It is hard to know how many men among us have TD, although data suggest that overall about 2.1% (about 2 men in every 100) may have TD. As few as 1% of younger men may have TD, while as many as 50% of men over 80 years old may have TD. People who study the condition often use different cut-off points for the numbers, so you may hear different numbers being stated.
In a recent study of male workers, men with low testosterone levels had an increased chance of severe erectile dysfunction (Kratzik et al 2005), although such a link had not been found previously (Rhoden et al 2002). Certainly erectile dysfunction is considered part of the clinical syndrome of hypogonadism, and questions regarding erectile dysfunction form part of the clinical assessment of patients with hypogonadism (Morley et al 2000; Moore et al 2004).
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.

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Prolactin is suppressed by dopamine activity. Since supplementing L-DOPA suppresses prolactin (by increasing dopamine activity), supplementing L-DOPA would increase testosterone if prolactin was abnormally high. The average, healthy male does not have elevated prolactin (unless he’s on steroids), so supplementing with L-DOPA will not increase your testosterone levels.
As “the ultimate guide” I want this article to be the last resource you need when it comes to boosting your testosterone. I have spent years researching this stuff, and experimenting on myself. And in case I am incomplete, I have linked out at the bottom of this page to all the best resources for increasing testosterone around the web. I truly believe there is no better resource out there than what you’re reading right now.

Puberty occurs when there is an “awakening” of the hypothalamic-pituitary axis. The hypothalamus increases its secretion of gonadotropin releasing hormone (GnRH) which in turn stimulates the release of luteinizing hormone (LH) and follicle stimulating hormone (FSH). This leads to a significant increase in the production of testicular testosterone and the induction of the well-known secondary sex characteristics associated with puberty: growth spurt, increased libido, increased erectile function, acne, increased body hair, increased muscle mass, deepening of the voice, spermatogenesis, gynecomastia (usually transient).

"Boy, I'm doing fine, you can't imagine! I play basketball 6 days a week all winter. I'm 63 years old. I play with 19-year-olds, and I hold my own every day. And Andro400 helps a lot. I'm quick as a cat -- it's amazing! I absolutely know the difference. I'm having a blast, and I appreciate your product. It works wonderfully! You can’t imagine what I can do at my age -- and you help. That ain't no kiddin!"

Testosterone treatment is unequivocally needed in classical hypogonadism for reasons discussed in subsequent subsections. In classical hypogonadism, testosterone production is usually clearly below the lower limit of normal and patients are highly symptomatic; the various symptoms are easily related to the deficiencies in various bodily systems where testosterone action is important. Symptoms of testosterone deficiency are listed in Table 2. A few prominent causes of classical hypogonadism are listed in Table 3.
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]
Herbalists have used _Trifolium pratense_, red clover, to treat menopausal symptoms like hot flashes. The mechanisms underlying these effects remain unknown. Testosterone decreases hot flashes in some postmenopausal women, so red clover may work in this way. A 2015 paper in the Avicenna Journal of Phytomedicine reviewed the literature testing this idea.
Cardiovascular disease, and its underlying pathological process atherosclerosis, is an important cause of morbidity and mortality in the developed and developing world. Coronary heart disease in particular is the commonest cause of death worldwide (AHA 2002; MacKay and Mensah 2004). As well as increasing with age, this disease is more common in the male versus female population internationally, which has led to interest in the potential role of sex hormones in modulating risk of development of atherosclerosis. Concerns about the potential adverse effects of testosterone treatment on cardiovascular disease have previously contributed to caution in prescribing testosterone to those who have, or who are at risk of, cardiovascular disease. Contrary to fears of the potential adverse effects of testosterone on cardiovascular disease, there are over forty epidemiological studies which have examined the relationship of testosterone levels to the presence or development of coronary heart disease, and none have shown a positive correlation. Many of these studies have found the presence of coronary heart disease to be associated with low testosterone levels (Reviews: Jones, Jones et al 2003; Jones et al 2005).
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.
There are supplements out there that promise to increase your libido while also upping your testosterone. There are over the counter testosterone supplements and prescription supplements. There are supplements that market themselves as T-boosters, while also touting themselves as an aphrodisiac. And then there are companies that claim to have developed a testosterone pill that contains the triumvirate of male-enhancing properties: T-boosting, libido-enhancing, and even fertility-increasing. These supplement makers sometimes throw in an additional claim of muscle gain as well.
Are you getting enough vitamin D? Vitamin D is an essential nutrient, but it can be difficult for people to know if they are getting the right amount. Some people will be able to get enough vitamin D from sunlight. Others may need to make dietary changes or take supplements. Here, we explain how to get vitamin D from sunlight, food, and supplements. Read now
A number of epidemiological studies have found that bone mineral density in the aging male population is positively associated with endogenous androgen levels (Murphy et al 1993; Ongphiphadhanakul et al 1995; Rucker et al 2004). Testosterone levels in young men have been shown to correlate with bone size, indicating a role in determination of peak bone mass and protection from future osteoporosis (Lorentzon et al 2005). Male hypogonadism has been shown to be a risk factor for hip fracture (Jackson et al 1992) and a recent study showed a high prevalence of hypogonadism in a group of male patients with average age 75 years presenting with minimal trauma fractures compared to stroke victims who acted as controls (Leifke et al 2005). Estrogen is a well known determinant of bone density in women and some investigators have found serum estrogen to be a strong determinant of male bone density (Khosla et al 1998; Khosla et al 2001). Serum estrogen was also found to correlate better than testosterone with peak bone mass (Khosla et al 2001) but this is in contradiction of a more recent study showing a negative correlation of estrogen with peak bone size (Lorentzon et al 2005). Men with aromatase deficiency (Carani et al 1997) or defunctioning estrogen receptor mutations (Smith et al 1994) have been found to have abnormally low bone density despite normal or high testosterone levels which further emphasizes the important influence of estrogen on male bone density.
Studies conducted in rats have indicated that their degree of sexual arousal is sensitive to reductions in testosterone. When testosterone-deprived rats were given medium levels of testosterone, their sexual behaviors (copulation, partner preference, etc.) resumed, but not when given low amounts of the same hormone. Therefore, these mammals may provide a model for studying clinical populations among humans suffering from sexual arousal deficits such as hypoactive sexual desire disorder.[37]

Grape seed extract is another ingredient with not enough research to suggest a dosage. Grape seed extract can interact with drugs like “blood thinners, NSAID painkillers (like aspirin, Advil, and Aleve), certain heart medicines, cancer treatments, and others.” If this sounds like you (or if you ever pop an Advil to clear off a headache), you’ll need to speak with a doctor to make sure this supplement is safe to take.
The aim of treatment for hypogonadism is to normalize serum testosterone levels and abolish symptoms or pathological states that are due to low testosterone levels. The exact target testosterone level is a matter of debate, but current recommendations advocate levels in the mid-lower normal adult range (Nieschlag et al 2005). Truly physiological testosterone replacement would require replication of the diurnal rhythm of serum testosterone levels, but there is no current evidence that this is beneficial (Nieschlag et al 2005).
Testosterone makes a contribution to nitric oxide formation. Nitric oxide, released from penile nerves stimulates guanylate cyclase which catalyzes the transformation of guanosine-5-triphosphate into 3′,5′-cyclic, guanosine monophosphate (cyclic GMP). Gyclic GMP causes vasodilatation and hence erection formation (Morelli et al 2005). The breakdown of cyclic GMP to GMP is mediated by the enzyme, phosphodiesterase type-5, the inhibitors of which (eg, sildenafil citrate) enhance erection formation and maintanence (Carson and Lue 2005).
Magnesium comes with a strict upper cap. Excess magnesium is hard on your kidneys, and can lead to kidney failure. The NIH recommends that men consume 400-420 mg of magnesium daily, but that they should not exceed 350 mg of supplemental magnesium per day. Because while it’s rare for people to chronically overdose on magnesium through diet (you’d have to eat a lot of almonds and spinach, for example), overdose by supplement is far more common.
The mechanism of age related decreases in serum testosterone levels has also been the subject of investigation. Metabolic clearance declines with age but this effect is less pronounced than a reduction in testosterone production, so the overall effect is to reduce serum testosterone levels. Gonadotrophin levels rise during aging (Feldman et al 2002) and testicular secretory responses to recombinant human chorionic gonadotrophin (hCG) are reduced (Mulligan et al 1999, 2001). This implies that the reduced production may be caused by primary testicular failure but in fact these changes are not adequate to fully explain the fall in testosterone levels. There are changes in the lutenising hormone (LH) production which consist of decreased LH pulse frequency and amplitude, (Veldhuis et al 1992; Pincus et al 1997) although pituitary production of LH in response to pharmacological stimulation with exogenous GnRH analogues is preserved (Mulligan et al 1999). It therefore seems likely that there are changes in endogenous production of GnRH which underlie the changes in LH secretion and have a role in the age related decline in testosterone. Thus the decreases in testosterone levels with aging seem to reflect changes at all levels of the hypothalamic-pituitary-testicular axis. With advancing age there is also a reduction in androgen receptor concentration in some target tissues and this may contribute to the clinical syndrome of LOH (Ono et al 1988; Gallon et al 1989).
Male hypogonadism becomes more common with increasing age and is currently an under-treated condition. The diagnosis of hypogonadism in the aging male requires a combination of symptoms and low serum testosterone levels. The currently available testosterone preparations can produce consistent physiological testosterone levels and provide for patient preference.
I know the experiment didn’t simply bring me back to my pre-August levels because of the fact that when I learned that the original test I took can sometimes overestimate your T levels, I took a more accurate test around four months after the start of the experiment (I’ve continued the lifestyle changes made during the experiment) and my total T had gone up again to 826.9 ng/dL.

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.

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You should also know that a lot of people are deficient in Vitamin D. In the USA & many other western regions in the world, vitamin D deficiency is at epidemic proportions. The best way to increase your D levels is sun exposure. You only need 20-30 minutes of exposure to a large amount of skin (i.e., take your shirt off and go for a walk during the day).

However, an important peculiarity of testosterone boosting products is their inability to cause addiction. Also, as opposed to steroids, the natural supplements don’t disturb the bodily functions. It means that these products don’t destroy the men’s hormone balance and don’t suppress the natural testosterone synthesis. Instead, the high-quality boosters successfully and safely eliminate the hormone imbalance issues in the men’s body.
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These results have been echoed in clinical trials. A meta-analysis of 24 RCTs looked at weight loss caused by diet or bariatric surgery:[22] In the diet studies, the average 9.8% weight loss was linked to a testosterone increase of 2.9 nmol/L (84 ng/dL). In the bariatric-surgery studies, the average 32% weight loss was linked to a testosterone increase of 8.7 nmol/L (251 ng/dL).

"I went from 230 pounds down to 192. When my son got married, I went for the suit fitting, and I was a size 48. When I went back to do the final fitting, I was a 44! I want to keep getting it for the weight loss; I lost 4 inches around my belly, and I want to get rid of the rest of the weight around my belly. I’m 57, and my wife says I look like I’m back in my 30s. I have more energy for sure, and I’m going to participate in one of those Savage races where they have the obstacle courses with one of our kids." 

If you do take DAA I recommend cycling it (i.e. 5 days on, 2 off, over 4 weeks then 4 weeks off). And taking it with an aromatase inhibitor (which ensures the aspartic acid doesn’t get converted to estrogen). Especially as more studies are coming out showing the increase in testosterone is limited to a week or two before it drops back to normal levels.

It seems that adequate testosterone levels are an important influence on sexual symptoms in the aging male and also influence the response of men to PDE-5 inhibitors, the first line treatment for erectile dysfunction in men. Many would now suggest screening for testosterone deficiency in all men presenting with erectile dysfunction (Gore and Rajfer 2004; Shabsigh 2005). This would seem appropriate because, in addition to benefits on sexual function, identification and treatment of hypogonadal men with testosterone could improve other symptoms of hypogonadism and protect against other conditions such as osteoporosis.
"Boy, I'm doing fine, you can't imagine! I play basketball 6 days a week all winter. I'm 63 years old. I play with 19-year-olds, and I hold my own every day. And Andro400 helps a lot. I'm quick as a cat -- it's amazing! I absolutely know the difference. I'm having a blast, and I appreciate your product. It works wonderfully! You can’t imagine what I can do at my age -- and you help. That ain't no kiddin!"
My educated opinion would be that it will help, but like I said I want to do some more research on the matter and I will probably end up writing a whole article on this subject, and how to reverse pufy nipples. I too have slightly puffy nipples genetically, so I have learned a lot over the years on how to reduce them and will share in an article shortly. I will message you when it is out.
Regardless of the method of testosterone treatment chosen, patients will require regular monitoring during the first year of treatment in order to monitor clinical response to testosterone, testosterone levels and adverse effects, including prostate cancer (see Table 2). It is recommended that patients should be reviewed at least every three months during this time. Once treatment has been established, less frequent review is appropriate but the care of the patient should be the responsibility of an appropriately trained specialist with sufficient experience of managing patients treated with testosterone.
Japanese Knotweed (a.k.a Hu Zhang or Polygonum cuspidatum) is highlighted by WebMD as needing more evidence to rate its effectiveness in a number of different areas: like treating constipation and liver or heart disease. They also warn that it can interact poorly with medications that are changed and broken down by the liver, and those that slow blood clotting (anticoagulants and antiplatelets).

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).
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.
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
Many clinical studies have looked at the effect of testosterone treatment on body composition in hypogonadal men or men with borderline low testosterone levels. Some of these studies specifically examine these changes in older men (Tenover 1992; Morley et al 1993; Urban et al 1995; Sih et al 1997; Snyder et al 1999; Kenny et al 2001; Ferrando et al 2002; Steidle et al 2003; Page et al 2005). The data from studies, on patients from all age groups, are consistent in showing an increase in fat free mass and decrease in fat mass or visceral adiposity with testosterone treatment. A recent meta-analysis of 16 randomized controlled trials of testosterone treatment effects on body composition confirms this pattern (Isidori et al 2005). There have been less consistent results with regard to the effects of testosterone treatment of muscle strength. Some studies have shown an increase in muscle strength (Ferrando et al 2002; Page et al 2005) with testosterone whilst others have not (Snyder et al 1999). Within the same trial some muscle group strengths may improve whilst others do not (Ly et al 2001). It is likely that the differences are partly due to the methodological variations in assessing strength, but it also possible that testosterone has different effects on the various muscle groups. The meta-analysis found trends toward significant improvements in dominant knee and hand grip strength only (Isidori et al 2005).

That testosterone decreases with age has been clearly established by many studies over many years in several different populations of men (Harman et al 2001; Feldman et al 2002; Araujo et al 2004; Kaufman and Vermeulen 2005). Of even greater significance is the steeper fall of the most biologically active fraction of total testosterone, non-sex hormone binding globulin (SHBG)- bound testosterone, or bioavailable testosterone (bio-T). The classical, but not the only approach to measuring bio-T, is to precipitate out SHBG (and hence the testosterone which is strongly bound to it as well) and measure the remainder as total testosterone (Tremblay 2003). Vermeulen et al (1999) have devised a less tedious and less expensive method of measuring a surrogate for bio-T, namely calculated bio-T, inserting total T, albumin, SHBG and a constant into a mathematical formulation. There is a strong correlation between actual bio-T and calculated bio-T (Emadi-Konjin et al 2003).

Testosterone is considered to be the "male hormone" that's produced in men by the testes. Although women's ovaries produce some testosterone, the hormone is produced in much higher concentrations in men and it is responsible for many of the secondary sex characteristics seen in men such as a deeper voice and hair on the chest, in addition to contributing to a healthy libido, building muscle mass, and maintaining energy levels.
Testosterone is observed in most vertebrates. Testosterone and the classical nuclear androgen receptor first appeared in gnathostomes (jawed vertebrates).[189] Agnathans (jawless vertebrates) such as lampreys do not produce testosterone but instead use androstenedione as a male sex hormone.[190] Fish make a slightly different form called 11-ketotestosterone.[191] Its counterpart in insects is ecdysone.[192] The presence of these ubiquitous steroids in a wide range of animals suggest that sex hormones have an ancient evolutionary history.[193]
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:
High intensity exercise is crucial to boost testosterone (13).  Exercises should be explosive in nature and maximize the resistant overload on the muscles.  Large muscle group compound lifts such as squats, deadlifts & burpees are some of the best testosterone boosting exercises.  The training session should be short (5-30 mins) and have very little rest periods between sets.
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.
Testosterone was first used as a clinical drug as early as 1937, but with little understanding of its mechanisms. The hormone is now widely prescribed to men whose bodies naturally produce low levels. But the levels at which testosterone deficiency become medically relevant still aren’t well understood. Normal testosterone production varies widely in men, so it’s difficult to know what levels have medical significance. The hormone’s mechanisms of action are also unclear.