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Related Topics:

• aromatization / impotence / prolactin / cortisol
• Testosterone: What's a Normal Testosterone Level in Men?
• Testosterone unit conversion

Alternative News:

• Serum testosterone and sex hormone-binding globulin are inversely associated with leucocyte telomere length in men: a cross-sectional analysis of the UK Biobank Study - Eur J Endocrinol 2023 Feb 8 - "Older men on average have lower testosterone concentrations compared with younger men, and more age-related comorbidities. Whether lower testosterone concentrations contribute to biological ageing remains unclear. Shorter telomeres are a marker for biological age. We tested the hypothesis that testosterone concentrations are associated with leucocyte telomere length (LTL), in middle to older aged men ... Total testosterone and SHBG were independently and inversely associated with LTL. Men with higher testosterone or SHBG had shorter telomeres, arguing against a role for testosterone to slow biological ageing in men" - But what about the argument for lowering SHBG? See my SHBG page for ways to lower it.
• Testosterone Therapy in Prostate Cancer - Curr Opin Urol. 2022;32(6):598-606 - "The use of TTh in hypongonadal men with a localized PCa has been shown to have positive clinical outcomes without increasing the rate of disease progression or recurrence. Further research, in a randomized controlled setting, is warranted"
• Metformin, testosterone, or both in men with obesity and low testosterone: A double-blind, parallel-group, randomized controlled trial - Metabolism 2022 Aug 16 - "Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) index ... the HOMA-IR index decreased significantly in all active groups compared to placebo (metformin - 2.4, 95 % CI -4.1 to - 0.8, p = 0.004; testosterone - 2.7, 95 % CI -4.3 to - 1.1, p = 0.001; combination - 3.4, 95 % CI -5.0 to - 1.8, p < 0.001). Combination therapy was not superior to testosterone alone in decreasing insulin resistance (-0.7, 95 % CI -2.3 to +0.9, p = 0.383). Only the combination of metformin plus testosterone significantly increased total and free testosterone concentrations, compared to placebo. No significant changes in body composition (except for a higher decrease in fat mass in the metformin and combination group), metabolic variables, erectile function, or HRQoL were found with any treatment" - See metformin at ReliableRX.
• Coenzyme Q 10 alleviates testicular endocrine and spermatogenic dysfunction induced by high-fat diet in male Wistar rats: Role of adipokines, oxidative stress and MAPK/ERK/JNK pathway - Andrologia 2022 Jul 27 - "The current study investigated the possible protective effects of Coenzyme Q10 (Co Q10 ) on rat model of high-fat diet (HFD) induced testicular dysfunction ... In comparison to the untreated HFD group, the Co Q10 treated group revealed significantly increased serum testosterone, adiponectin levels, and decreased LH, FSH, and leptin levels. In addition, HFD resulted in significant increase in testicular oxidative stress (increased MDA, iNOS, NO, XO & decreased catalase, SOD, GSH) and inflammation (increased pJNK/JNK, pERK/ERK, and p-p38MAPK/MAPK), while Co Q10 was effective to ameliorate these changes. In addition, Co Q10 significantly increased sperm count, motility and viability that were markedly deteriorated by HFD. Regarding testicular ultrastructure, seminiferous tubular diameter and epithelium height were reduced in HFD group and Co Q10 significantly improved these testicular changes. Finally, a significant reduction in spermatogenic cell proliferation was detected by PCNA fluorescent expression and Co Q10 significantly reversed this change" - See ubiquinol products at Amazon.com.
• The association between caffeine intake and testosterone: NHANES 2013-2014 - Nutr J 2022 May 17 - "These findings suggest a potential role for caffeine's contribution to the etiology of low testosterone and biochemical androgen deficiency" - Note: Caffeine increase SHBG which binds with testosterone. They might be the pathway.
• The effects of metformin and forskolin on sperm quality parameters and sexual hormones in type II diabetic male rats - Andrologia 2022 Apr 8 - "Treating diabetic rats with metformin and forskolin resulted in significant improvement in sperm quality parameters, increased testosterone levels, reduced oxidative stress in blood and testicular tissue, and decreased blood sugar, and Bax to Bcl-2 ratio level. Although the combination of metformin with forskolin had a higher effect in some parameters such as testosterone levels compared to treatment with metformin or forskolin alone, this combination had not shown a synergistic effect in all the sperm quality parameters. Metformin and forskolin are effective anti-diabetic agents, which significantly improve the sperm quality and sexual hormone levels in diabetic rats. Combining metformin and gorskolin resulted in significantly better testosterone level and antioxidant activity in blood serum without significant effect on sperm quality of diabetic rats" - See metformin at ReliableRX and forskolin at Amazon.com.
• A Proprietary Herbal Blend Containing Extracts of Punica granatum Fruit Rind and Theobroma cocoa Seeds Increases Serum Testosterone Level in Healthy Young Males: A Randomized, Double-Blind Placebo-Controlled Study - J Diet Suppl 2022 Feb 6 - "LN18178 is a proprietary herbal blend containing extracts of Punica granatum fruit rind and Theobroma cocoa seeds ... One hundred and twenty male volunteers (age 21-35 years) were randomized into three groups. Each group (n = 40) received a daily dose of either placebo or 200 or 400 mg LN18178 for fifty-six days. An increase in serum testosterone (free and total) was the primary efficacy measure of the study. The secondary measures included dihydrotestosterone (DHT), cortisol, Luteinizing hormone (LH), 17β-Estradiol (E2), hand grip strength, and the mid-upper arm circumferences (MUAC)" - See pomegranate extract at Amazon.com and Ghirardelli Chocolate Intense Dark Squares, Midnight Reverie, 4.12 oz., 86% Cacao (Pack of 6) at Amazon.com.
  • Pomegranate - Wikipedia - "The pomegranate (Punica granatum) is a fruit-bearing deciduous shrub in the family Lythraceae, subfamily Punicoideae, that grows between 5 and 10 m (16 and 33 ft) tall"
  • Theobroma cacao - Wikipedia - "Theobroma cacao, also called the cacao tree and the cocoa tree, is a small (4–8 m (13–26 ft) tall) evergreen tree in the family Malvaceae"
• Use of Tribulus terrestris and Lepidium meyenii extract in rats: reproductive, biochemical and body parameters - Andrologia 2021 Dec 28 - "It is concluded that the association of T. terrestris and L. meyenii has positive effects on serum testosterone, sperm concentration and epididymal morphology, with no evidence of effects in the testis, liver, spleen and kidneys" - See Tribulus terrestris at Amazon.com and Maca extract at Amazon.com.
• A 6-month, double-blind, placebo-controlled, randomized trial to evaluate the effect of Eurycoma longifolia (Tongkat Ali) and concurrent training on erectile function and testosterone levels in androgen deficiency of aging males (ADAM) - Maturitas 2021 Mar - "Androgen deficiency of aging males (ADAM) largely manifests as sexual symptoms. Erectile dysfunction is one of the most common symptoms of ADAM ... 6-month, randomized, double-blind, placebo-controlled four-arm clinical. 45 men (47.38 ± 5.03 years) were randomized into 4 groups (G1: control + placebo; G2: control + Eurycoma longifolia; G3: concurrent training + placebo; G4: concurrent training + Eurycoma longifolia). 22 received a 200 mg supplement of Eurycoma longifolia and 23 underwent the intervention with concurrent training, 3 times a week for 60 min at progressive intensity ... Erectile function demonstrated improvements in both interventions; however, the most significant results were obtained by men allocated to concurrent training + Eurycoma longifolia" - [Nutra USA] - See Tongkat at Amazon.com.
• Exercise associated or not to the intake of Eurycoma longifolia improves strength and cardiorespiratory fitness in men with androgen deficiency - Comp Ther Clin Prac, Feb 21 - "This study aims to analyze the effects of a concurrent training (CT) associated with Eurycoma longifolia (EL) supplementation on the muscle strength, cardiorespiratory fitness, and symptomatology score of men with the androgen deficiency of aging male (ADAM). Forty-five subjects (47.6 ± 5.2 years) were included in the study. The randomized, double-blinded, placebo controlled clinical trial lasted for 6 months. Participants were randomized into four groups, control (C; n = 12); EL (n = 11); CT (n = 11); and CT + EL (n = 11). Along this period, the isokinetic peak torque of the knee extensors increased in the CT (14%) and CT + EL (17%) groups (p = 0.040; p = 0.006, respectively), while the isokinetic peak torque of knee flexion increased in the CT + EL group only (p < 0.05). For all participants, testosterone levels were correlated with isokinetic peak torque of knee extension (r = 0.517, p = 0.001) and flexion (r = 0.362, p = 0.028). Subjects of the CT (27.3%) and CT + EL (36.1%) groups decreased the symptomatology of ADAM (p = 0.005). This study demonstrated the benefits of CT and EL consumption as a non-pharmacological treatment for ADAM" - [Nutra USA] - See Tongkat at Amazon.com.
• Mediterranean Diet Tied to Less Severe Erectile Dysfunction - Medscape. 9/7/21 "The men with a higher Mediterranean diet score (> 29) had better erectile performance (SHIM scores > 14), as well as higher testosterone levels, higher coronary flow reserve, and less arterial stiffness than the other men"
• The effect of Eurycoma Longifolia on the regulation of reproductive hormones in young males - Andrologia 2021 May - "Eurycoma longifolia supplementation increases testosterone levels in humans via activation of the hypothalamic-pituitary-gonadal axis and/or the hypothalamic-pituitary-adrenal axis mainly in older adults and nonhealthy populations ... Thirty-two males (24.4 ± 4.7 years; 1.74 ± 0.07 m; 73.7 ± 8.4 kg) in a placebo-controlled, double-blind, matched-paired study received 600 mg/day Eurycoma longifolia or placebo for two weeks. Blood analysis using repeated measures analysis of variance showed significant interaction and time effects for testosterone (F1,30 = 9.04, p = .005), free testosterone (F1,30 = 7.13, p = .012) and estradiol (F1,30 = 8.07, p = .008) levels in favour of the treatment group, while luteinising hormone, follicle-stimulating hormone and sexual hormone-binding globulin did not. The lack of changes in luteinising hormone and follicle-stimulating hormone levels suggests that a lesser role played by Eurycoma longifolia in activating the hypothalamic-pituitary-gonadal axis in the young adults. The raised testosterone level may be due to a greater rate of hormone production via the hypothalamic-pituitary-adrenal axis. The supplementation of Eurycoma longifolia for two weeks demonstrates steroidogenic effects on young men were dose-related. Consequently, the raised testosterone following Eurycoma longifolia supplementations could benefit muscle and strength gain in young adults" - [Nutra USA] - I take Eurycoma longifolia to lower SHBG. SHBG bines with total testosterone causing lower free testosterone. My SHBG was really high so I came up with my own formula: Tongkat Ali (Eurycoma longifolia), stinging nettle, boron, DHEA and 50 mg (a very low dose) of prescription danazol that I purchased from an overseas pharmacy. It makes a big difference in your sex life and getting rid of your gut.  See Tongkat (Eurycoma Longifolia) at Amazon.com and also the LJ 100 Tongkat used in this trial.
• Eating More Fat May Boost Borderline Low Testosterone - Medscape, 4/16/21 - "A total of 206 healthy men with normal testosterone received a high-fat diet followed by a low-fat diet (or vice versa), and their mean total testosterone levels were 10% to 15% lower (but still in the normal range) during the low-fat diet. ... A Mediterranean diet is a good way to increase 'healthy fats,' mono- and polyunsaturated fatty acids (MUFAs and PUFAs, respectively), which will likely decrease cardiovascular disease risk, and boost testosterone at the same time ... Olive oil has been shown to boost testosterone more than butter, and it also reduces CVD, he continued. Nuts are high in "healthy fats" and consistently decrease CVD and mortality and may boost testosterone. Other sources of "good fat" in a healthy diet include avocado, and red meat and poultry in moderation"
• The effects of 14-week betaine supplementation on endocrine markers, body composition and anthropometrics in professional youth soccer players: a double blind, randomized, placebo-controlled trial - J Int Soc Sports Nutr 2021 Mar 4 - "Betaine supplementation may enhance body composition outcomes when supplemented chronically during an exercise program. The purpose of this study was to evaluate the effect of betaine supplementation on development-related hormones, body composition, and anthropometrics in professional youth soccer players during a competitive season ... Twenty-nine players (age, 15.45 ± 0.25 years) were matched based upon position and then randomly assigned to a betaine group (2 g/day; n = 14, BG) or placebo group ... testosterone to cortisol ratio (T/C) ... Betaine supplementation increased testosterone levels and T/C ratio in youth professional soccer players during a competitive season. Betaine supplementation had no negative effects on growth (height and weight) and may attenuate reductions in testosterone due to intense training during puberty" - Note:  I which they would state whether it's betaine hydrochloride [HCl] or betaine anhydrous (trimethylglycine (TMG)).  It must be TMG because HCL is for digestion. - See betaine hydrochloride products at Amazon.com and betaine anhydrous (TMG) at Amazon.com.
  • Betaine HCl – Remembering the Basics - edu.emersonecologics.com - "Trimethylglycine (TMG) is a popular molecule in the betaine family – consisting of the amino acid glycine with three methyl groups attached. TMGs main uses are as either a primary (reducing homocysteine into L-methionine for cardio-protection) or secondary (affecting folate and SAMEe metabolism) methyl donor. For clarity it’s important to remember that the terms “TMG” and “betaine” are used interchangeably ... While still in the same molecular family, betaine hydrochloride [HCl] is a very different molecule. It is a protonated form of TMG, meaning it will give up or transfer a proton and a chloride ion in an aqueous solution (liquid). This makes betaine HCl a very good dietary source of hydrochloric or gastric acid"
• Dietary supplementation with docosahexaenoic acid rich fish oil increases circulating levels of testosterone in overweight and obese men - Prostaglandins Leukot Essent Fatty Acids 2020 Nov 12 - "Pre-clinical evidence suggests that omega-3 (n-3) polyunsaturated fatty acids (PUFAs), in particular, docosahexaenoic acid (DHA) have been shown to affect testosterone synthesis in males ... Participants were stratified by sex and randomly allocated to intervention (860 mg DHA + 120 g EPA/day; FO) or an isocaloric control (corn oil; CO) for 12 weeks ... DHA-enriched fish oil supplementation increased total testosterone levels in males after adjusting for baseline levels, age and BMI. There was no treatment effect in females. Changes in testosterone levels in males were positively associated with changes to omega-3 PUFAs EPA and DHA and inversely correlated with omega-6 PUFA, arachidonic acid and dihomo-gamma-linolenic acid content in erythrocyte membranes, and was associated with beneficial changes to fasting insulin and HOMA-IR across the course of the study. DHA-enriched fish oil supplementation increases testosterone levels in overweight and obese men" - [Nutra USA] - See docosahexaenoic acid at Amazon.com and and iHerb.
• Testofen® (Fenugreek extract) increases strength and muscle mass compared to placebo in response to calisthenics. A randomized control trial - Trans Spt Medicine, 10 Mar 20 - "A total of 138 male participants (25‐47yrs) were enrolled and randomized to three equal groups: 600 mg Testofen®/day, 300 mg Testofen®/day or placebo ... All groups improved their maximal leg press from baseline to 8 weeks, however, both Testofen® treated groups improved more than placebo (P < .05). The 600 mg group showed decreases in body mass of 1.2 kg, −1.4% body fat and an increase in lean mass (1.8%) at 8 weeks. The 600 mg group also demonstrated an increase in testosterone concentration from baseline to 8 weeks. This study indicates that Testofen® may be an effective ergogenic aid for individuals wanting to rapidly improve their exercise performance capabilities and body composition above and beyond that of calisthenic exercise alone" - [Nutra USA] - See Fenugreek at Amazon.com.
• Effect of fenugreek extract supplement on testosterone levels in male: A meta-analysis of clinical trials - Phytother Res. 2020 Feb 11 - "A total of four trials were included. Fenugreek extract has a significant effect on total serum testosterone. Results from clinical trials suggest that fenugreek extract supplement has an effect on serum total testosterone levels in male" - See fenugreek at Amazon.com.
• Long-Term Effect of Combination of Creatine Monohydrate Plus β-Hydroxy β-Methylbutyrate (HMB) on Exercise-Induced Muscle Damage and Anabolic/Catabolic Hormones in Elite Male Endurance Athletes - Biomolecules. 2020 Jan 15;10(1) - "randomized into four different groups: placebo group (PLG; n = 7), CrM group (CrMG; 0.04 g/kg/day of CrM; n = 7), HMB group (HMBG; 3 g/day of HMB; n = 7), and CrM-HMB group (CrM-HMBG; 0.04 g/kg/day of CrM plus 3 g/day of HMB; n = 7) ... we observed significant differences in CrM-HMBG with respect to PLG, CrMG, and HMBG on testosterone (p = 0.006; η2p = 0.454) and the testosterone/cortisol ratio (T/C; p = 0.032; η2p = 0.349). Moreover, we found a synergistic effect of combined supplementation on testosterone (CrM-HMBG = -63.85% vs. CrMG + HMBG = -37.89%) and T/C (CrM-HMBG = 680% vs. CrMG + HMBG = 57.68%) and an antagonistic effect on cortisol (CrM-HMBG = 131.55% vs. CrMG + HMBG = 389.99%). In summary, the combination of CrM plus HMB showed an increase in testosterone and T/C compared with the other groups after 10 weeks of supplementation. Moreover, this combination presented a synergistic effect on testosterone and T/C and an antagonistic effect on cortisol compared with the sum of individual or isolated supplementation" - [Nutra USA] - See creatine at Amazon.com and  HMB at Amazon.com.
• The Association between Popular Diets and Serum Testosterone among Men in the United States - J Urol. 2020 Feb;203(2):398-404 - "Mean testosterone was lower among men with a low fat diet (410.8 ± 8.1 vs 443.5 ± 7.3, p=0.005) and a Mediterranean diet (412.9 ± 9.1 vs 443.5 ± 7.3, p=0.002). Multivariable analysis controlling for age, body mass index, activity level, diabetes, comorbidities and prostate cancer showed that men with a nonrestrictive diet had higher serum testosterone than those adhering to a low fat diet" - [Nutra USA]
• Causal Link Between Vitamin D and Total Testosterone in Men - Medscape, 9/13/19 - "We provide evidence for the biologically plausible causal effects of 25(OH)D on total T using MR analysis. Whether vitamin D supplementation can raise androgen levels merits further investigation in long-term, randomized controlled trials" - See vitamin D at Amazon.com.
• Testofen, a specialised Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen decrease, increases testosterone levels and improves sexual function in healthy aging males in a double-blind randomised clinical study - Aging Male. 2016 Jan 20:1-9 - "Sexual function improved, including number of morning erections and frequency of sexual activity. Both total serum testosterone and free testosterone increased compared to placebo after 12 weeks of active treatment. Trigonella foenum-graecum seed extract is a safe and effective treatment for reducing symptoms of possible androgen deficiency, improves sexual function and increases serum testosterone in healthy middle-aged and older men" - [Nutra USA] - See Trigonella foenum-graecum at Amazon.com.
• Clinical evaluation of purified Shilajit on testosterone levels in healthy volunteers - Andrologia. 2015 Sep 22 - "placebo-controlled clinical study at a dose of 250 mg twice a day. Treatment with Shilajit for consecutive 90 days revealed that it has significantly (P < 0.05) increased total testosterone, free testosterone and dehydroepiandrosterone (DHEAS) compared with placebo. Gonadotropic hormones (LH and FSH) levels were well maintained" - [ Nutra USA] - See shilajit ayursante at Amazon.com.
• Tongkat Ali as a Potential Herbal Supplement for Physically Active Male and Female Seniors-A Pilot Study - Phytother Res. 2013 Jun 11 - "Tongkat Ali (Eurycoma longifolia; TA) is known to increase testosterone levels and alleviate aging males' symptoms. This study aimed at investigating TA as an ergogenic supplement for elderly people. Thirteen physically active male and 12 physically active female seniors (57-72 years) were supplemented with 400-mg TA extract daily for 5 weeks ... Treatment resulted in significant increases in total and free testosterone concentrations and muscular force in men and women. The increase in free testosterone in women is thought to be due to the significant decline in sex hormone-binding globulin concentrations" - See Tongkat Ali products at iHerb.
• Association Between Plasma 25-OH Vitamin D and Testosterone - Medscape, 7/13/12 - "In conclusion, the present study confirms previous findings of a positive association between vitamin D status as reflected by 25(OH) vitamin D levels and testosterone levels, although in our study, this finding was not supported by parallel seasonal variation patterns of 25(OH) vitamin D and testosterone. Whether these cross-sectional findings reflect a causal relationship deserves further scientific examination" - See vitamin D at Amazon.com.
• Association between plasma 25-OH vitamin D and testosterone levels in men - Clin Endocrinol (Oxf). 2012 Jan 2 - "A small randomized controlled trial suggested that vitamin D might increase the production of testosterone in men, which is supported by experimental studies in animals and a cross-sectional study showing positive associations between plasma 25-hydroxyvitamin D [25(OH)D] and testosterone and concordant seasonal variation of both biomarkers ... 25(OH)D was positively associated with total and free testosterone levels ... The shapes of the dose-response curves indicate that the association between 25(OH)D and total and free testosterone is linear at lower levels of 25(OH)D (below approximately 75-85 nmol/l), reaching a plateau at higher levels" - See vitamin D at Amazon.com.
• Association of hypogonadism with vitamin D status: the European Male Ageing Study - Eur J Endocrinol. 2011 Nov 2 - "In univariate analyses free T levels were lower (P=0.02) and E2 and LH higher (P<0.05) in men with deficient vitamin D (25(OH)D<50nmol/L). 25(OH)D was positively associated with total and free T, and negatively with E2 and LH in age and centre adjusted linear regressions. After adjusting for health and lifestyle factors no significant associations were observed between 25(OH)D and individual hormones of the HPT axis. However, deficient vitamin D was significantly associated with compensated [relative risk ratio (RRR)=1.52, P=0.03] and secondary hypogonadism (RRR=1.16, P=0.05). Seasonal variation was only observed for 25(OH)D (P<0.001).Conclusions: Secondary and compensated hypogonadism were associated with vitamin D deficiency and the clinical significance of this relationship warrants further investigation" - See vitamin D at Amazon.com.
• Sleep loss dramatically lowers testosterone in healthy young men - Science Daily, 5/31/11 - "The effects of sleep loss on testosterone levels were apparent after just one week of short sleep. Five hours of sleep decreased their testosterone levels by 10% to 15%. The young men had the lowest testosterone levels in the afternoons on their sleep restricted days, between 2 pm and 10 pm"
• Association of vitamin D status with serum androgen levels in men - Clin Endocrinol (Oxf). 2009 Dec 29 - "Men with sufficient 25(OH)D levels (>/=30 mug/l) had significantly higher levels of testosterone and FAI and significantly lower levels of SHBG when compared to 25(OH)D insufficient (20-29.9 mug/l) and 25(OH)D deficient (<20 mug/l) men (p<0.05 for all). In linear regression analyses adjusted for possible confounders, we found significant associations of 25(OH)D levels with testosterone, FAI, and SHBG levels (p<0.05 for all). 25(OH)D, testosterone, and FAI levels followed a similar seasonal pattern with a nadir in March (12.2 mug/l, 15.9 nmol/l, and 40.8, respectively) and peak levels in August (23.4 mug/l, 18.7 nmol/l, and 49.7, respectively) (p<0.05 for all). Conclusion: Androgen levels and 25(OH)D levels are associated in men and reveal a concordant seasonal variation" - See vitamin D at Amazon.com.
• Letrozole once a week normalizes serum testosterone in obesity-related male hypogonadism - Eur J Endocrinol. 2008 May;158(5):741-7 - "Isolated hypogonadotropic hypogonadism (IHH) is frequently observed in severely obese men, probably as a result of increased estradiol (E(2)) production and E(2)-mediated negative feedback on pituitary LH secretion. Aromatase inhibitors can reverse this process ... treated with 2.5 mg letrozole once a week for 6 months ... Six weeks of treatment reduced total E(2) from 123+/-11 to 58+/-7 pmol/l (P<0.001, mean+/-s.e.m.), and increased serum LH from 4.4+/-0.6 to 11.1+/-1.5 U/l (P<0.001). Total testosterone rose from 5.9+/-0.5 to 19.6+/-1.4 nmol/l (P<0.001), and free testosterone from 163+/-13 to 604+/-50 pmol/l (P<0.001). Total testosterone rose to within the normal range in all subjects, whereas free testosterone rose to supraphysiological levels in 7 out of 12 men ... Letrozole 2.5 mg once a week produced a sustained normalization of serum total testosterone in obese men with IHH. However, free testosterone frequently rose to supraphysiological levels. Therefore, a starting dose <2.5 mg once a week is recommended" - See Femara (letrozole) at OffshoreRX.  I've been taking a quarter table a day but it sounds like that's way to much an a quarter tablet every other day might be best which comes to 2.5 mg every 8 days.  People complain about the hassle to get doctors to prescribe testosterone.  It sounds like letrozole will give you the same or better numbers without the hassle.  Plus testosterone replacement increases estrogen but letrozole has the advantage of decreasing it.  See my aromatization page.
• Carnitine Improves Symptoms of Male Aging - Medscape, 4/14/04 - "Carnitine is more active than testosterone for improving symptoms of male aging such as sexual dysfunction, depressed mood, and fatigue ... In this trial, 120 patients were randomized to receive testosterone undecanoate 160 mg/day, propionyl-L-carnitine 2 g/day plus acetyl-L-carnitine 2 g/day, or placebo for six months" [Abstract] - See iHerb acetyl-l-carnitine products and iHerb propionyl-l-carnitine.
• Why Testosterone Levels Decline  - Life Extension Magazine, 11/99 - "Clinical studies using testosterone injections, creams, or patches have often failed to provide a long-lasting, libido-enhancing effect in aging men (98). We now know why. The testosterone can be converted to estrogen. The estrogen is then taken up by testosterone receptor sites in cells throughout the body. When an estrogen molecule occupies a testosterone receptor site on a cell membrane, it blocks the ability of serum testosterone to induce a healthy hormonal signal. It does not matter how much serum free testosterone is available if excess estrogen is competing for the same cellular receptor sites" - See aromatization.
• Correcting A Hormone Imbalance  - Life Extension Magazine, 11/99  - "If all of the above fail to increase free testosterone and lower excess estradiol, then ask your doctor to prescribe the potent aromatase inhibiting drug Arimidex (anastrozole) in the very low dose of one-half (0.5 mg) mg, twice a week"
• Better than testosterone? - Life Extension Foundation, 4/19/04 - "The April 2004 issue of the journal Urology published the findings ... Erectile function, sexual desire, sexual satisfaction and nocturnal penile tumescence increased over the course of the study in the group receiving testosterone as well as the group receiving carnitine. In addition, the group receiving carnitine experienced an increase in orgasm and general sexual well-being. Erectile function and nocturnal penile tumescence were significantly more improved in this group than in those receiving testosterone. While both treatments lowered depression scores, carnitine’s effect was greater"
• Testosterone Attacked by the Media - Life Extension Magazine, 2/04
• Report: Male Menopause - Life Extension Magazine, 10/03 - "there are a growing number of anti-aging researchers who believe that estrogen and its metabolites, such as 16-alpha-hydroxyesterone, may be more significant in the development of prostate cancer than testosterone. In fact, a recent report made the following statement, which just 10 years ago would have been considering heresy by mainstream medicine: "There is no evidence that exogenous testosterone stimulates the development of severe symptomatic prostate hyperplasia, nor does exogenous testosterone seem to increase the risk of clinically significant prostate cancer." ... male rats treated with testosterone alone showed significantly less prostate growth when compared to animals treated with both testosterone and estrogen"
• Improve Your Sex Life And Protect Against Heart Attack - Life Extension Magazine, 5/03 - "low testosterone levels were associated with several risk factors for heart attack such as high insulin levels, abnormal glucose metabolism, low levels of HDL cholesterol and high blood pressure. Moreover, he further proposed that the converse was also true: testosterone protects against heart disease in men"
• Bright Light Therapy May Boost Testosterone - WebMD, 4/22/03 - "early morning light therapy caused a surge in a pituitary hormone called luteinizing hormone (LH) that raises testosterone levels in men ... Previous studies have shown that bright light therapy of daily exposure to specially designed, high-intensity light boxes can alleviate many symptoms of depression, especially among people who suffer from seasonal affective disorder (SAD) during winter months" - I did a lot of research on lighting for our home owners association.  See http://qualitycounts.com/fp/lights.htm.  The closest fluorescents to actual sunlight are the ones with 5000 or 6500 Kelvin rating.  The lights advertised as "cool white" are around 2700 Kelvin.  I've always felt that the "cool white" phrase was just a gimmick to sell what was cheap to make.
• Testosterone Deficiency & Depression, Does DHEA Raise the Levels of Bioavailable Testosterone in Men? - Life Extension Magazine, 8/02 - "As testosterone replacement for women is becoming increasingly commonplace, women too report not just restored libido, but also improved mood and greater energy, less anxiety and more assertiveness ... low levels of free testosterone were the best predictor of depression, regardless of age ... the study [in men] showed no correlation between depression and free estradiol ... The mood-improving action of testosterone is more likely to be due to the direct action of testosterone on the brain-possibly through raising the levels of dopamine, a very important "reward" neurotransmitter ... We know that as cortisol rises, testosterone levels tend to drop ... It is insufficient to have your total testosterone tested; men should insist on a blood test for free testosterone ... The transdermal route (cream or gel), however, is widely regarded as the best, producing steady levels and the least stress on the liver. Methyl-testosterone is to be avoided, since it is harmful to the liver; in fact, it has been banned in Europe ... a well-controlled study published in the prestigious Journal of Clinical and Experimental Endocrinology and Metabolism did in fact find a significant rise in free testosterone in men aged 60 to 84 years, after three months on 100 mg of DHEA ... Some men on testosterone drug replacement therapy develop dangerously high estrogen levels. Estrogen can be suppressed by taking an aromatase-inhibiting drug like Arimidex (0.5 mg twice a week) or using a supplement like Super Mira Forte (six capsules daily)" - See Super Mira Forte at Life Extension Products.
• Low testosterone levels can mean high health risks - Life Extension Magazine, 11/00 - "the preponderance of the evidence shows that maintaining youthful testosterone levels does not affect prostate cancer risk, whereas waning testosterone levels carry their own health threats. Declining testosterone levels can lead to the development of numerous symptoms such as a decrease in virility, libido and sexual activity, general sense of well-being, as well as fatigue, depression and sleep disturbances. In addition to problems such as sexual dysfunction or general malaise, however, low testosterone also translates into decreased muscle mass and strength, as well as a decrease in bone mass and an increase in abdominal fat. Studies show that the latter two lay a role in degenerative diseases such as osteoporosis, cardiovascular disease and diabetes. Moreover, depleted testosterone levels are being linked to the incidence of various lipid disorders and heart disease."
• Male Hormone Modulation Therapy  - Life Extension Magazine, 11/99 - "One cause of hormone imbalance in men is that their testosterone is increasingly converted to estrogen. One report showed that estrogen levels of the average 54-year-old man are higher than those of the average 59-year-old woman . . . . High levels of estrogen have been implicated as a cause of benign prostatic hypertrophy (BPH)" - See my chrysin and I3C page about how of protect against this.
• Replenish Testosterone Naturally - Life Extension Magazine, 1/00 - "Through a variety of mechanisms, aging men suffer from the dual effects of having too little testosterone and excess estrogen. The result is a testosterone/ estrogen imbalance that can severely inhibit sexual desire and performance."
• Hormonal Rejuvenation for Men - How men can safely use testosterone to restore libido - Life Extension Magazine, 1/00 - "The medical disorders related to testosterone deficit include  depression, coronary artery disease, elevated cholesterol, abdominal weight gain, cognitive deficit, fatigue, immune dysfunction and many other diseases associated with "growing old."
• Replenish Testosterone Naturally - Life Extension Magazine, 1/00 - "Too much estrogen plays havoc with a man's sex life by binding to testosterone receptor sites and may contribute to the over-production of SHBG. SHBG binds free testosterone in a way that makes it unavailable to receptor sites in the brain, nerves and genitals."
• Evaluation and Treatment of Male Sexual Dysfunction  - American Association of Clinical Endocrinologists and The American College of Endocrinology - "increased prolactin levels may also cause erectile problems, even in the presence of a normal testosterone level . . . .Most problems revolve around dysfunction of the hypothalamic-pituitary-gonadal axis and are associated with either excess prolactin or decreased testosterone levels. Other endocrine disorders that may cause libido or erectile difficulties include hypothyroidism, hyperthyroidism, adrenal insufficiency, or excessive levels of adrenal corticosteroids." - see prolactin and cortisol
• Hypogonadism - American Association of Clinical Endocrinologists
• Erectile Dysfunction / Impotence - Prostate Health Guide - U. of Maryland Medicine - "Hormonal abnormalities such as increased prolactin (a hormone produced by the anterior pituitary gland), steroid abuse by body-builders, too much or too little thyroid hormone, and hormones administered for prostate cancer may cause impotence. Rarely is low testosterone responsible for impotence"
• Testosterone Therapy: No Prostate Cancer Link - WebMD, 1/15/04 - "One of doctors' greatest fears about testosterone therapy is that it may cause prostate cancer. But a new study shows that it won't increase a man's risk of prostate cancer -- even if he has precancerous prostate cells"

Other News:

• Metformin, Testosterone Replacement Linked to Reduced Cancer Risk - Medscape, 8/26/22 - "metformin and testosterone replacement therapy were independently and jointly associated with a reduced incidence of prostate cancer, with the greatest reduction with the combination of the two (joint odds ratio [OR],  0.44) ... The two drugs were also inversely associated with a high grade at prostate cancer diagnosis (joint OR, 0.36) and advanced cancer stage (joint OR, 0.47), after multivariate adjustment for factors including age, race/ethnicity, hypogonadism, hypertension, diabetes, insulin use, muscular wasting, and other factors ... Metformin and testosterone replacement therapy were also independently and in combination inversely associated with the incidence of colorectal cancers (joint OR, 0.47); however, the associations with higher grade and advanced stage were not consistent, the authors note" - Note: Good luck with that. Testosterone prescriptions are another one that's like getting a prescription for cocaine. Doctors seem locked in a previous era. See metformin at ReliableRX..
• Circulating free testosterone and risk of aggressive prostate cancer: prospective and Mendelian randomization analyses in international consortia - Int J Cancer 2022 May 17 - "In blood-based analyses there was no association with aggressive disease overall, but there was heterogeneity by age at blood collection (OR for men aged <60 years 1.14, CI=1.02-1.28; Phet =0.0003: inverse association for older ages). Associations for free testosterone were positive for overall prostate cancer (MR:1.20,1.08-1.34; blood-based:1.03,1.01-1.05) and early-onset prostate cancer (MR:1.37,1.09-1.73; blood-based:1.08,0.98-1.19). SHBG and total testosterone were inversely associated with overall prostate cancer in blood-based analyses, with null associations in MR analysis. Our results support free testosterone, rather than total testosterone, in the development of prostate cancer, including aggressive subgroups"
• Can we rely on total testosterone measurement to exclude hypogonadism in erectile dysfunction? - Int J Impot Res 2022 Mar 28 - "Although male hypogonadism (MH) is a prevalent comorbidity in patients presenting for erectile dysfunction (ED), its screening relies solely on total testosterone (TT). Ageing and other conditions can increase sex hormone-binding globulin (SHBG) and lower free testosterone (FT) causing symptomatic MH despite normal TT. The primary objective was to measure the prevalence of normal TT/low FT among patients presenting for ED ... Normal TT/low cFT is frequent and can be missed by current screening recommendations for MH in patients presenting for ED. Ageing seems to be the main culprit as elevated SHBG prevalence increases steeply after the sixth decade. TT cannot solely be relied on to exclude biochemical MH in patients presenting for ED, especially in patients over 60 years old"
• How Low Testosterone Affects Your ‘New Year, New Me’ Goals - WebMD, 2/1/22 - "Low T also plays a role in lowering your body’s metabolism ... Testosterone makes it easier for you to put on muscle when you exercise ... so just by having muscle, you burn more calories and your baseline metabolism goes up"
• Ultrasonic testicular size of 24,440 adult Vietnamese men and the correlation with age and hormonal profiles - Andrologia 2021 Dec 28 - "Hypogonadal men and unexplained infertile men had significantly smaller testicular sizes compared with healthy fathers ... Testicular size of Vietnamese men was negatively correlated with LH and FSH (Rho = -0.16 and -0.33, p < 0.001) and positively correlated with testosterone after adjusting for confounding factors"
• Effectiveness of testosterone replacement in men with obesity: a systematic review and meta-analysis - Eur J Endocrinol 2021 Nov 1 - "A total of 16 randomized controlled trials were included. With moderate certainty of the evidence, no difference was found between TRT and placebo regarding total adverse events, TRT led to a 2-kg lean body mass gain and slightly improved low-density lipoprotein (LDL), without effects on the blood pressure. Due to imprecision/heterogeneity, effects in cardiovascular events (relative risk 0.52, 95% CI 0.26 to 1.05, 7 trials, 583 participants), high-density lipoprotein, hematocrit, prostate-specific antigen, HbA1c, and quality of life were unclear. TRT was effective for waist circumference and body mass index; however, large between-study heterogeneity was found, with 95% prediction intervals crossing the null effect line. Meta-regression revealed that the average age of participants was a significant modifier for both outcomes"
• T4DM Trial and its T4Bone Substudy Shed Further Light on Effects of Testosterone Treatment in Middle-aged and Older Men - Medscape, 8/16/21 - "The Bone Trial of the TTrials demonstrated that testosterone treatment substantially increased volumetric bone mineral density (vBMD) of the lumbar spine ... Testosterone treatment for 2 years in the T4Bone trial was associated with greater improvements in the cortical and total vBMD and cortical area and thickness at the distal tibia and radius, compared with placebo. Testosterone treatment also significantly increased areal BMD (aBMD) at the lumbar spine and the hip ... Although the findings of the T4Bone trial are similar in some ways to those of the Bone Trial of the TTrials,[4] there also are some salient differences. In both, testosterone treatment, compared with placebo, increased vBMD. The magnitude of the increase of the primary end point (tibial cortical vBMD) in the T4Bone trial was smaller, 3% in 2 years, compared with 7% in 1 year of the primary end point (spine trabecular vBMD) in the Bone Trial. In the T4Bone trial, larger increases were observed in the cortical bone, while the Bone Trial found greater increases in the trabecular bone. The changes in aBMD at the hip and spine were similar in the 2 trials ... Testosterone threshold for eligibility in the T4DM Trial was 14nmol/L (403 ng/dL), and a majority had baseline testosterone levels in the eugonadal range. In contrast, the baseline mean testosterone levels in the Bone Trial were unequivocally, although modestly, hypogonadal (8.0 nmol/L [229.6 ng/dL]) and 8.3nmol/L [238.8ng/dL] in testosterone and placebo arms, respectively) ... Estradiol levels above 10 pg/mL and testosterone levels in the range of 200 to 300ng/dL have been considered sufficient to prevent increases in bone resorption and decreases in BMD in men"
• Testosterone Therapy for Hypogonadism With Diabetes? - Medscape, 8/2/21 - "among men with hypogonadism and type 2 diabetes, from baseline to 12 years, mean A1c decreased from 9.4% to 5.6% in the group that received testosterone undecanoate injections (T-group) and increased from 7.8% to 10.4% in the control group ... But in the T4DM trial, a safety trigger for a hematocrit >54% was met by 22% of patients receiving testosterone, vs 1% of patients in the control group, "and it is known that an elevated hematocrit is a risk factor for thromboembolic events," he pointed out ... during follow-up, fewer patients in the T-group than in the control group died (15 patients [8.2%] vs 61 patients [34%]) ... None of the patients in the T-group had an MI or stroke, compared to 56 cases of MI (31.5%) and 56 cases of stroke (31.5%) in the control group" - Note:  I'm always having a pissing contest with endocrinologists.  One question they should be asking themselves is whether the cutoff for free testosterone being low is black and while or whether there is a gray area when you approach that point.
• Effects of Testosterone Treatment, With and Without Exercise Training, on Ambulatory Blood Pressure in Middle-Aged and Older Men - Medscape, 7/30/21 - "Average 24-h systolic blood pressure (SBP) increased with T treatment (testosterone*time, p = .035). Average 24-h SBP increased in T+Ex ... Ex increased average 24-h pulse pressure (PP, exercise*time, p = .022), largely during daytime hours ... There was a main effect of T to increase 24-h SBP, primarily seen when T was combined with Ex. Exercise alone decreased 24-h and night-time DBP; an effect attenuated by T. BP should be carefully assessed and monitored, when prescribing T treatment to middle-aged and older men, especially when combined with exercise training"
• Interaction between testosterone and obesity on hypertension: A population-based cross-sectional study - Atherosclerosis 2021 Jun 24 - "Elevated levels of serum testosterone were associated with decreased BP parameters and prevalent hypertension in males, and obesity modifying effects of serum testosterone on BP parameters and hypertension"
• Testosterone Replacement Shows CV Benefit in Hypogonadal Men - Medscape, 7/12/21 - "The latest results come from a study of 805 men with hypogonadism from Germany and Qatar who were followed for nearly a decade. For those who received parenteral testosterone 1000 mg every 12 weeks, there were improvements in classical cardiovascular risk factors, such as obesity, lipid level, and inflammatory markers, whereas among those who chose not to take testosterone (control patients), all of these factors worsened ... In addition, there were only 16 deaths among patients in the TRT group, and none of the deaths were from myocardial infarction (MI) or stroke ... In contrast, there were 74 deaths among the control patients, as well as 70 cases of MI and 59 strokes"
• The role of testosterone replacement therapy and statin use, and their combination, in prostate cancer - Cancer Causes Control 2021 May 26 - "testosterone replacement therapy (TTh) ... prostate cancer-specific mortality (PCSM) ... Pre-diagnostic use of TTh or statins, independent or in combination, was inversely associated with aggressive PCa, including in NHW and Hispanics men, but was not with PCSM. The findings for use of statins with aggressive PCa are consistent with cohort studies"
• For men, low testosterone means high risk of severe COVID-19, study suggests - Science Daily, 5/25/21 - "The lower the levels of testosterone, the more severe the disease. For example, those with the lowest levels of testosterone in the blood were at highest risk of going on a ventilator, needing intensive care or dying ... In addition, the researchers found that lower testosterone levels in men also correlated with higher levels of inflammation"
• Testosterone Therapy Effects on Bone Mass and Turnover in Hypogonadal Men with Type 2 Diabetes - J Clin Endocrinol Metab 2021 Mar 18 - "Male hypogonadism is associated with low bone mineral density (BMD) and increased fragility fracture risk. Patients with type 2 diabetes (T2D) have relatively higher BMD, but greater fracture risk ... Testosterone therapy results in greater improvements in the skeletal health of hypogonadal men with T2D than their non-diabetic counterparts"
• Guys, Exercise Helps Aging Hearts, Testosterone Won't - WebMD, 2/23/21 - "arterial function shot up by 28% among those who exercised without taking testosterone therapy. That bested the 19% improvement seen among those exercised and took testosterone replacement therapy ... Those men who only received testosterone therapy saw no heart health improvement at all. The researchers concluded that exercise may be preferable over testosterone supplementation to improve heart health in older men"
• Serum testosterone is inversely, and sex hormone-binding globulin directly, associated with all-cause mortality in men - J Clin Endocrinol Metab 2020 Oct 16 - "Lower serum testosterone is independently associated with higher all-cause and cancer-related, but not CVD-related, mortality in middle-aged to older men. Lower SHBG is independently associated with lower all-cause, CVD-related and cancer-related mortality"
• Testosterone, Dihydrotestosterone, Bone Density, and Hip Fracture Risk among Older Men: The Cardiovascular Health Study - Metabolism 2020 Oct 12 - "In older men, DHT was inversely associated with hip fracture risk and SHBG was positively associated with hip fracture risk, while T was not"
• New Oral Testosterone Undecanoate Formulation Restores Normal Testosterone Levels - Medscape, 5/26/20 - "this is a novel oral twice-a-day medication free of hepatic side effects ... Treatment-emergent adverse events deemed related to study drug occurred in 18.7% of patients in the TU group and in 14.5% of the topical testosterone group"
• Testosterone therapy in relation to prostate cancer in a US commercial insurance claims database - Cancer Epidemiol Biomarkers Prev. 2019 Oct 22 - "Men who received TT did not have a higher rate of prostate cancer compared with the unexposed or PDE5i comparison groups. The inverse association between TT and prostate cancer could be the result of residual confounding, contraindication bias, or undefined biologic effect"
• AUA 2019: More Evidence That Testosterone May Be Safe After Treatment for Prostate Cancer - Medscape, 8/13/19 - "Neither of these cohorts showed any evidence of a problem from receiving TRT after diagnosis and treatment for prostate cancer. On the other hand, neither of these studies, and none of the others that have been presented, clearly prove that TRT is safe. Nevertheless, there is not an obvious risk to patients from these trials and, when presented with the information on the risks and benefits, most men are likely to make a quality-of-life decision, choosing TRT in order to restore their sexual function"
• Testosterone Therapy May Threaten the Heart - WebMD. 7/23/19 - "Those who took testosterone replacement therapy had a 21% higher risk of cardiovascular events such as heart attack, stroke or mini-stroke than those who did not take the therapy"
• Testosterone replacement therapy (TRT) can increase men's risk of stroke and heart attack - Science Daily, 7/18/19 - "a cohort of 15,401 men, aged 45 years or older, with low testosterone levels (hypogonadism). Users of TRT had a 21 percent greater risk of cardiovascular events compared with nonusers, corresponding to an additional 128 events. The increased risk appears to be transient, declining after two years of TRT use, which the investigators attribute to a phenomenon called "depletion of susceptibles.""
• High Testosterone Levels Bad News for the Heart - WebMD, 3/7/19 - "Men with a genetic predisposition to high testosterone levels have a nearly eightfold increased risk of heart failure and twice the risk of thromboembolism (blood clots that can block veins or arteries leading to the brain or lungs) ... Although the study focuses on men with naturally high testosterone, it has implications for aging men who are taking testosterone supplements to boost their energy levels and improve their sex drive ... Testosterone is believed to contribute to hardening of the arteries"
• Serum Testosterone and Non-alcoholic Fatty Liver Disease in men and Women in the US - Medscape, 12/10/18 - "In this nationally representative sample of adults in the US, low total testosterone levels were associated with suspected non-alcoholic fatty liver disease in men and post-menopausal women independent of known risk factors"
• High-Dose Testosterone Promising for Depression in Men - Medscape, 11/19/18 - "The main findings are that testosterone significantly reduces depressive symptoms compared to placebo, and with testosterone, men are 2.3 times more likely to show clinically relevant symptom reduction compared to placebo"
• Free testosterone correlated with erectile dysfunction severity among young men with normal total testosterone - Int J Impot Res. 2018 Oct 22 - "Decreased levels of FT were associated with lower IIEF-5 scores(β = 0.176, P = 0.048) and EHGS (β = 0.198, P = 0.026) after adjustment for age, body mass index (BMI), smoking, comorbidities, high-sensitive C-reactive protein (hsCRP), uric acid, fructosamine, and quantitative insulin sensitivity check index (QUICKI) ... Low FT level, even in the presence of normal TT, is associated with ED severity in young men. FT levels should be screened in ED patient even with normal total testosterone"
• Long-Term Testosterone Reverses Diabetes in Some Hypogonadal Men - Medscape, 7/5/18 - "After almost a decade of testosterone injections every 3 months, 22% of men with type 2 diabetes and hypogonadism had diabetes remission, in unexpected findings from a small registry study that was only designed to assess a new preparation of the hormone ... In the total group of 133 patients, there was not a single patient who did not benefit from testosterone therapy"
• Testosterone and All-cause Mortality in Older Men - Medscape, 5/28/18 - "Among men with MetS, a decrease in one standard deviation of testosterone was associated with higher mortality risk [HR 1.78 (95% CI 1.13 to 2.78) and HR 1.83 (95% CI 1.17 to 2.86) for total and bioavailable testosterone, respectively]. By contrast, there was no association of testosterone with mortality risk among men without MetS"
• Low total testosterone in men widespread, linked to chronic disease - Science Daily, 4/19/18 - "The researchers studied the prevalence of multimorbidity, or when two or more of the chronic conditions were present, among three age groups (young, middle-aged and older men) with and without testosterone deficiency. They found that low total testosterone was associated with multimorbidity in all age groups -- but it was more prevalent among young and older men with testosterone deficiency ... "We also found a large dose-response relationship between the age-specific low total testosterone and moderate total testosterone levels and multimorbidity, even after adjusting for obesity and muscle strength capacity," Peterson says. "Which means that men should be concerned about declining total testosterone, even if it has not reached a level to warrant a clinical diagnosis (<300 ng/dL [10.4 nmol/L]).""
• Testosterone Therapy and PCa Risk in Hypogonadal Men - Medscape, 12/27/17 - "At the end of the day, we can say that administering testosterone replacement to men who are hypogonadal does not appear to raise their risk of getting prostate cancer. We must ask ourselves why it should appear to lower the risk of having more aggressive disease. Another question is, why should men who are untreated when they are hypogonadal have a higher risk from their cancer? Curiously, we reported with some other authors many years ago on men who were being diagnosed and treated for metastatic prostate cancer. We found that lower testosterone conveyed a worse survival compared with men with higher testosterone levels"
• Pilot Study Eases Fears Over Testosterone in Advanced Prostate Cancer - Medscape, 10/30/17 - "All experienced improvements in vitality, strength, sexual desire, and function, and none had a "precipitous progression or unexpected complication ... What we did not see is maybe what's most important, and that was no vertebral collapse, spinal compression, or acute death. On the contrary, these men expressed gratitude for the opportunity to live a more satisfying and full life. They thanked us for our willingness to offer them a treatment that every other doctor said was going to kill them ... After 47 months' median follow-up, no evidence of increased recurrence or progression risk was observed"
• Long-term testosterone therapy improves urinary, sexual function and quality of life - Science Daily, 8/14/17 - ""It is thought that testosterone treatment in men may increase prostate size and worsen lower urinary tract symptoms," said Abdulmaged Traish, PhD, professor of urology at BUSM ... However, he and Gheorghe Doros, PhD, professor of biostatistics at BUSPH, discovered that despite increased prostate size in the group that received testosterone therapy, there were fewer urinary symptoms such as frequent urination, incomplete bladder emptying, weak urinary stream and waking up at night to urinate ... In addition to these subjective improvements, the researchers conducted objective testing that showed that those men treated with testosterone emptied their bladders more fully. Finally, testosterone treatment also increased the scores patients received on assessments of their erectile/sexual health and general quality of life"
• Testosterone Gel Didn’t Help Men’s Memories: Study - NBC News, 2/21/17 - "While testosterone use for one year appeared to strengthen bones and reduce anemia, it also showed signs of worsening artery disease and questions remain about other potential risks ... Testosterone had no effect on memory or mental function, based on tests given before, halfway and at the end of treatment to nearly 500 men with age-related memory decline"
• Atherosclerosis Speeds Up in Older Men on Testosterone: T Trial - Medscape, 2/24/17 - "In a randomized trial of 138 older men with age-related low testosterone levels, those who received testosterone gel (AndroGel, AbbVie) for a year to attain youthful testosterone levels had a 20% greater buildup of noncalcified plaque in their coronary arteries than those who received a placebo gel"
• Normal ranges for testosterone levels defined - Science Daily, 1/10/17 - "The harmonized normal range for testosterone in a non-obese population of European and American Men, 19-39 years, is 264-916 ng/dL"
• 2% Testosterone Ups Sex Drive, Energy for Men With Low T - Medscape, 8/24/16 - "Participants in both groups had similar baseline characteristics — to qualify for the trial, they had to be 18 years or older and have had two total testosterone levels < 300 ng/dL measured 1 week or more apart and at least one symptom of testosterone deficiency (low energy or low sex drive)"
• Testosterone Treatment and Sexual Function in Older Men with Low Testosterone Levels - J Clin Endocrinol Metab. 2016 Jun 29 - "Compared with placebo, T administration significantly improved 10 of 12 measures of sexual activity. Incremental increases in total and free T and estradiol levels were associated with improvements in sexual activity and desire, but not erectile function. No threshold T level was observed for any outcome, and none of the 27 baseline characteristics predicted responsiveness to T"
• Long-term Testosterone May Decrease Cardiovascular Risk - Medscape, 5/10/16 - "Long-term testosterone replacement therapy is associated with a decreased — not increased — risk for cardiovascular disease in men ... involved 10,311 men 66 years and older newly treated with testosterone replacement therapy and 28,029 untreated control subjects ... At a median follow-up of 5 years, overall mortality was lower in patients treated with testosterone replacement therapy than in control subjects (hazard ratio, 0.88) ... There was no increase in prostate cancer risk with short-term exposure, and the risk decreased with increasing exposure; with long-term exposure, prostate cancer decreased by 40%"
• Testosterone Gel Has Modest Benefits for Men, Study Says - N.Y. Times, 2/17/16 - "The study, led by the Perelman School of Medicine at the University of Pennsylvania and funded by the National Institutes of Health and AbbVie, the maker of the testosterone gel AndroGel, involved 790 men 65 and older with low testosterone levels for their age ... Men who had said their sexual functioning had been flagging reported moderate increases in their interest in sex and in their performance, although when it came to erections, a drug like Viagra or Cialis would be more effective, the researchers reported. Those who said they felt blue reported a small improvement in mood. But the drug had no discernible effect on vitality or walking speed in men with those complaints"
• Common Prostate Cancer Treatment May Double Risk for Alzheimer's -NBC News, 12/7/15 - "The study of more than 16,000 men being treated for prostate cancer showed that those who got any kind of androgen deprivation therapy had nearly twice the risk of developing Alzheimer's over the next 2 ½ years as men getting other treatments"
• Long-term 'T' Does Not Up Risk for High-grade Prostate Cancer - Medscape, 11/25/15 - "In the study cohort, 574 men had used testosterone in the 5 years before diagnosis and 51,945 has not. The incidence of high-grade prostate cancer was 20.1% in the testosterone users and 27.0% in the nonusers"
• Restoring testosterone rather than replacing it helps safeguard a man's fertility - Science Daily, 10/27/15 - "One of the basic tenets in medicine is to do no harm. As this study has shown in a randomized, double-blind, double-dummy, placebo-controlled manner, exogenous testosterone therapy with Androgel can clearly decrease sperm production and potentially impact fertility ... This study confirmed that Enclomiphene can maintain spermatogenesis while restoring testosterone levels to normal" - Note:  It just seems like Femara (letrozole) is a better way to go but I'm not a doctor.
• Testosterone Therapy and Mortality Risk - Medscape, 5/14/15 - "There appears to be no change in mortality risk overall for men utilizing long-term testosterone therapy"
• Hormone replacement therapy and longevity - Andrologia. 2015 Apr 19 - "It was found that testosterone replacement therapy of men suffering from late onset hypogonadism increased survival rate by 9-10% in 5 years, similar to that of eugonadal, non-LOH men with normal endogenous testosterone secretion. Oestrogen replacement therapy resulted in increased survival by 2.6% in 5 years. It is concluded that hormone replacement therapy increases longevity"
• Genetic and environmental influence on the association between testosterone, sex hormone binding globulin, and body composition in Korean men - Clin Endocrinol (Oxf). 2015 Jan 19 - "Each 1-SD increase in age-adjusted levels of TT, cFT, and SHBG were associated with lower levels of adiposity measures and absolute measures of lean body mass. On the other hand, percentage total lean mass increased with increasing levels of TT, cFT, and SHBG (P <0.05)"
• Total testosterone is the most valuable indicator of metabolic syndrome among various testosterone values in middle-aged Japanese men - Endocr J. 2014 Oct 23 - "TT and SHBG were significantly lower in men with MetS than in men without MetS. All testosterone values gradually decreased as the number of MetS components increased"
• Association of Sex Hormones with Sexual Function, Vitality and Physical Function of Symptomatic Older Men with Low Testosterone Levels at Baseline in the Testosterone Trials - J Clin Endocrinol Metab. 2014 Dec 30 - "Baseline serum TT and FT, but not E2 or SHBG levels had small, but statistically significant associations with validated measures of sexual desire, erectile function and sexual activity. None of these hormones was significantly associated within or across trials with FACIT-Fatigue, PHQ-9 Depression or Physical Function-10 scores, or gait speed"
• Risk of Myocardial Infarction in Older Men Receiving Testosterone Therapy - Ann Pharmacother. 2014 Jul 2 - "Older men who were treated with intramuscular testosterone did not appear to have an increased risk of MI. For men with high MI risk, testosterone use was modestly protective against MI"
• Long-term testosterone therapy does not increase risk of prostate cancer - Science Daily, 11/25/14 -"Although considerable evidence exists indicating no relationship between testosterone and increased risk of developing PCa, decades of physician training with the notion that testosterone is fuel for PCa made it difficult to dispel such fallacy and the myth continued to persist ... PCa incidence per 10,000 patient-years in cohorts 1 and 2 was 54.4 and 30.7, respectively, which is lower than 116 reported by the PLCO (Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial) and 96.6 reported by the ERSPC ( European Randomized Study of Screening for Prostate Cancer)"
• Low Testosterone in Diabetic Men Tied to Vascular Risk - Medscape, 10/22/14 - "A total of 79 men had normal total testosterone (> 12.1 nmol/L, or > 3.5 ng/mL), and 36 men had low total testosterone (< 12.1 nmol/L, or < 3.5 ng/mL) — based on International Society of Andrology cutoffs ... More patients with low vs normal testosterone levels had a CIMT of 0.1 cm or greater (80% vs 39%), atherosclerotic plaques (68.5% vs 44.8%), and endothelial dysfunction (80.5% vs 42.3%). Low testosterone levels were also associated with higher CRP levels"
• Testosterone and Mortality - Medscape, 10/2/14 - "The reason as to why testosterone is lower in these men at greater risk of earlier death may be that the degree of activation of pro-inflammatory cytokines reflects the severity of disease burden. There is clear evidence that testosterone levels are suppressed as a result of conditions which lead to the systemic production of inflammatory cytokines, be it as a result of low grade or more marked forms of chronic inflammation. Common clinical conditions which induce chronic inflammatory states are obesity, atherosclerosis, diabetes, chronic obstructive pulmonary disease and inflammatory arthritides. Acute illness as a result of infection, inflammation, infarction and trauma including surgery leads to severe suppression of the hypothalamic–pituitary–testicular axis resulting in levels of testosterone as low as 2 nmol/l. The majority of the studies described in this review especially in those which involve older men distinctly demonstrate that low testosterone is a biomarker disease severity and increased risk of mortality"
• The Effect of Testosterone Replacement on Prostate Cancer - Medscape, 8/14/14 - "This meta-analysis shows that regardless of the administration method, TRT is the short-term safety and does not promote prostate cancer development or progression but long-term data are warranted with justifiable end points"
• Best Time of Day for a Testosterone Test - NYTimes.com, 7/25/14 - "They further divided them into two time groups: those who had their testosterone measured from 7 a.m. to 9 a.m. and those measured from 9 a.m. to 2 p.m. All the men had erectile dysfunction, a symptom of low testosterone levels ... The only men who showed a statistically and clinically significant decrease in levels between the two time periods were those younger than 45"
• Lower free testosterone level is correlated with left ventricular diastolic dysfunction in asymptomatic middle-aged men with type 2 diabetes mellitus - Int J Clin Pract. 2014 Jul 16 - "Lower FT level was significantly associated with LVDD [univariate odds ratio (OR) = 0.63, p = 0.032; multivariate OR = 0.71, p = 0.039]"
• Testosterone replacement may help mobility limited older men improve and maintain aerobic capacity - Science Daily, 6/23/14 - "For 6 months, 28 men in one group received 10 milligrams of testosterone gel and 36 men in a second group received a placebo gel. All subjects completed a cycle exercise test to measure their peak aerobic fitness before and after the 6 month study ... The men taking testosterone displayed a slight improvement in aerobic fitness while those taking placebo showed a slight decline. This small increase in aerobic capacity in the testosterone group eliminated the expected decrease that men generally experience with natural aging ... Among the men taking testosterone, the age-related decline in the peak oxygen uptake was 3.4 times less than expected, while the rate of decline among the men taking placebo accelerated to nearly twice the expected rate"
• Low testosterone raises risk of age-related functional disability - Science Daily, 6/23/14 - "the research included 1,318 men ages 70 and older who had health assessments when they entered the study from 2005 to 2007, and again two years later ... they found that the lower the level of testosterone or either of the estrogens, the higher the chance that the men had worse functional abilities at the two-year follow-up evaluation ... This study suggests that low testosterone in older men could lead to a decline in muscle strength, which might explain their increased risk of functional disability"
• Testosterone, Dihydrotestosterone and Incident Cardiovascular Disease and Mortality in the Cardiovascular Health Study - J Clin Endocrinol Metab. 2014 Mar 14 - "Low testosterone (T) is associated with prevalent cardiovascular disease (CVD) and mortality. Dihydrotestosterone (DHT), a more potent androgen, may also be associated with CVD and mortality ... we evaluated whether total T, calculated free T (cFT), DHT, and calculated free DHT were associated with incident CVD and mortality in men in the Cardiovascular Health Study (mean age 76, range 66-97) who were free of CVD at the time of blood collection ... total T and cFT were not associated with incident CVD or all-cause mortality, while DHT and calculated free DHT had curvilinear associations with incident CVD (p<0.002 and p=0.04, respectively) and all-cause mortality (p<0.001 for both)"
• Excessive testosterone raises mortality risk in older men - Science Daily, 11/22/13 - "Men with circulating testosterone levels in the 9.8 to 15.8 nmol/L range tended to live longer"
• Testosterone Deficiency is Associated with Increased Risk of Mortality and Testosterone Replacement Improves Survival in Men with Type 2 Diabetes - Eur J Endocrinol. 2013 Sep 2 - "Low testosterone levels predict an increase in all-cause mortality during long-term follow up. Testosterone replacement may improve survival in hypogonadal men with type 2 diabetes"
• Testosterone Produces Mixed Results in Prostate Cancer Study - Medscape, 7/18/13 - "In men with prostate cancer, the use of transdermal testosterone-replacement therapy (TRT) after radical prostatectomy produced an increase in testosterone levels, but also had the undesirable effect of increasing prostate-specific antigen (PSA) levels ... However, the use of TRT did not appear to increase biochemical recurrence rates during follow-up, which was a median of 27.5 months for treated men"
• Testosterone improves verbal learning and memory in postmenopausal women - Science Daily, 6/17/13 - "the Australian researchers randomly assigned 92 healthy postmenopausal women, ages 55 to 65, who were not receiving estrogen therapy, to receive one of two treatments for 26 weeks. The treatments were a testosterone gel (LibiGel, BioSante Pharmaceuticals) applied daily to the upper arm, or a placebo, an identical-appearing gel containing none of the medication ... Before treatment and at 12 and 26 weeks of treatment, subjects underwent comprehensive testing of their cognitive function ... After 26 weeks, the women who received testosterone therapy had a statistically significant and clinically meaningful improvement in verbal learning and memory -- how well they recalled words from a list"
• Testosterone therapy may help improve pain in men with low testosterone - Science Daily, 6/17/13 - "The study included 84 men ages 18-64 years old with opioid-induced testosterone deficiency. Their average age was 49 years ... At the beginning of the study, and then again at 14 weeks, the investigators assessed pain measures and quality-of-life parameters"
• Low Testosterone Linked to Later Arthritis in Study - WebMD, 4/3/13 - "Swedish researchers analyzed blood samples collected from 104 men who were later diagnosed with rheumatoid arthritis and 174 men of the same age who did not develop the disease. The average time between collection of the blood sample and a diagnosis of rheumatoid arthritis was just less than 13 years ... men with lower testosterone levels were more likely to develop rheumatoid arthritis. They did not, however, prove a cause-and-effect link between the two ... These men also had significantly higher levels of follicle stimulating hormone -- a chemical involved in sexual maturity and reproduction -- before they were diagnosed with rheumatoid arthritis"
• Men taking long-acting chronic pain meds five times more likely to have low testosterone levels - Science Daily, 1/31/13 - "The study compared the use of short-acting opioids, which immediately release the pain medication and are taken every four to six hours, and long-acting opioids, which slowly release the pain medication and are taken every eight to 12 hours ... A healthy young man should have testosterone levels between 300 and 800 nanograms per deciliter (ng/dL); in this study, low testosterone, also known as hypogonadism, was defined as less than 250 ng/dL. Low testosterone levels have been associated with decreases in muscle mass, bone density (osteoporosis or osteopenia), cognition, mood, libido (sex drive) and general quality of life ... the odds of having low testosterone were 4.78 times greater for men taking a long-acting opioid than a short-acting opioid. Dose was not associated with an increased risk of low testosterone"
• The relationship between sex hormones, sex hormone binding globulin and peripheral artery disease in older persons - Atherosclerosis. 2012 Oct 3 - "Low SHBG and high T levels are significantly and independently associated with the presence of PAD in older men and women, respectively"
• Testosterone increases honesty, study suggests - Science Daily, 10/10/12 - "this sex hormone surprisingly also fosters social behavior. In play situations, subjects who had received testosterone clearly lied less frequently than individuals who had only received a placebo ... Neither the subjects themselves nor the scientists performing the study knew who had received testosterone and who hadn't"
• Testosterone Has Benefits for Metabolism, Weight Loss - Medscape, 7/18/12 - "All these patients presented [to a urologist] because of erectile dysfunction ... They received 4 years of testosterone therapy without interruption. To our surprise, we saw that they lost weight, and this was neither intended nor expected ... Specifically, they found that the mean weight decrease from baseline to the last patient visit was 14.3 kg [31.5 pounds], with 2 patients losing 40 kg [88 pounds] or more. The mean percentage weight loss was 13.0%, body mass index (BMI) decreased by a mean of 4.5 points, and the mean decline in waist circumference was 11 cm [4.3 inches]"
• Testosterone-replacement therapy improves symptoms of metabolic syndrome - Science Daily, 6/25/12 - "investigators found that the prevalence of metabolic syndrome dropped from 56 to 30 percent after 57 months of treatment with testosterone-replacement medication to regulate hormone levels. In addition, triglycerides, and levels of blood sugar and pressure significantly decreased, while the average waist circumference shrank by 11 centimeters ...Patients received 1,000 milligrams of a long-acting testosterone drug, called undecanoate, on the first day of the study, at week six, and then every three months"
• Long-term testosterone treatment for men results in reduced weight and waist size - Science Daily, 6/23/12 - "The substantial weight loss found in our study -- an average of 36 pounds -- was a surprise ... On average, the men weighed 236 pounds before beginning testosterone treatment and 200 pounds after treatment ... Weight loss was reportedly continuous, with an average reduction in body weight ranging from about 4 percent after one year of treatment to more than 13 percent after five years ... In addition, men lost an average of nearly 3.5 inches (8.8 centimeters) around their waist" - Note:  My testosterone has been about 10% above the high range number for years just by taking a quarter tablet of letrozole every two or three days plus testosterone increases estrogen as much as it increases testosterone (percentage wise).  See aromatization and also letrozole and aromatization.  See letrozole at OffshoreRx1.com.
• Bodybuilding myth debunked: Growth-promoting hormones don't stimulate strength - Science Daily, 6/14/12 - "anabolic hormones -- long thought to be essential for building a muscular frame -- do not influence muscle protein synthesis, the process that leads to bigger muscles ... In the first study, researchers examined the responses of both male and female participants to intense leg exercise. Despite a 45-fold difference in testosterone increase, men and women were able to make new muscle protein at exactly the same rate ... In the second study ... The men experienced gains in muscle mass that ranged from virtually nothing to more than 12 pounds, yet their levels of testosterone and growth hormone after exercise showed no relationship to muscle growth or strength gain ... Surprisingly, the researchers noted that cortisol -- considered to have the opposite effect of anabolic hormones because it reduces protein synthesis and breaks down tissue -- was related to the gain in muscle mass" - Note:  That may be true about cortisol but looking at it another way, cortisol could be an indicator of how much you're working out.
• Can Testosterone Therapy Help Obese Men Lose Weight? - US News and World Report, 5/9/12 - "The men were given 1,000 milligrams of testosterone by injection when the study started, again at six weeks and then every 12 weeks until the end of the trial ... The men who were followed for five years lost an average of 35 pounds ... they also saw improvements in their cholesterol and triglyceride levels, along with their blood pressure ... there was no increase in the risk of prostate cancer"
• Testosterone makes us less cooperative and more egocentric - Science Daily, 1/31/12 - "people given a boost of the hormone oxytocin tend to be cooperative ... the hormone testosterone has the opposite effect -- it makes people act less cooperatively and more egocentrically" - See Oxytocin Factor or oxytocin 6x5iu tablets.
• Testosterone Replacement Improves Male Metabolic Syndrome - Medscape, 12/19/11 - "Testosterone replacement to normal levels in middle-aged and elderly hypogonadal men significantly improved all components of the metabolic syndrome at 24 months ... At the end of the 48-month study period, the average reduction in waist circumference was "quite substantial," at 8.0 cm ... In addition, body weight was reduced by 12.9 kg, from an average of 106.6 to 93.7 kg ... In terms of percent weight change, subjects lost around 5% of their initial weight after about 15 months, and about 10% after 3.5 to 4.0 years of treatment ... People who are on treatment for 1 year may gain 4.5 to 5.0 kg of lean mass and lose 5.0 to 6.0 kg of fat mass — but the overall effect on weight is moderate. These 4-year data were a surprise when we saw people lost 12.9 kg, and the 60-month data suggest this continues — we have not yet reached the plateau, the weight is still declining ... Both systolic and diastolic blood pressure were also significantly reduced (by 15.2 and 13.3 mm Hg, respectively), dropping from 155/94 to 140/80.8 mm Hg at 48 months ... There was a significant improvement in lipid profiles, with total serum cholesterol dropping from 297.7 to 194.5 mg/dL, triglycerides dropping from 290.4 to 194.2 mg/dL, and low-density-lipoprotein cholesterol dropping from 160.4 to 118.3 mg/dL ... There was also an initial significant decrease in levels of liver enzymes, with aspartate aminotransferase dropping from 43.9 to 22.0 U/L and alanine aminotransferase dropping from 46.6 to 22.8 U/L over the first 24 months, and then leveling off ... there was a "marked reduction" in C-reactive protein levels over the 4-year period, from 7.1 to 1.6 mg/L ... mean plasma glucose levels declined from 105.8 to 97.0 mg/dL over the 4-year period"
• Older men with higher testosterone levels lose less muscle mass as they age - Science Daily, 10/27/11 - "Our study finds that men, aged 65 years and older, with higher testosterone levels lost less muscle mass, especially in their arms and legs, than men this age who had lower testosterone levels" - Note:  My testosterone has been slightly above the normal range.  I believe it's because of the quarter tablet of letrozole I take every third day.  See letrozole at OffshoreRX.
• Highest Testosterone Levels Equal Lowest Risk for CV Events - Medscape, 10/3/11 - "elderly men in the highest quartile of serum testosterone levels have around a 30% lower risk of cardiovascular events over five years compared with men in the lower three quartiles" - Note:  My testosterone has always been slightly above normal.  I think part of it might be taking a quarter table of letrozole every other day.  See Femara (letrozole) at OffshoreRX.
• Older age does not cause testosterone levels to decline in healthy men - Science Daily, 6/7/11 - "The modest decline in blood testosterone among older men, usually coupled with nonspecific symptoms, such as easy fatigue and low sexual desire, may be due to symptomatic disorders that accumulate during aging, including obesity and heart disease ... It does not appear to be a hormone deficiency state" - Note: For what it's worth, I had my testosterone checked about a years ago and it was about 10% over the high number range without any testosterone supplementation.
• Study suggests another look at testosterone-prostate cancer link - Science Daily, 4/19/11 - "This study, involving 13 symptomatic testosterone deficient men who also had untreated prostate cancer, suggests this traditional view is incorrect, and that testosterone treatment in men does not cause rapid growth of prostate cancer. It is the first to directly and rigorously assess changes in the prostate among men with prostate cancer who received testosterone therapy"
• Increase in deaths in men with type 2 diabetes and testosterone deficiency may be prevented by testosterone replacement, study suggests - Science Daily, 4/12/11 - "conducted a six year study of 587 men with type 2 diabetes, splitting them into three groups: those with normal total testosterone levels (above 10.4nmol/L, n=338), those with low testosterone levels (below 10.4nmol/L) that weren't treated with testosterone replacement therapy (n=182), and those with low testosterone levels treated with testosterone replacement therapy for two years or more during the follow up period (n=58) ... The findings show for the first time that low testosterone puts diabetic men at a significantly increased risk of death (p=0.001 log rank): 36 of the 182 diabetic men with untreated low testosterone died during the six year study, compared to 31 of the 338 men with normal testosterone levels (20% vs 9%). Furthermore, only 5 of the 58 diabetic men that were given testosterone replacement therapy died during the study (8.6%), meaning they showed significantly better survival compared to the non-treated group (p=0.049 log rank) ... In the 356 men with type 2 diabetes tested, health related quality of life decreased as testosterone levels decreased (r=0.353 p=0.044)"
• Testosterone linked to men's ability to 'woo' potential mates - Science Daily, 3/10/11
• Giftedness linked to prenatal exposure of higher levels of testosterone - Science Daily, 3/12/11 - "There seems to be some evidence that excessive prenatal exposure to testosterone facilitates increased connections in the brain, especially in the right prefrontal cortex ... That's why we see some intellectually gifted people with distinct personality characteristics that you don't see in the normal population ... Based on their observations, the researchers made the hypothesis that this hormonal "glitch" in the in-utero neurobiological development means that gifted children are born with an affinity for certain areas such as the arts, math or science"
• Beneficial Effects of Testosterone for Frailty in Older Men are Short-Lived - Doctor's Guide, 11/5/10 - "The beneficial effects of 6 months of testosterone treatment on muscle mass, strength, and quality of life (QOL) in frail elderly men are not maintained at 6 months post-treatment"
• Low testosterone linked to heightened risk of early death - Science Daily, 10/19/10 - "tracked for around 7 years ... One in four of the men was classified as having low testosterone, using measurements of either bioavailable testosterone (bio-T) -- available for tissues to use -- of under 2.6 mmol/l or total testosterone (TT) of under 8.1 mmol/l ... During the monitoring period almost twice as many men with low testosterone died as did those with normal levels"
• Low testosterone linked to Alzheimer's disease - Science Daily, 10/5/10 - "Low levels of the male sex hormone, testosterone, in older men is associated with the onset of Alzheimer's disease"
• Higher testosterone may raise risk of heart disease in elderly men - Science Daily, 7/1/10
• Adverse Cardiovascular Events in Older Men Reported in Testosterone Trial, Treatment Phase Halted - Doctor's Guide, 6/30/10 - "found a higher rate of adverse cardiovascular events, such as myocardial infarctions (MIs) and elevated blood pressure, in a group of older men receiving testosterone gel compared with those receiving placebo. Due to these events, the treatment phase of the trial was stopped"
• Symptoms of 'male menopause' unzipped - Science Daily, 6/16/10
• Use of testosterone for 'male menopause' questionable, experts argue - Science Daily, 6/2/10 - "The published evidence is also inconclusive on whether testosterone given to ageing men with low levels of the hormone improves symptoms, such as poor sexual function or depression ... Testosterone treatment also has several unwanted side effects, says DTB. These include a rise in prostate specific antigen (PSA), blockage of the urinary tract, development of prostate cancer and the development of breasts (gynaecomastia). And it can aggravate ischaemic heart disease, epilepsy, and sleep apnoea"
• Middle-aged men: Could dwindling testosterone levels decrease sleep? - Science Daily, 5/14/10 - "In young men, deep sleep represents 10 to 20 percent of total sleep. By age 50, it decreases to five to seven percent. For men over 60, it can disappear altogether ... Because deep sleep requires great synchronization ... Low levels of testosterone intensify the lack of synchronization and can explain 20 percent of men's inability to experience deep sleep ... Sekerovic suggests dwindling testosterone levels are what impact sleep, not vice-versa, as other studies have suggested ... If Sekerovic is right, his findings could re-ignite the hormone therapy debate. "The loss of deep sleep is a serious problem that could be treated with testosterone. That would be tremendous progress,""
• Sex Hormones and the Risk of Incident Prostate Cancer - Urology. 2010 May 6 - "Serum testosterone, estradiol, estrone, and sex hormone-binding globulin were assayed at baseline ... the mean age was 73 years. Higher serum estrone was strongly related to an increased risk of prostate cancer: compared with men in the lower quartile, the risk of prostate cancer among those in the highest 3 quartiles (>24.9 pg/dL) was nearly 4-fold higher (adjusted heart rate = 3.93, CI: 1.61-9.57). Other sex hormones were not associated with the risk of prostate cancer" - The following results for estrone are for women.   I didn't find any results for men but see the "For Aromatization (in males):" section on my letrozole page.
  • Letrozole suppresses plasma estradiol and estrone sulphate more completely than anastrozole in postmenopausal women with breast cancer - J Clin Oncol. 2008 Apr 1;26(10):1671-6 - "Letrozole reduces plasma E2 and E1S levels to a significantly greater extent than anastrozole" - See Femara (letrozole)at OffshoreRX.
  • Influence of letrozole and anastrozole on total body aromatization and plasma estrogen levels in postmenopausal breast cancer patients evaluated in a randomized, cross-over study - J Clin Oncol. 2002 Feb 1;20(3):751-7 - "estrone (E(1)), estradiol (E(2)), and estrone sulfate (E(1)S) ... Treatment with anastrozole suppressed plasma levels of E(1), E(2), and E(1)S by a mean of 81.0%, 84.9%, and 93.5%, respectively, whereas treatment with letrozole caused a corresponding decrease of 84.3%, 87.8% and 98.0%, respectively. The suppression of E(1) and E(1)S was found to be significantly better during treatment with letrozole compared with anastrozole"
• Testosterone directly amplifies but does not program male behaviors - Science Daily, 5/4/10 - "androgen receptor (AR) ... testosterone signaling via AR does not control masculine differentiation of the brain and behavior but regulates the frequency and extent of male typical behaviors"
• Obesity linked to low testosterone in men - Men's health - MSNBC, 5/3/10 - "Forty percent of obese participants in the study had lower-than-normal testosterone readings. And for those obese men who also had diabetes that percent rose to 50 percent"
• Low Testosterone Tied to Frailty in Older Men - Medscape, 4/26/10 - "In general, men with total testosterone levels below the median were more likely to be frail. Moreover, lower levels of free testosterone were tied to a greater risk of becoming frail over the next four to seven years"
• Erectile dysfunction and increased dangers of cardiovascular disease - Science Daily, 4/25/10 - "men with erectile dysfunction and low testosterone have a higher than normal risk of dying from cardiovascular disease. Further work from the same research group shows that obesity is also associated with an impairment of blood flow to the penis, which in turn is also associated with cardiovascular disease in men with erectile dysfunction ... Low testosterone itself was not associated with major cardiac events, but those patients with the lowest testosterone who had a major cardiac event were significantly more likely to die than those with higher levels of testosterone (P<0.001; the risk is increased by a factor of seven ... In a second study (but using the same group of patients as above), the group showed that the degree of obesity, along with erectile dysfunction, were significantly and independently associated with cardiac events"
• Statins May Lower Testosterone, Libido - WebMD, 4/16/10 - "When they compared men on statins to those not, the men on statins were twice as likely to have low testosterone, regardless of which of three commonly used thresholds for low testosterone they looked at"
• Serum free testosterone and metabolic syndrome in Japanese men - Endocr J. 2010 Apr 1 - "Among Japanese men who were mainly without diabetes, FT was associated with Mets independently of age, BMI, and WC. Mets and insulin resistance may decrease serum testosterone via induction of hypogonadotrophic hypogonadism, and the reduction of testosterone may in turn cause further obesity and insulin resistance, consequently initiating a vicious cycle"
• Association of Testosterone and Sex Hormone-Binding Globulin with Metabolic Syndrome and Insulin Resistance in Men - Diabetes Care. 2010 Apr 5 - "men in the first quartile (lowest) (PR, 2.16; 95% CI, 1.53-3.06) and second quartile of total testosterone (PR, 2.51; 95% CI, 1.86-3.37) were more likely to have metabolic syndrome than men in the fourth quartile ... Similarly, men in the first quartile of SHBG (PR, 2.17; 95% CI, 1.32-3.56) were more likely to have metabolic syndrome than men in the fourth quartile ... Low concentrations of total testosterone and SHBG were strongly associated with increased likelihood of having metabolic syndrome, independent of traditional cardiovascular risk factors and insulin resistance"
• Low testosterone levels and SHBG levels and high estradiol levels are independent predictors of type 2 diabetes in men - Eur J Endocrinol. 2010 Jan 8 - "There was a significantly lowered multi-adjusted risk for later diabetes with higher normal total testosterone levels, both linearly per SD increase (HR 0.71, CI 0.54-0.92) and in the higher quartiles of total testosterone compared to the lowest (HR 0.53, CI 0.33-0.84). A reduced multi-adjusted risk for incident diabetes was also found for men with higher SHBG levels, both linearly per SD increase (HR 0.55, CI 0.39-0.79) and when comparing the third (HR 0.38, CI 0.18-0.81) and the fourth quartile (HR 0.37, 0.17-0.82) to the lowest. The associations with total testosterone and SHBG were no longer significant after inclusion of waist circumference to the multivariate models. Estradiol was positively associated with incident diabetes after multivariate adjustments including waist circumference, when comparing the second (HR 0.49, CI 0.26-0.93) and the third (HR 0.51, CI 0.27-0.96) quartile to the highest Conclusion. Men with higher estradiol levels had an increased risk of later diabetes independent of obesity, while men with lower total testosterone and SHBG had an increased risk of diabetes that appeared dependent of obesity"

• Aromatase Inhibition Offers Little Benefit, Possible Harm to Men With Lo... - Medscape, 12/22/09 - "The inescapable conclusion from these data is that the 50% increase in testosterone levels was trumped by the much more modest 20% reduction in estradiol levels, leading to negative skeletal effects of anastrozole therapy in aging men" - Note:  I'm not sure that thought this though thoroughly.  Mortally in men is best when estrogen is around 25pg/mL.  I suspect that most have higher estrogen than that.  See:

  • High, Low Estradiol Levels and Mortality in Men With Systolic HF - Medscape, 5/19/09 - "Both low and high serum levels of estradiol, compared with mid-range levels, are significantly and independently associated with increased all-cause mortality in men with chronic systolic heart failure"
    Serum Estradiol Concentration Quintiles as Predictors of All-Cause Mortality in Men (With Quintile 3 as the Reference Group)

    Parameter	Quintile 1	Quintile 2	Quintile 3	Quintile 4	Quintile 5
    Estradiol concentration (pg/mL)	<12.903	12.90–21.79	21.80–30.11	30.12–37.39	>37.40
    3-y survival* (%)	44.6	65.8	82.4	79.0	63.6
    Quintile as mortality predictor,* HR (95% CI) vs quintile 3	4.17 (2.33–7.45)	2.15 (1.16–3.99)	--	1.22 (0.64–2.31)	2.33 (1.30–4.18)

    HR= hazard ratio
• Testosterone does not induce aggression, study shows - Science Daily, 12/9/09 - "New scientific evidence refutes the preconception that testosterone causes aggressive, egocentric, and risky behavior. A study at the Universities of Zurich and Royal Holloway London with more than 120 experimental subjects has shown that the sexual hormone with the poor reputation can encourage fair behaviors if this serves to ensure one's own status"
• Low testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors - Atherosclerosis. 2009 Nov 13 - "Cox proportional hazards models showed that the subjects with the lowest tertile of plasma testosterone (<14.2nmol/L) had an approximately 4-fold higher CV event risk compared to those with the higher testosterone tertiles after adjustment for coronary risk factors including medication and FMD (unadjusted hazard ratio, 3.61; 95% CI, 1.47-8.86: multivariate-adjusted hazard ratio, 4.61; 95% CI, 1.02-21.04). Multivariate analysis did not show any significant association of DHEA-S, estradiol or cortisol with CV events"

• Efficacy of testosterone gel in the treatment of erectile dysfunction in hypogonadal hemodialysis patients: a pilot study - Int J Impot Res. 2009 Nov 19 - "T administration significantly increased serum T levels to the normal range, and was associated with statistically significant improvements of the scores of the IIEF domains (erectile function from 7.6+/-8.0 to 12.8+/-7.8; intercourse satisfaction from 3.4+/-4.5 to 4.8+/-3.1; orgasmic function from 4.8+/-3.1 to 3.4+/-2.9; sexual desire from 3.4+/-2.9 to 4.4+/-0.6; overall sexual satisfaction from 2.6+/-1.3 to 3.8+/-1.0). But scores of the IIEF did not normalize. Frequency of weekly sexual intercourse increased from 0.4+/-0.4 to 1.1+/-0.8 (P<0.05) after 6 months. There were no adverse effects" - Note:  One problem with testosterone administration is that it increased estradiol by about the same percentage.  I'm 60 years old and my testosterone was above the limits just by taking a half tablet of letrozole per day.  I've cut it to a quarter tablet but haven't had it rechecked.  Letrozole has been shown to double or triple testosterone and lower estrogen at the same time.  Some studies indicate that you might want to keep estrogen around 25 for men.  See letrozole at OffshoreRx1.com.  See:

  • Androgel prescribing information - androgel.com - "Serum estradiol (E2) concentrations increased significantly within 30 days of starting treatment with AndroGel 5 or 10 g/day and remained elevated throughout the treatment period but remained within the normal range for eugonadal men"
  • High, Low Estradiol Levels and Mortality in Men With Systolic HF - Medscape, 5/19/09 - "Both low and high serum levels of estradiol, compared with mid-range levels, are significantly and independently associated with increased all-cause mortality in men with chronic systolic heart failure"
  • Short-term aromatase inhibition: effects on glucose metabolism and serum leptin levels in young and elderly men - Eur J Endocrinol. 2008 Dec 2 - "Ten elderly and nine young healthy men were randomized to receive letrozole 2.5 mg daily or placebo for 28 days in a crossover design. Results: Both in young and elderly men, active treatment significantly increased serum testosterone (+128 and +99%, resp.) and decreased estradiol levels (-41 and -62%, resp.). Fasting glucose and insulin levels decreased in young men after active intervention (-7 and -37%, resp.) compared to placebo. Leptin levels fell markedly in both age groups (-24 and -25%, resp.), while adiponectin levels were not affected by the intervention. Lipid profile was slightly impaired in both groups, with increasing LDL-cholesterol levels (+14%) in the younger age group and 10% lower levels of ApoA1 in the elderly. A decline in IGF-1 levels (-15%) was observed in the younger age group. No changes in weight or BMI were observed in either young or old men"
  • Letrozole once a week normalizes serum testosterone in obesity-related male hypogonadism - Eur J Endocrinol. 2008 May;158(5):741-7 - "Isolated hypogonadotropic hypogonadism (IHH) is frequently observed in severely obese men, probably as a result of increased estradiol (E(2)) production and E(2)-mediated negative feedback on pituitary LH secretion. Aromatase inhibitors can reverse this process ... treated with 2.5 mg letrozole once a week for 6 months ... Six weeks of treatment reduced total E(2) from 123+/-11 to 58+/-7 pmol/l (P<0.001, mean+/-s.e.m.), and increased serum LH from 4.4+/-0.6 to 11.1+/-1.5 U/l (P<0.001). Total testosterone rose from 5.9+/-0.5 to 19.6+/-1.4 nmol/l (P<0.001), and free testosterone from 163+/-13 to 604+/-50 pmol/l (P<0.001). Total testosterone rose to within the normal range in all subjects, whereas free testosterone rose to supraphysiological levels in 7 out of 12 men ... Letrozole 2.5 mg once a week produced a sustained normalization of serum total testosterone in obese men with IHH. However, free testosterone frequently rose to supraphysiological levels. Therefore, a starting dose <2.5 mg once a week is recommended"
  • Comparative assessment in young and elderly men of the gonadotropin response to aromatase inhibition - J Clin Endocrinol Metab. 2005 Oct;90(10):5717-22 - "As assessed after 28 d of treatment, letrozole lowered E2 by 46% in the young men (P = 0.002) and 62% in the elderly men (P < 0.001). In both age groups, letrozole, but not placebo, significantly increased LH levels (339 and 323% in the young and the elderly, respectively) and T (146 and 99%, respectively) (P value of young vs. elderly was not significant). Under letrozole, peak LH response to GnRH was 152 and 52% increase from baseline in young and older men, respectively"
  • Letrozole normalizes serum testosterone in severely obese men with hypogonadotropic hypogonadism - Diabetes Obes Metab. 2005 May;7(3):211-5 - "Six weeks of treatment decreased serum estradiol from 120 +/- 20 to 70 +/- 9 pmol/l (p = 0.006). None of the subjects developed an estradiol level of less than 40 pmol/l. LH increased from 4.5 +/- 0.8 to 14.8 +/- 2.3 U/l (p < 0.001). Total testosterone rose from 7.5 +/- 1.0 to 23.8 +/- 3.0 nmol/l (p < 0.001) without a concomitant change in sex hormone-binding globulin level. Those treated with Letrozole 17.5 mg per week had an excessive LH response"
• Low Bioavailable Testosterone Linked to Frailty in Older Men - Medscape, 10/30/09
• Testosterone of Benefit in CHF - Medscape, 8/28/09
• Increase In Visceral Fat During Menopause Linked With Testosterone - Science Daily, 8/20/09 - "The culprit is likely not age, as is commonly believed, but the change in hormone balance that occurs during the menopause transition ... Of all the factors we analyzed that could possibly account for the increase in visceral fat during this period in a woman's lifetime, levels of active testosterone proved to be the one most closely linked with abdominal fat ... in women, it is the change in the hormonal balance – specifically, the increase in active testosterone – that is predominantly responsible for visceral fat, and for the increased risk of cardiovascular disease"
• Hot Flash: Low Testosterone Robs Men of Joy, Sex, Energy - ABC  News, 8/10/09 - "By the time Dan hit 57, he didn't recognize himself. He was always tired, fell asleep after dinner and was angry all the time ... "After a year, the injections worked," Dan said. "It's not like I am doing physical feats that I was not doing before, but I was noticing a change when I would take groceries out of the car and move wood into the pile. Before, I used to groan as I did it and had more aches and pains.""
• Lower serum testosterone is independently associated with insulin resistance in non-diabetic older men. The Health In Men Study - Eur J Endocrinol. 2009 Aug 6 - "In older men, lower total testosterone is associated with insulin resistance independently of measures of central obesity. This association is seen with testosterone levels in the low to normal range. Further studies are needed to evaluate interventions which raise testosterone levels in men with reduced insulin sensitivity"
• Testosterone Therapy Improves Metabolic Syndrome, Liver Steatosis in Hypogonadal Men - Doctor's Guide, 6/22/09 - "After receiving TU for 6 months, their body mass index, waist circumference, and low-density and high-density lipoprotein were improved ... Similarly, their serum cholesterol and triglyceride levels decreased towards the end of the first year of treatment, and then remained stable for the duration of the study ... The mean tryglyceride levels after treatment with TU were 195 mg/dL, down from 312 mg/dL before treatment ... LDL levels decreased after treatment as well, from 164 to 134 mg/dL, whereas HDL levels increased from 36.5 to 54.6 mg/dL"
• Low free testosterone levels are associated with prevalence and incidence of depressive Symptoms in older men - Clin Endocrinol (Oxf). 2009 May 25 - "Free testosterone levels below 170 pmol/L are associated with depressive symptoms while free testosterone levels below 220 pmol/L (lowest quintile of our population) predict the onset of depressive symptoms"
• Low Serum Testosterone and Estradiol Predict Mortality in Elderly Men - J Clin Endocrinol Metab. 2009 Apr 28 - "mean follow-up period of 4.5 years ... low levels (within quartile 1; versus quartiles 2-4) of both testosterone (hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.29-2.12) and estradiol (HR 1.54, 95% CI 1.22-1.95) associated with mortality. A model including both hormones showed that both low testosterone (HR 1.46, 95% CI 1.11-1.92) and estradiol (HR 1.33, 95% CI 1.02-1.73) predicted mortality. Risk of death nearly doubled (HR 1.96, 95% CI 1.46-2.62) in subjects with low levels of both testosterone and estradiol compared with subjects within quartiles 2-4 of both hormones ... Elderly men with low serum testosterone and estradiol have increased risk of mortality, and subjects with low values of both testosterone and estradiol have the highest risk of mortality"
• Tadalafil Response in Patients With Erectile Dysfunction Is Androgen Dependent - Doctor's Guide, 3/23/09 - "Testosterone gel therapy significantly improves the response to tadalafil in nonresponding patients with erectile dysfunction (ED) -- but only if they have total testosterone levels of less than 3 ng/mL or bioavailable testosterone levels of less than 0.6 ng/mL"
• Obesity Linked To Hormone Imbalance That Impacts Sexual Quality Of Life - Science Daily, 3/3/09 - "In our study population, we found that lower testosterone levels and diminished ratings for sexual quality of life were correlated with increased BMI ... Subjects who lost weight through bariatric surgery experienced a reduction in estradiol levels, an increase in testosterone levels and an increase in ratings of sexual quality of life" - See my aromatization page.  Another way to increase testosterone and decrease estradiol is with letrozole.  I take a quarter tablet every other day.
  • Letrozole once a week normalizes serum testosterone in obesity-related male hypogonadism - Eur J Endocrinol. 2008 May;158(5):741-7 - "Isolated hypogonadotropic hypogonadism (IHH) is frequently observed in severely obese men, probably as a result of increased estradiol (E(2)) production and E(2)-mediated negative feedback on pituitary LH secretion. Aromatase inhibitors can reverse this process ... treated with 2.5 mg letrozole once a week for 6 months ... Six weeks of treatment reduced total E(2) from 123+/-11 to 58+/-7 pmol/l (P<0.001, mean+/-s.e.m.), and increased serum LH from 4.4+/-0.6 to 11.1+/-1.5 U/l (P<0.001). Total testosterone rose from 5.9+/-0.5 to 19.6+/-1.4 nmol/l (P<0.001), and free testosterone from 163+/-13 to 604+/-50 pmol/l (P<0.001). Total testosterone rose to within the normal range in all subjects, whereas free testosterone rose to supraphysiological levels in 7 out of 12 men ... Letrozole 2.5 mg once a week produced a sustained normalization of serum total testosterone in obese men with IHH. However, free testosterone frequently rose to supraphysiological levels. Therefore, a starting dose <2.5 mg once a week is recommended" - See Femara (letrozole) at OffshoreRX.
• Study: Testosterone Correlated to Successful Financial Trading - washingtonpost.com, 1/12/09
• Low Testosterone Levels Associated With Lone Atrial Fibrillation in Men - Medscape, 2/20/09 - "Mean testosterone levels in men with lone AF were significantly lower than those in healthy controls, the authors report, but mean estradiol levels did not differ significantly between the 2 groups"
• Sex Hormone Levels, Breast Cancer Risk, and Cancer Receptor Status in Postmenopausal Women: the ORDET Cohort - Cancer Epidemiol Biomarkers Prev. 2009 Jan;18(1):169-76 - "This study provides further evidence that high levels of circulating testosterone increase the risk of developing breast cancer in postmenopausal women. The cancers that develop are mainly estrogen receptor positive. Although HER2(+) and HER2(-) breast cancers were both associated with high total testosterone, they showed opposing associations with estrogen"
• Testosterone Gel Addition Benefits Men With Erectile Dysfunction Who Do Not Respond to PDE5s Alone if Testosterone Levels Are Low - Doctor's Guide, 12/10/08 - "Addition of testosterone gel to improve efficacy of the phosphodiesterase-5 (PDE5) inhibitor tadalafil in men with erectile dysfunction (ED) shows significant improvements for those with a serum testosterone level <=3 ng/mL at baseline"
• Short-term aromatase inhibition: effects on glucose metabolism and serum leptin levels in young and elderly men - Eur J Endocrinol. 2008 Dec 2 - "Ten elderly and nine young healthy men were randomized to receive letrozole 2.5 mg daily or placebo for 28 days in a crossover design. Results: Both in young and elderly men, active treatment significantly increased serum testosterone (+128 and +99%, resp.) and decreased estradiol levels (-41 and -62%, resp.). Fasting glucose and insulin levels decreased in young men after active intervention (-7 and -37%, resp.) compared to placebo. Leptin levels fell markedly in both age groups (-24 and -25%, resp.), while adiponectin levels were not affected by the intervention. Lipid profile was slightly impaired in both groups, with increasing LDL-cholesterol levels (+14%) in the younger age group and 10% lower levels of ApoA1 in the elderly. A decline in IGF-1 levels (-15%) was observed in the younger age group. No changes in weight or BMI were observed in either young or old men" - Note:  I take a quarter tablet of letrozole every other day to prevent aromatization.  See letrozole at OffshoreRx1.com.
• C-reactive protein levels and ageing male symptoms in hypogonadal men treated with testosterone supplementation - Andrologia. 2008 Dec;40(6):398-400 - "Aging Male Symptom (AMS) ... Testosterone administration resulted in a profound decline in CRP levels and AMS scores"
• Correlation between simultaneous PSA and serum testosterone concentrations among eugonadal, untreated hypogonadal and hypogonadal men receiving testosterone replacement therapy - Int J Impot Res. 2008 Oct 9 - "testosterone replacement therapy (TRT) ... does not appear to significantly influence serum PSA expression and no significant correlation was identified between PSA and serum testosterone among eugonadal, untreated hypogonadal and hypogonadal men receiving TRT"
• Prostate Cancer Therapy: Mental Impact? - WebMD, 7/29/08 - "ADT stands for "androgen-deprivation therapy" and is the standard type of treatment for prostate cancer that has spread to the bones or other organs ... there is a "strong argument" to be made that the hormone therapy is linked to "subtle but significant" cognitive declines in men with advanced prostate cancer"
• Prostate Cancer Hormone Therapy: No Survival Benefit in Older Men - WebMD, 7/8/08 - "In the U.S., older men often opt for stand-alone hormone therapy, even though there's no proof that it really helps. Hormone therapy's most obvious side effect is sexual dysfunction. Of greater concern are several recent studies linking androgen deprivation therapies to diabetes, heart disease, bone fractures, and reduced muscle mass ... Now a new study strongly suggests that hormone therapy offers older men no benefit to justify these serious risks" -  [Science Daily]
• Testosterone Gel Improves Insulin Sensitivity, Sexual Function in Hypogonadal Men With Diabetes and Metabolic Syndrome - Doctor's Guide, 6/20/08 - "Among patients with type 2 diabetes with or without metabolic syndrome, insulin resistance as measured by HOMA-IR improved from baseline in the testosterone-treated group compared with placebo at 6 months (testosterone: -0.62, placebo: +0.16; P = .049) and at 12 months (testosterone: -.58 ... Patients receiving testosterone also achieved more than a 5-point improvement over placebo-treated patients on the International Index of Erectile Function (IIEF) at 6 months (P < .05) and more than 6 points over placebo-treated patients at 12 months"
• Hormone Replacement for Men: Pros, Cons - WebMD, 6/18/08- "The supplemental testosterone reduced total cholesterol, "bad" LDL cholesterol, triglycerides, and body mass index while improving "good" HDL cholesterol. The men lost their pot bellies, Saad says. "What we see after 12 months is a reduction in two or three trouser sizes, three or four inches off the waist. We see a reduction by one-fourth to one-third of their total cholesterol"
• Low Testosterone Appears To Increase Long-term Risk Of Death - Science Daily, 6/17/08 - "Men with low testosterone levels had more than 2.5 times greater risk of dying during the next 10 years compared to men with higher testosterone"
• Low Testosterone May Cause Health Problems That Lead To Erectile Dysfunction - Science Daily, 6/16/08 - "It is becoming clear that obesity, diabetes, high blood pressure, cholesterol problems and erectile difficulties are intertwined, and a common denominator is testosterone deficiency"
• Testosterone Replacement Theraphy Beneficial In Men 60 And Older, Study Suggests - Science Daily, 4/7/08 - "These preliminary data show beneficial effects of testosterone therapy on bone turnover markers in older men with low-to-normal testosterone concentrations using both continuous and monthly cycled testosterone replacement"
• Previously Unrecognized Testosterone Deficiency Common In Men With Type 1 Diabetes - Science Daily, 3/26/08 - "Testosterone deficiency, previously recognized as common in men with type 2 diabetes, is also common in men with type 1 diabetes"
• Low Testosterone Levels Associated With Depression In Older Men - Science Daily, 3/4/08 - "men in the lowest quintile (20 percent) of free testosterone concentration had three times the odds of having depression compared to men in the highest quintile"
• Testosterone Reduces Visceral Fat Gain in Nonobese Older Men - Medscape, 2/1/08 - "Testosterone therapy lessens the gain in visceral adipose tissue and the loss of skeletal muscle in aging men who are not obese ... Given the strong association of visceral fat with metabolic syndrome -- leading to diabetes -- and cardiovascular disease ... these findings suggest testosterone may be used to modify the age-related increase in visceral adipose tissue, and possibly the associated adverse metabolic changes"
• Sex Hormones Unrelated To Prostate Cancer Risk, Report Shows - Science Daily, 1/30/08 - "collected the original data from 18 studies and analyzed it to determine the relationship between blood levels of sex hormones and prostate cancer. The pooled data included 3,886 men with prostate cancer and 6,438 controls ... The researchers found no association between prostate cancer risk and blood levels of different forms of testosterone or estrogen"
• Androgen-Deprivation Therapy Linked to Diabetes - Medscape, 1/22/08 - "After controlling for other factors, the estimated relative risk of incident diabetes associated with ADT was a significant 1.36"
• Low Testosterone Levels Associated With Risk Of Fracture In Men Over 60 - Science Daily, 1/14/08 - "Although low levels of estradiol and testosterone were associated with a higher risk of fracture in men over 60, only the effect of testosterone was independent of other risk factors, the authors conclude"
• Testosterone May Improve Mental Function - Science Daily, 1/14/08 - "higher testosterone levels in midlife have been linked to better preservation of tissue in some parts of the brain. And in older men, higher testosterone levels have been associated with better performance on cognitive tests ... Three studies linked impaired performance on cognitive tests with androgen deprivation therapy"
• Does Testosterone Aid Aging Men? - WebMD, 1/2/07
• Testosterone Supplementation May Increase Lean Body Mass in Older Men - Medscape, 1/2/08 - "lean body mass increased and fat mass decreased in the testosterone vs the placebo group ... Although insulin sensitivity improved, high-density lipoprotein (HDL) cholesterol levels decreased in the testosterone group. At the end of the study, metabolic syndrome was present in 47.8% in the testosterone vs 35.5% in the placebo group"
• Testosterone Supplementation For Older Men Appears To Have Limited Benefit - Science Daily, 1/1/08
• High Testosterone Enanthate Dose May Impair Memory in Older Men - Medscape, 12/13/07 - "supraphysiological testosterone levels may have detrimental effects on memory and brain function in elderly men ... the testosterone treatment was associated with declines of "medium effect size" in short-term verbal memory score (p < .05) and a nonsignificant decrease in composite verbal memory score (p = .09), as measured with the California Verbal Learning Test"
• Testosterone, diabetes mellitus, and the metabolic syndrome - Curr Urol Rep. 2007 Nov;8(6):467-71 - "One third of men with type 2 diabetes mellitus are now recognized as testosterone deficient. Emerging evidence suggests that testosterone therapy may be able to reverse some aspects of metabolic syndrome"
• Low Testosterone, Early Death? - WebMD, 11/27/07 - "The lower a man's testosterone level, the higher his risk of death -- especially death from heart disease ... Men in the highest quartile were 41% less likely to die"
• Too Much Sugar Turns Off Gene That Controls Effects Of Sex Steroids - Science Daily, 11/21/07 - "This discovery reinforces public health advice to eat complex carbohydrates and avoid sugar ... Glucose and fructose are metabolized in the liver. When there’s too much sugar in the diet, the liver converts it to lipid. Using a mouse model and human liver cell cultures, the scientists discovered that the increased production of lipid shut down a gene called SHBG (sex hormone binding globulin), reducing the amount of SHBG protein in the blood. SHBG protein plays a key role in controlling the amount of testosterone and estrogen that’s available throughout the body"
• Relationship between serum testosterone and measures of benign prostatic hyperplasia in aging men - Urology. 2007 Oct;70(4):677-80 - "the serum testosterone levels in aging men did not correlate with the measures of BPH, including prostate volume and IPSS, regardless of whether total, free, or bioavailable testosterone was used. Age correlated with the measures of BPH, especially prostate volume"
• Marriage And Fatherhood Linked To Lower Testosterone Levels - Science Daily, 10/10/07 - "monogamously married Ariaal men had significantly lower morning and afternoon testosterone levels compared to their single counterparts of similar age (20-39)"
• Low Serum Testosterone and Mortality in Older Men - J Clin Endocrinol Metab. 2007 Oct 2 - "Men whose total testosterone levels were in the lowest quartile (<241 ng/dl) were 40% (HR=1.40; 95% CI, 1.14-1.71) more likely to die than those with higher levels ... In cause-specific analyses, low testosterone predicted increased risk of cardiovascular (HR, 1.38; 95% CI, 1.02- 1.85) and respiratory disease (HR, 2.29; 95% CI, 1.25-4.20) mortality, but was not significantly related to cancer death (HR, 1.34"
• Low Testosterone Symptoms Rare - WebMD, 9/12/07 - "As many as 25% of U.S. men have low testosterone levels, but only 5.6% of men have symptoms linked to it ... know that prostate cancer often regresses when testosterone is removed, but there is very little evidence that supplementing normal testosterone levels increases risk of cancer -- and there is some evidence it may lower it"
• Testosterone Deficiency Relatively Rare In Men - Science Daily, 9/7/07
• Testosterone Patch Benefits Women With Low Sexual Desire - Science Daily, 8/14/07 - "A total of 132 participants from the 2 trials were interviewed after a 6-month treatment period regarding their experience with the treatment. Results revealed a significant increase in frequency of satisfying sexual activity and sexual desire based on women experiencing the treatment as beneficial. Those women had an average increase in sexual activity of 4.4 times per 4 weeks. In contrast, women who did not experience a benefit had only a 0.5 increase in activity per 4 weeks"
• Testosterone Replacement Therapy - Science Daily, 8/8/07 - "Spontaneously Hypertensive Rats (SHR) ... testosterone supplementation of aging male SHR promotes renal injury and thereby exacerbates hypertension. The results also show that removal of endogenous androgens later in life (eight months) prevents the development of hypertensive renal injury without altering existing hypertension levels"
• Hormones for Prostate Cancer? - Dr. Weil, 8/2/07
• Older Men May Not Live As Long If They Have Low Testosterone - Science Daily, 6/5/07 - "The group with low testosterone levels had a 33 percent greater risk of death during the next 18 years than the men with higher testosterone"
• Testosterone and Ageing - Medscape, 5/21/07 - "Recent studies have confirmed the long-held belief that adequate testosterone concentrations are important for sexual function and decreased testosterone concentrations are associated with impaired sexual health.[7,69,70] Testosterone replacement monotherapy has been shown to improve sexual desire and function in hypogonadal men,[7,46,69,71] with effects persisting for up to 3 years"
• Testosterone May Help Treat MS in Men - WebMD, 5/14/07
• A Lively Libido Isn’t Reserved for the Young - New York Times, 4/12/07 - "But the real libido hormone, for both men and women, is testosterone, which women produce in their ovaries and adrenal glands"
• Less Sleep May Lower Testosterone - WebMD, 4/2/07 - "The results of the study raise the possibility that older men who obtain less actual sleep during the night have lower blood testosterone levels in the morning"
• Testosterone Replacement Therapy for Male Hypogonadism: Part III. Pharmacologic and Clinical Profiles, Monitoring, Safety Issues, and Potential Future Agents - Medscape, 1/8/07 - "male hypogonadism is associated with a wide range of potentially distressing symptoms and signs, many of which are reversible through TRT. Such treatment confers at least short-term clinical benefits on sexual function, particularly libido, as well as erectile function, body composition, and possibly mood and/or a sense of vitality"
• Testosterone May Slow Alzheimer's - WebMD, 12/19/06 - "The mice that couldn't make testosterone developed more brain plaque, a hallmark of Alzheimer's disease. Those mice also had more trouble in a maze test"
• Testosterone Replacement Therapy Appears Safe For Prostate - Science Daily, 11/21/06 - "No treatment-related change was observed in prostate histology, tissue biomarkers, gene expression, or cancer incidence or severity. Treatment-related changes in prostate volume, serum prostate-specific antigen, voiding symptoms, and urinary flow were slight"
• Testosterone May Be Safe for Prostate - WebMD, 11/14/06 - "short-term testosterone replacement therapy (TRT) among men with low testosterone has little effect on the prostate gland"
• Depression May Be Related to Testosterone Levels in Men - Doctor's Guide, 11/13/06 - "Levels of TT were 11.94 among patients with major depression and 17.64 among healthy controls (P < .001). Bioavailable testosterone measures were 3.51 among patients with depression and 4.69 among controls ... Men with depression have a significantly lower BT level than do non-depressed men but using TT as the threshold to define hypogonadism revealed an even greater difference between the 2 groups in this study"
• The Evolving Role Of Testosterone In The Treatment Of Erectile Dysfunction - Medscape, 10/30/06 - "testosterone replacement therapy has evolved from a monotherapy for ED in cases of low testosterone, to a combination therapy with PDE5 inhibitors. There is increasing evidence that combination therapy is effective in treating the symptoms of ED in patients for whom treatment failed with testosterone or PDE5 inhibitors alone. Screening for hypogonadism and combination therapy of ED may be particularly useful in men with type 2 diabetes or the metabolic syndrome"
• Study: Men's Testosterone Levels Down - WebMD, 10/26/06 - "A new study shows a drop in average blood levels of testosterone in middle-aged Boston men over the last 20 years ... The reasons for that decline aren't clear"
• Elderly Men With Low Testosterone Levels More Likely To Fall - Science Daily, 10/25/06 - "among the one-fourth of participants with the lowest testosterone levels, the risk for falling was 40 percent higher than among the one-fourth with the highest testosterone levels. The association was stronger in younger men (ages 65 to 69) and not apparent in men older than 80"
• How Effective is Testosterone Replacement Therapy in Premenopausal Women with Severe Androgen Deficiency? - Medscape, 10/2/06 - "Beneficial effects of testosterone on mood (P = 0.029) and sexual functioning (P = 0.044) were observed. There was also a marked improvement in the general health and quality of life of patients receiving testosterone, although changes in cognition were limited. Women receiving testosterone had a 6% mean increase in total cholesterol levels when compared with those receiving placebo"
• Elevated Testosterone Kills Nerve Cells - Science Daily, 9/27/06 - "high levels of testosterone triggered programmed cell death in nerve cells in culture"
• Low Testosterone Associated With Fracture Risk in Older Men - Medscape, 9/18/06 - "total and free testosterone levels were found to be significant and independent predictors of osteoporotic fracture. The risk for any fracture increased by 40% and the risk for nonvertebral fracture increased by 50% for each SD decrease in testosterone levels"
• Low Testosterone Levels Associated With Increased Risk Of Death In Men - Science Daily, 8/17/06
• Prevalence of Hypogonadism in Males Aged at Least 45 Years: the HIM Study - Medscape, 8/16/06 - "Crude prevalence rate of hypogonadism was 38.7% ... Hypogonadism in men, characterised by a reduced concentration of serum testosterone, causes a constellation of signs and symptoms that may include decreased libido, erectile dysfunction, decreased volume of ejaculate, loss of body and facial hair, weakness, decreased bone density, decreased lean body mass, increased body fat, fatigue and anaemia"
• Hormone 'connected to death risk' - BBC News, 8/14/06 - "men with low hormone levels had an 88% increased risk of death compared with men with normal levels"
• Menopause Treatment a Cancer Risk? - WebMD, 7/24/06 - "women who had gone through menopause naturally and took estrogen plus testosterone had 2.5 times the risk of breast cancer than those who had never used hormone therapy. Estrogen-only therapy showed a 23% increased risk and estrogen-plus-progesterone therapy was linked to a 66% increased risk in those women with natural menopause"
• Combined Estrogen and Testosterone Use and Risk of Breast Cancer in Postmenopausal Women - Arch Intern Med, 7/24/06 - "Among women with a natural menopause, the risk of breast cancer was nearly 2.5-fold greater among current users of estrogen plus testosterone therapies ... Women receiving PMHs with testosterone had a 17.2% (95% confidence interval, 6.7%-28.7%) increased risk of breast cancer per year of use"
• High Estrogen Levels Associated With Dementia In Older Men; No Association Observed With Testosterone - Science Daily, 7/24/06 - "Levels of bioavailable testosterone were not associated with risk of cognitive decline and incident dementia," they report. "In contrast, higher levels of bioavailable estradiol were associated with an increased risk for cognitive decline and Alzheimer's disease." For each standard deviation increase in estradiol level, the risk for the disease went up by 25 percent" - I take a quarter tablet of Femara (OffshoreRX) to keep estrogen low. - Ben
• Testosterone Replacement Therapy and Prostate Cancer - Medscape, 7/19/06 - "there is currently no evidence that testosterone administration can initiate or promote a de novo or pre-existing prostatic malignancy in hypogonadal men.[40] In fact, there are strong indications that normal testosterone levels play a protective role in the natural history of prostate cancer"
• Low Testosterone Tied to Poor Health - WebMD, 6/5/06 - "odds of having low testosterone were ... 2.4 times higher for obese men ... 2.1 times higher for men with diabetes ... 1.8 times higher for men with high blood pressure ... Men with high cholesterol, prostate disease, and asthma were also more likely to have low testosterone than healthy men"
• Testosterone Gel Safe and Effective in Treating Hypogonadal Males With Erectile Dysfunction - Doctor's Guide, 7/3/06 - "Cavernous vasodilation, erectile capacity, sexual desire and body composition were also significantly improved with the Testogel combination"
• Data Suggest Testosterone Levels Correlate with Insulin Resistance and Insulin Sensitivity in Type 2 Diabetes Patients - Doctor's Guide, 6/21/06 - "Researchers found a general increase in insulin resistance in patients with Type 2 diabetes who have low total testosterone levels, compared to Type 2 diabetes patients with normal total testosterone levels"
• Testosterone Patch Helpful for Women With Androgen Deficiency and Hypopituitarism - Medscape, 5/15/06 - "Bone density increased in the hip and radius in the testosterone group by 0.9% and 0.8% at 1 year, respectively ... Fat-free mass increased by 3.4% and 0.6% in the testosterone vs placebo groups ... Testosterone increased muscle area in the thigh ... Mood and sexual function were improved"
• Male Hypogonadism: Etiology, Pathophysiology, and Diagnosis - Medscape, 5/9/06 - "Hypogonadism is characterized by low serum testosterone (T) levels (<300 ng/dl) together with ≥1 clinical symptom or sign. Symptoms of postpubertal hypogonadism include[1-3] (1) sexual dysfunction, such as reduced libido, erectile dysfunction (ED), diminished penile sensation, difficulty attaining orgasm, as well as reduced ejaculate with orgasm; (2) reduced energy, vitality, or stamina; (3) depressed mood or diminished sense of well-being; (4) increased irritability; (5) difficulty concentrating and other cognitive problems; and/or (6) hot flushes in some cases of acute onset"
• Lower Testosterone Levels Among Some Diabetic Patients May Lead to Increased Risk of Cardiovascular Disease - Doctor's Guide, 4/27/06 - "Men with type 2 diabetes should have their testosterone monitored, because one third of them may have low testosterone that could be related to a significantly higher risk of cardiovascular disease"
• Epidemiology of Hypogonadism - Medscape, 3/22/06 - "Male hypogonadism is a frequent and potentially undertreated condition ... One argument for using 300 ng/dl as the threshold for diagnosing male hypogonadism is that there is a functional correlation with erectile dysfunction (ED). Studying 162 elderly (mean age=64.1 years) men with ED (mean duration=45.6 months), a Korean group reported that hypogonadism (serum TT <300 ng/dl) was among the strongest independent predictors of a poor response to sildenafil 25-100 mg for 8 weeks"
• Alzheimer Patients Treated With Testosterone In UCLA-led Study Show Improved Quality Of Life - Science Daily, 1/10/06 - "Alzheimer patients treated with testosterone showed significant improvement on a quality-of-life instrument that encompasses memory, interpersonal relationships, physical health, energy, living situation and overall well-being compared with patients who received a placebo"
• Testosterone May Ease Alzheimer's - WebMD, 12/12/05 - "testosterone replacement therapy improved the mood, overall well-being, and personal relationships of men with Alzheimer's disease"
• Men With Diabetes Have Less Testosterone? - Physician's Weekly, 11/21/05 - "free testosterone levels below normal were strongly connected to diabetes, and low total testosterone levels were more commonly associated with obesity and central adiposity rather than diabetes"
• Androgens, Insulin Resistance and Vascular Disease in Men - Medscape, 9/8/05 - "Studies in healthy men have shown an inverse correlation between testosterone and insulin levels ... physiological testosterone replacement improves insulin sensitivity ... Insulin resistance also plays a role in the development of atherosclerosis and hypertension ... hypotestosteronaemia is associated with insulin resistance in men. Testosterone treatment inhibits the hyperinsulinaemia and thus may delay the onset of diabetes mellitus in men or even improve glycaemic control"
• Male Menopause? - Medscape, 7/1/05 - "In my experience, testosterone replacement in men with a physiologic need has not resulted in any negative effects. In fact, I have always been impressed on follow-up visits when men tell me how much better they feel, that their sex drives have increased, and that they feel "like themselves again.""
• Testosterone Replacement a Double-Edged Sword: Impact of supplementation is largely positive, but adverse effects found among men on highest doses - Clinical Psychiatry News, 8/05 - "Testosterone supplementation trims visceral fat, builds skeletal muscle, improves muscle strength, and promotes overall sexual function in healthy older men ... The adverse events included polycythemia, leg edema, and two cases of prostate cancer that may have been indolent prior to the patients' receiving high-dose testosterone ... Abdominal visceral fat, however, increased by 16.6% in the placebo group, and decreased by 6.8% in men taking testosterone—a significant difference between groups"
• Testosterone Replacement Improves Exercise Capacity in Men With CHF - Medscape, 6/8/05 - "Exercise capacity improved significantly in patients who were taking testosterone, but deteriorated in those who were receiving placebo"
• Men With Diabetes, Hypertension, or Hyperlipidemia More Likely to Be Hypogonadal - Doctor's Guide, 5/25/05 - "In men with a history of diabetes, 50% were hypogonadal. In men with a history of hypertension, 42% were hypogonadal, and in those with a history of hyperlipidaemia, 40% were hypogonadal"
• Obesity Is Risk Factor For Aggressive Prostate Cancer - Science Daily, 5/23/05 - "Hormone changes observed with obesity also cause decreased levels of the male hormone testosterone"
• Testosterone May Actually Help Men's Hearts - WebMD, 5/16/05 - "The thickness of the wall of this artery is a predictor of a higher risk of heart disease. The study showed that the wall thickness increased as testosterone levels dropped"
• Hormone Replacement May Fight Aging Frailty - CBS 2 Chicago, 1/26/05 - "Researchers at the University of Southern California say restoring levels of testosterone and growth hormone may help aging seniors avoid frailty"
• Testosterone Deficiency Found In One-Third Of Diabetic Men - Science Daily, 11/29/04 - "The surprisingly high prevalence of low testosterone levels was associated with lower levels of pituitary hormones called gonadotrophins ... The high prevalence of low testosterone in diabetic men is concerning, said Dhindsa, because in addition to lowered libido and erectile dysfunction, the condition is associated with loss of muscle tone, increase in abdominal fat, loss of bone density, and can affect mood and cognition"
• Testosterone Deficiency Found in One-Third of Diabetic Men - Doctor's Guide, 11/29/04
• Low Testosterone Linked With Memory Loss - WebMD, 10/27/04
• Testosterone Deprivation Makes Men Forget - Science Daily, 10/22/04 - "word retention drops sharply after only two minutes among men undergoing testosterone deprivation therapy"
• Testosterone Patch Can Improve Sexual Function in Women - Medscape, 10/11/04 - "Results at 24 weeks showed that TTP therapy significantly increased the frequency of "totally satisfying" sexual episodes compared with placebo (high SHBG level group: 2.1 vs 0.5 episodes/month, P < .0001; ITT group: 1.9 vs 0.5 episodes/month, P < .0001) and compared with baseline"
• Declining Estradiol Levels More Predictive of Fracture Risk Than Low Testosterone in Aging Men - Doctor's Guide, 10/8/04 - "While low levels of free testosterone are a predictor of hip-bone loss, declines in estradiol levels play a stronger role than testosterone"
• Testosterone Loss May Raise Alzheimer's Risk - WebMD, 9/24/04 [Science Daily] - "testosterone levels were significantly lower in the men with Alzheimer's disease compared with the men who did not have the disease ... the findings are significant because only testosterone levels appeared related to Alzheimer's risk ... It protects neurons from injury, and it reduces levels of beta-amyloid, the protein widely implicated as a causal factor in the disease"
• Viagra Plus Testosterone Gel May Treat ED Better - WebMD, 8/6/04
• Viagra (Sildenafil)/Testosterone Gel Combination May Benefit Men Who Fail Treatment with Pill Alone - Doctor's Guide, 8/5/04 - "For men with erectile dysfunction and low testosterone who do not respond to Viagra®* (sildenafil) alone, the supplemental use of AndroGel®** (testosterone gel) improves erectile function and overall sexual satisfaction"
• A New, Independent Risk Factor for Heart Disease - Life Extension Magazine, 8/04 - "In this study, aged men with low free testosterone and low HDL showed more severe coronary blockage ... Artery-protecting HDL can be increased by taking high doses of niacin and chromium, and/or one glass of red wine per day"
• Buccal Testosterone Delivery System Better Than Transdermal - Medscape, 5/28/04 - "Mean serum testosterone concentration during the 24-hour treatment period was 18.74 +/- 5.90 nmol/L in the buccal system group and 12.15 +/- 5.55 nmol/L in the transdermal patch group (P < .01). In the buccal system group, 97% of patients had average steady-state testosterone concentrations within the physiological range (10.41 - 36.44 nmol/L) compared with 56% in the transdermal patch group ... Striant was approved by the FDA in June 2003"
• High Blood Testosterone Levels Associated With Increased Prostate Cancer Risk - Science Daily, 5/10/04 - "One form of testosterone, called free testosterone, which is biologically active and can actually be used by the prostate, was found to be associated with increased prostate cancer risk"
• Testosterone Gel Is Safe, Effective Long-Term - Medscape, 5/7/04
• AndroGel (Testosterone) Shows Long-Term Benefits, Safety for Men With Hypogonadism - Doctor's Guide, 5/4/04 - "The study results showed significant improvements in mood and sexual performance, motivation and activity soon after initiating testosterone replacement. These improvements were maintained throughout treatment. Lean body mass increased (average of about 3 kg or 6.6 pounds) as early as three months after beginning treatment and was sustained with continuous treatment. Additionally, an increase in muscle strength associated with the increase in lean mass was reported"
• Testosterone Replacement Therapy - Physician's Weekly, 3/8/04 - "there is no compelling evidence whatsoever that TRT in men with low testosterone increases the risk of prostate cancer ... there is really no dispute in the literature that testosterone replacement therapy in hypogonadal men provides improvements in the areas of libido, muscle mass, and bone density. Areas that have shown promise include effects on mood, strength, frailty, cognition, and erectile dysfunction"
• Testosterone Plus Finasteride Improves BMD in Men With Low Testosterone - Medscape, 2/25/04 - "The combination of testosterone (T) and finasteride (F) improves bone mineral density (BMD) in men with low T levels without increasing prostate-specific antigen (PSA) levels"
• Low Testosterone May Cause Depression - 2/3/04 - "some 30% of men over age 55 have it. Low levels of the hormone can cause symptoms of fatigue, a decreased sex drive, and irritability ...the men with low testosterone were four times more likely to be diagnosed with clinical depression" - [Abstract]
• Low Free Testosterone Levels Linked to Alzheimer's Disease in Older Men - Doctor's Guide, 1/29/04
• Revised Guidelines Address Diagnosing And Treating Hypogonadism in Men - Clinical Psychiatry News, 12/03 - "In addition to decreased sex drive and sexual activity, men with low testosterone levels may exhibit anger, depression, fatigue, and confusion, as well as physical effects such as decreased muscle mass and bone density ... Based on the results of recent studies, the new guidelines state that testosterone replacement often alleviates associated psychological conditions, increases virilization, and optimizes bone density. Recent studies also indicate that the therapy may normalize growth hormone levels in elderly men. Therapy also may decrease cardiac mortality in this population"
• Don't Blame Testosterone for Aggression - WebMD, 11/11/03
• Testosterone Improves Sexual Function in Women With HSDD - Medscape, 10/15/03 - "After 24 weeks, the women in the testosterone group showed a significant increase in the sexual desire score of the PFSF compared with those in the placebo group ... Testosterone therapy also resulted in a statistically significant change versus placebo for each of the following PFSF domains: orgasm, sexual arousal, sexual responsiveness, sexual self-image, and sexual concerns"
• Short-Term Testosterone Therapy May Boost Effectiveness of Viagra - Clinical Psychiatry News, 10/03 - "The study is the first to indicate that men who have low, but not hypogonadal, levels of testosterone and who fail on Viagra can be helped with testosterone supplementation"
• Searching For A Female Viagra - Time Magazine, 9/29/03 - "Nearly 450 women who had lost their ovaries were given either a testosterone patch or a placebo. After six months of treatment, the women on 300 mcg of testosterone a day reported an 81% increase in satisfying sexual activity and a 66% increase in sexual desire"
• High on Testosterone - Newsweek, 9/29/03 - "Besides restoring libido, TRT has been shown to improve bone density and muscle mass. And a small study done at Boston’s McClean Hospital this year suggests that, when used in conjunction with antidepressants, testosterone may improve depression in difficult-to-treat men ... Morgentaler, whose new book, “The Viagra Myth,” explores the social impact of the popular drug, doesn’t think it’s proper to withhold TRT from older men with symptoms of low testosterone because of “theoretical, unproven concerns.”"
• Methyltestosterone/Oestrogen Therapy Improves Sexual Interest in Surgically Menopausal Women - Doctor's Guide, 9/25/03 - "Patients were randomised to receive either combined oral esterified oestrogens and methyltestosterone (EEMT, Estratest Tablets, Solvay Pharmaceuticals, Inc.) or oral esterified oestrogens alone (EE, two Estratab Tablets, 0.625 mg each) for 8 weeks ... Overall, the researchers observed significantly greater increases in SIQ total score, sexual interest and desire subscale score, and responsiveness scores after 8 weeks of treatment with EEMT as compared to EE therapy"
• Testosterone Measurements in Postmenopausal Women Should Include Both Free Testosterone and SHBG Levels - Doctor's Guide, 9/24/03 - "When evaluating testosterone levels in postmenopausal women, clinicians may need to monitor both free testosterone and SHBG levels, because women who are receiving testosterone therapy can have supraphysiologic serum total T concentration, but normal free T concentrations ... We're already seeing a testosterone patch for women going into phase II/phase III trials so I think we're going to see this treatment to be a common treatment for women in the next 5 years"
• Testosterone Patches Treat Low Sexual Desire in Surgically Menopausal Women - Doctor's Guide, 9/22/03
• FDA Approves Testosterone System - Physician's Weekly, 9/1/03 - "The FDA approved the testosterone buccal system (Striant), which slowly releases testosterone into mucous membranes in the mouth ... testosterone buccal system offers an alternative to testosterone delivered by transdermal patches, topical gels, or injection"
• Men Get Zip With Hormone Shots - CBS News, 7/30/03 - ""About three days after I had the first [testosterone] shot I was kicked right out of my depression," he says. "I was back in the gym again and I had a lot of energy. I felt great."
• Testosterone Increases Libido in Women - WebMD, 6/26/03 - "Half the women were treated for 16 weeks with the low-dose oral estrogen-testosterone combination drug Estratest HS ... By week eight, the testosterone-treated patients had measurable improvements in testosterone levels that put them in the upper normal range, and they reported improved interest in sex. They also reported none of the common side effects of treatment with larger doses of testosterone, such as excessive hair growth and acne" - See Estratest at drugstore.com.
• Men with Borderline Low and Low Baseline Testosterone Benefit Equally from Testosterone Gel (Androgel) - Doctor's Guide, 6/23/03 - "Transdermal testosterone replacement gel (Androgel) improves sexual function, body composition and bone mineral density in men with borderline low testosterone levels almost equal as in men with pretreatment testosterone levels below the normal"
• Androgens Add Muscle Mass, Not Strength - WebMD, 6/20/03 - "those who used androgens along with strength training saw more significant gains in both muscle mass and muscle quality. Their muscles not only got bigger, but they also got a greater increase in strength not attributable to size alone"
• FDA Approves Striant (Testosterone Buccal System), Treatment For Men With a Deficiency or Absence of Testosterone - Doctor's Guide, 6/20/03 - "The controlled- and sustained-release buccal testosterone product (which has the appearance of a small monoconvex tablet) acts by rapidly adhering to the buccal mucosa, the small, natural depression in the mouth where the gum meets the upper lip above the incisor teeth. As it is exposed to saliva the product softens into a gel-like form, which remains comfortably in place over each 12-hour dosing period. The product delivers testosterone through the buccal mucosa, where it is absorbed into the bloodstream and delivered directly into the superior vena cava (major blood vessel), bypassing the gastrointestinal system and liver. Striant is able to produce circulating testosterone concentrations in hypogonadal males that approximate physiologic levels seen in healthy young men. Because Striant is available in a single strength, no dose titration is required ... the most frequent adverse events that occurred with an incidence of one percent or greater were: gum or mouth irritation, bitter taste, gum pain, gum tenderness, headache, gum edema, and taste perversion. The majority of the gum-related adverse events were transient and resolved within 1 to 14 days"
• Testim Testosterone Gel Enhances Sexual Motivation and Performance In Males With Hypogonadism - Doctor's Guide, 6/10/03 - "Testim testosterone gel significantly improved sexual performance while also increasing lean body mass without exercise ... Patients treated with Testim also showed greater improvements in lean body mass, spontaneous erections, sexual desire and sexual performance as compared to patients treated with a transdermal patch or placebo ... prostate adverse events with Testim were very low, and similar to placebo"
• Low Testosterone Linked to Heart Disease - WebMD, 5/27/03 - "men with diabetes and very low testosterone levels were more likely to develop plaque in their arteries, which can lead to heart disease and stroke" - [Abstract]
• Free Testosterone Inversely Related to Carotid Atherosclerosis - Medscape, 5/23/03 - "Serum free testosterone is inversely related to carotid intima-media thickness (IMT) and plaque score (PS) ... There is evidence to suggest that low concentrations of testosterone are associated with an increased risk of CVD in men"
• Improving Erectile Function: Detection, Prevention, and Treatment of ED - PowerPak.com, exp. 4/1/05 - "ED was 82% more likely in men with depression ... Low serum testosterone levels are noted in up to 36% of patients with ED. However, the correction of sexual dysfunction with testosterone replacement therapy alone is poor, with treatment response at approximately 35%" - That may be because testosterone does two things that hinder sexual function.  It decreases HDL cholesterol and it increases estrogen. - Ben
• Testosterone In A Tube - CBS News, 5/19/03
• Tostrex (Testorone) Gel Name Changed To Fortigel - Doctor's Guide, 4/24/03
• Several Options Available for Androgen Replacement Therapy - Doctor's Guide, 4/8/03 - "By restoring them to a eugonadal state, it can increase muscle mass and strength, help maintain bone density, increase cognition and mood, improve libido, sexual function, and a generalized state of well-being ... Studies suggest that bringing a hypogonadal man back to a normal level of testosterone with exogenous androgen does not affect the prostate negatively. "There is essentially no significant change in the PSA [prostate specific antigen], in prostate volume, and in urinary symptoms," ... Side effects of exogenous androgen therapies are mood changes, polycythemia, gynecomastia, exacerbation of sleep apnea, and in some patients, acne" - See my aromatization page for ways that may prevent gynecomastia.
• Testosterone: The Fountain of Youth? - WebMD, 2/26/03 - "Slater says a good trial to determine if testosterone therapy increases the risk of prostate cancer would need a minimum of 6,000 men and would cost in excess of $100 million" - Kind of a worthless article written by anti-anti-aging people that doesn't say much.  I don't know why I included it.  I feel something that the anti-anti-aging people don't understand is that the objective for most people is quality of life, not who dies with the biggest number of years under their belt and those people don't have 30 years to wait for studies to be completed.
• Sex Drive Need a Tune-Up? - Dr. Weil, 2/12/03 - "Those [women] who had the most variability in testosterone levels were two to three times more likely to report decreased libido than those who had the most stable testosterone levels ... Apart from the fluctuations in testosterone levels, the only other factors affecting the female sex drive discovered in this study were depression and having children in the house ... Estratest, a prescription drug combining estrogen and testosterone" - See Estratest at Drugstore.com.
• Testosterone May Boost Efficacy Of Antidepressants in Men - Psychiatric News, 2/7/03
• Testim (Testosterone Gel) Gel For Treatment Of Testosterone Deficiency In Men Now Available In US - Doctor's Guide, 2/4/03 - "Testosterone deficiency can lead to a decline in energy, decreased muscle mass, an increase in abdominal fat, reduced bone density leading to an increased risk of osteoporosis, decreased libido, decreased sexual function and impotence, anemia, fatigue, and depression ... patients reported a 59 percent increase in sexual activity and a 78 percent increase in days with a spontaneous erection over a 90-day period. Patients also showed an average increase of 3.5 pounds in muscle mass in 90 days with no weight training and without overall weight gain. Initial analysis of long-term data suggests that Testim improves bone mineral density ... For additional information, visit http://www.auxilium.com" - Related article:
  • Newly Approved Drug Therapies (810): Testim, Auxilium Pharmaceuticals - centerwatch.com - "Side Effects ... Gynecomastia" - See my aromatization page.  I've been taking 1/4 mg of Femara per day via International Anti-aging Systems.  Another option might be chrysin plus Bioperine to increase absorption.
• Testosterone Replacement Therapy Faces Scrutiny - Intelihealth, 1/30/03
• Regular Periods Don't Rule Out Low Testosterone - Clinical Psychiatry News, 1/03 - "Physicians who see young women complaining of low libido should consider that the problem could be low testosterone even if the women have regular menstrual periods"
• Should Men Get HRT for Heart Health? - WebMD, 1/15/03 - "twice as many men with heart disease have low testosterone levels compared with men without heart disease. In fact, low testosterone is linked to a number of risk factors for heart disease ... if male rabbits have too little testosterone, they develop more atherosclerosis [hardening of the arteries] than animals with normal testosterone"
• Testosterone Gel Helpful in Refractory Depression - Medscape, 1/15/03
• Testosterone Gel Could Help Depressed Men With Low Testosterone Levels - Doctor's Guide, 1/8/03
• Testosterone May Help Depressed Men - WebMD, 1/3/03 - "nearly half of the men who had not responded to conventional depression treatment had low or low-to-normal testosterone levels. And several showed dramatic improvement when the male hormone was given along with antidepressants"
• Testosterone for 6 Weeks Helps Some Women With Sexual Dysfunction - Clinical Psychiatry News, 12/02 - "Women with sexual dysfunction whose free testosterone levels are in the bottom third of the normal range or below normal should be considered for a 6-week trial of androgen replacement therapy ... A total of 25 patients in the series had a good response, 8 had no response, 8 refused the therapy, and 9 were lost to follow-up"
• Auxilium Receives U.S. FDA Approval to Market Testim™ Testosterone Replacement Gel - Doctor's Guide, 11/1/02 - "Testim is approved for use in treating men with low testosterone levels ... Abnormally low levels of testosterone are linked to a decline in energy, decreased muscle mass, reduced bone density, decreased libido and sexual function, fatigue and depression"
• Extending Healthspan: Hormones, Supplements, Diet and Exercise - Life Extension Magazine, 10/02 - "Finally, the authors note that testosterone is an excellent antidepressant. It restores good mood, self-confidence and sociability, often making antidepressants such as Prozac no longer necessary. “Grumpy old men” are those with testosterone deficiency" - See Forever Ageless at Amazon.com
• Pharmacy Compounding Prone to Error, FDA Finds - Doctor's Guide, 9/24/02 - "More than half had less than 70 percent of the potency stated on labelling" - That's why I worry about compounded testosterone. - Ben
• Testosterone supplementation provides additional BMD gains in hypogonadal men following cardiac transplantation - Doctor's Guide, 9/23/02 - "hypogonadal men who received additional testosterone supplementation showed the largest increases in BMD [bone mineral density]"
• Testosterone Deficiency & Depression, Does DHEA Raise the Levels of Bioavailable Testosterone in Men? - Life Extension Magazine, 8/02 - "Some men on testosterone drug replacement therapy develop dangerously high estrogen levels. Estrogen can be suppressed by taking an aromatase-inhibiting drug like Arimidex (0.5 mg twice a week)"
• Decreased Testosterone Levels Linked to Sleep Disorder - Doctor's Guide, 7/25/02 - "Male patients who suffer from obstructive sleep apnea (OSA) -- the inability to breathe properly during sleep -- produce lower levels of testosterone, resulting in decreased libido and sexual activity"
• Testosterone-Induced Muscle Growth Linked To Muscle Fibre Hypertrophy - Doctor's Guide, 7/17/02
• Testosterone Supplementation Contraindicated after Prostate Cancer - Doctor's Guide, 7/10/02
• Insulin Resistance Tied to Low Testosterone in Men - Doctor's Guide, 6/24/02 - "Men who are insulin resistant are also more likely to have reduced testosterone secretions"
• Low-Dose Testosterone Replacement Safe, Effective - Medscape, 6/24/02 - "Since 1993, the subjects received intramuscular testosterone cypionate or testosterone enanthate, 25 mg weekly or 50 mg every 2 weeks ... Treatment had significant benefits on lipid metabolism, osteoporosis, muscle mass, fat distribution, libido, and sense of well-being, with a good safety profile ... The safety of low-dose testosterone for MHRT and [for] preventing rapid progression of dementia appears to be encouraging"
• Buccal Tablet Provides More Convenient Testosterone Dosing - Doctor's Guide. 6/24/02
• Testosterone Replacement May Disturb Sleep in Older Men - Doctor's Guide, 6/23/02
• Testosterone Therapy Improves Exercise Ability of Men with Chronic Congestive Heart Failure - Doctor's Guide, 6/21/02 - "After 12 weeks, the testosterone group achieved a 34 percent increase in exercise capacity compared to 2 percent for the control group ... In addition, the testosterone treatment improved depression and heart failure symptoms while causing few side effects"
• Oral Androgen Oxandrin (Oxandrolone) Increases Strength and Functioning in Elderly Men - Doctor's Guide, 6/20/02 - "Treatment with an oral androgen can significantly increase muscle strength and power in men over 60 years ... There's a lot of potential here ... The goal is to help people age in a much better fashion as the average life span is going up"
• Refractory Nonmotor Symptoms in Male Patients With Parkinson Disease Due to Testosterone Deficiency: A Common Unrecognized Comorbidity - Archives of Neurology, 5/02 - "Following testosterone replacement therapy, all 5 patients experienced significant improvements in their refractory nonmotor symptoms"
• Female Sexual Dysfunction, Thyroid Trouble May Be to Blame - WebMD, 3/21/02 - "she has seen no published studies evaluating the frequency of thyroid disease in women with sexual dysfunction issues ... But, with the exception of sexual issues related to menopause, I see it more often than anything else in my female patients" - I'm a male but I know that a few micrograms of T3 (liothyronine/Cytomel) plus T4 (levothyroxine/Synthroid) did a heck of a lot more than testosterone replacement.
• Oestrogen-Androgen Replacement Significantly Benefits Postmenopausal Women - Doctor's Guide, 4/26/02 - "Compared with oestrogen alone, oestrogen-androgen significantly increased total lean body mass and reduced the percentage fat for all body parts ... There was a statistically significant increase in weight in the oestrogen-androgen group (2.7 +/- 5.1 lb.) (1.22 +/- 2.31 kg.) compared with the oestrogen only group ... In self-reporting questionnaires, women who received oestrogen-androgen noted more improvement in sexual functioning and quality of life than the women who received oestrogen alone"
• Low Testosterone and the Brain - WebMD, 4/17/02 - "New research suggests the male hormone may help men reduce their risk of stroke as well as improve symptoms of Parkinson's disease ... When the five patients studied received testosterone replacement therapy, researchers found symptoms such as fatigue, depression, anxiety, and sexual function improved greatly"
• Testosterone Aids Cognition in Older Men - Doctor's Guide, 4/16/02 - "The men in the study with higher levels of bioavailable testosterone, the testosterone that can reach the brain, did significantly better on these cognitive tests than men with lower levels ... men have higher levels of both estrogen and testosterone than women" - On that second statement, I believe them meant older men.  See:
  • Male Hormone Modulation Therapy  - Life Extension Magazine, 11/99 - "One cause of hormone imbalance in men is that their testosterone is increasingly converted to estrogen. One report showed that estrogen levels of the average 54-year-old man are higher than those of the average 59-year-old woman . . . . High levels of estrogen have been implicated as a cause of benign prostatic hypertrophy (BPH)" - See my chrysin and I3C page about how of protect against this.
• Endogenous Hormones Might Lower Atherosclerosis Risk in Some Older Women - Doctor's Guide, 4/1/02 - "the researchers found no association between the odds of atherosclerosis and increasing quartiles of estrone, dehydroepiandrosterone sulphate or androstenedione ... Compared with participants in the lowest quartile of sex hormone-binding globulin, those in the highest quartile had significantly lower odds of atherosclerosis. Participants in the highest quartile of total testosterone also had lower odds of atherosclerosis"
• High Blood Pressure Kills Sex - WebMD, 3/21/02 - "the problem may not be with blood flow alone. New research suggests plummeting levels of the male hormone testosterone could partly be to blame"
• Testosterone May Help Fight Alzheimer's - Intelihealth, 1/25/02 - "There is increasing evidence that stress plays a role in the development of Alzheimer's ... Hormones such as testosterone have been shown to regulate the brain's stress response ... stress leads to a biochemical change in a brain protein, which is a primary culprit in Alzheimer's disease ... his findings suggest that giving testosterone to aging men or to postmenopausal women may help to delay, prevent and possibly treat Alzheimer's disease. The research was supported by the Alzheimer's Association"
• Power Lifts Urged For Older Men - Intelihealth, 11/19/01 - "Older men with low levels of testosterone can literally haul themselves away from frailty by combining supplemental doses of the male sex hormone with fast-movement weight training ... At the end of the year, both exercise groups had improved, but lifters who got testosterone supplements improved more. The exercise-plus-supplement group had raised performance by close to sixfold, while the exercise-alone group had improved by almost fivefold"
• Caution Urged in Treating Andropause with Testosterone - Doctor's Guide, 10/5/01
• Testosterone Leads to Improvements in Lean Mass for Men with Pulmonary Disease - Doctor's Guide, 9/25/01
• Is It Male Menopause? - WebMD, 7/13/01 - "those who got testosterone had significant improvements in a test of spatial memory ... They also had improvements in verbal memory ... Probably the most important area where it can help is with prevention of osteoporosis ... Probably the most important area where it can help is with prevention of osteoporosis"
• Testosterone Levels Correlated With Bone Density in Anorexics - Doctor's Guide, 6/22/01
• Testosterone Decreases Good Cholesterol But Does Not Influence Other Atherogenic Markers - Doctor's Guide, 6/21/01
• What You Eat Can Affect Sex Hormones, Testosterone Level Drops After Low-Fat Meal, May Protect Against Cancer - WebMD, 5/17/01 - "studied 15 healthy men 2-6 hours after eating four different types of meals under similar conditions. All meals contained the same number of calories, but differed in type of protein and in quantity and type of fat ... After low-fat meals of tofu or lean meat, but not after meals high in animal fat, testosterone and another index of male hormone levels dropped. Adding unsaturated vegetable oil to the lean meat meal didn't change the effect on lowering male hormones"
• Unisex Hormones?, Testosterone, DHEA May Help Both Sexes - WebMD, 5/4/01 - "Low levels of male hormones probably account for decreased muscularity, sexual interest, and bone density in menopausal women ... a 50 mg dose of DHEA each day enhanced sexual interest and satisfaction in aging women, while promoting stronger bones and younger-looking skin"
• Aromatase Inhibition Corrects Endocrinopathy In Infertile Men - Doctor's Guide, 4/9/01 - "investigators found that men with severe infertility had significantly lower testosterone (328 versus 543 ng/dl) and significantly higher oestradiol (58.4 versus 43.5 ng/l) than the fertile controls. As a result, the infertile men had much lower testosterone-to-oestradiol ratios ... These abnormalities were corrected in the 45 men who received testolactone and their testosterone-to-oestradiol ratios rose into the normal range"
• Is a Male 'Change of Life' Fact or Fiction? - WebMD, 10/20/00 - "A very small drop in testosterone -- 10% or so -- might cause symptoms like depression, mood swings, decreased muscle strength and energy, reduced sex drive, problems with erections."
• Male Hormone Gives Pain Relief to Some Men With Angina - WebMD, 10/16/00
• Testosterone supplements are hot, but will they really warm up your sex life? - WebMD, 10/16/00
• Youth for Sale, Antiaging Patients Looking, Feeling Good -- But Long-Term Safety Unknown - WebMD, 10/13/00
• Testosterone patch improves sexual function in women, study shows - CNN, 9/7/00
• Testosterone: It's Not Just for Men Anymore - WebMD, 9/6/00
• Testosterone Gel Increases Bone Mineral Density In Hypogonadal Men - Doctor's Guide, 6/23/00
• AndroGel (Testosterone) Improves Sexual Function and Strength In Testosterone Deficient Men - Doctor's Guide, 6/22/00
• Endocrinologists Highlight Importance of Appropriate Diagnosis, Treatment of Low Testosterone - Doctor's Guide, 6/22/00
• Low Dose Testosterone Aids Men With Chronic Stable Angina - Doctor's Guide, 6/22/00 - "men who had taken the low dose testosterone had overall better results in terms of social functioning, emotional well-being related to their heart condition, mental health and their general perception of their health."

Abstracts:

• Associations of bioavailable serum testosterone with cognitive function in older men: results from the National Health and Nutrition Examination Survey - J Gerontol A Biol Sci Med Sci 2022 Aug 5 - "with no signs of a plateau effect ... Calculated bioavailable testosterone presented a significant positive association with processing speed, sustained attention and working memory in older men above 60 years of age. Further research is warranted to elucidate the impact of the inevitable age-related decline in testosterone on cognitive function in older men"
• Oxidative stress and inflammation are associated with age-related endothelial dysfunction in men with low testosterone - J Clin Endocrinol Metab 2021 Oct 1 - "middle-age and older (MA/O) men ... Healthy MA/O men with low testosterone appear to have greater age-associated endothelial dysfunction, related in part to greater oxidative stress and inflammation. These data suggest that low testosterone concentrations may contribute to accelerated vascular aging in men"
• Testosterone, Dihydrotestosterone, Bone Density, and Hip Fracture Risk among Older Men: The Cardiovascular Health Study - Metabolism 2020 Oct 12 - "In older men, DHT was inversely associated with hip fracture risk and SHBG was positively associated with hip fracture risk, while T was not"
• Relation of Testosterone Levels to Mortality in Men With Heart Failure - Am J Cardiol. 2018 Mar 1 - "These patients were divided into quartiles based on their serum levels of total testosterone (TT): first (TT > 631 ng/dl, n = 154), second (462 < TT ≤ 631 ng/dl, n = 155), third (300 < TT ≤ 462 ng/dl, n = 156), and fourth (TT ≤ 300 ng/dl, n = 153) quartiles. In the Kaplan-Meier analysis (mean 1,281 days), all-cause mortality progressively increased throughout from the first to the fourth groups. In the multivariable Cox proportional hazard analysis, TT was found to be an independent predictor of all-cause mortality (hazard ratio 0.929, p = 0.042)"
• Testosterone and sexual function - Curr Opin Urol. 2017 Nov;27(6):516-518 - "The limited and inconsistent benefits of testosterone therapy for sexual function argue against use of this therapy in aging men, including those with 'low testosterone'"
• Effects of taking tadalafil 5 mg once daily on erectile function and total testosterone levels in patients with metabolic syndrome - Andrologia. 2017 Mar 15 - "All the patients received 5 mg tadalafil once a day for 3 months ... International Index of Erectile Function (IIEF) questionnaire ... At the end of 3 months, mean testosterone values and IIEF scores showed an improvement from baseline values (from 3.6 ± 0.5 to 5.2 ± 0.3, from 11.3 ± 1.9 to 19 ± 0.8 respectively). After the treatment, serum LH levels were decreased (from 5.6 ± 0.6 to 4.6 ± 0.5). There was significantly difference in terms of baseline testosterone and luteinising hormone values and IIEF scores (p < .05). Based on our findings, we recommend tadalafil 5 mg once daily in those men with erectile dysfunction especially low testosterone levels accompanied by metabolic syndrome" - Note: That's a 44% increase in testosterone by my calculations.
• Effects of transdermal testosterone gel or an aromatase inhibitor on serum concentration and pulsatility of growth hormone in older men with age-related low testosterone - Metabolism. 2017 Apr;69:143-147 - "Thirty-seven men, ≥65years with total testosterone <350ng/dL were randomized to 5g transdermal testosterone gel (TT), 1mg oral aromatase inhibitor (AI) or placebo daily for 12months ... At 6months, IGF-1 significantly increased by Δ 15.3±10.3ng/ml in the TT-group compared to placebo (P=0.03). Both intervention groups significantly increased GH pulse frequency (TT-group, P=0.04; AI-group, P=0.05) compared to placebo. The GH secretory-burst mode (duration) significantly decreased in the TT-group (P=0.0018) compared to placebo while it remained unchanged in the AI-group" - Note:  Everything I've read over the years seems to indicate that low dose Femara is a better way to go than testosterone replacement (which increases estrogen as much as testosterone percentage wise).
• Testosterone supplementation reduces heart attack risk in men with heart disease - Science Daily, 4/3/16 - "patients who received testosterone as part of their follow-up treatment fared much better than patients who didn't. Non-testosterone-therapy patients were 80 percent more likely to suffer an adverse event"
• Low Free Testosterone is Associated with Hypogonadal Signs and Symptoms in Men with Normal Total Testosterone - J Clin Endocrinol Metab. 2016 Feb 24 - "Low cFT, even in the presence of normal TT, is associated with androgen deficiency-related symptoms. Normal cFT, despite low TT, is not associated with cognate symptoms. Therefore cFT levels should be assessed in men with suspected hypogonadal symptoms"
• In older men, higher plasma testosterone or dihydrotestosterone are independent predictors for reduced incidence of stroke but not myocardial infarction - J Clin Endocrinol Metab. 2014 Sep 30:jc20142664 - "3,690 community-dwelling men aged 70-89 years ... follow-up was 6.6 years ... In multivariate analysis adjusting for age and other risk factors, neither T, DHT nor E2 were associated with incident MI (fully-adjusted hazard ratio [HR] for T in Quartile (Q)4 vs Q1: 0.92, 95% confidence interval [CI]=0.66-1.28; DHT: 0.83, 0.59-1.15; E2: 0.84, 0.62-1.15). Higher T or DHT was associated with lower incidence of stroke (T: Q4:Q1 fully-adjusted HR=0.56, 95% CI=0.39-0.81, p=0.002; DHT: 0.57, 0.40-0.81, p=0.002). E2 was not associated with stroke (HR=0.76, 95% CI=0.54-1.08, p=0.123)"
• Testosterone therapy and mortality risk - Int J Impot Res. 2014 Jul 31 - "There appears to be no change in mortality risk overall for men utilizing long-term testosterone therapy"
• Effect of testosterone treatment on constitutional and sexual symptoms in men with type 2 diabetes in a randomized, placebo-controlled clinical trial - J Clin Endocrinol Metab. 2014 Jun 30:jc20141872 - "Testosterone treatment did not substantially improve aging male symptoms (mean adjusted difference (MAD) in change over 40 weeks across the testosterone and placebo groups in AMS total score, -0.9 [95% CI -4.1, 2.2], p=0.67), or sexual desire (MAD in question 17 AMS, -0.3 [95% CI -0.8, 0.2], p=0.17). While compared to placebo, erectile function in men assigned to testosterone was reduced (MAD in IIEF-5, -2.0 [95% CI -3.4, -0.6], p<0.02), there was no significant difference between baseline and 40 week IIEF-5 scores if both groups were analyzed separately"
• In Older Men an Optimal Plasma Testosterone Is Associated With Reduced All-Cause Mortality and Higher Dihydrotestosterone With Reduced Ischemic Heart Disease Mortality, While Estradiol Levels Do Not Predict Mortality - J Clin Endocrinol Metab. 2013 Nov 20 - "Participants were community-dwelling men aged 70 to 89 years who were residing in Perth, Western Australia ... E2 was not associated with either all-cause or IHD mortality ... Optimal androgen levels are a biomarker for survival because older men with midrange levels of T and DHT had the lowest death rates from any cause, whereas those with higher DHT had lower IHD mortality"
• Limited effect of testosterone treatment for erectile dysfunction caused by high-estrogen levels in rats - Int J Impot Res. 2013 May 2 - "testosterone treatment did not improve the ED caused by high-estrogen levels" - Note:  One of the problems with testosterone replacement is that it increases estrogen (percentage wise) as much as testosterone.
• Both total testosterone and sex hormone-binding globulin are independent risk factors of metabolic syndrome: results from Fangchenggang Area Male Health and Examination Survey in China - Diabetes Metab Res Rev. 2013 Mar 6 - "Men with MetS had a lower level of TT, BT, FT or SHBG than those without MetS (all p < 0.001). Both TT and SHBG were inversely correlated with body mass index (BMI) or homeostasis model assessment of insulin resistance (HOMA-IR) (all age-adjusted p < 0.001). Men within the lowest quartile of TT (OR = 4.86, 95%CI = 2.72-8.68), BT (OR = 3.04, 95%CI = 1.81-5.10), FT (OR = 3.08, 95%CI = 1.81-5.27) or SHBG (OR = 4.28, 95%CI = 2.52-7.27) had a risk of MetS after adjusting for age, smoking, HOMA-IR and BMI. TT remained inversely associated with MetS after further adjusting for SHBG (OR = 0.95, 95%CI = 0.92-0.99), while SHBG remained inversely associated with MetS after further adjusting for TT (OR = 0.99, 95%CI = 0.97-1.00)"
• Plasma total testosterone and incident cardiovascular events in hypertensive patients - Am J Hypertens. 2013 Mar;26(3):373-81 - "Hypertension, a major contributory factor to the development of cardiovascular disease, has also been associated with increased prevalence of low testosterone. We investigated whether low androgen concentration predicts incident major adverse cardiovascular events (MACE) in middle-aged nondiabetic hypertensive patients without clinical atherosclerosis ... total testosterone (TT) ... Compared to patients who did not experience MACE, hypertensive subjects who developed MACE had lower TT concentration (3.9+/-0.7ng/ml vs. 4.6+/-1.5ng/ml, P < 0.01) and a higher prevalence of hypogonadism (36% vs. 16%, P < 0.05). Subjects in the lowest TT tertile (<4.0ng/ml) had a statistically significant higher risk of MACE compared to those in the highest tertile (>4.9ng/ml) in multivariate Cox models adjusted for age, systolic blood pressure, and risk factors (all P < 0.05). A TT plasma level of 5.04ng/ml was associated with a negative predictive value (ability to "rule out" MACE) of 97.2%. Addition of TT to standard risk factors model yielded a net reclassification improvement of 38.8 % (P < 0.05)"
• Androgen therapy in men with testosterone deficiency: can testosterone reduce the risk of cardiovascular disease? - Diabetes Metab Res Rev. 2012 Dec;28 - "In epidemiological studies, low T is associated with obesity, inflammation, atherosclerosis and the progression of atherosclerosis. Longitudinal epidemiological studies showed that low T is associated with an increased cardiovascular mortality. ADT brings about unfavourable changes in body composition, IR and dyslipidaemia. Increases in fibrinogen, plasminogen activator inhibitor 1 and C-reactive protein have also been observed. TRT in men with TD has consistently shown a decrease in fat mass and simultaneous increase in lean mass. T is a vasodilator and in long-term studies, it was shown to reduce blood pressure. There is increasing evidence that T treatment improves insulin sensitivity and lipid profiles. T may possess anti-inflammatory and anti-coagulatory properties and therefore TRT contributes to reduction of carotid intima media thickness. We suggest that T may have the potential to decrease CVD risk in men with androgen deficiency"
• Associations between Testosterone Levels and Incident Prostate, Lung, and Colorectal Cancer. A Population-Based Study - Cancer Epidemiol Biomarkers Prev. 2012 Jul 24 - "Demographic and clinical predictors of cancer, and testosterone, sex hormone-binding globulin (SHBG), and luteinizing hormone (LH) were measured between 2001 and 2004 in 3,635 community-dwelling men aged 70 to 88 years (mean 77 years). Cancer notifications were obtained via electronic record linkage until December 31, 2010 ... mean follow-up period of 6.7 +/- 1.8 years ... In adjusted competing risks proportional hazards models, each one SD increase in free testosterone was associated with a 9% increase in prostate cancer risk (95% confidence interval [CI], 1.00-1.18), but other hormones were not significantly associated. No significant associations were observed between hormonal parameters and colorectal cancer. Higher total testosterone was associated with lung cancer. Compared with the mean of 15 nmol/L, men with levels of 20 nmol/L were 1.38 times more likely to be cases (95% CI, 1.21-1.57), whereas those with levels of 30 nmol/L were 3.62 times more likely to be cases (95% CI, 2.53-5.18). Higher free testosterone was also associated with lung cancer, though SHBG and LH were not"
• Greater Percent-free Testosterone Is Associated With High-grade Prostate Cancer in Men Undergoing Prostate Biopsy - Urology. 2012 May 18 - "On multivariate analysis, testosterone (P ≥ .11) and free testosterone (P ≥ .45) were not significantly associated with low- or high-grade PCa. A greater %FT level significantly predicted high-grade PCa on both crude (P = .01) and multivariate (P = .02) analysis but not low-grade PCa (P ≥ .38). When examined in tertiles, men in the greatest %FT tertile had a significant twofold increased risk of high-grade PCa (odds ratio 2.04, 95% confidence interval 1.23-3.37, P = .005)"
• The Influence of Testosterone Suppression and Recovery on Sexual Function in Men With Prostate Cancer: Observations From a Prospective Study in Men Undergoing Intermittent Androgen Suppression - J Urol. 2012 Apr 12 - "Libido, sexual activity and perceptions of masculinity deteriorate during ONPhase. Of the sexually active men at baseline half will resume sexual activity despite 9 months of androgen deprivation therapy"
• Testosterone Treatment and Mortality in Men with Low Testosterone Levels - J Clin Endocrinol Metab. 2012 Apr 11 - "The mortality in testosterone-treated men was 10.3% compared with 20.7% in untreated men (P<0.0001) with a mortality rate of 3.4 deaths per 100 person-years for testosterone-treated men and 5.7 deaths per 100 person-years in men not treated with testosterone. After multivariable adjustment including age, body mass index, testosterone level, medical morbidity, diabetes, and coronary heart disease, testosterone treatment was associated with decreased risk of death (hazard ratio 0.61"
• Serum testosterone levels in diabetic men with and without erectile dysfunction - Andrologia. 2012 Apr 4 - "TT was lower in diabetic men with ED as compared to those with normal erectile function (EF), 392.4 +/- 314.9 versus 524.3 +/- 140.2 ng dl(-1) , respectively ... Receiver operating characteristic (ROC) curve of TT in men without associated co-morbidities showed that EF was compromised at TT = 403.5 ng dl(-1) or less. Sensitivity of 63.3% and a specificity of 94.0% were detected. At this level, ED was found in 33/38 (86.8%) men with TT 403.5 ng dl(-1) , whereas ED was observed in 57/147 (38.8%) men with TT ≥ 403.5 ng dl(-1) (P < 0.0001). We propose a cut-off value of 403.5 ng dl(-1) of TT blood levels as an indicator for initiation of testosterone replacement therapy in diabetic men with ED. Further prospective controlled trials are recommended"
• Low Testosterone as an Independent Predictor of Mortality in Men with Chronic Liver Disease - Clin Endocrinol (Oxf). 2012 Jan 27 - "in a Cox proportional hazard model, both low total (p= 0.02) and free testosterone (p= 0.007) remained predictive of death independently of established prognostic factors, such as the Model for End Stage Liver Disease (MELD) score, and serum sodium levels. A decrease in TT by 1 nmol/L and in cFT by 10 pmol/L was associated with an 8% increase in mortality"
• Testosterone therapy decreased subcutaneous fat and adiponectin in ageing men - Eur J Endocrinol. 2011 Dec 21 - "Our data showed that testosterone therapy decreased subcutaneous fat on the abdomen and lower extremities, but had no significant effect on visceral fat. Moreover, adiponectin levels were significantly decreased during testosterone therapy"
• High Serum Testosterone Is Associated With Reduced Risk of Cardiovascular Events in Elderly Men The MrOS (Osteoporotic Fractures in Men) Study in Sweden - J Am Coll Cardiol. 2011 Oct 11;58(16):1674-81 - "During a median 5-year follow-up, 485 CV events occurred. Both total testosterone and SHBG levels were inversely associated with the risk of CV events (trend over quartiles: p = 0.009 and p = 0.012, respectively). Men in the highest quartile of testosterone (≥550 ng/dl) had a lower risk of CV events compared with men in the 3 lower quartiles (hazard ratio: 0.70, 95% confidence interval: 0.56 to 0.88). This association remained after adjustment for traditional CV risk factors and was not materially changed in analyses excluding men with known CV disease at baseline (hazard ratio: 0.71, 95% confidence interval: 0.53 to 0.95). In models that included both testosterone and SHBG, testosterone but not SHBG predicted CV risk"
• Higher Testosterone Levels Are Associated with Less Loss of Lean Body Mass in Older Men - J Clin Endocrinol Metab. 2011 Oct 5 - "In weight losers, higher testosterone was associated with less decline in timed chair stands. Estradiol was not related to body composition or physical function changes. Higher SHBG was associated with less loss of appendicular lean mass and grip strength.Conclusions: Higher endogenous testosterone is associated with reduced loss of lean mass and lower extremity function in older men losing weight. Endogenous testosterone may contribute to healthy aging"
• The Relationships between Sex Hormones and Sexual Function in Middle-Aged and Older European Men - J Clin Endocrinol Metab. 2011 Aug 17 - "The aim of the study was to investigate the relationships between serum testosterone (T), estradiol (E2), and dihydrotestosterone (DHT) and sexual function in a multicenter population-based study of aging in men ... Total and free T, but not E2 or DHT, was associated with overall sexual function in middle-aged and older men. E2 was the only hormone associated with sexual function-related distress such that higher levels were related to greater distress. Free T levels were associated with masturbation frequency and erectile dysfunction in the fully adjusted models, such that higher T was associated with less dysfunction and greater frequency. Moreover, there was a T threshold for the relationship between total T, sexual function, and erectile dysfunction. At T concentrations of 8 nmol/liter or less, T was associated with worse sexual functioning, whereas at T levels over 8 nmol/liter, the relationship came to a plateau. Conclusions: These findings suggest that different hormonal mechanisms may regulate sexual functioning (T) vs. the psychological aspects (E2) of male sexual behavior. Moreover, there was a T threshold for overall sexual function such that at levels greater than 8 nmol/liter the relationship between T and sexual function did not become stronger"
• Effects of transdermal testosterone on bone and muscle in older men with low bioavailable testosterone levels, low bone mass, and physical frailty - J Am Geriatr Soc. 2010 Jun 1;58(6):1134-43 - "BMD on testosterone increased 1.4% at the femoral neck and 3.2% at the lumbar spine (P=.005) and decreased 1.3% at the mid-radius (P<.001). There was an increase in lean mass and a decrease in fat mass in the testosterone group but no differences in strength or physical performance. There were no differences in safety parameters ... CONCLUSION: Older, frail men receiving testosterone replacement increased testosterone levels and had favorable changes in body composition, modest changes in axial BMD, and no substantial changes in physical function"
• During testosterone administration, total and free E2 levels increased dose-dependently (dose effect, P < 0.001) in both young and older men - J Clin Endocrinol Metab. 2010 Jun 9 - "During testosterone administration, total and free E2 levels increased dose-dependently (dose effect, P < 0.001) in both young and older men"
• Low serum testosterone levels are associated with increased risk of mortality in a population-based cohort of men aged 20-79 - Eur Heart J. 2010 Feb 17 - "Men with low serum testosterone levels had a significantly higher mortality from all causes than men with higher serum testosterone levels (HR 2.24; 95% CI 1.41-3.57). After adjusting for waist circumference, smoking habits, high-risk alcohol use, physical activity, renal insufficiency, and levels of dehydroepiandrosterone sulfate, low serum testosterone levels continued to be associated with increased mortality (HR 2.32; 95% CI 1.38-3.89). In cause-specific analyses, low serum testosterone levels predicted increased risk of death from cardiovascular disease (CVD) (HR 2.56; 95% CI 1.15-6.52) and cancer (HR 3.46; 95% CI 1.68-6.68), but not from respiratory diseases or other causes"
• Association of sex hormones and C-reactive protein levels in men - Clin Endocrinol (Oxf). 2009 Sep 21 - "A robust, inverse dose-response correlation between testosterone and SHBG levels with CRP levels provides further evidence of a potential role of androgens in inflammatory processes"
• The relationship of serum and salivary cortisol levels to male sexual dysfunction as measured by the International Index of Erectile Function - Int J Impot Res. 2009 May 7 - "testosterone (T) and cortisol (F) ... (Total-T, Free-T, Bioavailable-T, Total-F and Bioavailable-F) and salivary hormones (Saliva-T and Saliva-F) ... International Index of Erectile Function (IIEF) ... Free-T and Bioavailable-T showed significant inverse correlations with age (P<0.01). In the group not taking antidepressants, the levels of Bioavailable-F and Saliva-F showed significant inverse correlations with a portion of the IIEF score (P<0.05). However, reductions in Bioavailable-T and Saliva-T showed no association with the IIEF score. In the group taking antidepressants, these hormone levels showed no correlation with IIEF"
• Effect of testosterone replacement therapy on arterial stiffness in older hypogonadal men - Eur J Endocrinol. 2009 Jan 27 - "pulse wave velocity (PWV) ... Male hypogonadism is associated with increased PWV, which is rapidly but incompletely ameliorated by normalization of circulating testosterone levels"
• Testosterone Gel Monotherapy Improves Sexual Function of Hypogonadal Men Mainly Through Restoring Erection: Evaluation by IIEF Score - Urology. 2008 Dec 30 - "After 3 months of testosterone gel therapy for the hypogonadal men, the most beneficial effect on sexual function was erectile function, with sexual desire and orgasmic satisfaction insignificantly affected. CONCLUSIONS: The results of our study have shown that transdermal testosterone gel treatment for hypogonadal patients can improve their sexual dysfunction mainly through restoring erectile function"
• The Dark Side of Testosterone Deficiency: II. Type 2 Diabetes & Insulin Resistance - J Androl. 2008 Sep 4 - "Low testosterone precedes elevated fasting insulin, glucose, and hemoglobin A1c (HbA1C) values and may even predict the onset of diabetes. Treatment of prostate cancer patients with surgical or medical castration exacerbates IR and glycemic control, strengthening the link between testosterone deficiency and onset of type-2 diabetes and IR. Androgen therapy of hypogonadal men improves insulin sensitivity, fasting glucose and Hemoglobin A1c levels. We suggest that androgen deficiency is associated with IR, T2D and MetS, and increased visceral fat deposition, which serves as an endocrine organ, producing inflammatory cytokines thus promoting endothelial dysfunction and vascular disease"
• Prevalence of low male testosterone levels in primary care in Germany: cross-sectional results from the DETECT study - Clin Endocrinol (Oxf). 2008 Aug 7 - "Stepwise logistic regression analysis revealed that obesity, metabolic syndrome, cancer, intake of six or more drugs, acute inflammation, and non-smoking were associated with hypogonadal testosterone levels. Higher age, liver diseases, and cancer were associated with very low testosterone levels (<1.0 ng/ml) ... Hypogonadal testosterone levels are common in primary care, particularly in patients with the above conditions"
• Healthier lifestyle predicts higher circulating testosterone in older men. The Health In Men Study - Clin Endocrinol (Oxf). 2008 Aug 7 - "In men >65 years old, higher lifestyle score reflecting greater engagement in healthy behaviours predicts higher subsequent total testosterone and SHBG levels. This relationship appears cumulative and may reflect interaction between lifestyle and insulin sensitivity. Successfully promoting healthy behaviours in older men could ameliorate the age-related decline in circulating testosterone"
• Testosterone therapy in hypogonadal men and potential prostate cancer risk: a systematic review - Int J Impot Res. 2008 Jul 17 - "Of studies that met inclusion criteria, none demonstrated that testosterone therapy for hypogonadism increased prostate cancer risk or increased Gleason grade of cancer detected in treated vs untreated men"
• Relationship of sex steroid hormones with bone mineral density in a nationally-representative sample of men - Clin Endocrinol (Oxf). 2008 May 14 - "Men in the lowest quartile of free estradiol had 70% increased odds (OR=1.69, 95% CI 0.95-2.98) of osteopenia compared with men in the highest quartile. Men in the lowest quartile of free testosterone had nearly four times the odds of osteopenia than those in the highest quartile (OR=3.82; 95% CI 1.87-7.78). Lower concentrations of SHBG appeared protective against osteopenia (p-trend=0.01). Neither total testosterone nor total estradiol was associated with BMD, although men with clinically low estradiol (<20 ng/l) had lower BMD (0.930 g/cm(2), 95% CI 0.88-0.98) than men with normal-range estradiol (1.024 g/cm(2), 1.01-1.04; p=0.004"
• Testosterone treatment in elderly men with subnormal testosterone levels improves body composition and BMD in the hip - Int J Impot Res. 2008 May 15 - "Men with subnormal testosterone had significantly higher weight, fat mass and abdominal adipose tissue. They also had significantly higher glucose and insulin levels, and they had higher triglyceride levels. Testosterone treatment had a large impact on body composition with reduced fat mass and abdominal adipose tissue and increased fat-free mass, but it did not affect weight and glucose and lipid metabolism. Bone mineral density in the hip was significantly higher after the testosterone treatment. Older men with subnormal testosterone levels had an unfavorable metabolic profile. Testosterone treatment improved body composition, but it did not reverse the unfavorable metabolic profile"
• Low Testosterone Levels are Common and Associated with Insulin Resistance in Men with Diabetes - J Clin Endocrinol Metab. 2008 Mar 4 - "Testosterone deficiency is common in men with diabetes, regardless of the type. Testosterone levels are partly influenced by insulin resistance, which may represent an important avenue for intervention"
• Low free testosterone concentration as a potentially treatable cause of depressive symptoms in older men - Arch Gen Psychiatry. 2008 Mar;65(3):283-9 - "Participants with depression had significantly lower total and free testosterone concentrations than nondepressed men (P < .001 for both). However, they were also more likely to smoke and to have low educational attainment, a body mass index categorized as obese, a Mini-Mental State Examination score less than 24, a history of antidepressant drug treatment, and greater concurrent physical morbidity. After adjusting for these factors and for age, men with depression were 1.55 (95% CI, 0.91-2.63) and 2.71 (95% CI, 1.49-4.93) times more likely to have total and free testosterone concentrations, respectively, in the lowest quintile"
• Low testosterone level is an independent determinant of endothelial dysfunction in men - Hypertens Res. 2007 Nov;30(11):1029-34 - "a low plasma testosterone level was associated with endothelial dysfunction in men independent of other risk factors, suggesting a protective effect of endogenous testosterone on the endothelium"
• Testosterone, diabetes mellitus, and the metabolic syndrome - Curr Urol Rep. 2007 Nov;8(6):467-71 - "One third of men with type 2 diabetes mellitus are now recognized as testosterone deficient. Emerging evidence suggests that testosterone therapy may be able to reverse some aspects of metabolic syndrome"
• Effects of androgen deprivation on glycaemic control and on cardiovascular biochemical risk factors in men with advanced prostate cancer with diabetes - Aging Male. 2007 Dec;10(4):189-96 - "In men with insulin-dependent diabetes, androgen deprivation therapy may have negative effects on their glycaemic control and may aggravate the biochemical risk profile of cardiovascular disease to which diabetics are predisposed. These observations are in agreement with the emerging role of low levels of testosterone in metabolic syndrome and insulin resistance"
• Erectile dysfunction is associated with low bioactive testosterone levels and visceral adiposity in men with type 2 diabetes - Int J Androl. 2007 Nov;30(6):500-7 - "ED is associated with low bioavailable and free testosterone levels, age, visceral adiposity and hypertension in type 2 diabetic men"
• Low Serum Testosterone Concentration in Middle-aged Men with Type 2 Diabetes - Endocr J. 2007 Nov 12 - "serum free testosterone concentration is certainly lower in a relatively large number of Japanese patients with type 2 diabetes compared with healthy men with each decade of life between 40 and 69 years old"
• Efficacy of changing testosterone gel preparations (Androgel or Testim) among suboptimally responsive hypogonadal men - Int J Impot Res. 2007 Sep 27 - "Changing from Androgel to Testim offers hypogonadal men the potential for improved clinical and biochemical responsiveness"
• Higher serum free testosterone is associated with better cognitive function in older men, while total testosterone is not. The Health In Men Study - Clin Endocrinol (Oxf). 2007 Sep 20 - "In community-dwelling older men, serum free testosterone >/= 210 pmol/l is associated with better cognitive performance"
• Serum testosterone level and related metabolic factors in men over 70 years old - J Endocrinol Invest. 2007 Jun;30(6):451-8 - "total testosterone is lower in elderly men with metabolic syndrome"
• Low serum testosterone in men is inversely associated with non-fasting serum triglycerides: The Tromsø study - Nutr Metab Cardiovasc Dis. 2007 Jun 7 - "a linear increase in serum TG levels was found in men with total testosterone levels below the 50th percentile during the day (p for trend=0.004). In contrast, serum triglycerides did not change during the day in men with testosterone levels above the 50th percentile. In regression analyses, total testosterone and SHBG were inversely and independently associated with TG (p<0.001 and p<0.001 respectively), and positively and independently associated with HDL"
• The association of sex hormone levels with quantitative ultrasound, bone mineral density, bone turnover and osteoporotic fractures in older men and women - Clin Endocrinol (Oxf). 2007 Jun 6 - "oestradiol (E2) and testosterone (T) ... Low levels of bioE2 and bioT were found to be associated with high bone turnover, low QUS and BMD and high risk of osteoporotic fractures in both men and women"
• Serum androgens and prostate cancer among 643 cases and 643 controls in the European Prospective Investigation into Cancer and Nutrition - Int J Cancer. 2007 May 18 - "After adjustment for potential confounders, there was no significant association with overall risk for prostate cancer for serum total or free testosterone concentrations (highest versus the lowest thirds: OR, 1.02; 95% CI, 0.73-1.41 and OR, 1.07, 95% CI, 0.74-1.55, respectively) or for other androgens or SHBG"
• Effects of Two Years of Testosterone Replacement on Insulin Secretion, Insulin Action, Glucose Effectiveness, Hepatic Insulin Clearance and Postprandial Glucose Turnover in Elderly Men - Diabetes Care. 2007 May 11 - "two years of treatment of elderly men with testosterone does not improve carbohydrate tolerance nor does it alter insulin secretion, insulin action, glucose effectiveness, hepatic insulin clearance or the pattern of postprandial glucose metabolism. Thus testosterone deficiency is unlikely to be the cause of the age associated deterioration in glucose tolerance commonly observed in elderly men"
• The effect of testosterone replacement therapy on adipocytokines and C-reactive protein in hypogonadal men with type 2 diabetes - Eur J Endocrinol. 2007 May;156(5):595-602 - "There was a significant inverse correlation between baseline IL-6 and total testosterone (r=-0.68; P=0.002) and bioavailable testosterone levels (r=-0.73; P=0.007). CRP levels also correlated significantly with total testosterone levels (r=-0.59; P=0.01). Testosterone treatment reduced leptin (-7141.9 +/- 1461.8 pg/ml; P=0.0001) and adiponectin levels (-2075.8 +/- 852.3 ng/ml; P=0.02). There was a significant reduction in waist circumference"
• Testosterone use in men with sexual dysfunction: a systematic review and meta-analysis of randomized placebo-controlled trials - Mayo Clin Proc. 2007 Jan;82(1):20-8 - "Testosterone use in men is associated with small improvements in satisfaction with erectile function and moderate improvements in libido"
• Androgens and Diabetes in Men: Results from the Third National Health and Nutrition Examination Survey (NHANES III) - Diabetes Care. 2007 Feb;30(2):234-8 - "Low free and bioavailable testosterone concentrations in the normal range were associated with diabetes, independent of adiposity"
• Association between hormones and metabolic syndrome in older italian men - J Am Geriatr Soc. 2006 Dec;54(12):1832-8 - "Total testosterone and SHBG are negatively and leptin is positively associated with MS in older men"
• Effects of modest testosterone supplementation and exercise for 12 weeks on body composition and quality of life in elderly men - Eur J Endocrinol. 2006 Dec;155(6):867-75 - "Modest testosterone supplementation to elderly men with relative testosterone insufficiency improved quality of life when accompanied by an exercise program"
• Effect of Testosterone Replacement Therapy on Prostate Tissue in Men With Late-Onset Hypogonadism: A Randomized Controlled Trial - JAMA, 11/15/06 - "These preliminary data suggest that in aging men with late-onset hypogonadism, 6 months of TRT normalizes serum androgen levels but appears to have little effect on prostate tissue androgen levels and cellular functions"
• Testosterone therapy for men at risk for or with history of prostate cancer - Curr Treat Options Oncol. 2006 Sep;7(5):363-9 - "Although still controversial, there appears to be little reason to withhold TRT from men with favorable outcomes after definitive treatment for PCa"
• The Age Related Decrease in Testosterone is Significantly Exacerbated in Obese Men With the Metabolic Syndrome. What are the Implications for the Relatively High Incidence of Erectile Dysfunction Observed in These Men? - J Urol. 2006 Oct;176(4):1524-8 - "testosterone decreased with increasing body mass index ... men with obesity and the metabolic syndrome have a significant decrease in total serum testosterone levels compared to aging, metabolically healthy men. These data suggest that the well established association between erectile dysfunction and pre-diabetes/diabetes (particularly in obese pre-diabetic/diabetic patients) may involve a hormonal component"
• Low Serum Testosterone and Mortality in Male Veterans - Arch Intern Med, 8/14/06 - "Mortality in men with normal testosterone levels was 20.1% (95% confidence interval [CI], 16.2%-24.1%) vs 24.6% (95% CI, 19.2%-30.0%) in men with equivocal testosterone levels and 34.9% (95% CI, 28.5%-41.4%) in men with low testosterone levels"
• Testosterone levels in men with erectile dysfunction - BJU Int. 2006 Jun;97(6):1278-83 - "The frequency of hypogonadism is higher when free testosterone levels are used for diagnosis. The total and free testosterone levels were not related to the level of sexual desire in men with ED. The free testosterone levels could be related to the quality and frequency of nocturnal erections, and when ED is more severe, it is more probable that free testosterone levels are below the 'normal' limit"
• Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes - Eur J Endocrinol. 2006 Jun;154(6):899-906 - "Testosterone replacement therapy reduces insulin resistance and improves glycaemic control in hypogonadal men with type 2 diabetes. Improvements in glycaemic control, insulin resistance, cholesterol and visceral adiposity together represent an overall reduction in cardiovascular risk"
• Does testosterone have a role in erectile function? - Am J Med. 2006 May;119(5):373-82 - "in most men circulating levels of testosterone, well below the normal range, are essential for normal erection and that higher levels of serum testosterone may not have major impact on erectile function"
• Adjunctive use of AndroGel (testosterone gel) with sildenafil to treat erectile dysfunction in men with acquired androgen deficiency syndrome after failure using sildenafil alone - Urology. 2006 Mar;67(3):571-4 - "At week 16, almost all (22 of 24, 92%) of the men reported improved potency with combination therapy. Improvement in erection quality was also observed"
• Hypogonadism and metabolic syndrome:: implications for testosterone therapy - J Urol. 2005 Sep;174(3):827-34 - "Hypogonadism is likely a fundamental component of metabolic syndrome. Testosterone therapy may not only treat hypogonadism, but may also have tremendous potential to slow or halt the progression from metabolic syndrome to overt diabetes or cardiovascular disease via beneficial effects on insulin regulation, lipid profile and blood pressure. Furthermore, the use of testosterone to treat metabolic syndrome may also lead to the prevention of urological complications commonly associated with these chronic disease states, such as neurogenic bladder and erectile dysfunction"
• Letrozole normalizes serum testosterone in severely obese men with hypogonadotropic hypogonadism - Diabetes Obes Metab. 2005 May;7(3):211-5 - "Six weeks of treatment decreased serum estradiol from 120 +/- 20 to 70 +/- 9 pmol/l (p = 0.006). None of the subjects developed an estradiol level of less than 40 pmol/l. LH increased from 4.5 +/- 0.8 to 14.8 +/- 2.3 U/l (p < 0.001). Total testosterone rose from 7.5 +/- 1.0 to 23.8 +/- 3.0 nmol/l (p < 0.001) without a concomitant change in sex hormone-binding globulin level. Those treated with Letrozole 17.5 mg per week had an excessive LH response" - Note:  A half tablet per day would be 8.75 mg/week.  I believe 40 pmol/l of estradiol is 11.54 pg/mL and the normal value for men is 10 to 52 pg/mL (Quest says 10 to 50).  The way I read that, testosterone tripled.  I take a half tablet a day of Femara (letrozole).  See Femara at International Anti-aging Systems or Letrozole 2.5mg (Generic Equivalent of Femara 2.5mg ) at OffshoreRx1.com.
• Endogenous sex hormones and metabolic syndrome in aging men - J Clin Endocrinol Metab. 2005 May;90(5):2618-23 - "Higher testosterone and SHBG levels in aging males are independently associated with a higher insulin sensitivity and a reduced risk of the metabolic syndrome, independent of insulin levels and body composition measurements, suggesting that these hormones may protect against the development of metabolic syndrome"
• Increased incidence of diagnosed depressive illness in hypogonadal older men - Arch Gen Psychiatry. 2004 Feb;61(2):162-7
• Free testosterone plasma levels are negatively associated with the intima-media thickness of the common carotid artery in overweight and obese glucose-tolerant young adult men - Int J Obes Relat Metab Disord. 2003 Jul;27(7):803-7 - "Hypotestosteronemia may accelerate the development of atherosclerosis and increase the risk for CHD in obese men"
• Association between serum testosterone concentration and carotid atherosclerosis in men with type 2 diabetes - Diabetes Care. 2003 Jun;26(6):1869-73
• Testosterone administration to men increases hepatic lipase activity and decreases HDL and LDL size in 3 wk - Am J Physiol Endocrinol Metab 2003 Jun;284(6):E1112-8 - "To determine how HDL-C and LDL-C particles are affected by testosterone administration to eugonadal men, testosterone was administered as a supraphysiological dose (600 mg/wk) for 3 wk to elderly, obese, eugonadal men before elective hip or knee surgery, and lipids were measured by routine methods and by density gradient ultracentrifugation. Hepatic lipase activity increased >60% above baseline levels, and HDL-C, HDL(2), and HDL(3) significantly declined in 3 wk. In addition, the LDL-C peak particle density and the amount of LDL-C significantly increased. Testosterone is therefore a potent stimulator of hepatic lipase activity, decreasing HDL-C, HDL(2), and HDL(3) as well as increasing LDL particle density changes, all associated with increased cardiovascular risk" - The best thing I've found to raise HDL is niacin.  As a comparison, Androgel 1% comes in 2.5 gram and 5 gram packets.  The 5 gram size contains 50 mg of testosterone.  So one per day would be 350 mg per week but the Androgel site claims only 10% is absorbed.  So that would make 35 mg per week.  It doesn't say whether they used the injectable or the gel in this study, which makes it impossible to compare.
• Testosterone Gel Supplementation for Men With Refractory Depression: A Randomized, Placebo-Controlled Trial - Am J Psychiatry 160:105-111, January 2003
• Can Sublingual Testosterone Increase Subjective and Physiological Measures of Laboratory-Induced Sexual Arousal? - Arch Gen Psychiatry 2002 May;59(5):465-6
• Bioavailable testosterone and depressed mood in older men: the Rancho Bernardo Study - J Clin Endocrinol Metab 1999 Feb;84(2):573-7
• Testosterone and frailty - Clin Geriatr Med 1997 Nov;13(4):685-95
• The effect of parenteral testosterone replacement on prostate specific antigen in hypogonadal men with erectile dysfunction - J Urol 1997 Nov;158(5):1775-7
• Outcomes of long-term testosterone replacement in older hypogonadal males: a retrospective analysis - J Clin Endocrinol Metab 1997 Nov;82(11):3793-6
• Testosterone replacement in older hypogonadal men: a 12-month randomized controlled trial - J Clin Endocrinol Metab 1997 Jun;82(6):1661-7
• Longitudinal changes in testosterone, luteinizing hormone, and follicle-stimulating hormone in healthy older men - Metabolism 1997 Apr;46(4):410-3
• Pharmacokinetics and metabolism of a permeation-enhanced testosterone transdermal system in hypogonadal men: influence of application site- -a clinical research center study - J Clin Endocrinol Metab 1996 May;81(5):1832-40
• Effects of testosterone replacement therapy in old hypogonadal males: a preliminary study - J Am Geriatr Soc 1993 Feb;41(2):149-52