Testosterone replacement natural supplement for low levels, Low T treatment by Ray Sahelian, M.D. Risks and side effects, will Low T therapy help you live longer or increase the risk for heart disease and cancer?


Testosterone is an androgen found in both men and women and its levels drop when a man becomes a father. This hormone is made in the testicles and ovaries, and in smaller amounts by the adrenal glands. It is also found in brain tissue. Testosterone is involved in mood, sex drive, vitality, fertility, bone density, and muscle mass. A very low testosterone level is associated with low energy, reduced libido, poor concentration, and fatigue. Levels drop about 1 percent each year after around age 40 and faster in those who are overweight. The chemical structure is similar to that of estrogen. As we get older, more is converted to estrogen than in youth. Although testosterone replacement can, in some people, improve the quality of their lives, it may carry serious risks.

 

Testing for blood levels and when to consider hormone replacement
I am of the opinion that the whole person has to be taken into account when considering hormone treatment as opposed to solely relying on blood studies. If a person feels fine even though a blood study shows a low testosterone hormone level, or low level of other adrenal hormones, this does not necessary mean replacement is necessary. How do we know replacement will improve health in the long run? What if replacement therapy results in various short term and long term side effects and even potentially increasing the risk for cancer and causing premature death? Even if the hormones are replaced, how do we know the ideal dosage and form? If a person has no major symptoms and is of good health, it may be better not to interfere for the time being and to not get any hormone tests done. Just focus or eating as much of a healthy diet as possible, exercise often, engage in a regular stretching or yoga program, get a deep night's rest, try to have low stress, enjoy life and do good unto others. However, if symptoms and signs, such as fatigue, low vitality, low sex drive, low mood, etc. indicate a potential low testosterone level, then it may be appropriate to consider replacement or the use of certain natural supplements that address the particular symptoms of such deficiency. Too many people are getting their levels tested and getting confused with what to do with the numbers rather than focusing on just living a healthy lifestyle.

 

Symptoms of low levels, deficiency
The aging male with reduced testosterone availability may present with a wide variety of symptoms which in addition to frailty and weakness include: fatigue, decreased energy, decreased motivation, cognitive impairment, decreased self-confidence, depression, irritability, osteoporotic pain and the lethargy of anemia. In addition, testosterone deficiency is also associated with type-2 diabetes, the metabolic syndrome, coronary artery disease, stroke and transient ischemic attacks, and cardiovascular disease in general. Men's levels of the hormone can vary quite a bit without causing sexual problems like impotence and decreased libido.

 

Symptoms of low testosterone may include: Low libido, Decreased sexual desire, Decreased rigidity of an erection, Reduced energy, Decreased sense of well-being, Brittle bones and General weakness.

 

Low T, risks of hormone replacement
Testosterone replacement therapy is questionable because it has risks, its efficacy is uncertain, and there's no strong agreement about whether low testosterone is really a disease in older age.

 

Elderly men with limitations in mobility who are treated with testosterone to improve strength appear to be at increased risk of cardiovascular-related adverse events. New England Journal of Medicine 2010.

 

Those who have low T and wish to take replacement therapy should consider the benefits versus the risks, and if still interested in replacement should take as low a dose that helps.
 

Alternatives
Testosterone replacement may be appropriate for those who have very low levels of this hormone, but not for those who have a slightly low level. Before you consider using testosterone injections or gels as replacement, consider more natural alternatives.

 

Better sex drive - natural options, such as Passion Rx, are extremely helpful. If you are considering using testosterone for sexual enhancement, consider Passion Rx or other sex herbs instead. Those interested in increasing sex drive without the use of testosterone should review this page on sex drive which offers natural alternatives such as tongkat ali and tribulus terrestris.

More energy - consider MultiVit Rx comprehensive multivitamin formula that enhances wellbeing, vitality, and energy.

Better sleep - Lack of adequate sleep reduces testosterone levels. consider Good Night Rx which gives you a deeper sleep so you feel more rested.

 

Bigger muscles - creatine monohydrate works very well to increase muscle size within a few days.

 

Better mind enhancement - consider Mind Power Rx. There are natural alternatives to testosterone for improved mood and vitality; exercise and yoga comes to mind.

 

Weight loss - consider Diet Rx appetite suppressant. Weight loss from around the belly reduces the risk of testosterone being converted to estrogen since fat cells have a tendency to make this conversion.

 

For prostate health, consider Prostate Power Rx which also provides a gentle sexual enhancement.

 

Natural ways to Increase testosterone
Men's testosterone levels fall as they get older, which may contribute to health problems such as diabetes, loss of bone and muscle mass, and sexual dysfunction. Hormone replacement is a complicated matter and there is a tendency for doctors to prescribe a higher dosage than patients require. This could also be true of natural hormones that are available over the counter. Many people may take too much not realizing the potential harmful effects of androgens.
   Before you start hormone therapy increase your daily walks and exercise so you are able to sleep deeper at night. This will help increase your levels a good amount.
   There are two hormone supplements available over the counter in health food stores that could elevate low testosterone levels. These are pregnenolone and DHEA. Testosterone cream and the gel are not sold over the counter. A natural testosterone supplement taken orally as a pill is not available over the counter, only by prescription.

 

What natural herb helps for low testosterone? I am typical male, and at the age of 58 still like to have good sex. Also my wife is 55 and suffers from dryness and gets sore, and has low estrogen.
    Lack of sex drive is not necessarily due to low testosterone levels alone, many factors are involved. Herbal supplements such as tongkat ali from Malaysia or tribulus terrestris extract may stimulate testosterone release, at least in the short term, but whether this continues long term is not clear. A tongkat ali extract called LJ100 is also available. Yohimbe does not seem to influence levels but is a good aphrodisiac herb.

 

I am looking to cycle some supplements to boost my testosterone. I found recommendations for muira puama, tribulus terrestris, passionflower and nettle on natural news dot com. What do you recommend?
    Before considering any supplementation one should think carefully why they wish to increase levels of this hormone and be aware of the potential benefits versus the risks and adverse effects. I have not seen any long term studies that have evaluated the influence of these natural sexual enhancers on levels of T hormone. Each of these herbs has potential side effects if misused and this has to be balanced against their potential benefits.

 

Benefit and role of the hormone
Testosterone has many physiological actions in: muscles, bones, hematopoietic system, brain, reproductive and sexual organs, adipose tissue. Within these areas it stimulates: muscle growth and maintenance, bone development while inhibiting bone resorption, the production of red blood cells to increase hemoglobin, libido, enhanced mood and cognition, erectile function and lipolysis.

 

Benefit of supplementation
Replacement in men with low levels may improve metabolic status by: lowering blood sugar and HbA1C in men with type-2 diabetes, reducing abdominal girth, ameliorating features of the metabolic syndrome, all of which may be protective of the cardiovascular system.

 

Decrease levels with age
It is well-established that total testosterone in men decreases with age and that bioavailable levels falls to an even greater extent. The clinical relevance of declining androgens in the aging male and use of replacement therapy in this situation is controversial. Most studies have been short term and there are few large randomized placebo-controlled trials. Anabolic deficits in aging men can induce: frailty, sarcopenia, poor muscle quality, muscle weakness, hypertrophy of adipose tissue and impaired neurotransmission.

 

Testosterone side effects - replacement therapy has risks and dangers
There is a potential for testosterone replacement to increase the risk of prostate cancer and other hormone sensitive cancers. Acne, deepening of voice, aggressiveness and menstrual changes in women are other potential side effects of testosterone therapy. Testosterone replacement should only be prescribed to men who have severe deficiency and the dosage should be as low as possible to take care of the deficiency.  The major safety issue is prostate cancer.

 

Hair Loss
There is a risk for hair thinning or hair loss with prolonged use. This can occur with testosterone replacement in a man or woman. To reverse the hair thinning, consider the temporary use of finasteride, also known as Propecia. The prescription drug Avodart is another option.


Role of the pituitary gland
The pituitary gland controls the level of testosterone in the body. When levels drop, the pituitary gland releases a hormone called luteinizing hormone. Luteinizing hormone stimulates the testicles to make more testosterone. Before puberty, the testosterone level in boys is normally low. It increases during puberty leading to a deeper voice, get bigger muscles, make sperm, and get facial and body hair. Levels are highest between the ages of 30 to 40, then gradually decline. Most of the testosterone in the blood is bound to a protein called sex hormone binding globulin (SHBG). Testosterone that is not bound ("free") can also be checked if a man is having sexual problems.

Testosterone replacement therapy
Various forms are available by prescription. These include injections, cream, and gel. Treatment is sometimes recommended for age related hormone decline in middle aged and older men and women in order to boost libido and vitality. It is also used in women who have had their ovaries removed. DHEA may be a good substitute for testosterone. However, both have short term and long term side effects.
    

Women seeking relief from menopausal symptoms and diminished sex drive by taking testosterone as well as estrogen face a higher risk of breast cancer than with estrogen alone. Analyzing data on more than 120,000 women in the Nurses’ Health Study, researchers from Boston’s Brigham and Women’s Hospital and Harvard Medical School found the more than 800 women who had taken estrogen with testosterone — which is targeted at boosting depressed mood and sex drive and lessen bone deterioration — faced an even higher risk of breast cancer.

 

Testosterone supplements may increase lean body mass and reduce fat mass in older men, but they don't seem to improve functional mobility or cognition. A study involved two hundred healthy men between 60 and 80 years of age who were randomized to receive testosterone undecenoate 80 mg pills or placebo capsules twice daily for 6 months. All of the men had low normal testosterone levels (<13.7 nmol/L). Dr. Marielle H. Emmelot-Vonk, from University Medical Center Utrecht in the Netherlands found no significant changes in cognitive function or bone mineral density with testosterone pill use. Testosterone pills had mixed metabolic effects. Use of the hormone enhanced insulin sensitivity, but was also associated with a drop in HDL cholesterol. Moreover, by the end of the study, 47% of testosterone-treated men had metabolic syndrome compared with 35% of those given placebo. Most importantly, testosterone pill use also had little effect on quality of life. Dr. Marielle  Emmelot-Vonk and colleagues say. "The findings in this testosterone study do not support a net benefit on several indicators of health and functional and cognitive performance with 6 months of modest testosterone supplementation in healthy men with circulating testosterone levels in the lower range." JAMA 2008.

 

Testosterone and sexual desire
Treatment with a patch containing the hormone testosterone can increase sexual desire and activity in women who experience reduced sexual desire after surgical removal of the ovaries.

 

Alcohol use
Problem drinking may dampen both a man's sex life and his chances of having children. Researchers in India found that men being treated for alcoholism had lower testosterone levels and more sperm abnormalities than non-drinkers did. It's known that alcoholic men can develop signs of low testosterone, including shrunken testicles and enlarged breasts.

 

Testosterone and weight loss
A condition involving abnormally high levels of androgens (steroid hormones) known in medical circles as "hyperandrogenemia" starts early in obese children, possibly placing them at increased risk for the metabolic syndrome -- a cluster of conditions such as high blood pressure and high blood sugar levels that raise the risk of heart disease and diabetes. Weight loss leads to decreasing androgen levels. Androgens are steroid hormones such as testosterone or androsterone, which control the development and maintenance of masculine characteristics in both males and females.

 

Testosterone and brain tissue
It is known that steroid abuse can cause behavior changes like aggressiveness and suicidal tendencies. Tests on brain cells in lab dishes show that while a little of the male hormone is good, too much testosterone causes cells to self-destruct in a process similar to that seen in brain illnesses such as Alzheimer's. "Too little testosterone is bad, too much is bad but the right amount is perfect," said Barbara Ehrlich of Yale University in Connecticut, who led the study. Men who experience a traumatic event, such as the loss of a wife, have a temporary drop in testosterone levels.

Testosterone replacement therapy in older men - Are the benefits worth the risks?
Long term concerns are justified in testosterone replacement. Treatment of aging men and women with testosterone supplements is increasing. The supplements are given to postmenopausal women mainly to improve their libido and to aging men as an anabolic to improve muscle mass and bone strength, to improve libido and quality of life, to prevent and treat osteoporosis, and, with the phosphodiesterase-5 inhibitors, such as sildenafil, to treat erectile dysfunction. The increased use of testosterone supplements in aging individuals has occurred despite the fact that there have been no rigorous clinical trials examining the effects of chronic use on the cardiovascular-renal disease risk. Studies in humans and animals have suggested that androgens can increase blood pressure and compromise renal function. Androgens have been shown to increase tubular sodium and water reabsorption and activate various vasoconstrictor systems in the kidney, such as the renin-angiotensin system and endothelin. There is also evidence that androgens may increase oxidative stress. Furthermore, the kidney contains the enzymes necessary to produce androgens de novo.


Testosterone and woman
Testosterone may benefit women by increasing libido, however side effects do occur. Natural testosterone boosters include DHEA and pregnenolone. Symptoms in women with deficiency include lack of sexual desire and vitality. Obese girls have several times the levels as girls of normal weight. A high level in girls influences reproductive health and may lead to undesirable side effects like excess hair growth.

 

Availability of testosterone supplement
This hormone is available in many ways, including testosterone gel, cream, patch, enanthate, depo, and injection. There is no such thing as an over the counter testosterone pill, Certain natural supplements may increase levels, but whether they do so when used for prolonged periods is not known for sure. These include tongkat ali and tribulus.

 

Hormone supplementation with the transdermic testosterone gel Testogel is well tolerated in men with mild hypogonadism and erectile dysfunction and can improve sexual desire and ability to achieve erection, researchers reported at the Endocrine Society's 88th Annual Meeting (ENDO 2006). A multicenter study enrolled 20 men 33 to 65 years of age who presented with erectile dysfunction and testosterone levels between 2.0 and 3.0 ng/mL on 2 consecutive occasions. Then men were randomized to Testogel 50 mg/day or placebo for 3 months, with both cohorts having access to sildenafil sulfate (Viagra) on demand. A crossover phase of the study had subjects receive the alternate treatment for 3 months. Lead investigator Andrea Fabbri, MD, PhD, associate professor of endocrinology, chair of endocrinology, department of medicine, University of Tor Vergata, Rome, Italy, presented the findings of the study. Results showed that serum testosterone levels were increased after the Testogel plus sildenafil combination therapy, but not after the placebo plus sildenafil combination. Testogel is a transparent, colorless gel that is applied daily to the skin on the upper arm, shoulders or stomach and quickly absorbed.

 

Low testosterone and mortality
 In a study of male veterans, low blood levels of the male hormone testosterone appeared to increase the risk of death in the next few years. The study involved 858 male veterans who were at least 40 years of age, prostate cancer-free, and had repeated testosterone levels taken between 1994 and 1999. The subjects included 166 with repeatedly low testosterone levels, 240 with an equal number of low and normal levels, and 452 with consistently normal levels. They were followed through 2002, for an average of 4.3 years. The mortality rate in the normal testosterone group was roughly 20 percent, which is lower than the roughly 25 percent and 35 percent rates noted in the equivocal and low testosterone groups, respectively. Archives of Internal Medicine August 14/28, 2006.
     Dr. Sahelian says: I'm not ready to make much of this study yet. Even if a low testosterone level is associated with higher mortality, this may not mean that providing replacement will improve mortality.

 

Q. Are there natural alternatives to testosterone prescription medicine use?
   A. I personally am of the opinion that the whole person has to be taken into account when considering hormone treatment as opposed to solely relying on blood studies. If a person feels fine even though a blood study shows a low testosterone hormone level, this does not necessary mean replacement is necessary. How do we know testosterone replacement will improve health in the long run? What if testosterone replacement therapy results in various short term and long term side effects? Even if testosterone is replaced, how do we know the ideal dosage and form? If a person has a low testosterone level but no major symptoms, it may be better not to interfere for the time being. However, if low testosterone levels are associated with symptoms of low testosterone, such as fatigue, low vitality, low sex drive, low mood, etc., then it may be appropriate to consider testosterone replacement or the use of certain natural supplements that address the particular symptoms of testosterone deficiency.
   Having said this, if the testosterone level is extremely low, then prescription testosterone use may be a good option. Another option is the over the counter hormone DHEA, or perhaps pregnenolone.

 

Testosterone test information - Normal levels
This test may be recommended by a doctor to:
Determine infertility. A low amount can lead to low sperm counts.
Determine if a low testosterone level is influencing a man's sex drive or erectile function. However, another option is to prescribe a low dose to see if there is an improvement in libido and erection. Doctors also have the option to recommend over the counter DHEA to see if this hormone improves sexuality.
Determine if excessive facial and body hair (hirsutism) and a deep voice in a woman is due to excess testosterone. This can occur in PCOS.
Determine if testosterone-lowering drugs are working in a man with advanced prostate cancer.

 

Normal total Testosterone level ranges:
7 months to 9 years - Less than 30 ng/dL in boys and girls
10 to 13 years - Less than 300 ng/dLin boys, Less than 40 ng/dL in girls
14 to 15 years - 150 to 500 ng/dL in boys, less than 50 ng/dL in girls
16 to 19 years - 240 to 900 ng/dL in boys, Less than 60 ng/dL in girls
20 years and older - 260 to 1000 ng/dL in men, less than 70 ng/dL in women
Normal free testosterone level is 0.3 to 2 pg/mL.

 

Low testosterone levels are typically defined as less than 300 ng/dL of total testosterone and less than 5 ng/dL of free testosterone.

 

High testosterone side effects
The results of a small study hint that high doses of testosterone has a negative impact on memory and brain function in elderly men. Dr. Pauline M. Maki studied 15 healthy men between 66 and 86 years old with no evidence of cognitive dysfunction. They men received shots of testosterone (200 milligrams) or placebo every other week for 90 days, followed by a 90-day clearing period, followed by a cross over to the other treatment. Total testosterone levels more than doubled after active treatment. The testosterone treatment led to a moderate decline in short-term verbal memory. Journal of Clinical Endocrinology and Metabolism, November 2007.

Review
Approximately 30% of men 60-70 years of age and 70% of men 70-80 years of age have low free testosterone levels leading to a condition called andropause or male menopause. Symptoms and findings of deficiency are similar to those associated with aging. They include loss of energy, depressed mood, decreased libido, impaired erectile function, decreased muscle mass and strength, increased fat mass, frailty, osteopenia, and osteoporosis. Several small clinical trials indicate that testosterone replacement therapy can improve many of these findings; however, the studies have not determined potential risks, such as benign prostatic hyperplasia, cancer, or cardiovascular events. Thus, the benefit / risk ratio of replacement therapy in aging men is not fully known. There has been a drop in U.S. men's testosterone levels since the 1980s.
     Testosterone is helpful in those who have low androgen levels, however the benefits must be balanced with the risks. Soy and isoflavones do have an influence on hormone levels, but the effects are not significant enough to have any major concerns. See soy protein for information and studies on the relationship of soy and hormone levels.

 

Testosterone and Insecticides
While infertility may be caused by a number of factors, new study findings suggest that exposure to nonpersistent, or short-lasting, insecticides may play a role in male fertility. Environmental exposure to chlorpyrifos or its metabolite (TCPY) may be associated with reduced levels of circulating testosterone in adult men. Epidemiology, January 2006.

 

Anti testosterone medication

Leuprolide is used to reduce the amount of testosterone or estrogen in the body and is often used in cases of prostate cancer or endometriosis.

 

Testosterone and exercise
An increasing amount of research studies in men indicate endurance exercise training has significant effects upon the major male reproductive hormone, testosterone, and the hypothalamic-pituitary-testicular axis that regulates reproductive hormones. A new term used is "exercise-hypogonadal male condition". Specifically, men with this condition exhibit basal (resting-state) free and total testosterone levels that are significantly and persistently reduced.
 

Testosterone treatment and sleep apnea
Q. About 15 weeks ago I began taking growth hormone (self-injection) and testosterone (cream). About 10 days ago I started developing sleep apnea. I stop breathing while sleeping and wake with a jolt and have to hyperventilate for a while to get re-oxygenated. Three days ago, this became much worse and I now can't sleep because the sleep apnea begins as soon as I start to fall asleep. This is obviously a very serious problem because I can't get more than a few moments sleep during the whole day and night. I found studies that indicate that both growth hormone and testosterone can induce apnea. A theory proposed by James Michael Howard suggests that testosterone depletes DHEA and that DHEA controls the breathing response. Yesterday, after finding this theory, I took 100 mgs of DHEA and the apnea went away in about 2 hours. Unfortunately, I used one dab of testosterone cream before bed last night and within 30 minutes, the apnea resumed. Taking more DHEA did not help. Can the growth hormone and testosterone cause apnea, and if so, is this process mediated by the depletion of essential nutrients by these hormones? Obviously, the depleted essential nutrients would need to be replenished. I plan on discontinuing all growth hormone and testosterone to see if this results in the apnea stopping.
   A. Testosterone treatment can cause sleep apnea. It probably effects the brain centers for breathing and sleep directly as opposed to depletion of nutrients. I could not find studies on the role of human growth hormone and sleep apnea.

Research
Testosterone increasing product
This is a press release: Gencor Pacific Announces Trial Completion for Testofen Ingredient, 2006-12-19 - Gencor Pacific, Inc. Gencor Pacific, Inc. has announced completion of an eight week, 60 patient double blind, randomized, placebo controlled human study on the company's proprietary ingredient Testofen to evaluate its effect on muscle mass and free testosterone increase. Participants on the active substance were on a dosage of 300 mg two times a day. The active group showed 98% increase in free testosterone levels. The increase in the active group was almost 100% compared to placebo. In addition to an increase in free testosterone levels, subjects supplementing with Testofen experienced reduction in skin fold thickness in the thigh and biceps regions without losing body weight, indicating a reduction of body fat and increase in muscle mass. Subjects on Testofen also demonstrated reductions in levels of blood urea nitrogen suggesting that Testofen prevents protein catabolism. This parameter also confirms muscle mass build up.
   Comments by Dr. Sahelian: The long term safety of increasing testosterone levels are not clear with the use of Testofen.

 

Emails
Q. My physician prescribed a post-menopausal hormone combo of estrogen, progesterone and testosterone about a year ago. Slowly but surely, I have been noticing discernible thinning of my already fine hair. I am a 57 year old woman for whom the testosterone additive was to improve libido. Are the effects of this artificial testosterone on my thinning /balding reversible?
   A. This is a good question. In some people testosterone induced hair loss is reversible, in others it  may not. Each person is different. The dose, length of use, individual biochemistry, etc are factors.

Q. I'm a 24 year old male who lifts weights to build muscle (and I'm working on the body fat as well). Recently a fellow weight-trainer mentioned to me that he thinks that weight-training decreases testosterone, and he gave the example of having lower libido during a course of weight-training. But I figured that weight-training and muscle-building if anything should actually increase testosterone. Since then I've been wondering if there could be any truth to what my friend said. So basically, does weight-training (somewhat like manual labour I guess) decrease one's testosterone levels? And, as someone who is interested in continuing vigorous workouts and building strength and muscle, while remaining optimally healthy, what can I do, what foods do I eat, and what herbs would you suggest, to maintain healthy testosterone levels even well into so-called middle age and beyond?
   A. Heavy workouts or physical exhaustion could potentially lower testosterone levels temporarily. Eating healthy, moderate exercise, deep sleep, low stress, can help maintain healthy hormone levels.
 

Q. Do lipoic acid, coq10 or the brain nutrient acetylcarnitine increase testosterone levels?
   A. I don't think so, I haven't seen such research.
 

Q. Enjoy your website and occasionally get products that you formulate. Is testosterone cyclodextrin available yet (sublingual tablet) - for HRT not other use?
   A. I do not keep up with the pharm drugs as much as herbal medicine so I am not sure about the status of testosterone cyclodextrin sublingual and its availability.
 

Q. I am an 53 year old man, in good circumstances (BMI = 22,0) living in switzerland, europe. I am trying the standards for men like me,  who want to slow down aging. Contrary to the most men in the same situation I make it in the scientific way and make things sure by laboratory results ! So I provide a DHEA Test for me. 100 mg in the morning an 100 mg in the evening ( I know this is a lot of, but I want to see clear effects and side effects) After 14 days a new laboratory measurement  and than again after 30 days. The side-effects are so worse, I don't continue any longer. Good effects : absolutely none ! Now the results : my estrogen E2 and testosterone are sinking in the first 14 days. Testosterone goes down like I have become castrated ! LH was nearly constant. So I think, DHEA does first not influence the regulation loop of testosterone via LH, but inhibits direct the production of testosterone. Furthermore there is no metabolisation from DHEA to estrogen, estrogen was sinking ! After 30 days my testosterone goes again down, but only a little bit more, LH goes down and estrogen increases ! End of try !
   A. Thanks for sharing dhea testosterone anecdote with us. The effects of DHEA on testosterone could be dose and time dependent. Perhaps the results may be completely different if only 5 mg of dhea is used or if the dhea is not taken in the evening. There are many different factors at play. But, we don't feel high doses of dhea are healthy, they may even cause premature death.
 

Q. Can I take tribulus terrestris with Prostate Power Rx? Which is best to increase testosterone levels? My free testosterone level is 6.4. How can I naturally increase it ( a little) and still provide prostate support ?
   A. Tribulus can be taken with Prostate Power Rx in low dosages. It is not yet clear if tribulus terrestris herb increases testosterone levels in any significant manner in humans.
 

Q. I had a testosterone injection given by a nurse. She said it would make me feel better since my testosterone level was 21. Well, I had a blood work done a week ago and my level is 150. My hair has been falling out by the hand falls it is already thin. I will not be taking any more injections.
 

Q. I am on depo testosterone injections. would saw palmetto help my some of my bodies organs from shrinking with this treatment?
   A. We doubt saw palmetto would be useful for this purpose.
 

Q. Your site does much good for those who care to do even minimal research into personal hormone experimentation. You also help keep at bay the least scrupulous of those calling themselves "businessmen". Currently, Renaissance Health, a firm in Boca Raton, FL, has flooded the mails with advertisements for a liposomal formulation of testosterone, DHEA and pregnenolone. The firm's product is named T-Boost, and its advertising completely ignores risks, unknowns and maximizes glowing anecdotes and quasi-claims. Renaissance Health president James DiGeorgia uses the personal endorsement of William S. Gruss, M.D., said to be an internist and cardiologist, to promote the safety and efficacy of T-Boost. According to company advertising, Gruss claims to use it with his own patients. DiGeorgia also makes a simplistic "proof" for his product by noting research associating Alzheimer's with low testosterone levels. Aside from its extremely expensive price ($177 for 90-days' supply)-- which may be all most need to know about the purpose of the sales campaign-- there is no specific information available in product advertising about dosage, or possible testosterone side effects. I note that over the years, as you have published your findings about DHEA and pregnenolone, among other substances, you have become much more conservative about personal supplementation. Is it possible you no longer will recommend their use except in specific therapeutic instances (hormonal insufficiency, etc.)? Also, do you recommend the viewpoint of author ((I hesitate to say "biochemist") Stephen Cherniske as a source for valid information about DHEA?
   A. Testosterone, DHEA, and pregnenolone are potent hormones with significant side effects when misused. With time, we have realized the potential serious dangers when this hormones are taken carelessly. We have also recognized that we had underestimated the potency of these hormones in the past, and now are warning users to be very careful. As to Stephen Cherniske and his views on DHEA, we prefer not to comment on other people unless they first make a comment about our work. It is up to the consumer to read various opinions and make their own decision.
 

Q. I was under the impression that yohimbe was a testosterone enhancer is this true?
   A. We have not seen any research that says yohimbe influences this hormone.
 

Q. I have a question about Testogel. I've never been able to put any weight on despite eating well, its like I have a fast metabolism or something, ive tried working out out the gym and eating lots of protein nothing happens. What I would really like to do it build some muscle mass, currently my body looks like a pre pubescent school kids, I was wondering if I should have my testosterone measures and if low whether Testogel might help me to develop some muscle mass with gym work. My only concern is that ive heard that if you use something like Testogel, once you stop your testosterone levels will be permanently lower then when you started taking something like Testogel.
   A. We can't give individual advice please. You should read about cautions with use of testosterone since long term side effects are possible.
 

Q. I am in the supplement business and I have greatly enjoyed your books and your website. What would you suggest for a 35 year old women who has borderline low testosterone and very low libido. In addition to that she is having a very difficult time reaching orgasm. She is otherwise very healthy. All other blood values came back fine. We are waiting to hear back from here gynecologist since here MD did know which way to proceed. I have a feeling that she may be resistant to trying a pharmaceutical testosterone
replacement. Since the low testosterone has been established should we look mainly at trying to raise this hormone with tongkat ali and possibly tribulus? Do you think that adding a small amount of dhea may help also? The Dr. said here dhea was in the middle normal range. Do you think that dopamine stimulation should still be looked at even though the low testosterone has been established?
   A. There are many factors besides testosterone that are involved in libido. It is impossible to predict which supplement will be most helpful to a person with low libido. Perhaps in your case the low testosterone is a factor in the low libido, or it may be another unidentified factor. One option is to try a sex herb for a week, if not helpful switch to another one. Always use a low dose such as a portion of a capsule at first since many sexual products may be too potent.
 

Q. How long it takes for Passion Rx to increase/improve testosterone levels, if it does that at all.
   A. Some of the herbs in Passion Rx, such as tribulus and tongkat ali, are thought to increase testosterone level, but there are many many factors besides testosterone that influence sexual enhancement. We have not done studies with passion rx to determine its influence on this hormone.
 

Q. I am taking testosterone in a shot every 14 days. The dose is 150 ml of 300 mg/ml. i was taking twice that and it raised my psa from 3.0 to 5.7. Will Passion Rx affect the psa if taken in low doses and is it OK to take it with testosterone?
   A. We have not tested Passion Rx long term to see whether it has an influence, pro or con, on PSA levels. Most of the time people take Passion Rx at most 3 days a week so we don't think ti has much of an influence.
 

Q. As a prostate cancer survivor for past five years and as a member of the online support group for prostate cancer patients / survivors (US 2), we find ourselves in a quandary about reasonably safe (if there is any) methods to naturally improve our testosterone levels, especially after radiation and radiation-seeding therapy.
   A. Why would you wish to raise testosterone levels. If it is for libido, then certain natural herbs could be helpful. If it is for other reasons, then perhaps other supplements can be used for that purpose. But increasing the level just for the sake of it is not advised for prostate cancer survivors.
 

Q. Just bought your book. Thank GOD for some honest facts on a web site without hype. Love your straight and honest knowledge on so many products. I have low testosterone Levels. I am 42 years old and in perfect health. What natural product (s) do you recommend to raise those levels. I currently take 150 mg testosterone injections every other week and if able rather to do it a natural way. I have read your information on DHEA, maca and tribulus in terms of testosterone level increase but not sure if this is the direction I should go.
   A. Often patients and doctors focus on the level of one hormone and try to manipulate these levels overlooking the whole picture. If a person is perfectly healthy and has good energy, mood, and sexual health, there is no reason to play with hormone injections or supplements to increase testosterone level. The whole person's mental and physical health has to be taken into account, not just a lab study. Now, a person could occasional experiment with natural supplements such as the tribulus, maca and other sexual herbs if they are interested in sexual enhancement, but it is potentially harmful to play around with hormones such as DHEA and testosterone since they have many side effects.

 

Q. Is it OK to take tribulus terrestris and tongkat Ali at the same time but on alternate days? I understand it is not advisable to take them on the same day. I am looking to boost my testosterone levels. Will Passion Rx do the same as if I take tribulus-T and tongkat ali, just as good or better? Answer what you can. I don’t want you to violate any FDA regulations.
   A. Firstly, one has to determine the purpose of raising testosterone levels. It may not always be beneficial to raise testosterone levels. There may be other ways to improve symptoms of a condition without relying on testosterone manipulation. Secondly, not enough long term human research has been done to know whether tongkat ali or tribulus terrestris raise testosterone levels when taken as supplements at the dosages normally consumed for sexual enhancement. We have not had any blood work done on enough people to test testosterone levels when Passion Rx is used. Normally Passion Rx is taken only 2 or 3 days a week, anyway. Tribulus and tongkat ali should not be taken daily on a long term basis.

 

Q. I am 44 years old and have low (bottom of normal range) testosterone levels, with very low DHEA levels. My doctor's suggested I take a supplement of oral DHEA. I've been reading the information on your site. I understand you don't advise which supplements to take but hope you can advise how each of the supplements, DHEA, 7-Keto DHEA and pregnenolone might impact my situation?
   A. I personally am of the opinion that the whole person has to be taken into account when considering hormone treatment as opposed to solely relying on blood studies. If a person feels fine even though a blood study shows a low testosterone hormone level, this does not necessary mean replacement is necessary. How do we know testosterone replacement will improve health in the long run? What if testosterone replacement therapy results in various short term and long term side effects? Even if testosterone is replaced, how do we know the ideal dosage and form? If a person has a low testosterone level but no major symptoms, it may be better not to interfere for the time being. However, if low testosterone levels are associated with symptoms of low testosterone, such as fatigue, low vitality, low sex drive, low mood, etc., then it may be appropriate to consider testosterone replacement or the use of certain natural hormones or natural supplements that address the particular symptoms of testosterone deficiency.

 

Q. I have been taking testosterone for about 1yr. I've had 2 prostate operations in the past yr. first i had the green light laser treatment and i developed scar tissue and two months later i had the turp treatment. What i would like to know is, will my taking bioidentical testosterone cause my prostate to enlarge again where i can't urinate? i understand the procedure has to be repeated in 5 to 10 yrs and i don't want to have to go through that procedure again any time soon. Should i stop taking the testosterone or not?
   A. We can't advise you whether to take or not to take testosterone. We can say that testosterone therapy is associated with a higher likelihood of prostate enlargement.

 

Q. I have read that one of the main hormonal changes in a man's body as he ages is a reduction of free testosterone and an increase of sex hormone binding globulin. Supposedly, it is free testosterone and not total testosterone that affects a man's sexual performance the most. Some companies claim to produce products that increase free testosterone. Some of this is claimed to be done by reducing the effects of SHGB on testosterone. Also, claims are made that increased free testosterone and reduced SHBG also reduces estrogen. Do you know how correct these claims are and whether the science is accurate?
   A. The first question that has to be asked is whether it is beneficial in the long run to increase testosterone levels. Unless a person has very low levels and clinical signs and symptoms of very low testosterone levels, there is no reason to take a testosterone supplement or any over the counter or prescription testosterone booster. Not enough human research has been done with most natural products to determine what influence they have over the long run in influencing testosterone, SHBH, estrogen, and other hormones in the body. Excess testosterone can increase the risk for hair loss and prostate cancer.  There are many natural supplements that improve sexual performance without the need to take a prescription testosterone medicine. Two otc hormones that increase testosterone are dhea and pregnenolone.

 

Q. I am 65 years old. 2 years ago a stent was installed in one of the arteries. Since then I have been taking Remipril 1.25 Mg, Bisoprolol 2.5 Mg, Lipitor 20 Mg, Norvasc 2.5 Mg and Aspirine 80 Mg. Testosterones level has gone down considerably. What can I do to increase testosterone without having many side effects.
   A. Testosterone is available by prescription, and DHEA is available without a prescription. However, unless testosterone levels are significantly low, one should rather focus on the whole body and overall symptoms and signs of deficiency than just treating an isolated blood test result.

 

Q. My husband has low testosterone due to hypogonadism (due to mumps) Can not afford the perscription given by Dr. of Androgel. Is there a natural precursor for testosterone?
   A. We are not aware of any herbs that increase testosterone levels consistently over long term use. However, DHEA can raise testosterone levels.

 

Q. I wonder what testosterone supplements might do for my sexual performance. My testosterone level is quite good. 6.8 and 10.9 free. I am 64 years old. Would such a testosterone supplement help me? Are there undesirable side effects? Is this available anywhere?
   A. Testosterone is a hormone which is available by prescription but not as an over the counter supplement.

 

Q. Do you have anything that would help my libido? I've tried tribulus and Simplex "M" from Standard Process with no success. I recently had my testosterone checked with the following results: My testosterone results from Quest Diagnostics:
Total Testotosterone: 546 ng/dL range 250-1100
%Free Testotosterone: 1.73% range 1.5-2.20
Free Testotosterone: 94.5 pg/mL range 35.0-155.0.
   A. We suggest you review the page on libido and discuss the options with your doctor. If one herb or formula does not work, another one may.

 

Q. My doctor recently let me know that I am estrogen dominant, with high estradiol, ok progesterone, and very low testosterone. He suggested I take 25 mg of DHEA every other day. I am concerned after reading your article that it will also increase my estradiol. Are you saying DHEA will always increase both estrogen and testosterone? Also, do you know other ways I can naturally increase testosterone production only?
   A. A direct way to increase testosterone is by taking testosterone itself. However hormone therapy has many risks and we suggest you and your doctor review this page.

 

I have briefly tried Tongkat Ali [Pasak Bumi} 50.1 four capsules per day three weeks on one week off. My reason was to elevate total testosterone to 1100 which is what I had up to age 50. I am not sure of the free testosterone levels up to age 50. I give my self half ML [100mg] bioidentical testosterone [from wild yams] per week. My More recent testosterone levels have been around 1032 and free testosterone around 137 pg/ml. I also give myself a half ML of methylcobalymin each week. My dihydrotestosterone is elevated at around 175, but my PSA is only 1.00. I am taking 50 mg organically grown saw palmetto and selenium to reduce DHT. I am age 65 and am able to do front squats with 225# with no joint discomfort. I do dips with 90#’s wrapped around me [5 sets 7-8 reps] fairly easily. This may have to do with 4000mg per day Omega 3’s’, but the testosterone has definitely increased strength and recovery times. I am interested in tongkat ali for producing an increased lean body mass. I am currently around 17% fat and would like to go to 10%. My extremities are all under 10%. Will tongkat ali increase the undesirable DHT and how does it affect free and total testosterone? Can I use the herb with bio-identical testosterone? Could you recommend a good doctor into bioidentical hormone replacement? I am pretty much on my own right now.
    I am not aware of herbs that consistently elevate testosterone levels over the long run.

 

I turned 44 today and my general lack of interest the female gender in quite disturbing. I have tried to talk to my doctor about my condition and he indicates its just age and not to worry. My energy levels are down some but not enough that I don’t do anything. I exercise on a regular basis , 3 times per week or every other day.
My concern is that I feel my testosterone levels are way done, no desire to have sex, my strength is down, way down… I am sure its an individual thing but when in the gym I can barely lift the weights I could easily do a few years back. My question – is there a product(s) that would boost testosterone levels back to my younger days?
    Perhaps the info on this page will help you.

 

I am considering beginning a course of supplements to correct a very low testosterone value. I took a saliva test that indicated a value of 122 pmol/L Testoterone (very low), 157 pg/mL DHEA (normal?). I will be taking a blood test to confirm these values within the next month (at my next HMO covered free annual physical). I am a very active 35 year old who has recently noticed low sex drive, impaired muscle recovery, decreased performance, fatigue, etc (classic low T). I participate in numerous strength and endurance activities and have recently lost weight. I eat a Paleolithic inspired high protein, low carbohydrate, and moderate fat diet (may need more fat). My body fat is about 8%. I have reviewed your website and others and intend to make the following adjustments to my diet and begin the following supplements. I would appreciate any additional suggestions, cautions, or adjustments based on your experience or knowledge of current nutritional research. DHEA 5mg/day (should I take more?) or 10mg 3xweek? ZMA before bed Chrysin? Tribulus? Thank you for any information you provide.
    Sorry but I can't give individual recommendations but hopefully the information on this page will help you decide.

 

I do have Passion Rx, a sexual enhancement product in stock. And I have noted that, some of its ingredients may release hormones (testosterone) into the body. My safety concern is that, since I just had a radical prostatectomy from prostrate cancer, do you think it is medically safe or wise for me to take such a supplement that in part generates testosterone? I am asking because, readings done so far indicate that, it is not safe for prostrate cancer patients to engage in any sorts of testosterone replacement therapy.
    We have no studies to show whether this product has an influence on testosterone levels. In the long run this sexual enhancing product is only used 2 days a week. There may be compounds in this herbal product that may be helpful for the prostate gland. Bottom line is that we don't know whether this sex formula has much of any influence on prostate cancer, positive or negative.

 

I recently came across information claiming that it was possible to boost your testosterone level from 250ng/dl to 800ng/dl using a variety of natural techniques. Do you think this kind of extreme boost is possible without steroids? I have a very low level and I am hoping to be put on testosterone replacement therapy because I am feeling many negative effects of my low level and I was informed it would be impossible to boost my level up too the higher end of normal naturally. I desire a level at the higher end of normal, around the 800 mark or above as I am a bodybuilder and cannot gain muscle at the moment. The boost would have to be significant. I feel bioidentical T in moderation may be a more reliable option. Also does Dr Ray Sahelian have any books on natural testosterone boosting?
    I am not aware of natural ways to increase T levels in a significant and consistent way with herbs, vitamins or supplements except for the natural hormones such as DHEA. However one must take into account the undesirable adverse effects that come from the use of certain hormones.

 

I am a post-menopausal female and have used several of your products. Due to severe menopause symptoms, I have been using bio-ID HRT for the last three months, in the form of estrogen, progesterone and testosterone creams, and BiEst troche, with some success. Most important, I am hoping to boost my blood testosterone level, which is currently at 21 ng/dl. Do you consider testosterone in a dose of 1% cream, 1/2 to 1 CC per day, excessively high? As an option, I am considering your Passion Rx to replace and/or supplement the testosterone cream. Could Passion Rx be used effectively in this way? Or is another of your products that would be better suited to this purpose?
    Passion Rx works to enhance sexual pleasure and libido, but we have not done any tests to see how it effects levels of testosterone in men or women. As to the dosage of the hormone, without doing a full history, review of symptoms, and medical exam, it is not easy to predict the amount of the cream to use. DHEA is known to increase testosterone levels but has to be used cautiously, as do other hormones.

 

I get testosterone injections (150 mg) every two weeks to maintain a normal range of blood level. I have read that the effectiveness of the PDE-5 impotence drugs depend on normal testosterone blood levels. Do you know, or deduce, that to also be true for Passion Rx?
    This is a good question but we do not have any studies to determine what role testosterone levels or injections play in the effectiveness of this formula. It is possible that if the testosterone injections are used for sexual enhancement the dosage would be less since Passion Rx will provide improved sexual urge and performance. Since this natural formula works in multiple ways to enhance sexuality, the role of testosterone would not be as important as that of the PDE-5 inhibitors.

 

Will the use of Passion Rx increase my testosterone levels or other hormones? I am 59 with low T, DHEA, etc.
   No such testing has been done with checking blood levels of testosterone after Passion Rx use, so we don't know what effects its use has on various hormone levels in the body.