The diagnosis of late-onset hypogonadism requires the combination of low serum testosterone levels with symptoms of hypogonadism. Questionnaires are available which check for the symptoms of hypogonadism. These have been validated for the assessment of aging patients with hypogonadism (Morley et al 2000; Moore et al 2004) but have a low specificity. In view of the overlap in symptoms between hypogonadism, aging and other medical conditions it is wise to use a formal method of symptom assessment which can be used to monitor the effects of testosterone replacement.
Transdermal preparations of testosterone utilize the fact that the skin readily absorbs steroid hormones. Initial transdermal preparations took the form of scrotal patches with testosterone loaded on to a membranous patch. Absorption from the scrotal skin was particularly good and physiological levels of testosterone with diurnal variation were reliably attained. The scrotal patches are now rarely used because they require regular shaving or clipping of scrotal hair and because they produce rather high levels of dihydrotestosterone compared to testosterone (Behre et al 1999). Subsequently, non-scrotal patches were developed but the absorptive capacity of non-scrotal skin is much lower, so these patches contain additional chemicals which enhance absorption. The non-scrotal skin patches produce physiological testosterone levels without supraphysiological dihydrotestosterone levels. Unfortunately, the patches produce a high rate of local skin reactions often leading to discontinuation (Parker and Armitage 1999). In the last few years, transdermal testosterone gel preparations have become available. These require daily application by patients and produce steady state physiological testosterone levels within a few days in most patients (Swerdloff et al 2000; Steidle et al 2003). The advantages compared with testosterone patches include invisibility, reduced skin irritation and the ability to adjust dosage, but concerns about transfer to women and children on close skin contact necessitate showering after application or coverage with clothes.
A team led by Dr. Joel Finkelstein at Massachusetts General Hospital investigated testosterone and estradiol levels in 400 healthy men, 20 to 50 years of age. To control hormone levels, the researchers first gave the participants injections of a drug that suppressed their normal testosterone and estradiol production. The men were randomly assigned to 5 groups that received different amounts (from 0 to 10 grams) of a topical 1% testosterone gel daily for 16 weeks. Half of the participants were also given a drug to block testosterone from being converted to estradiol.
As blood levels of testosterone increase, this feeds back to suppress the production of gonadotrophin-releasing hormone from the hypothalamus which, in turn, suppresses production of luteinising hormone by the pituitary gland. Levels of testosterone begin to fall as a result, so negative feedback decreases and the hypothalamus resumes secretion of gonadotrophin-releasing hormone.
First, it’s important to note that these tactics and practices to boost testosterone naturally probably won’t work with men who have hypoandrogenism. If the glands and cells responsible for producing testosterone are damaged or defective, no amount of eggs or sleep will help you raise testosterone levels. You’ll likely need to use testosterone replacement therapy to get your T levels to a healthy place.
The bones and the brain are two important tissues in humans where the primary effect of testosterone is by way of aromatization to estradiol. In the bones, estradiol accelerates ossification of cartilage into bone, leading to closure of the epiphyses and conclusion of growth. In the central nervous system, testosterone is aromatized to estradiol. Estradiol rather than testosterone serves as the most important feedback signal to the hypothalamus (especially affecting LH secretion). In many mammals, prenatal or perinatal "masculinization" of the sexually dimorphic areas of the brain by estradiol derived from testosterone programs later male sexual behavior.
How do you boost testosterone naturally? Testosterone is a male sex hormone. Low levels can cause changes to the distribution of body fat and muscle strength. Testosterone reduces with age, but people can boost it with lifestyle changes, including diet and exercise. Adequate sleep, nutritional supplements, and stress reduction may also help. Learn more here. Read now
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).
Finally, we looked at the proprietary blends of our remaining boosters, and dug into their ingredient lists. Supplements frequently include ingredients known for their “folk-lore” value; they’re believed to work, even when there isn’t any scientific background to prove it. Though we didn’t ding points if an ingredient wasn’t proven to be good (just so long as it wasn’t proven to be bad), we didn’t want to include any ingredient with evidence of causing harm.
What you really need to worry about is the level of triglycerides in your blood. High triglycerides are a big warning sign for potential cardiovascular problems and disease. Again, to keep your triglycerides low while on a high cholesterol diet, take in a lot of veggies, limit your carb intake (especially sugars), supplement with omega 3 fish oil (more fat to make your cholesterol better – ironic right?), and exercise regularly.
I recommend using a trans-mucosal DHEA cream. Applying it to the rectum or if you are a a woman, your vagina, will allow the mucous epithelial membranes that line your mucosa to perform effective absorption. These membranes regulate absorption and inhibit the production of unwanted metabolites of DHEA. I personally apply 50 milligrams of trans-rectal DHEA cream twice a day – this has improved my own testosterone levels significantly. However, please note that I do NOT recommend prolonged supplementation of hormones. Doing so can trick your body into halting its own DHEA production and may cause your adrenals to become seriously impaired down.
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.
Ashwagandha is sometimes included in testosterone supplements because of the hypothesis that it improves fertility. However, we couldn’t find sufficient evidence to support this claim (at best, one study found that ashwagandha might improve cardiorespiratory endurance). WebMD advocates caution when taking this herb, as it may interact with immunosuppressants, sedative medications, and thyroid hormone medications.
The same study showed that drinking did, however, lower semen count and quality. And I want to remind you – this is an article on improving testosterone levels, not general health as there are a lot of studies that show drinking leads to an assortment of health issues. This acute spike in Testosterone could be due to the effect alcohol has on libido, and also the energy influx in the liver?
When your testosterone levels go up, so does your libido. Unfortunately, the inverse is not true — your libido levels can go up without your testosterone levels also going up. And that’s how most supposed T-boosters “work”: they make you feel ornery, leading you to think that your T levels are appreciably higher, when they actually aren’t. In rare cases, supplementation will result in a 20% testosterone increase. This kind of improvement may sound impressive, but is irrelevant for practical purposes.
Now men everywhere are wondering what it was about this testosterone supplement that made the Sharks want to invest so much in it. Does it really work? It turns out, the Kim sisters have created a whole new chemical compound that boosts testosterone production in men. It is especially effective for men over 40 years old, which is the average age that testosterone begins to naturally diminish. There are plenty of supplements and other products on the market that promise to increase testosterone production in aging men, but very few of them deliver significant results…if any at all. What sets the Kim sisters' product apart from the rest is that it contains the first reuptake inhibitor, which makes it highly effective in boosting testosterone production and effectively curing things like erectile dysfunction.
Testosterone belongs to a class of male hormones called androgens, which are sometimes called steroids or anabolic steroids. In men, testosterone is produced mainly in the testes, with a small amount made in the adrenal glands. The brain's hypothalamus and pituitary gland control testosterone production. The hypothalamus instructs the pituitary gland on how much testosterone to produce, and the pituitary gland passes the message on to the testes. These communications happen through chemicals and hormones in the bloodstream.
Next, while testosterone levels do decline with age, this may simply be because the older that men get, the less they take care of themselves – they stop exercising, start putting on weight, and don’t pay as much attention to their diet. A recent study suggests that age-related T decline is not inevitable, and that if you keep living a healthy lifestyle, you can maintain healthy testosterone levels. So if you’re an older guy, try to do all you can as far as lifestyle changes before you get on the prescription T. I don’t mean doing a little cardio a few times a week, using the machines at the gym, and eating “pretty” healthy. Follow the guidelines above, and see what happens first.
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.
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.
Don't avoid natural fats. Many people think that all fat is bad and should be avoided, particularly by teenagers who are overweight. However, natural fats and cholesterol from animal products (meat, eggs, dairy) are essential nutrients, especially for the production of sex-related hormones such as testosterone. Eating moderate amounts of saturated and unsaturated fats does not typically trigger weight gain — too many refined carbohydrates and artificial trans fat are the real culprits of obesity. In fact, some studies show that low-fat diets reduce testosterone levels in males, as well as create other growth and development problems. Research indicates that a diet with less than 40% of the energy derived from fat leads to decreased testosterone levels.
Individuals with metabolic syndrome are at increased risk for developing coronary artery disease and diabetes mellitus. Predicting who might develop the metabolic syndrome would allow preventive measures to be taken in addition to weight control and other lifestyle modifications such as cessation of smoking and increased exercise. It is known that with decreasing testosterone availability in aging males there is an increase in fat mass and decrease in lean body mass (van den Beld et al 2000), there are disorders of insulin and glucose metabolism (Haffner et al 1996) and dyslipidemia (Tsai et al 2004). Kupelian and colleagues (2006) in analyzing data from the Massachusetts Male Aging Study demonstrated that men with low levels of testosterone, sex hormone-binding globulin, or clinical androgen deficiency, especially men with a BMI of greater than 25, were at increased risk of developing the metabolic syndrome and hence, diabetes mellitus and/or coronary artery disease.
To find the best testosterone booster, we collected every supplement available on BodyBuilding.com, and cross-checked our list against the top results on best of lists like MensFitness, BroScience, and BodyNutrition. We only looked at pills since some of the ingredients in testosterone boosters have a reputation for tasting bad, and powders just prolong the experience. There are a lot — 133 of them to be precise — and they all claim to boost testosterone levels. Testosterone (for men) is “thought to regulate sex drive (libido), bone mass, fat distribution, muscle mass and strength, and the production of red blood cells and sperm.” If a supplement can increase your natural testosterone levels, the rest should follow. As we mentioned above, it’s not that simple, and at best, you’ll experience only a short-lived boost.
Some of the effects of testosterone treatment are well recognised and it seems clear that testosterone treatment for aging hypogonadal men can be expected to increase lean body mass, decrease visceral fat mass, increase bone mineral density and decrease total cholesterol. Beneficial effects have been seen in many trials on other parameters such as glycemic control in diabetes, erectile dysfunction, cardiovascular risk factors, angina, mood and cognition. These potentially important effects require confirmation in larger clinical trials. Indeed, it is apparent that longer duration randomized controlled trials of testosterone treatment in large numbers of men are needed to confirm the effects of testosterone on many aspects of aging male health including cardiovascular health, psychiatric health, prostate cancer and functional capacity. In the absence of such studies, it is necessary to balance risk and benefit on the best available data. At the present time the data supports the treatment of hypogonadal men with testosterone to normalize testosterone levels and improve symptoms. Most men with hypogonadism do not have a contraindication to treatment, but it is important to monitor for adverse consequences including prostate complications and polycythemia.
Studies also show a consistent negative correlation of testosterone with blood pressure (Barrett-Connor and Khaw 1988; Khaw and Barrett-Connor 1988; Svartberg, von Muhlen, Schirmer et al 2004). Data specific to the ageing male population suggests that this relationship is particularly powerful for systolic hypertension (Fogari et al 2005). Interventional trials have not found a significant effect of testosterone replacement on blood pressure (Kapoor et al 2006).
If a young man's low testosterone is a problem for a couple trying to get pregnant, gonadotropin injections may be an option in some cases. These are hormones that signal the body to produce more testosterone. This may increase the sperm count. Hedges also describes implantable testosterone pellets, a relatively new form of treatment in which several pellets are placed under the skin of the buttocks, where they release testosterone over the course of about three to four months. Injections and nasal gels may be other options for some men.