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).

Conflicting results have been obtained concerning the importance of testosterone in maintaining cardiovascular health.[29][30] Nevertheless, maintaining normal testosterone levels in elderly men has been shown to improve many parameters that are thought to reduce cardiovascular disease risk, such as increased lean body mass, decreased visceral fat mass, decreased total cholesterol, and glycemic control.[31]
When you get tested, your doctor will see if you require supplementation. I try and have clients maintain a serum blood level between 50 and 80 ng/mL. Studies have shown that men with lower levels of vitamin D had lower levels of testosterone. If a man tests below my preferred range, I typically recommend 5,000 IUs a day until the levels improve. Vitamin D3 supplements are widely available (best is to get one that contains vitamin K as well, as that allows for greater absorption), and you can also bump up your sunlight exposure. I find, and studies confirm this, that many men are deficient in vitamin D and it is a huge issue relating to testosterone levels.
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The sexual hormone can encourage fair behavior. For the study, subjects took part in a behavioral experiment where the distribution of a real amount of money was decided. The rules allowed both fair and unfair offers. The negotiating partner could subsequently accept or decline the offer. The fairer the offer, the less probable a refusal by the negotiating partner. If no agreement was reached, neither party earned anything. Test subjects with an artificially enhanced testosterone level generally made better, fairer offers than those who received placebos, thus reducing the risk of a rejection of their offer to a minimum. Two later studies have empirically confirmed these results.[71][72][73] However men with high testosterone were significantly 27% less generous in an ultimatum game.[74] The Annual NY Academy of Sciences has also found anabolic steroid use which increase testosterone to be higher in teenagers, and this was associated with increased violence.[75] Studies have also found administered testosterone to increase verbal aggression and anger in some participants.[76]

This summary is intended for general informational purposes only, and should not be interpreted as specific medical advice. The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of purity, strength, or safety of the products. As a result, effects may vary. You should read product labels. In addition, if you are taking medications, herbs, or other supplements you should consult with a qualified healthcare provider before taking a supplement as supplements may interact with other medications, herbs, and nutritional products. If you have a medical condition, including if you are pregnant or nursing, you should speak to your physician before taking a supplement. Consult a healthcare provider if you experience side effects.
Get plenty of vitamin D. Vitamin D is a very important nutrient when it comes to testosterone production. This makes sense when you realize that vitamin D acts more like a steroidal hormone than it does like any typical vitamin. A 2010 study looked at the relationship between vitamin D supplementation and testosterone levels in men and found that those with higher levels of the vitamin also had higher levels of testosterone in their blood.[12] Vitamin D is made by human skin in response to intense summer sunshine, but a lack of going outdoors has triggered near epidemic levels of deficiency in American teenagers. Compounding this problem is that most northern states don't get enough sunshine to trigger vitamin D production for many months of the year.

Mood disturbance and dysthymia are part of the clinical syndrome of hypogonadism. Epidemiological studies have found a positive association between testosterone levels and mood, and depressed aging males have lower testosterone levels than controls (Barrett-Connor, Von Muhlen et al 1999). Furthermore, induction of a hypogonadal state during treatment of men for prostate cancer leads to an increase in depression scores (Almeida et al 2004). Trials of testosterone treatment effects on mood have varied in outcome. Data on the effects on men with depression are conflicting (Seidman et al 2001; Pope et al 2003) but there is evidence that testosterone treatment of older hypogonadal men does result in improvements in mood (Wang et al 1996) and that this may occur through changes in regional brain perfusion (Azad et al 2003).
Some of these signs and symptoms can be caused by various underlying factors, including medication side effects, obstructive sleep apnea, thyroid problems, diabetes and depression. It's also possible that these conditions may be the cause of low testosterone levels, and treatment of these problems may cause testosterone levels to rise. A blood test is the only way to diagnose a low testosterone level.
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