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.

Two of the immediate metabolites of testosterone, 5α-DHT and estradiol, are biologically important and can be formed both in the liver and in extrahepatic tissues.[155] Approximately 5 to 7% of testosterone is converted by 5α-reductase into 5α-DHT, with circulating levels of 5α-DHT about 10% of those of testosterone, and approximately 0.3% of testosterone is converted into estradiol by aromatase.[2][155][161][162] 5α-Reductase is highly expressed in the male reproductive organs (including the prostate gland, seminal vesicles, and epididymides),[163] skin, hair follicles, and brain[164] and aromatase is highly expressed in adipose tissue, bone, and the brain.[165][166] As much as 90% of testosterone is converted into 5α-DHT in so-called androgenic tissues with high 5α-reductase expression,[156] and due to the several-fold greater potency of 5α-DHT as an AR agonist relative to testosterone,[167] it has been estimated that the effects of testosterone are potentiated 2- to 3-fold in such tissues.[168]
If low T is your initial concern, lifestyle changes may help. “Dietary and exercise changes, particularly limiting sugars, especially fructose, eating healthy saturated fats, and engaging in high-intensity exercises may relieve symptoms of low testosterone," Lucille says. "Strength training, reducing stress, and optimizing vitamin D levels can also be very effective at boosting testosterone levels naturally."
My genetic make-up is 47XXY. I was diagnosed in September, 1976, and have been on some kind of T-therapy since – injections, pills, gels, patches, pellets, now back on injections. At this time, now, I inject 1/2cc deep IM, every 7-8 days. I suffered a blood clot between my knee and my groin (right leg) in January, 2017. I am now on Eliquis through June, 2017. My blood has always been quick to coagulate. I’ve read through all of this, and only found mention of blood clots sporadically in relation to T-therapy. I’m 70 yoa, have never had a problem before. Can you give me any info I can pass along to my doctor? Thank you.
I think that the biggest hurdle for most physicians prescribing testosterone is the fear that they’re going to promote prostate cancer. [See “Incongruous findings,” below.] That’s because more than six decades ago, it was shown that if you lowered testosterone in men whose prostate cancer had metastasized, their condition improved. (It became a standard therapy that we still use today for men with advanced prostate cancer. We call it androgen deprivation or androgen-suppressive therapy.) The thinking became that if lowering testosterone makes prostate cancer disappear, at least for a while, then raising it must make prostate cancer grow. But even though it’s been a widely held belief for six decades, no one has found any additional evidence to support the theory.
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.
Millions of men use testosterone therapy to restore low levels and feel more alert, energetic, mentally sharp, and sexually functional. But it's not that simple. A man's general health also affects his testosterone levels. For instance, being overweight, having diabetes or thyroid problems, and taking certain medications, such as glucocorticoids and other steroids, can affect levels. Therefore, simply having low levels does not always call for taking extra testosterone.
There is increasing interest in the group of patients who fail to respond to treatment with PDE-5 inhibitors and have low serum testosterone levels. Evidence from placebo-controlled trials in this group of men shows that testosterone treatment added to PDE-5 inhibitors improves erectile function compared to PDE-5 inhibitors alone (Aversa et al 2003; Shabsigh et al 2004).
The general recommendation is that men 50 and older who are candidates for testosterone therapy should have a DRE and a PSA test. If either is abnormal, the man should be evaluated further for prostate cancer, which is what we do with everybody whether they have low testosterone or not. That means a biopsy. But if all of those results are normal, then we can initiate testosterone therapy. The monitoring that needs to happen for men who begin testosterone therapy is really very simple: DRE, PSA, and a blood test for hematocrit or hemoglobin, once or twice in the first year and then yearly after that, which is pretty much what we recommend for most men over age 50 anyway.

A study in the European Journal of Clinical Nutrition that showed drops in cholesterol levels also highlighted the benefits of Fenugreek in controlling glucose levels (this is in fact what the trial was intended to test). When you eat, your glucose levels spike. Fenugreek helps stimulate insulin release to slow down the absorption of sugars in your intestinal tract. Fenugreek might help control blood sugar levels in diabetics.  Furthermore, high glucose levels create a poor environment for testosterone production.  This is why Tim Ferris, in his testosterone diet, advises against consuming sweets and simple starches when you are trying to increase T levels.
i have been on T therapy for 32 years now after being diagnosed with Klinefelters. Recently my pharmacy had been non responsive to my request to refill and they flat out refused/declined the request from my doctor which was T powder mixed with a cream base that you place on the shoulder. I asked if I could purchase it with cash and they told me that the FDA is not approving this usage anymore but did not provide an option. Completely out now for close to a week and have been working for five weeks trying to get again. Now what to do, I’m having all kinds of weird feelings including anxiety to the max, nervous, irritable, muscle cramps/pains … I guess they just don’t care that we cannot get something our bodies have adjusted too for many years. Strange thing is I think I have found a compounding pharmacy in Houston Texas that will fill this Rx. I’m not sure how one can do this and another cannot especially if they have compounding capabilities. Now I’m wondering if I can get thru this and stop taking it alltogether however I already know I’m seeing signs of being forgetful, lack of energy and foggy brain. I wonder if this will ever stop. The really bad thing is that I’m traveling for work and cannot get into my doctor’s office. This whole process is not great. I can only imagine what a person must feel taking hard drugs then not getting any all at once.
I bought most of the ingredients for my Testosterone Salad at Whole Foods. For those curious, I added up all the ingredients and divided by six (I typically ate six of these salads in a week). The cost per salad was roughly $5. That’s about the price many folks pay every day for a crappy fast food meal. If you’re on a budget, I’m sure you could get the ingredients at Walmart and bring the cost per salad down even more.

Testosterone belongs to a class of male hormones called androgens, which are sometimes called steroids or anabolic steroids. In men, testosterone is produced mainly in the testes, with a small amount made in the adrenal glands. The brain's hypothalamus and pituitary gland control testosterone production. The hypothalamus instructs the pituitary gland on how much testosterone to produce, and the pituitary gland passes the message on to the testes. These communications happen through chemicals and hormones in the bloodstream.
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.

Testosterone plays a role in certain behaviors, including aggression and dominance. It also helps to spark competitiveness and boost self-esteem. Just as sexual activity can affect testosterone levels, taking part in competitive activities can cause a man’s testosterone levels to rise or fall. Low testosterone may result in a loss of confidence and lack of motivation. It can also lower a man’s ability to concentrate or cause feelings of sadness. Low testosterone can cause sleep disturbances and lack of energy.
I am 31, been on HRT for about 6 months now. Started with Oxandralone (orally, 3 x 10mg tablets per day) and found a 20-30% increase in strength and outlook on life. Stopped taking it and now use Primo Testostin Depot (test enanthate – 1 x 250mg shot every 2 weeks). In the first week I feel a lot stronger, voice deepens etc but these benefits quickly diminish after about 5-7 days
Men who watch a sexually explicit movie have an average increase of 35% in testosterone, peaking at 60–90 minutes after the end of the film, but no increase is seen in men who watch sexually neutral films.[43] Men who watch sexually explicit films also report increased motivation, competitiveness, and decreased exhaustion.[44] A link has also been found between relaxation following sexual arousal and testosterone levels.[45]
Once your elevate testosterone levels, you will also sharpen your focus, enhance sports performance, and enjoy enormous competitive spirit. You will also soon notice that the lack of motivation is no longer your problem. Being highly motivated and aggressive due to the action of testosterone boosters, you will experience better muscle gain. Whether you are a novice or a professional sportsman, you will quickly reach your sports goals.
Binge drinking on the other hand does impact Testosterone levels – especially on a short term basis. Two studies (22 & 23) show that large acute quantities of alcohol consumption in a short period led to decreases in Testosterone levels by a whooping 20-23% after 24hours! Note however this is drinking to extreme excess! Likewise, chronic alcohol abuse is known to reduce testosterone more notably (as seen in alcoholics).
Low Testosterone has a big impact on men. Some males suffer debilitating symptoms when their bodies produce insufficient levels of testosterone, resulting in a condition called hypogonadism. Hypogonadism is the decreased functionality of the testes in producing an adequate amount of testosterone. Hypogonadism is not permanent, and can be treated with hormone replacement therapy, specifically Low Testosterone Therapy.
Testosterone replacement therapy is currently only FDA approved for men who have been diagnosed with hypogonadism, but it’s also prescribed off-label for older men who take it in hopes that it will improve their libido. The use of testosterone therapy is increasingly common in the United States, with more than 2 million men receiving the therapy. Not every man benefits from taking testosterone supplements. Testosterone is available in different forms, including topicals such as gels, creams, and patches; injections; and pellets that are surgically placed directly beneath the skin. (7)