Testosterone News - Low T Treatment Trends, TRT Medical Articles
The Hormone of Desire Testosterone - Just as estrogen and progesterone are the female sex hormones, Testosterone is the male sex hormone. Testosterone is the main hormone produced in the testicles and secreted by the testes.
Low T can cause loss of muscle, low sex drive, extreme fatigue, rapid weight gain, excess body fat, insomnia, moodiness and depression.
Receive the latest Testosterone Replacement Therapy and Low T Testosterone Program information - Get Testosterone Program info.
Testosterone News, Articles & Information
How To Buy Testosterone & Where To Buy Testosterone
OK, so you are looking to buy Testosterone - Low T Injections - Hormone Creams, Patches or Androgen Gels to boost levels
For those looking to buy testosterone, it is important to order and purchase only high-quality FDA-approved Testosterone Injections Hormone Medication. There are various types of testosterone and numerous testosterone delivery methods. Even if you decide to use a testosterone cream, a testosterone gel like Androdgel®, or a patch for testosterone replacement therapy, be sure to do so with a prescription and supervision of a licensed medical doctor. It is important to determine beforehand any side effects, allergies or symptoms that could occur from testosterone injections and to get the dosage as accurate as possible to optimize your low testosterone levels.
Reminder: Get Tested for Low Testosterone first!
Until you know if your health symptoms are caused by a low testosterone level, injecting or applying ‘testosterone’ may not be what is medically indicated and you should not necessarily be looking to purchase testosterone when perhaps another form of hormone replacement therapy is indicated. Visit an experienced HRT physician, get tested and find out first if you have Low T. Only then with a proper diagnosis in hand should you get a testosterone prescription.
Getting a prescription for testosterone injections, testosterone gels, testosterone creams or testosterone patches is the most common method to buy testosterone. These hormone replacement methods will help increase your testosterone levels. After you are on testosterone replacement therapy with injections or otherwise, a follow up test should be performed to verify that the testosterone dosage is appropriate to alleviate symptoms, and if not the doctor will modify the prescription for testosterone.
How to Buy Testosterone
Normally, If a man is looking for testosterone replacement therapy, they will find a testosterone doctor by searching online or through word of mouth who after comprehensive testing and physical examination will prescribe it for them if medically needed. Although Testosterone Therapy is still fairly new it is becoming an accepted form of hormone treatment for men by medical doctors. Many age management physicians and even general medical practitioners are learning the benefits of testosterone replacement in middle-aged and aging men. They are learning that as testosterone levels decline, mental, physical, emotional and sexual symptoms result. Men who are aging may complain to their doctors that they have low sex drive or erectile dysfunction, are gaining weight rapidly, losing muscle tone fast, are unable to sleep, feel tired and angry all the time.
The symptoms of low testosterone are experienced during a phase in a man's life known as andropause or male menopause. Clinically low testosterone in men is called hypogonadism.
If you think you may be suffering from a testosterone deficiency and are looking for a doctor to test, examine, diagnose and prescribe testosterone for your symptoms, then locate a doctor who has experience prescribing testosterone.
Cost of Testosterone
Pricing of Testosterone therapy and testosterone prescriptions depends upon the dosage, frequency and length of the hormone treatment program. Likewise a man's age and medical history play a role. Creams and gels may be less expensive than injections but dosage and frequency of application are a big factor. A man should never buy illegal testosterone injections online or use testosterone of any kind without the close supervision and monitoring of a licensed doctor who will show you how to apply or administer testosterone injections properly. Your health is of paramount importance and you want to avoid infections or serious side effects of improper dosage to ensure you gain only the positive benefits from testosterone treatment.
The cost of Testosterone cypionate, Testosterone enanthate, and Testosterone propionate can be obtained through your licensed physician. These types of Testosterone injections need to be injected either every other day, weekly, or biweekly, which is another reason testosterone injections need doctor supervision. Testosterone injections like Depo-Testosterone, Paddock and Watson Injectable Testosterone are the most effective methods of testosterone delivery but if injecting testosterone frequently is not something a man wants to do, testosterone creams, gels, patches and even testosterone impalantable hormone pellets are available at reasonable cost .
With advanced bio-technology, natural testosterone boosters like testosterone boosting supplements complement a testosterone therapy program. Testosterone supplements that help increase low testosterone levels and also decrease excess estrogen in a man's body are also available. One of the benefits of testosterone supplements are that they are easy to take like vitamins, are cheaper than other forms of testosterone therapy, and have little to no side effects and do nit require a prescription like topical and injectable forms of testosterone.
Some testosterone enhancing supplements also help increase libido (sex drive). Some herbal testosterone supplement increase libido and when used together with properly administered testosterone treatments can help positively effect testosterone levels.
Where to Buy Testosterone
Prescription testosterone – You must visit with a licensed doctor, get tested with blood work, and have a physical examination - only then will the doctor determine if testosterone replacement is the best choice for treatment. Based on a complete assessment, your doctor will recommend testosterone injections, gels, creams, patch or pellet. Help and information for buying and ordering testosterone with a prescription is also available online.
Learn The Facts about Testosterone Therapy
What is Testosterone Therapy?
Testosterone is what makes a man, a man! Testosterone is the primary male sex hormone responsible for male characteristics and sex drive in both men and women. Testosterone hormone is produced by the Leydig cells in the testes in response to luteinizing hormone or (LH) secreted by the pituitary gland in the brain. Age related declines in testosterone hormone in men occur in two principal ways. The primary way is a decrease in the number of Leydig cells. The second is a natural decrease in LH or luteinizing hormone secreted resulting in a decrease in the amount of testosterone produced by the testes.
A clinical study demonstrated that total number of Leydig cells is reduced by as much as 44% in men over the age of 50. Age is the single largest factor contributing to decline in testicular function and testosterone production.
The secondary cause of testosterone hormonal dysfunction is failure of the hypothalamic-pituitary-gonadal axis to function as it did when a man was young. Declines in T levels in men are gradual over time and result in the condition known as "Low T" we all hear about in television commercials, unlike the quick decline in estrogen levels experience by menopausal women. Low testosterone levels affect men and women's sex drive and can leave their libid in free-fall. Lack of desire and inability to function sexually are normal the results of low testosterone production in men and women.
The gradual nature of the low t condition ensures that not all men will experience andropause at the same age but rather in a broad age range. Although testosterone levels begin to decline at around 30, it is not until the range of 35 to 45 that men might start to notice the symptoms and effects of low testosterone, also known as male menopause (andropause) or hypogonadism.
Testosterone Therapy also known as TRT or Testosterone Replacement Therapy is being used to replace a man's lost testosterone and raise it back to within a normal range. This is known as hormone modulation or hormone optimization. One of the most effective ways of treating men with testosterone deficiency is with testosterone injections. Creams, gels and patches are also available but have less abiltiy to be absorped quickly.
Read about Testosterone Treatments for Men - Testosterone Therapy
Get Testosterone Injections at the best price for TRT - Testosterone Replacement
Low T Therapy can help men with Testosterone Deficiency - Testosterone Treatment
Low Testosterone Symptoms occur in Men Over Time - Low Testosterone Levels
Buy Testosterone Injections from Paddock, Watson, Sandoz and Pfizer Depo-Testosterone - Testosterone Injections
Find A Testosterone Doctor Nationwide in the US - Testosterone Doctors
Learn more about Andropause, the Male Menopause or Hypogonadism - Male Menopause & Erectile Dysfunction
Where to get Testosterone Online - Purchase Testosterone Injection & Creams - Buy Testosterone Online
Treat Low T or Testosterone Deficiency at the Best Male Anti-Aging Clinic - Treat Low T - a Male Hormone or Testosterone Deficiency
The Testosterone Rejuvenation Center @ www.TestosteroneTherapy.org is the Best Testosterone Replacement Information Resource - Get the Facts about Testosterone Therapy and HRT for Men - Testosterone Therapy Facts & Info
IS YOUR SEX DRIVE DECLINING? - IT COULD BE LOW T! Take the Low T Test and Learn How to Get Your Sex Drive Back! If you're feeling weak, lethargic, and gaining weight — feel less drive at work and in daily life—your testosterone levels might be low. You've seen the Low Testosterone TV commercials, but Low T doesn't only happen to aged men, it begins to decline around the age 30 to 35. THE FACT IS UNDENIABLE: A man's body changes over time. With each passing year, levels of testosterone in men's bloodstream declines and he loses muscle mass and bone mass as a result.
Men's Health's breakthrough using Testosterone Therapy can replace testosterone production in a man's body so he can restore his sex life and enjoy physical, mental, and sexual benefits of that an increase in testosterone can deliver. First step for you if you think you might have Low T is to take a quick blood test to see if you might be low in Free Testosterone.
DO YOU HAVE LOW T? Only a doctor reviewing your blood test can diagnose low testosterone, but there are easily recognized symptoms that may offer clues. If you have experienced three or more of these low testosterone symptoms, check with your doctor and consider trying Testosterone Therapy:
Are you gaining weight fast with a waist circumference of more than 40-44 inches?
Are you seeing diminished results from your exercise and workouts?
Are you finding it more difficult to stay in shape even with a healthy diet?
Does your sex drive seem lower than usual or non-existent?
Are you having trouble sleeping through the night?
Are you experiencing joint or muscle pain or losing lean muscle?
Are you feeling tired all the time, moody and unmotivated?
Are your erections soft or have you lost morning erections?
Are you having memory problems, feel depressed or withdrawn?
Are you low on energy, stamina and endurance or fall asleep after a meal?
WHAT CAN BOOSTING TESTOSTERONE LEVELS DO FOR YOU? Here are just some of the benefits of boosting your testosterone levels, many of which you'll notice during the first weeks of a Testosterone Treatment program:
You'll burn more belly fat You'll feel more energetic, alert, and intellectually sharp You'll build thicker, stronger muscles.
You'll have reduced cravings for carbs and sweets.
You'll experience firmer, stronger erections.
You'll sleep better and feel more rested.
Testosterone Therapy at the Testosterone Rejuvenation Center comprises nutrition, exercise, and healthy lifestyle changes and testosterone hormone replacement.
Latest Testosterone Replacement Therapy News
FDA Approved Testosterone Update
The FDA has cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use - FDA Testosterone Safety Update
FDA has approved testosterone products to replace testosterone in men who have low testosterone levels associated with certain medical conditions. Examples of these conditions include:
Failure of the testicles to produce testosterone because of genetic problems or because of damage from chemotherapy
Problems with the pituitary gland or part of the brain called the hypothalamus that control the production of testosterone by the testicles
FDA-approved testosterone formulations include gels, solution, skin patch, intramuscular injection, pellets implanted under the skin, and a buccal system applied to the upper gum or inner cheek.
Testosterone is a hormone essential for the growth and development of male sex organs and maintenance of secondary male characteristics, such as facial hair.
In the past 5 years, the use of testosterone replacement therapy has increased significantly, from 1.3 million patients in 2009 to 2.3 million patients in 2013 receiving a prescription for a testosterone product. Currently, approximately 70 percent of men who receive testosterone prescriptions through retail pharmacies are between 40 and 64 years old.1 The most common diagnostic code associated with testosterone therapy is the non-specific diagnosis of “testicular hypofunction, not elsewhere classified.”2
A diagnosis of hypogonadism requires laboratory evidence of low testosterone levels measured on at least two separate mornings. However, in one health plan database, approximately 20 percent of men who received testosterone prescriptions had no insurance claims for laboratory testing of testosterone levels.3
A list of FDA-approved testosterone products can be found by searching for testosterone on the FDA.gov website or at ">Testosterone Drugs FDA Approved
FDA Approved Testosterones
ANDROID 10 METHYLTESTOSTERONE
ANDROID 25 METHYLTESTOSTERONE
ANDROID 5 METHYLTESTOSTERONE
AVEED TESTOSTERONE UNDECANOATE
DELATESTRYL TESTOSTERONE ENANTHATE
DEPO-TESTADIOL ESTRADIOL CYPIONATE; TESTOSTERONE CYPIONATE
DEPO-TESTOSTERONE TESTOSTERONE CYPIONATE
DITATE-DS ESTRADIOL VALERATE; TESTOSTERONE ENANTHATE
ORETON METHYL METHYLTESTOSTERONE
TESTODERM TTS TESTOSTERONE
TESTOSTERONE CYPIONATE TESTOSTERONE CYPIONATE
TESTOSTERONE CYPIONATE-ESTRADIOL CYPIONATE ESTRADIOL CYPIONATE; TESTOSTERONE CYPIONATE
TESTOSTERONE ENANTHATE TESTOSTERONE ENANTHATE
TESTOSTERONE ENANTHATE AND ESTRADIOL VALERATE ESTRADIOL VALERATE; TESTOSTERONE ENANTHATE
TESTOSTERONE PROPIONATE TESTOSTERONE PROPIONATE
Testosterone therapy could help men
Globe News Article
Men may have seen ads asking whether they've lost that loving feeling and wondered whether they should get their testosterone levels tested. The promises made by pharmaceutical companies pitching testosterone creams or gels directly to men sound too good to pass up: bigger muscles, more energy, stronger sex drive. And prescriptions for the therapy have jumped more than 500 percent over the past two decades.
Whether men should get tested and treated for low-T as drug company ads call it - remains controversial because of unknown risks of long-term testosterone therapy and hints that it could cause life-threatening health problems in older men who tend to have the lowest levels.
Researchers at the New England Research Institutes are conducting an observational study involving nearly 1,000 men over age 18 who are being treated with long-term testosterone therapy to boost low hormone levels in order to determine whether it raises their risk of prostate cancer.
A 2010 study published in the New England Journal of Medicine found that men over 65 years of age with low testosterone levels who were treated with a daily testosterone gel for six months gained muscle strength and endurance compared with those who used a placebo gel but also had more heart attacks. Out of 209 study participants, 23 in the testosterone group had a heart attack, a blocked artery that required treatment, or died of heart problems during the study, compared with 5 in the placebo group.
Testosterone treatment also has side effects including shrunken testicles, hair loss, acne, breast enlargement, and sterility.
Just as women experience declining estrogen levels as they age and get close to menopause, men also experience a slowing in their production of testosterone as they hit mid-life. What's more, a study published last month suggests that men today have lower testosterone levels than in decades past, possibly due to increasing rates of obesity and exposure to more chemicals in plastics and other substances that disrupt the production of sex hormones.
About 2 to 5 percent of men under age 40 have low testosterone, according to Dr. Brad Anawalt, chief of medicine at the University of Washington Medical Center and chair of the Endocrine Society's Hormone Health Network. The percentage gradually rises to the point that one in four men over age 70 have low levels. But just as most women don't need hormone replacement therapy after menopause, men usually don't need testosterone replacement in their senior years. It all depends on how much they're bothered by symptoms, said Anawalt.
He also recommends against routine testing of testosterone levels if a man is having vague symptoms such as feeling tired or out of sorts. One of the real tip-offs of low testosterone is a decline in sex drive, he added. Most of us advise against routine testing unless a man has specific symptoms like decreased libido, sexual fantasies, pleasure in sex, and morning erections.
Those symptoms can also be accompanied by depression, decreased muscle strength and endurance, and low energy. Men with osteoporosis are also more likely to have low testosterone levels, and Anawalt said he frequently tests hormone levels in those with severe bone loss.
Getting a proper reading on a test can be tricky, however, because blood tests can be notoriously unreliable. Because testosterone levels tend to decline throughout the day, getting tested between 7 and 10 a.m. is ideal. About 15 percent of men with normal testosterone levels in the morning will have a reading that comes back low later in the day, Anawalt said.
Men also need to have more than one testosterone test to verify a low reading because respiratory infections and other illnesses can temporarily suppress testosterone levels.
I think testosterone tests, when done correctly, can be a good measure of a man's metabolic health, said Dr. Martin Miner, codirector of the Men's Health Center at Miriam Hospital in Providence. Low testosterone levels have been associated with type 2 diabetes, cholesterol abnormalities, chronic lung disease, and obesity, but that doesn't mean low levels of the hormone cause these conditions, nor that treatment with the hormone can reverse them.
End Testosterone Article. Learn more about Low Testosterone Treatment - Low Testosterone Treatment
Natural Ways to Boost Testosterone
Men's Health Article - Boosting Testosterone Levels
The normal level of testosterone in your bloodstream is between 350 and 1,000 nanograms per deciliter (ng/dl). Like combable hair, those quantities silently start to wane around age 40. You lose about 1 percent a year -- a harmless decline in the short term, but a cause of obesity, brittle bones, muscle loss and impotence by the time you reach your 60s -- if you live that long. Testosterone levels in the low range (a blood serum score below 350 ng/dl) may increase your chances of dying of a heart attack.
It's not just an old man's problem, either. Men in their 30s and 40s also fall prey to low testosterone levels. It's a disorder called hypogonadism, and it can be caused by an undescended testicle, a testicular injury, a pituitary gland disorder or even prescription drugs. It usually goes undiagnosed until a man hits his doctor with a telltale complaint: I can't get an erection.
If you have reduced levels of sexual desire, have your testosterone level checked immediately, says Dr. Allen Seftel, a urologist at Case Western Reserve University Hospitals of Cleveland. You can replenish your testosterone stores with injections, gels, pills or patches, but these medical treatments are no panacea: Side effects include acne, high cholesterol, shrunken testicles and liver damage. Further, don't take supplements like DHEA or androstenedione to boost testosterone; they might increase your risks of prostate cancer and heart disease.
For men with borderline testosterone scores, I advise them to try to raise their levels through exercise and weight loss before going on testosterone therapy, says Dr. Goldberg. And it might pay to start young. Since your testosterone declines at a steady rate, it's conceivable that raising your hormone levels naturally in your 20s and 30s could help you maintain higher levels later on, he says. Either way, the reward can be a stronger physique and better bedroom sessions than you'd otherwise deserve. Below are 13 tips designed to get your juice up safely.
Get Rid of the Flopping Belly -
Or you'll grow a pair of fetching breasts to complement it. Carrying excess body fat elevates your estrogen levels, and that may cause your testosterone levels to sink, says Joseph Zmuda, an epidemiologist at the University of Pittsburgh. Louie Anderson is proof enough of this. Two or three extra pounds won't cause this hormonal shift; it really occurs once you're 30 percent over your ideal body weight. Unfortunately, that's pretty common now, says Dr. Dobs.
But Lose Only One Pound a Week -
When you want to trim down quickly, you probably starve yourself while exercising like a madman. One of the many reasons this stops working in your 30s, when your natural testosterone levels start dropping, is pretty simple: Cutting your calorie intake by more than 15 percent makes your brain think you're starving, so it shuts down testosterone production to wait out the famine. There's no need to reproduce if you're starving, explains Thomas Incledon of Human Performance Specialists in Plantation, Fla. Ironically, this dive in circulating testosterone stops you from burning body fat efficiently, so you're actually thwarting your hard efforts to melt that tire off your gut.
Skip the Atkins Fad -
Research suggests that eating a high-protein, low-carbohydrate diet can cramp your testosterone levels. High amounts of dietary protein in your blood can eventually lower the amount of testosterone produced in your testes, says Incledon, who observed this relationship in a Penn State study of 12 healthy, athletic men.
Your protein intake should be about 16 percent of your daily calories, Incledon says. So, if you're the average 170-pound man who eats 2,900 calories a day, you should eat about 140 grams of protein daily, which is about the amount in two chicken breasts and a 6-ounce can of tuna.
Have Morning Sex -
German scientists found that simply having an erection causes your circulating testosterone to rise significantly and having one in the morning can goose your natural post-dawn testosterone surge. It's a sure bet you'll burn a little fat, too.
Stick With Tough Exercises -
To beef up your testosterone levels, the bulk of your workout should involve compound weight-lifting exercises that train several large muscle groups, and not just one or two smaller muscles. For example, studies have shown that doing squats, bench presses or back rows increases testosterone more than doing biceps curls or triceps pushdowns, even though the effort may seem the same. This is why doing squats could help you build bigger biceps.
Make Nuts Your Midnight Snack -
Nuts are good for your nuts. Research has found that men who ate diets rich in monounsaturated fat - the kind found in peanuts had the highest testosterone levels. It's not known why this occurs, but some scientists believe that monounsaturated fats have a direct effect on the testes, says Incledon. Nuts, olive oil, canola oil and peanut butter are good sources of monounsaturated fat.
Squeeze Out Five Repetitions per Set -
Throwing around 5-pound dumbbells won't help you effect a rise in testosterone. Start off by using a heavy weight that you can lift only five times. That weight is about 85 percent of your one-repetition maximum. A Finnish study found that this workload produced the greatest boosts in testosterone.
Do Three Sets of Each Weight-Lifting Movement
Researchers at Penn State determined that this fosters greater increases in testosterone than just one or two sets. Rest a full minute between sets, so you can regain enough strength to continue lifting at least 70 percent of your one-rep maximum during the second and third sets.
Rest Harder Than You Work Out -
If you overtrain - meaning you don't allow your body to recuperate adequately between training sessions your circulating testosterone levels can plunge by as much as 40 percent, according to a study at the University of North Carolina. The symptoms of overtraining are hard to miss: irritability, insomnia, muscle shrinkage, joining the Reform Party. To avoid overtraining, make sure you sleep a full eight hours at night, and never stress the same muscles with weight-lifting movements two days in a row.
Drive Home Sober
To maintain a healthy testosterone count and titanium erections, cut yourself off after three drinks. Binge drinking will kill your testosterone levels, warns Incledon. Alcohol affects the endocrine system, causing your testes to stop producing the male hormone. That's one reason drinking often causes you to go limp at the moment of truth.
Have a Sandwich at 3 p.m. -
As any sensible woman knows, the way to put hair on a man's chest is to fill his stomach. Your body needs a ready supply of calories to make testosterone, so regularly skipping meals or going for long stretches without eating can cause your levels of the hormone to plummet. Then again, that's probably the warden's plan.
Buy the Fried Tortilla Chips -
If you want to raise your testosterone score, eat a diet that includes about 30 percent fat, and not much less. Your body needs dietary fat to produce testosterone, so eating like a vegetarian aerobics instructor will cause your testosterone levels to sink drastically. This is bad, unless you actually are a vegetarian aerobics instructor.
Stop Surfing for Porn at 2 a.m.
Sleeping less than seven to eight hours a night can screw up your circadian rhythm. That's why it's no wonder your testosterone levels are higher in the morning after a good night's sleep. So if your work or social schedule keeps you stooped in perpetual jet lag, don't be surprised if you stop craving sex. At least that'll make it easier to stay out of bed.
End Men's Health Testosterone News Article.
How to Get More Testosterone
Testosterone is a hormone that is produced in large amounts by males. Testosterone is present in very small amounts in females. In men, it is produced by the testes and adrenal glands, and in women, it is produced (in small amounts) by the adrenal glands and ovaries. It affects sexual features and development. To start increasing testosterone, follow the simple steps below.
Develop healthy eating habits, heavily weighted toward fresh fruits and vegetables. The following foods may specifically help your body develop more testosterone:
Nuts, such as almonds. A handful or two of walnuts or almonds is a great start. Branch out to brazil nuts, cashews, avocados, and other foods high in monounsaturated fats, as men who regularly consume these fats have higher testosterone levels than men who don't.
Oysters boost testosterone - Six oysters is all the boost your body needs to produce more testosterone, as oysters contain loads of zinc. Oatmeal boosts testosterone - Oatmeal is loaded with L-arginine, an amino acid that reacts with nitric oxide to relax blood vessels. When those blood vessels expand, blood flow is increased mightily.
Amino Acids boost testosterone - L-Arginine supplements will help increase testosterone levels as will other natural testosterone boosters - Ginseng, Zinc, Yohimbe, Nettles, Saw Palmetto, Horny Goat Weed and other organic herbs.
Vitamin D3 is technically a hormone, but a really important one. Studies show that people who regularly take D3 supplements actually have higher testosterone levels.
Omega-3 fish oil boosts testosterone (cod-liver oil or flax seed oil) - Omega-3 fish oil has been linked to the production of the Luteinizing hormone, which is what causes the testes to produce more testosterone.
Lift Weight s& Develop a healthy exercise plan. Do not over-exercise because your body will start making estrogen, but make it a part of your daily activity, even if it's just walking. Fatty tissue contributes to aromatization or conversion of testosterone to estrogen.
So the more fatty tissue you birn the better. Scientists have found that obese men are 2.4 times likelier to have low testosterone than their counterparts. Find a way to exercise in order to keep your weight down with:
Cardiovascular exercises such as running, swimming, or spinning, Strength training, Interval training and High Impact or Weight training help to boost testosterone levels.
Start lifting weights with small reps. If you really want to boost testosterone, you should begin to lift weights. Lift heavy but do not strain or overexert yourself, and avoid the weight machines. Stick with free weights and lift large muscle groups. Studies show that lifting larger muscle groups will help increase production of testosterone.
For this reason, stick with bench press, squats, deadlift, and shoulder press. Try to work out with high volume. The volume of your workout is determined by this formula: reps x sets x weight = volume.
Rest a bit, but not too long, in between sets. Rest for at least a minute, but no longer than two minutes. Personal trainers are a treasue of valuable and practical workout information - find one if you can.
Have more sex - Sex helps to naturally boost your testosterone levels. Even having an erection increases testosterone levels in men.
Low Testosterone Could Kill You / ABC News Medical Unit
Low testosterone may lead to a greater risk of death, according to a study presented Tuesday at the annual meeting of the Endocrine Society in Toronto.
Men with low testosterone had a 33 percent greater death risk over their next 18 years of life compared with men who had higher testosterone, according to the study conducted by Dr. Elizabeth Barrett-Connor and colleagues at the University of California at San Diego.
It's very exciting and potentially a groundbreaking study," said Barrett-Connor. But it needs to be confirmed.
The study tracked nearly 800 men, 50 to 91 years old, living in California. Their testosterone level was measured at the beginning of the study, and their health was then tracked over the next 20 years.
How Low Is Low?
Testosterone normally declines as men get older. However, a clear definition of "low" testosterone does not yet exist.
No one knows what low really is, said Dr. Joel Finkelstein, endocrinologist and associate professor at Harvard Medical School. The study authors defined it at 250 [nanograms per deciliter], which is a definition, but no one has figured out what low is.
Barrett-Connor and her colleagues found that nearly 30 percent of the men they studied met their criterion score of 250 or lower for low testosterone.
They noted that many men with this definition of low testosterone were "healthy men in the community who would not know that they had low testosterone.
Men With Hot Flashes ( A Low Testosterone Symptom )
Symptoms of low testosterone depend on how low the level is. At the lowest levels, men will have hot flashes, much like those experienced by women during menopause.
At levels not quite that low, men have decreases in their libido, erectile dysfunction, fatigue and physiological changes many will not immediately recognize, Finkelstein said, adding that these could include loss of strength, decrease in bone density and decreased muscle mass.
However, absent symptoms, there is no reason to get testosterone treatment.
The indication for testosterone is having a low testosterone level in the presence of symptoms, or physiological consequences such as low bone density," said Finkelstein.
Doctors should not prescribe testosterone because a level is low, or because patients think it will make them live longer.
Barrett-Connor agrees. Don't take testosterone just because you want to feel like you're 30 again.
And higher levels of testosterone aren't necessarily a good thing, either. The study authors found that for those with medium to high levels of testosterone, there was no added benefit for those with boosted levels.
Some of the side effects of testosterone treatment include sleep apnea, thickened blood and a possible increase in prostate disease for certain patients.
For those who actually need testosterone treatment, though, the hormone can be given in a few different ways, including injection and a in gel absorbed through the skin.
Testosterone injections are given every one to two weeks and can be administered by the patients themselves, said Dr. Larry Lipshultz, professor of urology at Baylor College of Medicine. Gels are applied daily.
Low Testosterone May Hit at the Belt with increased Belly Fat
Men with low testosterone in the study were also more likely to have larger waist girth. These men also appeared to be at higher risk for cardiovascular disease and diabetes.
How testosterone would cause these effects is becoming better understood.
Baby Boomers find Youth in Testosterone
How Baby Boomer Generation is Discovering Testosterone Therapy
CNN News Article
John Freiburger, 48, says people have noticed the difference in his energy levels since he began taking testosterone.
TESTOSTERONE STORY HIGHLIGHTS
In 2011, consumers spent approximately $1.6 billion on testosterone products.
Testosterone promises increased energy, better concentration, more muscle, higher sex drive.
The body's natural production shuts down when one begins testosterone replacement.
For thousands of years, explorers have been searching for the Fountain of Youth. Legend has it the elusive fountain contains a restorative source that brings endless vitality to those who drink from its pool.
No one knows what the source is, exactly. It's been called everything from the water of life to the elixir of immortality.
These days, anti-aging specialists simply refer to it as T.
You'd think T, or testosterone, was pure magic from its advertised results: increased energy, better mental concentration, less fat, more muscle, fewer sleepless nights and a higher sex drive. But experts say altering your body's natural hormone levels can be dangerous if not done properly.
As more FDA-approved products hit the market, the baby boomer generation is taking note. In 2011, consumers spent approximately $1.6 billion on prescription testosterone therapies, almost triple the amount spent in 2006, according to market research company IMS Health.
Dr. Harvey Bartnof is the founder of the California Longevity & Vitality Medical Institute. His practice focuses on age management medicine and hormone replacement therapies for both men and women. He says patients come to him to slow the aging process; they want to remain active and engaged as they grow older.
We have medications that help people stay alive longer, but the quality of life declines, Bartnof says. People would rather not go down the pathway of ... mom, dad if they don't have to.
Viagra for the boardroom
Testosterone is naturally produced primarily through a man's testes. (The hormone is also found in women, but that's another story.) The hormone helps regulate bone density, fat distribution, muscle strength, red blood cell production, sex drive and sperm production, according to the Mayo Clinic.
Bartnof compares it to oil in a machine -- while other systems make your body go, hormones such as testosterone grease the wheels so they work smoothly.
The body's production of testosterone peaks in early adulthood and typically declines about 1% each year after age 30, according to the Mayo Clinic website. A low testosterone level is called hypoandrogenism.
Symptoms of hypoandrogenism include insomnia, fewer erections, reduced muscle strength, depression, trouble concentrating and hair loss.
In other words, getting old, John Freiburger quips. The 48-year-old financial planner first started feeling the effects of his age a few years ago.
As the founder of an Illinois wealth management firm, he was juggling multiple clients' portfolios a day. He found his concentration in meetings started to fade earlier, even when he made an effort to hit the gym more often and eat right.
Being in the business that I'm in, you need to be on top of your game, Freiburger says. For a lot of men, it's like, Oh yeah, I'm getting old. I'm not very good at accepting that it's the way it needs to be.
Up until a few years ago, testosterone was mostly the choice of competitive body builders and professional athletes. Now, everyone from Wall Street executives to corporate office managers are taking what the media has dubbed Viagra for the boardroom.
Testosterone replacement therapies come in many forms, according to Nelson Vergel, author of Testosterone: A Man's Guide. The hormone can be injected into muscle, absorbed through the skin via a cream/gel, or released slowly through a small pellet that's inserted into the body.
A doctor does regular blood tests to determine the correct dosage.
Freiburger saw results just two days after beginning his hormone therapy. First, his energy levels skyrocketed. Then he saw an increase in his concentration level at work. Soon after, his libido returned, and within a month he was losing weight and putting on muscle at the gym.
I'm a better person. I'm a better wealth manager, he said. I have the energy, vitality to go conquer the world.
Testosterone is no magic pill
You've likely read that there's no magic pill for perfect health. While direct-to-consumer marketing may make it seem otherwise, testosterone is no exception, Vergel says.
I'm just amazed how many men start a hormone without doing research, he says. It's a wonderful thing to start if you need it. It also has some side effects if not done properly.
The hormone will help you lose weight and build muscle, but not without proper exercise and nutrition. It will also improve your sex drive; what it won't do, Vergel says, is make you into a teenage Casanova.
A 2004 study showed nearly 20% of patients may not respond fully to testosterone therapies. And the benefits from testosterone can plateau anywhere from six weeks to one year into treatment.
One of the biggest things to be aware of is that most men never stop testosterone replacement therapy, says Dr. Gregory Broderick, a urologist with the Mayo Clinic.
Once you start, your body begins shutting down natural production of the hormone, thinking it's no longer needed, he explains. This can lead to shrinkage of the testicles and a suppression of sperm production.
Broderick says finding a qualified doctor is key. Anti-aging is a new field and most doctors are not trained in hormone therapy, so they learn as they go from pharmaceutical reps and the latest published research. Testosterone replacement therapies often fall to physicians who specialize in boutique medicine.
Once you find a physician, he or she should screen for prostate cancer before starting treatment. While studies have shown testosterone replacement therapies do not increase the likelihood of developing the cancer, they can encourage tumor growth if a patient already has it.
Broderick recommends getting blood work done every three to four months after beginning testosterone therapy. Men taking testosterone have increased levels of red blood cells, which can lead to complications with circulation, depriving areas of the body of oxygen, and potentially put them at risk for cardiovascular problems.
On average, testosterone replacement therapy costs less than $40 a month. But many baby boomers, such as Freiburger, are using it as part of a more expensive holistic approach to staying healthy into their senior years, and they say it's worth the cost.
I would like to have as much quality of life and be as vital as I can as long as the Lord's going to have me on this earth, Freiburger says. I'm going to take the time and financial resources to try to make that a reality.
Testosterone is a hormone that increases sex drive, sperm production, bone density, and muscle mass. Many men worry about declining sex drive as they age-and for good reason. The Mayo Clinic reports that testosterone levels peak in early adulthood and drop about one percent (1%) each year after age 30 (Mayo Clinic, 2012).
Relationship Between Testosterone and Erectile Dysfunction
Although erectile function is clearly androgen dependent, is it just as clear at what level of testosterone erectile dysfunction (ED) begins? Does the decline in testosterone that occurs with aging always produce ED? Are exogenous androgens the answer to ED? The answers range from clear to complex.
Key words: Androgens, synthetic; Erectile dysfunction; Hypogonadism; Impotence; Testosterone ; Testosterone Replacement; Male HRT;
Of the major causes of erectile dysfunction (ED), disorders of the endocrine system are the rarest. Within this etiologic category, the most common cause of ED is hypogonadism. While logic dictates that treating this underlying endocrinopathy should reverse the ED, there is a lack of clinical evidence to support this expectation; ie, not all patients with ED and a low testosterone level have an improvement in erectile function when treated with exogenous androgen. Similarly, some patients with normal testosterone levels and ED who are given exogenous androgen therapy empirically report improvement in erectile function. This review will cover the relationship between testosterone and ED, highlighting what is known and unknown regarding the effect of testosterone on penile function, what to look for in the evaluation of the ED patient suspected of having a lower-than-normal serum testosterone level, and the methods currently available to treat patients with this hypogonadal condition.
Initial Evaluation of the Impotent Patient
The medical history and physical examination provide important clues to the cause of the patient's complaints and initially guide the physician to order the appropriate laboratory investigations (Table 1). For example, a history of diabetes may suggest a vasculopathy and/or neuropathy, certain dyslipidemic states may infer a vasculopathy, and chronic alcoholism and/or liver disease may induce a hyperestrogenic state, with a resultant low level of circulating free testosterone. A history of previous surgery on the pituitary (hyperprolactinemia) or thyroid gland (hyperthyroidism with increased binding globulin, resulting in a decrease in free testosterone levels), excess endogenous (Cushing syndrome) or exogenous (hypergonadism) steroid exposure, obesity (which causes a decrease in free testosterone levels), and various chronic diseases (AIDS, malnutrition) may also indicate or suggest endocrinopathy. A history of excess blood transfusions for certain hematologic diseases may lead to hemochromatosis, which, in turn, may interfere with testosterone production by the testes. Certain medications (such as antiandrogens, gonadotropin-releasing hormone agonists, cimetidine, ketoconazole, progestins, and cannabis) may alter the hypothalamic-pituitarytesticular axis and affect testosterone production or action. Finally, a history of testicular disorders (trauma, torsion, cryptorchidism, testicular cancer), particularly if these disorders have been bilateral, may affect testosterone production. In addition, many patients with low testosterone levels may complain only of loss of libido.
Conditions That May Indicate Endocrinopathy in the Male
The physical examination may provide important clues to endocrinopathy associated with hypogonadism. Normal pubertal development in the male will lead to axillary and pubic hair and a normal male escutcheon, normal temporal balding, and absence of gynecomastia. Palpation of the neck may reveal a goiter. Goiter may be associated with hyperthyroidism, which affects the binding of testosterone by proteins in the blood. The genitalia should demonstrate a normal phallus, with the meatus at the distal tip of the penis (no hypospadias) as well as bilaterally descended testes of normal size and consistency. The rectal examination should determine the size and consistency of the prostate, the bulbocavernosus reflex, and anal sphincter tone. Additional clues on the physical examination may be obtained by examining the skin for spider angiomas (liver disease) or excessive sweating (hyperthyroidism), by the presence of exophthalmos, or by finding a palpable thyroid (hyperthyroidism).
Role of Testosterone in Erectile Dysfunction or Impotence
Androgens have always been assumed to play a major role in male erectile function because: There is a decrease in serum testosterone levels with aging and a time period when the prevalence of ED increases.
Castration usually causes a decline in sexual function. Sexual function returns to normal in castrated (severely hypogonadal) men who undergo treatment with exogenous androgens.
Erections are clearly androgen-dependent, as evidenced by the observation that men with marked hypogonadism have a marked reduction in the frequency, amplitude, and rigidity of erections. However, the level of hypogonadism required to induce this ED is debatable.Tab to the next button to revert the control to an accessible version.Destroy user interface control10–Tab to the next button to revert the control to an accessible version.Destroy user interface control13 It is believed that normal adult testosterone levels are not required for normal erections to occur and that when this threshold of testosterone is reached, additional amounts do not further increase the frequency, amplitude, or rigidity of erections.
It is well accepted that there is a gradual, age-related decline in serum total and free testosterone levels in healthy adult men.
Cross-sectional studies have also demonstrated a significant increase in sex hormone- binding globulin (SHBG) concentrations in the aging male.
Thus, not only does total testosterone decline, but also a higher percentage of the remaining testosterone is bound tightly to SHBG, further reducing the amount of bioavailable (and bioactive) testosterone. Data demonstrate that the free testosterone levels at age 75 are 50% of those found in men at age 25.15 However, not all aged men have abnormal free testosterone levels, even though the levels may be half those of men much younger. While there is little debate on how to define hypogonadism in the young man, controversy still exists regarding the definition of hypogonadism in the aged individual. Does one compare the total testosterone values found in older men with those found in younger men? Or does one use the free testosterone level to determine hypogonadism, in which case about 50% of aged men will fall into this category?
The cause of the hypogonadism of aging is unclear and may be multifactorial. For example, some experimental evidence suggests that aging induces a Leydig cell dysfunction, while some studies demonstrate the possibility of a hypothalamic-pituitary defect.16–18 Korenman and associates identified an elevated sex steroid- binding globulin protein as the culprit in reducing bioavailable testosterone in elderly men. Measurement of gonadotropins and prolactin may assist in determining the type of hypogonadism (hypo- or hypergonadotropic) in any such individual.
The clinical signs and symptoms of hypogonadism in the aging male may be a decline in libido; a decrease in beard growth, muscle mass, and strength; a lack of energy; osteopenia; a decrease in cognition; irritability; and, occasionally, excessive sweating and hot flushes. It is generally accepted, however, that most elderly men seen for ED are clinically not hypogonadal and do not have a low serum testosterone level-even though these aging signs and symptoms are clearly similar to those seen in men with hypogonadism. This is the reason it is common for physicians to attribute at least part of these clinical indicators to the age-associated decrease in serum testosterone levels.
A Testosterone deficiency may be the cause of erectile dysfunction or symptoms of impotence. To find out, a man should get his hormone levels tested.
To learn more about treating ED with testosterone visit the Treat Low t & ED page Testosterone Therapy to Treat ED - Impotence in Men
While hypogonadism is the most common etiology of endocrinopathy causing ED, it is still one of the rarest causes. When free testosterone is measured in impotent patients, some investigators have found that between 20% and 40% of these men have low free testosterone levels; other investigators, however, have failed to corroborate these findings. It should be reiterated that while ED and hypogonadism are common conditions of the aging male, these 2 conditions may not be causally related.
If a low or borderline total testosterone level is obtained during the evaluation of ED patients (Table 2), a second measurement is recommended, because a substantial number of impotent patients with a low serum total testosterone level at a first determination have a normal level when the test is repeated. The reason for the low testosterone level can be ascertained further by measuring the bioavailable fraction of serum testosterone, luteinizing hormone (LH), and prolactin to determine whether the hypogonadism is hypogonadotropic or hypergonadotropic. Measuring gonadotropins is necessary to avoid missing many states of compensated testicular failure in which serum testosterone levels are usually normal. Measuring a single instead of pooled determination of LH samples is preferable and is a cost-effective approach. However, measurement of both gonadotropins, LH and follicle-stimulating hormone (FSH), rather than LH alone can be helpful in certain clinical situations.
Clinical Evaluation of Serum Testosterone Levels
In hypogonadotropic hypogonadism, in which the serum LH and FSH levels are low or are normal with a concomitant low serum testosterone level, the evaluation for identifying a cause of secondary hypogonadism should be mandatory and include a serum iron study, thyroid function tests, and a serum prolactin test (to check for a pituitary adenoma). Routine measurement of prolactin on the initial screening blood tests is usually not recommended; isolated hyperprolactinemia is rare, and most patients with hyperprolactinemia have abnormally low testosterone levels. Patients who present with the symptoms of hyperprolactinemia, such as decreased libido and headache, may have depressed testosterone levels suggestive of a prolactinoma that may be diagnosed by an MRI and/or CT scan.
Role of Thyroid on Testis Function and Testosterone Production
Thyroxin can affect the male reproductive system. Hyperthyroidism has been associated with an increase in total serum testosterone levels but with normal unbound or bioactive testosterone. This is caused by the increase in the SHBG levels associated with hyperthyroidism. The increase in SHBG causes a relative decrease in the free testosterone levels, which leads to an elevation of the serum LH (negative feedback), a further increase in serum testosterone and, by peripheral conversion, an increase in serum estradiol. As a result of the increase in circulating estrogens, these men with hyperthyroidism may complain of or present with gynecomastia, spider angiomas, and a decrease in libido.
Treatment of the thyrotoxicosis reverses the symptoms and signs of the disorder. In hypothyroidism, LH and FSH are usually elevated, which is consistent with testicular resistance to gonadotropins.
The serum testosterone and SHBG are usually decreased, while the free testosterone has been reported to be increased, decreased, or normal. Some men with hypothyroidism may complain of ED; in this setting, replacement with thyroxin rarely improves potency.
Treatment With Testosterone
The clinical signs of hypogonadism in elderly men with ED can be improved with androgen treatment, although erectile function may not improve. Therefore, in men who have normal or borderline levels of serum testosterone, exogenous androgens may be given for a time to determine the efficacy of the treatment for both ED and non-ED signs and symptoms. In our clinic, we treat such patients for 3 months with exogenous testosterone to determine whether there is an effect on either the ED or the clinical signs of hypogonadism (if present). If the ED is not reversed, which is common, and other aspects of hypogonadism are improved, it may be prudent to keep these men on exogenous testosterone as long as there are no contraindications to its use.
Contraindications to Androgen Treatment (Testosterone Replacement Therapy)
There is currently little clinical evidence that exogenous androgen treatment will directly lead to prostate disease. However, caution is advised in men with any history of cancer and or coronary disease and your physician should be consulted before starting any TRT program.
In spite of the clinical studies, androgen (testosterone) administration to men above age 50 requires careful monitoring of the prostate on behalf of a qualified physician.
A baseline digital rectal examination (DRE) and measurement of a prostate-specific antigen (PSA) level are recommended prior to starting exogenous androgen therapy. An abnormal DRE and/or an abnormal PSA requires further evaluation of the prostate to rule out prostate cancer before androgen therapy can be initiated.
Epidemiologic studies show that hypogonadal men are at higher risk for cardiovascular events than are normal men. Generally, there is an inverse correlation between testosterone levels and the atherogenic lipid profile, presence of atheromatosis,androgen supplementation within the physiologic range normalizes the lipid profile, probably by increasing insulin sensitivity, and decreases HDL cholesterol with little effect on LDL cholesterol and triglycerides(the latter 2 being well-known risk factors for atherosclerosis). Testosterone also has complex effects on both the coagulation and fibrinolytic profiles; supraphysiologic levels of testosterone, nonaromatizable anabolic steroids, or alpha alkylated androgens are clearly atherogenic and often may cause cardiovascular accidents.
As a result, blood hematocrit levels should be determined before starting exogenous androgen therapy. Men with severe coronary disease are not candidates for androgen therapy.
- Mimic diurnal patterns of adenogenous hormone secretion.
- Produce physiologic levels of not only testosterone but also its metabolites: dihydrotestosterone (DHT) and estradiol (E2).
- Be well tolerated, comfortable and convenient to use, and cost-effective. Medications available in the United States currently include oral, intramuscular, and transdermal agents (Table 4). Implantable testosterone pellets, while used abroad, are not currently available for treatment of patients in the United States.
Clinically Available Testosterone Preparations - (Testosterone Treatments)
Oral. Oral agents for testosterone replacement are clearly convenient and comfortable to use. Oral testosterone, however, is absorbed rapidly from the GI tract and circulates through the portal blood. Because of this portal circulation and rapid hepatic metabolism, only a small volume of testosterone is circulated, and only serum testosterone metabolites are raised. Most important, these agents have been reported to produce significant long-term hepatic toxicity. Oral testosterone does not reproduce the circadian pattern of testosterone production by the testes, nor does it achieve normal physiologic levels of DHT or estradiol.
An example of an active oral preparation is testosterone undecanoate; it is partially absorbed via the lymph, thus escaping first-pass hepatic inactivation. Testosterone undecanoate, unfortunately, is available only outside of the United States. Absorption and plasma levels achieved are variable, but the compound restores serum testosterone levels and improves libido in hypogonadal men. Plasma estradiol levels also rise to physiologic levels with oral testosterone undecanoate treatment.
The most effective of oral agents of testosterone are the 17α alkylated testosterones, such as methyltestosterone. These 17α alkylated testosterones may be administered either orally or buccally but, because of their high cost, minimal potency, and risk of hepatotoxicity, these types of oral androgens should not be used clinically for androgen replacement.
Parenteral. Intramuscular preparations of testosterone are effective in increasing serum testosterone levels, although they produce significant elevations immediately after administration and a very low nadir before repeat injection. These parenteral androgens do not provide the normal circadian pattern of testosterone, and the injections are uncomfortable at times. Intramuscular testosterone can be administered in its aqueous, unmodified form; however, its rapid absorption and degradation make this form unsatisfactory for testosterone replacement. Similarly, while restoring serum DHT levels, estradiol levels may be excessive in patients with high testosterone levels after injection of aqueous, unmodified testosterone.
The 17β-hydroxyl esters of testosterone, however, are modifications of aqueous testosterone that are more widely used, can be administered with slow-release injection vehicles, and are more useful for testosterone replacement therapy. These 17β hydroxyl esters lack inherent androgenic activity and must be hydrolyzed to testosterone before they become active. Parenteral preparations of testosterone are usually administered in an oil-based vehicle, such as cottonseed or sesame oil. In the United States, the 17β-hydroxyl esters of testosterone include the short-acting testosterone propionate and longer-acting testosterones enanthate and cypionate. Because of the short activity of testosterone propionate, it is impractical to use; it must be injected every second day to maintain serum testosterone levels. In men requiring testosterone replacement, testosterones enanthate and cypionate may be administered every 2 to 3 weeks to maintain normal average testosterone levels.
There are, however, surges in the serum testosterone level about 1 to 2 days after administration, sometimes reaching serum levels as high as 1400 ng/dL, which then decline over 14 to 21 days, reaching a nadir approximately at day 21. Because of these significant peaks and valleys in serum testosterone levels, patients may have mood swings and significant changes in sexual function.
Testosterones enanthate or cypionate may be administered in doses of 200, 300, or 400 mg every week, or 2 to 4 weeks depending on your physicians TRT protocol. The 200-mg injections maintain normal testosterone levels for approximately 2 weeks, while 300-mg levels will maintain serum testosterone levels in the eugonadal range for approximately 3 weeks. The 400-mg doses, while obtaining higher peak values, will not maintain eugonadal levels beyond the 3-week limit. In hypogonadal men, these agents will produce an improvement in libido, sexual function, potency, energy level, and mood if these abnormalities are due to the androgen depletion. Increased sexual aggressiveness and overall aggressive behavior during peak levels of injectable testosterone have been reported, and careful counseling about these mood and behavioral changes in patients undergoing injectable testosterone therapy is essential. These adverse effects are rare, however, and testosterone enanthate has become the most widely used agent for exogenous testosterone replacement in the United States. It is safe, cost-effective, and convenient.
Besides aggression, there are other side effects from androgen therapy, such as the development of an atherogenic lipid profile, insulin resistance, polycythemia, sleep apnea, fluid retention, acne, and hypertension. Supraphysiologic levels of testosterone in the blood lead to increased peripheral aromatization of testosterone to estradiol, and this may produce gynecomastia.
Patches. Because of concern that supraphysiologic levels of testosterone play a major role in the development of side effects from testosterone treatment, transdermal testosterone patches, notwithstanding their high cost, avoid supraphysiologic levels of testosterone and restore the normal diurnal testosterone pattern. Another advantage of the patch over the injection is that if and when any disturbing side effects from testosterone occur, the patches can be removed immediately.
Transdermal testosterone is currently available as a scrotal or nonscrotal patch. Transdermal vehicles use unmodified testosterone and are an alternative to intramuscular or oral medications. When applied prior to bedtime, these transdermal patch systems provide normal testosterone levels with diurnal variations in a physiologic fashion. Peak testosterone levels are achieved in the early morning, with a nadir prior to bedtime. While the scrotal patch (Testoderm) requires scrotal shaving weekly and increases DHT levels somewhat beyond the normal range, normal physiologic serum testosterone levels can be obtained. The nonscrotal transdermal patch (Androderm) also maintains a diurnal serum concentration curve with normal testosterone, estradiol, and DHT levels. Because testosterone levels do not increase beyond normal, the mood swings and aggressiveness that sometimes occur with intramuscular testosterone should not be seen with the transdermal preparations. While long-term studies are still unavailable on these issues, a smoother, more natural serum testosterone level can be obtained with the patches. Transdermal systems, however, are much more expensive than the parenteral preparations.
Clinical studies of these transdermal preparations demonstrate improved sexual function, libido, and nocturnal penile tumescence response, with normal hematocrit, lipid, and PSA levels. The side effect of dermatitis makes the transdermal agents inappropriate for some men.
Testosterone Deficiency & Treatment Summary
Hypogonadism is the most common cause for endocrinopathy leading to ED, although the endocrine disorders themselves are some of the rarest of all causes of ED. Most men experience a lowering of their serum testosterone levels with age, but these levels usually are not low enough to induce ED. When hypogonadism is suspected of causing ED, treatment with exogenous androgens is recommended if there are no contraindications to its use in this setting. If the ED does not resolve after a finite time of treatment with the exogenous testosterone, other causes (vascular and/or neurologic) must be suspected. Even men with normal serum testosterone levels may require or request exogenous testosterone therapy because of other constitutional symptoms. Patients on long-term androgen therapy require follow-up of their PSA, hematocrit, and liver enzymes about every 6 to 12 months.
- Although endocrinopathy is a rare cause of erectile dysfunction (ED), within that category, hypogonadism is the most common.
- Normal adult testosterone levels are not necessary for normal erections.
- There is a gradual decline with age of total and free testosterone levels in healthy men.
- ED and hypogonadism are common in the aging male, but they may not be causally related.
- Treatment with exogenous androgens may produce clinical improvement in the signs of hypogonadism but may not improve sexual function.
- Men with hypogonadism are at higher risk for cardiovascular events than are normal men.
- A testosterone replacement treatment should mimic diurnal patterns of testosterone production, produce physiologic levels of testosterone and its metabolites, be well tolerated, and be cost-effective to use.
For more ED (Male Impotence) Treatment info visit Treatments for Erectile Dysfunction, Low T and Male Impotence
Testosterone Information References - Latest Hormone Therapy News Citations
1. Johnson AR, Jarow JP. Is routine endocrine testing of impotent men necessary? J Urol. 1992;47:1542–1543. [PubMed]
2. Morley JE, Kaiser FE, Perry HM, et al. Longitudinal changes in testosterone, luteinizing hormone and follicle stimulating hormone in healthy old men. Metabolism. 1997;46:410–413. [PubMed]
3. Tenover JL. Testosterone and the aging male. J Androl. 1997;18:103–106. [PubMed]
4. Rousseau L, Dupont A, Labrie F, Couture M. Sexuality changes in prostate cancer patients receiving antihormonal therapy combining the antiandrogen flutamide with medical (LHRH agonist) or surgical castration. Arch Sex Behav. 1988;17:87–98. [PubMed]
5. Bagatelle C, Heiman JR, Rivier RE, Bremmer WJ. Effects of endogenous testosterone and estradiol on sexual behavior in normal young men. J Clin Endocrinol Metab. 1994;78:711–716. [PubMed]
6. Davidson JM, Camargo CA, Smith ER. Effects of androgen on sexual behavior in hypogonadal men. J Clin Endocrinol Metab. 1979;48:935–941. [PubMed]
7. Morales A, Johnston B, Heaton JP, Lundie M. Testosterone supplementation for hypogonadal impotence: assessment of biochemical measures and therapeutic outcomes. J Urol. 1997;157:849–854. [PubMed]
8. Carani C, Zini D, Baldini A, et al. Testosterone and prolactin: behavioural and psychophysiological approaches in men. In: Bancroft J, et al., editors. The Pharmacology of Sexual Function and Dysfunction. Amsterdam: Elsevier Science; 1995. pp. 145–150. (Esteve Foundation Symposia, vol 6. Excerpta Medica).
9. Rosen RC. Pharmacological effects on nocturnal penile tumescence (NPT) In: Bancroft J, editor. The Pharmacology of Sexual Function and Dysfunction. Amsterdam: Elsevier Science; 1995. pp. 277–287. (Esteve Foundation Symposia, vol 6. Excerpta Medica).
10. Buena F, Swerdloff R, Steiner BS, et al. Sexual function does not change when serum testosterone levels are pharmacologically varied within the normal male range. Fertil Steril. 1993;59:1118–1123. [PubMed]
11. Salminies S, Kockott G, Pirke KM, et al. Effects of testosterone replacement on sexual behavior in hypogonadal men. Arch Sex Behav. 1982;11:345–353. [PubMed]
12. O'Carroll R, Bancroft J. Testosterone therapy for low sexual interest and erectile dysfunction in men: a controlled study. Br J Psychiatry. 1984;145:146–151. [PubMed]
13. Anderson RA, Bancroft J, Wu FC. The effects of exogenous testosterone on sexuality and mood of normal men. J Clin Endocrinol Metab. 1992;75:1503–1507. [PubMed]
14. Vermeulen A, Kaufman JM. Ageing of the hypothalamo-pituitary-testicular axis in men. Horm Res. 1995;43:25–28. [PubMed]
15. Vermeulen A, Kaufman JM, Giagulli VA. Influence of some biological indices on sex hormone binding globulin and androgen levels in aging and obese males. J Clin Endocrinol Metab. 1996;81:1921–1927. [PubMed]
16. Davies TF, Gomez-Pan A, Watson MJ, et al. Reduced gonadotrophin response to releasing-hormone after chronic administration to impotent men. Clin Endocrinol. 1977;6:213–218. [PubMed]
17. Deslypere JP, Kaufman JM, Vermeulen T, et al. Influence of age on pulsatile luteinizing hormone release and responsiveness of the gonadotrophs to sex hormone feedback. J Clin Endocrinol Metab. 1987;64:68–73. [PubMed]
18. Vermeulen A, Kaufman JM. Role of the hypothalamo- pituitary function in the hypoandrogenism of healthy aging. J Clin Endocrinol Metab. 1992;75:704–706. [PubMed]
19. Korenman SG, Morley JE, Mooradian AD, et al. Secondary hypogonadism in older men: its relation to impotence. J Clin Endocrinol Metab. 1990;71:963–969. [PubMed]
20. Buvat J, Lemaire A. Endocrine screening in 1022 men with erectile dysfunction: clinical significance and cost-effective strategy. J Urol. 1997;158:1764–1767. [PubMed]
21. Pirke KM, Kockott G, Aldenhoff J, et al. Pituitary gonadal system function in patients with erectile impotence and premature ejaculation. Arch Sex Behav. 1979;8:41–48. [PubMed]
22. Maatman TJ, Montague DK. Routine endocrine screening in impotence. Urology. 1986;27:499–502. [PubMed]
23. Wheeler MJ. The determination of bio-available testosterone. Ann Clin Biochem. 1995;32:345–357. [PubMed]
24. Rosner W. Errors in the measurement of plasma testosterone. J Clin Endocrinol Metab. 1997;82:2015–2015. [PubMed]
25. Kidd GS, Glass AR, Vigersky RA. The hypothalamic-pituitary-testicular axis in thyrotoxicosis. J Clin Endocrinol Metab. 1979;48:798–802. [PubMed]
26. Worstman J, Rosner W, Dufau ML. Abnormal testicular function in men with primary hypothyroidism. Am J Med. 1987;82:207–212. [PubMed]
27. O'Carroll R, Bancroft J. Testosterone therapy for low sexual interest and erectile dysfunction in men: a controlled study. Br J Psychiatry. 1984;145:146–151. [PubMed]
28. Buvat J, Lemaire A, Buvat-Herbaut M. Human chorionic gonadotropin treatment of nonorganic erectile failure and lack of sexual desire: a double-blind study. Urology. 1987;30:216–219. [PubMed]
29. Morales A, Johnston B, Heaton JP, Lundie M. Testosterone supplementation for hypogonadal impotence: assessment of biochemical measures and therapeutic outcomes. J Urol. 1997;157:849–854. [PubMed]
30. Guay AT, Bansal S, Heatley GJ. Effect of raising endogenous testosterone levels in impotent men with secondary hypogonadism: double blind placebo-controlled trial with clomiphene citrate. J Clin Endocrinol Metab. 1995;80:3546–3552. [PubMed]
31. Morales A, Bain J, Ruijs A, et al. Clinical practice guideline for screening and monitoring male patients receiving testosterone supplementation therapy. Int J Impot Res. 1996;8:95–97. [PubMed]
32. Tenover J. Effects of androgen administration in the ageing male. In: Oddens BJ, Vermeulen A, editors. Androgens and the Ageing Male. New York: Parthenon Publishing Group Inc; 1997. pp. 191–204.
33. Jackson JA, Waxman J, Spiekerman AM. Prostatic complications of testosterone replacement therapy. Arch Intern Med. 1989;149:2365–2366. [PubMed]
34. Curran MJ, Bihrle W. Dramatic rise in prostatespecific antigen after androgen replacement in a hypogonadal man with occult adenocarcinoma of the prostate. Urology. 1999;53:423–424. [PubMed]
35. Bagatell CJ, Bremner WJV. The effects of aging and testosterone on lipids and cardiovascular risk. J Clin Endocrinol Metab. 1998;83:3340–3341.
36. Marin P, Lonn L, Andersson B, et al. Assimilation of triglycerides in subcutaneous and intraabdominal adipose tissue in vivo in men: effects of testosterone. J Clin Endocrinol Metab. 1996;81:1018–1022. [PubMed]
37. Phillips GB, Pinkernell RH, Jing TY. The association of hypotestosteronemia with coronary artery disease. Arterioscler Thromb. 1994;14:701–706. [PubMed]
38. Zmuda JM, Thompson PD, Dickinson R, Bausserman LL. Testosterone decreases lipoprotein(a) in men. Am J Cardiol. 1996;77:1244–1247. [PubMed]
39. Glazer G. Atherogenic effects of anabolic steroids on serum lipids. Steroids. 1991;151:1925–1933. [PubMed]
40. Barrett-Connor E, Khaw KS. Endogenous sex hormones and cardiovascular disease in men: a prospective population based study. Circulation. 1988;78:539–545. [PubMed]
41. Haffner LM. Androgens in relation to cardiovascular disease and insulin resistance in aging men. In: Oddens BJ, Vermeulen A, editors. Androgens and the Ageing Male. New York: Parthenon Publishing Group Inc; 1997. pp. 65–93.
42. Tenover JS. Effect of testosterone supplementation in the aging male. J Clin Endocrinol Metab. 1992;75:1092–1098. [PubMed]
43. Morales A, Johnston B, Heaton JW, Clark A. Oral androgens in the treatment of hypogonadal impotent men. J Urol. 1994;152:1115–1118. [PubMed]
44. Bagheri SA, Boyer JL. Peliosis hepatis associated with androgenic-anabolic steroid therapy; a severe form of hepatic injury. Ann Intern Med. 1974;81:610–618. [PubMed]
45. Benkert O, Witt W, Adam W, Leitz A. Effects of testosterone undecanoate on sexual potency and the hypothalamic-pituitary-gonadal axis of impotent males. Arch Sex Behav. 1979;8:471–480. [PubMed]
46. Wilson JD, Griffin JE. The use and misuse of androgens. Metabolism. 1980;29:1278–1295. [PubMed]
47. Nankin HR, Lin T, Osterman J. Chronic testosterone cypionate therapy in secondary impotence. Fertil Steril. 1986;46:300–307. [PubMed]
48. Wu FC, Farley TM, Peregoudov A, Waites GM. Effects of testosterone enanthate in normal men: experience from a multicenter contraceptive efficacy study. WHO task force on methods for the regulation of male fertility. Fertil Steril. 1996;65:626–636. [PubMed]
49. Krauss DJ, Taub HA, Lantiga LJ. Risks of blood volume changes in hypogonadal men treated with testosterone enanthate for erectile impotence. J Urol. 1991;146:1566–1570. [PubMed]
50. Rakic Z, Starcevic V, Starcevic VP, Marinkovic J. Testosterone treatment in men with erectile disorder and low levels of total testosterone in serum. Arch Sex Behav. 1997;26:495–504. [PubMed]
51. Vermeulen A. Clinical review 24. Androgens in the aging male. J Clin Endocrinol Metab. 1991;73:221–224. [PubMed]
52. Arver S, Dobs AS, Meikle AW, et al. Improvement of sexual function in testosterone deficient men treated for 1 year with a permeation enhanced testosterone transdermal system. J Urol. 1996;155:1604–1608. [PubMed]
53. Weksler M. Hormone replacement therapy for men: has the time come? Geriatrics. 1995;50:52–55. [PubMed]
Testosterone News: The Heart and Testosterone Article
Higher Testosterone May Equal Lower Heart Risks
Elderly men with naturally higher levels of testosterone may be less likely to suffer a heart attack or stroke than those men with lower levels of the hormone, according to a study. Findings published in the Journal of the American College of Cardiology showed that of 2,400 Swedish men in their 70s and 80s, those with the highest testosterone levels were less likely to suffer a heart attack or stroke over the next several years than men with the lowest levels.
But the results do not prove that testosterone itself deserves the credit, and it's too soon to recommend testosterone replacement to try to lower heart risks.
What we can say is that elderly men with high testosterone levels are relatively protected against cardiovascular events, and therefore lower testosterone is a marker for increased cardiovascular risk, said Asa Tivesten, at Sahlgrenska University Hospital in Goteborg, Sweden , who led the testosterone study.
What seems to be evident, is that very low testosterone levels are found in men with heart disease and that too much testosterone is also not healthy for men with heart disease. Testostene appears to have a beneficial effect on cholesterol and on smoothing or making the arterial walls more pliable, therefore
helping to reduce somewhat the risks due to hardening of the arteries through plaque build-up. It would appear that optimal levels of testosterone (neither too much or too little) are the most beneficial for men.
It's known that any serious health condition can lower testosterone levels, as can obesity. But in the study, the researchers accounted for a number of health factors including the men's weight, blood pressure and any diagnoses of diabetes, heart disease or stroke at the outset.
Of 604 men in the bottom quarter for levels of the male hormone at the studies start, 21 percent had a heart attack, severe chest pain or stroke over roughly five years.
That compared with roughly 16 percent of the 606 men who started out with the highest testosterone levels.
Even accounting for health factors, men in the highest-testosterone group still showed a 30 percent lower risk of heart disease or stroke compared with the other three-quarters of the study group.
But that doesn't rule out the possibility that something other than testosterone may be at work, said JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital in Boston, who was not involved in the study.
"Low testosterone may be a marker of other health conditions that put men at higher risk of cardiovascular disease," she said.
So seeking testosterone replacement therapy may be a viable option for many aging men.
Potential reasons for why higher natural testosterone levels may be good for the heart include the fact that higher testosterone generally means less body fat and more lean muscle.
What's needed, she added, is evidence from clinical trials that actually test whether testosterone replacement in older men cuts the risk of heart disease and stroke.
Those trials are ongoing and so far, she noted, the results are mixed on whether testosterone replacement improves "intermediate" outcomes like cholesterol or blood sugar levels.
No one yet knows if it affects the ultimate outcomes of cardiovascular disease and lifespan.
There are many unanswered questions, and I don't think this means that men should be trying to boost their testosterone with testosterone replacement therapy, she said.
The experience with hormone replacement therapy (HRT) in women offers a cautionary tale.
Before 2002, many women used HRT in the hopes of warding off heart disease and osteoporosis. Then a large U.S. clinical trial found that women given pills containing estrogen and progesterone actually had higher risks of blood clots, heart attack, stroke and breast cancer than women given placebo pills.
Now HRT or TRT is largely used only for treating severe hot flashes -- and then, only at the lowest dose and for the shortest time possible.
So there are concerns about the risks in men, Manson said. Among those are the potential for testosterone to contribute to blood clots, liver damage or prostate cancer.
This is a study of endogenous (natural) hormone production. It does not provide information about what is happening when hormones are given as a therapy, Tiveston said.
- Testosterone News Article from Reuters Health.
Testosterone Levels Affect Overall Health - News Article
Low testosterone levels in men are linked to increased risk of premature death.
Health warning signs of low testosterone are manifested beyond simple loss of libido or sex drive. Testosterone deficiency an pose a serious health issue for men.
The latest research suggests that aging men without enough of the hormone face a higher risk of several serious illnesses, including diabetes, osteoporosis, and cardiovascular disease.
A simple blood test can reveal whether a guy has low "T," or hypogonadism a symptom of andropause in men, but there are plenty of other clues that a problem exists.
Testosterone is what fuels a man's sex drive. If he's low on "T" he's likely to become less interested in having sex. Testosterone is what's responsible for sexual desire, says Dr. Abraham Morgentaler, associate clinical professor of medicine at Harvard Medical School and the author of "Testosterone for Life."
He says men differ in how frequently they like to have sex. But for men with low testosterone, he says, "It's completely absent."
Testosterone and Erectile Dysfunction in Men
Erections are triggered by the body's release of a tiny molecule called nitric oxide. But testosterone is what's needed to trigger this release, and if there's not enough of it, well, nothing much happens down below.
Either erections are impossible, or they're not firm enough for sexual intercourse.
That is why some men who take Viagara®, Cialis® or Levitra® still can't have firm enough erections and may seek alternative forms of hormone replacement.
Health News Florida Article - Testosterone and the Heart
There's new evidence that widely prescribed testosterone drugs - touted for men with flagging libidos and general listlessness - might increase the risk of heart attacks.
A study of more than 55,000 men found a doubling of heart attack risk among testosterone users older than 65, compared with men who didn't take the drug.
This testosterone study needs to be balanced with findings that have shown testosterone to improve cardiovascular health and arteriosclerosis.
The research was inspired by a smaller study published in 2010 that hinted at an elevated risk among frail, older men who were on testosterone replacement therapy. The earlier study was halted ahead of schedule because of a higher rate of heart attacks, strokes and other cardiovascular problems.
What's new, says William Finkle, lead author of a study published Wednesday by PLOS ONE, is that in men younger than 65 with known heart disease, "we also found a twofold increase in risk of non-fatal heart attack shortly after initiation of testosterone therapy."
Non-users had a risk of heart attack of 5 per 1,000 men followed for 1 year, while testosterone users older than 65, and those under 65 with known heart disease, had an absolute risk of 10 per 1,000 patient years. These numbers were adjusted to account for other health issues, including high blood pressure, diabetes and smoking.
As men age, their production of testosterone falls. For some, testosterone drops so low that it becomes a medical problem. But millions of U.S. men use testosterone drugs as lifestyle drugs, resorting to replacements to reverse a natural decline. In a sign of the drugs' popularity, sales of AbbVie's Androgel, the leading testosterone replacement, surpassed Viagra's in 2012.
In one frequently aired TV ad, a youthful-looking 50-something man owns up to having "low T," which his doctor discovered after he complained of sagging energy and irritability. After taking Androgel, he's back in the swing of things, the ad suggests, riding around in a convertible with a younger-looking woman.
With such inducements (and common symptoms), some specialists worry that many men are being prescribed testosterone drugs even if they have normal levels of the male sex hormone. The drugs cost around $300 to $400 a month, but companies are offering to cover patients' insurance copayments or are giving away the first month's supply.
In addition to the new study and the one in 2010, a Veterans Affairs study last November found a higher rate of heart attacks, strokes and deaths among 1,223 men taking testosterone therapy, compared with 7,486 who didn't get the hormone treatment.
Finkle, who's with a California firm called Consolidated Research, tells Shots that "the risk of heart attack should be added to the discussion between patients and physicians" before anyone starts testosterone treatment.
He also says the Food and Drug Administration should require a warning on the labels of testosterone drugs such as Androgel and Axiron. "We have a 2010 study that was canceled because of unexpected cardiovascular risk," he tells Shots. "I think that was sufficient to justify a warning. Why withhold that from the patient?"
Dr. Sidney Wolfe, of the Health Research Group, tells Shots that his consumer advocacy organization plans to petition the FDA, asking for a strong warning on the instructions for testosterone drugs. The group also intends to ask the FDA to hold off on a long-acting, injectable form of testosterone called Aveed. The agency is expected to make a decision on the drug in February.
But at least one advocate of testosterone therapy says the evidence of risks is overblown and poorly founded. "It feels almost like it's open season on testosterone," Boston urologist Abraham Morgentaler tells Shots. "None of the studies is very impressive."
Morgentaler, author of Testosterone for Life, published by Harvard Health Books, says authors of the latest study "have made the classic mistake of confusing treatment for a condition with the condition. There's a rich literature spanning more than 20 years that shows low testosterone itself is a risk factor for cardiovascular events."
He also criticizes the new study for not following patients long enough, and notes that the rate of heart attacks among testosterone users was low.
It's "high time" for a study of testosterone therapy involving a large number of men who are followed for years, Morgentaler says, similar to the Women's Health Initiative study on postmenopausal estrogen supplements.
There is potential for testosterone to be important for general health and longevity," Morgentaler says. "There's strong evidence it increases muscle strength and decreases fat - things we would associate with improved health.
But large, lengthy studies cost hundreds of millions of dollars. And in the case of estrogen replacement, that sort of research ultimately discredited the long-held belief that taking hormone supplements lowers the risk of heart attacks.
Visit the Florida Testosterone Page to find Testosterone Replacement Therapy In Florida.
AP Health News Article - Testosterone Safety Review
WASHINGTON - The Food and Drug Administration said Friday it is reviewing the safety of popular testosterone drugs for men in light of recent studies suggesting they can increase the risk of heart attack, stroke and death.
A study published earlier this week suggested testosterone therapy could double the risk of those problems in men older than 65. Another study published in November found that the hormone increased the risk by 30 percent.
The FDA said it is evaluating information from those studies and others but hasn't yet reached any conclusion.
The investigation comes amid an advertising blitz for testosterone gels, patches and injections marketed for low sex drive, fatigue and other age-related ailments in men.
U.S. prescriptions for testosterone have increased more than five-fold in recent years, with sales over $1.6 billion.
These findings should be balanced with other clinical studies that have demonstrated that men with heart disease die sooner if their testosterone levels are low.
Those studies made clear that Low Testosterone is indeed a risk marker for heart disease in men and it appears low testosterone predicts worse outcomes in men who already have heart disease.
What those studies show is that low testosterone can identify men at risk of heart disease.
What still isn't clear, however, is whether testosterone deficiency causes, simply identifies or worsens heart disease in men and to what extent testosterone replacement therapy would help improve or further prevent heart disease.
It is not yet known whether normalizing testosterone levels will reduce the excess heart attack risk but many studies have shown that men do feel better.
Only properly conducted clinical trials can prove whether hormone replacement therapy can improve heart health.
many physicians do warn that too much testosterone is clearly a heart risk, and that the goal of testosterone replacement should be to approximate or optimize T levels, not to exceed normal testosterone levels.
Testosterone injections have long been used for men with hypogonadism, a disorder defined by low testosterone caused by injury or infection to the reproductive organs.
But the latest marketing push by drugmakers is for easy-to-use gels and patches that are aimed at a much broader population of otherwise healthy older men with low levels of testosterone, the male hormone that begins to decline in the body after age 40.
Drugmakers and many doctors claim testosterone therapy can reverse some unpleasant of the signs of aging ranging from insomnia to erectile dysfunction. Those claims are mostly based on short-term studies.
The National Institute on Aging is currently conducting a long-term, 800-man trial to definitively answer whether testosterone therapy improves walking ability, sexual function, energy, memory and blood cell count in men 65 years and older.
Meanwhile the market for testosterone replacements has grown increasingly crowded.
The top-selling product in the field is Abbvie's Androgel®, which is applied to the shoulders and arms. Watson Pharmaceuticals markets the Androderm patch, which slowly releases testosterone into the bloodstream. Fortesta is another testosterone gel from Endo Pharmaceuticals, and Eli Lilly's Axiron is an underarm gel that rolls on like deodorant.
Paddock and Pfizer are the leading brand name suppliers of Testosterone Cypionate and Enanthate Intramuscular Injections.
Study Raises Questions About Testosterone Therapy
Too much Testosterone increases risk but it seems so does too little.
(HealthDay News), research suggests that men who take testosterone supplements after undergoing a minor cardiac procedure are more likely to suffer strokes, heart attacks or die.
But it's not clear if there's truly an extra risk for these men and urologists aren't calling for caution beyond the usual warnings about potential overuse of testosterone supplements.
Doctors mostly agree that too much testosterone is not a healthy thing and that testosterone treatment should entail increasing testosterone to normal levels not superseding normal levels.
The investigators simply do not know all of the potential differences between the men who were treated with testosterone and those who were not, said Dr. Bradley Anawalt, an endocrinologist and chief of medicine service at the University of Washington Medical Center in Seattle. He was not involved with the study.
VA Eastern Colorado Health Care System cardiologist Dr. P. Michael Ho, a study co-author, acknowledged that the results don't confirm that testosterone supplements are especially risky for men with suspected heart problems. However, "this hopefully provides information that doctors can use when they discuss with their patients about whether to start or continue testosterone therapy.
Testosterone therapy has become a hot topic in doctor's offices in recent years as late-night TV ads (Low T Commercials) warn male viewers that Low T could explain fatigue and low libidos. A study earlier this year found that the use of testosterone therapy by U.S. men aged 40 and up tripled between 2001 and 2011.
Some urologists and endocrinologists warn that doctors are over-prescribing the supplements, which can cost thousands of dollars a year and are linked to side effects such as blood clots, male breast growth and infertility.
Keep in mind that many complications from testosterone replacement may be caused due to improper dosage, incomplete protocols and inexperience on the part
of a particular endocrinologist or urologist in diagnosing and treating hypogonadism, andropause or LOW T
In the new study, researchers looked at the medical records of more than 8,700 men in the United States who underwent angiographs, a procedure that uses scans to examine blood flow in the body. Angiographs are different from angiograms, in which doctors send catheters up into an artery to determine whether blood vessels are clogged.
All of the men in the study had testosterone levels that were considered to be on the low side; on average, the men were in their early 60s. A total of 1,223 of the men used testosterone therapy after their angiographs.
The researchers tracked the men for an average of 28 months and adjusted the study's statistics so they wouldn't be thrown off by high or low numbers of men with heart disease (almost all had signs of it). The investigators found that the men in the study were about 30 percent more likely to suffer a heart attack or stroke and to die after going on testosterone therapy, although these conditions weren't extremely common overall. (Nine percent of the men died.)
The study has limitations. It's not clear why men who went on testosterone therapy sought it in the first place. And the study didn't examine the benefits that the treatment could have brought to the men in terms of things like their sex lives, energy levels and overall happiness.
Study co-author Ho pointed out that the researchers tried to account for the possible effect of health conditions such as diabetes. It's conceivable that testosterone supplements could worsen sleep apnea and boost the risk of blood clots, he suggested.
Dr. John Amory, a professor of medicine at the University of Washington Medical Center, said the findings shouldn't worry people because they could easily be misleading. But they do point to the importance of research that will do a better job of identifying any risks from testosterone supplements. "The final verdict will wait," he said.
Amory added that testosterone treatment is definitely a good idea in certain cases, such as in a young man who's lost his testicles to cancer. In other men, especially those who are older and sicker, it's not as clear that the benefits outweigh the risks, he said.
The study appears in the Nov. 6 issue of the Journal of the American Medical Association.
Testosterone Injections Help Men with Low T Symptoms Regain Vitality
South Florida Testosterone Article - Doctors urge caution as clinics for men with Low-T thrive
Middle-aged men seeking to restore their energy and sex drive are flocking to South Florida clinics promising renewed vigor through testosterone, the male sex hormone.
Influenced by an abundance of television commercials, Internet ads and billboards asking if they have Low-T, many say they had been depressed about the aging process and were seeking a way to regain the stamina they miss from their youth.
Low Testosterone levels in men can cause hormone related health problems that testosterone replacement therapy can help alleviate. It is
for this reason men are starting to become increasingly interested in the available hormone therapy options available to them.
They say the hormone has revived their endurance and virility, although some doctors caution that extra testosterone can have side effects and could cause long-term problems that have not yet been thoroughly studied.
Such warnings have not deterred enthusiasts such as Skip Guarniere, a Delray Beach fitness trainer, who believes his weekly injection makes him lively and fit.
A year ago, Guarniere said, he had lost his libido, was unable to sleep and felt listless. He had his testosterone checked at Core Institute, an anti-aging clinic in Delray Beach.
His level was 190, below the 300 to 1,200 range doctors consider ideal. Guarniere said he began to sleep better and get his energy back after just a few weeks of injections, administered by his mother, a nurse.
Men taking testosterone under a doctor's supervision say they are different from athletes and bodybuilders who use anabolic steroids, a synthetic form of testosterone whose non-medical use is illegal and banned by major sports bodies.
Several fraudulent clinics have been shut down over the past few years, including a Deerfield Beach center that provided steroids to eight Broward sheriff's deputies.
I'm not trying to be Arnold Schwarzenegger," said Guarniere, a divorced father of two. "I just want to be normal and healthy.
Men's production of testosterone - needed for bone strength, muscle mass and sperm production - begins a gradual ebb around age 40. This decline, often called "andropause," can cause depression, night sweats and fatigue, symptoms similar to women's menopause.
Concern about the symptoms of aging used to be the province of women, some of whom get plastic surgery, take hormone supplements and try Pilates to maintain their good looks. But now that baby boomers are beginning to age en masse, medical and business establishments are discovering a growth industry in men who also seek to slow their degeneration.
They want to stay young forever, said Dr. Angelos Manganiotis, a urologist and chief of surgery at Boca Raton Regional Hospital. "Men are later to this issue than women are."
Although he has a traditional urology practice, Manganiotis said a growing number of patients have been asking him about testosterone injections and gels. A few years ago, when research showed appropriate supplementing of testosterone had few risks when a man's fertile years were over, he began to offer it to patients who had their prostates checked and showed extremely low levels in their blood.
There still are several potential dangers, though, including stroke, testicular atrophy and prostate cancer, Manganiotis said.
Testosterone Costs vary widely, but most clinics charge about $150 to $400 a month for treatment and monitoring. Dr. Ferdinand Cabrera of Genesis Health Institute, an anti-aging center in Wilton Manors, said he charges $350 for a consultation and $750-$1,200 for a five-month supply, whether it's an injection, cream or pellet under the skin.
He said his testosterone business has been increasing about 10 percent a year for the past five years.
Sidney Gordon, founder of Core Institute, said he gets about 25 new testosterone patients each week, up from 15 a week three months ago. Gordon, 34, began taking testosterone at 28, when he suffered from low libido, loss of appetite and stress.
Once you get your hormones balanced, you can begin to tackle the issues in your life, he said.
Do you have Low T ? Men with these symptoms may have low testosterone. Decreased sex drive, Impotence, Low sperm count, Increased breast size,
Hot flashes, Irritability, Depression, Source: National Institutes of Health
To explore more about Low Testosterone Treatments including doctors and clinics providing Low T Replacement Therapy, visit - Testosterone Replacement Therapy.
Perrigo Approved for Testosterone Gel 1%
Testosterone Drug News | February 5, 2015 -
Perrigo announced that it has received approval from the FDA for its New Drug Application (NDA) for Testosterone Gel 1%, the generic version of AbbVie's AndroGel 1%.
AndroGel is a Schedule III controlled substance requiring a prescription, it is an androgen drug indicated for testosterone replacement therapy in adult males.
Endogenous androgens, including testosterone and dihydrotestosterone (DHT), are responsible for the normal growth and development of the male sex organs and for maintenance of secondary sex characteristics.
To learn more about the different types of testosterone drugs and Low T medications visit - Testosterone Drug Medications for Low T & ED
Endocrine Society talks about recent Testosterone Studies and Heart Disease
Testosterone Therapy News | February 27, 2015
Specialists in hormonal therapy at the Endocrine Society said the risks and benefits of testosterone supplements for older men with age-related declines in testosterone levels must be investigated more carefully.
This view concurs with the FDA's view that the safety of testosterone treatments for men with a history of heart disease should be better studied.
The Endocrine Society issued the warning after three recent studies revealed testosterone may not be safe for older men with a history of heart disease. The studies found these men had more heart-related events than men not on testosterone therapy.
For example, in one study published recently in the journal PLoS One, an increased risk of heart attack was found in men younger than 65 with a history of heart disease, and in older men even if they didn't have a history of the disease.
Testosterone therapy has been widely advertised (you have seen the Low T Commercials on TV and the internet) as a way to help aging men improve low sex drive and reclaim diminished energy, and use of the supplements is on the increase.
Although the FDA approved testosterone therapy for the treatment of diseases involving the testes, pituitary and hypothalamus, it has not been approved for treating age-related declines in testosterone levels.
Earlier this month, the FDA announced it is investigating the risk of stroke, heart attack and death in men taking FDA-approved testosterone products, based on the recent studies.
This is an important study because some former studies have indicated that testosterone hormone replacement therapy was indeed helpful in decreasing heart associated and cardiovascular disease in men
with low testosterone levels.
The U.S. National Institute on Aging is also expected to release the results of research on the safety of testosterone. The study involved roughly 800 older men with low testosterone and symptoms associated with this condition, such as sexual and physical dysfunction. Since the men's heart health was carefully monitored, the research is expected to shed more light on the safety of testosterone therapy.
The Endocrine Society added that more large, randomized controlled studies are needed to investigate the risks and benefits of the treatment for older men.
Meanwhile, the group advised that middle-aged and older men who are thinking about using testosterone therapy to treat age-related declines in this hormone should be warned about the possibility of heart-related side effects.
California Testosterone Therapy News
California and Nevada placing bans on Testosterone Steroid Levels
California Testosterone Therapy News | March 6, 2015
Athletes and Testosterone. Athletes in extreme fighting sports including boxing, martial arts, and UFC®-style fighting will now be subject to restrictions on the use of testosterone.
Nevada State Sports Officials and California State Athletic Commissions are adopting new rules when it comes to TUE's for their participating athletes.
TUE or Therapeutic Use Exemption for doctor prescribed testosterone replacement therapy will no longer be accepted until new rules are adopted. An athlete's testosterone levels can not be more than 4:1 as this will now be the highest acceptable T level for a person who wishes to participate in the sport.
This pronouncement currently places a total ban on therapeutic TRT until rules are established, even though officials recognize that patients must take their hormone medications to stay healthy.
They are not advocating an athlete stop taking their required testosterone medication, only that if they wish to be part of the sport, they will have to make a choice between their
hormone treatment and the sport. New guidelines will allow for the issuance of TRT exemptions if an athlete is eligible under the new guidelines.
New Testosterone standards. According to the athletic commissions, the standards of the WADA - World Anti-Doping Agency will be applied in order for an athlete to receive a TUE exemption.
The goal is to reduce the controversy over steroid abuse versus legitimate medical requirements that would afford a TRT exemption.
The California State Athletic Commission statement reads:
The California State Athletic Commission fully supports the Nevada State Athletic Commission's decision to eliminate Therapeutic Use Exemptions (TUE) for Testosterone Replacement Therapy (TRT) in boxing and mixed martial arts.
California is a strong supporter of anti-doping efforts. As part of California's anti-doping efforts, the Commission recently began the rule-making process to require meeting World Anti-Doping Agency (WADA) standards as the only way to obtain a TUE for TRT.
This standard is so high that it is an effective ban except under the most extreme circumstances.
Until the rule-making process is complete and the regulations are fully adopted, the Commission has a total ban on TRT. California remains committed to protecting the health and safety of athletes and having strict anti-doping standards is one of the ways this is accomplished.
For more information about California Testosterone Replacement Therapy visit - California TRT - Testosterone Treatment Therapy in California
Harvard Author & Anti-Aging Medicine Pioneer
Guideline for Male Testosterone Therapy
TRT News Report - Abraham Morgentaler, Age Management Clinician -Republished March 7, 2015
Abraham Morgentaler, a well known author and lecturer is a pioneer in male hormone replacement and the anti-aging medicine field, He is an Associate Clinical Professor of Urology and Surgery at Harvard Medical School.
Located in Boston Massachusetts, he is also the founder of Men's Health Boston (www.MensHealthBoston.com), a medical center focusing on sexual health.
Dr. Morgentaler is an expert regarding the diagnosis and treatment of Andropause or hypogonadism (low testosterone), ED (erectile dysfunction), sexual dysfunction, prostate and endocrine disorders, vasectomy, TRT and male infertility.
He has authored "Testosterone for Life" which was the first book about Low T - low testosterone by a Harvard medical specialist in the field of endocrine therapy,
and "The Male Body: A Physician's Guide to What Every Man Should Know About His Sexual Health". Combined, these publications discuss and explain in depth male hormone deficiency, symptoms, diagnosis and treatment.
Below are excerpts from Dr Morgentaler that provide great insight into the field of androgen deficiency and testosterone therapy.
Given the amount and complexity of new information regarding androgen deficiency and its treatment, The Endocrine Society's Clinical Practice Guidelines (1) (the Guidelines) are a welcome addition to the literature, representing the consensus recommendations of some of the most thoughtful greybeards in the field.
However, the absence of large-scale clinical testosterone trials leaves room for alternative approaches, and I am grateful for the opportunity to share my views as a urologist specializing in the treatment of male sexual dysfunction.
During my training, I had been taught that androgen deficiency was rare and testosterone treatment ineffective.
I was therefore surprised, when I began my practice in 1988, to discover that low levels of total and free testosterone were frequently associated with erectile dysfunction (ED), and testosterone injections regularly improved erections.
I was further gratified when patients thanked me for making them feel normal again. When patients complained that their symptoms recurred 10-14 d after their last testosterone injection, coinciding with the anticipated testosterone nadir, I became convinced this was not a placebo effect and that men could determine when their testosterone levels were low.
Today, testosterone therapy is recognized as an effective treatment for diminished libido and ED in many men who have low testosterone levels. Other sexual symptoms may also improve, including difficulty achieving orgasm, reduced orgasmic intensity, reduced sexual sensation in the genitalia, and reduced ejaculate volume (2).
In the androgen-deficient man with ED, my bias is to treat first with testosterone rather than a phosphodiesterase type-5 inhibitor (PDE5i), due to the additional symptomatic benefits that might occur, and also because the good responders will be cured without the need to plan for sex, as is necessary with PDE5i treatment. If ED persists after a trial of testosterone, I then add a PDE5i. Testosterone treatment may also rescue erections among men who failed PDE5i therapy.
In one report, one third of androgen-deficient men who failed sildenafil developed adequate erections with testosterone alone, and another third responded with the combination of testosterone and sildenafil (3).
Testosterone has direct effects on the penis as well as the brain. Testosterone receptors are present in the corpora cavernosa, and castration results in decreased production of cavernosal nitric oxide, the mediator of erection. In rabbits castration abolished nerve-stimulated erections and was associated with loss of cavernosal smooth muscle and, remarkably, the de novo appearance of adipocytes in the subtunical area critical for veno-occlusion (4).
Despite acknowledging that the testosterone concentration below which testosterone administration improves outcomes is unknown and may vary among individuals and among target organs, the Guidelines still makes the firm recommendation that only men with unequivocally low testosterone, specifically less than 300 ng/dl, be considered androgen deficient. In the absence of clinical correlation, this and the various other testosterone thresholds proposed over the years must all be recognized as arbitrary.
From a clinical perspective, there is little justification for denying a trial of treatment to symptomatic men with testosterone greater than 300 ng/dl if they have evidence of low levels of bioavailable or free testosterone. Men with elevated SHBG may be truly androgen deficient yet their total T may appear normal. Prospective clinical trials are silent on the efficacy of treatment in men with testosterone greater than 300 ng/dl, because these men are generally excluded.
Yet in one retrospective, uncontrolled study of men with sexual dysfunction and low free testosterone, 73.6% of men with total testosterone greater than 300 ng/dl reported improved erections (5).
Conversely, there is no guarantee that men with unequivocally low testosterone will respond to treatment, since less than half of those with testosterone less than 200 ng/dl reported improved erections (5). The diagnosis of androgen deficiency clearly resists easy categorization by total testosterone values.
My approach to diagnosis emphasizes clinical history, with confirmation provided by low levels of either total or free testosterone. I usually begin testosterone treatment with transdermal gel, making sure that treatment levels reach the mid-normal range or higher. Raising testosterone only into the low-normal range will be subtherapeutic for most men. If there is no symptomatic benefit by 3 months, I discontinue treatment. I therefore use testosterone treatment as a therapeutic trial rather than a commitment to lifelong therapy.
Several of the Guidelines recommendations fall into the realm of testosterone lore and should be discarded. One is the impractical requirement to obtain blood in the early morning. There is no evidence that morning levels more accurately diagnose androgen deficiency than afternoon levels, especially since diurnal variation is substantially blunted in older men (8).
Another is the requirement to confirm low testosterone by repeat testing. Given the variation in testosterone levels and the arbitrary nature of diagnostic thresholds, what would be the justification in denying treatment to a symptomatic man whose initial testosterone level was 290 ng/dl and whose repeat level was 315 ng/dl?
Finally, age-adjusted testosterone reference values should be eliminated. Since testosterone values decline with age, it makes no sense to define normal by comparing individuals to populations of similarly aged men who have also experienced a decline in values. Imagine if we denied eyeglasses to all but those with visual acuity in the lowest 2.5% (2 sd from the mean) of their contemporaries!
Review of the available evidence suggests that the long-standing fear of stimulating prostate cancer with testosterone is without a scientific basis (9). One explanation for this lack of increased risk is that testosterone treatment fails to increase concentrations of testosterone or dihydrotestosterone within the prostate itself (10).
A new concern is the association of low levels of testosterone with prostate cancer. Approximately 15% of hypogonadal men with a prostate-specific antigen (PSA) 4.0 ng/ml or less have biopsy-detectable cancer, and the risk of cancer was increased for men with more severe reductions in testosterone (11).
Low levels of testosterone have also been associated with high-grade prostate cancer, higher stage at presentation, and worse prognosis (9).
With regard to PSA monitoring, I fear the recommendations in the Guidelines are too lax. Urologists view yearly PSA increases of 0.7 to 0.9 ng/ml as suspicious and generally perform prostate biopsy for an increase of 1.0 ng/ml or greater (2).
The diagnosis of androgen deficiency requires only an ear attuned to the characteristic symptoms and a blood test providing evidence of reduced levels of total or free testosterone. Treatment provides an opportunity for gratifying results, for patients and clinicians alike.
Definitions: ED (Erectile dysfunction); PDE5i (phosphodiesterase type-5 inhibitor); PSA (prostate-specific antigen)
Legal News Report - Testosterone Therapy
Published March 7, 2015 - Legal actions against brand name testosterone manufacturers seem to be imminent.
Due to the recent FDA pronouncement that further investigation is required to ascertain the safety, risks and side effects of testosterone treatment in men, legal ramifications may be
forthcoming until such time the FDA is able to put to rest the safety of testosterone for use in hormone replacement among men with a history of heart disease.
Multiple former clinical testosterone studies had demonstrated that Low T or men suffering from hypogonadism were more at risk for coronary and cardiovascular disease.
To date, Testosterone Replacement Therapy drug medications and testosterone boosting supplement products have been prescribed to millions of men to treat andropause (male menopaue) symptoms associated with Low T or low testosterone levels such as loss of sex drive, erectile dysfunction (ED), decreased lean muscle mass, osteoporosis (loss of bone density), extreme fatigue, low energy, hot flashes, sleep problems, moodiness and depression.
Medical prescriptions for testosterone have reached over 400 million including the famous Androgel®, testosterone creams, transdermal patches, hormone pellets and injections of cypionate, enanthate and propionate.
Testosterone prescription treatments have FDA approval to treat men with a diagnosis of hypogonadism or Andropause characterized by lower than normal testosterone levels
which can become common due to a testosterone deficiency during the aging process.
Aging or middle-aged men experience hormonal imbalance symptoms like low energy, muscle loss, weight gain, insomnia and depression, and endocrinologists, urologists, age management and hormone therapy specialists have
prescribed testosterone replacement to boost low t levels and to help alleviate adverse health symptoms. Some of the FDA-Approved testosterone hormone drug medications are
Androgel®, Androderm®, Axirom®, Bio-T-Gel®, Delatestryl® (testosterone enanthate), Dep-Testosterone® (testosterone cypionate),
Fortesta®, Striant® Buccal Gum Therapy, Testim®, Testopel® implantable hormone pellets.
Testosterone Treatment Breaking News
Testosterone Therapy Pioneer Dr. Abraham Morgentaler from BIDMC speaks out.
Famous hormone therapy doctor wants (JAMA) medical journal to retract adverse testosterone study.
Published April 11, 2015 - Legal actions against brand name testosterone manufacturers seem to be imminent.
Beth Israel Deaconess researcher Dr. Abraham Morgentaler displays the disputed testosterone article in JAMA at his Brookline office.
A Boston researcher is demanding a medical journal retract a study that suggests testosterone therapy comes with heart risks, a move that one pharmacy industry critic says reflects a growing trend of doctors who work with drug companies combating negative findings.
Dr. Abraham Morgentaler of Beth Israel Deaconess Medical Center and other men's health experts around the world are demanding the Journal of the American Medical Association (JAMA) retract a study they say used faulty numbers about testosterone therapy, a treatment for a range of ailments such as fatigue and erectile dysfunction.
JAMA, which has already corrected the article twice, did not respond to the Herald yesterday. The study's authors could not be reached. The article says that among two large groups of Veterans Administration heart patients with low testosterone, the incidence of heart attack and stroke was less than 20 percent in the no-testosterone therapy group, and nearly 26 percent in the testosterone therapy group.
This despite, that at this time, the FDA has not concluded that FDA-approved testosterone treatment with FDA-approved testosterone drugs increases the risk of stroke, heart attack, or death.
This has taken me by surprise. Everybody in the field was scratching their heads, said Morgentaler, who submitted a petition questioning the study's statistical analysis.
There has been a rise in both calls for retractions and actual retractions in medical journals in recent years, observers told the Herald.
There were 10 times as many retractions in 2010 as there were in 2001, said Ivan Oransky, cofounder of the site RetractionWatch.com.
We have been seeing more retractions, and we're not sure why. Retractions of medical articles, which generally involve fraud or misconduct, still represent less than 1 percent of all the papers published.
Meanwhile, Dr. Adriane Fugh-Berman, director of the PharmedOut project at Georgetown University Medical Center, said she believes the pharmaceutical industry has upped its demands for retractions as a defensive measure to protect products.
In the case of testosterone treatments, the typical health and side effect warnings are for the most part presented, however - it is the marketing practice of presenting the therapy as a
panacea for the common middle-aged male without clearly stating the potential risks and complications especially in men with coronary disease that makes the current medical articles
different from the other medical treatment article retractions.
There's definitely been a rise in calls for retractions. This is an intimidation tactic from industry, using third-party experts, Fugh-Berman said.
Fugh-Berman works as a paid witness in litigation involving drug company marketing. According to a ProPublica database that tracks drug company contributions to doctors, Morgentaler has received payments from pharmaceutical company giants Merck and Eli Lilly, which both sell testosterone products.
This smells like industry influence, Fugh-Berman said of Morgentaler's retraction demand.
Morgentaler called that a naive argument and said he is concerned only with what he considers sloppy science in the JAMA article.
If I give a talk to a group, they pay me for my time and my expertise, he said. Do I gain anything if the companies sell more testosterone? No.
Read more about Low Testosterone Treatments, Male Hormone Therapy options, Andropause and Hypogonadism at Male Testosterone Hormone Therapy
Low T Diagnoses and Testosterone Testing - Breaking News
Testosterone Therapy with careful Medcial Supervision.
Ongoing monitoring during Testosterone Treatment is essential.
Published Jun 6, 2015
Testosterone treatment monitoring is essential to ensure healthy, safe therapy outcomes.
There are critical blood tests that need be done prior to and during the treatment including red blood cell counts and estrogen levels.
Higher red blood cell counts and higher estrogen levels are well-known issues among experience TRT Physicians or Testosterone Replacement Specialists, that may occur in men given testosterone therapy.
Without proper assessment of testosterone levels, estrogen, HGH (Human Growth Hormone), cortisol and red blood cell counts both prior to and during testosterone treatment, it is extremely difficult to tell if a patient is
either a qualified candidate for testosterone therapy and if their treatment protocol is progressing well.
Hormone Physicians, Endocrinologists and urologists offering Male HRT need to be well-educated regarding the contraindictions and warnings regarding
testosterone therapy and to educate their patients on possible risks including possible increased risks of heart disease or stroke.
Physicians must carefully monitor levels of red blood cells and elevated levels of estrogen and take countermeasures to increase estrogen blocking medications, reduce red blood cells, cease therapy and/or adjust hormone medication dosages as medically required.
Treatment protocols should call for strict screening prior to commencement and strict monitoring of patients' blood cell counts and estrogen levels on testosterone therapy to assess for these risk factors with regards to cardiovascular risk or disease.
FDA Strengthens Testosterone Label Warnings - Breaking HRT News
Testosterone Treatment Risk Warning Labels.
Testosterone Therapy Safety Usage is essential.
Published on July 18, 2015
FDA Strengthens Warning Label For Testosterone Therapy Risks and Dangers
The U.S. Food and Drug Administration (FDA) announced that it will strengthen the label on testosterone treatments to warn about the risks of developing blood clots. Testosterone treatments have been associated with a number of adverse health risks including cardiovascular problems among male patients who use it, especially those with a history of coronary disease.
According to the FDA Safety Reports there have been medical reports of health risks in men with heart disease including venous blood clots and the FDA is requiring a change to testosterone hormone drug labeling to include all testosterone medication products to provide a more general warning regarding venous blood clots with testosterone use.
Commonly, blood clots associated with testosterone treatments occurred because of polycythemia, which is where the patient’s body produces an abnormally increased amount of blood cells because of treatment.
The FDA order to have a warning label will affect all the pharmaceutical companies that produce testosterone treatments, including AbbVie Inc., maker of the famous topical testosterone treatment AndroGel®.
AbbVie, and other manufacturers of testosterone hormone treatments have experienced legal adversity as the testosterone treatments produced have been reported to some cardiovascular problems in testosterone therapy patients.
Medical studies have linked low t treatments to an increased risk of heart attack, stroke, and even death especially in men with coronary risk and cardiovascular disease.
The FDA has been investigating the health risks associated with topical testosterone treatments like AndroGel®, Fortesta&re; and other topical testosterone therapies.
Teens and Athletes are using hormone therapies in increasing number study shows - Breaking HGH & Testosterone News
Testosterone and Human Growth Hormone Warnings for Teen and Athlete Health.
Testosterone Therapy Safety is becoming a real issue for teenagers and athletes who sacrifice health for hormone treatment benefits.
Published on July 26, 2015
A new study shows that many teenagers are willing to sacrifice their long-term health for perceived short term gains.
Teenagers, body builders, athletes and extreme sports enthusiasts are using HGH (human growth hormone), androgen steroids like testosterone and other anabolic steroids to
increase muscle mass, bulk up or enhance performance. These powerful hormones are not indicated or approved for such purposes and pose a potential health threat to those
abusing these substances.
Many Professional Sports Organization policies help. Thankfully, many athletes can be tested for these substances at any time.
Some of the Non-Approved Substances policies address the issue of the abuse of pharmacological substances for the purpose of sport's
performance enhancement. Many substances are not approved by any governmental regulatory health authority like the FDA for teen or athletic use.
In additon, athletes that may want to participate in drug research trials for drugs that are not yet approved may be prevented from doing so. Already, testosterone, even when prescribed by a licensed physician is not allowed for use by professional athletes if they wish to continue to play in the sport.
Anabolic Steroid Agents
For athletes Anabolic Steroid Agents are entirely prohibited including prescription testosterone creams such as Androgel®, testosterone injections, DHEA supplements and any other anabolic steroids that have a similar chemical structure or similar biological effect on the body.
For example, Clenbuterol is prescribed to treat asthma, is as dietary supplements, and sometimes used as a weight loss drug - but is a prohibited substance for athletes.
Peptide Hormones, Human Growth Hormone Factors, and Related Hormone Substances These hormonal substances include
EPO - Erythropoietin, HCG - Human Chorionic Gonadotropin, LH - Luteinizing Hormone, HGH - Human Growth Hormone (Somatropin for Injections), Insulin-Like Growth factor-1 (IGF-1), and Corticotrophins (and steroids).
Growth hormone factors affect muscles, tendons, or ligaments, vascularization, increased energy utilization, and tissue regenerative and healing capacity.
Many dietary supplements contain these growth factor substances that help increase the release of EPO, IGF-1, and human growth hormone. Peptide hormones, and their releasing factors like Sermorelin Acetate,
and other hormone releasing or boosting substances with similar chemical structure or biological effect are prohibited for sports performance enhancement purposes.
HCG in the form of injections is used in Hormone Replacement Therapy or TRT (Testosterone Replacement Therapy) and female infertility therapies. Human chorionic gonadotrophin (HCG) is likewise entirely prohibited in sports as it helps increase testosterone production.
Unfortunately, HCG that is not FDA-approved is many times sold online and in some vitamin shops in the form of oral drops, pills, pellets, and sprays.
Platelet Rich Plasma (PRP) PRP is allowed although it contains some growth factors. This is true because it is not in its purified concentrated form.
Likewise, Colostrum is not entirely prohibited although it has IGF-1 and other growth factors.
Estrogen Blockers and Inhibitors Excess testosterone is normally converted to estrogen in the bloodstream (aromatization) and many HRT patients use them to inhibit or block the excessive estrogen produced as a result.
Aromatase inhibitors and SERM or selective estrogen receptor modulators and other substances that block estrogen effects known as anti-estrogens as well as insulin may be prohibited for athletes.
Athletes diagnosed with Insulin-Dependent Diabetes or other hormone health conditions are able to submit a TUE for the use of insulin or other substances.
American Men Seeking Testosterone Therapy - Breaking Testosterone Therapy News
Testosterone Prescriptions for Gels, Patches and Injections up over a Decade Ago
Men's Testosterone Treatment is becoming Commonplace in Men over the Age of 40 and 50
Published on August 11, 2015
American adult men increasing use of testosterone and testosterone supplements. Research shows American men up to five times more likely to be taking testosterone therapy with prescription injections, androgen gels and patches than ten years ago.
Men over the age of 40 and certainly in their fifties and sixties are taking some form of testosterone hormone.
Many men experience a significant enough of a testosterone decline in their forties and test for Low T or testosterone deficiency with lower than normal blood levels of the androgen hormone.
Subsequently, there has been a marked increase in testosterone prescriptions and usage.
There is clinical evidence that testosterone replacement therapy benefits men who have been diagnosed with Low T (andropause) or hypogonadism.
In the case of a genuine hormone deficiency, Testosterone treatment helps boost libido, increase energy, maintain lean muscle, combat fatty tissue formation, prevent osteoporosis, improve cholesterol profile, alleviate sleep problems and depression.
To learn more about Male Hormone Replacement, visit the Men's HRT Page Male Testosterone Hormone Replacement Therapy
What hormones should men have checked? - Latest Testosterone News
Male Health and Hormone Levels as Men Age
The main hormones to have checked are Testosterone, HGH (IGF1), DHEA, Thyroid and Insulin
Published on August 12, 2015
FDA call upon an Advisory Committee to discuss Testosterone Safety - Latest Testosterone News
Cardiovascular Health in Men and the Use of Testosterone
Testosterone Labels for Safety Warnings to be considered by the FDA
Published on August 14, 2015
The U.S. Food and Drug Administration will be meeting with a health and safety committee
to address the cardiovascular health problems in men prescribed testosterone replacement therapy.
Since testosterone has some beneficial affects on bones and fighting Oteoporosis, specialists from bone as well as urology will discuss the drug safety and risks involved with testosterone use.
Back in June, the FDA had proposed that testosterone products on the market should include warnings about the risk of blood clots in veins.
Current and future testosterone drug medications on the market would be covered by the proposed labeling requirement including androgen hormone products
from AbbVie (AndroGel®), Endo (Aveed®), etc. Doctors prescribe androgen treatments for men who have low levels of testosterone. Caution is advised for those with a history of coronary disease or cancer.
Important FDA Update for Testosterone Products
Testosterone FDA/CDER Statement - Risk of Venous Blood Clots
Patient safety is a critical factor in hormone replacement using testosterone drug medications and the FDA has been vigilant in assessing testosterone safety usage in order to better protect patients.
Below is a recent FDA Testosterone pronouncement regarding Venous Blood Clots and all prospective physicians, pharmacies and patients should be aware of the risks, side effects as well as benefits of using testosterone.
Healthcare professionals are strongly encouraged to carefully screen prospective TRT candidates and to report adverse events or side effects related to the use of these androgen steroid products.
FDA notified health professionals and their medical care organizations that it is requiring the manufacturers of all approved testosterone products to include a warning in the drug labeling about the risk of blood clots in the veins, also known as venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE).
The risk of venous blood clots as a possible consequence of polycythemia is already included in the labeling of testosterone products. Because there have been postmarket reports of venous blood clots unrelated to polycythemia, FDA is requiring a change to drug labeling of all testosterone products to provide a more general warning regarding venous blood clots, to ensure this risk is described consistently in the labeling of all approved testosterone products.
FDA Testosterone Note - This new warning, a class labeling change, is not related to an ongoing FDA evaluation of the possible risk of stroke, heart attack, and death in patients taking testosterone products.
FDA is currently evaluating the potential risk of these cardiovascular events, which are related to blood clots in the arteries.
Source: January 31, 2015 FDA MedWatch Safety Alert.
REMEMBER: Buying Testosterone is only permitted with a Licensed Physician's Prescription. Contact the Low Testosterone Center for TRT Program Details
Testosterone therapy with androgen boosting steroids are the key to male vitality and sexual health.
The possibilities and potential health benefits for men with Low T or hypogonadism (Andropuase) with testosterone therapy are many - increasing lean muscle mass and tone, building stronger muscle, mental acuity, memory, focus and concentration, boosting sex drive, sexual performance and increasing low libido, improving mood,
sleep, and controlling weight and reducing body fat.
Testosterone treatment helps with sex and aging, especially loss of sex drive in men. Middle aged men and senior adults
can experience ED or Erectile Dysfunction, impotence, soft erections or no erection - Testosterone Replacement Therapy can be used to
help treat male impotence where ED is being caused by lower than normal testosterone levels.
Your hormone specialist, endocrinologist or urologist can explain in detail how testosterone replacement therapy can be used to treat erectile dysfunction (ED).
Ask him or her about Testosterone Replacement Therapy using Testosterone Injections and when you should be treated for low testosterone?
Also ask your doctor about the benefits, risks, and side effects of TRT - testosterone replacement therapy. TRT - Low Testosterone Replacement Therapy
Asking your Doctor about Testosterone
Ask the Hormone Doctors about Low T at TestosteroneTherapy.org - Ask the Hormone Doctors about Low T at TestosteroneTherapy.org
New Male Hormone Clinic Openings and Locations - 2015
IMPORTANT: Low Testosterone Therapy Risks and Benefits - before enrolling in a Low Testosterone Treatment program always discuss the risks and benefits of testosterone therapy for men with low testosterone levels
with your physician. Low Testosterone Therapy and Treatments include Injections, Gels, Patches, Pellets and Creams - Testosterone replacement offers Low T symptom relief but is not for everyone.
Men with a history of certain illness, cancer, heart and cardiovascular diseases may not be suitable candidates for TRT.
Read the FDA's Testosterone Drug Safety Announcement - FDA's Testosterone Drug Safety Announcement
Latest News on Testosterone Cypionate Intramuscular Injection - October 2015
Cypionate Products Affected - Description
Actavis Testosterone Cypionate intramuscular injection has been discontinued.
200 mg/mL, 10 mL vial, 1 count (NDC 00591-3223-79) - currently discontinued
Testosterone Cypionate intramuscular injection, Paddock
200 mg/mL, 1 mL vial, 1 count (NDC 00574-0820-01)
200 mg/mL, 10 mL vial, 1 count (NDC 00574-0820-10) expect shortages and delays
The reason for the cypionates shortages in 2015 are due to the follwing:
- Actavis discontinued testosterone cypionate injection in 2015.
- Paddock has testosterone on shortage due to increased demand and shipping delays from their contract manufacturer.
The estimated resupply dates for Paddock testosterone include cypionate 200 mg/mL 1 mL and 10 mL vials in one count allocation.
- West-Ward had testosterone cypionate on shortage due to manufacturing delays.
- Sandoz discontinued testosterone cypionate 200 mg/mL 1 mL and 10 mL vials in September 2011. Sandoz discontinued final presentation in first half of 2012.
- Sun Pharmaceuticals could not provide a reason for the shortage.
Currently Available Cypionate Products
Depo-Testosterone intramuscular injection, Pfizer
100 mg/mL, 10 mL vial, 1 count (NDC 00009-0347-02)
200 mg/mL, 1 mL vial, 1 count (NDC 00009-0417-01)
200 mg/mL, 10 mL vial, 1 count (NDC 00009-0417-02)
Depo-Testosterone for Sale
Testosterone cypionate intramuscular injection, Paddock
200 mg/mL, 10 mL vial, 1 count (NDC 00574-0827-10)
Testosterone cypionate intramuscular injection, Sun Pharma
100 mg/mL, 10 mL vial, 1 count (NDC 62756-0017-40)
200 mg/mL, 1 mL vial, 1 count (NDC 62756-0015-40)
200 mg/mL, 10 mL vial, 1 count (NDC 62756-0016-40)
Testosterone Cypionate intramuscular injection, Sandoz
100 mg/mL 10 mL Label (NDC 0781-3073-70)
Testosterone Cypionate intramuscular injection, West-Ward
200 mg/mL, 10 mL vial, 1 count (NDC 00143-9726-01)
Testosterone Cypionate for Sale
- What causes testosterone deficiency?
- What are the symptoms of testosterone deficiency or Low T?
- What changes occur in the body due to testosterone deficiency?
- How do I find out if I have a testosterone deficiency?
- How is testosterone deficiency treated?
- How much does testosterone therapy cost?
- Where can I buy testosterone injections?
- Can I get testosterone injections online?
- Who shouldn't take testosterone replacement therapy?
- What are the side effects of testosterone replacement therapy?