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February 9, 2012

Testosterone Part III: Supplementation

Testosterone Supplementation

After reading part one and two you should have a fairly good understanding of the benefits of testosterone. Below is a quick review of the benefits of testosterone supplementation.

  1. Increased Libido
  2. Increased bone mineral densityTestosterone Supplementation and Injection
  3. Increased muscle mass
  4. Decreased fat
  5. mproved sleep
  6. Improved Memory
  7. Improved concentration
  8. Feeling of well-being
  9. Increased insulin sensitivity
  10. Improved cholesterol panel
  11. Increased coronary blood flow
  12. Reversal of arterial plaque
  13. Endothelial health
  14. Decrease incidence of prostate cancer
  15. Increased energy

These benefits strongly support the use of testosterone supplementation in individuals who have sub-optimal levels, the next question is what is the best route. We will look at each option and you can read pros and cons of each.

Natural Testosterone Boosters

You can see these advertised late night on TV and in the back of many magazines, they claim to be very effective and the natural safe way to raise your testosterone to optimal levels. The bottom line they don’t work, save your money. Fish oil has some slight effect by decreasing the production of sexual hormone binding globulin leaving more testosterone  free and functional, but it is a very small amount. Zinc has also been shown to block the aromatase step that converts testosterone to estrogen but again the overall effect is slight. Far and away the best supplement is DHEA which converts both to estrogen and testosterone but again the effect is minimal and will not increase levels to optimal.I can’t say this loud enough natural testosterone boosters are a waste of your money.

Patches and Cremes

These have definitely become more popular in the last 5-10 years prior to that they were mainly used by females. The cremes need to be applied everyday and must be rubbed into a hairless area of skin thoroughly. The patches were used to decrease the effort associated to with application of a daily creme.  These both have similar results and are usually met with less than desirable results. The absorption of the testosterone transdermally is inconsistent and associated with a high conversion to dihydro-testosterone. It is this dihydro-testosterone that causes mens hair to fall out and to make their prostate big.  While these are convenient, if you don’t mind rubbing a creme on everyday or applying a patch, patient satisfaction long-term is low.

Oral Testosterone Supplementation

Used most commonly in women the results are poor and associated with liver damage. Testosterone is metabolized by the liver and of little to no benefit when taken orally. There is a form, methyl-testosterone, which can be taken orally but it last for only a few hours and it would require the patient o take it every 4-6 hours. Compliance is very poor with any medication taken more than once or twice a day.

Human Chorionic Gonadotropin

This is the one you have heard of associated with weight loss, eat 500 calories a day, inject HCG and you lose weight. I would suggest, as have others, eat 500 calories a day and you’ll lose weight skip the daily HCG injection. For testosterone production it is used slightly different, injections are done twice weekly and have a direct effect on the leydig cell in the testicles triggering testosterone production. Limitations are most commonly associated with age. The older your leydig cells the less able they are to produce testosterone no matter how much HCG is injected. In the 40-50 year old male these injections work quite well and have no suppression on spermatogenesis.

Testosterone Injections

This is the gold standard of testosterone replacement therapy. Most common form used is testosterone cypionate, which is testosterone in cotton seed oil. Injections are done on a weekly to twice weekly  basis and  done as a intra-muscular injections. The cotton seed oil is used to create a depot effect that allows small amounts to be absorbed into the circulation, creating a more consistent testosterone level. The only drawback is sticking your self once or twice a week.

Conclusion

Testosterone supplementation can be very beneficial to the aging male ( and Female) when used under medical supervision and with close followup. I would recommend that anyone interested in this type or therapy find an individual who is well-trained in age-management and discuss this with them. Men wishing to have children need to be very careful about using testosterone due to the possible suppression of spermatogenesis. These individuals would be better of using HCG.

See related articles.

“Testosterone Part II: Erectile Dysfunction”

“Testosterone Part 1: What’s Normal?”

“Cardiovascular Disease Linked to Treatments that Lower Testosterone”

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Dr. Joe Jacko


Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio. Read more about Dr. Joe Jacko

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