That there is an association between depression and testosterone concentration seems possible because of the observation that depression may be associated with reduced testosterone concentrations, hypogonadal men may have their symptoms of depression relieved by TRT and that testosterone itself may have anti-depressant properties (Pope et al 2003). The evidence, however, is inconsistent. Seidman and colleagues (2002), for example, found that there was no relationship between testosterone and depression but there was an association of testosterone with dysthymia. McIntyre and colleagues (2006), on the other hand, found that middle-aged men with depression did have a reduction in bio-available testosterone.
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.
Male hypogonadism is a clinical syndrome caused by a lack of androgens or their action. Causes of hypogonadism may reflect abnormalities of the hypothalamus, pituitary, testes or target tissues. Increases in the amount of testosterone converted to estrogen under the action of the enzyme aromatase may also contribute to hypogonadism. Most aspects of the clinical syndrome are unrelated to the location of the cause. A greater factor in the production of a clinical syndrome is the age of onset. The development of hypogonadism with aging is known as late-onset hypogonadism and is characterised by loss of vitality, fatigue, loss of libido, erectile dysfunction, somnolence, depression and poor concentration. Hypogonadal ageing men also gain fat mass and lose bone mass, muscle mass and strength.

The Organon group in the Netherlands were the first to isolate the hormone, identified in a May 1935 paper "On Crystalline Male Hormone from Testicles (Testosterone)".[180] They named the hormone testosterone, from the stems of testicle and sterol, and the suffix of ketone. The structure was worked out by Schering's Adolf Butenandt, at the Chemisches Institut of Technical University in Gdańsk.[181][182]
Dr. Anthony’s Notes: DHEA is a powerful supplement for testosterone, energy, and overall well-being in our older Fit Fathers. A small dose of 25-50mg/day is enough to exert noticeable benefits. This supplement is over-the-counter. Verdict: this is one of the testosterone supplements that work. How To Take DHEA: Take 25-50mg once per day with food. Special Medical Note: DHEA is a MILD CYP3A4 inhibitor (a liver enzyme that processes MANY very common medications). This is the same isoenzyme that Grapefruit inhibits – albeit DHEA inhibits to a much weaker degree. If you’ve ever heard “don’t eat grapefruit with your Lipitor (cholesterol medication)”… this is the reason why. When we inhibit the CYP3A4 enzyme, more of the medications you're taking circulates (it’s not metabolized as fast). Check with your doctor for medication interactions before using DHEA.
During the second trimester, androgen level is associated with sex formation.[13] This period affects the femininization or masculinization of the fetus and can be a better predictor of feminine or masculine behaviours such as sex typed behaviour than an adult's own levels. A mother's testosterone level during pregnancy is correlated with her daughter's sex-typical behavior as an adult, and the correlation is even stronger than with the daughter's own adult testosterone level.[14]

High intensity exercise is crucial to boost testosterone (13).  Exercises should be explosive in nature and maximize the resistant overload on the muscles.  Large muscle group compound lifts such as squats, deadlifts & burpees are some of the best testosterone boosting exercises.  The training session should be short (5-30 mins) and have very little rest periods between sets.
Your first step should be to see your doctor. If you think you have low testosterone, we cannot stress enough that you should proceed with caution and talk to a medical professional — taking a booster can definitely do more harm than good. Low testosterone can be a symptom of more serious problems, like a pituitary disorder or a side-effect of medication, and a booster can mask the root cause. A doctor will be able to evaluate your testosterone levels with a simple blood test, and if you both decide a booster is the way to go, give the ingredients of any supplement a once-over to make sure that they’re not at risk of making your personal health situation worse.

I know the experiment didn’t simply bring me back to my pre-August levels because of the fact that when I learned that the original test I took can sometimes overestimate your T levels, I took a more accurate test around four months after the start of the experiment (I’ve continued the lifestyle changes made during the experiment) and my total T had gone up again to 826.9 ng/dL.
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
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.
This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
You should also know that a lot of people are deficient in Vitamin D. In the USA & many other western regions in the world, vitamin D deficiency is at epidemic proportions. The best way to increase your D levels is sun exposure. You only need 20-30 minutes of exposure to a large amount of skin (i.e., take your shirt off and go for a walk during the day).

It may also become a treatment for anemia, bone density and strength problems. In a 2017 study published in the journal of the American Medical Association (JAMA), testosterone treatments corrected anemia in older men with low testosterone levels better than a placebo. Another 2017 study published in JAMA found that older men with low testosterone had increased bone strength and density after treatment when compared with a placebo. 
The maximum hormone concentration in the blood is reported immediately after the workout. And the effect lasts throughout the day. However, it’s important to ensure that your physical activity is moderate. The matter is that too much high-intensity exercise can give an undesirable result. But even if for any reason you can’t attend a gym, it’s not a problem. Just move as much as possible during the day. Even simple walking will be of great benefit.
Testosterone is a stimulant of hematopoiesis in the bone marrow and consequently, increases the hematocrit (Shahidi 1973). Men with unexplained anemia should have their testosterone measured and if reduced, these men should be treated with testosterone. Because of the erythropoietin stimulating effect of testosterone, one of the parameters to be monitored during testosterone treatment is hematocrit since a small percent of testosterone-treated men develop polycythemia.
Testosterone is significantly correlated with aggression and competitive behaviour and is directly facilitated by the latter. There are two theories on the role of testosterone in aggression and competition.[77] The first one is the challenge hypothesis which states that testosterone would increase during puberty thus facilitating reproductive and competitive behaviour which would include aggression.[77] Thus it is the challenge of competition among males of the species that facilitates aggression and violence.[77] Studies conducted have found direct correlation between testosterone and dominance especially among the most violent criminals in prison who had the highest testosterone levels.[77] The same research also found fathers (those outside competitive environments) had the lowest testosterone levels compared to other males.[77]
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As we age, the body undergoes multiple degenerative changes at multiple sites and in multiple systems. The changes of aging are inevitable and inexorable and represent the march toward ultimate death. We are mortal beings whose destiny it is to die. As we come to learn about the processes of life we can better prepare ourselves for the finality of death and on the way perhaps retard the degenerative process, or repair it (for however long we may enjoy this repair), or substitute chemical compounds that our bodies once produced in abundance, an abundance which fades with the advance of age.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
As we age, the body undergoes multiple degenerative changes at multiple sites and in multiple systems. The changes of aging are inevitable and inexorable and represent the march toward ultimate death. We are mortal beings whose destiny it is to die. As we come to learn about the processes of life we can better prepare ourselves for the finality of death and on the way perhaps retard the degenerative process, or repair it (for however long we may enjoy this repair), or substitute chemical compounds that our bodies once produced in abundance, an abundance which fades with the advance of age.

‘Testosterone boosting’ products  - found online, or in health food or body-building shops, these products claim to boost testosterone levels if you buy them. The majority of these products will not have the effect you want and are not worth spending money on. Any of these products that do have a real effect may have a form of prescription medication in which is both dangerous and illegal.
In addition to its role as a natural hormone, testosterone is used as a medication, for instance in the treatment of low testosterone levels in men and breast cancer in women.[10] Since testosterone levels decrease as men age, testosterone is sometimes used in older men to counteract this deficiency. It is also used illicitly to enhance physique and performance, for instance in athletes.
The University of Connecticut recently published findings stating that those who supplemented with whey protein produced less cortisol, a stress hormone, than those who did not supplement. Cortisol lowers production of sex hormones and is also responsible for belly fat formation. Ricotta is an excellent source of natural whey protein and amino acids, both of which are essential to muscle growth and avoiding the spare tire.
When you're under a lot of stress, your body releases high levels of the stress hormone cortisol. This hormone actually blocks the effects of testosterone,6 presumably because, from a biological standpoint, testosterone-associated behaviors (mating, competing, aggression) may have lowered your chances of survival in an emergency (hence, the "fight or flight" response is dominant, courtesy of cortisol).
Nearly 1 out of every 4 men over age 50 experience the pain of losing the ability to perform sexually as a result of erectile dysfunction (ED). Common causes of ED are atherosclerosis, diabetes, prescription drug use (namely high blood pressure, depression, and allergy drugs), and—you guessed it—low testosterone. Supplements that may help include the following:
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).
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.
Testosterone makes a contribution to nitric oxide formation. Nitric oxide, released from penile nerves stimulates guanylate cyclase which catalyzes the transformation of guanosine-5-triphosphate into 3′,5′-cyclic, guanosine monophosphate (cyclic GMP). Gyclic GMP causes vasodilatation and hence erection formation (Morelli et al 2005). The breakdown of cyclic GMP to GMP is mediated by the enzyme, phosphodiesterase type-5, the inhibitors of which (eg, sildenafil citrate) enhance erection formation and maintanence (Carson and Lue 2005).
It seems like today it’s a badge of honor to train every day until exhaustion. The ethos is to push yourself harder and harder every day. If that’s your philosophy towards exercise, you might be sabotaging your testosterone levels (as well as your 20 Mile March). Studies have shown that overtraining can reduce testosterone levels significantly. Yes, it’s important to exercise hard, but it’s even more important to give your body rest so it can recuperate from the damage you inflicted upon it.
When you’re under stress (be it from lack of sleep, workplace stress, emotional stress, stress from a bad diet, overtraining etc.), your body releases cortisol. Cortisol blunts the effects of testosterone (47), which makes sense from an evolutionary point of view – if we were stressed as cavemen chances are it was a life or death situation – not running late to a meeting - in this state (i.e. running from a lion) the body wouldn’t care if you couldn’t get it up, there was more to worry about!
Testosterone makes a contribution to nitric oxide formation. Nitric oxide, released from penile nerves stimulates guanylate cyclase which catalyzes the transformation of guanosine-5-triphosphate into 3′,5′-cyclic, guanosine monophosphate (cyclic GMP). Gyclic GMP causes vasodilatation and hence erection formation (Morelli et al 2005). The breakdown of cyclic GMP to GMP is mediated by the enzyme, phosphodiesterase type-5, the inhibitors of which (eg, sildenafil citrate) enhance erection formation and maintanence (Carson and Lue 2005).
Sergeant Steel ran into trouble here because it contains Shilajit — a type of plant-based resin. Shilajit is banned in Canada because the Canadian government found heavy metal levels when investigating the ingredient. Shilajit is hard to find, and sensitive to water and variations in temperature, so most manufacturers mix it with additives to make it more stable. Research at Boston University School of Medicine found that “nearly 21 percent of 193 ayurvedic herbal supplements [...] contained lead, mercury or arsenic,” and included shilajit on the list of contaminated ingredients. Even though Sergeant Steel lists its shilajit is “purified,” it doesn’t offer any third-party testing to confirm whether or not their shilajit contains heavy metals, and so we cut it.
In addition to its role as a natural hormone, testosterone is used as a medication, for instance in the treatment of low testosterone levels in men and breast cancer in women.[10] Since testosterone levels decrease as men age, testosterone is sometimes used in older men to counteract this deficiency. It is also used illicitly to enhance physique and performance, for instance in athletes.
In summary, low testosterone levels are linked to the presence of numerous cardiovascular risk factors. Testosterone treatment acts to improve some of these factors, but effects may vary according to pre- and post-treatment testosterone levels, as well as other factors. There is little data from trials specific to aging males. Appropriately-powered randomized controlled trials, with cardiovascular disease primary endpoints, are needed to clarify the situation, but in the meantime the balance of evidence is that testosterone has either neutral or beneficial effects on the risk of cardiovascular disease in men. It is particularly important to define the effect of testosterone treatment on cardiovascular disease in view of its potential use as an anti-anginal agent.
As we age, the body undergoes multiple degenerative changes at multiple sites and in multiple systems. The changes of aging are inevitable and inexorable and represent the march toward ultimate death. We are mortal beings whose destiny it is to die. As we come to learn about the processes of life we can better prepare ourselves for the finality of death and on the way perhaps retard the degenerative process, or repair it (for however long we may enjoy this repair), or substitute chemical compounds that our bodies once produced in abundance, an abundance which fades with the advance of age.
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.
The sex hormone testosterone is far more than just the stuff of the alpha male's swagger. Though it plays a more significant role in the life of the biological male, it is actually present in both sexes to some degree. Despite popular perceptions that testosterone primarily controls aggression and sex drive—although it does play a role in both of those things—research has shown that individual levels of testosterone are also correlated with our language skills and cognitive abilities. Testosterone occurs in the body naturally, but can be administered as a medication, too: its most common uses are in the treatment of hypogonadism and breast cancer, as well as in hormone therapy for transgender men.
Prolactin is suppressed by dopamine activity. Since supplementing L-DOPA suppresses prolactin (by increasing dopamine activity), supplementing L-DOPA would increase testosterone if prolactin was abnormally high. The average, healthy male does not have elevated prolactin (unless he’s on steroids), so supplementing with L-DOPA will not increase your testosterone levels.
Estrogen is important in men, but too high of a level has all sorts of negative consequences – ranging from heart attacks to prostate cancer (32 & 33). The balance between testosterone and estrogen (or estradiol) is critical for a man. If the ratio is out and estrogen starts to dominate you run into all sorts of issues – such as breast cell growth, prostate enlargement and of course lower testosterone.
Dr. Anthony’s Notes: Magnesium is best to take at night as it is relaxing. Supplemental magnesium can cause loose stools at high doses. If you experience loose stools, you'll know to back off your dose. This is a really useful supplement for overall health – not JUST for testosterone. Verdict: this is one of the natural testosterone supplements that work. Best Food Sources: pumpkin seeds, spinach, swiss chard, black beans, cashews, quinoa, quality whole gains like Ezekiel bread How To Take Magnesium: 200-400mg capsule form at night before bed.
My favorite overall tool to manage stress is EFT (Emotional Freedom Technique), which is like acupuncture without the needles. It's a handy, free tool for unloading emotional baggage quickly and painlessly, and so easy that even children can learn it. Other common stress-reduction tools with a high success rate include prayer, meditation, laughter and yoga, for example. Learning relaxation skills, such as deep breathing and positive visualization, which is the "language" of the subconscious.
As you can see, the entire workout is only 20 minutes. Twenty minutes! That really is a beautiful thing. And within those 20 minutes, 75 percent of that time is warming up, recovering or cooling down. You're really only working out intensely for four minutes. It's hard to believe if you have never done this that you can actually get that much benefit from four minutes of exercise. That's all it is.
Fitness Disclaimer: The information contained in this site is for educational purposes only. Vigorous high-intensity exercise is not safe or suitable for everyone. You should consult a physician before beginning a new diet or exercise program and discontinue exercise immediately and consult your physician if you experience pain, dizziness, or discomfort. The results, if any, from the exercises may vary from person-to-person. Engaging in any exercise or fitness program involves the risk of injury. Mercola.com or our panel of fitness experts shall not be liable for any claims for injuries or damages resulting from or connected with the use of this site. Specific questions about your fitness condition cannot be answered without first establishing a trainer-client relationship.
Cross-sectional studies have not shown raised testosterone levels at the time of diagnosis of prostate cancer, and in fact, low testosterone at the time of diagnosis has been linked with more locally aggressive and malignant tumors (Massengill et al 2003; Imamoto et al 2005; Isom-Batz et al 2005). This may reflect loss of hormone related control of the tumor or the effect of a more aggressive tumor in decreasing testosterone levels. One study found that 14% of hypogonadal men, with normal digital rectal examination and PSA levels, had histological prostate cancer on biopsy. It is possible that low androgen levels masked the usual evidence of prostate cancer in this population (Morgentaler et al 1996). Most longitudinal studies have not shown a correlation between testosterone levels and the future development of prostate cancer (Carter et al 1995; Heikkila et al 1999; Stattin et al 2004) but a recent study did find a positive association (Parsons et al 2005). Interpretation of such data requires care, as the presentation of prostate cancer could be altered or delayed in patients with lower testosterone levels.
‘Testosterone boosting’ products  - found online, or in health food or body-building shops, these products claim to boost testosterone levels if you buy them. The majority of these products will not have the effect you want and are not worth spending money on. Any of these products that do have a real effect may have a form of prescription medication in which is both dangerous and illegal.
There are several supplements on the market claiming to be natural testosterone boosters. I get these sorts of things in the mail all time. The companies that produce these products claim that the herbs (typically stinging nettle and tribulus) in their pills increase free testosterone by reducing SHBG. They also throw in some B vitamins for “increased energy and vitality.”

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.
The science backs up the soldier’s self discovery, in fact, exposure to radiation (whether it’s from an army radar or the cell phone in your pocket, or the wifi router in your house) has been shown to lower sperm quality, fertility and testosterone. This is true not only for military personnel (88, 89,90) but all males living in a modern world (91).

Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 1 Mar 2019), Cerner Multum™ (updated 1 Mar 2019), Wolters Kluwer™ (updated 28 Feb 2019) and others. Refer to our editorial policy for content sources and attributions.
Testosterone may prove to be an effective treatment in female sexual arousal disorders,[52] and is available as a dermal patch. There is no FDA approved androgen preparation for the treatment of androgen insufficiency; however, it has been used off-label to treat low libido and sexual dysfunction in older women. Testosterone may be a treatment for postmenopausal women as long as they are effectively estrogenized.[52]
Now that we know chronic insulin spikes lead to lower Testosterone production, I hope I haven’t sent you running into the low carb camp! There are a few studies out there showing that long term low carb or ketogenic dieting leads to higher cortisol levels (especially with subjects who are training), and decreased testosterone levels (28 & 29). I have used low carb diets in the past with successful results (winning a national bodybuilding title), however the key is to use cyclical carb re-feeds. If you’re going to go on a low carb diet for whatever reason, be sure to work in a large carb reefed once a week.
Grape seed extract is another ingredient with not enough research to suggest a dosage. Grape seed extract can interact with drugs like “blood thinners, NSAID painkillers (like aspirin, Advil, and Aleve), certain heart medicines, cancer treatments, and others.” If this sounds like you (or if you ever pop an Advil to clear off a headache), you’ll need to speak with a doctor to make sure this supplement is safe to take.
For people who are worried about low or high testosterone, a doctor may perform a blood test to measure the amount of the hormone in the patient's blood. When doctors find low-T, they may prescribe testosterone therapy, in which the patient takes an artificial version of the hormone. This is available in the following forms: a gel to be applied to the upper arms, shoulders or abdomen daily; a skin patch put on the body or scrotum twice a day; a solution applied to the armpit; injections every two or three weeks; a patch put on the gums twice a day; or implants that last four to six months.
Dr. Anthony’s Notes: Correcting a common zinc deficiency can really help testosterone levels. This is why many supplement companies make testosterone boosting supplement stacks called “ZMA” (which stands for Zinc-Magnesium Aspartate) – which is essentially a combination of zinc and magnesium. Do note that LONG TERM high dose zinc supplementation is NOT a good idea (above 30-40mg). Taking too much zinc can lead to a copper deficiency (the two minerals compete for absorption), which causes problems of its own. Verdict: this is one of the natural testosterone supplements that work. Best Food Sources: Beef, lamb, oysters, pumpkin seeds, cashews, quinoa, turkey, chickpeas How To Take Zinc: 30mg once per day with food is ideal. And as we alluded to above in my “notes,” it's often best to take zinc WITH the next supplement on our list…
While researchers in Brisbane, Australia, found that while Testofen (“a standardized [fenugreek] extract and mineral formulation”) significantly improved the sexual arousal, orgasm, and the general quality of life of participants, it did not remarkably increase testosterone above normal levels. Participants who took Testofen were more satisfied with their energy, well-being, and muscle strength than those who took the placebo.
Intramuscular testosterone injections were first used around fifty years ago. Commercially available preparations contain testosterone esters in an oily vehicle. Esterification is designed to retard the release of testosterone from the depot site into the blood because the half life of unmodified testosterone would be very short. For many years intramuscular preparations were the most commonly used testosterone therapy and this is still the case in some centers. Pain can occur at injection sites, but the injections are generally well tolerated and free of major side effects. Until recently, the available intramuscular injections were designed for use at a frequency of between weekly and once every four weeks. These preparations are the cheapest mode of testosterone treatment available, but often cause supraphysiological testosterone levels in the days immediately following injection and/or low trough levels prior to the next injection during which time the symptoms of hypogonadism may return (Nieschlag et al 1976). More recently, a commercial preparation of testosterone undecanoate for intramuscular injection has become available. This has a much longer half life and produces testosterone levels in the physiological range throughout each treatment cycle (Schubert et al 2004). The usual dose frequency is once every three months. This is much more convenient for patients but does not allow prompt cessation of treatment if a contraindication to testosterone develops. The most common example of this would be prostate cancer and it has therefore been suggested that shorter acting testosterone preparations should preferably used for treating older patients (Nieschlag et al 2005). Similar considerations apply to the use of subcutaneous implants which take the form of cylindrical pellets injected under the skin of the abdominal wall and steadily release testosterone to provide physiological testosterone levels for up to six months. Problems also include pellet extrusion and infection (Handelsman et al 1997).

In fact, high cortisol deals a crushing blow to testosterone in two ways. During, long-lasting stress, high amounts of cortisol release very often and have a direct negative influence on T levels. Thus, cortisol inhibits testosterone synthesis in the testes and hypothalamus. In addition, the production of cortisol is impossible without cholesterol. But testosterone synthesis also demands cholesterol. Since during stress cholesterol is first of all used for making cortisol, T levels simply plummet.
Dr. Anthony’s Notes: Vitamin D has about 100 other beneficial body functions outside of it's impact on testosterone. Make sure you take the active Vitamin D3 (not D2 – from plant sources!) It’s also advisable to get 20 minutes of sunshine daily (weather permitting) – without sunscreen. Verdict: this is one of the natural testosterone supplements that work. Best Food Sources of Vitamin D3: Wild Alaskan Salmon (#1), Sardines, Eggs How To Take Vitamin D3: Using 3000-5000IU of Vitamin D3 per day is a good safe, research supported dose. Your physician can also test your blood for D3 levels for more precise monitoring.
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.

Unlike women, who experience a rapid drop in hormone levels at menopause, men experience a more gradual decrease of testosterone levels over time. The older the man, the more likely he is to experience below-normal testosterone levels. Men with testosterone levels below 300 ng/dL may experience some degree of low T symptoms. Your doctor can conduct a blood test and recommend treatment if needed. They can discuss the potential benefits and risks of testosterone medication, as well.
TT may help you but it may have adverse (harmful) results. (See discussion of these side effects below.) The Federal Drug Administration (FDA) has said that testosterone drug labels should state that there is a risk for heart disease and stroke for some men using testosterone products. All men should be checked for heart disease and stroke before, and periodically while on, TT. The AUA however, on careful review of evidence-based peer review literature, has stated that there is no strong evidence that TT either increases or decreases the risk of cardiovascular events.
Low testosterone levels can cause mood disturbances, increased body fat, loss of muscle tone, inadequate erections and poor sexual performance, osteoporosis, difficulty with concentration, memory loss and sleep difficulties. Current research suggests that this effect occurs in only a minority (about 2%) of ageing men. However, there is a lot of research currently in progress to find out more about the effects of testosterone in older men and also whether the use of testosterone replacement therapy would have any benefits.
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