Testosterone is an androgen found in both men and women. Testosterone is made in the testicles and ovaries, and in smaller amounts by the adrenal glands. Testosterone is also found in brain tissue. Testosterone is involved in mood, sex drive, vitality, fertility, and muscle mass. Testosterone levels drop about 1 percent each year after around age 40 and faster in those who are overweight. The structure of testosterone is similar to that of estrogen. As we get older, more testosterone is converted to estrogen than in youth. Although testosterone replacement can, in some people, improve the quality of their lives, it does carry serious risks.

Alternatives to testosterone
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 testosterone replacement, consider more natural alternatives. Testosterone replacement therapy can have serious short term and long term side effects.

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

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

Better sleep - consider Good Night Rx which gives you a deeper sleep so you feel more rested.

Bigger muscles - creatine monohydrate works very well.

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 convert testosterone to estrogen.

High Quality products formulated by a medical doctor
These top quality products include Mind Power Rx for better mental focus, concentration, and mood; Diet Rx which helps you eat less. It really does curb appetite; Good Night Rx for better sleep; Eyesight Rx for better vision, often within days; MultiVit Rx a daily comprehensive multivitamin for more energy and vitality; Joint Power Rx for healthy joints; Prostate Power Rx for a healthy prostate gland and gentle sexual enhancement; and Passion Rx for sexual enhancement, better libido, and improved performance and stamina in men and women.

Subscribe to a FREE Supplement Research Update newsletter. Twice a month you will receive an email with reviews of several studies on various supplements and natural medicine topics, including testosterone, and their practical interpretation by Ray Sahelian, M.D. Testosterone is the primary sex hormone for men, though it is found in women as well. It helps maintain muscle mass and bone density and keeps sex drive and physical energy at healthy levels.

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. Gaining too much weight can accelerate the decline in testosterone levels that accompanies aging. However, testosterone and hormone replacement is a complicated matter and there is a tendency of prescribing a higher testosterone 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 these testosterone and androgen precursors.
   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 a testosterone gel are not sold over the counter. A natural testosterone supplement taken orally is not available over the counter. Certain herbs may potentially and temporarily increase testosterone levels, for instance tribulus terrestris.

Q. What natural herb helps for low testosterone? At the moment I am having testosterone injections but don't like chemicals every 10 weeks. 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, so can you help out there.
   A. 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, an extract called LJ100 is also availalbe. Yohimbe does not seem to influence testosterone levels but is a good aphrodisiac herb. Discuss with your doctor the natural herbal options that are available. For more yohimbe bark information.

Testosterone side effects - Testosterone replacement therapy has risks and dangers
Testosterone has many side effects. 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. Too much testosterone many not be healthy for brain cells. A cosmetic testosterone side effect is hair loss on the scalp. Male pattern baldness is a testosterone side effect that is of high concern to men.
   Testosterone replacement should only be prescribed to men who have severe deficiency and the testosterone dosage should be as low as possible to take care of the deficiency.

Danger of testosterone supplements in rodents
Testosterone supplements given to rats leads to potential side effects such as kidney damage and increased high blood pressure. Dr. Radu Iliescu, of University of Mississippi Medical Center, Jackson, found that testosterone supplements caused about a 2-fold increase in testosterone levels in the blood of male rats. They also found that blood pressure was significantly higher in testosterone-supplemented rats compared with normal "control" rats.

Hair Loss and Testosterone
There is a risk for hair thinning or hair loss with the prolonged use of testosterone. This can occur with testosterone replacement in a man or woman. To reverse the hair thinning from testosterone use, 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 testosterone 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. Testosterone increases during puberty leading to a deeper voice, get bigger muscles, make sperm, and get facial and body hair. The level of testosterone is the highest between the ages of 30 to 40, then gradually becomes declines. 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
Testosterone replacement is an option with various forms of testosterone available by prescription. These include testosterone injections, testosterone cream, and testosterone gel. Testosterone replacement is sometimes recommended for age related hormone decline in middle aged and older men and women in order to boost libido and vitality. Testosterone replacement is also used in women who have had their ovaries removed. I believe DHEA may be a good substitute for testosterone. However, both testosterone replacement and DHEA use have short term and long term side effects.
    

Testosterone replacement and cancer
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 supplement study finds no improvement in quality of life
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 hundred7 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;299:39-52.

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. Passion Rx works very well to increase sexual desire.

Testosterone and 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
Too much testosterone can kill brain cells. 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?
Male hypogonadism is a clinical situation characterized by a low serum testosterone level in combination with a diversity of symptoms and signs such as reduced libido and vitality, decreased muscle mass, increased fat mass and depression. Similar symptoms in combination with subnormal testosterone levels are seen in some elderly men. Several publications have suggested that testosterone treatment in hypogonadal men may have beneficial effects, but it is still uncertain whether testosterone substitution in the aging man is indicated. Despite this uncertainty the sale of testosterone have increased enormously over the last few years. The result from placebo-controlled studies of testosterone substitution in elderly men differ substantially, but testosterone seems to improve, among other things, bone mineral density, body composition, perception of physical strength, and maybe libido. In the short term there have been few problems or complications with testosterone treatment, but effects on the cardiovascular system and the prostate over the long term remain uncertain. Before any general recommendation could be given, longer lasting prospective studies have to be performed. Testosterone treatment should, however, be considered in men with testosterone in the hypogonadal range accompanied by clinical symptoms. Treatment needs to be individualized and should preferably be done for the shortest possible time period and with the lowest effective testosterone dose.
   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 testosterone 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. Low testosterone symptom in women with testosterone deficiency include lack of sexual desire. Obese girls have two to nine times the levels of testosterone as girls of normal weight. A high testosterone level in girls influences reproductive health and may lead to undesirable testosterone side effects like excess hair growth.

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

Testosterone gel

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.

Testosterone and body composition
The relevant age-related changes in male body composition are mainly related to the progressive decrease in the level of circulating anabolic hormones, among which testosterone is rather important. The decline of testosteone between the ages of 35 and 75, is associated with a loss of muscle mass and fibers number, a doubling of fat mass and a decrease in bone mineral density by 0.3% per year after age 35; thus the relationship between age-related changes in body composition and testosterone bioactivity reflects an important endocrine aspect of the aging male.

Testosterone patch decreases abdominal fat
Treatment with testosterone can help curb the gain in abdominal fat as well as the loss of skeletal muscle seen in non-obese aging men. Dr. Carolyn Allan, from Prince Henry's Institute in Victoria, Australia, enrolled 60 healthy men who were at least 55 years of age with low-normal testosterone levels. The men wore a testosterone patch or placebo patch for 12 months. Men using the testosterone patch experienced a 30 percent increase in serum testosterone levels. The control group, by contrast, saw their testosterone levels fall by 10 percent. Men in the testosterone group experienced increases in fat free mass and skeletal muscle with a drop in abdominal fat accumulation. Journal of Clinical Endocrinology and Metabolism, January 2007.
   Comments: Until long term benefit and risk of testosterone use in known, one should be quite cautious in using this hormone for prolonged periods.

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 testosterone replacement will improve mortality.

Q. Are there natural alternatives to testosterone prescription medicine use. My recent test showed I have low testosterone levels.
   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 testosterone levels
A testosterone test may be recommended by a doctor to:
Determine infertility. A low amount of testosterone 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 of testosterone 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. Many studies indicate that low testosterone levels lead to cognitive decline and dementia in aging men. Some studies have suggested beneficial effects of testosterone treatment and high blood testosterone, but the overall findings have been mixed. 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.

Testosterone summary by Ray Sahelian, M.D.
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 testosterone deficiency are similar to those associated with aging. They include loss of energy, depressed mood, decreased libido, impaired erectile dysfunction, 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 testosterone replacement therapy in aging men is not fully known.
     Testosterone is helpful in those who have low androgen levels, however the benefits of testosterone must be balanced with the risks. DHEA is an alternative to testosterone. Either DHEA or testosterone can by used temporarily and safely in low doses.

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. Until 2000, chlorpyrifos was one of the most common insecticides used in homes. The Environmental Protection Agency restricted its residential use to reduce children's exposure to the chemical after research revealed it can affect the central nervous system. Just one year earlier, however, up to 19 million pounds of the chlorpyrifos were used in the United States, and recent investigations suggest that individuals still experience environmental exposure to the substance, despite EPA restrictions. The Second National Report on Human Exposure to Environmental Chemicals found that more than 90 percent of men had detectable levels TCPY in their urine. SOURCE: Epidemiology, January 2006.

Testosterone levels lower in men
There has been a drop in U.S. men's testosterone levels since the 1980s. The average testosterone level dropped by 1 percent a year, Dr. Thomas Travison and colleagues from the New England Research Institutes in Watertown, Massachusetts, found. This means that, for example, a 65-year-old man in 2002 would have testosterone levels 15 percent lower than those of a 65-year-old in 1987. This also means that a greater proportion of men in 2002 would have had below-normal testosterone levels than in 1987. Travison and his team analyzed data from the Massachusetts Male Aging Study, a long-term investigation of aging in about 1,700 Boston-area men. Data from the men were collected for three time intervals: 1987-1989, 1995-1997, and 2002-2004. While a man's testosterone level will fall steadily as he ages, the researchers observed a speedier decline in average testosterone levels than would have been expected with aging alone. They hypothesized that the rising prevalence of obesity as well as the sharp decline in cigarette smoking might help explain their findings, given that testosterone levels are lower among overweight people and smoking increases testosterone levels. But these factors accounted for only a small percentage of the observed difference. It's likely that some sort of environmental exposure is responsible for the testosterone decline. Journal of Clinical Endocrinology and Metabolism, January 2007.

Testosterone and Alzheimer's disease
A testosterone patch can improve the quality of life for men with Alzheimer's disease (AD), but it seems to have little effect on cognition. Reports have suggested that testosterone levels are lower in men with Alzheimer's than in their counterparts without the neurologic disorder. Testosterone use has been shown to improve cognition in older men without Alzheimer's disease and, in animal models, treatment with the male hormone has been linked to reduced formation of beta-amyloid, the protein that forms the plaques that clog the brains of Alzheimer's patients. In a 24-week, study, Dr. Po H. Lu, from the University of California at Los Angeles, and colleagues assessed the effects of daily treatment with testosterone or placebo gel in 16 men with Alzheimer's disease and 22 healthy men. In the Alzheimer's group, testosterone therapy lead to improvements in caregiver-rated quality of life, compared with placebo. Source: Archives of Neurology, February 2006.

Testosterone and female attraction to men
Women can pick up cues about how men feel about children from their faces and use the subtle signs to rate them as potential partners. An affinity for children and testosterone levels play a role in determining how attractive men are to women. In a study of nearly 70 men and women, an interest in children was linked to long-term partnership potential while women were attracted to men with higher testosterone levels as short-term romantic mates. The scientists tested the testosterone levels of 39 male undergraduate students from saliva samples. They also determined their interest for children by asking them to choose between photos of an adult or a baby and to rate their interest. The researchers photographed the men and showed the photos to 29 female students who were asked to rate the men on whether they thought they liked children, their masculinity, physical attractiveness and potential as short and long-term partners. Women were able to choose the men who had expressed an interest in children during the photo test. They also described men who had high testosterone levels as being masculine.

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 in sports

July 2006 - Tour de France winner Floyd Landis tested positive for the male sex hormone testosterone. There was an unusual level of testosterone / epitestosterone ratio in the test made on Floyd Landis after stage 17 of the Tour de France. Landis produced a remarkable effort to win the 17th stage of cycling's showpiece event following a disastrous 16th stage in which he dropped from first to 11th place.

Testosterone testing in athletic competition
Testosterone alone may not explain such astonishing performances as that produced Floyd Landis in the 17th stage of the Tour de France this year. Testosterone doping is very efficient. It still is common practice because the oral absorption is hard to detect and the testosterone is then quickly eliminated by the body. But testosterone itself may not explain a performance such as Landis's during the 17th stage of the Tour de France.
   There are two types of tests for testosterone. The classic one, which shows the ratio of testosterone in the urine to another hormone, epitestosterone. But it does not tell whether the testosterone is natural or synthetic.  The second test, called IRMS (Isotope Ratio Mass Spectometre), determines whether the testosterone is synthetic or not.

Testosterone treatment and sleep apnea
Q. I believe that you might be one of the few people in the world who might have an answer to my question. 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. My question for you is this: 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.

The short-term effects of high-dose testosterone on sleep, breathing, and function in older men.
J Clin Endocrinol Metab. 2003 Aug;88(8):3605-13. Liu PY, Yee B, Wishart SM, Jimenez M, Jung DG, Grunstein RR, Handelsman DJ. Department of Andrology, ANZAC Research Institute and Concord Hospital, University of Sydney, Sydney, 2139 Australia.
Androgen therapy may precipitate obstructive sleep apnea in men. Despite increasing androgen use in older men, few studies have examined sleep and breathing. Randomized, double-blind, placebo-controlled studies examining effects of testosterone simultaneously on sleep, breathing, and function in older men are not available. Short-term administration of high-dose testosterone shortens sleep and worsens sleep apnea in older men but did not alter physical, mental, or metabolic function. These changes did not appear to be due to upper airway narrowing. Further study of longer-term lower-dose androgen therapy on sleep and breathing is needed to evaluate its safety in older men.
 

Testosterone research update
Men with more advanced prostate cancer often undergo treatment to reduce testosterone levels , which drives tumor growth. Now, a new study shows that this so-called androgen deprivation can be rapidly reversed. In the study, testosterone levels that were effectively supressed with a hydrogel implant releasing the hormone-suppressing drug histrelin rebounded rapidly after removal of the implant. However, the rebound was not as swift when a similar therapy called depot GnRH was injected.

Testosterone replacement therapy and the risk of prostate cancer. Is there a link?
Int J Impotence Res. 2005 Nov 10; Barqawi A, Crawford ED.
1Section of Urologic Oncology, University of Colorado Health Sciences Center, Aurora, CO
Substantial evidence supports the value of testosterone replacement therapy in improving quality of life in men with proven aging male syndrome (AMS). Benefits of testosterone replacement therapy include improved bone mineral density, reduced fracture risk, increased muscle mass, and improved mood, sense of well being, and libido, among others. There is currently a heated debate about the theoretical association between testosterone replacement therapy and the initiation, progression, and aggressiveness of prostate cancer; however, this link has not been uniformly studied, and any results have been contradictory and nonconclusive. Although no clear evidence links testosterone replacement therapy to prostate cancer, the possibility of increasing the risk of a clinical manifestation of a latent pre-existing malignancy can influence the decision about testosterone replacement therapy use. Current recommendations are to exclude prostate cancer before initiating testosterone replacement therapy in men over age 40 and to closely monitor men in the first year of testosterone replacement, followed by observation in subsequent years
 

Men over the age of 45 with diabetes are more than twice as likely as non-diabetic men in the age group to have low testosterone, making them susceptible to sexual dysfunction. Women who feel less sexy after a hysterectomy may get a boost from testosterone. U.S. investigators found that women who reported a loss of their libido after surgeons removed their uterus and ovaries tended to show improvements after using a testosterone patch for 24 weeks. Women who tried the testosterone patch were equally likely to report side effects as women who used a placebo patch. However, testosterone-takers reported more side effects related to male hormones, such as acne and voice deepening. The study was funded by Proctor & Gamble Pharmaceuticals, which is developing a female testosterone patch called Intrinsa, designed to spark women's sexual appetite. Previous research has shown that women's sexual health is influenced by testosterone, and a loss of testosterone increases the risk of a loss of libido. The ovaries produce a significant amount of testosterone. Consequently, studies show that after women's ovaries are removed, up to 50 percent report a decrease in libido. As part of the current study, the women, who had reduced sexual desire after hysterectomy and removal of the ovaries were randomly assigned to use a testosterone or placebo patch twice per week for 24 weeks. Women also kept a sexual activity log, in which they recorded the quality and quantity of sexual encounters. In addition to more satisfying sexual encounters, women who received testosterone showed more improvements in desire, arousal, pleasure, orgasms, responsiveness, and self-image than those who received placebo.

Low Testosterone Levels Predict Incident Depressive Illness in Older Men: Effects of Age and Medical Morbidity.
J Clin Psychiatry. 2005 Jan;66(1):7-14.
Prior studies found that chronic low testosterone levels are associated with an increased risk of depression. We investigated whether low testosterone levels in older men predict depressive illness over 2 years, while controlling for age and medical morbidity. Participants were 748 men, aged 50 years or older, without prior ICD-9-diagnosed depressive illness, with a testosterone level obtained between 1995 and 1997. Measures were age, mean total testosterone levels (low: </= 2.5 ng/mL), medical morbidity, and incidence and time to depressive illness. RESULTS: Men with low testosterone levels had a greater 2-year incidence of depressive illness (18.5% vs. 10.4%, df = 1, p = .006) and a shorter time to onset of depressive illness. The unadjusted hazard ratio (HR) for depressive illness in men with low testosterone levels was 1.9. After adjustment for age and medical morbidity, men with low testosterone levels continued to have a shorter time to depressive illness. Due to a significant interaction between age and medical morbidity, we conducted stratified Cox regression analyses and found that low testosterone levels and high medical morbidity or an age of 50 to 65 years were associated with increased depressive illness (p = .002). CONCLUSION: Low testosterone levels are associated with an earlier onset and greater incidence of depressive illness. Men with low testosterone levels who had high medical morbidity or were aged 50 to 65 years had an increased risk for depressive illness. Further prospective studies are needed to examine the role of testosterone in depressive illness in older men.

Could seasonal variation in testosterone levels in men be related to sleep?

Aging Male. 2004 Sep;7(3):205-10.
We have previously reported seasonal variations in both total and free testosterone in men living in north Norway. The aim of this cross-sectional study was to determine whether seasonal variation in testosterone also occurs in men living in geographical areas with less extreme seasonal variation in sunlight and temperature. In 915 men aged 24-91 years from Rancho Bernardo, a suburb of San Diego in southern California, we found that neither total nor bioavailable testosterone varied by season, with or without adjustments for age and anthropometric measurements. Of all examined covariates, only physical activity showed a seasonal variation, with a peak in August (p < 0.001), and adjusting for physical activity did not change the lack of seasonal variation in testosterone. In addition, there was no association between testosterone and mean air temperature, or testosterone and possible hours of sunshine. We conclude that men living in southern California show no seasonal variation in testosterone levels. One possible explanation, besides the difference in climate, for the diverging findings between our previous study and the present study is different sleep patterns.

Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life.
Heart. 2004 Aug;90(8):871-6.
Low serum testosterone is associated with several cardiovascular risk factors including dyslipidaemia, adverse clotting profiles, obesity, and insulin resistance. Testosterone has been reported to improve symptoms of angina and delay time to ischaemic threshold in unselected men with coronary disease. OBJECTIVE: This randomised single blind placebo controlled crossover study compared testosterone replacement therapy (Sustanon 100) with placebo in 10 men with ischaemic heart disease and hypogonadism. RESULTS: Baseline total testosterone and bioavailable testosterone were respectively 4.2 (0.5) nmol/l and 1.7 (0.4) nmol/l. After a month of testosterone, delta value analysis between testosterone and placebo phase showed that mean (SD) trough testosterone concentrations increased significantly by 4.8 (6.6) nmol/l (total testosterone) (p = 0.05) and 3.8 (4.5) nmol/l (bioavailable testosterone) (p = 0.025), time to 1 mm ST segment depression assessed by Bruce protocol exercise treadmill testing increased by 74 (54) seconds, and mood scores assessed with validated questionnaires all improved. Compared with placebo, testosterone therapy was also associated with a significant reduction of total cholesterol and serum tumour necrosis factor alpha with delta values of -0.41 (0.54) mmol/l and -1.8 (2.4) pg/ml respectively. Testosterone replacement therapy in hypogonadal men delays time to ischaemia, improves mood, and is associated with potentially beneficial reductions of total cholesterol and serum tumour necrosis factor alpha.

Physiological testosterone replenishment in healthy elderly men does not normalize pituitary growth hormone output: evidence against the connection between senile hypogonadism and somatopause.
J Clin Endocrinol Metab. 2004 Jul;89(7):3255-60.
Normal aging in men is accompanied by lower serum testosterone, GH, and IGF-I concentrations. The mechanisms of the age-related diminution in the activity of the somatotropic axis (somatopause) are uncertain. Several explanations have been proposed, including a lower hypothalamic GHRH output. The aim of the present study was to test the hypothesis that the physiological hypogonadism that accompanies normal aging is responsible for GHRH deficiency. We assessed the suppressibility of spontaneous and GHRH-stimulated GH secretion by a specific competitive GHRH receptor antagonist in seven elderly (61-76 yr old) and six young (20-23 yr old) healthy nonobese men. Elderly men then received transdermal testosterone (5 mg/d) for 5-6 wk and had the same experiment repeated. Mean final total testosterone, free testosterone, and dihydrotestosterone increased in elderly men to the levels found in their younger controls, but estradiol did not change. GH pulse frequency or amplitude and maximum GH were not altered, and the integrated GH concentrations actually decreased. The percent suppression of GH output in the elderly did not change during GHRH antagonist infusion. We conclude that the testosterone deficiency of old age is unlikely to be the proximate cause of the somatopause.

An FDA advisory panel refused to recommend approval of a new testosterone skin patch to treat low libido in women, saying that its manufacturer, Procter & Gamble, did not provide enough evidence that it is safe for long-term use. The panel voted unanimously that the company did not have sufficient data to show that prolonged exposure to testosterone is safe in women. This is good, since there are natural herbs that work just as well or better to enhance female libido, such as muira puama, tribulus, horny goat weed, and tongkat ali. They may take a few days to fully work. Passion Rx, a combination product with 15 herbs, works within days.

Soy protein isolates of varying isoflavone content exert minor effects on serum reproductive hormones in healthy young men.
J Nutr. 2005 Mar;135(3):584-91.
Inverse associations between soy and prostate cancer and the contribution of hormones to prostate cancer prompted the current study to determine whether soy protein could alter serum hormones in men. Thirty-five men consumed milk protein isolate (MPI), low-isoflavone soy protein isolate (SPI) (low-iso SPI; 1.64 +/- 0.19 mg isoflavones/d), and high-iso SPI (61.7 +/- 7.35 mg isoflavones/d) for 57 d each in a randomized crossover design. In conclusion, soy protein, regardless of isoflavone content, decreased DHT and DHT/ testosterone with minor effects on other hormones, providing evidence for some effects of soy protein on hormones. The relevance of the magnitude of these effects to future prostate cancer risk requires further investigation.

Testosterone therapy -- what, when and to whom?
Aging Male. 2004 Dec;7(4):319-24. Jockenhovel F.
Department of Medicine, Evangelisches Krankenhaus Herne, Wiescherstrasse 24, Herne, Germany.
Testosterone therapy has been used for more than 60 years in the treatment of male hypogonadism. The classical forms of hypogonadism are comprised of primary testicular failure or insufficient testicular stimulation due to the lack of pituitary gonadotropins. Typical causes of primary hypogonadism are Klinefelter's syndrome, anorchia or acquired disturbances of testicular function. Secondary hypogonadism is characterized by insufficient production of pituitary gonadotropins, due either to pituitary failure or defects at the hypothalamic level. It is unequivocally accepted in clinical practice that any male with inadequately low testosterone production for his age will require androgen therapy. In addition to the classical forms of hypogonadism, the past decade of research has clearly demonstrated that, with increasing age, many men will suffer from decreasing testosterone production. About 15-25% of men over the age of 50 years will experience serum testosterone levels well below the threshold considered normal for men between 20 and 40 years of age. Studies substituting testosterone in elderly men with low serum testosterone have shown that men with clinical symptoms identical to the symptomatology of classical hypogonadism will benefit most from such therapy. Therefore, it is the general consensus to treat men with age-related hypogonadism only when clinical symptoms are present that can be potentially corrected by testosterone administration. Until recently, intramuscular injections of esters, such as testosterone enanthate, have been the mainstay of testosterone therapy. The introduction of testosterone patches has not challenged this approach, since many users of patches suffer from moderate to severe skin reactions. Some oral testosterone formulations have proven to be problematic, as absorption can be variable, bioavailability is frequently poor, due to the first-pass effect of the liver, and frequent administration is often required. Oral testosterone undecanoate avoids, at least partially, the first-pass effect of the liver. However, plasma testosterone levels generally undergo large fluctuations. The large fluctuations in serum testosterone levels caused by conventional intramuscular injections result in unsatisfactory shifts in mood and sexual function in some men, which, combined with the frequency of injections, make the intramuscular mode of delivery far from ideal. Recently, a hydroalcoholic gel containing 1% testosterone has proven to be as efficient as a testosterone patch, but with fewer side-effects and a higher grade of patient satisfaction. Doses of 50-100 mg gel applied once daily on the skin deliver sufficient amounts of testosterone to restore normal hormonal values and correct the signs and symptoms of hypogonadism. The gel has been shown to be effective and successful in patients in the United States, who have benefited from its availability for almost 3 years. In the near future, intramuscular injections of testosterone undecanoate will become commercially available. Such injections have a very favorable pharmacokinetic profile, with one injection every 3 months maintaining serum testosterone well within the normal range. In phase III studies, intramuscular testosterone undecanoate proved to be as efficient as testosterone enanthate, with only one-quarter of the number of injections required and more stable serum testosterone levels. Thus, the new application modes--hydroalcoholic gel (for example, Testogel, Schering AG, Germany) and intramuscular testosterone undecanoate (Nebido, Schering AG, Germany)--appear to be the methods of choice in the near future, one being very suitable for hormone therapy in elderly men, the other for long-term substitution in classical forms of hypogonadism.

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.

Testosterone 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. Can I buy a testosterone supplement in a store?
   A. Testosterone is only available by prescription.
 

Q. I've read (on the Internet, of course :) ) that too much soy can reduce a man's testosterone levels. Has this been shown to be true in any reasonably conducted study or is this just one more Internet myth?
   A. 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.

Q. I am a 46 year-old male in excellent health (6 ft, 165 lbs, low blood pressure and cholesterol, and don’t smoke). I had my testosterone tested a couple of years ago. My doctor said I have good testosterone level but a moderately low free form of testosterone. Are there any herbs or supplements that can increase free testosterone? I read of one study that said wild oats can help. Is there anything to that? Are there other herbs that might help?
   A. It is best not to place too much emphasis on a single blood level. One has to look at overall health, what kind of signs and symptoms a person may have, what does the physical exam say, what do the basic blood studies say? One can be steered in the wrong direction by basing a course of action on one hormone level, such as the testosterone level. Nevertheless, to answer your question, certain herbs such as tribulus and tongkat ali may stimulate testosterone release, and whether they would do this consistently or whether an exhaustion or depletion occurs is not known.
 

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 testosterone 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. Will my hair keep falling out? I am taking 10 mg biotin and prenatal vitamins right now.
   A. Please see the hair web page for more information. It's likely that once the testosterone injection is stopped, most if not all the hair that was lost will return, but each person is unique and it is difficult to predict. Your doctor should be informed. 
 

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 enhances testosterone.
 

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. The amount of information that you bring to the public is
astounding. 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 Tx, 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 testosterone levels after use, it costs tens of thousands of dollars to do even a simple study, it is rare for supplement products to have rigorous testing since it is so expensive. Most people notice the sexual benefit effects within 2 to 4 days, we suggest not taking Passion Rx more than 2 days in a row. taking days off helps the product work better.
 

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. As to testosterone injections, it may be best to avoid Passion Rx on the days where you think you reach the peak of the testosterone effect. We have not had any feedback from users who have taken Passion Rx along with testosterone injections, therefore we don't know for sure. Perhaps your doctor may want to skip a dose of testosterone initially while you start the Passion Rx, but this is just a thought.
 

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 testosterone level just for the sake of increasing testosterone level 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. Dr.Sahelian! Perhaps in one of your future newsletters, you can address how we, prostate cancer survivors, can improve our testosterone levels. Radiation therapy is damaging to testosterone levels which in turn cause all sorts of "Quality of Life" issues.

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 had some blood work done, and my testosterone level was low and I am looking at a way to enhance that naturally without the use of drugs.

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.

This testosterone page was last updated Feb 2008.