What makes TestoFuel different from other testosterone boosters on the market is that the company is constantly researching and updating the ingredients. So, you know you are getting a product that has been formulated using the latest clinical studies. Unlike most other companies that formulate a product and update it every 3 – 5 years or never at all.
Testosterone is well known as the most critical anabolic, not to mention androgenic, hormone in the body. It’s what separates the men from the boys. Healthy testosterone levels are critical for guys who want to build muscle mass, boost strength, and drop body fat. Testosterone also supports sexual health and gives a competitive edge. It’s truly the alpha hormone.
One preliminary study by researchers from Tikrit University showed high statistically significant increase of serum hormones (p< 0.01) in infertile men [9]. After 30 week treatment serum testosterone has increased by 17,7%, serum luteinizing hormone by 43,2% and serum follicle-stimulating hormone by 17,6%; dosage of ginger used was not disclosed [9]. It is suggested that improved testosterone production is because ginger was shown to be effective in decreasing SDF (sperm DNA Fragmentation) in infertile men [22]. SDF is negatively correlated with testosterone levels [23].
Vitamin D is arguably the most important vitamin when it comes to testosterone. A study published in the Journal of Clinical Endocrinology examined the relationship between vitamin D supplementation and testosterone levels in men. The authors found that participants with higher levels of vitamin D had significantly higher levels of free testosterone compared to those with insufficient levels of vitamin D.8 Based on these study results, it appears vitamin D has a strong relationship with testosterone levels.
Research shows that bone density increases with testosterone treatment as long as the dose is high enough. on the effect of testosterone on bone density found increases in spinal and hip bone density. Another of females transitioning into males found that testosterone increased bone mineral density. But it’s unknown if testosterone can help with reducing fracture risk.
Likewise, the amino acids in a protein-rich diet play a big role in both testosterone and muscle growth. As Chris Lockwood, Ph.D., explains, "When combined with training, which increases the sensitivity of androgen receptors, and the consumption of essential amino acids necessary to support protein synthesis, the effects of testosterone on muscle and performance is significantly amplified."[3,4]
Other side effects include increased risk of heart problems in older men with poor mobility, according to a 2009 study at Boston Medical Center. A 2017 study published in JAMA found that treatments increase coronary artery plaque volume. Additionally, the Food and Drug Administration (FDA) requires manufactures to include a notice on the labeling that states taking testosterone treatments can lead to possible increased risk of heart attacks and strokes. The FDA recommends that patients using testosterone should seek medical attention right away if they have these symptoms:
The final two studies looked directly at soy vs testosterone levels. The first looked at introducing consumption of soya flour on testosterone levels. They found that those who ate the Soy flour lowered their T levels during the study (43). And the second study looked at the consumption of soy protein isolates (powder) in healthy men. They found that testosterone levels decreased upon consumption of soy powder (45).
The medical conditions that cause excess testosterone are rare, argues Drincic. "Many people mistake the symptoms of anabolic steroid abuse with symptoms of high testosterone,” he says. Anabolic steroids, which are sometimes abused by athletes and body builders, are synthetic versions of the male hormone testosterone. They can cause behavior and mood changes that include rage, paranoia, irritability, and poor judgment.

I am 45 years old and have been diagnosed with low testosterone levels. In 2014 my levels were 16.5 and in 2016 that dramatically reduced to a score of 10.4. My doctor prescribed me Testo gel which I rub on every morning and have done so for the last 6 weeks. I keep myself fit, gym twice a week and martial arts twice a week and found my energy levels were depleting and didn’t seem to recover quickly the next day. I started to feel exhausted and experienced low libido,lack of motivation and mental focus. I actually thought oh well this is what happens when you get older.

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.
In a subsequent study of 345 men with normal PSA and low testosterone, we found the cancer rate was similar: 15%. And we had a large enough group to look at the impact of testosterone on cancer risk. For men whose total testosterone or free testosterone value was in the lowest third, the odds of having a positive biopsy were double the odds in the rest of the men. That’s the first evidence that low testosterone may be an independent predictor for the development of prostate cancer.

Popular through the centuries in Ayurvedic healing (a traditional practice of medicine in India) ashwagandha is what is known as an "adaptogen." This means the body may be able to use it to help adapt to stressors. While many people supplement with it for reducing cortisol, anxiety, and fatigue levels, ashwagandha also holds relevance for us here with potential testosterone boosting benefits.[8]
I’m telling you all of this because no matter who you are, keeping your testosterone levels balanced is more important now than ever before. Modern living has not been kind to our hormones. In American men, serum testosterone levels have declined by about 1% each year for the past 30 years [5], and you can make a few educated guesses about why. Hormone-disrupting chemicals are more prevalent than ever before, physical activity is less and less common, veganism is popular (I was a raw vegan for a while), and many doctors insist on pushing a low-fat, low-cholesterol diet for health (by the way, the concept of a low-fat diet began in the mid-70s, shortly before the nationwide testosterone decline. It could be a coincidence, but I doubt it).

Testosterone therapy improves body composition (increase in lean body mass, decrease in fat mass) in men with hypogonadism.1 There is a supplementary improvement in muscle strength and physical function. The benefits of testosterone treatment on body composition have consistently been demonstrated in clinical studies of testosterone therapy in hypogonadal men or men with borderline low testosterone levels,1,6,8,12,13 and confirmed by systematic reviews or meta-analyses of randomized controlled trials.4,5,6,13
55+ million men in america between 40 and 70 years of age is a large enough group to warrant interest in a thorough study of the aged male delivery system and other sex related issues. There is a good chance there are 55 million women out there wishing for some kind of help also. Those are significant numbers, about 1/3 of the total population and the lions share of the income producers. And the best the medical community can do is speculate at the real cause for a significant cancer? Perhaps prostate cancer is the real cause of global warming, there is no real science unless there is a real paycheck?
Tribulus is a herb used in China and India for many centuries, mainly for it’s libido enhancing properties and supposed testosterone boosting properties. It enhances testosterone levels by increasing luteinizing hormone (LH) levels. LH is responsible for “telling” the body to produce testosterone. This herb contains Dioscin, protodioscin, diosgenin. These three organic component stimulate sexual performance and may be useful for a variety of sexual disorders such as low testosterone, low sexual energy and weak erections.

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In the 2nd study, short-term testosterone treatment in older men significantly increased noncalcified coronary artery plaque volumes, possibly raising their risk of cardiovascular (CV) events,2 according to Matthew J. Budoff, MD, a professor of medicine at the David Geffen School of Medicine at UCLA and the Los Angeles Biomedical Research Institute in Torrance, California, and colleagues. 

Zinc deficiency also negatively affects testosterone levels, according a 2014 article in the Journal of Plant Biochemistry and Physiology. The authors of this review note that zinc supplementation can increase circulating testosterone in some populations. In fact, daily supplementation with typical doses may double testosterone within a few months.
The biologically available part of total testosterone is called free testosterone, and it’s readily available to the cells. Almost every lab has a blood test to measure free testosterone. Even though it’s only a small fraction of the total, the free testosterone level is a pretty good indicator of low testosterone. It’s not perfect, but the correlation is greater than with total testosterone.
You can find a whole bunch of HIIT workouts online, but the one I used during my 90-day experiment was a simple wind sprint routine. On Tuesdays I went to the football field near my house, marked off 40 yards with some cones, and sprinted as fast as I could. I’d slowly walk back to the starting line, giving my body about a minute to rest, and then I’d sprint again. I typically did 40 sets of 40-yard sprints in a workout. I love sprints.
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
Epidemiological studies suggest that many significant clinical findings and important disease states are linked to low testosterone levels. These include osteoporosis (Campion and Maricic 2003), Alzheimer’s disease (Moffat et al 2004), frailty, obesity (Svartberg, von Muhlen, Sundsfjord et al 2004), diabetes (Barrett-Connor 1992), hypercholesterolemia (Haffner et al 1993; Van Pottelbergh et al 2003), hypertension (Phillips et al 1993), cardiac failure (Tappler and Katz 1979; Kontoleon et al 2003) and ischemic heart disease (Barrett-Connor and Khaw 1988). The extent to which testosterone deficiency is involved in the pathogenesis of these conditions, or to which testosterone supplementation could be useful in their treatment is an area of great interest with many unanswered questions.

There are two ways that we determine whether somebody has low testosterone. One is a blood test and the other is by characteristic symptoms and signs, and the correlation between those two methods is far from perfect. Generally men with the lowest testosterone have the most symptoms and men with highest testosterone have the least. But there are some men who have low levels of testosterone in their blood and have no symptoms.
Hello everyone. First off, thank you Dr. Abraham Morgentaler, for the excellent and refreshing article. I do not intend to spill my guts about symptoms or values on here as it has already been done so many times over. I will say that I am an RN BSN and have been on HRT for going on 6 yrs. I live in Oklahoma and when I first started noticing symptoms I knew something was wrong and began to do research myself. With an initial level of 241 no doctor here at that time, would even consider HRT as I was only 35ish at the time.
Epidemiological studies suggest that many significant clinical findings and important disease states are linked to low testosterone levels. These include osteoporosis (Campion and Maricic 2003), Alzheimer’s disease (Moffat et al 2004), frailty, obesity (Svartberg, von Muhlen, Sundsfjord et al 2004), diabetes (Barrett-Connor 1992), hypercholesterolemia (Haffner et al 1993; Van Pottelbergh et al 2003), hypertension (Phillips et al 1993), cardiac failure (Tappler and Katz 1979; Kontoleon et al 2003) and ischemic heart disease (Barrett-Connor and Khaw 1988). The extent to which testosterone deficiency is involved in the pathogenesis of these conditions, or to which testosterone supplementation could be useful in their treatment is an area of great interest with many unanswered questions.
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
"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.”
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.
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.

The evidence shows that testosterone treatment does not change the strength or rate of urine flow, does not change the ability to empty the bladder, and does not change other symptoms such as frequency or urgency of urination, as assessed by the American Urological Association Symptom Score or the International Prostate Symptom Score. I’ve had a couple of patients over the years who had some worsening of urinary symptoms with testosterone, but that’s rare, even with long-term use.
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.
Felt I was more sluggish than I should be,Went on TRT ’cause my bloodwork said I fell in the parameters for hormone therapy. When i started felt I was 17, (I was 50))I did everything possible and passed for type A, and physiologically, things seem to heal faster. But I missed memories, now that I was speeded-up I no longer could easily connect and be a part of them.
Then in 2017, Melville carried out another study on DAA.[4] This time he recruited 22 men in a randomized, double-blind fashion and had them consume either a placebo or 6g of DAA. After 12 weeks of supplementation, researchers observed that DAA had no significant impact on resting levels of either free or total testosterone. Any improvements in strength or hypertrophy were similar to those in the placebo group.

Margaret, I’m on Trt, and my wife is 43 going through Peri- (early/pre) menopause. She started trying about a drop a day to see if her libido would improve, and it did, dramatically, and also her moods and patience. After about a month of feeling 30again, she started noticing lite facial hair developing, decreased breast size, and return of all previous symptoms. So she went off it. About a month later, she started St.JohnsWart, and everything improved tenfold. Now she feels 20 instead of just 30 on testosterone. She literally glows with smiles and energy, and has an extremely high libido. Maybe try that first. Good luck.
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“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.“
I started testosterone therapy on August 25th 2005. I remember this so well because my life pretty much changed after that. I think I’ve had low testosterone my entire life, though I’ve always had a healthy sex drive I was always tired and always sensed something was wrong although I sought out treatment at the doctor’s but just could never quite pinpoint what the problem was. long story short, I’ve had nothing but good things from testosterone therapy. mostly just more vitality and a better outlook on life
BSN Evotest the next ranked testosterone booster and is a unique option in that it’s available in both capsule and powdered drink form. For those who dislike swallowing pills, this will be a better route to go. There are mixed reports on the taste quality of the product, however, this is an individual preference and should not be something that deters you from purchasing it. It mixes fairly well by most reports, so is something that you should be able to easily take with you to the gym for use during the workout session.
If you take a statin (cholesterol lowering medication) and you follow the 30-Day Heart Tune-Up program, there is a good chance you’ll be able to work with your doctor and over time safely stop your statin medication. Statin medications lower cholesterol, and you need cholesterol to make testosterone. Ask your doctor what you can do with lifestyle changes to not need a statin medication. Improving your cholesterol profile is only part of the answer. Many of the risk calculators doctors use look at tobacco use, body weight, blood pressure, blood sugar, and cholesterol. Improve all your risk factors, and often you won’t qualify for a medication!

There have been a number of smaller studies on men receiving testosterone-replacement therapy, and if you look at the results cumulatively, the rate of prostate cancer in these men was about 1% per year. If you look at men who show up for prostate cancer screening, same sort of age population, the rate tends to be about the same. You have to be cautious in comparing studies and combining the results, but there’s no signal in these results that testosterone-replacement therapy creates an unexpectedly high rate of prostate cancer.
The partial synthesis in the 1930s of abundant, potent testosterone esters permitted the characterization of the hormone's effects, so that Kochakian and Murlin (1936) were able to show that testosterone raised nitrogen retention (a mechanism central to anabolism) in the dog, after which Allan Kenyon's group[190] was able to demonstrate both anabolic and androgenic effects of testosterone propionate in eunuchoidal men, boys, and women. The period of the early 1930s to the 1950s has been called "The Golden Age of Steroid Chemistry",[191] and work during this period progressed quickly. Research in this golden age proved that this newly synthesized compound—testosterone—or rather family of compounds (for many derivatives were developed from 1940 to 1960), was a potent multiplier of muscle, strength, and well-being.[192]
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]
46 year old whose suffered with low libido and all the related symptoms for over a decade. Finally had the courage to have a frank talk with dr. and urologist. Testosterone level 165, free testos level 3.6. Re-doing blood work again just to be sure in the next week or so, and will post updates then as things progress. Normal ranges are 300-1200 and 6 to 12.
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].
When looking for a solid natural testosterone booster, you’ll want one that has the ability to increase natural testosterone levels, increase muscular strength, improve performance and stamina, and help pack on lean muscle mass.  With a mix of key ingredients like D-AA, Tribulus, Fenugreek, and DIM, Evlution’s booster aims to take your training to the next level.  It can also help improve your sleep which is vital in allowing the body to recover from intense sessions in the gym.
Testosterone is used as a medication for the treatment of males with too little or no natural testosterone production, certain forms of breast cancer,[10] and gender dysphoria in transgender men. This is known as hormone replacement therapy (HRT) or testosterone replacement therapy (TRT), which maintains serum testosterone levels in the normal range. Decline of testosterone production with age has led to interest in androgen replacement therapy.[109] It is unclear if the use of testosterone for low levels due to aging is beneficial or harmful.[110]
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.

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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?
Erectile dysfunction is a common finding in the aging male. A prevalence of over 70% was found in men older than 70 in a recent cross-sectional study (Ponholzer et al 2005). Treatment with phosphodiesterase-5 (PDE-5) inhibitors is proven to be effective for the majority of men but some do not respond (Shabsigh and Anastasiadis 2003). The condition is multi-factorial, with contributions from emotional, vascular, neurological and pharmacological factors. The concept of erectile dysfunction as a vascular disease is particularly interesting in view of the evidence presented above, linking testosterone to atherosclerosis and describing its action as a vasodilator.
The biologically available part of total testosterone is called free testosterone, and it’s readily available to the cells. Almost every lab has a blood test to measure free testosterone. Even though it’s only a small fraction of the total, the free testosterone level is a pretty good indicator of low testosterone. It’s not perfect, but the correlation is greater than with total testosterone.
*IMPORTANT TESTOSTERONE TREATMENT WARNING: Who Should Not Enroll in Testosterone Replacement Therapy? Men who have or had prostate cancer or breast cancer should not take testosterone replacement therapy. All men considering treatment should undergo a thorough prostate cancer screening prior to starting any therapy program with a rectal exam and PSA test. *Men who have or have had cardiovascular disease, or are at risk for coronary disease, or have had a history of heart disease may not be candidates for testosterone treatment. Blood testing, thorough physical examination and careful screening by your physician is absolutely essential before considering a hormone therapy program of any kind. Always discuss the potential benefits, uses, side effects and risks of prescription hormones and steroid drugs with your treating physician. Hormone Treatment is for medically qualified candidates only. The FDA has cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use - FDA Testosterone Safety Update

Before we go any further, know that fenugreek is an herb of Asian origin, commonly used in Indian cuisine.  The Indians have been consuming it as an aphrodisiac and an herbal cure-all for centuries which might explain why that waiter in your local Indian restaurant is always smiling. As it turns out, there is actually some validity to the purported claims.


Many endocrinologists are sounding the alarm about the damaging effects that come with exposure to common household chemicals. Called “endocrine disruptors,” these chemicals interfere with our body’s hormone system and cause problems like weight gain and learning disabilities. One type of endocrine disruptor is particularly bad news for our testosterone levels.

What makes TestoFuel different from other testosterone boosters on the market is that the company is constantly researching and updating the ingredients. So, you know you are getting a product that has been formulated using the latest clinical studies. Unlike most other companies that formulate a product and update it every 3 – 5 years or never at all.
• In a trial of men with anemia, 58% percent were no longer anemic after a year of therapy, compared to 22% who received a placebo. In addition, testosterone therapy was associated with higher hemoglobin levels. Hemoglobin is a protein in the blood that carries oxygen from the lungs to other areas of the body. It also brings carbon dioxide back to the lungs.
Felt I was more sluggish than I should be,Went on TRT ’cause my bloodwork said I fell in the parameters for hormone therapy. When i started felt I was 17, (I was 50))I did everything possible and passed for type A, and physiologically, things seem to heal faster. But I missed memories, now that I was speeded-up I no longer could easily connect and be a part of them.
There are several supplements on the market claiming to be natural testosterone boosters. I get these sorts of things in the mail all time. The companies that produce these products claim that the herbs (typically stinging nettle and tribulus) in their pills increase free testosterone by reducing SHBG. They also throw in some B vitamins for “increased energy and vitality.”
Most people associate testosterone with facial hair, gigantic muscles & illegal steroids.  Naturally produced testosterone plays a very important role in male/female metabolic function.  Lowered testosterone is a chronic epidemic that is threatening lives all around the world.  This article will go over 12 ways to boost testosterone levels naturally through healthy lifestyle measures.

With the help of the three main ingredients, you have the ability to naturally raise your free testosterone levels giving you an increase in strength, muscle mass, stamina, and libido.  NutriSuppz Ultra Test aims to help you sleep better, burn fat easier, and feel energized, and have improved mental alertness.  Another perk of NutriSuppz Ultra Test is that it is a fully transparent profile with no proprietary blends—allowing you to know exactly what you are getting in each dose.
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]

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.

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