I’m afraid I have no super cool “secrets” to share and there are no easy shortcuts to increasing your T. If you were expecting some magical potion or supplement or weird body hack that will instantly and naturally increase your T levels, what follows is bound to disappoint. Despite what some companies or websites might tell you, there’s no single thing that will boost your testosterone naturally for the long term.
My last injection was November 2017 and i decided to rest for a quarter and see what the impact is. My energy and muscle tone has definitely dropped but I don’t have back acne, sour sweat and I sleep better. In my case anyway I feel like my T is being regulated lower. I turn up the heat and T , my body turns up the aircon which suppresses the T. I can’t find any discussion on correlation between temperature/climate and T anywhere but given that we all live in climate controlled environments now seems worthy of some study.
An international consensus document was recently published and provides guidance on the diagnosis, treatment and monitoring of late-onset hypogonadism (LOH) in men. The diagnosis of LOH requires biochemical and clinical components. Controversy in defining the clinical syndrome continues due to the high prevalence of hypogonadal symptoms in the aging male population and the non-specific nature of these symptoms. Further controversy surrounds setting a lower limit of normal testosterone, the limitations of the commonly available total testosterone result in assessing some patients and the unavailability of reliable measures of bioavailable or free testosterone for general clinical use. As with any clinical intervention testosterone treatment should be judged on a balance of risk versus benefit. The traditional benefits of testosterone on sexual function, mood, strength and quality of life remain the primary goals of treatment but possible beneficial effects on other parameters such as bone density, obesity, insulin resistance and angina are emerging and will be reviewed. Potential concerns regarding the effects of testosterone on prostate disease, aggression and polycythaemia will also be addressed. The options available for treatment have increased in recent years with the availability of a number of testosterone preparations which can reliably produce physiological serum concentrations.
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.
Let me start out by saying that I didn't notice anything for about the first 10 days. After week 2, I had moderate energy increases buy by far the most noticeable difference for me was in the bedroom. After using this product for over a moth now, I normally run out of energy before I run out of "stamina". This will be a permanent regimen for my daily supplements from now on. I take 4 a day. 2 in the morning and 2 about 5pm. I thought about lowering the dosage to see if it had the same effect, but for the price, why? LOL.
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I have been on TRT for over 8 years now. I feel GREAT! I read all these studies, hear in the news, and see all these dumb lawsuit commercials about testosterone causing cardiovascular events, blood clots and many other things. If anyone takes the time to do the due diligence and read the studies the picture becomes very clear. Unless you monitor all the other hormones, specifically, Estradiol, DHT, Pregenolone, Total Testosterone, Free Direct Testosterone, and DHEAS you are playing a deadly game. The reason is you must give something to control the pathways of T conversion into estradiol and or DHT. The vast majority of the studies used nothing to control those pathways and they gave men way, way more T than they needed to start with. They also gave forms of T that are not acceptable. Especially the oral version.
According to studies by Srivastava [15] and Thomson et al. [21] ginger can be used as natural antithrombotic agent. Ginger has also been recorded as useful remedy in preventing post-operative nausea and vomiting in humans [13] as well as preventing morning sickness during pregnancy [16]. At high doses (500 mg/kg) aqueous extract of ginger exhibits cholesterol-lowering effect [21].
Ten healthy men aged around 24 years old spent 1 week sleeping for 8 hours per night at home, they then spent the next 11 nights in a lab. They slept for 10 hours per night for 3 nights, followed by 8 nights of restricted sleep, when they slept for only 5 hours. Doctors checked their blood every 15 to 30 minutes during the last night that they slept 10 hours, as well as on the sleep-restricted session.
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.
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]
Mental status changes including excess aggression are a well known phenomenon in the context of anabolic steroid abuse (Perry et al 1990). An increase in self-reported aggressive behaviors have also been reported in one double blind placebo controlled trial of testosterone in young hypogonadal men (Finkelstein et al 1997), but this has not been confirmed in other studies (Skakkebaek et al 1981; O’Connor et al 2002). Aggression should therefore be monitored but in our experience is rarely a significant problem during testosterone replacement producing physiological levels.
Osteoporosis refers to pathological loss of bone density and strength. It is an important condition due to its prevalence and association with bone fractures; most commonly of the hip, vertebra and forearm. Men are relatively protected from the development of osteoporosis by a higher peak bone mass compared with women (Campion and Maricic 2003). Furthermore, women lose bone at an accelerated rate immediately following the menopause. Nevertheless, men start to lose bone mass during early adult life and experience an increase in the rate of bone loss with age (Scopacasa et al 2002). Women of a given age have a higher prevalence of osteoporosis in comparison to men but the prevalence increases with age in both sexes. As a result, men have a lower incidence of osteoporotic fractures than women of a given age but the gap between the sexes narrows with advancing age (Chang et al 2004) and there is evidence that hip fractures in men are associated with greater mortality than in women (Campion and Maricic 2003).
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
“This study establishes testosterone levels at which various physiological functions start to become impaired, which may help provide a rationale for determining which men should be treated with testosterone supplements,” Finkelstein says. “But the biggest surprise was that some of the symptoms routinely attributed to testosterone deficiency are actually partially or almost exclusively caused by the decline in estrogens that is an inseparable result of lower testosterone levels.”
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.
Hello..was prescribe andro gel 1.62 for about 2 years..borderline low..At time 54 year old now 57..a year ago switched doctors..new doctor would not prescribe andro gel..without me stopping use and then being checked after 6 months..it’s been a year..by the way felt great while on it much more energy. .did notice some hair receding. .but felt stronger..my question is..by using andro gel ..did I turn off my body’s natural ability to make testosterone as using andro gel..if so what do I need to do too turn my body on if my doctor does not renew therapy. .by way the past without andro gel…little too no energy..weight gain of 40 lbs..especially around the belly..thank you for your time and reply

Studies of the effects on cognition of testosterone treatment in non-cognitively impaired eugonadal and hypogonadal ageing males have shown varying results, with some showing beneficial effects on spatial cognition (Janowsky et al 1994; Cherrier et al 2001), verbal memory (Cherrier et al 2001) and working memory (Janowsky et al 2000), and others showing no effects (Sih et al 1997; Kenny et al 2002). Other trials have examined the effects of testosterone treatment in older men with Alzheimer’s disease or cognitive decline. Results have been promising, with two studies showing beneficial effects of testosterone treatment on spatial and verbal memory (Cherrier et al 2005b) and cognitive assessments including visual-spatial memory (Tan and Pu 2003), and a recent randomized controlled trial comparing placebo versus testosterone versus testosterone and an aromatase inhibitor suggesting that testosterone treatment improves spatial memory directly and verbal memory after conversion to estrogen (Cherrier et al 2005a). Not all studies have shown positive results (Kenny et al 2004; Lu et al 2005), and variations could be due to the different measures of cognitive abilities that were used and the cognitive state of men at baseline. The data from clinical trials offers evidence that testosterone may be beneficial for certain elements of cognitive function in the aging male with or without cognitive decline. Larger studies are needed to confirm and clarify these effects.

However, an important peculiarity of testosterone boosting products is their inability to cause addiction. Also, as opposed to steroids, the natural supplements don’t disturb the bodily functions. It means that these products don’t destroy the men’s hormone balance and don’t suppress the natural testosterone synthesis. Instead, the high-quality boosters successfully and safely eliminate the hormone imbalance issues in the men’s body.

The mineral zinc is important for testosterone production, and supplementing your diet for as little as six weeks has been shown to cause a marked improvement in testosterone among men with low levels.1 Likewise, research has shown that restricting dietary sources of zinc leads to a significant decrease in testosterone, while zinc supplementation increases it2 -- and even protects men from exercised-induced reductions in testosterone levels.3

A meta-analysis of nine randomized controlled trials [31] evaluated effects of ginger on net changes in blood glucose and lipid concentrations (total cholesterol, triglyceride, low-density lipoprotein cholesterol, high density lipoprotein cholesterol).  In a total of 609 adults with T2DM or hyperlipidemia, ginger supplementation led to significant reductions in plasma levels of total cholesterol, triglycerides, and blood glucose, but non-significant reduction in LDL-c levels.


Testosterone. During adolescence and early adulthood, testosterone levels in men are naturally high resulting in a feeling of strength, sexual charge and vitality. But as men get older, the aging process causes testosterone levels to decline, often resulting in a decrease in sexual desire, decrease in muscle mass, excessive weight gain, feeling tired all day, extreme mood swings, insomnia, depression and hair loss.
"I am only 10 weeks into taking your product and I have lost 12 pounds and three inches from my waist. Normally I scoff at radio or TV ads promising results like this. But in this case, my results have far exceeded my expectations. My energy level has increased and my appetite has decreased! All this without any extra exercise program. Thanks from a very satisfied customer!"
The all-new True Grit Test Booster is scientifically engineered to deliver the most powerful testosterone-boosting ingredients on the market today. This powerful 3-in-1 formula offers the benefits of both free and total testosterone boost as well as cortisol balance. Using powerful clinically studied key ingredients, True Grit Test Booster works with the body to naturally increase testosterone levels while staying within the normal healthy range
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Feeling low energy, lack of enthusiasm, but not so much on the sexual side, seems okay. At age 63 started an exercise program. nothing seem to help bring me back, so had my blood test at age 64. 150. 6 months later 165. My doctor started me on testosterone patches after a heart and prostate exam. Now two months into program, now using the gel, there seems little change. Disappointed. I am guess my next blood test will show less than 200. I am disappointed sufficiently to decide not to continue the program. I mean, the drugs cost $500 a month, although my cost is less. I guess my question is if I quit the program, will my body return to its normal, or will it be worse. i can live with a low normal, but less would not not be acceptable.

Made many mistakes growing up. Late highschool, small group of guys tried Testosterone and obviously it worked great on all levels especially on the football field etc. College years we did it again and again but not anywhere near the levels of body builders we knew and saw at the gym. When it became harder to find, then….. poof it became “legal” in the form of Pro-hormones. Great right? Not so. It worked but it also worked on everything else in a negative way. Mainly liver toxicity that I noticed and just the general idea of not really knowing what was in it. When I was 38 I had a bad event with diverticulitis. I was hospitalized for 4 days and it was horrible. This is in an infection in a diverticula that forms in your intestines. It was so bad and fast that it spread with a rapid onset of epididymitis ( infection on the epididymis of your testical). After the hospital I went see my gastro who was a board member of a large anti aging group of doctors. We did bloodwork and My testosterone levels were lower than a woman! Like 110. He also explained to me that I had probably never fully recovered normal test levels from my last “get in shape” run with pro hormones 2 years before and it probably played a part in the weakening of my intestinal wall and immune system and after discussion I realized that I had exhibited all of the text book effects of low T to the letter. After spilling my guts to my doctor we decided upon the gel. It worked great but having kids around I was worried about it affecting them so we switched to in ejections taken every 2 weeks of cypionate 200mg and my wife helps me with that at home and I never stray from the regime . My levels are around 700 to 750 and basically PSA that is non existent. I am now 41 and feel great , go to Doctor twice a year for bloodwork and all is well. My doctor also tells me that in his opinion our environmental factors play a huge role in this, meaning hormones in meats, milks, public water etc. and because of that together with “Poor decision making (me in highschool, college etc) America is in the midst of an epidemic that is being under advertised and overlooked. I constantly read up on the latest info I can find and I liked reading this and your posts. Sometimes I feel guilty because I get comments on how I look and my energy levels and I wonder is this too good to be true? But if I am following a strict regiment and bloodwork reports good things…. Do I need to worry about anything else??? This is my story and I have never shared it with ANYONE other than my wife. Big move for me!! Last point……. This is a generalization but…….all women take hormones. It’s is universally accepted and part of a woman’s life without a doubt. Why is it Taboo to publicly discuss men and hormones? I guarantee if you are a man 35 and above and you did dumb things like me and or exhibit symptoms of low T, do yourself a huge favor and go see a doctor and get blood work done. More than likely you have it! I still hide all of this and I don’t want to shout it out because I feel embarrassed. WHY? Enough already!!!!


I started testosterone therapy in January 25th 2014. Original Levels 206 total and 3.5 free. Now I am 1350 total and 125 free. I can honestly say I have felt no different. Still just as tired, Sexual interest is very high as it was before therapy. I am over weight with a fat belly. My biggest complaint is feeling tired. That has not changed. My weight increased a .little since beginning therapy. Who knows??
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?
Intramuscular testosterone injections were first used around fifty years ago. Commercially available preparations contain testosterone esters in an oily vehicle. Esterification is designed to retard the release of testosterone from the depot site into the blood because the half life of unmodified testosterone would be very short. For many years intramuscular preparations were the most commonly used testosterone therapy and this is still the case in some centers. Pain can occur at injection sites, but the injections are generally well tolerated and free of major side effects. Until recently, the available intramuscular injections were designed for use at a frequency of between weekly and once every four weeks. These preparations are the cheapest mode of testosterone treatment available, but often cause supraphysiological testosterone levels in the days immediately following injection and/or low trough levels prior to the next injection during which time the symptoms of hypogonadism may return (Nieschlag et al 1976). More recently, a commercial preparation of testosterone undecanoate for intramuscular injection has become available. This has a much longer half life and produces testosterone levels in the physiological range throughout each treatment cycle (Schubert et al 2004). The usual dose frequency is once every three months. This is much more convenient for patients but does not allow prompt cessation of treatment if a contraindication to testosterone develops. The most common example of this would be prostate cancer and it has therefore been suggested that shorter acting testosterone preparations should preferably used for treating older patients (Nieschlag et al 2005). Similar considerations apply to the use of subcutaneous implants which take the form of cylindrical pellets injected under the skin of the abdominal wall and steadily release testosterone to provide physiological testosterone levels for up to six months. Problems also include pellet extrusion and infection (Handelsman et al 1997).
A couple years ago I was having a problem with my thighs burning when walking up stairs. I noticed the muscles in my legs looking smaller. So I had my doc to check my T levels , and it was under 100. So she started me on testosterone injections weekly 200mg . After several injections I felt great , muscles in legs came back , lots of energy everything good . Leveled out at 3 injections a week 100mg , had a T level of 550 . So I go in for my scheduled injection and they tell me there out of testosterone . I might mention, this is a health care facilility that gives financial assistant if needed. And they have 3 or doctors and a nurse practitioner, which was who I was seeing . So I went on to check back often and got the same reply , were out of supply . So finally after months of the same , I gave up . I started loosing wait and my nerves got bad . Was having panic attacks etc. but I was coming off Prozac at the same time so I blamed it all on that. I was so bad with my nerves I ended up in the ER while on vacation . Doc there put me on a med for stress which I’m still using . After close to a year I checked back with the place I was getting TRT and they were resupplyed with testosterone. So I started back up because of low sex drive and ED. My first injection of 200mg was just short of a Marical , nerves felt great ED gone , had a sex drive , lot of energy . Then after 7 days or so all gone bad nerves started back up . He had me scheduled for anouther injection in 4 weeks 100mg . I went in for injection and after a couple days started feeling a little better . Then same thing as before about 7 days later nerves and everything else as before got worse . 3 weeks later I finally got a appt. with this different doc then I use to have . Told him the problems I was having , which included a horrible down mood , no energy . He decided to start injections every 2 weeks and upped the dose slitley. It’s been 5 days and already noticing ED problem reaccuring . He’s worried about the threat of prostate cancer. And doesn’t want to add any more injection to the schedule. I guess I’m going to have to start seeing the nurse practitioner who seemed to be more liberal and informed about TRT. I feel once a week injection is what it will take to get feeling good again. I’m 57 now with good health . Just need to get my T level on track with a doctor that will listen to how his patient is feeling . My last T level was at 365 . I failed to mention before I started the injections I was on androgel Dailey , 5 pumps a day . Then he gave me the injection of 200mg test . That’s when I felt fantastic for about a week or so . Then down hill . And I wanted to switch because the injection just seem so much better and they are . I noticed a big difference.
A: Depo-Testosterone is a brand name medication that contains testosterone cypionate. Depo-Testosterone is given as an intramuscular injection. The medication is indicated for replacement therapy for men that have conditions associated with symptoms of deficiency in the hormone or absence of testosterone produced in the body. Conditions that can be associated with low testosterone include: delayed puberty, impotence and hormonal imbalances. Testosterone is a sex hormone that is naturally produced in the male testicles. In women, small amounts of testosterone is produced in the ovaries and by the adrenal system. Testosterone is available in various medications for testosterone replacement therapy. Different forms of testosterone (e.g. cypionate, enanthate etc) are contained in different brand name medications. Jen Marsico, RPh
A: Endocrinology is a very difficult subject, some physicians and pharmacists alike have more difficulty with endocrinology than neurology. The reason for this is that there is no clear cut answer. Every hormone interacts with another hormone system in the body whether it be parathyroid hormone, cortisol, follicle stimulating hormone, etc. By in large, testosterone will increases lean body mass, which is to say that it typically increases muscle and or bone mass. We use it in the hospital to put weight on in patients needing to gain weight. That is partially the reason why we refer to testosterone as an "anabolic" hormone; anabolic meaning 'to build'. For more information, please visit us here at: //www.everydayhealth.com/drugs/testosterone Matt Curley, PharmD

• 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.
“I'll be totally honest I tried a different product, and I wasn't happy with the different product and so I've been without any supplement for some time now, and I can really feel the difference. And I had fantastic results with the Andro400 Max. Probably lost 35 pounds. And more impressive than that was the inches I lost off of my belly and my waist. The increased energy is fantastic, and the mood enhancement is really good. I'm very impressed with it. You guys are considerably cheaper than the other brand. I get 2 bottles a month from you guys and that's even $15 less than the GNC product.”
Testosterone is only one of many factors that influence aggression and the effects of previous experience and environmental stimuli have been found to correlate more strongly. A few studies indicate that the testosterone derivative estradiol (one form of estrogen) might play an important role in male aggression.[66][71][72][73] Studies have also found that testosterone facilitates aggression by modulating vasopressin receptors in the hypothalamus.[74]
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]
Vitamin D: Recent research suggests a strong link between vitamin D and hormone function—but as much as 40 percent of Americans are estimated to be deficient. That’s where supplements come in: According to a study published in the journal Hormone and Metabolic Research, vitamin D-deficient men who also had low T experienced a roughly 25 percent increase in T levels after supplementing with 3,000 IU of vitamin D3 for one year.
In my late 40’s I was on Androgel. I lost weight and gained muscle; became healthier over all, brighter outlook, more active, and a harder erection that had a mind of it’s own. Then I went on injectable testosterone. My numbers are normal but my weight is up even after eating less. As well everything else is shelter smelter. I intend to get back to Androgel. (this, of course, is my own personal study)
Hoffman, J., Ratamess, N., Kang, J., Magine, G., Faigenbaum, A. & Stout, J. (2006, August). Effect of creatine and beta-alanine supplementation on performance and endocrine responses in strength/power athletes [Abstract]. International Journal of Sport Nutrition and Exercise Metabolism, 16(4), 430–46. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17136944

To get your levels into the healthy range, sun exposure is the BEST way to optimize your vitamin D levels; exposing a large amount of your skin until it turns the lightest shade of pink, as near to solar noon as possible, is typically necessary to achieve adequate vitamin D production. If sun exposure is not an option, a safe tanning bed (with electronic ballasts rather than magnetic ballasts, to avoid unnecessary exposure to EMF fields) can be used.
An added testosterone benefit of my high fat and balanced protein and carb diet was that it probably helped me lose some body fat (I went from 18% to 12% body fat). Studies show that high fat diets actually contribute to increased body fat loss. And as we discussed earlier, as you lose body fat, your T production ramps up. Virtuous cycle for the win!
Like other steroid hormones, testosterone is derived from cholesterol (see figure).[128] The first step in the biosynthesis involves the oxidative cleavage of the side-chain of cholesterol by cholesterol side-chain cleavage enzyme (P450scc, CYP11A1), a mitochondrial cytochrome P450 oxidase with the loss of six carbon atoms to give pregnenolone. In the next step, two additional carbon atoms are removed by the CYP17A1 (17α-hydroxylase/17,20-lyase) enzyme in the endoplasmic reticulum to yield a variety of C19 steroids.[129] In addition, the 3β-hydroxyl group is oxidized by 3β-hydroxysteroid dehydrogenase to produce androstenedione. In the final and rate limiting step, the C17 keto group androstenedione is reduced by 17β-hydroxysteroid dehydrogenase to yield testosterone.
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An international consensus document was recently published and provides guidance on the diagnosis, treatment and monitoring of late-onset hypogonadism (LOH) in men. The diagnosis of LOH requires biochemical and clinical components. Controversy in defining the clinical syndrome continues due to the high prevalence of hypogonadal symptoms in the aging male population and the non-specific nature of these symptoms. Further controversy surrounds setting a lower limit of normal testosterone, the limitations of the commonly available total testosterone result in assessing some patients and the unavailability of reliable measures of bioavailable or free testosterone for general clinical use. As with any clinical intervention testosterone treatment should be judged on a balance of risk versus benefit. The traditional benefits of testosterone on sexual function, mood, strength and quality of life remain the primary goals of treatment but possible beneficial effects on other parameters such as bone density, obesity, insulin resistance and angina are emerging and will be reviewed. Potential concerns regarding the effects of testosterone on prostate disease, aggression and polycythaemia will also be addressed. The options available for treatment have increased in recent years with the availability of a number of testosterone preparations which can reliably produce physiological serum concentrations.
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