Overall, few patients have a compelling contraindication to testosterone treatment. The majority of men with late onset hypogonadism can be safely treated with testosterone but all will require monitoring of prostate parameters HDL cholesterol, hematocrit and psychological state. It is also wise to monitor symptoms of sleep apnea. Other specific concerns may be raised by the mode of delivery such as local side effects from transdermal testosterone.
More can be learned from a large, randomized, placebo-controlled trial of finasteride treatment in 18,800 men aged 55 or more. Finasteride is a 5α-reductase inhibitor which acts to prevent the metabolism of testosterone to dihydrotestosterone (DHT) – the most active androgen in the prostate. The trial showed a greater overall incidence of prostate cancer in the control group, but men treated with finasteride were more likely to have high grade tumors (Thompson et al 2003), suggesting that reduced androgen exposure of the prostate may delay the presentation of prostate cancer and/or promote advanced disease in some other way.
Before assessing the evidence of testosterone’s action in the aging male it is important to note certain methodological considerations which are common to the interpretation of any clinical trial of testosterone replacement. Many interventional trials of the effects of testosterone on human health and disease have been conducted. There is considerable heterogenicity in terms of study design and these differences have a potential to significantly affect the results seen in various studies. Gonadal status at baseline and the testosterone level produced by testosterone treatment in the study are of particular importance because the effects of altering testosterone from subphysiological to physiological levels may be different from those of altering physiological levels to supraphysiological. Another important factor is the length of treatment. Randomised controlled trials of testosterone have ranged from one to thirty-six months in duration (Isidori et al 2005) although some uncontrolled studies have lasted up to 42 months. Many effects of testosterone are thought to fully develop in the first few months of treatment but effects on bone, for example, have been shown to continue over two years or more (Snyder et al 2000; Wang, Cunningham et al 2004).

In fact, there is increasing evidence of the potential benefits of testosterone replacement therapy on multiple cardiovascular risk factors. This evidence recently has been comprehensively reviewed by Traish et al. in the Journal of Andrology.16 Although the full effects of testosterone replacement therapy on cardiovascular risk are yet to be established, the balance of emerging evidence from clinical studies suggests that testosterone replacement therapy in hypogonadal men may improve endothelial function, reduce proinflammatory factors, reduce hypertension, and improve the lipid profile.
A related issue is the potential use of testosterone as a coronary vasodilator and anti-anginal agent. Testosterone has been shown to act as a vasodilator of coronary arteries at physiological concentrations during angiography (Webb, McNeill et al 1999). Furthermore men given a testosterone injection prior to exercise testing showed improved performance, as assessed by ST changes compared to placebo (Rosano et al 1999; Webb, Adamson et al 1999). Administration of one to three months of testosterone treatment has also been shown to improve symptoms of angina and exercise test performance (Wu and Weng 1993; English et al 2000; Malkin, Pugh, Morris et al 2004). Longer term studies are underway. It is thought that testosterone improves angina due its vasodilatory action, which occurs independently of the androgen receptor, via blockade of L-type calcium channels at the cell membrane of the vascular smooth muscle in an action similar to the dihydropyridine calcium-channel blockers such as nifedipine (Hall et al 2006).
Before taking any supplements, at either end of the spectrum, you need to check whether it’s low testosterone that is actually causing the problem. Taking something that you don’t need could potentially cause irreversible issues. For that reason, steroid hormones like DHEA should never be prescribed without having blood tests first. Roked also recommends regular blood monitoring to make sure you’re taking the correct dosage.

According to a study in the International Journal of Reproductive BioMedicine, D-Aspartic acid increases testosterone levels in some animals. However, studies that have looked at its effects on humans are inconclusive and mainly of poor quality. The paper says there is an urgent need for more research on this chemical, which occurs naturally in some human tissues.


The Prime Labs Men’s Testosterone Booster made our top spot for testosterone booster caplets. These natural testosterone supplements improve the symptoms of low testosterone, which include low energy, a lack of stamina, a low sex drive, and a decrease in strength. The results include improvement in all of the above and the can also boost your overall mood, making you feel more confident and in control.
When I first started TRT, my physician prescribed a cream that you rub into your skin. The cream version of TRT is not too convenient, because if someone touches you while you have the cream on, the testosterone can rub off on him/her. This can be really bad around kids or pregnant women. If you’re sleeping next to someone, the cream can get on the sheets and transfer over that way, too. The cream can be annoying, but it works. There’s also a gel version called AndroGel; I skipped it because it doesn’t absorb as well as the cream does.
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
I thought your article was informative if researching effects of testosterone on cardiovascular and urological findings. However, it failed to key in on the psychological effects which cause noted behavioral changes. My husband was diagnosed with mildly low testosterone level and a fatty liver. Upon convincing his NP to put him on the topical gel as a first course of treatment he has stated he feels great, no longer foggy, and energetic like never before. Please understand, he was not having any sexual dysfunction but instead decreased energy and increased fatigue. What I also noticed is that he is now acting more dominant and agressive in his behavior. He speaks with the intent that nothing he says matters to him regardless of bluntness or disrespect. He has requested a divorce after 18 years of marriage without any prior indication that this was his intentions blindsiding our entire family and friend network. He recently got a job promotion since being on testosterone therapy and has a grandiose personal about him. He has lost 22 pounds and has decreased communications and contact with loved ones. He is scheduled to return to practitioner for a refill on his gel prescription and we, his family, are hoping that he may be taken off this medication which has drastically changed the man I have known for nearly 20 years. Unfortunately because he is a pilot and travels frequently we can only hope that he has not allowed his mental alertness spill over into his physical needs and allowed for infidelity to occur as he has changed all personal passwords, eliminated me accesss to flight benefits and checking account. We no longer get his schedule and therefore only await his sporadic call/texts to let us know if his whereabouts. He has developed a despiteful attitude towards me in a matter of 3 weeks which weeks. He has been on this medication for almost one month now. Prior to the medication, all was well and happy. This medication has completely changed our lives in a negative way. Perhaps practitioner need to consider the behavioral outcomes as well especially in men in their 40’s who may also be going through a mid life crisis. Take it from my firsthand experience that it is not been considered thoroughly in his case.

Known as the "male hormone," testosterone is produced primarily by the testicles. "Beginning around age 30, testosterone levels begin to decline naturally and continue to do so as a man ages," says Holly Lucille, ND, RN, a naturopathic doctor, educator, and author, "sometimes leading to low testosterone symptoms such as depressed moods, decreased sex drive, erectile dysfunction, and difficulties with concentration and memory.”


In a recent study of male workers, men with low testosterone levels had an increased chance of severe erectile dysfunction (Kratzik et al 2005), although such a link had not been found previously (Rhoden et al 2002). Certainly erectile dysfunction is considered part of the clinical syndrome of hypogonadism, and questions regarding erectile dysfunction form part of the clinical assessment of patients with hypogonadism (Morley et al 2000; Moore et al 2004).
There are three ways to increase testosterone activity naturally with simple lifestyle choices. The first is to increase total testosterone production. Second is to increase the amount of free and active testosterone that can stimulate testosterone receptors. The third is to unblock testosterone receptors, opening them up for testosterone stimulation.
If you have low testosterone, your functional medicine or anti-aging physician will help you diagnose it. There are several different hormones your physician should measure, but the most important two are your free testosterone and estrogen levels, because converting too much testosterone to estrogen is a problem that’s different from not making enough testosterone in the first place. In my case, I wasn’t making very much testosterone, and what I was making my body converted to estrogen way too effectively.

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“About 2 weeks after starting Andro400, I noticed my belly fat disappearing. Now, after only one month, I've lost about ten pounds all in my mid section. What a miracle! I have more energy and don't have to hold my gut in any longer. I'm more relaxed and my libido has increased 5 fold! I'm 58 years old and beginning to feel like a teenager again! Your product has delivered exactly as advertised. I'm elated!”
Started HRT in my early 50’s as I had all the low-T symptoms and Type 2 Diabetes, which was hammering my body. My total T was about 100 (not sure about Free at that point). First started with Androgel, and was getting decent symptomatic improvement, but didn’t like the residue from the cream, and traveling with the creams was a problem. I’ve gone to pellet implants for the past 7 years. Every 4-5 months, very happy with results to date.
With ingredients like Fenugreek, Ashwagandha, Shilajit, and Boron Citrate, you can expect to see some increases in lean muscle mass thanks to the hike in free and total testosterone levels as well as its ability to suppress cortisol, a natural hormone that can reduce the body’s ability to use fat stores as energy. True GRIT Test Booster does not contain proprietary blends, so you can actually see the exact dosage you are getting from each ingredient listed.
Saw palmetto and testosterone facts Testosterone is the primary male sex hormone. Boosting its levels can have many effects, such as promoting muscle growth and improving libido. Saw palmetto, a plant resembling the leaves of a palm tree, may boost testosterone levels and offer other health benefits. Learn more about saw palmetto and testosterone here. Read now
This evidence, together with the beneficial effects of testosterone replacement on central obesity and diabetes, raises the question whether testosterone treatment could be beneficial in preventing or treating atherosclerosis. No trial of sufficient size or duration has investigated the effect of testosterone replacement in primary or secondary prevention cardiovascular disease. The absence of such data leads us to examine the relationship of testosterone to other cardiovascular risk factors, such as adverse lipid parameters, blood pressure, endothelial dysfunction, coagulation factors, inflammatory markers and cytokines. This analysis can supply evidence of the likely effects of testosterone on overall cardiovascular risk. This has limitations, however, including the potential for diverging effects of testosterone on the various factors involved and the resultant impossibility of accurately predicting the relative impact of such changes.
The regular intake of testosterone boosters is known for the high level of safety comparing to the hormone injections and the use of illegal steroids. But still to protect yourself against any possible adverse reactions, you should remember that the supplementation can’t be continuous. The breaks from time to time are required. Such an approach to the use of boosters is healthy and best-working if you aspire to enhance own hormone production without any harm.
Ashwagandha is shown to be effective at reducing cortisol which in turn helps with testosterone production. There are also numerous studies showing the effects on improving testosterone in infertile men (ref 80).  If you are using the Aggressive Strength product you don't need to supplement with ashwagandha as it's included in the test booster formula. Likewise if you're using Tian Chi (my daily herb drink).

In fact, there is increasing evidence of the potential benefits of testosterone replacement therapy on multiple cardiovascular risk factors. This evidence recently has been comprehensively reviewed by Traish et al. in the Journal of Andrology.16 Although the full effects of testosterone replacement therapy on cardiovascular risk are yet to be established, the balance of emerging evidence from clinical studies suggests that testosterone replacement therapy in hypogonadal men may improve endothelial function, reduce proinflammatory factors, reduce hypertension, and improve the lipid profile.
Testosterone boosters are formulated for men in most cases, though there are a few brands that are appropriate for women. These are generally for men who want to improve their lean muscle mass, stamina, and energy levels. If you have low testosterone levels, these are great to ward off symptoms like low energy, excessive body fat, and a low sex drive. Some athletes might benefit from these boosters. You should always check with your doctor before adding these supplements or any other supplements to your regimen, particularly if you have chronic health conditions or if you are already taking medications or supplements.
6., 7. JK, Udani, George AA, Musthapa M, Pakdaman MN, and Abas A. "Effects of a Proprietary Freeze-Dried Water Extract of Eurycoma Longifolia (Physta) and Polygonum minus on Sexual Performance and Well-Being in Men: A Randomized, Double-Blind, Placebo-Controlled Study." National Center for Biotechnology Information. U.S. National Library of Medicine, 12 Jan. 2014.
Sleep apnea is another frequently listed contraindication to testosterone treatment. There have been a few reports of the development, or worsening, of sleep apnea during testosterone therapy (Matsumoto et al 1985) but sleep apnea is actually associated with lower serum testosterone levels (Luboshitzky et al 2002). The reduction in fat mass during treatment with testosterone could potentially be beneficial for sleep apnea, so many specialists will still consider patients for treatment with appropriate monitoring. It is wise to take a clinical history for sleep apnea during testosterone treatment in all men and perform sleep studies in those who develop symptoms.
Zinc is an essential mineral that plays an important role in improving testosterone levels as well as sperm production. Oysters are rich sources of this mineral. An increase in testosterone levels also helps improve your sexual desire and energy, which means that you are going to derive more pleasure from your sexual encounters besides having higher chances of conceiving.
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!!!!

Natural testosterone boosters also help to increase the amount of free testosterone in the body. There are a couple of different ingredients they use that help with this. One of these ingredients is stinging nettle. Stinging nettle is actually able to bind to the globulin in place of testosterone, therefore leaving more free testosterone in the body that is unbound.
For this reason I recommend doing your own research on this supplement before taking it. 5g of ground up dried powder is what was used in the studies. I recommend taking 1-2 capsules of the concentrated form from Paradise Herbs. Alternatively, the Aggressive Strength Test Booster also has MP in its formula so you may prefer to use that blend instead. 
“What on earth do you mean?” Well, I don’t literally mean taking it to the compound. What I mean to say is that you should be incorporating the three most important compound exercises into your routine: bench press, squats, and deadlifts. In case you didn’t know, by training large muscle groups your body releases more testosterone. When you do these three lifts, and perform them properly, then you’ll reap the benefits of not only muscle gains, but also that of an increased release of testosterone and growth hormone.
I definitely enjoyed an increase in muscle mass during my experiment. Despite dropping six percentage points in body fat in three months, my weight stayed about the same; I began the experiment weighing 185 pounds and I ended it weighing the same. The body fat I lost was replaced with muscle. It was fun to see and hear Kate’s reaction when I’d take off my shirt to get into the shower. “Whoa! Your muscles have gotten huge!”
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.
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!
I am a 43 year old and have undergone pituitary sectioning/surgery twice. Since then i have been using the testoterone gel daily for 12 years without any problem. However, i still have pituitary tumor and also diagnosed with colon cancer. I am thinking of stopping the HRT because i felt it is worsening the illness. I would be glad if you could advice me of the risk of stopping the treatment.
A number of research groups have tried to further define the relationship of testosterone and body composition by artificial alteration of testosterone levels in eugonadal populations. Induction of a hypogonadal state in healthy men (Mauras et al 1998) or men with prostate cancer (Smith et al 2001) using a gonadotrophin-releasing-hormone (GnRH) analogue was shown to produce increases in fat mass and decreased fat free mass. Another experimental approach in healthy men featured suppression of endogenous testosterone production with a GnRH analogue, followed by treatment with different doses of weekly intramuscular testosterone esters for 20 weeks. Initially the experiments involved men aged 18–35 years (Bhasin et al 2001) but subsequently the study was repeated with a similar protocol in men aged 60–75 years (Bhasin et al 2005). The different doses given were shown to produce a range of serum concentrations from subphysiological to supraphysiological (Bhasin et al 2001). A given testosterone dose produced higher serum concentrations of testosterone in the older age group (Bhasin et al 2005). Subphysiological dosing of testosterone produced a gain in fat mass and loss of fat free mass during the study. There were sequential decreases in fat mass and increases in fat free mass with each increase of testosterone dose. These changes in body composition were seen in physiological and supraphysiological treatment doses. The trend was similar in younger versus older men but the gain of fat mass at the lowest testosterone dose was less prominent in older patients (Bhasin et al 2001; Bhasin et al 2005). With regard to muscle function, the investigators showed dose dependent increases in leg strength and power with testosterone treatment in young and older men but there was no improvement in fatigability (Storer et al 2003; Bhasin et al 2005).

This evidence, together with the beneficial effects of testosterone replacement on central obesity and diabetes, raises the question whether testosterone treatment could be beneficial in preventing or treating atherosclerosis. No trial of sufficient size or duration has investigated the effect of testosterone replacement in primary or secondary prevention cardiovascular disease. The absence of such data leads us to examine the relationship of testosterone to other cardiovascular risk factors, such as adverse lipid parameters, blood pressure, endothelial dysfunction, coagulation factors, inflammatory markers and cytokines. This analysis can supply evidence of the likely effects of testosterone on overall cardiovascular risk. This has limitations, however, including the potential for diverging effects of testosterone on the various factors involved and the resultant impossibility of accurately predicting the relative impact of such changes.

This product is to be taken once daily on an empty stomach. Is there a particular time frame when food can be eaten? If I were to take this in the morning right when I wake up and then eat breakfast an hour later, is that fine? Also, mostly the only time of day my stomach is usually empty is right before going to bed. If it is taken at this time, will this affect sleep at all?


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.
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?
With the ever-increasing interest in IGF-1, a growing number of legal, over-the-counter supplements have emerged which are aimed at amplifying the body’s own supply of this age-reversing hormone. The most common tend to be in the form of deer antler velvet extracts, delivered as a spray, due to the naturally occurring IGF-1 contained in the velvet itself.

The most popular way is to combine with a good tasting protein powder. Advanced BCAA’s taste very bitter due to the high amount of peptides. Peptides taste very bitter. You want to use 1 tsp of Advanced BCAA’s with every serving of protein powder. This will really upgrade the quality of the protein powder by adding BCAA, AND in peptides form. If you are using a whey protein you’ll increase the overall BCAA content by over 20%
A: There are no over-the-counter products approved by the U.S. Food and Drug Administration (FDA) to increase testosterone levels. There are several prescription medication options available. Please consult with your health care provider in regards to your testosterone levels and to determine which treatment option best meets your individual needs. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Kristen Dore, PharmD
I’m a low key,thinker-type, after a test I learned my T hormone was so low I should be rigid. TRT sent my drive into negative overdrive: ambition, cunning, entrepreneurial risk, physcal and psychological risks: drugs,you name it. I was lucky it happened after 50 years of memories ’cause I missd and have problems recalling the last seven years that I was on TRT (5 pumps a day of 1.25mgs). If you’re starting, take a pictoral record at the least of your monthly life ( a flick a month).
“Life for the winner is more glorious. It enters the next round of competition with already elevated testosterone levels, and this androgenic priming gives it an edge that increases its chances of winning yet again. Through this process an animal can be drawn into a positive-feedback loop, in which victory leads to raised testosterone levels which in turn leads to further victory.”

Sharma, R., Oni, O. A., Gupta, K., Chen, G., Sharma, M., Dawn, B., … & Barua, R. S. (2015, August 6). Normalization of testosterone level is associated with reduced incidence of myocardial infarction. European Heart Journal, 36(40), 2706-2715. Retrieved from https://academic.oup.com/eurheartj/article/36/40/2706/2293361/Normalization-of-testosterone-level-is-associated
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