Dick Van Antwerp


Testosterone, Low T
  and Andropause

Requirements | Why People Take It | Andropause or Low T| Anti-Aging Considerations | Safety Considerations | References

Testosterone, the most important male hormone, is produced by the gonads (testes in men, ovaries in women) and transported by the circulatory system throughout the body. According to some sources, testosterone makes everyone Ð men and women Ð desire sexual activity. [1]

Testosterone is the androgenic ("male producing"), anabolic ("tissue building"), naturally occurring steroid that primarily drives male sexuality, as well as influencing muscle and bone development. Testosterone production begins before birth, and influences the fetal growth of male genitals as well as the development of the brain, muscle, kidney, and liver. Throughout boyhood, testosterone production is low. At puberty, testosterone levels increase dramatically, causing the genitals to mature, facial and body hair to grow, the voice to deepen, and adult male musculature to develop. Testosterone controls sperm production, sexual drive, and sexual performance throughout a man's life. Testosterone levels diminish when men are in their mid-forties or fifties, although some men continue to have relatively high levels into their eighties and beyond.

Testosterone (C19H28O2) is produced in men by the Leydig cells, which are very small structures in the testes. Decreased production of testosterone can be caused by subnormal activity of the gonads, resulting from problems in the testes, or in the hypothalamus or pituitary glands that stimulate testosterone production. Located in the brain, the hypothalamus produces gonadotrophin-releasing hormone (GnRH), which promotes the production of luteinizing hormone (LH) by the pituitary gland. The pituitary, also located in the brain, secretes several hormones including LH, which stimulates the production of testosterone, and follicle stimulated hormone (FSH), which promotes sperm production.

In women, prior to menopause, the ovaries produce about one-tenth the amount of testosterone found in men's bodies. [1] Testosterone's role in women's health and sexuality is not fully understood and merits further study.


R.D.A. Minimal Requirements. The U.S. Government does not have a Recommended Dietary Allowance (RDA) for testosterone or its releasers. Testosterone levels can be measured with a simple blood test, and monitoring of testosterone levels in the blood is highly advisable before and during testosterone supplementation.

Unique Needs. More than 100 testosterone derivatives have been synthesized, some of which are used in human medicine and to enhance athletic training and competition.

Information Source

Typically Occurring Testosterone [T] Ranges and Suggested Optimal Ranges

Grow Young with HGH [2]

Male Testosterone [T] Range in nanograms per deciliter (ng/dl) of blood serum

Men's age in years








Normal serum levels: T in ng/dl









Resetting the Clock [3]: T in ng/dl








Signs of Andropause or Low T. Testosterone deficiency "Low T" has the following signs and symptoms: decreased libido, sexual dysfunction (impotence), infertility, small testes, and decreased muscle mass and strength. [4, 5] Associated conditions include advanced age, obesity, liver disease, alcoholism, osteoporosis, rheumatoid arthritis, AIDS, chronic renal failure, diabetes, and chronic anemia. In the United States, an estimated five million men have the medical condition of testosterone deficiency (hypogonadism), which is approximately one in twenty adult males.

Food Sources. Proper nutrition is vital to healthy hormone production, including testosterone. A study at Penn State shows that a drop in testosterone occurs in diets with too much protein and too few carbohydrates, as well as high-carbohydrate low-fat diets. [6]. Proper dietary intake levels of vitamin A, B6, vitamin C, boron, zinc, and branched-chain amino acids are necessary for testosterone production. [5, 7, 8]. Testosterone levels can be increased to some extent through exercise. [9]

Forms. Testosterone replacement therapy (TRT) can be administered by means of several delivery systems, including pills (more commonly found in Europe), lozenges that are taken sublingually (so that they dissolve directly into the bloodstream), topical ointments (creams and gels), transdermal time-release mechanism (skin patches placed on the back, arms, thighs, or buttocks), scrotum patches, intramuscular injections, and subdermal implants (for reversible male contraception). Testosterone is available by prescription in the U.S.A. The various products are marketed under a variety of brand names. Pills are considered by some to be the least effective. [9]

Why People Take It

Enhanced Sexuality. When men are young, their testosterone levels are at their peak. As men age, their testosterone levels naturally diminish, although some degree of testosterone production continues throughout a man's lifetime. Studies have shown that lower testosterone levels do not necessarily mean reduced sexual drive or capacity. [10] Through testosterone replacement, older men can undertake to restore the sexual vitality of their youth. However, human sexuality is complex and involves multiple factors, including general health, emotional well being, psychological factors, etc. Testosterone replacement may provide short-term increased sexual drive and enhanced sexual performance (erections achieved more rapidly, greater rigidity, prolonged performance, more frequent erections, etc.), but the longer-term effects are not clearly known and the risk factors should be considered.

Mental Acuity. Studies have shown that adequate testosterone levels are associated with increased mental alertness, visual spatial comprehension, memory skills, and language communication skills. According to one source, testosterone may play a protective role in Alzheimer's disease [1].

Body Building. Increased levels of testosterone promote increases in lean muscle mass. According to research reported in The New England Journal of Medicine, elevated testosterone levels caused increased muscle size and increased muscle strength in one test group, even without exercise. The study also found significantly increased muscle mass and strength in the group that received testosterone injections and also exercised. [11] A related study at the University of Washington of men 60+ years in age showed weight loss and increased muscle mass without exercising for the group receiving testosterone injections. [1]

AIDS. Men with acquired immune deficiency syndrome (AIDS) commonly lose substantial amounts of weight, particularly lean muscle mass, which contributes to weakness, fatigue, and loss of physical endurance. Recent studies have linked reduced testosterone levels and unwanted weight loss in men with AIDS. Research shows that up to 50% of men with AIDS have subnormal levels of testosterone. [12]. Testosterone replacement reduces unwanted weight loss and increases strength and stamina.

Recovery from Serious Injury or Surgery. Physicians sometimes prescribe testosterone to accelerate recovery from severe injury, illness, surgery, etc. [10] Testosterone has also been shown to be linked to increased red blood cell production and is useful in treating anemia. However, overproduction of red blood cells can increase the risk of stroke.

Osteoporosis. Testosterone therapy has been shown in some cases to reduce bone loss and form new bone. [1, 2]

Testicular Cancer. Testicular cancer accounts for approximately one percent of all cancer in men, and is the most common type of cancer malignancy among men between the ages of 20 and 35. If not detected and treated in time, the progression of testicular cancer may result in the surgical loss of one but rarely both testes. To compensate for the gonadal loss, patients commonly take testosterone replacement therapy.

Anti-Aging Considerations

As men grow older, they often experience loss of reduced sexual drive and performance, abdominal obesity, hair loss, memory loss, muscle strength and bone density, etc. One of the major factors that influence the aging process is lowered production of hormones. As men grow older, their testes have fewer functioning Leydig cells, as well as reduced production of hormones in the hypothalamus and pituitary glands, which also contributes to reduced production of testosterone.

Some experts hail testosterone supplementation as a safe and effective way to substantially reduce the effects of aging and enjoy enhanced quality of life [1, 3], while others are more cautionary and advise that the risks may outweigh the benefits, particularly for individuals with otherwise normal testosterone levels for their age group. [2, 7, 8, 10, 11, 13-15].

Safety Considerations

Testosterone supplementation may prove beneficial for men with low testosterone levels; however, supplementation for men with normal levels for their age group may involve risks that outweigh the anticipated benefits. Quoting from "The Anabolic Action of Testosterone," an editorial in The New England Journal of Medicine (July 4, 1996): "The concern that testosterone may be hazardous stems from the belief that is partly responsible for the higher risk of coronary artery disease in men than in women; that little, if any, prostate cancer develops in men without active Leydig cells; and that androgens induce rage and anger." [11]

Adverse reactions are identified by the pharmaceutical companies that produce testosterone replacement products [skin patches, intramuscular injections, etc.] that "may effect 1% or more" of patient populations.


[1] Regelson, M.D., William and Colman, Carol, The Super-Hormone Promise (New York: 1996, Simon & Schuster), pages 115-152. ISBN: 0-684-83011-6

[2] Klatz, D.O., Ronald with Kahn, Carol, Grow Young with HGH (New York: 1997, HarperCollins Publishers, Inc.), pages 181-186. ISBN 0-06-018682-8

[3] Cranton, M.D., Elmer and Fryer, William, Resetting the Clock (New York: 1996, M. Evans and Company, Inc.), pages 166-181. ISBN 0-87131-823-7

[4] Baker, H.W.G., "Testicular dysfunction in systematic disease," in: Becker, K.L, ed., Principles and Practice of Endocrinology and Metabolism, 2nd edition (Philadelphia: 1995, J.B. Lippincott Co.), pages 1083-1089.

[5] Hendler, M.D., Ph.D., Sheldon Saul, The Doctor's Vitamin and Mineral Encyclopedia (New York: 1990, Fireside), pages 201, 385-387. ISBN 0-671-66784-X

[6] Journal of Applied Physiology article on a Penn State study, cited in the Penn State Sports Medicine Newsletter (March 1997), and cited in http://www.psu.edu/ur/NEWS/news/imbalance.html

[7] Colgan, Ph.D., Michael, Optimum Sports Nutrition: Your Competitive Edge (Ronkonkoma NY: 1993, Advanced Research Press), pages 389-390. ISBN 0-964840-5-9

[8] Mindell, R.Ph., Ph.D., Earl, Earl Mindell's Anti-Aging Bible (New York: 1996, Fireside), pages 258, 269-270. ISBN 0-684-81106-5

[9] Klatz, D.O., Ronald and Goldman, D.O., Robert Stopping the Clock (New Canaan, Connecticut: Keats Publishing, Inc., 1996), pages 95-111. ISBN: 0-87983-717-9

[10] Winter, M.S., Ruth, The Anti-Aging Hormones (New York: 1997, Three Rivers Press, Crown Publishers, Inc.), pages 136-158. ISBN 0-609-80015-9

[11] Bhasin, S., Storer, T.W, et al., "The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men" in The New England Journal of Medicine, July, 4, 1996; vol. 335, no. 1, as cited in the journal's website and a same-issue editorial online at http://www.nejm.org/public/1996/0335/0001/0001/1.htm and http://www.nejm.org/public/1996/0335/0001/0052/1.htm

[12] Grinspoon, S., Corcoran, C. et al. "Loss of lean body and muscle mass correlates with androgen levels in hypogonadal men with acquired immunodeficiency syndrome and wasting," Journal of Clinical Endocrinology and Metabolism. 1996; vol. 81, no. 11: pages 4051-4058.

[13] Cherniske, M.S., Stephen, The DHEA Breakthrough (New York: 1996, Ballantine Books, a division of Random House), page 36. ISBN 0-345-41140-4

[14] Evans, Ph.D., William and Rosenberg, M.D., Irwin H., Biomarkers: The 10 Keys to Prolonging Vitality (New York: Fireside, 1992), page 4. ISBN: 0-671-77898-6

[15] Lamm, M.D., Steven and Couzens, Gerald Secor, Younger at Last: The New World of Vitality Medicine (New York: 1997, Simon & Schuster), pages 70-74. ISBN 0-684-83438-3





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