Sleep apnea is another frequently listed contraindication to testosterone treatment. There have been a few reports of the development, or worsening, of sleep apnea during testosterone therapy (Matsumoto et al 1985) but sleep apnea is actually associated with lower serum testosterone levels (Luboshitzky et al 2002). The reduction in fat mass during treatment with testosterone could potentially be beneficial for sleep apnea, so many specialists will still consider patients for treatment with appropriate monitoring. It is wise to take a clinical history for sleep apnea during testosterone treatment in all men and perform sleep studies in those who develop symptoms.

Some boys even develop enlarged testicles and penis, armpit or pubic hair, as well as facial hair as early as age nine! Early puberty is not something to be taken lightly because it can significantly influence physical and psychological health, including an increased risk of hormone-related cancers. Precocious sexual development may also lead to emotional and behavioral issues, such as:

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.


I am also suspect of the fact that men 100 years ago had testosterone levels of 800-2000 ng/dL. The truth is that there are men today that are stronger and more muscular than the men from 100 years ago. Sure the “average man” of today is less than the “average man” of prior generations, but this is because we sit around in offices all day, and then come home to sit on the couch and watch tv…little to no activity.

So out of all the natural testosterone boosting supplements out there I only really recommend tongkat ali extract, d-aspartic acid, and ashwagandha. There are a many others out there, but none that meet the standard that these do. And most of the other ones are actually in Testofuel. But remember, use at your own discretion. Even natural supplements can have side effects, so talk to your doctor first, and start slow.


In fact, high cortisol deals a crushing blow to testosterone in two ways. During, long-lasting stress, high amounts of cortisol release very often and have a direct negative influence on T levels. Thus, cortisol inhibits testosterone synthesis in the testes and hypothalamus. In addition, the production of cortisol is impossible without cholesterol. But testosterone synthesis also demands cholesterol. Since during stress cholesterol is first of all used for making cortisol, T levels simply plummet.
Hooper, D. R., Kraemer, W. J., Saenz, C., Schill, K. E., Focht, B. C., Volek, J. S. … Maresh, C. M. (2017, July). The presence of symptoms of testosterone deficiency in the exercise-hypogonadal male condition and the role of nutrition [Abstract]. European Journal of Applied Physiology, 117(7), 1349–1357. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28470410
There is also solid research indicating that if you take astaxanthin in combination with saw palmetto, you may experience significant synergistic benefits. A 2009 study published in the Journal of the International Society of Sports Nutrition found that an optimal dose of saw palmetto and astaxanthin decreased both DHT and estrogen while simultaneously increasing testosterone.6 Also, in order to block the synthesis of excess estrogen (estradiol) from testosterone there are excellent foods and plant extracts that may help to block the enzyme known as aromatase which is responsible producing estrogen. Some of these include white button mushrooms, grape seed extract and nettles.7

Exercise boosts testosterone in two important ways. First, specific types of exercise actually cause our body to produce more testosterone. We’ll talk more about those in a bit. Second, exercise helps to increase muscle mass and decrease body fat. As we’ve discussed previously, adipose tissue converts testosterone into estrogen. The less fat we get, the more T we have.
It sounds like a creature from Jurassic World, but this plant is worth learning to pronounce, especially if you haven’t had great sex since dinosaurs roamed the earth. A 2012 study showed that consuming six grams of tribulus root for 60 days improved erections and frequency of sex in men with low sperm counts. It also reduced sexual fatigue. Furthermore, their testosterone jumped by a whopping 16%. “Trib,” as it’s called, is thorny and bitter, so look to a supplement for consuming it. Epiq’s Quad Test includes Tribulus terrestris. (epiqresults.com)
Zaima, N., Kinoshita, S., Hieda, N., Kugo, H., Narisawa, K., Yamamoto, A., ... Moriyama, T. (2016, September). Effect of dietary fish oil on mouse testosterone level and the distribution of eicosapentaenoic acid-containing phosphatidylcholine in testicular interstitium. Biochemistry and Biophysics Reports, 7, 259–265. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613343/
Exercise boosts testosterone in two important ways. First, specific types of exercise actually cause our body to produce more testosterone. We’ll talk more about those in a bit. Second, exercise helps to increase muscle mass and decrease body fat. As we’ve discussed previously, adipose tissue converts testosterone into estrogen. The less fat we get, the more T we have.
Testosterone retains nitrogen and is an essential ingredient in the development and maintenance of muscle mass (Sinha-Hikim et al 2006). With a diminution in testosterone, muscle mass diminishes as does strength. Weakness and fatigue result. A number of studies have demonstrated the ability of testosterone to restore lean body mass (muscle) in hypogonadal men, while at the same time causing a reduction in fat mass (Wang et al 2004). Treatment of hypogonadal men with testosterone results in improvement in overall physical performance as well as strength as assessed by, eg, hand grip power (Page 2005). Because of decreased muscle strength and impaired balance, older hypogonadal men are susceptible to falling and since they may already be osteopenic or osteoporotic as a consequence of hypogonadism, they are at increased risk for fracture as a result of the fall (Szulc et al 2003). Men with low levels of testosterone as in androgen deprivation therapy for prostate cancer, have a significant decrease in lean body mass and hemoglobin, while at the same time they experience an increase in weight, body fat and body mass index (Smith et al 2002). Treatment of frail hypogonadal men with testosterone, therefore, can result in changes in muscle gene expression, increased muscle mass, improvements in strength, power and endurance and improved physical function.
If your levels are indeed low, there are a number of synthetic and bioidentical testosterone products on the market, as well as DHEA, which is the most abundant androgen precursor prohormone in the human body, meaning that it is the largest raw material your body uses to produce other vital hormones, including testosterone in men and estrogen in women.
In fact, high cortisol deals a crushing blow to testosterone in two ways. During, long-lasting stress, high amounts of cortisol release very often and have a direct negative influence on T levels. Thus, cortisol inhibits testosterone synthesis in the testes and hypothalamus. In addition, the production of cortisol is impossible without cholesterol. But testosterone synthesis also demands cholesterol. Since during stress cholesterol is first of all used for making cortisol, T levels simply plummet.

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).
DHEA (dehydroepiandrosterone) extract - this is a chemical that used in your body which a ‘hormone precursor’. This means it’s the chemical used by the body to create hormones like oestrogen or testosterone. When taken as supplement it is believed to boost testosterone levels, but DHEA has not been shown to increase testosterone in men. DHEA comes in two form:
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.
Men can experience a range of symptoms if testosterone decreases more than it should. Low testosterone, or low T, is diagnosed when levels fall below 300 nanograms per deciliter (ng/dL). A normal range is typically 300–1000 ng/dL, according to the U.S. Food and Drug Administration. A blood test called a serum testosterone test is used to determine your level of circulating testosterone.

Studies have demonstrated reduced testosterone levels in men with heart failure as well as other endocrine changes (Tappler and Katz 1979; Kontoleon et al 2003). Treatment of cardiac failure with chronic mechanical circulatory support normalizes many of these changes, including testosterone levels (Noirhomme et al 1999). More recently, two double-blind randomized controlled trials of testosterone treatment for men with low or low-normal serum testosterone levels and heart failure have shown improvements in exercise capacity and symptoms (Pugh et al 2004; Malkin et al 2006). The mechanism of these benefits is currently unclear, although a study of the acute effects of buccal testosterone given to men with chronic cardiac failure under invasive monitoring showed that testosterone increased cardiac index and reduced systemic vascular resistance (Pugh et al 2003). Testosterone may prove useful in the management of cardiac failure but further research is needed.
Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256]
Testosterone is included in the World Health Organization's list of essential medicines, which are the most important medications needed in a basic health system.[107] It is available as a generic medication.[10] The price depends on the form of testosterone used.[108] It can be administered as a cream or transdermal patch that is applied to the skin, by injection into a muscle, as a tablet that is placed in the cheek, or by ingestion.[10]
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A team led by Dr. Joel Finkelstein at Massachusetts General Hospital investigated testosterone and estradiol levels in 400 healthy men, 20 to 50 years of age. To control hormone levels, the researchers first gave the participants injections of a drug that suppressed their normal testosterone and estradiol production. The men were randomly assigned to 5 groups that received different amounts (from 0 to 10 grams) of a topical 1% testosterone gel daily for 16 weeks. Half of the participants were also given a drug to block testosterone from being converted to estradiol.

There are studies that show Soy consumption in humans leads to lower sperm count, but unfortunately they did not look at testosterone levels in the study (40). This (41) particular study compared the estrogen production of men drinking soy protein to those drinking whey. After two weeks they found the estradiol levels were equal, however soy drinkers had LOWER Testosterone levels and HIGHER cortisol levels (both bad).

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Smoking doesn’t promote maintaining male hormone levels healthy. The study has shown that smoking deprives the body from zinc. Zinc deficiency is dangerous for men because it is fraught with testosterone deficiency. The matter is that zinc is a kind of structural material for building the testosterone molecules. So, smoking combined with unhealthy diet strikes a blow against normal testosterone production.
According to the Mayo Clinic, testosterone therapy can help treat hypogonadism. This condition occurs when the body can’t produce enough testosterone on its own. However, it’s unclear whether supplements can help. A study published in found no scientific reason to prescribe testosterone to men over 65 years of age with normal or low to normal testosterone levels.
Acne and Allergic Reactions: The testosterone is universally regarded as one of the triggering factors for acne. It stimulates the activity of oil glands making the skin more oily and vulnerable to acne. This body hormone might also cause allergic reactions, such as hives, rash, difficulty breathing, itching, chest tightness, and big swelling of the facial parts.
Dr. Darryn Willoughby, a professor of health, human performance and recreation and the director of the Exercise and Biochemical Nutrition Laboratory at Baylor University, told us that even in studies where there was an increase in testosterone, it was only around 15–20 percent. “In men with clinically normal testosterone levels, this modest increase will most likely not be anabolic enough to improve exercise performance,” he says. So if you have normal testosterone levels, and are simply trying to get an extra edge in gaining muscle, losing weight, or some extra time in the bedroom — you might see some results from taking a testosterone booster. But really, these will be most useful for men with low testosterone trying to get back to a healthy testosterone range.

The testosterone booster pills are effective from 4 to 8 hours. To maintain testosterone levels high during the whole day, you need a multiple daily dosing regimen. 2-times daily dosing still not always can improve hormone production to the greatest extent. 3-4-times daily dosing is the best solution to make your body normalize testosterone synthesis and prevent it from decreasing before you take another pill. Don’t forget that the regularity of daily supplement intake is crucial if you really aspire to give a boost to hormone production.

There is an increased incidence of hypogonadism in men with rheumatoid arthritis. Tengstrand et al (2002) studied hormonal levels in 104 men with rheumatoid arthritis and 99 age-matched healthy men. They divided their subjects into 3 age groups: 30–49, 40–59, 60–69. Mean non-sex hormone binding globulin-bound testosterone (bioavailable testosterone) was lower in men with rheumatoid arthritis for each of the three groups. LH was also found to be lower in the patients with rheumatoid arthritis suggesting a hypothalamic-pituitary cause of the reduced bioavailable testosterone. Of the 104 men with rheumatoid arthritis, 33 had hypogonadism compared to 7 of the 99 healthy controls.


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.
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. 
Early infancy androgen effects are the least understood. In the first weeks of life for male infants, testosterone levels rise. The levels remain in a pubertal range for a few months, but usually reach the barely detectable levels of childhood by 4–7 months of age.[15][16] The function of this rise in humans is unknown. It has been theorized that brain masculinization is occurring since no significant changes have been identified in other parts of the body.[17] The male brain is masculinized by the aromatization of testosterone into estrogen, which crosses the blood–brain barrier and enters the male brain, whereas female fetuses have α-fetoprotein, which binds the estrogen so that female brains are not affected.[18]
Watch out for ingredients that interfere with blood clotting If you are taking any kind of blood medication, take aspirin or ibuprofen, or have any kind of blood-related condition, you’ll want to consult your doctor before taking any of these supplements. Fenugreek, Forskolin, and Acetyl-L-carnitine are just a few of the ingredients that can make these situations worse and increase your chances of bruising and bleeding.
Why bother with such common micronutrients? Because it's not uncommon for athletes to suffer from zinc and magnesium deficiencies, partly due to inadequate replenishing of levels after intense bouts of exercise. Deficiencies in these key minerals can lead to a poor anabolic hormone profile, impaired immune function, and increased cortisol, ultimately leading to decreases in strength and performance.[6]
This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
Epidemiological data has associated low testosterone levels with atherogenic lipid parameters, including lower HDL cholesterol (Lichtenstein et al 1987; Haffner et al 1993; Van Pottelbergh et al 2003) and higher total cholesterol (Haffner et al 1993; Van Pottelbergh et al 2003), LDL cholesterol (Haffner et al 1993) and triglyceride levels (Lichtenstein et al 1987; Haffner et al 1993). Furthermore, these relationships are independent of other factors such as age, obesity and glucose levels (Haffner et al 1993; Van Pottelbergh et al 2003). Interventional trails of testosterone replacement have shown that treatment causes a decrease in total cholesterol. A recent meta-analysis of 17 randomized controlled trials confirmed this and found that the magnitude of changes was larger in trials of patients with lower baseline testosterone levels (Isidori et al 2005). The same meta-analysis found no significant overall change in LDL or HDL cholesterol levels but in trials with baseline testosterone levels greater than 10 nmol/l, there was a small reduction in HDL cholesterol with testosterone treatment.
The ingredients in testosterone supplements may be different. Some testosterone supplements contain zinc and magnesium. They increase testosterone levels in men who exercise. Some other testosterone supplements have hormones like DHEA (dehydroepiandrosterone) and pregnenolone. They help with making new testosterone and may help improve the ability to have an erection. But it doesn't seem to be helpful if the problem with erections is caused by diabetes or nerve disorders. Some testosterone booster supplements contain natural ingredients like herbs and botanicals. They may increase testosterone by increasing a hormone produced by the brain, which signals the testicles to produce more testosterone. In addition, others work by releasing bound testosterone, so it is in a form the body can use. Studies do not provide strong evidence that women benefit from taking these supplements. You need to talk to your doctor or pharmacist before starting a testosterone booster supplement. Discuss your medical history and current prescribed medications, over the counter medications, and any supplements that you are taking. Your doctor or pharmacist can tell you if a testosterone booster supplement is right for you. Once you know if a testosterone booster supplement is right for you, Walgreens has a variety of testosterone booster supplements to choose from and they come in different forms like tablets, capsules or gels.

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.

Testosterone is an anabolic steroid hormone that plays a critical role in metabolism, sex drive, muscle building, mood regulation, memory & cognitive function.  Normal testosterone levels play a huge role in maintaining optimal weight as well as reducing risk of degenerative diseases such as osteoporosis, heart disease, diabetes, & certain cancers (1, 2, 3).
Do low levels of testosterone produce symptoms in middle-aged men? Absolutely. In fact, the classic symptoms were first recognized more than 70 years ago when two American physicians, Carl Heller, MD, and Gordon Myers, MD, showed the effectiveness of testosterone treatment for symptoms of fatigue, depression, irritability, low sex drive, erectile dysfunction, night sweats, and hot flashes in men. Over the years, subsequent studies have found that some—but not all—men with low, age-adjusted testosterone levels exhibit symptoms consistent with andropause. All experience improvement with testosterone therapy.

show that total testosterone levels increase after exercising, especially after resistance training. Low testosterone levels can affect your sex drive and your mood. The good news is that exercise improves mood and stimulates brain chemicals to help you feel happier and more confident. Exercise also boosts energy and endurance, and helps you to sleep better. Fitness experts recommend 30 minutes of exercise every day.

Erectile dysfunction is a common finding in the aging male. A prevalence of over 70% was found in men older than 70 in a recent cross-sectional study (Ponholzer et al 2005). Treatment with phosphodiesterase-5 (PDE-5) inhibitors is proven to be effective for the majority of men but some do not respond (Shabsigh and Anastasiadis 2003). The condition is multi-factorial, with contributions from emotional, vascular, neurological and pharmacological factors. The concept of erectile dysfunction as a vascular disease is particularly interesting in view of the evidence presented above, linking testosterone to atherosclerosis and describing its action as a vasodilator.
If testosterone deficiency occurs during fetal development, then male characteristics may not completely develop. If testosterone deficiency occurs during puberty, a boy’s growth may slow and no growth spurt will be seen. The child may have reduced development of pubic hair, growth of the penis and testes, and deepening of the voice. Around the time of puberty, boys with too little testosterone may also have less than normal strength and endurance, and their arms and legs may continue to grow out of proportion with the rest of their body.
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