have found the presence of coronary heart disease to be associated with low testosterone levels (Reviews: Jones, Jones et al 2003; Jones et al 2005).
I am 41, T was tested at 400 last month. I was Very active /hyper growing up. I have felt my strength and energy fade over the last 10 years to the point that i now take a nap in the afternoon. Sexual performance has been on a steep decline since 35 to the point of disfunction with out herbal pills or cialis. Also had 2 kids in last 5 years,(second marriage) , and at times have a hard time tolerating the stresses due to lack of energy to cope with the increased emotional load.

“What on earth do you mean?” Well, I don’t literally mean taking it to the compound. What I mean to say is that you should be incorporating the three most important compound exercises into your routine: bench press, squats, and deadlifts. In case you didn’t know, by training large muscle groups your body releases more testosterone. When you do these three lifts, and perform them properly, then you’ll reap the benefits of not only muscle gains, but also that of an increased release of testosterone and growth hormone.
^ Butenandt A, Hanisch G (1935). "Uber die Umwandlung des Dehydroandrosterons in Androstenol-(17)-one-(3) (Testosterone); um Weg zur Darstellung des Testosterons auf Cholesterin (Vorlauf Mitteilung). [The conversion of dehydroandrosterone into androstenol-(17)-one-3 (testosterone); a method for the production of testosterone from cholesterol (preliminary communication)]". Chemische Berichte (in German). 68 (9): 1859–62. doi:10.1002/cber.19350680937.
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The one side effect that no one talks about is psychological for me. Because I am 67 years old and suddenly look, feel and act 37 I only want to be around younger people. I have no use associating with people my own age. I have nothing in common and even look different. This year at my class reunion was a glaring example…..no doubt I looked younger than anyone, but it is sooo much more than just very that. My customers are young, all my girlfriends and associates. This all has a large effect on my mind. It’s hard to grasp suddenly looking and acting 30 years younger than your friends. My mind is so confused about how old I really am. I do a lot of adrenalin sports for my age snow ski, wake-surf, wake-board, scuba dive and it is no doubt just a matter of time till I get hurt doing these wild sports. In my mind I’m 37 so I think it’s all normal. This whole experience has been incredible and very positive with the only one psychological effect and no other physical side effect.
A large number of side-effects have been attributed to testosterone. In our clinical experience, the incidence of significant adverse effects with treatment producing physiological testosterone levels is low, and many side effects attributed to testosterone are mainly relevant to supraphysiological replacement. Some adverse effects are specific to a given mode of delivery and have already been described. Potential adverse effects concerning the prostate have also been discussed and require appropriate monitoring of symptoms, PSA and digital rectal examination. Other tumors which may be androgen responsive include cancer of the breast and primary liver tumors, and these are both contraindications to testosterone treatment
“Life for the winner is more glorious. It enters the next round of competition with already elevated testosterone levels, and this androgenic priming gives it an edge that increases its chances of winning yet again. Through this process an animal can be drawn into a positive-feedback loop, in which victory leads to raised testosterone levels which in turn leads to further victory.”
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
The Prime Labs Men’s Testosterone Booster made our top spot for testosterone booster caplets. These natural testosterone supplements improve the symptoms of low testosterone, which include low energy, a lack of stamina, a low sex drive, and a decrease in strength. The results include improvement in all of the above and the can also boost your overall mood, making you feel more confident and in control.
Sexual dysfunction and low libido are among the most easily reversible symptoms of hypogonadism. Systematic reviews of randomized, placebo-controlled clinical trials of testosterone in men, including older men (aged 60 years and over) and middle-aged men, with sexual dysfunction and hypogonadism have shown large favourable effects on libido and moderate effects on satisfaction with erectile function.1-5 In men who do not respond sufficiently to testosterone therapy alone, the combination of phosphodiesterase 5-inhibitors and testosterone may be indicated, as there are suggestions that the combination may be synergistic.1
Afrisham, R., Sadejh-Nejadi, S., SoliemaniFar, O., Kooti, W., Ashtary-Larky, D., Alamiri, F., … Khaneh-Keshi, A. (2016, November 24). Salivary testosterone levels under psychological stress and its relationship with rumination and five personality traits in medical students. Psychiatry Investigations, 13(6), 637–643. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5128352/
I’m a 70 year old male. Here’s my brief story, I was exhausted all the time after an encounter with H-Py-Lori. After may tests it was found out that my T-count was at about 250. I was put on a testosterone cream replacement therapy. Before I knew it, at about month I was at 1500 count. This was at 4 cream applications a day. The doctor took me down to twice/two applications a day, now I was at 600. I felt great at both levels.

Testosterone may strengthen your heart. Research on testosterone’s relation to heart health is split. Some scientists have found that men with higher testosterone levels have an increased risk of heart disease, while recent studies have shown that men with below-normal T levels are more at risk for heart problems. The research is still on-going, but many doctors find the evidence compelling that optimal testosterone levels can help prevent cardiovascular disease.
Vitamin D3: Vitamin D3 is actually more hormone than it is a vitamin. Vitamin D is taken in by around 10% of our diets and D3 is mostly absorbed from the sun, which can be linked to greater testosterone production. The link between the two is a result from the luteinizing hormone playing its role. Read more about how vitamin D3 effects testosterone — the evidence is staggering.

One study that compared athletes to non-active individuals found that supplementing with 22 mg magnesium per pound of body weight of the course of four weeks raised testosterone levels in both groups. And two separate studies, one on a group of men over the age of 65 and a second on a younger 18-30 year old cohort, present the same conclusion: levels of testosterone (and muscle strength) are directly correlated to the levels of magnesium in the body.
When I was using the gel my testicles also shrank a bit, but not anywhere near this amount. And when I stopped using the gel they plumbed back up again to their former size. It took some time but their size came back. This may be an issue for the younger guys, but I think most older guys can easily handle this as no big deal, because overall it’s not.
When I was using the gel my testicles also shrank a bit, but not anywhere near this amount. And when I stopped using the gel they plumbed back up again to their former size. It took some time but their size came back. This may be an issue for the younger guys, but I think most older guys can easily handle this as no big deal, because overall it’s not.

Testosterone decreases body fat. Testosterone plays an important role in regulating insulin, glucose, and fat metabolism. As our T levels decrease, our body’s ability to regulate insulin, glucose, and fat metabolism decreases, which in turn causes adipose tissue (i.e. fat) to begin accumulating. To add insult to injury, that increased adipose tissue may also contribute to further decreasing testosterone levels because it converts testosterone into estrogen.
Some anti-aging physicians also use sublingual ( taken under the tongue) forms of non-bioidentical testosterone like oxandrolone. I took oxandrolone with a physician’s guidance for about two weeks, and I got pimples and hair loss. I quit and was bummed that it didn’t generate enough impact to write a blog post about it. I have continued to recommend bioidentical testosterone since.
Since then, multiple studies have found no link between high testosterone levels and increasing your chances of developing prostate cancer. However — and this is a BIG however — if you already have prostate cancer, increased levels of testosterone may exacerbate the problem. It’s best to wait until after you treat your prostate cancer before you begin any T-boosting regimens. Tread carefully and talk with your doctor.
I am 35 and had the non sexual symptoms for awhile now( weight gain/muscle loss, extreme fatigue, lack of clarity/concentration) I got my testosterone levels checked last week and it was 35.4 ng. Not a typo, 35.4. I was told by my dr. That I needed to start TRT right away as low t can effect a lot different things in your body. I did my first injection last night (200mg/ml every 2 weeks) about 8 pm and td now 3:30 am and I’m wide awake and feel extremely motivated to go to the gym and work out. I know each person is different but should I feel like this already, or is it a placebo effect at this point?
“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.
It may also become a treatment for anemia, bone density and strength problems. In a 2017 study published in the journal of the American Medical Association (JAMA), testosterone treatments corrected anemia in older men with low testosterone levels better than a placebo. Another 2017 study published in JAMA found that older men with low testosterone had increased bone strength and density after treatment when compared with a placebo. 
A recent study compared total and bioavailable testosterone levels with inflammatory cytokines in men aged 65 and over. There was an inverse correlation with the pro-inflammatory soluble interleukin-6 receptor, but no association with interleukin-6 (IL-6), highly sensitive CRP (hsCRP), tumor necrosis factor-α (TNF-α) or interleukin-1β (IL-1β (Maggio et al 2006). Another trial found that young men with idiopathic hypogonadotrophic hypogonadism had higher levels of proinflammatory factors interleukin-2 (IL-2), interleukin-4 (IL-4), complement C3c and total immunoglobulin in comparison to controls (Yesilova et al 2000). Testosterone treatment in a group of hypogonadal men, mostly with known coronary artery disease, induced anti-inflammatory changes in the cytokine profile of reduced IL-1β and TNF-α and increased IL-10 (Malkin, Pugh, Jones et al 2004).
There’s a significant failure rate of the PDE5 inhibitors for erectile dysfunction, something on the order of 25% to 50%, depending on the underlying condition. It turns out that a third of those men will have adequate erections with testosterone-replacement therapy alone and another third will have adequate erections with the pills and testosterone combined. There’s still a third who don’t respond, but normalizing their testosterone level has definitely rescued many men who had failed on PDE5 inhibitors.

And the ads have been working: The number of prescriptions written for testosterone have skyrocketed by more than 300 percent since 2001, reaching 7.2 million in 2013, according to a report published in 2016. Another study, published in JAMA in 2017, found that between 2009 and 2013, testosterone testing and treatment rose substantially in areas of the U.S. where such ads were very common.
I think we’ll also find out in five years that there very well may be general health benefits of having normal testosterone compared to low testosterone. There are growing data for all-cause mortality that men who have low testosterone die earlier than those who have normal testosterone. A study by the Veterans Administration reported about a year ago showed low testosterone levels were associated with a dramatically increased mortality rate. It’s hard to know why that is, but I think we’ll be focused on that in the coming years.

Joe Costello is a Nutrition & Wellness Consultant, certified by the American Fitness Professionals & Associates (AFPA), author, and internet blogger. Joe has more than 9 years of experience in the sports nutrition industry and over 3 years of experience as a supplement and nutrition blogger. As a certified NWC who specializes in dietary supplements, Joe strives to deliver accurate, comprehensive, and research-backed information to his readers. You can find more of Joe’s work including his E-Books about fitness and nutrition at his official website joecostellonwc.com, or connect with him on LinkedIn, Facebook, Instagram, Vimeo, or YouTube.
Pellets. Your doctor will place the testosterone pellets under the skin of your upper hip or buttocks. Your doctor will give a shot of local anesthesia to numb your skin, then make a small cut and place the pellets inside the fatty tissues underneath your skin. This medication dissolves slowly and is released over about 3-6 months, depending on the number of pellets. 
You may be interested in boosting your testosterone levels if your doctor says you have low levels, or hypogonadism, or need testosterone replacement therapy for other conditions. If you have normal testosterone levels, increasing your testosterone levels may not give any additional benefits. The increased benefits mentioned below have only been researched in people with low testosterone levels.
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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