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Professional Guide: Testosterone

Amateurs and professionals alike have spent years trying to optimize testosterone levels. For some, that means using exogenous hormones (steroids). For the majority, however, maximizing testosterone though diet, training and supplementation is the main focus.

In this guide we’ll cover everything you ever wanted to know about testosterone and the available options for increasing your testosterone levels.

A Brief History of Testosterone

Nearly two millennia ago a Greek physician named Galen made huge strides toward discovering testosterone’s power. His accomplishments in the fields of anatomy, pathology, and surgery put him on the short list of most influential doctors of ancient times.

By recognizing important links between male vigor and the testes, Galen came to value the testes above even the heart [1]. This led him to prescribe the consumption of animal testes to patients that needed a boost in their strength and sexual function.

Creatine Molecule

Photo Credit: Wikipedia.org

Even in 1889 a Harvard professor, Charles-Édouard Brown-Séquard, concocted sexual “rejuvenating elixirs” which required eating monkey testes [2]. Later in life he theorized about the existence of “substances” produced by organs, much like hormones. Brown-Séquard even injected himself with the substances to test his theories [3].

By the 1930s purified testosterone was finally isolated and extracted. At the end of the decade, human grade testosterone was synthesized earning Adolf Butenandt a Nobel Prize [4].

Ever since, testosterone research has advanced to medical treatments, illegal injections and casual supplementation.

What Is Testosterone?

Testosterone is a steroid hormone produced primarily in the testes. Testosterone is the hormone primarily responsible for the development of male reproductive organs and is an anabolic steroid. In addition, testosterone stimulates certain characteristics including muscle mass, aggressiveness, energy, metabolism, and a healthy sex drive.

Testosterone is secreted mainly by male testes in large quantities while the adrenal cortex and ovaries produce significantly less testosterone. In fact, men produce about 20x the amount of testosterone as women [5].

Testosterone is an essential hormone that directly impacts a person’s overall health.

Why Is Testosterone Important?

While testosterone plays a role from prenatal development through adulthood, testosterone plays its most significant role during puberty. The testosterone surge both men and women experience during puberty is what catapults them into physical adulthood. During puberty, testosterone helps gland development, increases the libido, increases hair growth, increases muscle mass and strength, plays a part in deepening the voice, helps bones to grow and mature and more.

Throughout adulthood, testosterone plays a key role when it comes to a man’s sexual health, energy levels, the ability to develop muscle and increase strength and the ability to burn fat. The effects of testosterone often decline with age as testosterone levels begin to decline.

Healthy Testosterone Levels

What’s considered a healthy level for men has a reference range between 290 nanograms per deciliter (ng/dL) and 1,000 ng/dL[6]. This scope is large due to the fact that men of all ages are used to determine the range, so a healthy level certainly changes with age. A more exact, individual level can be ascertained through basic blood work.

Creatine Supplementation

After about age 30, testosterone production begins to decline at a rate of 1 to 2% per year in most men [7] with an escalating decrease in subsequent years. In addition, overall average testosterone levels in men in general have declined from 1987-2004 [8]. Researchers don’t agree on the reasons as to why, but the fact still stands that men’s testosterone levels are lower than ever on average.

The low end for what’s considered “normal” is about 300 nanograms per deciliter (ng/dL). However, this is based off a reference range, which basically means 300 ng/dL is low for both a 30 year old as well as an 80 year old. This leaves room for physician interpretation. For men 30-50 years old, with testosterone levels below 500 ng/dL, clinical data shows definite benefits can be available from a boost in testosterone [9].

If left untreated, low testosterone levels can create metabolic concerns with both short and long-term consequences, in addition to diminishing libido and numerous other health concerns. The clinical term for low testosteorne is called hypogonadism.

Symptoms

There are several signs and symptoms that can alert you to low testosterone. The most frequent symptoms of low testosterone include:

  • Lower libido
  • Decrease in sexual desire
  • Loss of memory
  • Difficulty with concentration
  • Depressed sense of well-being
  • Difficulty concentrating [10][11]
  • Weight gain
  • Reduced energy levels

Hypogonadism can seriously affect organ function and negatively impact overall quality of life and overall health. But because hypogonadism symptoms are broad, it is best to get blood work done before you jump to treatment.

Symptoms

Many of the short-term effects of low testosterone are directly related to the symptoms mentioned above. There are also several measurable effects that come with low testosterone:

  • Decreased muscle mass
  • Loss of strength
  • Reduced bone density
  • Erectile Dysfunction
  • Anemia
  • Insomnia
  • High blood pressure
  • Increased belly fat [12][13][14][15]

Long-Term Effects

The long term effects of low testosterone are much more severe. Hypogonadism has been linked to several long term health detriments:

  • Diabetes
  • Obesity
  • Metabolic syndrome
  • Anxiety
  • Prostate cancer
  • Heart disease
  • Cardiovascular disease
  • Depression
  • Death [16][17][18]

Testosterone Supplements

Testosterone supplements have dramatically evolved as laws banning some first generation products are passed. Researchers have also come a long way in creating new legal products that are not only safe, but highly effective.

Here is a rundown on testosterone supplements in various forms; but with emphasis on supplements that are legal and can be obtained without a doctor’s prescription.

Prescription Testosterone Medications

Testosterone is a perfectly legal medication for men suffering with low testosterone. Its uses are widespread, but it’s often prescribed as part of hormone replacement therapy (HRT) or testosterone replacement therapy (TRT).

This synthetic form of pure testosterone is traditionally administered via injection every two weeks. Gels or patches are becoming a popular way to increase testosterone. With a patch or a gel, the synthetic testosterone is absorbed through the skin, or transdermal absorption.

Prescription transdermal testosterone treatments are used by millions of men whose levels have crashed (below 200 ng/dL). Nevertheless, it is a long term treatment plan that requires doctor supervision to regulate the body’s delicate hormone balance and can only be obtained with a prescription.

Prohormones

Prohormones are chemicals that convert to hormones such as testosterone or testosterone-like equivalents in the body. However, in 2005, these compounds became illegal and added to the list of Schedule III Drugs [19].

The ban on the sale and use of prohormones gave way to a new wave of supplements called “designer steroids.” These steroids are typically estrogen derivatives and have varying levels of effectiveness.

There are also several products in the legal grey area that can be considered either prohormones or designer steroids. The availability of these products is limited to a short window of time as they’re often added to the banned substance list within months of being released.

As with synthetic testosterone, the body recognizes the exogenous testosterone from these products. This causes natural testosterone production to slow or even stop. This can lead to side effects without the supervision of a doctor.

Natural Testosterone Boosters

Testosterone boosters are substances (often herbal and natural) that coax the body to produce more luteinizing hormone (LH). LH is the messenger hormone secreted by the pituitary gland that signals the testes to produce more testosterone. Natural testosterone boosters also signal the testes directly to produce more testosterone.

Since 2005, these natural supplements make up the bulk of the testosterone supplements sold over the counter. Testosterone supplements rely on naturally increasing testosterone production without synthetic testosterone or prohormones. Testosterone boosters are considered a safer and more convenient way for men to increase testosterone production.

Testosterone boosters are also used by a wider variety of men. While prescription testosterone products are limited to men with very low testosterone, boosters are often used to supplement existing testosterone.

Who Uses Testosterone Supplements?

Testosterone supplements inherently appeal to men with low testosterone. Yet, some men with normal testosterone levels find the benefits of increased testosterone appealing. The groups most interested in testosterone supplements include:

  • Athletes — Competitors of various sports incorporate testosterone supplements when permitted (more on this below), to enhance athletic performance.
  • Natural Bodybuilders — Either by federation restriction or choice, natural bodybuilders refrain from using illegal substances. Natural testosterone boosters are a great way to stay competitive without using steroids and other potentially dangerous substances.
  • Exercise Enthusiasts — The largest portion of testosterone supplement users come from this group. From college-aged men adding summer-time muscle to 50-somethings wanting a better workout – exercise enthusiasts benefit from extra testosterone.
  • Aging Men — With testosterone in decline, older men seek testosterone boosters to help maintain muscle and strength, prevent a loss in energy and to stay healthy sexually. But aging can also cause hypogonadism, critically low testosterone levels, and general health becomes a concern, not just vitality.
  • General Users — Many men use testosterone supplements to treat erectile dysfunction, low libido, and overall sexual performance at any age. Other general benefits include enhanced mental focus, increased energy levels and weight loss.

Testosterone Benefits

Testosterone has an extensive list of positive effects. This guide will focus on the benefits to athletic performance, physique, and sexual health.

Testosterone’s Effects on Sports Performance

It’s no secret testosterone is used by athletes to enhance their performance. Almost more emphasized than the coverage of the game itself is revealing who is illegally using performance enhancing drugs.

More often than not, the drug in question is either testosterone or its derivative. In some cases they are prohormones or even natural testosterone boosters in question.

Testosterone builds muscle mass, increases strength, and dramatically reduces recovery time [20]. These effects help athletes train harder, go faster, jump higher, hit a ball further, and extend careers well beyond natural limits. For bodybuilders and other physique competitors, this means more muscle for cosmetic reasons.

Obviously this drives some athletes to cheat and use banned substances like steroids. But for others it means proper training, nutritional programs, and approved supplements to promote testosterone production.

Effects of Testosterone on Libido

In 1998, Viagra (sildenafil) quickly became the de facto treatment for men with erectile dysfunction and other libido-related issues. However, reduced libido is now considered the most prominent symptom of low testosterone [21]. Some analysts predict sales for hypogonadism treatments could triple to $5 billion by 2017 [22].

True to the trend, over-the-counter testosterone supplement sales have increased dramatically as men look to raise their libido [23].

Testosterone builds muscle mass, increases strength, and dramatically reduces recovery time [20]. These effects help athletes train harder, go faster, jump higher, hit a ball further, and extend careers well beyond natural limits. For bodybuilders and other physique competitors, this means more muscle for cosmetic reasons.

Obviously this drives some athletes to cheat and use banned substances like steroids. But for others it means proper training, nutritional programs, and approved supplements to promote testosterone production.

Testosterone Benefits

The most severe testosterone side effects are associated with prescription-based or prohormones. Nevertheless, increasing testosterone can cause mild side effects even when using a natural testosterone supplement.

Acne

This side effect is the principle concern with testosterone boosters. Elevated testosterone levels can increase oiliness in hair and skin. Excessive oil is the root cause of acne for those who use a testosterone booster and notice a spike in acne. Body and face washes with salicylic acid can minimize this side effect and in some cases, eliminate it.

True to the trend, over-the-counter testosterone supplement sales have increased dramatically as men look to raise their libido [23].

Estrogen Conversion

High levels of exogenous (synthetic) testosterone can be converted to estrogen via the aromatase enzyme. This can be highly problematic and is directly responsible for these side effects:

Hair Loss

Exogenous testosterone can convert to dihydrotestosterone (DHT) via the 5-alpha reductase enzyme. DHT is the primary contributing factor in male pattern baldness and accelerates the process in predisposed men supplementing with testosterone.

Gynecomastia

Estrogen conversion can also trigger the growth of female breast tissue in men. Gynecomastia is irreversible and requires surgery to remove. Generally this is associated with prohormones and unsupervised used of prescription-based testosterone.

Prostate Enlargement

Testosterone’s association with prostate health is usually mentioned when talking about men with low testosterone. While low testosterone can be a cause of prostate concerns, some researchers believe elevated testosterone levels accelerate the growth of existing prostate problems.

There are certainly conflicting studies when it comes to linking testosterone and prostate health. One recent study found that men receiving testosterone replacement therapy (TRT) were no more likely to develop prostate problems than the general population [24]. But another 2012 study established a link between elevated testosterone and prostate cancer [25]. This link however, does not establish that high testosterone leads to prostate cancer. Instead, it merely states there is an association between the rates of growth in existing prostate cancer.

While the evidence is conflicted, it’s suggested that middle-aged men get semi-annual checkups when taking a testosterone supplement or receiving TRT to ensure the health of their prostate [26].

Positive Drug Test (NCAA, USADA, WADA)

Testosterone is heavily restricted by many of the governing bodies in sports: NCAA, NBA, NFL, MLB, IOC, etc. The organizations that test for banned substances, are principally the United States Anti-Doping Agency (USADA) domestically, and the World Anti-Doping Agency (WADA) internationally.

Unfortunately, using testosterone supplements is considered doping in most sports. Even some natural testosterone boosters will cause you to test positively. Consequently, athletes considering a testosterone supplement should first check the list (hyperlink: http://www.wada-ama.org/en/World-Anti-Doping-Program/Sports-and-Anti-Doping-Organizations/International-Standards/Prohibited-List/) that WADA has established. This list is uniform with most other anti-doping agencies including USADA. Nevertheless, consult your own governing body as an extra precaution.

Popular Ingredients

With prohormones’ legality in question, and prescription testosterone limited, this list is focused on legal ingredients in natural testosterone boosters.

Tribulus Terrestris

Tribulus Terrestris is far and away the most popular of all natural testosterone boosting ingredients due to its effectiveness [27].

The key to its potency is the percentage of saponins in tribulus terrestris. Several manufacturers list this percentage on the ingredient label. Occasionally it’s listed as ‘protodioscin’, which is one of the saponins in tribulus.

Look for products that contain at least 60% saponins. Some of the most popular products contain as much as 80% and generally get the highest ratings among users.

ZMA

ZMA (Zinc monomethionine and aspartate and Magnesium Aspartate) is often used by athletes and bodybuilders in a combination of zinc, magnesium and vitamin B6.

Both zinc and magnesium independently raise testosterone levels, especially for those who work out. Combined to form the foundation of ZMA, these ingredients have been studied together as far back as 1998 and have been shown to increase free testosterone levels in clinical trials [28].

When choosing a ZMA product or a product that contains ZMA, look for the standardized amounts: 30 mg zinc, 450 mg, and 10.5 mg vitamin B6.

D-Aspartic Acid

D-aspartic acid (D-AA) is quickly becoming one of the most popular ingredients in natural testosterone boosters.

D-AA is a naturally occurring acid found in humans. In men it plays a role in sperm production as well as releasing testosterone and luteinizing hormone. Since luteinizing hormone stimulates testosterone production, this can help increase testosterone levels. In fact, supplemental D-AA has been proven to increase testosterone production in men [29].

D-AA does seem to work better when taken for 4-8 weeks. Though it’s a relatively new ingredient used in testosterone boosting supplements, it’s safety and effectiveness have been studied to show it can be one of the best ways to safely boost testosterone levels.

Testofen®/Fenugreek

Testofen® is a trademarked version of fenugreek extract. It is used as a third-party ingredient in an number of testosterone boosters.

Fenugreek extract raises natural free testosterone levels and increases libido in men [30].

Testofen® uses a standardized fenugreek extract that has stood up to clinical testing, showing documented testosterone increase. Interestingly, it’s been studied alongside ZMA with promising data to support a synergistic effect of both.

Mucuna Pruriens

Mucuna pruriens is a tropical plant that treats male sexual dysfunction. Recently it has been shown to increase testosterone as well as luteinizing hormone (LH). This two-fold action ranks this ingredient with the highest quality testosterone boosters [31].

Eurycoma Longifolia

Eurycoma longifolia, more commonly called long jack or tongkat ali, is an herbal plant initially used to aid in sexual function. Later it was studied for its testosterone boosting effects where it garnered attention from the sports community [32].

Today it’s found in many popular natural testosterone boosters. Eurycoma longifolia is also marketed as a standalone product for both low testosterone treatment as well as sexual dysfunction.

Testosterone Advantage®

Testosterone Advantage® is a trademarked version of calcium fructate. It’s another ingredient that has picked up steam as a free testosterone booster.

Calcium fructate has yet to stand on its own as a proven testosterone booster. Nevertheless, products that include it are currently some of the most popular and effective.

Forskolin

Forskolin is a coleus forskohlii extract. It’s been marketed for years as a weight loss aid but in 2005 it showed it could significantly increase free testosterone levels [33].

Forskolin

Forskolin is a coleus forskohlii extract. It’s been marketed for years as a weight loss aid but in 2005 it showed it could significantly increase free testosterone levels [33].

Deer Antler Velvet

Deer antler velvet has been around for some time. It was recently popularized when several NFL players used a spray form. Even a coach for a prominent team endorsed deer antler velvet at one point.

Studies are still emerging, but it contains nearly 40 compounds, with about 50% of them being some form of amino acid. Several of these compounds act as precursors to increased testosterone production [34].

DHEA

Dehydroepiandrosterone, commonly called DHEA, is a hormone that’s naturally produced in the body. It acts as precursor to testosterone, and as is the case with testosterone, DHEA gradually declines with age.

DHEA is often recommended to aging men and women by doctors and measurably impacts testosterone levels [35].

Additional Ingredients found in Testosterone Supplements

Some testosterone boosting products contain ingredients limited to just increasing luteinizing hormone and/or testosterone. However, because low testosterone negatively impacts sexual function and muscle mass, several manufacturers add secondary ingredients to help overcome these issues.

  • Horny Goat Weed — This herbal supplement is widely recognized and used as a sexual health support for both men and women.
  • Avena Sativa — This wild oat supplement is another with a very long history as an aphrodisiac and is often marketed as sexual enhancer.
  • Safed Musli — An herb traditionally used for both libido and increasing natural testosterone production.
  • 20-Hydroxyecdysterone — A relatively new ingredient, it has no effect on sex hormones but stimulates muscle growth.

How to Use Testosterone Supplements

Testosterone supplements can be used in multiple ways, with the most popular method being cycling. Cycling involves taking the product in intervals of time-on and time-off, similar to most fat burners.

By taking time off from a testosterone product, your body can rebalance its hormone levels and prime itself before taking the product again.

Cycling Testosterone Supplements

Some manufacturers include specific directions for cycle length, and these directions should be followed — especially by first time users.

Other manufacturers list the serving size and directions for use without input on how long a cycle should last. For those products, a 4 week on/4 week off cycle is generally a good way to use the product.

Best Time to Take Testosterone Supplements

Most manufacturers either recommend anywhere from 1-3 doses each day. Taking a testosterone supplement during times of naturally elevated levels seems to be the most efficient. Those elevated times are in the morning, afternoon, and directly after exercise.

Many of the above testosterone-boosting ingredients are slightly less bioavailable when taken with food. Consequently, take testosterone supplements 30 min prior to a meal to aid absorption.

Post Cycle Therapy

Post cycle therapy, commonly called PCT, is the term for the time immediately following a testosterone supplement cycle. Since this is a period where the body is striving for balance, many manufacturers make auxiliary products that facilitate this.

For patients receiving short-term testosterone replacement therapy or those using prohormones there is a greater need for PCT. When exogenous testosterone is present, the testes are signaled to shut down endogenous (internal) production. This can disturb the delicate hormonal balance that exists within the body.

Currently it’s unclear how necessary PCT is after using a natural testosterone booster. Anecdotal evidence suggests the body simply reduces natural testosterone back to the base line it was at before. In fact, many of the natural ingredients on the list above are used in PCT products as well.

Leave a Comment

Comments (4)

Byron schaffner

September 30, 2013

Testosterone

Which is the best testosterone on the market

Reply
    Mike Jackson

    Mike Jackson

    September 30, 2013

    Comment

    Great question. There is much debate as to what product is the best testosterone booster/supplement on the market. Since we’re frequently getting asked this, we had our team of product experts analyze all the top testosterone boosting products and compile a ranking based on the results.

    You can check out the top 10 ranking here »

    You can also see the full list of our testosterone boosting products here »

suraj

December 6, 2014

suraj goyal

Very good knowledge man ….keep it up..

Reply

Andrea Castillo

July 30, 2016

DHEA is banned by WADA

Just wanted to warn people that DHEA & 7 Keto DHEA & all of it’s metabolites have been banned by WADA.

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