This one is another herb that is known to increase semen volume. It has been found that men who consume this herb in the form of a supplement can expect higher sperm count per milliliter of semen, higher semen volume per ejaculation and also better sperm motility. It is also known to have a positive effect on the sex drive and arousal of both men and women.

Unfortunately, in the modern world, stresses and emotional exhaustion lie in wait for men at every step. Nowadays, burnout is a constant state for many men. Of course, this causes great harm to the men’s health. Stresses drain of vitality and affect emotional state. Besides, they are also very dangerous for the nervous system. The nature is wise. And the body of a man who is not subject to stress can produce more testosterone.
Ashwagandha is sometimes included in testosterone supplements because of the hypothesis that it improves fertility. However, we couldn’t find sufficient evidence to support this claim (at best, one study found that ashwagandha might improve cardiorespiratory endurance). WebMD advocates caution when taking this herb, as it may interact with immunosuppressants, sedative medications, and thyroid hormone medications.

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.
That said, keep in mind that using leucine as a free form amino acid can be highly counterproductive as when free form amino acids are artificially administrated, they rapidly enter your circulation while disrupting insulin function, and impairing your body's glycemic control. Food-based leucine is really the ideal form that can benefit your muscles without side effects.
Men who produce more testosterone are more likely to engage in extramarital sex.[55] Testosterone levels do not rely on physical presence of a partner; testosterone levels of men engaging in same-city and long-distance relationships are similar.[54] Physical presence may be required for women who are in relationships for the testosterone–partner interaction, where same-city partnered women have lower testosterone levels than long-distance partnered women.[59]
If you have low testosterone and are prescribed testosterone therapy by your doctor, it does not increase your risk for getting prostate cancer. However, in some patients with existing prostate cancer, adding testosterone hormone therapy can make the cancer grow faster. Men with low testosterone levels are actually more likely to get prostate cancer than men with normal prostate levels. You need to discuss these details with your physician and make the best decision for you.
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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.
Zinc: Another potent ingredient to add to any testosterone booster is zinc. This study shows how zinc is able to prevent a decline in testosterone levels during intense and hard workouts performed by wrestlers. Researchers found that the group who was administered with a placebo had a reduction in testosterone, as opposed to the group who were supplemented with zinc. The placebo group had a notable drop in their testosterone count during this process. Zinc has also been shown to increase the number of free testosterone and lower SHBG.
Testosterone booster products obtained from trusted sources and administered as per the recommendations of the manufacturer may still present some health risks. The present case provided weak evidence of causality between acute liver injury and a commercial testosterone booster. To guarantee an optimal outcome with no severe side effects, further research is warranted to confirm the present findings and determine whether the effects observed in this case report would be statistically significant in larger samples.

Free testosterone (T) is transported into the cytoplasm of target tissue cells, where it can bind to the androgen receptor, or can be reduced to 5α-dihydrotestosterone (DHT) by the cytoplasmic enzyme 5α-reductase. DHT binds to the same androgen receptor even more strongly than testosterone, so that its androgenic potency is about 5 times that of T.[118] The T-receptor or DHT-receptor complex undergoes a structural change that allows it to move into the cell nucleus and bind directly to specific nucleotide sequences of the chromosomal DNA. The areas of binding are called hormone response elements (HREs), and influence transcriptional activity of certain genes, producing the androgen effects.
Ghlissi, Z., Atheymen, R., Boujbiha, M. A., Sahnoun, Z., Makni Ayedi, F., Zeghal, K., ... Hakim, A. (2013, December). Antioxidant and androgenic effects of dietary ginger on reproductive function of male diabetic rats [Abstract]. International Journal of Food Sciences and Nutrition, 64 (8), 974–978. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23862759
Nutritional developers formulated Nugenix® with Testofen®, a key natural ingredient to help boost “free” testosterone along with resistance training. This key ingredient is carefully extracted from the fenugreek plant. A Testofen® study in Irvine, California indicated positive free testosterone-related results. Nugenix also includes L-Citrulline Malate, Tribulus, Zinc, plus Vitamins B6 and B12 to help promote overall health and performance.*

Hi my names Graham. I’ve suffered with Gyno for most of my adult life. Even when I’ve lost a ton of weight , those two unhelpful bags of fat are still there. To save me 4 to 6 grand on liposuction or surgery, will an estrogen blocker and testosterone booster help. I’ve also heard of a cream called andractim that can help , but they are expensive. Any advice would be great . Thanks.
Take 1 teaspoon. Incredibly dense in nutrients and feed by bees to the larvae who grows on to be the queen bee. I found one human study where a 4g daily serving led to an small increase in testosterone in older men (ref 78). There are also numerous animal studies (ref 79) showing positive effects. Personally I source NZ manuka royal jelly from Manuka Health.

We start with plastic. A lot of plastic contains bisphenol A (BPA); BPA is a weak synthetic estrogen. Like many other chemicals used in making plastics, BPA is a hormone disruptor and can block or mimic hormones and how they act in the body (34). If you think you’re safe with BPA plastic, think again. Research shows that BPA free plastic has similar estrogen-like effects on the body.
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.
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.
Conflicting results have been obtained concerning the importance of testosterone in maintaining cardiovascular health.[29][30] Nevertheless, maintaining normal testosterone levels in elderly men has been shown to improve many parameters that are thought to reduce cardiovascular disease risk, such as increased lean body mass, decreased visceral fat mass, decreased total cholesterol, and glycemic control.[31]
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.
A testicular action was linked to circulating blood fractions – now understood to be a family of androgenic hormones – in the early work on castration and testicular transplantation in fowl by Arnold Adolph Berthold (1803–1861).[181] Research on the action of testosterone received a brief boost in 1889, when the Harvard professor Charles-Édouard Brown-Séquard (1817–1894), then in Paris, self-injected subcutaneously a "rejuvenating elixir" consisting of an extract of dog and guinea pig testicle. He reported in The Lancet that his vigor and feeling of well-being were markedly restored but the effects were transient,[182] and Brown-Séquard's hopes for the compound were dashed. Suffering the ridicule of his colleagues, he abandoned his work on the mechanisms and effects of androgens in human beings.
BCAA peptides are the building blocks of muscle.  Your body cannot make BCAA’s.  You have to eat them.  One easy way of course is food and things like whey protein powder.  That is why whey protein works so well because it contains BCAA’s at high levels.  Advanced BCAA is 50% BCAA in peptide form!!  Peptides are digested faster and more efficiently than whole foods and normal protein powders.  This means more muscle building and recovery support!!
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.
The hormone also plays a role in sex drive, sperm production, fat distribution, red cell production, and maintenance of muscle strength and mass, according to the Mayo Clinic. For these reasons, testosterone is associated with overall health and well-being in men. One 2008 study published in the journal Frontiers of Hormone Research even linked testosterone to the prevention of osteoporosis in men.
I have had BPH for years. Am in early 60s and recently had a 12 site prostate biopsy after a very slow rise of PSA to 4.5 (over a period of 10 years). There were two sites with PIN (one with outpouching and one was focal). Have been on various form of test replacement…changing methods periodically from test cyp IM, or SQ, with and without HCG or HCG alone. I want to continue a very low dose of either HCG or Test Cyp (10-20mg twice/week). What are your thoughts?

Testosterone, historically believed to be important only for male sexual function, has over the past decades transformed from niche hormone to multi-system player.22 There is increasing recognition of the harmful consequences of hypogonadism (also known as testosterone deficiency) wide spectrum of beneficial health effects of testosterone therapy and.23, 24


Professional-athlete-turned-biohacker Maximilian Gotzler gave a speech about boosting testosterone at the 2015 Bulletproof Conference. He started by leading the room through the Haka, a Maori war dance that New Zealand’s pro rugby team has made popular. The Pasadena Conference Center trembled as over 100 people shouted and stomped in unison. It was awesome.
Whether you are currently on a plateau or you are looking to obtain more energy in life and in the gym this test booster and its full coverage blend of natural extracts is designed to support your body’s anabolic potential without compromising natural production. Test Booster 1.0 works with your body to promote elevations in natural test levels; helping to support muscle density, a balanced metabolism, and insane natural energy levels.
DHEA (dehydroepiandrosterone) extract - this is a chemical that used in your body which a ‘hormone precursor’. This means it’s the chemical used by the body to create hormones like oestrogen or testosterone. When taken as supplement it is believed to boost testosterone levels, but DHEA has not been shown to increase testosterone in men. DHEA comes in two form:
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].
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The results of these studies indicate that testosterone treatment in older men with low testosterone may proffer some benefits. However, testosterone treatments may also entail risks. The exact trade-off is unknown. Larger and longer studies need to be performed to clarify the effects of testosterone on heart health, bone health, disability, and more.
The diagnosis of late-onset hypogonadism requires the combination of low serum testosterone levels with symptoms of hypogonadism. Questionnaires are available which check for the symptoms of hypogonadism. These have been validated for the assessment of aging patients with hypogonadism (Morley et al 2000; Moore et al 2004) but have a low specificity. In view of the overlap in symptoms between hypogonadism, aging and other medical conditions it is wise to use a formal method of symptom assessment which can be used to monitor the effects of testosterone replacement.
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.

There are pills in the United States for testosterone supplementation, but their use is strongly discouraged because they cause significant liver toxicity. A safe oral formulation called testosterone undecanoate is available in Canada and in Europe, but not in the United States. What’s quite exciting is that an injectable version of testosterone undecanoate (Nebido) was submitted to the FDA for approval in August 2007. (It’s already approved in many other countries.) It lasts for 12 weeks, so a patient could come in and get a shot about four times a year. [Editor’s note: In December 2009, the brand name of the drug in the United States was changed to Aveed. As of January 2011, it was still awaiting FDA approval.]
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.
Testosterone levels peak by early adulthood and drop as you age—about 1% to 2% a year beginning in the 40s. As men reach their 50s and beyond, this may lead to signs and symptoms, such as impotence or changes in sexual desire, depression or anxiety, reduced muscle mass, less energy, weight gain, anemia, and hot flashes. While falling testosterone levels are a normal part of aging, certain conditions can hasten the decline. These include:
In 2002, the federally sponsored Women’s Health Initiative (WHI) stopped its hormone replacement therapy (HRT) trial (estrogen plus progestin), which included more than 16,000 women, three years early because those taking the pills had an increased risk of developing breast cancer and blood clots, and an increased risk of suffering a stroke or heart attack than those taking a placebo. The findings ran counter to the long-held belief that HRT could preserve health — and trim heart-disease risk in women.
One study showed that six months of zinc supplementation among slightly zinc-deficient elderly men doubled serum levels of testosterone. And another eight-week trial found that college football players who took a nightly zinc supplement showed increased T-levels and increased leg strength that was 250 percent greater than a placebo! Holy quads, Batman! Research has also shown deficiencies in zinc to be a risk factor for infertility caused by low testosterone levels.
Eggs often come up in reproductive health discussion. This time we’re talking about dietary eggs, as in omelets, and the role they play in boosting testosterone. The hormone boost from eggs comes primarily from the yolks, which are rich in dietary cholesterol, mono- and saturated fats—nutrients once demonized by health experts that have since proven to positively influence waistlines and hormone-health.
Today we take a look at some of the physical and psychological benefits that come with having optimal testosterone levels (I’ll talk about what “optimal” means regarding T later this week). You probably know about some of the benefits already, but some of the ones I discuss may surprise you. When appropriate, I’ll report any health benefits that I experienced during my own 90-day testosterone boosting experiment.
We start with plastic. A lot of plastic contains bisphenol A (BPA); BPA is a weak synthetic estrogen. Like many other chemicals used in making plastics, BPA is a hormone disruptor and can block or mimic hormones and how they act in the body (34). If you think you’re safe with BPA plastic, think again. Research shows that BPA free plastic has similar estrogen-like effects on the body.

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

I’m 56 and 5 years ago dropped to 270 with all the side effects listed for low test. After trying shots and not liking the roller coaster effect, I switched to gels. Androgel and Axiron had too low a dosage and far too messy. They need to not call them gels but liquids. If it pours like water it’s a liquid. My doctor recommended a compounding Pharmacy that made a cream and it was perfect. It had a click dispenser that looked like a deoderant that would pre-measure the dosage and I could rub it on my arms and shoulders or on my neck, really anywhere not covered in hair but the thinner the skin the better. It dried instantly so I could get dressed in a couple minutes. My totals never got out of the 400’s until I started the 150mg daily cream dosage, then they hovered around 700. The down side was Insurance didn’t cover it and I had to pay $50 a month vs free shots from the doctors office or $10 for the so-called gels. Bad news is it has now doubled in price due to new Federal production regs on compounding Pharms. Now, I am going back on the shots which I now have to buy the vile for $125 for 10 doses and have to take it to my doctor to administer it every 2wks while I am looking into bioidentical pellet implants.
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.

Avoid stressful situations – It is actually that simple. If you can avoid stressful situations, then you can significantly improve your overall testosterone production. Why is that? Well, you should know that stress makes our bodies to produce cortisol that is a notorious and well-known testosterone killer. So, what can you do about it? Well, you should definitely try deep breathing, meditating, exercising, and other lifestyle changes that can help you deal with the stressful situations the right way.


Regardless of the method of testosterone treatment chosen, patients will require regular monitoring during the first year of treatment in order to monitor clinical response to testosterone, testosterone levels and adverse effects, including prostate cancer (see Table 2). It is recommended that patients should be reviewed at least every three months during this time. Once treatment has been established, less frequent review is appropriate but the care of the patient should be the responsibility of an appropriately trained specialist with sufficient experience of managing patients treated with testosterone.
TestoGen USA stood head and shoulders above the rest, which is why it earned the top spot on our list. This testosterone supplement will help keep men on a more even keel when it comes to both stamina and temperament. You won’t feel wiped out at the end of the day and you’ll be less likely to feel your tension levels rising as you deal with everyday annoyances. In addition, it will stimulate your libido and can even help you lose excess body fat.
I request that my full name not be released. Ron will do. I am 81 years old and am not after a hot time in the sack, although I don’t pass up opportunity. Patches, gel and spray did not do much for my disposition, energy or overall sense of well being. 14 pellets every 3 to 4 months have made a world of difference. It is a bit painful but worth it as long as it helps. My Primary Dr. did have me state that I would not seek treatment for prostate cancer when I declined a biopsy. I pay for the pellets and at my age see no need for Medicare to pay for questionable tests.
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 is an androgen hormone produced by the adrenal cortex, the testes (in men), and the ovaries (in women). It is often considered the primary male sex hormone. Testosterone stimulates the development of male secondary sex characteristics (like body hair and muscle growth) and is essential in the production of sperm. In women, testosterone plays a role in egg development and ovulation.
Advanced BCAA’s are made from a hydrolyzed whey protein isolate.  Its 100% whey protein really.  But the amazing thing about this hydrolyzed whey isolate is that it is a whopping 50% BCAA!  Incredible really.  A pre digested whey protein that is 50% BCAA.  Normally hydrolyzed whey protein is only 30% BCAA.  Thus for every 10 grams of Advanced BCAA you are getting 5 grams of pre-digested BCAA peptides.  NOT free form amino acids from China.  Why is this so exciting and valuable to your bodybuilding goals?

Our clients love the results and energy they’ve get once their hormonal levels are fully balanced. Because hormones are so important, we’re proud to lend our medical expertise to ensure all our hormonal treatments are tailored to your specific needs. If you’re curious about NHT, you can take a short quiz to see if NHT would be a good fit for your body.
I’m a 49yr old who had a testosterone level of below 300 . I have been on AndroGel for over one year now. The first three months my levels were running between 500 and 600.in the fourth month my level spiked to over 1200 and cut my doctor cut my dosage back to half. my levels fell back to below normal and have since remained that way even though I have been put on the normal dosage again. It seems as though my body has stopped responding to the andro gel.
*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
While steroids like DHEA can be used to boost testosterone, if used in the wrong dosages or by people who don’t need them they can raise T-levels far beyond the normal range, which is what causes accelerated muscle gain. According to Dr. Emil Hodzovic, who is a competitive bodybuilder as well as a doctor with Medichecks, steroids come with “a set of risks, including liver damage, hormone imbalance, high blood pressure, and a higher risk of a stroke or heart attack”.
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.

Epidemiological evidence supports a link between testosterone and glucose metabolism. Studies in non-diabetic men have found an inverse correlation of total or free testosterone with glucose and insulin levels (Simon et al 1992; Haffner et al 1994) and studies show lower testosterone levels in patients with the metabolic syndrome (Laaksonen et al 2003; Muller et al 2005; Kupelian et al 2006) or diabetes (Barrett-Connor 1992; Andersson et al 1994; Rhoden et al 2005). A study of patients with type 2 diabetes using measurement of serum free testosterone by the gold standard method of equilibrium dialysis, found a 33% prevalence of biochemical hypogonadism (Dhindsa et al 2004). The Barnsley study demonstrated a high prevalence of clinical and biochemical hypogonadism with 19% having total testosterone levels below 8 nmol/l and a further 25% between 8–12 nmol/l (Kapoor, Aldred et al 2007). There are also a number longitudinal studies linking low serum testosterone levels to the future development of the metabolic syndrome (Laaksonen et al 2004) or type 2 diabetes (Haffner et al 1996; Tibblin et al 1996; Stellato et al 2000; Oh et al 2002; Laaksonen et al 2004), indicating a possible role of hypogonadism in the pathogenesis of type 2 diabetes in men. Alternatively, it has been postulated that obesity may be the common link between low testosterone levels and insulin resistance, diabetes and cardiovascular disease (Phillips et al 2003; Kapoor et al 2005). With regard to this hypothesis, study findings vary as to whether the association of testosterone with diabetes occurs independently of obesity (Haffner et al 1996; Laaksonen et al 2003; Rhoden et al 2005).
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