#9

I guess my questions are, have they just tested levels or have they tried anything to bring your husbands testosterone up? There are options to be explored before using exogenous testosterone. I agree with Dr. Fraser, that getting your own system working is the best option, if possible.

3 Likes
#10

I would be really interested in seeing this, as I have just started TRT last week

3 Likes
#11

I don’t know of any good, reliable options to bring up testosterone when it’s already below the reference ranges, do you? He did lose 25 lbs and is within 5 lbs of his ideal weight. He takes acarbose and has gotten his blood glucose under good control. He started rapamycin in February. He takes ashwagandha and has reduced his dosages of metformin and atorvastatin. I don’t want to add weird supplements like Tongkat Ali, because we just don’t know enough about their long-term safety. He needs to build more muscle and does lift some weights a couple of times a week, but he’s not super motivated like most of you here. Don’t like the idea of clomid and none of his doctors have suggested it, either. Not sure what else is left to try. He’ll be 67 this month so doesn’t have a lot of time to waste.

2 Likes
#12

It is great that he has been working on his health and weight loss. That can certainly help. Does he have symptoms of low T or is it just the number that is concerning?
I would not rely on supplements to change his issues. Doctors can try different things, and identify where the “chain is broken.” There are several medications that a doctor could use, such as HCG, HMG, FSH, Proviron, Clomiphene, etc. to help make a diagnosis. I am not a doctor, but I would want to get to the root cause of the deficiency before getting on replacement. In the end. he may truly be a good candidate for replacement, but that is a lifetime commitment that should be taken seriously.

If testosterone replacement therapy (TRT) is not an option or preferred, there are some medications and lifestyle changes that may help increase testosterone levels naturally or address underlying issues contributing to low testosterone. Here are some options:

  1. Clomiphene citrate (Clomid): This medication stimulates the body’s own production of testosterone by increasing the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. It’s often used off-label for treating low testosterone in men.
  2. Human chorionic gonadotropin (hCG): Similar to Clomid, hCG can stimulate the testes to produce more testosterone. It’s sometimes used in combination with other treatments.
  3. Selective estrogen receptor modulators (SERMs): Medications like tamoxifen may be used to block estrogen receptors in the body, which can increase testosterone production by reducing the negative feedback loop on the hypothalamus and pituitary gland.
  4. Aromatase inhibitors: These medications block the conversion of testosterone to estrogen, potentially increasing testosterone levels indirectly.
  5. Weight loss and exercise: Obesity is associated with lower testosterone levels, so losing weight through diet and exercise can help increase testosterone levels. Resistance training, in particular, has been shown to boost testosterone levels.
  6. Dietary changes: Consuming a balanced diet rich in protein, healthy fats, and micronutrients like zinc and vitamin D can support testosterone production. Zinc and vitamin D are especially important for testosterone synthesis.
  7. Stress reduction: Chronic stress can lower testosterone levels, so techniques like mindfulness, meditation, and relaxation exercises may help improve testosterone levels.
  8. Sleep improvement: Getting enough quality sleep is crucial for testosterone production. Aim for 7-9 hours of sleep per night and maintain a consistent sleep schedule.

It’s important to note that the effectiveness of these approaches may vary depending on individual factors such as the underlying cause of low testosterone and overall health. It’s best to consult with a healthcare professional to determine the most appropriate treatment plan.

9 Likes
#13

This is the key obstacle to an optimal solution. But @RickCohenMD says a short term pharma boost can help with this.

Here are some notes from my interview

  • Get sleep, move, lift heavy things, get off of toxic foods, don’t over-train…quick fixes. Lifting heavy and sprinting are the big levers.
  • Sometimes people need a short treatment of medication to stimulate natural T production to boost motivation and mood so that they can do what is needed to do to increase testosterone production back to normal without drugs. Enclomiphene. hCG.
  • Supplements mentioned: Akarkara root, Pine pollen, Tongat Ali
5 Likes
#14

There is a good podcast on this topic:

Also many discussions in the past. You may want to search on testosterone using the search button in the upper right corner of the page.

9 Likes
#15

I’ve done that and listened to that podcast, and was just hoping for feedback more focused on my husband’s situation. Listened to couple of good Peter Attia podcasts too. Thank you.

1 Like
#16

Another possibility, if his DHEA level is low, is to take a DHEA supplement in the range of 25mg to 50mg - not forever but until a blood test shows DHEA back within the reference range. DHEA is important in its own right, and its levels usually drop significantly with age. The body can metabolize DHEA into testosterone and/or estradiol - taking chrysin as a supplement should have some effect of reducing conversion of DHEA to estradiol. As a 70+ male who takes low-dose metformin (250mg) and atorvastatin (5mg) daily, and 10mg rapamycin once weekly, I’ve seen modest increases in testosterone from taking DHEA - differences are I’m non-diabetic and in the middle of the reference range for T.

7 Likes
#17

No easy answers here. Biology is complicated, obviously. That said, the data I have seen suggests that increasing testosterone levels from low to normal increases life expectancy and reduces heart attack risk.

See for example, this paper: https://doi.org/10.1093/eurheartj/ehv346

If that link doesn’t work try Googling “Normalization of testosterone level is associated with reduced incidence of myocardial infarction and mortality in men”

I think some of the bad rap for testosterone comes from people taking it to go from normal levels to abnormally high levels. For instance, body builders often do this. We refer to this as steroid use rather than TRT, and we have plenty of examples of very muscular young men looking quite good in their caskets. Which is terribly sad and unfortunate.

My view is if he is low, work with qualified doctors to start treating the problem in some way (either TRT or some other approach depending on the root cause of the problem).

Good luck!

4 Likes
#18

I think I probably agree with you completely on this, depending…. We really need to put some numbers to the phrase “high testosterone”. Depending on what you mean by that, I might not agree at all.

I think it is probable that increasing testosterone levels from, say, 150 to 900 ng/dL improves both healthspan and lifespan (in men). However, increasing levels from, say, 500 to 2,000 ng/dL probably statistically reduces lifespan.

Like many things, there is probably a U-shaped curve, and there is a level that is too low such that increasing is helpful, and a level that is too high, such that decreasing is helpful.

5 Likes
#19

I have been experimenting the last 4 weeks to raise my free testosterone via supplements and DHEA, avoiding injections at this point… all I am after is a little bump nothing significant.

Supplements – Long Jack, Ashwagandha, Fenugreek; all have been show to raise T, I take these every other day and only one type and rotate them

DHEA – 20mg cream, 10mg tablets; I take these every other day and alternate them, not on the same days as the supplements… I take 30mg of tablets and it gives me a boost, I apply the cream to my rectum/perineum area as it absorbs readily there and it gives me a boost.

I don’t take any of these the day I take Rap!

So my schedule is something like this Saturday Long Jack, Sunday DHEA cream, Monday Fenugreek, Tuesday 30mg of DHEA pills, Wednesday Ashwagandha, Thursday Cream, Friday is Rap day.

I can say it has improved my muscle tone and strength while doing my daily strength training, improved energy and mood, have not had a chance yet to test it out downstairs but that happen next month when I visit my gf overseas Lol

Plan to get blood workup soon to see where I am at.

5 Likes
#20

hope @desertshores weighs in, he has done quite a lot of experimenting in this area, including trying out meds from India

#21

Yes, a testosterone level of 2000 is a steroid cycle. That will increase estradiol and DHT levels pretty high and potentially cause other side effects in the long term that’s probably not good for longevity.

On the other hand, a low testosterone level (not totally sure which lab number would be considered “low” though) also increases risk of diseases. Free Testosterone is a better lab marker.

Like with most things, too much of a good thing becomes a bad thing, so optimal should be the target. It’s hard to say what testosterone level is “optimal”, and there is debate over whether that number changes once TRT is introduced though.

Let’s not forget an optimal testosterone level also improves quality of life.

5 Likes
#22

It’s a choice… and there are many ways to do it. I have been on TRT for 6 years now, I am 66 … my only regret is not having started earlier as it gave me so much healthspan wise than any other interventions I had tried by the time I started. I tried everything… food, exercise, nothing worked but oh boy, when I started TRT, another life started for me…

All my markers improved. I was able to exercise without extenuating myself and most of all without injuring myself… Recuperation was solid, sleep improved, joint pain went away (propably the estradiol boost) …

How can this be bad for longevity? I might be dead by now if it was not for this, my life was basically not worth living much…

A few things I learned in those 6 years… dose and schedule is everything. I ran too high in the beginning although not high enough to get bp or hematocrit issues but still too high… My best results are with low almost microdosing every two days… This does not spike my levels to supra physiological levels and keeps me in a normal/mid level range throughout… I also do HCG which I cycle in and out. Here again, microdosing every two days… It’s a lot of injections, but the outcome is worth it and removes the stress of a large bolus of T once or twice a week which spikes your levels too high leading to more aromatization and I think stress…

I think it should be in the tool. kit of every man (or woman) as we age. I don’t mind dying, it is inevitable, but I do mind how I live and I want to have pep in my step… nothing puts some pep in a man like T (when needed naturally) … YMMV …

11 Likes
#23

Anyone have experience using the online TRT providers?

#24

According to a 2012 study published in Current Biology, eunuchs, or castrated men, live 14–19 years longer than other men, with an average lifespan of 70 years. The study analyzed the genealogy records of 81 eunuchs who worked in the Korean imperial court during the Chosun Dynasty, which ruled from the 14th to early 20th centuries. Three of the eunuchs lived to be over 100 years old, which is at least 130 times higher than the current rate in developed countries.

5 Likes
#25

You make a compelling argument … still not going for this treatment! Will go for alternative routes to 100 years.

9 Likes
#26

Thanks - this is the path that i am on at age 70, HRT for 7-8 years and just started rapamycin. I have had to back the Free T down due to feeling angry and agressive, but healing, sexual, activity, and overall health was mantained. i also use a thyroid supplement.

7 Likes
#27

I found a supplier for Enclomiphene Citrate, a little pricey compared to the India suppliers but they seem legitimate:

I am going to to order some and see how it goes, seems like a good alternative to needles. I reached out to Jagdish who has been very reliable for Rap, he sent me a quote for a very good price on “Enclomisign , Enclomiphene”, but @desertshores received this and believed it is really Clomid instead.

I asked an AI search engine to give me the molecular formula and this is what it found: The molecular formula for Enclomiphene Citrate is C32H36ClNO8. That is the same formulation listed from the supplier so I’m hopeful it’s legit.

Starting out I plan to use this 2 times a week 12.5mg per dose, along with the supplement and DHEA protocol I listed in my previous post. Also, I’m adding DIM to the stack on days when I take DHEA. So rotoate the Enclomiphine/DHEA/Supplements on a 6 day cycle, day 7 is for Rap only.

1 Like
#28

My husband spoke with his endocrinologist and saw his urologist again. It was agreed that he’d try Clomid first, at a dose of 25 mg on Monday, Wednesday, and Friday. He’ll retest his hormone levels again in 3 months and see how he’s feeling. If Clomid doesn’t work well after a reasonable trial, he’ll explore TRT next.

Prescribed off label like this, Clomid is not covered by insurance. But 30 of the 50 mg tabs are only $115-$140 at Cost Plus Drugs or with a GoodRx coupon.

Thank you all for your insights and opinions.

3 Likes