Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
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
12) Use Aswaghanda and Collagen Protein: This adaptogenic herb has been shown to reduce stress hormone, increase DHEA and boost testosterone levels. You can take the Cortisol Defense to help you get restorative sleep at night which will support your testosterone. In addition, I personally enjoy using the Organic Bone Broth Collagen in addition to the Amino Strong for a post weight training shake. This protein powder has all the benefits of collagen protein and it has 500 mg of high potency ashwagandha in each serving!
Many studies demonstrate an improvement in mood of hypogonadal men treated with testosterone (Wang et al 1996; Azad et al 2003). The relationship between testosterone status and mood, particularly depression, remains unresolved. Using Beck’s Depression Inventory, Barrett-Connor and colleagues found that the depression score worsened as men aged, exactly at a time when testosterone levels are decreasing (Barrett-Connor et al 1999). Pope and colleagues found that testosterone treatment in men with refractory depression lowered the Hamilton Depression rating scale and the Clinical Global Impression severity rating (Pope et al 2003). The Beck Depression Inventory remained unchanged in Pope’s study.
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 most common "out of balance" testosterone levels are found to be on the low side of normal; this occurs because a male's highest testosterone level usually peaks at about age 20, and then it decreases slowly with age. It has been suggested that a 1% decrease in testosterone level per year is not unusual for middle-aged (30 to 50 years old) and older males. While this decrease may not be noticeable in some men, others may experience significant changes starting in their middle-aged years or more commonly at age 60 and above. This drop in testosterone levels is sometimes termed hypogonadism, "male menopause" or andropause.
Kostic TS, Stojkov NJ, Bjelic MM, Mihajlovic AI, Janjic MM, Andric SA: Pharmacological doses of testosterone upregulated androgen receptor and 3-Beta-hydroxysteroid dehydrogenase/delta-5-delta-4 isomerase and impaired leydig cells steroidogenesis in adult rats. Toxicol Sci. 2011 Jun;121(2):397-407. doi: 10.1093/toxsci/kfr063. Epub 2011 Apr 6. [PubMed:21427060]
Testosterone replacement therapy is currently only FDA approved for men who have been diagnosed with hypogonadism, but it’s also prescribed off-label for older men who take it in hopes that it will improve their libido. The use of testosterone therapy is increasingly common in the United States, with more than 2 million men receiving the therapy. Not every man benefits from taking testosterone supplements. Testosterone is available in different forms, including topicals such as gels, creams, and patches; injections; and pellets that are surgically placed directly beneath the skin. (7)
Testosterone may prove to be an effective treatment in female sexual arousal disorders, and is available as a dermal patch. There is no FDA approved androgen preparation for the treatment of androgen insufficiency; however, it has been used off-label to treat low libido and sexual dysfunction in older women. Testosterone may be a treatment for postmenopausal women as long as they are effectively estrogenized.
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In many of the studies we found, those who saw the most improvement in health, testosterone, or muscle gain were those with existing nutrient or vitamin deficiencies. This means that some gains may be due more to dietary changes and generally restoring nutrient and vitamin levels than any one magic ingredient, but also that making sure your diet includes healthy amounts of nutrients should be your first step.
The second theory is similar and is known as "evolutionary neuroandrogenic (ENA) theory of male aggression". Testosterone and other androgens have evolved to masculinize a brain in order to be competitive even to the point of risking harm to the person and others. By doing so, individuals with masculinized brains as a result of pre-natal and adult life testosterone and androgens enhance their resource acquiring abilities in order to survive, attract and copulate with mates as much as possible. The masculinization of the brain is not just mediated by testosterone levels at the adult stage, but also testosterone exposure in the womb as a fetus. Higher pre-natal testosterone indicated by a low digit ratio as well as adult testosterone levels increased risk of fouls or aggression among male players in a soccer game. Studies have also found higher pre-natal testosterone or lower digit ratio to be correlated with higher aggression in males.
Ashwagandha is shown to be effective at reducing cortisol which in turn helps with testosterone production. There are also numerous studies showing the effects on improving testosterone in infertile men (ref 80). If you are using the Aggressive Strength product you don't need to supplement with ashwagandha as it's included in the test booster formula. Likewise if you're using Tian Chi (my daily herb drink).
If you’re already taking your tongkat ali, your maca, your fenugreek, and your tribulus, good job! Your testicles might be bursting at the seams. However, there is more you can do, another effective natural method. Consider adding foods that increase testosterone levels to your diet. If you are skeptical that it can really make a difference, eating these types of foods can increase testosterone by about 20%-30%. Or, if you’re like me and a huge Tim Ferriss fan, you actually believe his almost preposterous claim to having doubled his testosterone through diet alone. Read my article, Tim Ferriss’s testosterone diet, if you’re curious.
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.
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.
Testosterone is a male hormone. Hormones are chemical messengers that are secreted by the brain directly into the blood, which carries them to organs and tissues of the body to perform their functions. Testosterone is produced by the testicles, two oval organs that produce sperm in men. Dietary supplements help with increasing the levels of hormones if we have low levels in the body. In men, testosterone plays a key role in the development of male reproductive organs. In addition, it helps with increasing muscle mass, bone mass, and the growth of body hair. It is also good for general health and well-being. It also prevents loss of bone mass and density. Testosterone also helps maintain the sex drive and energy levels. Moreover, it helps with production of sperm and red blood cells. Testosterone levels start to fall with age. As a result, some men who have low testosterone levels may benefit from testosterone prescribed by their doctor. Testosterone booster supplements may also help.
With the decline of ovarian function in menopause, not only do estrogen levels decline, but so does testosterone availability, since the ovaries contribute, either by direct secretion or through precursor production, about 50 percent of circulating testosterone. The other 50 percent is supplied by the adrenal glands. Many post-menopausal or oophorectomized women are symptomatic as a consequence of reduced testosterone, the leading symptom being loss of libido (Sherwin and Gelfand 1987; Simon et al 2005). There is an increasing trend toward testosterone supplementation in these women. Such supplementation may also lead, not only to increased libido, but to increased bone mineral density and an improvement in general overall sense of well-being including energy, strength, motivation and mood (Davis et al 1995; Davis et al 2000).
Try a protein deprivation diet. According to "Optimum Anabolics," the body produces more testosterone in response to heavy training when there is insufficient protein in the diet. Testosterone provides a hypertrophic, or muscle-building, backup system, allowing for muscle recovery when protein is not available. To follow this diet, take in only 30 grams of high-quality, fast-digesting protein (whey protein) immediately following your weight training. The rest of the days, your calories, split into five or six meals, should be divided between low-glycemic carbohydrates (oatmeal, whole grains and sweet potatoes) and healthy fats. After three weeks of this diet, switch back to a higher-protein diet (1 gram of protein per pound of body weight), adding one extra 20 to 30 gram serving of protein before bed.
Changes in body composition are seen with aging. In general terms, aging males are prone to loss of muscle mass and a gain in fat mass, especially in the form of visceral or central fat. An epidemiological study of community dwelling men aged between 24 and 85 years has confirmed that total and free testosterone levels are inversely correlated with waist circumference and that testosterone levels are specifically related to this measure of central obesity rather than general obesity (Svartberg, von Muhlen, Sundsfjord et al 2004). Prospective studies show that testosterone levels predict future development of central obesity (Khaw and Barrett-Connor 1992; Tsai et al 2000). Reductions in free testosterone also correlate with age related declines in fat free mass (muscle mass) and muscle strength (Baumgartner et al 1999; Roy et al 2002). Studies in hypogonadal men confirm an increase in fat mass and decrease in fat free mass versus comparable eugonadal men (Katznelson et al 1998). Taken together, the epidemiological data suggest that a hypogonadal state promotes loss of muscle mass and a gain in fat mass, particularly visceral fat and therefore mimics the changes of ‘normal’ aging.
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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
Free testosterone (T) is transported into the cytoplasm of target tissue cells, where it can bind to the androgen receptor, or can be reduced to 5α-dihydrotestosterone (DHT) by the cytoplasmic enzyme 5α-reductase. DHT binds to the same androgen receptor even more strongly than testosterone, so that its androgenic potency is about 5 times that of T. The T-receptor or DHT-receptor complex undergoes a structural change that allows it to move into the cell nucleus and bind directly to specific nucleotide sequences of the chromosomal DNA. The areas of binding are called hormone response elements (HREs), and influence transcriptional activity of certain genes, producing the androgen effects.
Testosterone functions within the brain. There are several lines of evidence for this: there are androgen receptors within the brain; testosterone is converted to both dihydrotestosterone (DHT) and estradiol by the actions of 5-α-reductase and aromatase respectively in the brain; steroid hormones promote neuronal cell growth and survival (Azad et al 2003). Testosterone enhances cerebral perfusion in hypogonadal men and that perfusion takes place specifically in Brodman areas 8 and 24, regions of the brain that are concerned with: strategic planning, higher motor action, cognitive behaviors, emotional behavior, generalized emotional reaction, wakefulness and memory (Greenlee 2000; Azad et al 2003). Studies of cognition demonstrate that older men with higher levels of free testosterone index (a surrogate measure of bioavailable testosterone) have better scores in tests of: visual memory, verbal memory, visuospatial functions and visuomotor scanning. Hypogonadal men have lower scores in tests of memory, visuospatial function, with a faster decline in visual memory (Moffat et al 2002). In a very small, short term placebo-controlled study hypogonadal men with Alzheimer’s Disease (AD) treated with testosterone demonstrated a modest improvement in a cognition assessment score in AD (Tan and Pu 2003).
Researchers found that the simple act ‘expressing power through open, expansive postures’ (i.e. standing up straight and proud) can increase Testosterone and decrease cortisol (58), along with improving feelings of power and tolerance for risk. Easy! Your mother was right – don’t slouch. This could be a handy trick before making a speech or going on a date!
In order to discuss the biochemical diagnosis of hypogonadism it is necessary to outline the usual carriage of testosterone in the blood. Total serum testosterone consists of free testosterone (2%–3%), testosterone bound to sex hormone binding globulin (SHBG) (45%) and testosterone bound to other proteins (mainly albumin −50%) (Dunn et al 1981). Testosterone binds only loosely to albumin and so this testosterone as well as free testosterone is available to tissues and is termed bioavailable testosterone. Testosterone bound to SHBG is tightly bound and is biologically inactive. Bioavailable and free testosterone are known to correlate better than total testosterone with clinical sequelae of androgenization such as bone mineral density and muscle strength (Khosla et al 1998; Roy et al 2002). There is diurnal variation in serum testosterone levels with peak levels seen in the morning following sleep, which can be maintained into the seventh decade (Diver et al 2003). Samples should always be taken in the morning before 11 am to allow for standardization.
Testosterone boosters are supplementary substances that can be used for the purpose of increasing testosterone levels in the blood. This study aimed to evaluate the side effects and health risks of testosterone boosters among athletes. A sportsman came to the King Saud Hospital, Unaizah, Qassim, Saudi Arabia, suffering from abdominal pain. The attending doctor requested general laboratory tests. He admitted to having consumed two courses of a testosterone booster over a period of 42 days following the instructions of the manufacturer. In total, the athlete in question consumed several courses, twice before the abdominal pain started and twice after it subsided. The blood tests and reports suggested that the commercial product consumed might negatively affect several hepatic functions and resulted in slightly increased testosterone concentrations after the fourth course. In conclusion, administration of testosterone booster products, although obtained from trusted sources, may still present some health risks. Further studies with large sample size and for a long period need to be done to confirm the current findings.
Because of inconclusive or conflicting results of testosterone treatment studies reported in the literature, Rabkin and colleagues (2004) undertook a comparison study among testosterone, the anti-depressant, fluoxetine, and placebo in eugonadal HIV positive men. They found that neither fluoxetine nor testosterone were different from placebo in reducing depression, but that testosterone did have a statistically significant effect in reducing fatigue. It is note-worthy that fatigue was reduced with testosterone treatment even though virtually all the men in the study had testosterone levels within the reference range.
Millions of American men use a prescription testosterone gel or injection to restore normal levels of the manly hormone. The ongoing pharmaceutical marketing blitz promises that treating "low T" this way can make men feel more alert, energetic, mentally sharp, and sexually functional. However, legitimate safety concerns linger. For example, some older men on testosterone could face higher cardiac risks.