Testosterone supplement natural for women and older men, ways to increase low levels, herbal, vitamin
Low T treatment, risks and side effects
Will Low T therapy help you live longer or increase the risk for heart disease and cancer?
Should you consider natural alternatives that are safer?
April 15 2018
by Ray Sahelian, M.D.

Testosterone is an androgen found in both men and women. This hormone is made in the testicles and ovaries, and in smaller amounts by the adrenal glands. It is also found in brain tissue. It is involved in mood, sex drive, vitality, fertility, bone density, and muscle mass. A low testosterone level is associated with low energy, reduced libido, poor concentration, and fatigue. Levels drop about 1 percent each year after around age 40 and faster in those who are overweight. The chemical structure of this male hormone is similar to that of estrogen. As we get older, more is converted to estrogen than in youth. Although testosterone replacement can, in some people, improve the quality of their lives, it may carry serious risks including a higher risk of heart attacks. Many men are visiting their doctors and requesting testosterone replacement through prescriptions medications and ask for natural supplementation. Is this a wise choice or should you consider the adverse outcomes that can occur or possible natural alternatives that are safer?


Daily exposure to high-intensity light early in the morning improves sexual satisfaction and boosts testosterone levels in men with reduced libido or erection difficulty.


Natural ways to Increase testosterone, herbs, vitamins, supplements
Men's testosterone levels fall as they get older, which may contribute to health problems such as diabetes, loss of bone and muscle mass, and sexual dysfunction. Hormone replacement is a complicated matter and there is a tendency for doctors to prescribe a higher dosage than patients require. This could also be true of natural hormones that are available over the counter. Before you start hormone therapy increase your daily walks and exercise so you are able to sleep deeper at night. One way to increase levels in those who are overweight is to lose several pounds by eating less or exercising. There are two hormone supplements available over the counter in health food stores that could elevate low testosterone levels. These are pregnenolone and DHEA. Testosterone cream and the gel are not sold over the counter. A natural testosterone supplement taken orally as a pill is not available over the counter, T is only available by prescription. In a rodent study, onion intake increased levels of testosterone.

Although certain herbs and supplements may slightly raise testosterone levels, at least temporarily, their effects are miniscule to actual testosterone treatment through pills, gels, lotions, and injections.

Q. What natural herb helps for low testosterone? I am typical male, and at the age of 58 still like to have good sex. Also my wife is 55 and suffers from dryness and gets sore, and has low estrogen.
    A. Lack of sex drive is not necessarily due to low testosterone levels alone, many factors are involved. Herbal supplements such as tongkat ali from Malaysia or tribulus terrestris extract may stimulate testosterone release, at least in the short term, but whether this continues long term is not clear. A tongkat ali extract called LJ100 is also available. Yohimbe does not seem to influence levels but is a good aphrodisiac herb.


I am planning to use Tongkat ali to increase my testosterone level naturally without any side effects. My age is 32 and I am doing bodybuilding naturally for last 7 years used whey protein and some other supplements. My diet is good too. I am thinking to add this product is it helpful to increase my muscles size?
   A. I do not believe tongkat ali is a reliable way to increase muscle size. See bodybuilding for better ways to improve muscle strength and size.

I am looking to cycle some supplements to boost my testosterone. I found recommendations for muira puama, tribulus terrestris, passionflower and nettle on natural news dot com. What do you recommend?
    Before considering any supplementation one should think carefully why they wish to increase levels of this hormone and be aware of the potential benefits versus the risks and adverse effects. I have not seen any long term studies that have evaluated the influence of these natural sexual enhancers on levels of T hormone. Each of these herbs has potential side effects if misused and this has to be balanced against their potential benefits.


Q. Thank you for LJ-100 and your illuminating exposition on Tongkat ali, which may inhibit Sexual Hormone Binding Globulin ("SHBG") from capturing and neutralizing free testosterone. Also I believe in order to maximize the amount of T, the T hijackers aromatase (converts T to estrogen), 5-alpha-reductase (converts T to DHT), and SHBG must be inhibited, for example, by consumption/assimilation of the following nutrients: SHBG: Tonkat ali; aromatase: resveratrol, genistein, chrysin, quercetin, beta-sitosterol; 5-alpha-reductase inhibitor: beta-sitosterol. I would deeply appreciate your comments, corrections, and suggestions for maximizing T and minimizing estrogen and DHT.
   A. There is still a lot of uncertainty and many more trials are required before I have a clearer understanding of these relationships.


Q. Is it ok to take tongkat ali while on testosterone replacement therapy I stopped taking HCG hormone in July because even taking the small amount 5 days a week seemed to make my skin darker so since then my skin has started to lighten again on the spots that carry pigment.
   A. I do not advise taking the herb and TRT together, it can be too potent and heart racing could occur.


Alternatives and natural supplements to prescription testosterone use
Testosterone replacement may be appropriate for those who have very low levels of this hormone, but not for those who have a slightly low level. Before you consider using testosterone injections or gels as replacement, consider more natural alternatives.


Better sex drive - Natural options, such as Passion Rx herbal formula or individual sex herbs, are extremely helpful. Those interested in increasing sex drive without the use of testosterone should review this page on sex drive which offers natural alternatives such as Tongkat Ali, horny goat weed, maca, mucuna pruriens, and tribulus terrestris.

More energy - consider MultiVit Rx comprehensive multivitamin formula that enhances wellbeing, vitality, and energy.


For those who have infertility problems, see fertility on how to improve sperm count or volume.

Better sleep - Lack of adequate sleep reduces testosterone levels.


Bigger muscles - creatine monohydrate works very well to increase muscle size within a few days.


Better mind enhancement - consider Mind Power Rx. There are natural alternatives to testosterone for improved mood and vitality; exercise and yoga comes to mind.


Weight loss - consider Diet Rx appetite suppressant. Weight loss from around the belly reduces the risk of testosterone being converted to estrogen since fat cells have a tendency to make this conversion.


For prostate health, consider Prostate Power Rx which also provides a gentle sexual enhancement.


Exp Biol Med. 2013. Fresh onion juice enhanced copulatory behavior in male rats with and without paroxetine-induced sexual dysfunction. Onion (Allium cepa) has long been used in dietary and therapeutic applications. Treatment with fresh onion juice has been reported to promote testosterone production in male rats. Testosterone is the male sex hormone responsible for enhancing sexual libido and potency. This study conclusively demonstrates that fresh onion juice improves copulatory behavior in sexually potent male rats and in those with paroxetine-induced sexual dysfunction by increasing serum testosterone levels.


Morning light exposure
Daily exposure to high-intensity light early in the morning improves sexual satisfaction scores and boosts testosterone levels in men with reduced libido or erection difficulty. Bright light exposure, especially in the morning, stimulates the pituitary gland to produce leutinizing hormone. This results in increased levels of testosterone and inhibition of melatonin production by the pineal gland. Decreased plasma melatonin is thought to lead to reduced serum prolactin – and high prolactin has been linked to sexual dysfunction.


Availability of testosterone supplement
This hormone is available by prescription in many forms, including testosterone gel, cream, patch, enanthate, depo, and injection. There is no such thing as an over the counter testosterone pill, Certain natural supplements may increase levels, but whether they do so when used for prolonged periods is not known for sure. These include tongkat ali and tribulus.


Q. Are there natural alternatives to testosterone prescription medicine use?
   A. I personally am of the opinion that the whole person has to be taken into account when considering hormone treatment as opposed to solely relying on blood studies. If a person feels fine even though a blood study shows a low testosterone hormone level, this does not necessary mean replacement is necessary. How do we know testosterone replacement will improve health in the long run? What if testosterone replacement therapy results in various short term and long term side effects? Even if testosterone is replaced, how do we know the ideal dosage and form? If a person has a low testosterone level but no major symptoms, it may be better not to interfere for the time being. However, if low testosterone levels are associated with symptoms of low testosterone, such as fatigue, low vitality, low sex drive, low mood, etc., then it may be appropriate to consider testosterone replacement or the use of certain natural supplements that address the particular symptoms of testosterone deficiency. Having said this, if the testosterone level is extremely low, then prescription testosterone use may be a good option. Another option is the over the counter hormone DHEA, or perhaps pregnenolone.


Anti-aging supplement? Most likely not
Castrated men -- sometimes called eunuchs -- in the old Korean dynasty lived much longer than other men. Could male sex hormones such as testosterone be one reason men tend to have a shorter life span than women?


Australian researchers measured the testosterone levels of nearly 3,700 men, aged 70 to 89, between 2001 and 2004. They then checked to see how many were still alive in 2010. Those with the lowest testosterone levels had the highest death rate, followed by those with the highest levels. Men with mid-range levels had the highest survival rate, Journal of Clinical Endocrinology & Metabolism, news release, Nov. 20, 2013. This indicates that either too low or too high levels (often from taking pills or injections) can be detrimental.


Testosterone therapy, advertised as a way to help men improve a low sex drive and enhance energy, raises the risk of heart attack,  Jan. 29, 2014, online, PLoS One.


Concerns persist that testosterone supplements increase a man's risk of heart attack or stroke. The FDA requires all prescription testosterone products to carry a warning about these potential hazards.


Testing for blood levels and when to consider hormone replacement
I am of the opinion that the whole person has to be taken into account when considering hormone treatment as opposed to solely relying on blood studies. If a person feels fine even though a blood study shows a low testosterone hormone level, or low level of other adrenal hormones, this does not necessary mean replacement is necessary. How do we know replacement will improve health in the long run? What if replacement therapy results in various short term and long term side effects and even potentially increasing the risk for cancer and causing premature death? Even if the hormones are replaced, how do we know the ideal dosage and form? If a person has no major symptoms and is of good health, it may be better not to interfere for the time being and to not get any hormone tests done. Just focus or eating as much of a healthy diet as possible, exercise often, engage in a regular stretching or yoga program, get a deep night's rest, try to have low stress, enjoy life and do good unto others. However, if symptoms and signs, such as fatigue, low vitality, low sex drive, low mood, etc. indicate a potential low testosterone level, then it may be appropriate to consider replacement or the use of certain natural supplements that address the particular symptoms of such deficiency. Too many people are getting their levels tested and getting confused with what to do with the numbers rather than focusing on just living a healthy lifestyle.


Symptoms of low levels, deficiency
The aging male with reduced testosterone availability may present with a wide variety of symptoms which in addition to frailty and weakness include: fatigue, decreased energy, decreased motivation, cognitive impairment, decreased self-confidence, depression, irritability, osteoporotic pain and the lethargy of anemia. In addition, testosterone deficiency is also associated with type-2 diabetes, the metabolic syndrome, coronary artery disease, stroke and transient ischemic attacks, and cardiovascular disease in general. Men's levels of the hormone can vary quite a bit without causing sexual problems like impotence and decreased libido. Levels drop when a man becomes a father


Symptoms of low testosterone may include: Low libido, Decreased sexual desire, Decreased rigidity of an erection, Reduced energy, Decreased sense of well-being, Brittle bones and General weakness.


Men who have a lack of energy should first see their doctor and ask about screening for depression and other conditions -- such as thyroid disease or B12 deficiency -- that could also be the cause rather than T deficiency.


In the northern hemisphere men normally see their testosterone levels fall off between November and April, before beginning a gradual climb back up during the summer. Sunlight exposure may have something to do with it.

Testosterone side effects - replacement therapy has risks and dangers

2016 - FDA Warns of Dangers From Testosterone Supplements
Supplemental testosterone and related anabolic-androgenic steroids can heart attack, heart failure, stroke, depression, hostility, aggression, liver toxicity and male infertility. Individuals abusing high doses of testosterone have also reported withdrawal symptoms, such as depression, fatigue, irritability, loss of appetite, decreased libido and insomnia. Millions of American men currently use testosterone pills, gels or get injections in hopes of boosting their physical health or libido. Anabolic steroids are synthetic variations of testosterone and are legally prescribed to treat conditions such as delayed puberty and diseases that cause muscle loss, such as cancer or AIDS. But testosterone and other anabolic-androgenic steroids are abused by adults and adolescents, including athletes and body builders.


Testosterone replacement therapy is questionable because it has risks, its efficacy is uncertain, and there's no strong agreement about whether low testosterone is really a disease in older age. Those who have low T and wish to take replacement therapy should consider the benefits versus the risks, and if still interested in replacement should take as low a dose that helps. But side effects such as male breast growth and blood clots can occur and few doctors are aware that high dosages can turn off their sperm production. The risk for increased blood clots has been found in several studies.

Sperm production could be reduced in men who are taking prescription T and this could cause infertility, according to Peter Kolettis, M.D., professor, urology, University of Alabama at Birmingham and Bradley Anawalt, M.D., endocrinologist and chief, medicine service, University of Washington Medical Center, Seattle. They discussed their finding on May 9, 2013 at the American Urological Association in San Diego.


Elderly men with limitations in mobility who are treated with testosterone to improve strength appear to be at increased risk of cardiovascular-related adverse events. New England Journal of Medicine 2010.


There is a potential for testosterone replacement to increase the risk of prostate cancer and other hormone sensitive cancers. Acne, deepening of voice, aggressiveness and menstrual changes in women are other potential side effects of testosterone therapy. Testosterone replacement should only be prescribed to men who have severe deficiency and the dosage should be as low as possible to take care of the deficiency.  The major safety issue is prostate cancer.


There is a risk for hair thinning or hair loss with prolonged use. This can occur in a man or woman. To reverse the hair thinning, consider the temporary use of finasteride, also known as Propecia. The prescription drug Avodart is another option.


PLoS One. 2014. Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men. There is an increased risk for heart attack.


The U.S. Food and Drug Administration, in June 2014, said all testosterone products on the market should include in their labels a general warning about the risk of blood clots in veins.


Aging Male. 2014. A 6-month observational study of energy, sexual desire, and body proportions in hypogonadal men treated with a testosterone 1% gel. This was a 6-month, open label, multinational, observational study in hypogonadal men treated with daily titrated dose of 50, 75, or 100 mg 1% testosterone gel (AndroGel®) in community practice. Substantial improvements in hypogonadal symptoms, quality of life, fatigue, erectile dysfunction, and libido/sexual desire were observed.


Sleep problems testimonials
My doctor prescribed testosteronere placement cream and a small dose of progesterone. I took these and my insomnia returned. 


I currently take 65mg Testosterone cypionate twice per week and 0.05mg of Arimidex twice per week. I cannot sleep much and usually awake at 4am and can’t fall back asleep. Lots of body tremors and strong pulse with around 90 beats per minute. Have lost some weight but don’t feel tired though-out the day, more amped up.


Benefit and role of the hormone
Testosterone has many physiological actions in: muscles, bones, hematopoietic system, brain, reproductive and sexual organs, adipose tissue. Within these areas it stimulates: muscle growth and maintenance, bone development while inhibiting bone resorption, the production of red blood cells to increase hemoglobin, libido, enhanced mood and cognition, erectile function and lipolysis.


Benefit of supplementation
Replacement in men with low levels may improve metabolic status by: lowering blood sugar and HbA1C in men with type-2 diabetes, reducing abdominal girth, ameliorating features of the metabolic syndrome, all of which may be protective of the cardiovascular system.


Decrease levels with age
It is well-established that total testosterone in men decreases with age and that bioavailable levels falls to an even greater extent. The clinical relevance of declining androgens in the aging male and use of replacement therapy in this situation is controversial. Most studies have been short term and there are few large randomized placebo-controlled trials. Anabolic deficits in aging men can induce: frailty, sarcopenia, poor muscle quality, muscle weakness, hypertrophy of adipose tissue and impaired neurotransmission.

Role of the pituitary gland
The pituitary gland controls the level of testosterone in the body. When levels drop, the pituitary gland releases a hormone called luteinizing hormone. Luteinizing hormone stimulates the testicles to make more testosterone. Before puberty, the testosterone level in boys is normally low. It increases during puberty leading to a deeper voice, get bigger muscles, make sperm, and get facial and body hair. Levels are highest between the ages of 30 to 40, then gradually decline. Most of the testosterone in the blood is bound to a protein called sex hormone binding globulin (SHBG). Testosterone that is not bound ("free") can also be checked if a man is having sexual problems.


Testosterone replacement therapy, risks
Various forms are available by prescription. These include injections, cream, and gel. Treatment is sometimes recommended for age related hormone decline in middle aged and older men and women in order to boost libido and vitality. It is also used in women who have had their ovaries removed. DHEA may be a good substitute for testosterone. However, both have short term and long term side effects.

Women seeking relief from menopausal symptoms and diminished sex drive by taking testosterone as well as estrogen face a higher risk of breast cancer than with estrogen alone.


Alcohol use
It's known that alcoholic men can develop signs of low testosterone, including shrunken testicles and enlarged breasts.


Testosterone and weight loss
A condition involving abnormally high levels of androgens (steroid hormones) known in medical circles as "hyperandrogenemia" starts early in obese children, possibly placing them at increased risk for the metabolic syndrome -- a cluster of conditions such as high blood pressure and high blood sugar levels that raise the risk of heart disease and diabetes. Weight loss leads to decreasing androgen levels. Androgens are steroid hormones such as testosterone or androsterone, which control the development and maintenance of masculine characteristics in both males and females.


Testosterone replacement therapy in older men - Are the benefits worth the risks?
Treatment of aging men and women with testosterone supplements is increasing. The supplements are given to postmenopausal women mainly to improve their libido and to aging men as an anabolic to improve muscle mass and bone strength, to improve libido and quality of life, to prevent and treat osteoporosis, and, with the phosphodiesterase-5 inhibitors, such as sildenafil, to treat erectile dysfunction. The increased use of testosterone supplements in aging individuals has occurred despite the fact that there have been no rigorous clinical trials examining the effects of chronic use on the cardiovascular-renal disease risk. Studies in humans and animals have suggested that androgens can increase blood pressure and compromise renal function. Androgens have been shown to increase tubular sodium and water reabsorption and activate various vasoconstrictor systems in the kidney, such as the renin-angiotensin system and endothelin. There is also evidence that androgens may increase oxidative stress. Furthermore, the kidney contains the enzymes necessary to produce androgens de novo. High testosterone side effects - High doses have a negative impact on memory and brain function in elderly men.

Role in a woman
Testosterone may benefit women by increasing sexual desire, however side effects do occur. Natural testosterone boosters include DHEA and pregnenolone. Symptoms in women with deficiency include lack of sexual desire and vitality. Obese girls have several times the levels as girls of normal weight. A high level in girls influences reproductive health and may lead to undesirable side effects like excess hair growth.


Testosterone test information - Normal levels
This test may be recommended by a doctor to:
Determine infertility. A low amount can lead to low sperm counts.
Determine if a low testosterone level is influencing a man's sex drive or erectile function. However, another option is to prescribe a low dose to see if there is an improvement in libido and erection. Doctors also have the option to recommend over the counter DHEA to see if this hormone improves sexuality.
Determine if excessive facial and body hair (hirsutism) and a deep voice in a woman is due to excess testosterone. This can occur in PCOS.
Determine if testosterone-lowering drugs are working in a man with advanced prostate cancer.


Normal total Testosterone level ranges:
7 months to 9 years - Less than 30 ng/dL in boys and girls
10 to 13 years - Less than 300 ng/dLin boys, Less than 40 ng/dL in girls
14 to 15 years - 150 to 500 ng/dL in boys, less than 50 ng/dL in girls
16 to 19 years - 240 to 900 ng/dL in boys, Less than 60 ng/dL in girls
20 years and older - 260 to 1000 ng/dL in men, less than 70 ng/dL in women
Normal free testosterone level is 0.3 to 2 pg/mL.


Low testosterone levels are typically defined as less than 300 ng/dL of total testosterone and less than 5 ng/dL of free testosterone.
It is interesting that after winning a team competition against strangers or rivals, men's testosterone levels increase. But when they're victorious against friends, their levels remain the same.


Potential problems or concerns with testing
There are a number of issues that can affect or confound results or the interpretation of results (1) social and demographic factors, gender and sex (2) biological rhythms (diurnal variation; seasonality; menstrual cycles; aging and menopause), (3) sample collection, handling, and storage (saliva vs. blood; sialogogues, saliva, and tubes; sampling frequency, timing, and context; shipping samples), (4) health, medical issues, and the body (hormonal contraceptives; medications and nicotine; health conditions and stress; body composition, weight, and exercise), (5) different labs may have different ways of testing and the same sample tested in different laboratories may show different numbers.


Approximately 30% of men 60-70 years of age and 70% of men 70-80 years of age have low free testosterone levels leading to a condition called andropause or male menopause. Symptoms and findings of deficiency are similar to those associated with aging. They include loss of energy, depressed mood, decreased libido, impaired erectile function, decreased muscle mass and strength, increased fat mass, frailty, osteopenia, and osteoporosis. Several small clinical trials indicate that testosterone replacement therapy can improve many of these findings; however, the studies have not determined potential risks, such as benign prostatic hyperplasia, cancer, or cardiovascular events. Thus, the benefit / risk ratio of replacement therapy in aging men is not fully known. There has been a drop in U.S. men's testosterone levels since the 1980s.
     Testosterone is helpful in those who have low androgen levels, however the benefits must be balanced with the risks. Soy and isoflavones do have an influence on hormone levels, but the effects are not significant enough to have any major concerns. See soy protein for information and studies on the relationship of soy and hormone levels.


Anti testosterone medication

Leuprolide is used to reduce the amount of testosterone or estrogen in the body and is often used in cases of prostate cancer or endometriosis.


Testosterone and exercise
An increasing amount of research studies in men indicate endurance exercise training has significant effects upon the major male reproductive hormone, testosterone, and the hypothalamic-pituitary-testicular axis that regulates reproductive hormones. A new term used is "exercise-hypogonadal male condition". Specifically, men with this condition exhibit basal (resting-state) free and total testosterone levels that are significantly and persistently reduced. Heavy workouts or physical exhaustion could potentially lower testosterone levels temporarily. Eating healthy, moderate exercise, deep sleep, low stress, can help maintain healthy hormone levels.

Testosterone treatment and sleep apnea
Q. About 15 weeks ago I began taking growth hormone (self-injection) and testosterone (cream). About 10 days ago I started developing sleep apnea. I stop breathing while sleeping and wake with a jolt and have to hyperventilate for a while to get re-oxygenated. Three days ago, this became much worse and I now can't sleep because the sleep apnea begins as soon as I start to fall asleep. This is obviously a very serious problem because I can't get more than a few moments sleep during the whole day and night. I found studies that indicate that both growth hormone and testosterone can induce apnea. A theory proposed by James Michael Howard suggests that testosterone depletes DHEA and that DHEA controls the breathing response. Yesterday, after finding this theory, I took 100 mgs of DHEA and the apnea went away in about 2 hours. Unfortunately, I used one dab of testosterone cream before bed last night and within 30 minutes, the apnea resumed. Taking more DHEA did not help. Can the growth hormone and testosterone cause apnea, and if so, is this process mediated by the depletion of essential nutrients by these hormones? Obviously, the depleted essential nutrients would need to be replenished. I plan on discontinuing all growth hormone and testosterone to see if this results in the apnea stopping.
   A. Testosterone treatment can cause sleep apnea. It probably effects the brain centers for breathing and sleep directly as opposed to depletion of nutrients. I could not find studies on the role of human growth hormone and sleep apnea.

Q. My physician prescribed a post-menopausal hormone combo of estrogen, progesterone and testosterone about a year ago. Slowly but surely, I have been noticing discernible thinning of my already fine hair. I am a 57 year old woman for whom the testosterone additive was to improve libido. Are the effects of this artificial testosterone on my thinning /balding reversible?
   A. This is a good question. In some people testosterone induced hair loss is reversible, in others it  may not. Each person is different. The dose, length of use, individual biochemistry, etc are factors.

Q. Do lipoic acid, coq10 or the brain nutrient acetylcarnitine increase testosterone levels?
   A. I don't think so, I haven't seen such research.

Q. I am an 53 year old man, in good circumstances (BMI = 22,0) living in switzerland, europe. I am trying the standards for men like me,  who want to slow down aging. Contrary to the most men in the same situation I make it in the scientific way and make things sure by laboratory results ! So I provide a DHEA Test for me. 100 mg in the morning an 100 mg in the evening ( I know this is a lot of, but I want to see clear effects and side effects) After 14 days a new laboratory measurement  and than again after 30 days. The side-effects are so worse, I don't continue any longer. Good effects : absolutely none ! Now the results : my estrogen E2 and testosterone are sinking in the first 14 days. Testosterone goes down like I have become castrated ! LH was nearly constant. So I think, DHEA does first not influence the regulation loop of testosterone via LH, but inhibits direct the production of testosterone. Furthermore there is no metabolisation from DHEA to estrogen, estrogen was sinking ! After 30 days my testosterone goes again down, but only a little bit more, LH goes down and estrogen increases ! End of try !
   A. Thanks for sharing dhea testosterone anecdote with us. The effects of DHEA on testosterone could be dose and time dependent. Perhaps the results may be completely different if only 5 mg of dhea is used or if the dhea is not taken in the evening. There are many different factors at play. But, we don't feel high doses of dhea are healthy, they may even cause premature death.

Q. Can I take tribulus terrestris with Prostate Power Rx? Which is best to increase testosterone levels? My free testosterone level is 6.4. How can I naturally increase it ( a little) and still provide prostate support ?
   A. Tribulus can be taken with Prostate Power Rx in low dosages. It is not yet clear if tribulus terrestris herb increases testosterone levels in any significant manner in humans.

Q. I am on depo testosterone injections. would saw palmetto help my some of my bodies organs from shrinking with this treatment?
   A. We doubt saw palmetto would be useful for this purpose.

Q. Your site does much good for those who care to do even minimal research into personal hormone experimentation. You also help keep at bay the least scrupulous of those calling themselves "businessmen". Currently, Renaissance Health, a firm in Boca Raton, FL, has flooded the mails with advertisements for a liposomal formulation of testosterone, DHEA and pregnenolone. The firm's product is named T-Boost, and its advertising completely ignores risks, unknowns and maximizes glowing anecdotes and quasi-claims. Renaissance Health president James DiGeorgia uses the personal endorsement of William S. Gruss, M.D., said to be an internist and cardiologist, to promote the safety and efficacy of T-Boost. According to company advertising, Gruss claims to use it with his own patients. DiGeorgia also makes a simplistic "proof" for his product by noting research associating Alzheimer's with low testosterone levels. Aside from its extremely expensive price ($177 for 90-days' supply)-- which may be all most need to know about the purpose of the sales campaign-- there is no specific information available in product advertising about dosage, or possible testosterone side effects. I note that over the years, as you have published your findings about DHEA and pregnenolone, among other substances, you have become much more conservative about personal supplementation. Is it possible you no longer will recommend their use except in specific therapeutic instances (hormonal insufficiency, etc.)? Also, do you recommend the viewpoint of author ((I hesitate to say "biochemist") Stephen Cherniske as a source for valid information about DHEA?
   A. Testosterone, DHEA, and pregnenolone are potent hormones with significant side effects when misused. With time, we have realized the potential serious dangers when this hormones are taken carelessly. We have also recognized that we had underestimated the potency of these hormones in the past, and now are warning users to be very careful. As to Stephen Cherniske and his views on DHEA, we prefer not to comment on other people unless they first make a comment about our work. It is up to the consumer to read various opinions and make their own decision.

Q. I have a question about Testogel. I've never been able to put any weight on despite eating well, its like I have a fast metabolism or something, ive tried working out out the gym and eating lots of protein nothing happens. What I would really like to do it build some muscle mass, currently my body looks like a pre pubescent school kids, I was wondering if I should have my testosterone measures and if low whether Testogel might help me to develop some muscle mass with gym work. My only concern is that ive heard that if you use something like Testogel, once you stop your testosterone levels will be permanently lower then when you started taking something like Testogel.
   A. We can't give individual advice please. You should read about cautions with use of testosterone since long term side effects are possible.

Q. I am in the supplement business and I have greatly enjoyed your books and your website. What would you suggest for a 35 year old women who has borderline low testosterone and very low libido. In addition to that she is having a very difficult time reaching orgasm. She is otherwise very healthy. All other blood values came back fine. We are waiting to hear back from here gynecologist since here MD did know which way to proceed. I have a feeling that she may be resistant to trying a pharmaceutical testosterone
replacement. Since the low testosterone has been established should we look mainly at trying to raise this hormone with tongkat ali and possibly tribulus? Do you think that adding a small amount of dhea may help also? The Dr. said here dhea was in the middle normal range. Do you think that dopamine stimulation should still be looked at even though the low testosterone has been established?
   A. There are many factors besides testosterone that are involved in libido. It is impossible to predict which supplement will be most helpful to a person with low libido. Perhaps in your case the low testosterone is a factor in the low libido, or it may be another unidentified factor. One option is to try a sex herb for a week, if not helpful switch to another one. Always use a low dose such as a portion of a capsule at first since many sexual products may be too potent.

Q. How long it takes for Passion Rx to increase/improve testosterone levels, if it does that at all.
   A. Some of the herbs in Passion Rx, such as tribulus and tongkat ali, are thought to increase testosterone level, but there are many many factors besides testosterone that influence sexual enhancement. We have not done studies with passion rx to determine its influence on this hormone.

Q. I am taking testosterone in a shot every 14 days. The dose is 150 ml of 300 mg/ml. i was taking twice that and it raised my psa from 3.0 to 5.7. Will Passion Rx affect the psa if taken in low doses and is it OK to take it with testosterone?
   A. We have not tested Passion Rx long term to see whether it has an influence, pro or con, on PSA levels. Most of the time people take Passion Rx at most 3 days a week so we don't think ti has much of an influence.

Q. As a prostate cancer survivor for past five years and as a member of the online support group for prostate cancer patients / survivors (US 2), we find ourselves in a quandary about reasonably safe (if there is any) methods to naturally improve our testosterone levels, especially after radiation and radiation-seeding therapy.
   A. Why would you wish to raise testosterone levels. If it is for libido, then certain natural herbs could be helpful. If it is for other reasons, then perhaps other supplements can be used for that purpose. But increasing the level just for the sake of it is not advised for prostate cancer survivors.

Q. Thank GOD for some honest facts on a web site without hype. Love your straight and honest knowledge on so many products. I have low testosterone Levels. I am 42 years old and in perfect health. What natural product (s) do you recommend to raise those levels. I currently take 150 mg testosterone injections every other week and if able rather to do it a natural way. I have read your information on DHEA, maca and tribulus in terms of testosterone level increase but not sure if this is the direction I should go.
   A. Often patients and doctors focus on the level of one hormone and try to manipulate these levels overlooking the whole picture. If a person is perfectly healthy and has good energy, mood, and sexual health, there is no reason to play with hormone injections or supplements to increase testosterone level. The whole person's mental and physical health has to be taken into account, not just a lab study. Now, a person could occasional experiment with natural supplements such as the tribulus, maca and other sexual herbs if they are interested in sexual enhancement, but it is potentially harmful to play around with hormones such as DHEA and testosterone since they have many side effects.


Q. I am 44 years old and have low (bottom of normal range) testosterone levels, with very low DHEA levels. My doctor's suggested I take a supplement of oral DHEA. I've been reading the information on your site. I understand you don't advise which supplements to take but hope you can advise how each of the supplements, DHEA, 7-Keto DHEA and pregnenolone might impact my situation?
   A. I personally am of the opinion that the whole person has to be taken into account when considering hormone treatment as opposed to solely relying on blood studies. If a person feels fine even though a blood study shows a low testosterone hormone level, this does not necessary mean replacement is necessary. How do we know testosterone replacement will improve health in the long run? What if testosterone replacement therapy results in various short term and long term side effects? Even if testosterone is replaced, how do we know the ideal dosage and form? If a person has a low testosterone level but no major symptoms, it may be better not to interfere for the time being. However, if low testosterone levels are associated with symptoms of low testosterone, such as fatigue, low vitality, low sex drive, low mood, etc., then it may be appropriate to consider testosterone replacement or the use of certain natural hormones or natural supplements that address the particular symptoms of testosterone deficiency.


Q. I have been taking testosterone for about 1yr. I've had 2 prostate operations in the past yr. first i had the green light laser treatment and i developed scar tissue and two months later i had the turp treatment. What i would like to know is, will my taking bioidentical testosterone cause my prostate to enlarge again where i can't urinate? i understand the procedure has to be repeated in 5 to 10 yrs and i don't want to have to go through that procedure again any time soon. Should i stop taking the testosterone or not?
   A. We can't advise you whether to take or not to take testosterone. We can say that testosterone therapy is associated with a higher likelihood of prostate enlargement.


Q. I am 65 years old. 2 years ago a stent was installed in one of the arteries. Since then I have been taking Remipril 1.25 Mg, Bisoprolol 2.5 Mg, Lipitor 20 Mg, Norvasc 2.5 Mg and Aspirine 80 Mg. Testosterones level has gone down considerably. What can I do to increase testosterone without having many side effects.
   A. Testosterone is available by prescription, and DHEA is available without a prescription. However, unless testosterone levels are significantly low, one should rather focus on the whole body and overall symptoms and signs of deficiency than just treating an isolated blood test result.


Q. My husband has low testosterone due to hypogonadism (due to mumps) Can not afford the perscription given by Dr. of Androgel. Is there a natural precursor for testosterone?
   A. We are not aware of any herbs that increase testosterone levels consistently over long term use. However, DHEA can raise testosterone levels.


Q. I wonder what testosterone supplements might do for my sexual performance. My testosterone level is quite good. 6.8 and 10.9 free. I am 64 years old. Would such a testosterone supplement help me? Are there undesirable side effects? Is this available anywhere?
   A. Testosterone is a hormone which is available by prescription but not as an over the counter supplement.


Q. Do you have anything that would help my libido? I've tried tribulus and Simplex "M" from Standard Process with no success. I recently had my testosterone checked with the following results: My testosterone results from Quest Diagnostics:
Total Testotosterone: 546 ng/dL range 250-1100
%Free Testotosterone: 1.73% range 1.5-2.20
Free Testotosterone: 94.5 pg/mL range 35.0-155.0.
   A. We suggest you review the page on libido and discuss the options with your doctor. If one herb or formula does not work, another one may.


I turned 44 today and my general lack of interest the female gender in quite disturbing. I have tried to talk to my doctor about my condition and he indicates its just age and not to worry. My energy levels are down some but not enough that I don’t do anything. I exercise on a regular basis , 3 times per week or every other day.
My concern is that I feel my testosterone levels are way done, no desire to have sex, my strength is down, way down… I am sure its an individual thing but when in the gym I can barely lift the weights I could easily do a few years back. My question – is there a product(s) that would boost testosterone levels back to my younger days?
    Perhaps the info on this page will help you.


I am considering beginning a course of supplements to correct a very low testosterone value. I took a saliva test that indicated a value of 122 pmol/L Testoterone (very low), 157 pg/mL DHEA (normal?). I will be taking a blood test to confirm these values within the next month (at my next HMO covered free annual physical). I am a very active 35 year old who has recently noticed low sex drive, impaired muscle recovery, decreased performance, fatigue, etc (classic low T). I participate in numerous strength and endurance activities and have recently lost weight. I eat a Paleolithic inspired high protein, low carbohydrate, and moderate fat diet (may need more fat). My body fat is about 8%. I have reviewed your website and others and intend to make the following adjustments to my diet and begin the following supplements. I would appreciate any additional suggestions, cautions, or adjustments based on your experience or knowledge of current nutritional research. DHEA 5mg/day (should I take more?) or 10mg 3xweek? ZMA before bed Chrysin? Tribulus? Thank you for any information you provide.
    Sorry but I can't give individual recommendations but hopefully the information on this page will help you decide.


I do have Passion Rx, a sexual enhancement product in stock. And I have noted that, some of its ingredients may release hormones (testosterone) into the body. My safety concern is that, since I just had a radical prostatectomy from prostrate cancer, do you think it is medically safe or wise for me to take such a supplement that in part generates testosterone? I am asking because, readings done so far indicate that, it is not safe for prostrate cancer patients to engage in any sorts of testosterone replacement therapy.
    We have no studies to show whether this product has an influence on testosterone levels. In the long run this sexual enhancing product is only used 2 days a week. There may be compounds in this herbal product that may be helpful for the prostate gland. Bottom line is that we don't know whether this sex formula has much of any influence on prostate cancer, positive or negative.


I recently came across information claiming that it was possible to boost your testosterone level from 250ng/dl to 800ng/dl using a variety of natural techniques. Do you think this kind of extreme boost is possible without steroids? I have a very low level and I am hoping to be put on testosterone replacement therapy because I am feeling many negative effects of my low level and I was informed it would be impossible to boost my level up too the higher end of normal naturally. I desire a level at the higher end of normal, around the 800 mark or above as I am a bodybuilder and cannot gain muscle at the moment. The boost would have to be significant. I feel bioidentical T in moderation may be a more reliable option. Also does Dr Ray Sahelian have any books on natural testosterone boosting?
    I am not aware of natural ways to increase T levels in a significant and consistent way with herbs, vitamins or supplements except for the natural hormones such as DHEA. However one must take into account the undesirable adverse effects that come from the use of certain hormones.


I am a post-menopausal female and have used several of your products. Due to severe menopause symptoms, I have been using bio-ID HRT for the last three months, in the form of estrogen, progesterone and testosterone creams, and BiEst troche, with some success. Most important, I am hoping to boost my blood testosterone level, which is currently at 21 ng/dl. Do you consider testosterone in a dose of 1% cream, 1/2 to 1 CC per day, excessively high? As an option, I am considering your Passion Rx to replace and/or supplement the testosterone cream. Could Passion Rx be used effectively in this way? Or is another of your products that would be better suited to this purpose?
    Passion Rx works to enhance sexual pleasure and libido, but we have not done any tests to see how it effects levels of testosterone in men or women. As to the dosage of the hormone, without doing a full history, review of symptoms, and medical exam, it is not easy to predict the amount of the cream to use. DHEA is known to increase testosterone levels but has to be used cautiously, as do other hormones.


I get testosterone injections (150 mg) every two weeks to maintain a normal range of blood level. I have read that the effectiveness of the PDE-5 impotence drugs depend on normal testosterone blood levels. Do you know, or deduce, that to also be true for Passion Rx?
    This is a good question but we do not have any studies to determine what role testosterone levels or injections play in the effectiveness of this formula. It is possible that if the testosterone injections are used for sexual enhancement the dosage would be less since Passion Rx will provide improved sexual urge and performance. Since this natural formula works in multiple ways to enhance sexuality, the role of testosterone would not be as important as that of the PDE-5 inhibitors.


Will the use of Passion Rx increase my testosterone levels or other hormones? I am 59 with low T, DHEA, etc.
   No such testing has been done with checking blood levels of testosterone after Passion Rx use, so we don't know what effects its use has on various hormone levels in the body.