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.
A notable study out of Wayne State University in Indiana found that older men who had a mild zinc deficiency significantly increased their testosterone from 8.3 to 16.0 nmol/L—a 93 percent increase—following six months of zinc supplementation. Researchers of the study concluded that zinc may play an important role in modulating serum testosterone levels in normal healthy men.6

Studies conducted in rats have indicated that their degree of sexual arousal is sensitive to reductions in testosterone. When testosterone-deprived rats were given medium levels of testosterone, their sexual behaviors (copulation, partner preference, etc.) resumed, but not when given low amounts of the same hormone. Therefore, these mammals may provide a model for studying clinical populations among humans suffering from sexual arousal deficits such as hypoactive sexual desire disorder.[37]
I turned 50 and noticed I had low energy and no desire to workout. I decided to try a testosterone enhancer. I bought these and upon taking them I felt immediate results. I then ordered 3 more bottles on the spot. It is truly amazing how much of a difference it has made in my strength and endurance. Not to mention stamina. I never would've guessed that anything would have such a noticeable positive effect on strength and energy. I am so impressed.
There have been case reports of development of prostate cancer in patients during treatment with testosterone, including one case series of twenty patients (Gaylis et al 2005). It is not known whether this reflects an increase in incidence, as prostate cancer is very common and because the monitoring for cancer in patients treated with testosterone is greater. Randomized controlled trials of testosterone treatment have found a low incidence of prostate cancer and they do not provide evidence of a link between testosterone treatment and the development of prostate cancer (Rhoden and Morgentaler 2004). More large scale clinical trials of longer durations of testosterone replacement are required to confirm that testosterone treatment does not cause prostate cancer. Overall, it is not known whether testosterone treatment of aging males with hypogonadism increases the risk of prostate cancer, but monitoring for the condition is clearly vital. This should take the form of PSA blood test and rectal examination every three months for the first year of treatment and yearly thereafter (Nieschlag et al 2005). Age adjusted PSA reference ranges should be used to identify men who require further assessment. The concept of PSA velocity is also important and refers to the rate of increase in PSA per year. Patients with abnormal rectal examination suggestive of prostate cancer, PSA above the age specific reference range or a PSA velocity greater than 0.75 ng/ml/yr should be referred to a urologist for consideration of prostate biopsy.
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.
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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.
Bikinis, models, nuts … Is there anything Brazilian that’s not sexy? Selenium is a trace mineral found in Brazil nuts that plays an important role in hormone health. You only need a tiny bit for healthy sperm, but a tiny deficiency can be catastrophic for reproductive health. In one study, men who had lower testosterone and were infertile also had significantly lower selenium levels than the fertile group. Supplementing with the mineral improved chances of successful conception by 56 percent. And a second study that included 69 infertile men with low levels of the mineral, found selenium supplementation could significantly improve sub-par sperm motility associated with testosterone deficiency. Moreover, 11 percent of the men successfully impregnated their partners during the trial!
^ Southren AL, Gordon GG, Tochimoto S, Pinzon G, Lane DR, Stypulkowski W (May 1967). "Mean plasma concentration, metabolic clearance and basal plasma production rates of testosterone in normal young men and women using a constant infusion procedure: effect of time of day and plasma concentration on the metabolic clearance rate of testosterone". The Journal of Clinical Endocrinology and Metabolism. 27 (5): 686–94. doi:10.1210/jcem-27-5-686. PMID 6025472.

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.
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).
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.
The unsexy truth is that increasing T naturally simply comes down to making some long-term changes in your diet and lifestyle. As you’ll see, what I did to increase T largely boils down to eating better, exercising smarter, and getting more sleep. That’s pretty much it. But as with most things in life, the devil is in the details, so I’ll share with you exactly what I did and provide research that explains why the things I did helped boost my testosterone.
A: Testosterone production declines naturally with age. Low testosterone, or testosterone deficiency (TD), may result from disease or damage to the hypothalamus, pituitary gland, or testicles that inhibits hormone secretion and testosterone production. Treatment involves hormone replacement therapy. The method of delivery is determined by age and duration of deficiency. Oral testosterone, Testred (methyltestosterone), is associated with liver toxicity and liver tumors and so is prescribed sparingly. Transdermal delivery with a testosterone patch is becoming the most common method of treatment for testosterone deficiency in adults. A patch is worn, either on the scrotum or elsewhere on the body, and testosterone is released through the skin at controlled intervals. Patches are typically worn for 12 or 24 hours and can be worn during exercise, bathing, and strenuous activity. Two transdermal patches that are available are Androderm (nonscrotal) and Testoderm (scrotal). The Androderm patch is applied to the abdomen, lower back, thigh, or upper arm and should be applied at the same time every evening between 8 p.m. and midnight. If the patch falls off before noon, replace it with a fresh patch until it is time to reapply a new patch that evening. If the patch falls off after noon, do not replace it until you reapply a new patch that evening. The most common side effects associated with transdermal patch therapy include itching, discomfort, and irritation at the site of application. Some men may experience fluid retention, acne, and temporary abnormal breast development (gynecosmastia). AndroGel and Testim are transdermal gels that are applied once daily to the clean dry skin of the upper arms or abdomen. When used properly, these gels deliver testosterone for 24 hours. The gel must be allowed to dry on the skin before dressing and must be applied at least 6 hours before showering or swimming. Gels cannot be applied to the genitals. AndroGel is available in a metered-dose pump, which allows physicians to adjust the dosage of the medication. Side effects of transdermal gels include adverse reactions at the site of application, acne, headache, and hair loss (alopecia). For more specific information on treatments for low testosterone, consult with your doctor or pharmacist for guidance based on current health condition. Kimberly Hotz, PharmD
Epidemiological studies suggest that many significant clinical findings and important disease states are linked to low testosterone levels. These include osteoporosis (Campion and Maricic 2003), Alzheimer’s disease (Moffat et al 2004), frailty, obesity (Svartberg, von Muhlen, Sundsfjord et al 2004), diabetes (Barrett-Connor 1992), hypercholesterolemia (Haffner et al 1993; Van Pottelbergh et al 2003), hypertension (Phillips et al 1993), cardiac failure (Tappler and Katz 1979; Kontoleon et al 2003) and ischemic heart disease (Barrett-Connor and Khaw 1988). The extent to which testosterone deficiency is involved in the pathogenesis of these conditions, or to which testosterone supplementation could be useful in their treatment is an area of great interest with many unanswered questions.
I highly recommend using a great essential amino acid mix post-exercise in order to boost testosterone.  These essential amino acids and especially the concentrated branched chain amino acids leucine, isoleucine and valine stimulate muscle protein synthesis.  Getting these amino acids in the post-workout window dramatically boosts testosterone production (14).  I like using our Amino Strong and will often recommend a scoop pre-workout and post-workout for the best muscle building, testosterone boosting benefits.
By passing this bill, the Congress has amended the Controlled Substances Act to include Androstenedione supplements such as 4 Androstenediol, 5 Androstenediol, etc. The original Anabolic Steroid Control Act was passed in 1990 creating a list of anabolic steroids that would be classified as "Schedule III" substances and put in the same category as drugs such as heroin and cocaine. Now, with the passage of Senate Bill 2195 (the Anabolic Steroid Control Act of 2004), they have added Androstenedione supplements to the Controlled Substances Act.
   The International Journal of Sports Physiology and Performance recently studied tennis players, rugby teams, and wrestlers to find a link between testosterone and competitive outcome. They found that the difference between winning and losing was reflected in testosterone levels! The athletes' own natural testosterone prior to the game was directly related to the outcome after the game -- the higher the testosterone, the more frequently the athlete won.6
Alcohol has constantly been shown to lower testosterone levels. It’s even worse if you’re a heavy beer drinker. Wanna know why? Because beer raises your estrogen levels due to the phytoestrogens that are produced from the hops used to make beer. If that’s not enough, studies have shown that alcoholics have lower levels of testosterone than non-alcoholics.

Testosterone boosters are supplements used to improve workout performance, recovery, and the body’s natural ability to produce testosterone. T-Boosters are typically derived from herbs and other natural ingredients, so they’re generally safe to use in competition (Due to your own due diligence, however). What man on earth doesn’t want more testosterone? 
“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.”

if you’re a physician, you’re the real one who’s playing doctor. Stop prescribing low T treatment and let your patients go to a real doctor and not continue suffering. A simple picture of how hormones are created and their pathways will make you understand that E follows T, when we increase T, E2 will follow which negates all the positive effects of treatment. Without understanding this, you better leave the patient alone.

Most men report being able to lose body fat and gain lean muscle more easily when they take testosterone boosters. These supplements can also raise a man’s mood and make him feel more confident. You might notice that your libido gets a boost, too. They make workouts more effective and, in some cases, easier. Testosterone boosters are also great for men with low testosterone levels, as they will combat the low energy and fatigue that go along with low levels. Other supplements to consider are energy-boosting supplements and pre-workout supplements.
This has become a common practice despite an Institute of Medicine (IOM) report issued in 2003, indicating insufficient evidence of any benefit derived from testosterone hormone therapy to address expected symptoms of male aging.4  These studies, and 2 others (to be presented in a separate EW research brief) come on the heels of research on the efficacy of prescribing testosterone5 that appeared in the NEJM last year.
Glad to be heard. I have been using 10 times the recommended prescription dose of injectable test over the course of 6 years. Yes, 10 times the recommended dose. I use 250 at the lowest and 1000 mgs a week and sometimes 1200 mgs weekly. I am 50 years old. I look better than 90% of the 25 year olds I see in the gym. I have had zero issues. Acne a little , testicle shrinkage maybe 15%. No big deal. My sex drive is on fire. I bench pressed 340 pound today. I weigh 195 pounds and lean and muscles defined and hard as a rock. Doctors in the USA have no clue what they are doing. They read literature and have no experience or facts about test. They prescribe 50 mgs a week. Way short of what we as men need. Everyone is different, but 250mgs weekly is what we need typically. Injectable is the way to go. Gels are a weak joke. My doctor basically told me he was scared to prescribe more than 50 mgs weekly for fear of being sued if something went wrong. I found my own source and have been on top of the world for 6 years. Father died of prostate cancer. Mine prostate is fine. Prostate cancer from test is another example of ignorance in medical field. I am living proof that one can inject 10 times the recommended rate for the better part of a decade with no probs. I do hope the medical field catches up with the times and stops relying on archaic info.
In males, the testosterone test can help find the reason for sexual problems, like reduced sex drive or erectile dysfunction. If you’re having a hard time getting your partner pregnant, the test can tell if your blood testosterone level is low. It can also screen for problems with the hypothalamus or pituitary gland. This controls how much testosterone your body makes.
If your need is greater though, there are other legal options to consider. DHEA is a precursor steroid hormone that is only available on prescription in the UK, but if taken under close supervision it can have dramatic effects. It must be taken under supervision though because too high a dose can cause mood changes and aggression — roid rage, in other words — as well as all the other unwanted by-products of too much testosterone.
That said, a group of researchers at the National University of Malaysia did a systemic literature review of longjack, looking for clinical research that demonstrated a relationship between the shrub and testosterone levels. Of 150 articles, only 11 met their inclusion criteria — involving humans and scientifically rigorous. However, of those 11 studies, seven “revealed remarkable association” between using longjack and improving male sexual health, while the remaining four “failed to demonstrate sufficient effects.” The team concluded that longjack looks “promising” when it comes to raising low testosterone, and that there is convincing evidence that it works.
Margaret, I’m on Trt, and my wife is 43 going through Peri- (early/pre) menopause. She started trying about a drop a day to see if her libido would improve, and it did, dramatically, and also her moods and patience. After about a month of feeling 30again, she started noticing lite facial hair developing, decreased breast size, and return of all previous symptoms. So she went off it. About a month later, she started St.JohnsWart, and everything improved tenfold. Now she feels 20 instead of just 30 on testosterone. She literally glows with smiles and energy, and has an extremely high libido. Maybe try that first. Good luck.
Testosterone begins with cholesterol. In fact, every single sex hormone you make you synthesize from cholesterol – that’s one reason a “heart healthy” low-fat, low-cholesterol diet limits your performance. Fat and cholesterol don’t make you fat. They give your body the building blocks to create abundant testosterone and other sex hormones, which actually makes you lose weight and build muscle, especially if your current testosterone levels are low [1].
In my late 20’s, I visited an anti-aging doctor who was one of the pioneers of what we now call functional medicine. I got a full hormone test. Shockingly, my testosterone was lower than my mother’s. No wonder I felt crappy and was overweight. My other sex hormones were out of whack too, especially my estrogen levels. They were high because the little testosterone I did make my body converted into estrogen. I went on a mix of topical replacement testosterone cream, plus small doses of pharmaceuticals like clomid and arimidex in order to keep my other sex hormones functioning properly.
Cholesterol is the building block of testosterone, and eating healthy fats, including saturated fats, helps your body make “good” cholesterol while also supporting healthy hormone balance. Give your body a dose of healthy fats and proteins by consuming moderate amounts of meats from hormone-free animals, grassfed cattle, and wild-caught fish. Nosh on healthy-fat sources such as olives, nuts, seeds, avocados, and coconut oil.
Fenugreek, in the form of a capsule, testofen, or Fenugreek tea could do the trick. The fact that fenugreek increases libido is not mythology; it is backed by a clinical study which showed the libido of men aged 25-52 increased by 25%[1] on average when taking fenugreek extract for six weeks.  According to Lee Myer, of www.peaktestosterone.com fame, fenugreek will help you achieve orgasm as well, so if this is an issue for you, fenugreek may be the answer.  It’s a frustrating problem to have.

The sexual hormone can encourage fair behavior. For the study, subjects took part in a behavioral experiment where the distribution of a real amount of money was decided. The rules allowed both fair and unfair offers. The negotiating partner could subsequently accept or decline the offer. The fairer the offer, the less probable a refusal by the negotiating partner. If no agreement was reached, neither party earned anything. Test subjects with an artificially enhanced testosterone level generally made better, fairer offers than those who received placebos, thus reducing the risk of a rejection of their offer to a minimum. Two later studies have empirically confirmed these results.[75][76][77] However men with high testosterone were significantly 27% less generous in an ultimatum game.[78] The Annual NY Academy of Sciences has also found anabolic steroid use which increase testosterone to be higher in teenagers, and this was associated with increased violence.[79] Studies have also found administered testosterone to increase verbal aggression and anger in some participants.[80]
So if you’re intent on maximizing your testosterone levels, and/or you have applied all of the above and you’re still not satisfied with your results (which would be surprising) then you could try the below. I will point out that some of these tips may not have the scientific evidence to back them up like the previous points, but I can assure you that either I have or do use them (and have positive results), or a client has used them with pleasing results, or finally it is such a new conception that there isn’t enough evidence to prove it one way or another.
Now, many men bypass the natty test booster category altogether, head straight for designer anabolic steroids, and start injecting testosterone (among other things). And, while exogenous testosterone administration will always trump the effects of natural testosterone boosters, that instant gratification does not come without a long, dreadful list of unwanted consequences.

Sportsmen are permitted to use the boosters to trigger the mechanism of testosterone synthesis in the body. These products won a wide popularity among the sportsmen. The matter is that the supplements work by substantially enhancing sports performance, reviving strength, boosting endurance, coping with excessive stress levels, and decreasing time necessary for recovery after exhausting exercises.

As with a number of treatments or medicines that have been around for a long, long time, it hasn’t been scrutinized like a new drug would be. And although they’ve been discussed, there aren’t any large-scale, randomized controlled clinical trials of testosterone-replacement therapy under way. [See “A male equivalent to the Women’s Health Initiative?” below.]
Hypogonadism (as well as age-related low testosterone) is diagnosed with blood tests that measure the level of testosterone in the body. The Endocrine Society recommends testing for suspected low T with a total testosterone test. It may be performed in the morning when testosterone levels tend to be highest in young men, although this isn't necessarily the case in older men. The test may be repeated on another day if the results show a low T level. (5)
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