Osteoporosis refers to pathological loss of bone density and strength. It is an important condition due to its prevalence and association with bone fractures; most commonly of the hip, vertebra and forearm. Men are relatively protected from the development of osteoporosis by a higher peak bone mass compared with women (Campion and Maricic 2003). Furthermore, women lose bone at an accelerated rate immediately following the menopause. Nevertheless, men start to lose bone mass during early adult life and experience an increase in the rate of bone loss with age (Scopacasa et al 2002). Women of a given age have a higher prevalence of osteoporosis in comparison to men but the prevalence increases with age in both sexes. As a result, men have a lower incidence of osteoporotic fractures than women of a given age but the gap between the sexes narrows with advancing age (Chang et al 2004) and there is evidence that hip fractures in men are associated with greater mortality than in women (Campion and Maricic 2003).

Testosterone [Figure 1] is the main male sex hormone. It is responsible for male sexuality and is the main hormone-producing the features associated with masculinity such as substantial muscle mass, facial hair, libido, and sperm production.[1] Besides, the hormone has other vital functions as the basic chemical composition of testosterone is steroidal; and steroids are known to have significant physiological, as well as psychological, effects in male individuals, especially adults.[1] Testosterone production is reduced gradually in men starting from the age of 30.[2] Hence, testosterone blood concentrations slowly diminish as age progresses. As a result, men may experience a number of physiological and psychological events, such as a lack of sex-drive, erectile dysfunction, acute depression, fatigue, low energy levels, and insomnia.[3]
A: Testosterone is the male androgen, or sex hormone. It controls too many things to list here. While it does help regulate mood, sex drive, and metabolism, it does this by working in tandem with other hormones in your body. It's produced by the male testes and the adrenal glands. For more information, go to //www.everydayhealth.com/drugs/testosterone. Matt Curley, PharmD
Likewise, the amino acids in a protein-rich diet play a big role in both testosterone and muscle growth. As Chris Lockwood, Ph.D., explains, "When combined with training, which increases the sensitivity of androgen receptors, and the consumption of essential amino acids necessary to support protein synthesis, the effects of testosterone on muscle and performance is significantly amplified."[3,4]
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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.
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
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.

Consume enough zinc. Zinc is a mineral needed for many body functions including healthy immune function, bone strength and the production of testosterone. In fact, low levels of zinc are correlated to low levels of testosterone in men and teenage boys.[8] Mild zinc deficiency is now fairly common among Americans, so there's a good chance your teenage boy (particularly if he isn't a healthy eater) may be deficient. Ask your doctor for a blood test to get a better idea, but in the meantime, focus on serving and eating foods that are rich in zinc, such as meats, fish, low-fat milk, hard cheeses, beans and some nuts and seeds.

A study out of the University of Mary Hardin-Baylor in Belton, Texas, examined the effects of fenugreek supplementation on strength and body composition in resistance-trained men. Researchers found that while both the placebo and fenugreek groups significantly increased their strength during the first four weeks, only the fenugreek group saw significant increases in strength after eight weeks of training and supplementation.[5]
Lets touch on these individually. Gluten has been shown to increase prolactin levels in male mice (48 & 49). Increased prolactin levels in males leads to all sorts of horrible things: Man Boobs (50), High inflammation (51), and most importantly, higher prolactin levels have been shown to be testosterone lowering and lead to shrinking of the testicle (52).
The reasons for considering such therapy become evident from the many associations, indicated above, that reduced testosterone has with a variety of both physiological functions (bone metabolism, muscle mass, cognitive function, libido, erectile function) and pathophysiological states (metabolic syndrome, diabetes mellitus, obesity, insulin resistance, autoimmune disease). Although a definitive long-term, large scale placebo-controlled double-blind study of testosterone therapy in the aging male has not yet been carried out, multiple shorter-term trials have suggested improvement by testosterone with a resultant enhancement of muscle mass, bone density, libido, erectile function, mood, motivation and general sense of well-being.
In over two decades of medical practice, I've come to realize that the majority my patients' complaints stem from issues that are within their control—meaning diet and lifestyle changes can help them greatly. And that goes for hormonal imbalances, like low testosterone and high estrogen, as well. In previous articles I've outlined what men can do to address this common issue, including eating lots of healthy fats, HIIT exercises, and controlling stress. Once the easy stuff has been taken care of, it's time to tackle testing, bioidentical hormones, and supplements that can also help with low T.
Stick to protocols that stress large degrees of muscle mass and are moderate- to high-intensity. Additionally, more seasoned gym-goers may want to incorporate forced repetitions periodically into their programs, as testosterone increases have been observed with this type of training.14 Incorporating other post-failure training techniques such as dropsets or partials may similarly be associated with higher T production.

Testosterone is a hormone that is secreted in both men and women. It is responsible for sex drive, as well as protein processing for muscle mass development and strength. Testosterone declines with age, illness and poor nutrition in both genders, though this change may be more marked in men. Synthetic hormone replacement therapy can cause adverse side effects. A natural way to raise the body’s testosterone levels safely include supplementing the diet with specific nutrients and physical exercise.
Epidemiological studies suggest that many significant clinical findings and important disease states are linked to low testosterone levels. These include osteoporosis (Campion and Maricic 2003), Alzheimer’s disease (Moffat et al 2004), frailty, obesity (Svartberg, von Muhlen, Sundsfjord et al 2004), diabetes (Barrett-Connor 1992), hypercholesterolemia (Haffner et al 1993; Van Pottelbergh et al 2003), hypertension (Phillips et al 1993), cardiac failure (Tappler and Katz 1979; Kontoleon et al 2003) and ischemic heart disease (Barrett-Connor and Khaw 1988). The extent to which testosterone deficiency is involved in the pathogenesis of these conditions, or to which testosterone supplementation could be useful in their treatment is an area of great interest with many unanswered questions.

So if you’re intent on maximizing your testosterone levels, and/or you have applied all of the above and you’re still not satisfied with your results (which would be surprising) then you could try the below. I will point out that some of these tips may not have the scientific evidence to back them up like the previous points, but I can assure you that either I have or do use them (and have positive results), or a client has used them with pleasing results, or finally it is such a new conception that there isn’t enough evidence to prove it one way or another.

I think that revamping your diet and lifestyle could be enough alone (no sugar, high fat, low carbs, lots of veggies, working out, low stress). Tongkat Ali would be an amazing added extra. I don’t know about mixing Tongkat with DAA and other stuff. Probably would be fine, but it’s strong. I usually say pick one. I know Testofuel has Fenugreek in it, but I don’t have too much experience with it. It has been proven to have effects. See this article.

Testosterone is everywhere playing multiple roles from intrauterine life to advanced age. Table 1, the contents of which are always undergoing change primarily because of newly observed associations, provides an overview of the bodily systemic functions and patho-physiological states in which testosterone finds itself implicated. In some of these states there is a clear physiological cause and effect relationship. In others, evidence of the physiological role is early or tenuous.
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In males, the testosterone test can help find the reason for sexual problems, like reduced sex drive or erectile dysfunction. If you’re having a hard time getting your partner pregnant, the test can tell if your blood testosterone level is low. It can also screen for problems with the hypothalamus or pituitary gland. This controls how much testosterone your body makes.
Travison, T. G., Vesper, H. W., Orwoll, E, Wu, F., Kaufman, J. M., Wang, Y., …Bhasin, S. (2017, April1). Harmonized reference ranges for circulating testosterone levels in men of four cohort studies in the United States and Europe. The Journal of Clinical Endocrinology & Metabolism, 102(4), 1161–1173. Retrieved from https://academic.oup.com/jcem/article/102/4/1161/2884621

Try diet and exercise changes as your health permits. Losing weight, eating the right foods, and getting more exercise are great ways to naturally increase testosterone while also improving your overall health. While mild to moderate changes are likely safe in most teenage boys, you should consult your doctor before making any significant changes to make sure those changes will be right for your specific health needs.
Testosterone is only one of many factors that influence aggression and the effects of previous experience and environmental stimuli have been found to correlate more strongly. A few studies indicate that the testosterone derivative estradiol (one form of estrogen) might play an important role in male aggression.[66][67][68][69] Studies have also found that testosterone facilitates aggression by modulating vasopressin receptors in the hypothalamus.[70]
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.
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.
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.”
Thus, alcohol metabolism destroys the essential coenzyme required for T synthesis. Alcohol also contributes to the release of special endorphins which inhibit hormone production. In addition, drinking too much alcohol leads to the elevation of estrogen levels in men because of the conversion of testosterone in estrogen. It means that T levels come down with a run.

Zinc deficiency also negatively affects testosterone levels, according a 2014 article in the Journal of Plant Biochemistry and Physiology. The authors of this review note that zinc supplementation can increase circulating testosterone in some populations. In fact, daily supplementation with typical doses may double testosterone within a few months.
Michael T. Murray, ND, is widely regarded as one of the leading authorities on natural medicine. He is the author of many books, including the classic Encyclopedia of Nutritional Supplements. His latest book is What the Drug Companies Won’t Tell You and Your Doctor Doesn’t Know. Visit him online at doctormurray.com.   Article Courtesy of Better Nutrition  
The confusion is understandable, as one in-vitro study noted that high doses of zinc blocked the enzyme 5-a reductase inside test-tubes. But the studies that don’t see much daylight actually show that oral zinc supplementation on actual living, breathing, humans is able to significantly boost the production of dihydrotestosterone, and it does so even when there’s no deficiency in the mineral.
“I'm 55 years old and hitting the ball further than I've ever hit, and I'm not getting tired going 18 holes! And when I play softball I'm hitting the ball further. I work for the DWP in LA and it's a very physically demanding job. Andro400 really helps because we work 16 hour days a lot. I was turning down a lot of overtime, but when I started taking Andro400, it got me through the day. I really notice a difference – even my wife did. It really works!”
Longjack, also known as Tongkat ali and pasak bumi, is a shrub hailing from Southeast Asia purporting to improve libido. It’s gaining traction in the scientific community for potentially increasing testosterone levels, and researchers at South Africa’s University of the Western Cape found that longjack improved testosterone levels and muscular strength in physically active seniors (a population with typically low testosterone).
One study found that men who took 3,332 international units (IU) of vitamin D daily for one year significantly increased their testosterone levels. But vitamin D supplements may only work for men who are severely deficient in this specific vitamin. Another study found that men without a vitamin D deficiency had no increase in testosterone levels after taking vitamin D.
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It's not enough just to increase the testosterone your body produces, because as we age, the testosterone we naturally produce is often bound by SHBG (sex hormone binding globulin) thus becoming unavailable for use in the body. It’s imperative that your testosterone remains unbound or “free” if you want to enjoy all the wonderful benefits testosterone provides.

Our culture sees meat and fat as the enemy, while carbs and sugars are treated like gold. High fructose corn syrup is in almost everything you buy, and this sugar is known to wreak absolute havoc on our endocrine systems. Food companies are well aware that this stuff is destroying you, but as long as people continue to indulge on it they will continue to produce it.
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).
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.
“I can't tell you how good the product is! I'm in the best shape of my life. I used to take blood pressure medication and I don't even take that anymore. It's changed every aspect of my life. I was a 40 waist and I'm down to a 36. I'm 54 years old, and people tell me I look better than I ever have, and I look like I'm in my early 40s! And I'm telling you it's the Andro. This product is so much better than even the advertisements! From taking Andro400 I immediately notice a burst of energy . . . and my skin color, my sexual advancements, my energy, plus the weight loss, the toning of the body, and the increase strength and endurance . . . it's like night and day where I was then and where I am now, and Andro400 has made the difference. And my wife also takes it, 1 pill every other day, and she has experienced an amazing transformation in her body alone, with her hair, her complexion, and as well as in the gym. It's an outstanding product. My customers, my friends, my family, everybody is noticing the difference!”

We scoured the database of the National Center for Biotechnology Information (part of the U.S. National Library of Science) for articles. Of the many ingredients marketed as boosting testosterone levels, we only found four backed by multiple articles based on human testing. For the best chance of boosting testosterone levels, a supplement needs to contain magnesium, fenugreek, and longjack — and some zinc wouldn’t go astray, either.
Over the years I have successfully treated many men with low T. My treatment of choice often includes a combination of bioidentical hormones. Bioidentical hormones are made from natural compounds and are identical to our body’s own natural hormones, which mean they are more easily metabolized and utilized by the body without the negative side effects often associated with synthetic hormones. There are prescription-based bioidentical hormones that are FDA approved. Testosterone hormone replacement therapy can consist of creams, gels, pellets (inserted under the skin), injections, and oral tablets. Men need to be cautious with creams and gels as contact with children or partners can result in them absorbing the testosterone.

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.
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
Dr. Anthony’s Notes: I use Maca often in cycles throughout the year. I typically buy the raw Maca powder, which has a VERY “dirt-like” earthy taste. Beware if you are a bit squeamish on tastes! How To Take Maca: 1500-3000mg of Maca powder is a typical dosage take daily alongside food. From personal experience, I've found that it’s best to buy the Maca powder as a standalone supplement and throw it into a blended protein shake to mask the taste.
Thus, alcohol metabolism destroys the essential coenzyme required for T synthesis. Alcohol also contributes to the release of special endorphins which inhibit hormone production. In addition, drinking too much alcohol leads to the elevation of estrogen levels in men because of the conversion of testosterone in estrogen. It means that T levels come down with a run.
Before we get into the topic, let’s jog our memory on what testosterone is. The human body is a system made of many components, each with a specific function targeting a specific area that affects our lives. Just like how the brain is associated with mentality, thinking, and rationalization and the heart is associated with blood flow and sentimentality, testosterone are hormones associated with a wide variety of body functions, predominantly sex drive, metabolism, muscle growth, and a general sense of well-being in men (women also have testosterone albeit in low levels)

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.
Autopsy studies have found histological prostate cancer to be very common, with one series showing a prevalence of greater than fifty percent in men over age sixty (Holund 1980). The majority of histological cancers go undetected so that the clinical incidence of the disease is much lower, but it is still the most prevalent non-skin cancer in men (Jemal et al 2003). Prostate cancer is also unusual in comparison to other adult cancers in that the majority of those with the disease will die of other causes. Treatment of prostate cancer with androgen deprivation is known to be successful and is widely practiced, indicating an important role for testosterone in modifying the behavior of prostate cancer. In view of this, testosterone treatment is absolutely contraindicated in any case of known or suspected prostate cancer. The question of whether testosterone treatment could cause new cases of prostate cancer, or more likely cause progression of undiagnosed histological prostate cancer that would otherwise have remained occult, is an important consideration when treating ageing males with testosterone.
Men who produce more testosterone are more likely to engage in extramarital sex.[55] Testosterone levels do not rely on physical presence of a partner; testosterone levels of men engaging in same-city and long-distance relationships are similar.[54] Physical presence may be required for women who are in relationships for the testosterone–partner interaction, where same-city partnered women have lower testosterone levels than long-distance partnered women.[59]

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


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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.
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).
You can find a whole bunch of HIIT workouts online, but the one I used during my 90-day experiment was a simple wind sprint routine. On Tuesdays I went to the football field near my house, marked off 40 yards with some cones, and sprinted as fast as I could. I’d slowly walk back to the starting line, giving my body about a minute to rest, and then I’d sprint again. I typically did 40 sets of 40-yard sprints in a workout. I love sprints.
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