As you cut these dietary troublemakers from your meals, you need to replace them with healthy substitutes like vegetables and healthy fats (including natural saturated fats!). Your body prefers the carbohydrates in micronutrient-dense vegetables rather than grains and sugars because it slows the conversion to simple sugars like glucose, and decreases your insulin level. When you cut grains and sugar from your meals, you typically will need to radically increase the amount of vegetables you eat, as well as make sure you are also consuming protein and healthy fats regularly.
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)

Findings that improvements in serum glucose, serum insulin, insulin resistance or glycemic control, in men treated with testosterone are accompanied by reduced measures of central obesity, are in line with other studies showing a specific effect of testosterone in reducing central or visceral obesity (Rebuffe-Scrive et al 1991; Marin, Holmang et al 1992). Furthermore, studies that have shown neutral effects of testosterone on glucose metabolism have not measured (Corrales et al 2004), or shown neutral effects (Lee et al 2005) (Tripathy et al 1998; Bhasin et al 2005) on central obesity. Given the known association of visceral obesity with insulin resistance, it is possible that testosterone treatment of hypogonadal men acts to improve insulin resistance and diabetes through an effect in reducing central obesity. This effect can be explained by the action of testosterone in inhibiting lipoprotein lipase and thereby reducing triglyceride uptake into adipocytes (Sorva et al 1988), an action which seems to occur preferentially in visceral fat (Marin et al 1995; Marin et al 1996). Visceral fat is thought to be more responsive to hormonal changes due to a greater concentration of androgen receptors and increased vascularity compared with subcutaneous fat (Bjorntorp 1996). Further explanation of the links between hypogonadism and obesity is offered by the hypogonadal-obesity-adipocytokine cycle hypothesis (see Figure 1). In this model, increases in body fat lead to increases in aromatase levels, in addition to insulin resistance, adverse lipid profiles and increased leptin levels. Increased action of aromatase in metabolizing testosterone to estrogen, reduces testosterone levels which induces further accumulation of visceral fat. Higher leptin levels and possibly other factors, act at the pituitary to suppress gonadotrophin release and exacerbate hypogonadism (Cohen 1999; Kapoor et al 2005). Leptin has also been shown to reduce testosterone secretion from rodent testes in vitro (Tena-Sempere et al 1999). A full review of the relationship between testosterone, insulin resistance and diabetes can be found elsewhere (Kapoor et al 2005; Jones 2007).
Present in much greater levels in men than women, testosterone initiates the development of the male internal and external reproductive organs during foetal development and is essential for the production of sperm in adult life. This hormone also signals the body to make new blood cells, ensures that muscles and bones stay strong during and after puberty and enhances libido both in men and women. Testosterone is linked to many of the changes seen in boys during puberty (including an increase in height, body and pubic hair growth, enlargement of the penis, testes and prostate gland, and changes in sexual and aggressive behaviour). It also regulates the secretion of luteinising hormone and follicle stimulating hormone. To effect these changes, testosterone is often converted into another androgen called dihydrotestosterone. 
The regular intake of testosterone boosters is known for the high level of safety comparing to the hormone injections and the use of illegal steroids. But still to protect yourself against any possible adverse reactions, you should remember that the supplementation can’t be continuous. The breaks from time to time are required. Such an approach to the use of boosters is healthy and best-working if you aspire to enhance own hormone production without any harm.
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.
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.
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.

The second theory is similar and is known as "evolutionary neuroandrogenic (ENA) theory of male aggression".[78][79] 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.[78] 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.[80] Studies have also found higher pre-natal testosterone or lower digit ratio to be correlated with higher aggression in males.[81][82][83][84][85]

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).


Once you have surpassed your early twenties, natural testosterone levels slowly begin to decline. This is a natural occurrence which occurs in all men, however can be prevented to some extent by ensuring your diet is rich in vitamins, minerals and quality fats. You can also supplement with a Natural Testosterone Booster which will work by encouraging your body to produce more Testosterone, back up to levels you could produce in your younger years.
There are positive correlations between positive orgasm experience in women and testosterone levels where relaxation was a key perception of the experience. There is no correlation between testosterone and men's perceptions of their orgasm experience, and also no correlation between higher testosterone levels and greater sexual assertiveness in either sex.[34]

FITNESS DISCLAIMER: The information contained in this site is for educational purposes only. Vigorous high-intensity exercise is not safe or suitable for everyone. You should consult a physician before beginning a new diet or exercise program and discontinue exercise immediately and consult your physician if you experience pain, dizziness, or discomfort. The results, if any, from the exercises may vary from person-to-person. Engaging in any exercise or fitness program involves the risk of injury. Mercola.com or our panel of fitness experts shall not be liable for any claims for injuries or damages resulting from or connected with the use of this site. Specific questions about your fitness condition cannot be answered without first establishing a trainer-client relationship.
Growth of spermatogenic tissue in testicles, male fertility, penis or clitoris enlargement, increased libido and frequency of erection or clitoral engorgement occurs. Growth of jaw, brow, chin, and nose and remodeling of facial bone contours, in conjunction with human growth hormone occurs.[21] Completion of bone maturation and termination of growth. This occurs indirectly via estradiol metabolites and hence more gradually in men than women. Increased muscle strength and mass, shoulders become broader and rib cage expands, deepening of voice, growth of the Adam's apple. Enlargement of sebaceous glands. This might cause acne, subcutaneous fat in face decreases. Pubic hair extends to thighs and up toward umbilicus, development of facial hair (sideburns, beard, moustache), loss of scalp hair (androgenetic alopecia), increase in chest hair, periareolar hair, perianal hair, leg hair, armpit hair.
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.
Cross-sectional studies have found a positive association between serum testosterone and some measures of cognitive ability in men (Barrett-Connor, Goodman-Gruen et al 1999; Yaffe et al 2002). Longitudinal studies have found that free testosterone levels correlate positively with future cognitive abilities and reduced rate of cognitive decline (Moffat et al 2002) and that, compared with controls, testosterone levels are reduced in men with Alzheimer’s disease at least 10 years prior to diagnosis (Moffat et al 2004). Studies of the effects of induced androgen deficiency in patients with prostate cancer have shown that profoundly lowering testosterone leads to worsening cognitive functions (Almeida et al 2004; Salminen et al 2004) and increased levels of serum amyloid (Gandy et al 2001; Almeida et al 2004), which is central to the pathogenesis of Alzheimer’s disease (Parihar and Hemnani 2004). Furthermore, testosterone reduces amyloid-induced hippocampal neurotoxity in vitro (Pike 2001) as well as exhibiting other neuroprotective effects (Pouliot et al 1996). The epidemiological and experimental data propose a potential role of testosterone in protecting cognitive function and preventing Alzheimer’s disease.
You’re probably most familiar with testosterone as being the sex hormone responsible for defining “manhood.” And, yes, it does. However, proper levels of this key hormone are also necessary to stimulate sexual desire, increase libido, heighten arousal and ensure sexual satisfaction for both men and women. It’s also necessary to maintaining the following:
Why do we need magnesium? Magnesium is an essential nutrient in the body that can help decrease the risk of developing osteoporosis, improve insulin sensitivity, and lower the risk of hypertension. This article looks at other health benefits of magnesium, what happens if a person has a deficiency, supplements, and how to include it in the diet. Read now
Other Potential risks that can be caused by use of testosterone supplements are: People who take good testosterone supplements or any other kind of testosterone boosters can also experience many other side effects, including stomachache, problems with urination, dizziness, mood changes, intermittent breathing during sleep, changes in testicles, appetite loss, inflammation of gums, weight gain, nausea, painful erection, and protracted erection.
Transdermal preparations of testosterone utilize the fact that the skin readily absorbs steroid hormones. Initial transdermal preparations took the form of scrotal patches with testosterone loaded on to a membranous patch. Absorption from the scrotal skin was particularly good and physiological levels of testosterone with diurnal variation were reliably attained. The scrotal patches are now rarely used because they require regular shaving or clipping of scrotal hair and because they produce rather high levels of dihydrotestosterone compared to testosterone (Behre et al 1999). Subsequently, non-scrotal patches were developed but the absorptive capacity of non-scrotal skin is much lower, so these patches contain additional chemicals which enhance absorption. The non-scrotal skin patches produce physiological testosterone levels without supraphysiological dihydrotestosterone levels. Unfortunately, the patches produce a high rate of local skin reactions often leading to discontinuation (Parker and Armitage 1999). In the last few years, transdermal testosterone gel preparations have become available. These require daily application by patients and produce steady state physiological testosterone levels within a few days in most patients (Swerdloff et al 2000; Steidle et al 2003). The advantages compared with testosterone patches include invisibility, reduced skin irritation and the ability to adjust dosage, but concerns about transfer to women and children on close skin contact necessitate showering after application or coverage with clothes.
Hoffman, J., Ratamess, N., Kang, J., Magine, G., Faigenbaum, A. & Stout, J. (2006, August). Effect of creatine and beta-alanine supplementation on performance and endocrine responses in strength/power athletes [Abstract]. International Journal of Sport Nutrition and Exercise Metabolism, 16(4), 430–46. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17136944

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]
“About 2 weeks after starting Andro400, I noticed my belly fat disappearing. Now, after only one month, I've lost about ten pounds all in my mid section. What a miracle! I have more energy and don't have to hold my gut in any longer. I'm more relaxed and my libido has increased 5 fold! I'm 58 years old and beginning to feel like a teenager again! Your product has delivered exactly as advertised. I'm elated!”

I bought most of the ingredients for my Testosterone Salad at Whole Foods. For those curious, I added up all the ingredients and divided by six (I typically ate six of these salads in a week). The cost per salad was roughly $5. That’s about the price many folks pay every day for a crappy fast food meal. If you’re on a budget, I’m sure you could get the ingredients at Walmart and bring the cost per salad down even more.
^ Mehta PH, Jones AC, Josephs RA (Jun 2008). "The social endocrinology of dominance: basal testosterone predicts cortisol changes and behavior following victory and defeat" (PDF). Journal of Personality and Social Psychology. 94 (6): 1078–93. CiteSeerX 10.1.1.336.2502. doi:10.1037/0022-3514.94.6.1078. PMID 18505319. Archived from the original (PDF) on April 19, 2009.
Among my favorite stress management tools is the Emotional Freedom Technique (EFT), a method similar to acupuncture but without the use of needles. EFT is known to eliminate negative behavior and instill a positive mentality. Always bear in mind that your emotional health is strongly linked to your physical health, and you have to pay attention to your negative feelings as much as you do to the foods you eat.
In summary it’s important to know that this topic is still hotly debated, and there are a lot of inconsistencies in the data. We do know that soy contains phytoestrogens and does seem to have a lot of affects on the body, including some studies that show decreased Testosterone levels. For that reason (and the fact that it tastes like ass) I avoid it, and I recommend you also avoid it (in particular soy isolates!) if you’re seeking higher testosterone.
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.
Most Americans today are sleep deprived, which may be a contributing factor to declining testosterone levels in men. See, our body makes nearly all the testosterone it needs for the day while we’re sleeping. That increased level of T that we experience at night is one of the reasons we wake up with “Morning Wood.” (If you don’t have Morning Wood on a consistent basis, you might have low T).
The partial synthesis in the 1930s of abundant, potent testosterone esters permitted the characterization of the hormone's effects, so that Kochakian and Murlin (1936) were able to show that testosterone raised nitrogen retention (a mechanism central to anabolism) in the dog, after which Allan Kenyon's group[186] was able to demonstrate both anabolic and androgenic effects of testosterone propionate in eunuchoidal men, boys, and women. The period of the early 1930s to the 1950s has been called "The Golden Age of Steroid Chemistry",[187] and work during this period progressed quickly. Research in this golden age proved that this newly synthesized compound—testosterone—or rather family of compounds (for many derivatives were developed from 1940 to 1960), was a potent multiplier of muscle, strength, and well-being.[188]
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2019, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM Health Solutions.
Fitness Disclaimer: The information contained in this site is for educational purposes only. Vigorous high-intensity exercise is not safe or suitable for everyone. You should consult a physician before beginning a new diet or exercise program and discontinue exercise immediately and consult your physician if you experience pain, dizziness, or discomfort. The results, if any, from the exercises may vary from person-to-person. Engaging in any exercise or fitness program involves the risk of injury. Mercola.com or our panel of fitness experts shall not be liable for any claims for injuries or damages resulting from or connected with the use of this site. Specific questions about your fitness condition cannot be answered without first establishing a trainer-client relationship.
It is a natural hormone present in the body known as Dehydroepiandrosterone (DHEA). It reduces the estrogen levels while boosting testosterone levels. It has been in use since so long to raise testosterone levels. Among all supplements, it is one of the famous and many researchers are working on it to tell how it stimulates testosterone production. It is banned for athletes and professional players.
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.

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.
1. Go Mediterranean. Keeping up with specific types of food that you should or should not eat can be hard, especially if you don’t have a general guide. There are a number of studies that have concluded that the Mediterranean diet can indeed boost the amount of testosterone in the body, and enhance the strength of an erection as well. The Mediterranean diet contains a lot of healthy fat, like polyunsaturated fat and monounsaturated fat. Aside from being pro-testosterone, the Mediterranean diet is also the only diet that is certified to help decrease the chances of developing cancer and heart conditions. Those who are taking erection enhancement supplements can also benefit from the Mediterranean diet. This type of diet originated from the Southern part of Greece, and is composed of food groups such as nuts, whole grains, fruits, extra virgin olive oil, red wine, fats and vegetables.

Two of the immediate metabolites of testosterone, 5α-DHT and estradiol, are biologically important and can be formed both in the liver and in extrahepatic tissues.[151] Approximately 5 to 7% of testosterone is converted by 5α-reductase into 5α-DHT, with circulating levels of 5α-DHT about 10% of those of testosterone, and approximately 0.3% of testosterone is converted into estradiol by aromatase.[2][151][157][158] 5α-Reductase is highly expressed in the male reproductive organs (including the prostate gland, seminal vesicles, and epididymides),[159] skin, hair follicles, and brain[160] and aromatase is highly expressed in adipose tissue, bone, and the brain.[161][162] As much as 90% of testosterone is converted into 5α-DHT in so-called androgenic tissues with high 5α-reductase expression,[152] and due to the several-fold greater potency of 5α-DHT as an AR agonist relative to testosterone,[163] it has been estimated that the effects of testosterone are potentiated 2- to 3-fold in such tissues.[164]


This over-the-counter supplement is intended to increase your body's level of testosterone to its highest. The manufacturer also advertises the positive effect that the drug can have on your sex life and achieving muscle growth. As a supplement, you are instructed to take four capsules each night before bed. On training days, recommended dosage is two capsules before you workout. Ingredients found in the product include tribulis terristris, long jack, maca root and epimedium.
Before assessing the evidence of testosterone’s action in the aging male it is important to note certain methodological considerations which are common to the interpretation of any clinical trial of testosterone replacement. Many interventional trials of the effects of testosterone on human health and disease have been conducted. There is considerable heterogenicity in terms of study design and these differences have a potential to significantly affect the results seen in various studies. Gonadal status at baseline and the testosterone level produced by testosterone treatment in the study are of particular importance because the effects of altering testosterone from subphysiological to physiological levels may be different from those of altering physiological levels to supraphysiological. Another important factor is the length of treatment. Randomised controlled trials of testosterone have ranged from one to thirty-six months in duration (Isidori et al 2005) although some uncontrolled studies have lasted up to 42 months. Many effects of testosterone are thought to fully develop in the first few months of treatment but effects on bone, for example, have been shown to continue over two years or more (Snyder et al 2000; Wang, Cunningham et al 2004).
Total levels of testosterone in the body are 264 to 916 ng/dL in men age 19 to 39 years,[165] while mean testosterone levels in adult men have been reported as 630 ng/dL.[166] Levels of testosterone in men decline with age.[165] In women, mean levels of total testosterone have been reported to be 32.6 ng/dL.[167][168] In women with hyperandrogenism, mean levels of total testosterone have been reported to be 62.1 ng/dL.[167][168]
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.

Some of the effects of testosterone treatment are well recognised and it seems clear that testosterone treatment for aging hypogonadal men can be expected to increase lean body mass, decrease visceral fat mass, increase bone mineral density and decrease total cholesterol. Beneficial effects have been seen in many trials on other parameters such as glycemic control in diabetes, erectile dysfunction, cardiovascular risk factors, angina, mood and cognition. These potentially important effects require confirmation in larger clinical trials. Indeed, it is apparent that longer duration randomized controlled trials of testosterone treatment in large numbers of men are needed to confirm the effects of testosterone on many aspects of aging male health including cardiovascular health, psychiatric health, prostate cancer and functional capacity. In the absence of such studies, it is necessary to balance risk and benefit on the best available data. At the present time the data supports the treatment of hypogonadal men with testosterone to normalize testosterone levels and improve symptoms. Most men with hypogonadism do not have a contraindication to treatment, but it is important to monitor for adverse consequences including prostate complications and polycythemia.


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
3. Beans. Beans are an excellent source of fiber, protein and zinc. If you compare beans with other vegetables, you will see that beans have the highest zinc content. This is a good thing if you’re trying to get your testosterone levels up since zinc plays an important role when it comes to testosterone production. Without an adequate amount of zinc in the body, the testosterone produced will be converted into estrogen. Likewise zinc may help convert estrogen back into testosterone.  Yet another study on rats confirms this.  Sorry for the rat-heavy studies in this post.

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Testosterone has two major effects on bones: (a) through conversion to estradiol by way of the enzyme, aromatase, testosterone inhibits osteoclastic activity and hence bone resorption; and (b) through conversion to DHT via 5-α-reductase, it stimulates osteoblastic activity and so enhances the laying down of bone (Tivesten et al 2004; Davey and Morris 2005). Hypogonadal men are at risk for the development of osteopenia or osteoporosis and hence for subsequent fracture (Fink et al 2006). About one-third of all osteoporotic hip fractures occur in men and the risk of any osteoporotic fracture in men over 50 is as high as 25 percent (Seeman 1997; Adler 2006). Although treatment with testosterone in hypogonadal men increases bone mineral density (Katznelson et al 1996), it has not yet been established that this results in a reduction in fracture rate.
Cognitive abilities differ between males and females and these differences are present from childhood. In broad terms, girls have stronger verbal skills than boys who tend to have stronger skills related to spatial ability (Linn and Petersen 1985). It is thought that the actions of sex hormones have a role in these differences. Reviewing different cognitive strengths of male versus female humans is not within the scope of this article but the idea that cognition could be altered by testosterone deserves attention.
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).
Mental status changes including excess aggression are a well known phenomenon in the context of anabolic steroid abuse (Perry et al 1990). An increase in self-reported aggressive behaviors have also been reported in one double blind placebo controlled trial of testosterone in young hypogonadal men (Finkelstein et al 1997), but this has not been confirmed in other studies (Skakkebaek et al 1981; O’Connor et al 2002). Aggression should therefore be monitored but in our experience is rarely a significant problem during testosterone replacement producing physiological levels.

Important future developments will include selective androgen receptor modulators (SARMs). These drugs will be able to produce isolated effects of testosterone at androgen receptors. They are likely to become useful clinical drugs, but their initial worth may lie in facilitating research into the relative importance of testosterone’s action at the androgen receptor compared to at other sites or after conversion to other hormones. Testosterone will remain the treatment of choice for late onset hypogonadism for some time to come.

Testosterone levels generally peak during adolescence and early adulthood. As you get older, your testosterone level gradually declines — typically about 1 percent a year after age 30 or 40. It is important to determine in older men if a low testosterone level is simply due to the decline of normal aging or if it is due to a disease (hypogonadism).
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