In order to discuss the biochemical diagnosis of hypogonadism it is necessary to outline the usual carriage of testosterone in the blood. Total serum testosterone consists of free testosterone (2%–3%), testosterone bound to sex hormone binding globulin (SHBG) (45%) and testosterone bound to other proteins (mainly albumin −50%) (Dunn et al 1981). Testosterone binds only loosely to albumin and so this testosterone as well as free testosterone is available to tissues and is termed bioavailable testosterone. Testosterone bound to SHBG is tightly bound and is biologically inactive. Bioavailable and free testosterone are known to correlate better than total testosterone with clinical sequelae of androgenization such as bone mineral density and muscle strength (Khosla et al 1998; Roy et al 2002). There is diurnal variation in serum testosterone levels with peak levels seen in the morning following sleep, which can be maintained into the seventh decade (Diver et al 2003). Samples should always be taken in the morning before 11 am to allow for standardization.
Thanks for reaching out, looks like you’re in a difficult situation here, but don’t worry, you can turn it around. For starters I would focus on getting your stress under control, this has a direct impact on your T-levels. Then look at your diet. Try to eat healthy fats, along with good carbs, and proteins. I’d recommend cutting down on anything containing sugar – again it’s testosterone worst nightmare. If you really want to kick it up a gear, and it sounds as if you do, we recommend using testofuel.com – its’ by far the best natural testosterone booster on the market – you won’t be disappointed! Good luck my friend.
Both Beast Sports’ Super Test and iSatori’s ISA-Test contain a proprietary blend, which means they don’t disclose the amount of each and every ingredient in the mix. This is only a problem if there is an ingredient tucked into a proprietary blend for which we need to know an amount, like magnesium and zinc. While none of the ingredients in Beast Sports’s proprietary blend raised any red flags, iSatori’s blend contains melatonin, a hormone that helps regulate sleep. Melatonin is an ingredient that has a hard upper limit — Healthline suggests at most 10mg for an adult — and even lower doses can interact poorly with many medications. Since we can’t confirm whether the amount of melatonin in iSatori’s proprietary blend is under 10mg, we cut iSatori.
More specifically, saw palmetto is frequently used to suppress prostate growth and combat abnormal urine flow that results from an enlarged prostate. The reason it is believed that saw palmetto can combat prostate hyperplasia is based on some research indicating it may block an enzyme (5-alpha-reductase) that converts testosterone into dihydrotestosterone (DHT).[21]
Finally, related to the point about competitiveness above, studies have shown that testosterone levels not only go up before a fight or competition, they increase after each win, and this gives the winner a much higher probability of winning his next round, and the next round after that, even against evenly matched competitors. This is called the “winner-effect,” and John Coates, author of The Hour Between Dog and Wolf: Risk Taking, Gut Feelings and the Biology of Boom and Bust, explains why it works:

Testosterone boosters are supplementary substances that can be used for the purpose of increasing testosterone levels in the blood. This study aimed to evaluate the side effects and health risks of testosterone boosters among athletes. A sportsman came to the King Saud Hospital, Unaizah, Qassim, Saudi Arabia, suffering from abdominal pain. The attending doctor requested general laboratory tests. He admitted to having consumed two courses of a testosterone booster over a period of 42 days following the instructions of the manufacturer. In total, the athlete in question consumed several courses, twice before the abdominal pain started and twice after it subsided. The blood tests and reports suggested that the commercial product consumed might negatively affect several hepatic functions and resulted in slightly increased testosterone concentrations after the fourth course. In conclusion, administration of testosterone booster products, although obtained from trusted sources, may still present some health risks. Further studies with large sample size and for a long period need to be done to confirm the current findings.
A: Depo-Testosterone is a brand name medication that contains testosterone cypionate. Depo-Testosterone is given as an intramuscular injection. The medication is indicated for replacement therapy for men that have conditions associated with symptoms of deficiency in the hormone or absence of testosterone produced in the body. Conditions that can be associated with low testosterone include: delayed puberty, impotence and hormonal imbalances. Testosterone is a sex hormone that is naturally produced in the male testicles. In women, small amounts of testosterone is produced in the ovaries and by the adrenal system. Testosterone is available in various medications for testosterone replacement therapy. Different forms of testosterone (e.g. cypionate, enanthate etc) are contained in different brand name medications. Jen Marsico, RPh
Topical testosterone, specifically gels, creams and liquids, may transfer to others. Women and children are most at risk of harmful effects from contact with them. You should take care to cover the area and wash your hands well after putting on the medication. Be careful not to let the site with the topical TT touch others because that could transfer the drug.
Because clomiphene citrate is not approved by the FDA for use in men, little information exists about the long-term effects of taking it (including the risk of developing prostate cancer) or whether it is more effective at boosting testosterone than exogenous formulations. But unlike exogenous testosterone, clomiphene citrate preserves — and possibly enhances — sperm production. That makes drugs like clomiphene citrate one of only a few choices for men with low testosterone who want to father children.
I am sorry but if you are a doctor you really are making it obvious that it’s possible for doctors to know nothing about this problem.What kind of Doctor are you? Or did you get a doctorate in some obscure field? Are you a reverend doctor by chance? I think for the sake of people who need this help you should quit talking out your ass .I won’t say you are wrong.You have already proved you don’t know anything useful about HRT and I doubt you are a doctor.

When females have a higher baseline level of testosterone, they have higher increases in sexual arousal levels but smaller increases in testosterone, indicating a ceiling effect on testosterone levels in females. Sexual thoughts also change the level of testosterone but not level of cortisol in the female body, and hormonal contraceptives may affect the variation in testosterone response to sexual thoughts.[51]


When I was on 4 pumps per day, I had a reduction of ejaculate, and sometimes found it hard to ejaculate. Getting erections is no problem, and I even take BP meds. I vary it now. When I’m not going to the gym, or traveling, I cut down to 2 pumps, or take a break for a few days. When I’m intense in the gym, I stick with 4 pumps (about 5mg). I do still have the belly flab unfortunately. I need to increase cardio, and change up the diet some, but honestly, I am not too bad with my diet, so I’m a little frustrated.
It could be said that testosterone is what makes men, men. It gives them their characteristic deep voices, large muscles, and facial and body hair, distinguishing them from women. It stimulates the growth of the genitals at puberty, plays a role in sperm production, fuels libido, and contributes to normal erections. It also fosters the production of red blood cells, boosts mood, and aids cognition.
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.
While I do have a pretty manly mustache, I’m not a doctor or a medical expert. I’m a guy with a law degree he’s never used who blogs about manliness. What I’m about to share shouldn’t be taken as a substitute for qualified medical expertise. It’s simply my experience and views on the subject. Before you make any changes in lifestyle or diet, talk to your doctor or healthcare provider. Be smart.
Testosterone may strengthen your heart. Research on testosterone’s relation to heart health is split. Some scientists have found that men with higher testosterone levels have an increased risk of heart disease, while recent studies have shown that men with below-normal T levels are more at risk for heart problems. The research is still on-going, but many doctors find the evidence compelling that optimal testosterone levels can help prevent cardiovascular disease.
Testosterone may fight depression. If you’ve been battling the black dog of depression, it may be because of low testosterone levels. Researchers have found that men suffering from depression typically have deficient testosterone levels. While scientists haven’t been able to figure out whether it’s low testosterone that causes depression or if depression causes low T levels, preliminary research has shown that some men suffering depression report improvement in mood and other factors of depression after undergoing doctor-directed testosterone treatments.
“The Andro 400 has been a plus to my daily requirements of energy, stamina and weight loss. I have seen a noticeable reduction in my waistline from a 40" waist to a 37" waist. I am 6'6" and weighed 252, I now weigh 238 and feel much better. Without too much information, my sex drive and performance has been positively enhanced with greater sensitivity and stamina during those intimate times with my wife. Greater sensation, pleasure and results are evident.”
Lose some weight – It goes without saying that being overweight is unhealthy for more than one reason. As your weight increases, your testosterone levels decrease inevitably. The good news is that as soon as you start losing weight, you can reverse this process and your testosterone levels will begin rising again. Could you think of a better reason to exercise regularly?
Oral ginger was reported to accelerate gastric emptying and stimulate gastric motility (spontaneous movements of the stomach that aid in digestion). Most studies report some beneficial effect on gastric emptying time but mostly during some sort of disease state [10,11]. In healthy individuals ginger also seems to increase gastric emptying via antral contraction stimulation [12]. However, Phillips and colleagues [13] reported that ginger is not associated with an effect on gastric emptying. In animals, ginger and its active constituent [6]-Gingerol were reported to enhance gastrointestinal tract transit [14].
^ David KG, Dingemanse E, Freud JL (May 1935). "Über krystallinisches mannliches Hormon aus Hoden (Testosteron) wirksamer als aus harn oder aus Cholesterin bereitetes Androsteron" [On crystalline male hormone from testicles (testosterone) effective as from urine or from cholesterol]. Hoppe-Seyler's Z Physiol Chem (in German). 233 (5–6): 281–83. doi:10.1515/bchm2.1935.233.5-6.281.

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.]
46 year old whose suffered with low libido and all the related symptoms for over a decade. Finally had the courage to have a frank talk with dr. and urologist. Testosterone level 165, free testos level 3.6. Re-doing blood work again just to be sure in the next week or so, and will post updates then as things progress. Normal ranges are 300-1200 and 6 to 12.
Alterations in mood and depression are a symptom of, but not confined to, hypogonadism.1,6 Outcomes in clinical trials of the effect of testosterone treatment on mood have varied. However, there is evidence that testosterone treatment results in improvements in mood, particularly in older men with hypogonadism.7,8Similarly, although there is an established association between measures of cognitive ability and serum levels of testosterone, the benefits of testosterone treatment on cognition are less clearly established, with some studies reporting improvements in some measures of cognitive function and others failing to detect benefits.6,9-11 Although a potential role for testosterone in protecting cognitive function and preventing Alzheimer’s disease has been proposed by some researchers, confirmation from appropriately-designed clinical trials is awaited.
Preliminary research has shown that clomiphene citrate (Clomid), a drug generally prescribed to stimulate ovulation in women struggling with infertility, can foster the production of natural testosterone, termed endogenous testosterone, in men. In a recent prospective study, 36 hypogonadal men took a daily dose of clomiphene citrate for at least three months. Within four to six weeks, all of the men had heightened levels of testosterone; none reported any side effects during the year they were followed.
Ok. So this product is meant to be taken continuously and without side-effects. But my question is, will there be replenishment from this product in aiding the body's natural ability to produce testosterone? In other words, will there ever be a time when I can say well I don't have to take this any more as my body is producing testosterone again on it's own and my muscle mass has been enhanced?

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.
D-Aspartic acid is a natural amino acid involved in the synthesis and release of testosterone, which research shows can be used as a testosterone booster for infertile men. One 90-day study gave D-Aspartic acid to men with impaired sperm production, and found their sperm count rose from 8.2 million sperm per ml to 16.5 million sperm per ml, more than a 100 per cent increase.
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.

Cognitive abilities differ between males and females and these differences are present from childhood. In broad terms, girls have stronger verbal skills than boys who tend to have stronger skills related to spatial ability (Linn and Petersen 1985). It is thought that the actions of sex hormones have a role in these differences. Reviewing different cognitive strengths of male versus female humans is not within the scope of this article but the idea that cognition could be altered by testosterone deserves attention.
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!!!!
This particular product contains the largest dose of D-Aspartic Acid making it a highly effective muscle and strength builder. In addition, TestoFuel contains optimum doses the proven ingredients of Vitamin D, Oyster Extract, Zinc, Magnesium, Vitamin B6, Vitamin K2, Fenugreek and Siberian Ginseng. And you won’t get filler ingredients with this one like you do with many others.
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.

Hi.i have a simple question…I AM 60 YEARS OLD and my free testosterone is 7… and my regular testosterone is 700+…I really need TRT …and in case yes i need it the doctor said if i start i need to do it for the rest of my life !!! he said is not coming back!!! ..i don’t know is true or not??? With my testosterone levels i need or not to do TRT???..i am going in gym daily and i feel good in general …all my blood results are perfect …///Again if i take the TRT will help me in general ??or is better to not use the “TRT”..Thank you for your time to answer HONEST for my question ..I ask this because i don’t know what to do ..i don’t want to do something wrong???…!!!..ps .if is possible to answer me on my email ..Thank you v v much and GOD BLESS YOU …Chris…R…
The chemical synthesis of testosterone from cholesterol was achieved in August that year by Butenandt and Hanisch.[187] Only a week later, the Ciba group in Zurich, Leopold Ruzicka (1887–1976) and A. Wettstein, published their synthesis of testosterone.[188] These independent partial syntheses of testosterone from a cholesterol base earned both Butenandt and Ruzicka the joint 1939 Nobel Prize in Chemistry.[186][189] Testosterone was identified as 17β-hydroxyandrost-4-en-3-one (C19H28O2), a solid polycyclic alcohol with a hydroxyl group at the 17th carbon atom. This also made it obvious that additional modifications on the synthesized testosterone could be made, i.e., esterification and alkylation.
Testosterone levels naturally rise in response to sexual arousal and activity. Men with higher levels of testosterone usually have greater sexual activity. Older men need more testosterone for libido and erectile function. But it’s important to note that erectile dysfunction is often due to other conditions or medications rather than low testosterone levels.
Benefits: Maca roots originates from the mountains of Peru. For a long time, natives have been using Maca roots as not only a food supply but for it’s properties for increasing sexual potency. It has been prove to improve erectile dysfunctions, libido and sperm production. Maca roots stimulate semen volume, sperm count and sperm motility, which makes Maca a powerful Aphrodisiac.
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.
Zinc is little more of a nice-to-have ingredient than a must-have. It’s on our radar as an ingredient that possibly boosts testosterone levels, and while we couldn’t find enough supporting evidence that taking zinc would increase natural testosterone, low zinc levels have been connected to infertility. A low zinc level is also possibly a sign of hypogonadism. The closest support we found is in a study which found that people recovered from nutritional deficiency-related problems more quickly if they took a zinc supplement than those who did not. Zinc is available in many foods, such as oysters, fortified breakfast cereals, and red meat.

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).
I am now 65 & have had Low-T problems since I was about 60. I took topical Testosterone for a few years until insurance stopped covering it. Then I took injections at a Men's Health-Low-T Clinic. Then I was diagnosed with Prostate Cancer & was told to stop taking Testosterone. I underwent radiation treatment to cure the Prostate cancer, but since there is a theory that taking Testosterone can lead to Prostate cancer, I have chosen not to resume taking it. While I am glad to be free of the cancer, I have been feeling extremely fatigued & tired all the time to the point that doing much of anything like a little yard work would leave me exhausted for days.
While testosterone stimulates a man’s sex drive, it also aids in achieving and maintaining an erection. Testosterone alone doesn’t cause an erection, but it stimulates receptors in the brain to produce nitric oxide. Nitric oxide is a molecule that helps trigger a series of chemical reactions necessary for an erection to occur. When testosterone levels are too low, a man may have difficulty achieving an erection prior to sex or having spontaneous erections (for example, during sleep).
A: If a health insurance company is providing coverage for a medication, including testosterone replacement therapy, they determine the final cost of the product. Costs will vary from one health insurance plan to another. To determine the costs of the testosterone replacement options, the health insurance plan should be contacted. There are various options for testosterone replacement therapy including gels, injections, patches, and tablets that dissolve under the lip. All of the formulations can be effective and each has advantages and disadvantages. The most appropriate testosterone replacement therapy depends on a variety of factors, including cost, patient preference, and tolerability. Testosterone replacement gels, such as AndroGel and Testim, are very effective and easy to administer. AndroGel and Testim can be easily applied to the skin once daily. However, the gels can be irritating to the skin and AndroGel and Testim are typically quite expensive. Testosterone replacement injections, such as Depo-Testosterone (testosterone cypionate) and Delatestryl (testosterone enanthate), are usually inexpensive. The injections are given only once every one to two weeks. The major disadvantage with injectable testosterone is that testosterone levels may be difficult to control. Levels may be too high after an injection and too low before the following injection. A testosterone replacement patch, such as Androderm, is applied every night and left on for 24 hours. Androderm can be applied to the arm, back or stomach, in an area without too much hair. Androderm can cause irritation of the skin. A testosterone tablet, Striant, is placed under the upper lip against the gums and replaced every 12 hours. Striant molds to the upper gum so that eating and drinking can occur normally. The testosterone tablet can irritate the gums and cause a bitter taste and toothache. People with low testosterone should work with their doctor or healthcare provider to find a safe, effective, and affordable testosterone replacement option for them. 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. Derek Dore, PharmD
A: If a health insurance company is providing coverage for a medication, including testosterone replacement therapy, they determine the final cost of the product. Costs will vary from one health insurance plan to another. To determine the costs of the testosterone replacement options, the health insurance plan should be contacted. There are various options for testosterone replacement therapy including gels, injections, patches, and tablets that dissolve under the lip. All of the formulations can be effective and each has advantages and disadvantages. The most appropriate testosterone replacement therapy depends on a variety of factors, including cost, patient preference, and tolerability. Testosterone replacement gels, such as AndroGel and Testim, are very effective and easy to administer. AndroGel and Testim can be easily applied to the skin once daily. However, the gels can be irritating to the skin and AndroGel and Testim are typically quite expensive. Testosterone replacement injections, such as Depo-Testosterone (testosterone cypionate) and Delatestryl (testosterone enanthate), are usually inexpensive. The injections are given only once every one to two weeks. The major disadvantage with injectable testosterone is that testosterone levels may be difficult to control. Levels may be too high after an injection and too low before the following injection. A testosterone replacement patch, such as Androderm, is applied every night and left on for 24 hours. Androderm can be applied to the arm, back or stomach, in an area without too much hair. Androderm can cause irritation of the skin. A testosterone tablet, Striant, is placed under the upper lip against the gums and replaced every 12 hours. Striant molds to the upper gum so that eating and drinking can occur normally. The testosterone tablet can irritate the gums and cause a bitter taste and toothache. People with low testosterone should work with their doctor or healthcare provider to find a safe, effective, and affordable testosterone replacement option for them. 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. Derek Dore, PharmD
Tarig Elraiyah, Mohamad Bassam Sonbol, Zhen Wang, Tagwa Khairalseed, Noor Asi, Chaitanya Undavalli, Mohammad Nabhan, Osama Altayar, Larry Prokop, Victor M. Montori, Mohammad Hassan Murad; The Benefits and Harms of Systemic Dehydroepiandrosterone (DHEA) in Postmenopausal Women With Normal Adrenal Function: A Systematic Review and Meta-analysis, The Journal of Clinical Endocrinology & Metabolism, Volume 99, Issue 10, 1 October 2014, Pages 3536–3542, https://doi.org/10.1210/jc.2014-2261
As with cognitive effects, previous studies examining CVD changes following testosterone treatment have been conflicting and inconclusive. Dr. Budoff and his research team used coronary computed tomographic angiography (CCTA) to assess 138 men, including 73 treated with testosterone and 65 receiving placebo, for changes in coronary artery plaque volume after 1 year.

Common side effects from testosterone medication include acne, swelling, and breast enlargement in males.[10] Serious side effects may include liver toxicity, heart disease, and behavioral changes.[10] Women and children who are exposed may develop virilization.[10] It is recommended that individuals with prostate cancer not use the medication.[10] It can cause harm if used during pregnancy or breastfeeding.[10]
“We need carbs, fats, and proteins to have optimal T levels,” says Howse. A healthy amount of carbs, for example, keeps cortisol levels low (more on why this is important to come). Meanwhile, dietary fats produce cholesterol, which our body can later convert into testosterone. And, finally, protein supports body composition by enhancing muscle repair and growth and increasing satiety.
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.

Another point I’d like to make for people worried about a link between high testosterone and prostate cancer is that it just doesn’t make sense. Prostate cancer becomes more prevalent in men as they age, and that’s also when their testosterone levels decline. We almost never see it in men in their peak testosterone years, in their 20s for instance. We know from autopsy studies that 8% of men in their 20s already have tiny prostate cancers, so if testosterone really made prostate cancer grow so rapidly — we used to talk about it like it was pouring gasoline on a fire — we should see some appreciable rate of prostate cancer in men in their 20s. We don’t. So, I’m no longer worried that giving testosterone to men will make their hidden cancer grow, because I’m convinced that it doesn’t happen.

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).
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