The reliable measurement of serum free testosterone requires equilibrium dialysis. This is not appropriate for clinical use as it is very time consuming and therefore expensive. The amount of bioavailable testosterone can be measured as a percentage of the total testosterone after precipitation of the SHBG bound fraction using ammonium sulphate. The bioavailable testosterone is then calculated from the total testosterone level. This method has an excellent correlation with free testosterone (Tremblay and Dube 1974) but is not widely available for clinical use. In most clinical situations the available tests are total testosterone and SHBG which are both easily and reliably measured. Total testosterone is appropriate for the diagnosis of overt male hypogonadism where testosterone levels are very low and also in excluding hypogonadism in patients with normal/high-normal testosterone levels. With increasing age, a greater number of men have total testosterone levels just below the normal range or in the low-normal range. In these patients total testosterone can be an unreliable indicator of hypogonadal status. There are a number of formulae that calculate an estimated bioavailable or free testosterone level using the SHBG and total testosterone levels. Some of these have been shown to correlate well with laboratory measures and there is evidence that they more reliably indicate hypogonadism than total testosterone in cases of borderline biochemical hypogonadism (Vermeulen et al 1971; Morris et al 2004). It is important that such tests are validated for use in patient populations relevant to the patient under consideration.
There is also a crazy case study about a Thai-male who reportedly got his DHT levels all the way to 158% above medical reference ranges after supplementing with Butea Superba (he visited the doctor and complained of too high libido), after some examination and questioning, the doctors thought it might be the supplement causing this sudden increase in androgenic hormones and they instructed him to seize the consumption. Within a week his blood serum 5-a DHT had fallen back to normal.
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).
The participants were seen every 4 weeks. Blood was taken to measure hormone levels, and questionnaires were given to assess physical function, health status, vitality, and sexual function. Body fat and muscle measurements were also taken at the beginning and end of the 16 weeks. The study was funded in part by NIH’s National Institute on Aging (NIA) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Results appeared in the September 12, 2013, issue of the New England Journal of Medicine.
Oral/buccal (by mouth). The buccal dose comes in a patch that you place above your incisor (canine or "eyetooth"). The medication looks like a tablet but you should not chew or swallow it. The drug is released over 12 hours. This method has fewer harmful side effects on the liver than if the drug is swallowed, but it may cause headaches or cause irritation where you place it.
Unlike aerobics or prolonged moderate exercise, short, intense exercise was found to be beneficial in increasing testosterone levels. The results are enhanced with the help of intermittent fasting. Intermittent fasting helps boost testosterone by improving the expression of satiety hormones, like insulin, leptin, adiponectin, glucacgon-like peptide-1 (GLP-1), cholecystokinin (CKK), and melanocortins, which are linked to healthy testosterone function, increased libido, and the prevention of age-induced testosterone decline. When it comes to an exercise plan that will complement testosterone function and production (along with overall health), I recommend including not just aerobics in your routine, but also:
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.
The largest amounts of testosterone (>95%) are produced by the testes in men, while the adrenal glands account for most of the remainder. Testosterone is also synthesized in far smaller total quantities in women by the adrenal glands, thecal cells of the ovaries, and, during pregnancy, by the placenta. In the testes, testosterone is produced by the Leydig cells. The male generative glands also contain Sertoli cells, which require testosterone for spermatogenesis. Like most hormones, testosterone is supplied to target tissues in the blood where much of it is transported bound to a specific plasma protein, sex hormone-binding globulin (SHBG).
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
Longitudinal studies in male aging studies have shown that serum testosterone levels decline with age (Harman et al 2001; Feldman et al 2002). Total testosterone levels fall at an average of 1.6% per year whilst free and bioavailable levels fall by 2%–3% per year. The reduction in free and bioavailable testosterone levels is larger because aging is also associated with increases in SHBG levels (Feldman et al 2002). Cross-sectional data supports these trends but has usually shown smaller reductions in testosterone levels with aging (Feldman et al 2002). This is likely to reflect strict entry criteria to cross-sectional studies so that young healthy men are compared to older healthy men. During the course of longitudinal studies some men may develop pathologies which accentuate decreases in testosterone levels.
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.
It goes without saying that a healthy diet, quality sleep, productive lifestyle, and regular exercises can contribute to the overall increase of testosterone. However, it is also true that these activities are very often not enough for guys who have the problems with naturally low testosterone levels. This situation also includes people who want to boost their existing testosterone levels.
We start with plastic. A lot of plastic contains bisphenol A (BPA); BPA is a weak synthetic estrogen. Like many other chemicals used in making plastics, BPA is a hormone disruptor and can block or mimic hormones and how they act in the body (34). If you think you’re safe with BPA plastic, think again. Research shows that BPA free plastic has similar estrogen-like effects on the body.
Consume vegetable carbohydrates and healthy fats. Your body requires the carbohydrates from fresh vegetables rather than grains and sugars. In addition to mono- or polyunsaturated fats found in avocados and raw nuts, saturated fats are also essential to building your testosterone production. According to research, there was a decrease in testosterone stores in people who consumed a diet low in animal-based fat.11 Aside from avocados and raw nuts, ideal sources of healthy fat that can boost your testosterone levels include:
The biggest change I made to my diet was increasing my fat and cholesterol intake. There’s a reason why old school strong men would drink raw eggs — studies have suggested that higher fat and cholesterol consumption results in increased levels of total T; men eating low-fat diets typically have decreased testosterone levels. The emphasis on increasing fat and cholesterol consumption meant I got to eat like Ron Swanson for three months — bacon and eggs and steak was pretty much the staple of my diet.
If you want to naturally boost testosterone and HGH then combining weight training with HIIT workouts (high intensity interval training). Go to the gym at least three days a week, ideally at least three days a week, and lift heavy weights. Lifting heavy weights 6–12 reps with larger muscle groups like your quadriceps, hamstrings, back, shoulders and chest will help your body pack on the maximum amount of muscle. Specifically, lifting at least 30 minutes up to as long as an hour or so can be very, very beneficial boost low testosterone levels.
6., 7. JK, Udani, George AA, Musthapa M, Pakdaman MN, and Abas A. "Effects of a Proprietary Freeze-Dried Water Extract of Eurycoma Longifolia (Physta) and Polygonum minus on Sexual Performance and Well-Being in Men: A Randomized, Double-Blind, Placebo-Controlled Study." National Center for Biotechnology Information. U.S. National Library of Medicine, 12 Jan. 2014.
Scientists in Italy found that subjects who consumed roughly 3 grams of D-AA for 12 days observed a 42 percent increase in testosterone levels. The researchers also noted that the D-AA group still had 22 percent more testosterone than the placebo group three days after they stopped supplementing. Conversely, a more recent article published in Nutrition Research found no increase in testosterone levels in resistance-trained males after supplementing with 3 grams of D-AA for 28 days.
Beast Sports recommends taking four capsules twice per day. The pills are about the same size as a multivitamin or a Tylenol liquid gel pill — not tiny tablets, unfortunately, but they aren’t horse pills. They smell like the boxes of raisins your Mom packed into your school lunch, but stale, like they were forgotten in the pantry for a few years, and a little spicy, like she sprinkled curry powder on them. If you follow this eight pills per day regime, your $46 bottle will last you twenty-two days, and cost you about $2 per day.
Natural remedies for treating erectile dysfunction Erectile dysfunction has many causes, can affect any male, and is often distressing? Some people advocate several different natural remedies, mostly herbs and other plants. Here, we look at their merits and side effects, plus lifestyle changes, and alternative therapies that may bring relief for erectile dysfunction. Read now