Testosterone's Role:
When you think of testosterone, what comes to mind? Macho men? Aggressive, impatient, type A behavior? Road rage? Violence? Testosterone's role in bad behavior is largely a myth. What's more, testosterone plays other important roles in health and disease that may surprise you. For example, did you know that testosterone is a key player in prostate cancer? Or, that women need testosterone, too? There's more to testosterone than guys behaving badly.

Did You Know:
Testosterone is synthesized in the body from cholesterol. But having high cholesterol doesn't mean your testosterone will be high. Testosterone levels are too carefully controlled by the pituitary gland in the brain for that to occur.

The Perils of Too Much Testosterone:
Having too much naturally-occurring testosterone is not a common problem among men. Blood levels of testosterone vary dramatically over time and even during the course of a day. In addition, what may seem like a symptom of testosterone excess (see below) may actually be unrelated to this hormone. In fact, most of what we know about abnormally high testosterone levels in men comes from athletes who use anabolic steroids, testosterone or related hormones to increase muscle mass and athletic performance. Problems associated with abnormally high testosterone levels in men include:

• Low sperm counts, shrinking of the testicles and impotence (seems odd, doesn't it?)
• Heart muscle damage and increased risk of heart attack
• Prostate enlargement with difficulty urinating
• Liver disease
• Acne
• Fluid retention with swelling of the legs and feet
• Weight gain, perhaps related in part to increased appetite
• High blood pressure and cholesterol
• Insomnia
• Headaches
• Increased muscle mass
• Increased risk of blood clots
• Stunted growth in adolescents
• Uncharacteristically aggressive behavior (although not well studied or clearly proven)
• Mood swings, euphoria, irritability, impaired judgment, delusions

Among women, perhaps the most common cause of a high testosterone level is polycystic ovary syndrome (PCOS). This disease is common. It affects 6% to 10% of premenopausal women.

Low Testosterone:

• Testosterone is a hormone produced by the human body.
• It's mainly produced in men by the testicles.
• Testosterone affects a man's appearance and sexual development.
• It stimulates sperm production as well as a man's sex drive.
• It also helps build muscle and bone mass.
• Testosterone production typically decreases with age.

About 2 out of 10 men older than 60 years have low testosterone. That increases slightly to 3 out of 10 men in their 70s and 80s. Men can experience a range of symptoms if testosterone decreases more than it should. Signs of low Testosterone are often subtle.

Here are 12 signs of low Testosterone in men:

1. Low sex drive:
   Testosterone plays a key role in libido (sex drive) in men. Some men may experience a decline in sex drive as they age. However, someone with low T will likely experience a more drastic drop in their desire to have sex.
2. Difficulty with erection:
   When testosterone levels are too low, a man may have difficulty achieving an erection prior to sex or having spontaneous erections (for example, during sleep). Many times, other health problems play a role in erectile difficulties. In a review of studies that looked at the benefit of testosterone in men with erection difficulties, nearly half showed no improvement with testosterone treatment.
3. Low semen volume:
   Men with low T will often notice a decrease in the volume of their semen during ejaculation.
4. Hair loss:
   Balding is a natural part of aging for many men. While there is an inherited component to balding, men with low T may experience a loss of body and facial hair, as well.
5. Fatigue:
   You might have low T if you're tired all of the time despite getting plenty of sleep or if you're finding it harder to get motivated to exercise.
6. Loss of muscle mass:
   Because testosterone plays a role in building muscle, men with low T might notice a decrease in muscle mass.
7. Increased body fat:
   In particular, they sometimes develop gynecomastia, or enlarged breast tissue. This effect is believed to occur due to an imbalance between testosterone and estrogen within men.
8. Decreased bone mass:
   Osteoporosis, or the thinning of bone mass, is a condition often associated with women. However, men with low T can also experience bone loss. Testosterone helps produce and strengthen bone. So men with low T, especially older men, have lower bone volume and are more susceptible to bone fractures.
9. Mood changes:
   Because testosterone influences many physical processes in the body, it can also influence mood and mental capacity. ResearchTrusted Source suggests that men with low T are more likely to face depression, irritability, or a lack of focus.
10. Affected memory:
    Both testosterone levels and cognitive functions - particularly memory - decline with age. As a result, doctors have theorized that lower testosterone levels could contribute to affected memory.
11. Smaller testicle size:
    Because the body requires testosterone to develop the penis and testicles, low levels could contribute to a disproportionately smaller penis or testicles compared to a man with normal testosterone levels. However, there are other causes of smaller-than-normal testicles in addition to low testosterone levels, so this isn't always just a low testosterone symptom.
12. Low blood counts:
    Some of the symptoms anemia can cause include problems concentrating, dizziness, leg cramping, problems sleeping, and an abnormally rapid heart rate. When the researchers administered testosterone gel to anemic men who also had low testosterone, they saw improvements in blood counts compared to men who used a placebo gel.

Unlike women, who experience a rapid drop in hormone levels at menopause, men experience a more gradual decrease of testosterone levels over time. The older the man, the more likely he is to experience below-normal testosterone levels. Men with testosterone levels below 300 ng/dL may experience some degree of low T symptoms. Your doctor can conduct a blood test and recommend treatment if needed.

12 Signs of Low Testosterone:
https://www.healthline.com/health/low-testosterone/warning-signs

Testosterone therapy:
Testosterone therapy might seem like the ultimate anti-aging formula. Yet the health benefits of testosterone therapy for age-related decline in testosterone aren't clear.

What happens to testosterone levels with age?
Testosterone levels generally peak during adolescence and early adulthood. As you age, your testosterone level gradually declines - typically about 1% a year after age 30 or 40. For older men, it's important to determine if a low testosterone level is due to normal aging or if it is due to a disease (hypogonadism).

Hypogonadism hampers the ability to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy, in the form of injections, pellets, patches or gels, can improve the signs and symptoms of low testosterone in these men.

Does a naturally declining testosterone level cause the signs and symptoms of aging?
Not necessarily. Men can have many signs and symptoms as they age. Some that might occur as a result of lower testosterone levels can include:

• Changes in sexual function:
  This might include reduced sexual desire, fewer spontaneous erections - such as during sleep - and infertility.
• Physical changes:
  Various physical changes are possible, including increased body fat, reduced muscle bulk and strength, and decreased bone density. Swollen or tender breasts (gynecomastia) and body hair loss are possible. You might have less energy than you used to.
• Emotional changes:
  Low testosterone can contribute to a decrease in motivation or self-confidence. You might feel sad or depressed, or have trouble concentrating or remembering things.

Some of these signs and symptoms can be caused by other factors, including medication side effects, obstructive sleep apnea, thyroid problems, diabetes and depression. It's also possible that these conditions cause low testosterone levels, so treatment might result in increase of testosterone levels.

A blood test is used to diagnose a low testosterone level.

Treating normal aging with testosterone therapy is not advisable. If you don't have a medical condition that's contributing to your decline in testosterone levels, your doctor might suggest natural ways to boost testosterone, such as losing weight and increasing muscle mass through resistance exercise.

Testosterone therapy: Potential benefits and risks as you age:
https://www.mayoclinic.org/healthy-lifestyle/sexual-health/in-depth/testosterone-therapy/art-20045728

Testosterone Replacement Therapy:
Many men with low testosterone report improved energy levels, sex drive, and mood after testosterone treatment. If testosterone is low, why not replace it? Not so fast. A low testosterone level by itself doesn't need treatment. Testosterone replacement therapy can have side effects, and the long-term risks and benefits aren't known. Only men with symptoms of low testosterone and blood levels that confirm this as the cause of symptoms should consider testosterone replacement. Talking with your doctor is the only way to know if testosterone therapy is right for you.

If men have symptoms of low testosterone and tests show they have an abnormally low testosterone level, a doctor may suggest treatment. For millions of men who have low testosterone levels but no symptoms, no treatment is currently recommended. It is has also not been approved for treating men with low levels because of aging.

Forms of Testosterone Supplements:
Testosterone replacement therapy is available in several forms. All can improve testosterone levels:

• Skin patch (transdermal):
  Androderm is a skin patch worn on the arm or upper body. It's applied once a day.
• Gels:
  AndroGel and Testim come in packets of clear testosterone gel. Testosterone is absorbed directly through the skin when you apply the gel once a day. AndroGel, Axiron, and Fortesta also come in a pump that delivers the amount of testosterone prescribed by your doctor. Natesto is a gel applied inside the nose.
• Mouth patch:
  Striant is a tablet that sticks to the upper gums above the incisor, the tooth just to the right or left of the two front teeth. Applied twice a day, it continuously releases testosterone into the blood through the oral tissues.
• Injections and implants:
  Testosterone can also be injected directly into the muscles, or implanted as pellets in the soft tissues. Your body slowly absorbs the testosterone into the bloodstream.

Why not a simple testosterone pill?
Oral testosterone is available. However, some experts believe oral testosterone can have negative effects on the liver. Using other methods, such as skin patches, gels, orally disintegrating tablets, or injections, bypasses the liver and gets testosterone into the blood directly.

Is Testosterone Replacement Therapy Right for You?
https://www.webmd.com/men/guide/testosterone-replacement-therapy-is-it-right-for-you

Testosterone Skin Patch (transdermal):

• Once-Daily Patch
• The testosterone in the Androderm 2 mg/day and 4 mg/day patches is contained within the center of the patch and surrounded by an adhesive that you stick onto your skin.
• Wait 3 hours before showering, bathing, or swimming after applying Androderm

  Normal testosterone level achieved in 28 days In a clinical trial,* 97% (34/35) of participants had testosterone levels within the normal range for healthy men after 28 days of treatment. 86% (31/35) of those men stayed on the 4 mg starting dose of Androderm, based on the Day 8 testosterone levels.

• Androderm patches come in 2 strengths, 2mg and 4mg
• Once on your skin, the patch delivers the prescribed amount of testosterone for the next 24 hours.

The most common side effects of Androderm include:

• Skin redness, irritation, burning, or blisters where Androderm is applied
• Back pain
• Depression
• Headache
• Prostate abnormalities

Other side effects include more erections than are normal for you or erections that last a long time.

Testosterone Gel:
Androgel is a gel containing testosterone. It is administered through the skin for treatment of low testosterone levels. It belongs to a class of drugs called androgens. Other testosterone replacement products include Androderm, Axiron, Testim, and Fortesta. Androgel and other testosterone replacement products supplement or replace natural production of testosterone and reverse symptoms of low testosterone levels. The FDA approved Androgel in February 2000.

What are the side effects of Testosterone Gel?

The most common side effects of Androgel are:

• Headache
• High blood pressure
• Acne
• Abnormal lab tests (for example, glucose and cholesterol tests)
• Application site reactions (for example, itching, blisters, and redness)
• Enlarged prostate
• Increased serum prostate specific antigen (PSA) levels

Testosterone Mouth patch:
Striant is designed to adhere to the gum or inner cheek. It provides a controlled and sustained release of testosterone through the buccal mucosa as the buccal system gradually hydrates. Application of Striant twice a day, in the morning and in the evening, provides continuous systemic delivery of testosterone. Striant is a white to off-white colored, monoconvex, tablet-like, mucoadhesive buccal system. Striant adheres to the gum tissue above the incisors, with the flat surface facing the cheek mucosa. The active ingredient in Striant is testosterone. Each buccal system contains 30 mg of testosterone.

Side Effects (Clinical Trials Experience):
Twelve Week Clinical Trials in Hypogonadal Men. In the Phase 3, open-label study, 98 patients received Striant for up to 12 weeks. Adverse reactions to Striant reported by less than 1% of patients are listed:

Adverse Reactions Observed:
Adverse Reaction:	Striant (n=98):
Gum or Mouth Irritation Taste Bitter Gum Pain Gum Tenderness Headache Gum Edema Taste Perversion	9.2% 4.1% 3.1% 3.1% 3.1% 2.0% 2.0%

Testosterone Injections:
Can come in several varieties:

• Testosterone cypionate (Depo-Testosterone)
• Testosterone enanthate (Xyosted and also available in its generic form)
• Testosterone undecanoate (Aveed, which is a long acting formulation)

How to use them:
When a person receives a testosterone injection, the hormone directly enters the body through the muscle. People can choose between two methods:

• Self-administering the injections at home, using a home injection kit to inject the hormone into the thigh
• Having a doctor administer them into the buttocks muscle during a visit to the doctor's office

When having testosterone injections, people will usually visit their doctor every few months for monitoring. Treatments could last for a lifetime or be short-term, depending on the individual's circumstances.

Injection Side Effects:
Some people may have an allergic reaction to testosterone injections. For example, testosterone undecanoate may cause a serious allergic reaction or breathing issues following the injection. Symptoms can include breathing problems, dizziness, and skin rashes. Other forms of testosterone, including testosterone enanthate, may increase blood pressure, which can raise the risk of a stroke or heart attack.

What is the most important information I should know about testosterone injection?

• You should not be treated with testosterone if you have prostate cancer, male breast cancer, a serious heart condition, severe liver or kidney disease, or an allergy to castor oil or sesame oil. This medicine is not for use in treating low testosterone without certain medical conditions or due to getting older. Testosterone should not be used to enhance athletic performance.
• Testosterone injection is not for use in women who are pregnant.
• Testosterone can increase your risk of heart attack, stroke, or death. You may need to stop using testosterone or start taking blood pressure medication.
• Misuse of testosterone can cause dangerous or irreversible effects. Do not share this medicine with another person.

Testosterone Injection (Brand: Aveed, Depo-Testosterone, Testosterone Cypionate, Testosterone Enanthate, Xyosted):
https://www.uofmhealth.org/health-library/d00558a1

Testosterone Implants:
Testosterone pellets are a form of hormone replacement therapy. They are about the size of a grain of rice, and a doctor will implant them under the skin. These pellets contain crystallized testosterone and deliver a steady, low dose of this hormone to the individual for up to 6 months at a time. Testosterone pellets work by emitting a steady, low level of testosterone over a period of several months. A doctor will typically implant the pellets under the skin, or subcutaneously, near the hip or on the buttocks. This procedure is quick and can take place in the doctor's office. First, the doctor will thoroughly clean the area where they plan to implant the pellets. They will then administer a local anesthetic before making a small incision in the skin and using a tool called a trocar to insert about ten pellets. The pellets should release a steady dose of the hormone for several months following the implantation.

Testosterone pellets have received mixed feedback

Testosterone pellets also come with specific health risks. These risks include:

• Infection of the insertion site
• The pellets dislodging and coming out of the skin
• Incorrect dosage

Testosterone Therapy:
Testosterone replacement therapy, also called androgen replacement therapy, is approved to treat male hypogonadism (low testosterone), a condition in which the body fails to make enough hormones because of a problem with the testicles, pituitary gland or brain. A number of prescription testosterone products are available to treat hypogonadism. Testosterone products come in different forms, including gels, injectable solutions, patches, pills and pellets implanted under the skin.

Once a patient starts testosterone therapy, the patient usually undergoes lifelong treatment. Doctors will monitor the patient's hormone levels every six months to a year. Depending on the patient, the checkups may be more frequent.

Fast Facts: Use of Testosterone Therapy Over the Years:

• American men spend $2 billion on testosterone each year
• Four times as many men used testosterone products in 2014 than in 2000
• In 2013, 2.3 million Americans were being treated with testosterone therapy
• In 2011, nearly one in 25 men in their 60s was taking testosterone
• Prescription sales of testosterone increased from $18 million in 1988 to $1.6 billion in 2011

While many testosterone products are available only with a prescription, some drug stores and health food stores sell them over the counter. A few of these products also claim to be all-natural.

Low Testosterone Testing:

Tests for testosterone levels are done by sampling the blood early in the morning when levels of testosterone are highest. Your doctor may want to run a second test a few days later to check for consistency in testosterone levels measured. Normal testosterone levels range from about 300 to 1000 nanograms per deciliter (ng/dL), although some labs consider 200 ng/dL the cutoff for low testosterone. Your doctor will help interpret the tests for you.

If you are diagnosed with low testosterone, your primary care doctor may suggest you see a specialist such as an urologist or an endocrinologist. Not everyone with low testosterone will need or qualify for treatment. These specialists will help guide your treatment and design an approach to your low testosterone problem that is best for you.

Testosterone is a steroid sex hormone found in both men and women.

• In men, testosterone is produced primarily by the Leydig (interstitial) cells of the testes when stimulated by luteinizing hormone (LH). It functions to stimulate spermatogenesis, promote physical and functional maturation of spermatozoa, maintain accessory organs of the male reproductive tract, support development of secondary sexual characteristics, stimulate growth and metabolism throughout the body and influence brain development by stimulating sexual behaviors and sexual drive.
• In women, testosterone is produced by the ovaries (25%), adrenals (25%) and via peripheral conversion from androstenedione (50%). Testerone in women functions to maintain libido and general wellbeing. Testosterone exerts a negative feedback mechanism on pituitary release of LH and follicle-stimulating hormone (FSH). Testosterone may be further converted to dihydrotestosterone or estradiol depending on the tissue.

The effects of testosterone in humans and other vertebrates occur by way of two main mechanisms: by activation of the androgen receptor (directly or as DHT), and by conversion to estradiol and activation of certain estrogen receptors.

Testosterone is used as hormone replacement or substitution of diminished or absent endogenous testosterone. Use in males: For management of congenital or acquired hypogonadism, hypogonadism associated with HIV infection, and male climacteric (andopause). Use in females: For palliative treatment of androgen-responsive, advanced, inoperable, metastatis (skeletal) carcinoma of the breast in women who are 1-5 years postmenopausal; testosterone esters may be used in combination with estrogens in the management of moderate to severe vasomotor symptoms associated with menopause in women who do not respond to adequately to estrogen therapy alone.

Testosterone:
https://drugs.ncats.io/drug/3XMK78S47O

132nd most prescribed medicine in the United States for 2017

Important Information:

Do not use this medicine if you are pregnant or may become pregnant.

You should not receive testosterone if you have prostate cancer, male breast cancer, a serious heart condition, or severe liver or kidney disease.

Misuse of testosterone can cause dangerous or irreversible effects. Testosterone injections should be given only by a healthcare professional. Testosterone can lead to serious problems with the heart, brain, liver, endocrine, and mental health systems. Stopping testosterone may also lead to unpleasant withdrawal symptoms.

Testosterone injections have also been linked to a condition called pulmonary oil microembolism (POME), or a blood clot in the lung that can be fatal. Seek medical help immediately for symptoms including chest pain, dizziness, trouble breathing, urge to cough, throat tightening and fainting.

Interactions:

Drug Interactions (224) Alcohol/Food Interactions (1) Disease Interactions (8)

What other drugs will affect testosterone?
Certain drugs may interact with testosterone, including;

• Blood thinners (including warfarin, Coumadin, Jantoven)
• Anti-inflammatory drugs, such as oxyphenbutazone

Other prescription and over-the-counter medicines, vitamins, and herbal products may also react with testosterone. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

A total of 146 drugs are known to interact with Thiopental.

• 9 major drug interactions
• 134 moderate drug interactions
• 3 minor drug interactions

Testosterone Interactions:
https://www.drugs.com/testosterone.html

Testosterone Pharmaceutical Chemical Safety Information

Chemical Safety Summary:
INCHEM
Testosterone: http://www.inchem.org/documents/pims/pharm/pim519.htm
Main risks and target organs:
There is no serious risk from acute poisoning, but chronic use can cause harm. The main risks are those of excessive androgens: menstrual irregularities and virilization in women and impotence, premature cardiovascular disease and prostatic hypertrophy in men. Both men and women can suffer liver damage with oral anabolic steroids containing a substituted 17-alpha-carbon. Psychiatric changes can occur during use or after cessation of these
Summary of clinical effects:
Acute overdosage can produce nausea and gastrointestinal upset. Chronic usage is thought to cause an increase in muscle bulk, and can cause an exageration of male characteristics and effects related to male hormones. Anabolic steroids can influence sexual function. They can also cause cardiovascular and hepatic damage. Acne and male- pattern baldness occur in both sexes; irregular menses, atrophy of the breasts, and clitoromegaly in women; and testicular atrophy and prostatic hypertrophy in men.
Diagnosis:
The diagnosis depends on a history of use of oral or injected anabolic steroids, together with signs of increased muscle bulk, commonly seen in "body-builders". Biochemical tests of liver function are often abnormal in patients who take excessive doses of oral anabolic steroids. Laboratory analyses of urinary anabolic steroids and their metabolites can be helpful in detecting covert use of these drugs.
First aid measures and management principles:
Supportive care is the only treatment necessary or appropriate for acute intoxication. Chronic (ab)users can be very reluctant to cease abuse, and may require professional help as with other drug misuse.

Breastfeeding:

Summary of Use During Lactation:

Limited data indicate that a low-dose (100 mg) subcutaneous testosterone pellet given to a nursing mother appears not to increase milk testosterone levels markedly.

Subcutaneous testosterone cypionate does increase milk testosterone levels. However, testosterone has low oral bioavailability because of extensive first-pass metabolism, so it appears to not increase serum testosterone levels in breastfed infants. Breastfed infants appear not to be adversely affected by maternal or transgender paternal testosterone therapy.

High doses of testosterone can suppress lactation.

Effects in Breastfed Infants:
An infant (age not stated) was breastfed (extent not stated) after implantation of 100 mg of testosterone subcutaneously. No adverse effects were noted in the infant over a 5-month period

Effects on Lactation and Breastmilk:
Supraphysiologic serum levels of testosterone, either from a tumor or from exogenously administered testosterone, reduces milk production in postpartum women. Testosterone alone reduces serum prolactin; however, when given in combination with estrogen and progestin, serum prolactin levels are not markedly reduced. Testosterone was previously used therapeutically to suppress lactation, usually in combination with an estrogen.

Testosterone Drug Levels and Effects:
https://www.ncbi.nlm.nih.gov/books/NBK501721/

IMPORTANT WARNING:
Testosterone undecanoate injection (Aveed) may cause serious breathing problems and allergic reactions, during or immediately after the injection. The injection should be given by a doctor or nurse in a healthcare setting where these problems or reactions can be treated. You will need to remain in the healthcare setting for at least 30 minutes after you receive your injection. Tell your doctor or nurse immediately if you experience any of the following symptoms during or after your injection: tightening of your throat, difficulty breathing, difficulty swallowing, shortness of breath, cough or urge to cough, chest pain, dizziness, fainting, sweating, rash, hives, or itching.

A program has been set up to limit the use of testosterone undecanoate injection (Aveed) and to inform people about the increased risk of breathing problems and allergic reactions while receiving this medication. The program also makes sure that everyone who received this medication understands the risks and benefits from this medication and receives the medication in a setting where they can be monitored for serious reactions.

Testosterone enanthate injection (Xyosted) and other testosterone products may cause an increase in blood pressure which can increase your risk of having a heart attack or stroke that may be life-threatening. Tell your doctor if you have or have ever had high blood pressure, heart disease, a heart attack, or a stroke. Tell your doctor and pharmacist if you are taking medications for blood pressure, pain, or cold symptoms. If you experience any of the following symptoms, call your doctor immediately: chest pain; shortness of breath; pain in the arms, back, neck, or jaw; slow or difficult speech; dizziness or faintness; or weakness or numbness of an arm or leg.

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly.

Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with testosterone undecanoate injection or testosterone enanthate injection (Xyosted). Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.

Testosterone Injection:
https://medlineplus.gov/druginfo/meds/a614041.html

(2015) FDA Warning:
WASHINGTON - The Food and Drug Administration is warning doctors against over-prescribing testosterone-boosting drugs for men, saying the popular treatments have not been established as safe or effective for common age-related issues like low libido and fatigue.

The agency says drugmakers must clearly state in their labeling and promotions that the drugs, currently taken by millions of U.S. men, are only approved to treat low testosterone levels caused by disease or injury, not normal aging.

Additionally, the FDA cautioned that the drugs may increase the risk of heart attack, stroke and other cardiovascular problems. Drugmakers must add information about that potential risk to their prescribing labels and conduct a long-term study to further examine the issue, the FDA said. Health officials in Canada issued a similar warning about testosterone risks last July.

The warning comes just over a year after a study at UCLA documented the link between testosterone supplements and heart attacks. The analysis of insurance claims for more than 55,000 men found that in men 65 and older, the risk of heart attack more than doubled within 90 days of starting testosterone drugs. In men younger than 65,with a history of heart disease, the risk almost tripled.

Should I Worry About My Testosterone Levels?
If you have any concerns, get your levels tested by a doctor. It's that simple. Typically, they'll test for total testosterone, which includes free testosterone and bound testosterone. Those measurements will give you a great place to start.

Unless you have low bioavailable testosterone, or have an androgen receptor disorder that doesn't enable your body to respond adequately to the testosterone your body produces, there's no need to take supplemental testosterone. Just stick with finding natural ways to boost your body's production of testosterone, sensitivity to it, or both, and avoid environmental and lifestyle factors that would otherwise reduce testosterone, increase its conversion to estrogens, or results in chronically high circulating cortisol.

And I can't be clear enough about this: If you do begin experiencing signs of low testosterone, go to your doctor - not the guy at the gym with huge traps and little calves - to seek treatment.

What are the best home remedies for low testosterone?:

1. Lose the extra weight:
   Excess weight reduces testosterone in the body. An enzyme in fat tissue converts testosterone into estrogen, a female hormone. Estrogen, in turn, inhibits testosterone production. Weight loss is hands down the first and most effective home treatment for low testosterone.
2. Exercise more:
   Exercise increases the body's production of testosterone in men. Testosterone production goes up once exercise reaches a certain intensity level and continues to increase until exercise stops. Exercise also significantly prevents or reverses the effects of low testosterone. Exercise increases muscle strength, prevents bone loss, boosts energy levels, and improves physical performance. Intensity is the key. Weight training and intense interval training seem to have the greatest effect on testosterone, but any level of exercise will raise testosterone.
3. Eat a balanced and nutritious diet:
   There is no magic food or dietary supplement that increases testosterone. Some foods or nutrients, such as vitamin D or zinc, may help increase total testosterone levels, but not in a clinically significant way.
4. Practice good sleep hygiene:
   The body's production of testosterone peaks during sleep and falls off during the active hours of the day. Not getting enough sleep can have a dramatic effect on testosterone levels, particularly for young men or adolescents.
5. Lower stress levels:
   Stress reduces testosterone levels in the blood. The body responds to stress by producing cortisol, a steroid that breaks down proteins and fats into sugar to provide more energy. Cortisol also inhibits the production of testosterone. Avoiding stress is not always possible, but stress can be reduced through relaxation activities, exercise, good sleep hygiene, and avoiding stimulants such as caffeine and nicotine.
6. Avoid medications that lower testosterone:
   Many drugs and medications reduce testosterone. Some, like opioids and anabolic steroids, greatly reduce the body's production of testosterone. Corticoid steroids and taking too many NSAIDs contribute to reduced testosterone levels. Some drugs, like caffeine, actually may increase serum testosterone in men, but they also contribute to stress and interfere with sleep. Several over the counter, testosterone boosters/supplements may actually decrease testosterone production and can result in infertility.

Low Testosterone Treatments and Medications:
https://www.singlecare.com/conditions/low-testosterone-treatment-and-medications

Major brand names of testosterone and/or its esters include:

• Andriol
• Androderm
• AndroGel
• Axiron
• Delatestryl
• Depo-Testosterone
• Intrinsa
• Nebido
• Omnadren
• Primoteston
• Sustanon
• Testim
• TestoGel
• TestoPatch
• Testoviron
• Tostran

• A medication and naturally occurring steroid hormone
• The primary use of testosterone is the treatment of males with too little or no natural testosterone production (hypothyroidism). It is also used to treat gender dysphoria, and certain types of breast cancer.
• It may also be used to increase athletic ability in the form of doping.
• Testosterone was first isolated in 1935
• Approved for medical use in 1939
• Rates of use have increased three times in the United States between 2001 and 2011
• It is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system
• It is available as a generic medication
• In 2017, it was the 132nd most commonly prescribed medication in the United States, with more than five million prescriptions.
• Common side effects of testosterone include acne, swelling, and breast enlargement in men.
• Serious side effects may include liver toxicity, heart disease, and behavioral changes
• Women and children who are exposed may develop masculinization
• It is recommended that individuals with prostate cancer not use the medication.
• It can cause harm to the baby if used during pregnancy or breastfeeding
• Testosterone is in the androgen family of medications.

Testosterone can be used as a gel or patch that is applied to the skin, injection into a muscle, tablet that is placed in the cheek, or tablet that is taken by mouth