There are the testosterone deficiency signs, such as loss of sexual desire, erectile dysfunction, impaired fertility, chronic fatigue, etc. But it’s not always possible to understand which medical condition caused the decrease in testosterone levels. For example, if you always feel exhausted and have no sexual desire, it may provide evidence of depression.
Dobs and colleagues found that men with an increased body mass index had both reduced testosterone and reduced high density lipoprotein (HDL) levels. Treatment with testosterone increased the levels of HDL (Dobs et al 2001). Rising levels of HDL are not a consistent finding with TRT. More often, however, one finds reduced total cholesterol, low density lipoprotein (LDL) cholesterol and triglyceride levels with TRT (Zgliczynski et al 1996; Whitsel et al 2001).
Cardiovascular disease, and its underlying pathological process atherosclerosis, is an important cause of morbidity and mortality in the developed and developing world. Coronary heart disease in particular is the commonest cause of death worldwide (AHA 2002; MacKay and Mensah 2004). As well as increasing with age, this disease is more common in the male versus female population internationally, which has led to interest in the potential role of sex hormones in modulating risk of development of atherosclerosis. Concerns about the potential adverse effects of testosterone treatment on cardiovascular disease have previously contributed to caution in prescribing testosterone to those who have, or who are at risk of, cardiovascular disease. Contrary to fears of the potential adverse effects of testosterone on cardiovascular disease, there are over forty epidemiological studies which have examined the relationship of testosterone levels to the presence or development of coronary heart disease, and none have shown a positive correlation. Many of these studies have found the presence of coronary heart disease to be associated with low testosterone levels (Reviews: Jones, Jones et al 2003; Jones et al 2005).
The real danger comes when you eat a diet high in sugars and carbohydrates (90% of Americans). The sugar binds to LDL (So-called bad cholesterol – PS: It’s not even cholesterol, it’s a protein) and renders it inert. When inert, the LDL cannot pull good cholesterol (HDL) into your cells. This is bad. So what you need to do in conduction with your high fat diet is take in a lot of cruciferous vegetables, limit your carb intake, don’t touch toxic sugars. And exercise regularly.
Zinc is involved in virtually every aspect of male reproduction, including testosterone metabolism. Several studies support the use of zinc for treating low sperm counts, especially when accompanied by low testosterone levels. In these studies, zinc has shown an ability to raise both sperm counts and testosterone levels. Many men may be suffering from low testosterone simply because of a zinc deficiency. Taking 30–45 mg of zinc per day is recommended; balance with 2–3 mg of copper for best results.
We know stress generates too much cortisol and shuts down sexual hormones since our bodies go into a "fight or flight" mode. Supplements that nourish our adrenals are key to correcting those imbalances. A few recommendations that I have include adrenal adaptogens such as maca, ashwagandha, Siberian ginseng, and rhodiola. Adaptogens are a great way to restore adrenal glands, balance hormones, and detoxify. Supplementing with 25 to 50 mg of DHEA, and a high-quality multivitamin with bioavailable B vitamins and high dose vitamin C can also be helpful. It's important to eat a diet high in quality omega-3s like salmon, oysters, and sardines. I suggest 2,000 to 6,000 mg per day of carnitine to improve energy production and mitochondrial function.

Pellets. Your doctor will place the testosterone pellets under the skin of your upper hip or buttocks. Your doctor will give a shot of local anesthesia to numb your skin, then make a small cut and place the pellets inside the fatty tissues underneath your skin. This medication dissolves slowly and is released over about 3-6 months, depending on the number of pellets. 
A: Androderm comes in the form of a transdermal patch and is used for testosterone replacement therapy in patients who have insufficient levels of testosterone. Testosterone is a hormone produced in the body that plays a key role in many physiological processes in men. In some men, however, the body does not produce enough of the hormone, resulting in a variety of symptoms including decreased libido, erectile dysfunction, muscle loss, anemia and depression, among others. Androderm helps treat these symptoms and raise low testosterone levels by delivering therapeutic amounts of the hormone, which are absorbed through the skin. According to the prescribing information for Androderm, depression was a reported side effect of the medication. Other common side effects of Androderm include itching and redness at the application site, prostate abnormalities, headache, and burning or hardening of the skin at the application site. Less common side effects of Androderm include reduced libido (sex drive), fatigue, high blood pressure, anxiety, confusion, increased appetite, and body pain. For more specific information, consult with your doctor for guidance based on your health status and current medications, particularly before taking any action. Your physician can determine if your dosage of the medication needs to be adjusted or if an alternative medication should be considered. Lori Poulin, PharmD
Why niacinamide could positively impact 5-a reduced androgens? It’s complex, but simply put, its a crucial part of this compound called NADPH (Nicotinamide adenine dinucleotide phosphate). And NADPH is a co-factor in many anabolic/androgenic reactions of the body, including both testosterone and dihydrotestosterone production (NADPH is needed for the production of 5-ar enzyme).
Why the difference? The discrepancy in findings between these studies is likely due to the initial training status and base testosterone levels of the subjects. While more research is warranted on this ingredient, D-AA is one of several ingredients suggested to be effective in boosting test levels, especially for older men whose natural testosterone levels have declined due to the natural course of aging.
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High vitamin D intake (via D3) is helpful to low D3 tested people. However, if your D3 is already sufficient then thos dosages you advocate can lead to toxicity and the high intake of D3 must be accompanied by a lower level of calcium intake daily or it will affect your bones and loss of bone calcium. One you get to a sufficient level of D3 via blood test results you only need to get a smaller level of D3 supplements to retain that level.
The converse is also true; there is an increased incidence of rheumatic/autoimmune disease in men with hypogonadism. Jimenez-Balderas et al (2001) carried out neuroendocrine, genetic and rheumatologic investigations in hypogonadal men. Of the 13 hypogonadal patients, 8 (61%) had rheumatic autoimmune disease (ankylosing spondylitis, systemic lupus erythemetosus, rheumatoid arthritis, dermatomyositis). There is a low frequency of those diseases (0.83%) in the general population.
Testosterone levels generally peak during adolescence and early adulthood. As you get older, your testosterone level gradually declines — typically about 1 percent a year after age 30 or 40. It is important to determine in older men if a low testosterone level is simply due to the decline of normal aging or if it is due to a disease (hypogonadism).
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