Low Testosterone Treatment (TRT) – New & Updated Guide

Low Testosterone Treatment (TRT) – Ultimate Guide

No man wants to experience the symptoms and effects of low testosterone, but this is a problem that does impact on the lives of some men and for various reasons.

While only a small percentage of men suffer with low testosterone, the risk increases with age. So the older you get, the higher the chance your T levels are going to drop to the point where you experience some potentially life altering symptoms.

Thankfully, if you do find yourself with lower than normal testosterone levels there are a good number of options at your disposal to get the problem under control and regain your quality of life as a man.

What is Low Testosterone? (TRT)

Low testosterone in men is medically called hypogonadism. A testosterone deficiency happens when your body is not making enough of this essential male sex hormone which is a powerful androgen that’s responsible for or contributes to so many aspects of your physical and mental health as an adult male.

Men have their highest natural levels of testosterone between 20 and 30 years of age, and it naturally starts to reduce from then on over the next several decades.

How is Low Testosterone Diagnosed? (TRT)

Even though you might suspect that your testosterone levels are below normal if you’re experiencing some symptoms, the only way to find out for sure is to visit your doctor. Many illnesses can cause most of the different effects that you’ll see with low testosterone, so it’s important not to jump to conclusions without a proper medical diagnosis.

Your doctor will ask about your medical history, lifestyle including diet and exercise habits, and of course ask about the symptoms you’re concerned about. These might be anything from low energy and depression, to low sex drive, weight gain or a combination of many different signs.

If your doctor decides a testosterone test is necessary, you’ll have a simple blood test where testosterone serum levels are determined. Because your T levels naturally fluctuate throughout the day, and are usually at their highest early in the morning, your doctor might advise getting the test done early in the day for the most accurate result.

In a lot of cases your doctor will want two separate blood tests on different days to compare T levels across both. To be accurately diagnosed as having low testosterone levels, both of these tests will need to come back with low T levels clearly showing. If this happens, you’ll likely be having further blood tests for other hormones and other blood components that could impact your testosterone,

This allows your doctor to build a fuller picture of exactly what’s going on with your T levels and what might be the underlying cause.

Common Symptoms of Low Testosterone

Low testosterone levels can bring about a whole range of different symptoms and signs. Some of these can seem very benign and you can easily overlook them or assume they’re being caused by some other health issue, or that you’re just tired and rundown.

It’s when a combination of these symptoms start developing together that you might start suspecting that testosterone is the problem.

Here are some of the most common symptoms associated with low testosterone:

• Tiredness, low energy and reduced physical ability; general physical fatigue
• Concentration and memory problems; lack of focus at work and home
• Signs of depression like sadness and reduced motivation
• Noticeable loss of muscle mass
• Gaining of fat even if your diet or exercise regime hasn’t changed
• Negative changes to cholesterol levels
• Less facial hair growth and loss of body hair
• Decreased sex drive and erectile function

Many men will experience some of these issues throughout adult life for different reasons, but when you start noticing multiple signs occurring at the same time, it’s time to see your doctor to ask about testosterone.

Low Testosterone Treatment Options

Once you’ve confirmed through your doctor that you do indeed have a low testosterone condition, it’s time to think about treatment options.

The path you go down to treat your low testosterone will greatly depend on the cause; if it’s an underlying health issue then you may require medication, while hormonal dysfunction can make you a candidate for testosterone replacement therapy. In many cases, lifestyle adjustments will also be recommended to encourage healthy testosterone function.

Testosterone Replacement Therapy

TRT is a reliable and often used therapy for low testosterone in men when the cause of low T has been found to be basic hormone production. In other words, there aren’t underlying medical issues or disease causing the low testosterone. In cases where there is disease, TRT may still be used to relieve the serious symptoms of testosterone deficiency. While TRT will be effective at increasing circulating testosterone levels, it won’t necessarily fix all of your symptoms.

Types of TRT include topical or transdermal such as gels and patches, injections, oral patches and nasal gels. Men who are planning to have children soon will not be prescribed any TRT treatments. Topical testosterone products should also not come into contact with children and women, so must be used with care.

The three main types of medical treatments for low testosterone are testosterone replacement therapy which comes in various forms, and prescription medications in the categories of estrogen blockers and aromatase inhibitors.

Testosterone

Although there are different forms of direct testosterone treatment, they all have the same goal and that is to provide a direct source of the testosterone hormone into the body. This can be done by using a patch that slow releases testosterone through the skin, or gels and pellets that act in a similar way. These transdermal patches and gels are a popular option because they’re easy to use provide a stable release of testosterone. These must be used carefully however, as they should never come into contact with women and children.

Another option is testosterone injections which make use of synthetic testosterone in a slow release intramuscular injection form which is long acting so you do not require very frequent injections – usually just once every 3 months. Testosterone treatment is generally not used in age related low testosterone, but mainly for men suffering hypogonadism which is being caused by certain disorders concerning the pituitary gland, testicles or hypothalamus with the main goal of treating the severe symptoms of low T.

Medications

Besides medications which might be prescribed to treat an underlying health condition, other more specific medications for low testosterone are an option. These are not often prescribed because of the risk of side effects and the relatively low benefit they deliver. The main categories of medications include aromatase inhibitors (Arimidex) and selective estrogen receptor modulators (Clomid).

Clomid (Clomiphene Citrate)

 

All men have small amounts of estrogen naturally produced in the body, and that is critical for normal testosterone to function. By taking an estrogen blocker like Clomid, males will be able to have an increased amount of testosterone production stimulated in the brain as the medication stops estrogen from interacting with the pituitary gland. This allows more luteinizing hormone (LH) and follicle-stimulating hormone (FSH) to be produced, leading to higher testosterone production.

Arimidex (Anastrozole)

 

Aromatase inhibitors (AI) drugs stop the conversion of testosterone into estrogen, allowing a higher level of testosterone to remain in circulation. These medications stop the aromatase enzyme from undertaking this hormone conversion and thus limit the level of estrogen present; the higher the level of estrogen in a male, the lower testosterone will be.

Aromatase inhibitors are mostly useful in men who have low testosterone due to age, or due to being overweight. Arimidex is a common AI drug used for this purpose.

These drugs, when used to treat the symptoms of low T, are being used off label as most were originally developed to treat serious medical conditions in women like breast cancer. These estrogen blocker or estrogen modulator medications can help address any rise in estrogen in males while testosterone is deficient; therefore helping restore the hormonal balance. Erectile dysfunction and infertility are two circumstances where testosterone deficient men might be using these types of medications.

Natural Products

Different herbal remedies and other natural supplements may be used to encourage testosterone function. Some natural products have been in use for centuries, while others come and go with questionable claims. When considering a natural product it’s important you look closely at the evidence of how (or if) it can specifically help with testosterone deficiency.

Some natural products can help you address specific symptoms and you may choose to use them alongside other types of treatments for low testosterone. One of the great benefits of most natural remedies is the lack of side effects and low cost, while the downside is that they are not always guaranteed to give you the results you expect.

Natural Treatments for Low Testosterone

Natural low testosterone treatments are highly desirable because they provide a possible solution or at least an improvement to your testosterone, with little to no risk of adverse side effects. They can also be very affordable or as simple as implementing some small changes or additions to your diet and lifestyle.

Natural Testosterone Boosters

Some health and supplement companies have developed formulations that specifically target the issue of low testosterone. These generally have the main goal of naturally boosting testosterone production, and they aim to do that by using only natural ingredients. There are no steroids or other synthetic hormones in any of these products. Ingredients such as herbs, extracts, vitamins and amino acids can feature in these products.

Not all products are created equal, and there are certainly many so called natural test boosters out there which have powerful marketing behind them, but little to no results to show for it.

Testosterone Boosting Herbs

Herbs have been used by humans to treat or enhance just about any and all aspects of health for thousands of years. The first pharmaceutical drugs, and even those today, are based on medicinal plants and their various powerful components.

Some herbs have a long history of being very effective, and that includes their use for enhancing virility, fertility, energy, and even helping to contribute to testosterone function.

Along with herbs, certain vitamins, minerals and amino acids have shown to be effective and in some cases, essential for testosterone function and may be able to help boost your T levels. Here are 15 of the best testosterone boosting herbs, vitamins and minerals:

• D-Aspartic Acid – Although not technically a herb or a mineral, but instead an amino acid, D-Aspartic Acid is another natural ingredient we so often see in testosterone boosting supplements – and for good reason. But it can also be used on its own. D-aspartic acid is closely involves in the process of testosterone production and studies show it’s particularly good at increasing total testosterone in men who don’t regularly undertake resistance training.
• Zinc – Considered the most important mineral for testosterone health, zinc is powerful enough that being deficient in this mineral can lead to low testosterone levels. Studies show that males who take in just 30mg daily of zinc see a measurable increase in testosterone. Zinc can be consumed through food, and supplements are also available. As a trace mineral, we only need a small amount so there’s no need to over-do the zinc.
• Magnesium – If you are deficient in magnesium, taking a supplement of this mineral can help restore normal testosterone levels. Supplementation of magnesium has also shown to help raise free testosterone levels in men who regularly exercise, and while it can also raise testosterone in sedentary men, those who work out regularly have shown to receive the greatest benefit. Many testosterone supplements contain a combination of zinc and magnesium to take advantage of the powerful testosterone enhancing qualities of both these minerals.
• Vitamin D – Deficiency in Vitamin D is common and it’s been found that when you’re deficient you are also at risk of low testosterone; indicating that this vitamin plays a critical role in testosterone production. It’s possible that increasing your vitamin D level, and ensuring you don’t become deficient, might boost testosterone as well as enhance sperm quality and boost other health issues that arise with low T, like low energy and depression.
• DHEA – Dehydroepiandrosterone or DHEA is a steroid hormone that the body naturally produces. Some of this hormone is converted to testosterone in the body, so taking a DHEA supplement may help increase testosterone. Experts state that DHEA should not be taken in combination with testosterone as this can result in gynecomastia and low sperm count.
• Ashwagandha – This ancient medicinal herb may be useful in boosting testosterone particularly in men who are suffering with stress, as it has shown to potentially lower the level of cortisol – a stress hormone that can bring about a decrease in testosterone. Enhancing sexual functions and body composition are extra benefits of Ashwagandha.
• Fenugreek – A powerful compound in fenugreek – furostanolic saponins – may be responsible for helping boost testosterone and that has made this herb a common ingredient in many testosterone boosters. It can also be taken alone as a supplement. Multiple studies have showed the benefits of fenugreek in increasing testosterone levels.
• Tribulus Terrestris – One of the more controversial testosterone boosting ingredients, Tribulus Terrestris has shown to have some benefits for male health but has not specifically shown benefits clearly in studies that it does increase testosterone. However, it can be useful for addressing symptoms of low testosterone such as enhancing the libido.
• Tongkat Ali – This herb can be useful particularly for older men who are suffering with age related low testosterone. Studies have shown supplementing with Tongkat Ali everyday resulted in a notable increase in levels of serum testosterone after just one month.
• Yohimbe – This extract comes from the bark of a tree, and may boost libido and help with fat loss. But what about boosting testosterone? There is no clear evidence that this extract will boost your T levels, but it can help with those low testosterone symptoms that relate to low libido and fat gain.
• Horny Goat Weed – This herb has long been used to assist sexual performance and as a natural aid for erectile dysfunction (ED). This can lead to thoughts that it could increase testosterone and the jury is still out on its effectiveness on T levels. It is most useful for treating the more worrying symptoms of low testosterone like low libido and ED.
• Panax Ginseng – Another ancient herb which has also been scientifically studied in the modern day to determine its true benefits. Panax ginseng contains a compound called Ginsenoside Rg1 and it’s this that’s thought to be responsible for its ability to boost serum testosterone levels. As a bonus, ginseng enhances many of the areas that suffer when you have low T: it can help with ED and brain function, and boosts immunity.
• Vitamin B6 – Deficiency in vitamin B6 may contribute to lowered testosterone levels, among other health issues. Although B6 alone is unlikely to significant boost testosterone, it is known that this vitamin has some important function in the way testosterone is produced. Vitamin B6 is often combined with zinc and magnesium to provide a testosterone boosting super supplement.
• Maca Root – Maca is commonly included in testosterone booster supplements, although its ability to boost testosterone is still being evaluated and as yet, studies have not shown that it can directly improve testosterone levels. However there are still some useful benefits of Maca Root targeting symptoms of low testosterone; especially in improving libido and potentially improving fertility.
• Rhodiola Rosea – This herb has long been used to help with ailments like depression and fatigue and improving sleep quality. Since excessive and ongoing stress has the potential to negatively impact testosterone, Rhodiola Rosea may be able to indirectly help improve testosterone function by reducing stress and the negative effects of the stress hormone cortisol.

Testosterone Boosting Foods

Research has shown that some foods may be able to raise testosterone naturally if you include them regularly in your diet. These foods all have other positive health benefits as well, so there’s certainly no harm in adding them to your meals on a regular basis. Here are ten of the best foods that may help boost low testosterone:

• Ginger – Ginger has long been used to help improve fertility and some studies have shown ginger supplementation can increase testosterone. Consuming enough ginger in the diet without a supplement might seem tricky, but this spicy ingredient goes well with healthy orange vegetables like sweet potato and pumpkin. Ginger can be used powdered and dried, or fresh and can be added to a range of meals to spice up your health and flavor.
• Leafy Greens – Magnesium is another mineral that has shown to contribute to the restoration of normal testosterone levels when the cause of the low T is a deficiency. This shows it has a critical impact on testosterone, and leafy greens are packed with magnesium. Collard greens, kale, spinach, turnip greens and mustard greens are all high in magnesium and simple to add to meals.
• Fortified milks and cereals – Some cereals and milks are fortified with Vitamin D, so these are an easy choice over non-fortified types. Avoid high sugar cereals. Plant milks such as almonds, soy, and flax can provide a quarter of your daily vitamin D requirements and there’s little need to worry about consuming soy, as studies have debunked the myth that soy lowers testosterone
• Olive Oil – It’s easy to include olive oil in your diet as it can be poured on just about anything from salads to hot meals. The extra virgin type is your best bet as this is the least processed and healthiest form of olive oil.
• Legumes – A lot of different legumes contain enough zinc to make them beneficial to testosterone health. They also come with a huge range of other health benefits and provide a meat-free protein source. Lentils, chickpeas and even baked beans are quality zinc sources.
• Oysters – They’re not everyone’s cup of tea, but if you can stomach the occasional oyster they hold clear and proven benefits for testosterone health. Oysters are extremely rich in zinc, which is one of the most critical minerals for testosterone and reproductive function.
• Red meat – Moderate amounts of high quality, lean red meat and in particular beef will provide a good source of Vitamin D and zinc. Avoid fatty cuts and avoid consuming it everyday to maintain the benefits without falling into the negative effects of eating too much meat.
• Omega-3 fatty acids – Not a food in itself, but eating foods that are rich in omega-3 can provide a boost to testosterone serum levels. It’s also critical for brain health which will lift your mood and mental focus. Fatty fish like salmon, sardines and mackerel all contain rich amounts of omega-3.
• Eggs – The yolk of eggs is a rich source of Vitamin D, and we know this vitamin contributes to normal testosterone function. Consider adding one egg daily to your diet, and make sure the yolk is included as that’s where the greatest benefit lies for Vitamin D consumption.
• Shellfish – Like oysters, shellfish is also zinc rich and studies clearly show that consuming small amounts of zinc regularly can increase levels of free testosterone. Deficiencies in zinc can be associated with low testosterone, so consider this trace mineral a top priority in your diet.

Your diet is one of the most critical lifestyle areas that can directly impact your testosterone health, and you have full control over it. What you eat can have a greater impact than you might think on your testosterone levels.

Testosterone Boosting Exercises

We know that exercise has an all encompassing benefit for health. So will it help with your low testosterone? It can certainly assist with reducing some of the symptoms, but more than that it’s known that exercise does help stimulate testosterone production. Sedentary men are likely to have lower testosterone levels, as well as be overweight.

• Weight training – Any sort of high intensity resistance training is essential so include bench press and general weight lifting into your routine a few times weekly. Weight lifting is still considered the best type of exercise to boost testosterone, so ensure you make it a priority.
• Interval training – Interval training involves interchanging high intensity exercise with lower intensity routines. For your high intensity portion you could combine weights or fast aerobic activity for five minutes, followed by a minute or two of a slow jog or walk. Repeat this or 30 minutes and you have a top quality workout for testosterone health.
• Hiking – Don’t want to hit the gym or do structured exercise? Take a hike then, and include some uphill portions to get the blood pumping and the leg muscles working. An intense 30-60 minute hike a few times per week is going to provide a real testosterone and health boost.
• Push-ups – Making use of important large joints and muscles, push ups are a sure fire testosterone boosting exercise you can fit into even the busiest of schedules. Make sure your hands are kept at shoulder width, and lower yourself as far as possible. If you’re rusty on push-ups it will take some time to get down low, but keep at it and go a little further each time.
• Pull-ups – Again, you’re making use of big joints and muscles which is where the greatest testosterone benefit is. Pull ups can be done almost anywhere including at home. 4 sets of 8 reps with a couple of minutes rest in between will give you a super workout any time of day with minimal equipment.

Any exercise is good, but higher intensity exercise provides the greatest benefit

Testosterone Replacement Therapy

TRT can come in many different forms, but all have the one aim and that is to provide you with a direct source of the testosterone hormone which will start working immediately to both relieve the symptoms of low testosterone, and to encourage an increase in your levels of circulating testosterone

How can you get TRT?

The different methods of TRT simple provide various ways of physically getting the testosterone into your body and bloodstream. All have their positive and negative aspects. The main forms of TRT products are:

Topical / Gels

Topical gel options provide a non-invasive and pain free way of obtaining testosterone. They are simply applied to the skin like any cream and it is then absorbed through the skin. AndroGel and Testim are common brand names. This method allows a slow and stable release of testosterone, with the downsides being the risk of the gel being transferred to other people who come into contact with it, and this must be avoided.

Injections (Depo-Testosterone)

Many men may be more hesitant about injectable forms of TRT, but injections usually come with the big benefit of only being required once every few months. Injections are either put into the muscle or under the skin. The downside of injectable TRT is less control over the release of testosterone and this results in changing levels, possibly bringing about side effects of mood swings and energy dips.

Patches (Androderm)

Patches provide another non-invasive and do it yourself TRT option similar to gels. The transdermal patch slow releases testosterone through the skin. Itching and irritation on the patch site can be potential side effects.

Oral tablets – Andriol (Testosterone Undecanoate) and Virilon (Methyltestosterone)

Tablets are easy to take but this is rarely an option that is prescribed by doctors for low testosterone treatment. The main reason is that they pose a great risk to the liver, especially when used for long periods of time. Those at higher risk of stroke or heart attack would need to strictly avoid oral tablets like Andriol as these drugs increase the risk of cardiovascular complications.

Pellets

Pellets are implanted just under the skin and allow the gradual release of testosterone. Usually the hormone is released over a period of several months. Many people are not comfortable with having a pellet placed under the skin, although the treatment itself is highly convenient once the minor implant procedure has been done.

Why Men Use Testosterone Replacement Therapy

Men decide to use TRT to address the distressing effects that come with having low testosterone, as well as to help address certain sexual problems, or just to boost physical performance and body composition.

• Treating Low T – Treating low testosterone is the intended use of TRT. TRT is a common and effective treatment for men who suffer with hypogonadism that comes with symptoms. The TRT will relieve these symptoms which will include increasing energy and the libido, improving mood and focus, building muscle and losing body fat.
• Remedying Erectile Dysfunction – Men with low testosterone who have erectile dysfunction can benefit from TRT, but many men with ED are not experiencing the condition due to low T, but rather due to other health issues. In those cases, TRT is unlikely to be of any benefit. The TRT can still contribute to restoring a man’s sex drive.
• Enhancing Physical Performance – TRT may be used to boost physical performance, and this can be considered as anabolic steroid use. The extra testosterone boosts strength and muscle growth, encourages fat burning and provides all the expected benefits of testosterone. TRT dosages are generally very low, and those wanting a big boost to performance often go far beyond the medically recommended TRT dosage schedule.

TRT Side Effects

TRT can come with risk of side effects, ranging from mild up to more serious but uncommon adverse effects. Your doctor will do a full run down of your medical history and current health to work out your side effect risk profile, and whether it’s safe for you to undertake TRT.

The side effects of TRT can be considered in two categories: one relates to the method itself that you’re using to obtain the testosterone and any local effects it might cause. Secondly are the potential negative reactions or impacts of the testosterone itself.

• TRT may increase the risk of infertility and cause a shrinkage of the testicles.
• Increased risk of oily skin and acne can occur.
• Prostate cancer and BPH can develop due to increased growth of the prostate.
• There is possible a higher risk of cardiovascular issues and strokes with some forms of TRT.
• Transdermal treatments like gels or patches may irritate the skin, while injections may be painful.
• Injectable TRT can bring about fluctuations in mood and sex drive.
• When TRT treatment stops, symptoms can return as your body’s ability to make testosterone has been suppressed.

These are some of the main possible side effects to consider with testosterone replacement therapy.

Common FAQ

Who Shouldn’t Take Testosterone Replacement Therapy?

Men with certain medical conditions should not take TRT. This includes anyone with prostate or breast cancer, severe sleep apnea, heart failure and urinary tract conditions. Your doctor will take a complete medical history to determine whether TRT is safe for you.

What are the side effects of testosterone replacement therapy?

Since taking testosterone is in effect the same as taking anabolic steroids, just at a much lower dose, you may be at risk of experiencing the side effects that come with increased androgenic activity and this can include acne, enlargement of the breast tissue and fluid retention. If these effects do occur, your doctor may adjust the TRT dosage.

What is the best medical treatment for low testosterone?

Debate still rages among medical experts as to which medication or treatment is the best option for low testosterone. Testosterone replacement is still the most common form of medical treatment for low T. But the best treatment for you personally is the one that addresses both the cause and severity of your condition.

What is the best testosterone booster?

The best booster for you might be different to the best one for the next guy. It heavily depends on the cause of your low T and what symptoms you’re getting. The best test booster when it comes to TRT is Testosterone Cypionate.

What are the best home remedies for low testosterone?

Home remedies for testosterone are easy to implement and mostly involve basic lifestyle changes, which will also improve all other aspects of your health. You should exercise more often (daily is ideal), eat mostly vegetables and whole-grains, plus legumes and fish while keeping red meat to a few times per week only.

Get enough sleep every night and try and keep your stress levels under control – all these simple home remedies will have a positive impact on testosterone.

How is TRT used medically?

TRT is used to treat hypogonadism, but is also useful in treating low testosterone that is being caused by other health conditions like autoimmune conditions, genetic disorders, and cancer radiation therapy.

Which is the best TRT therapy?

TRT comes in multiple formats. You can choose injections if you prefer to have your treatment just a few times annually, or if you prefer to avoid needles you have the option of taking tablets. All TRT options come with their own advantages and disadvantages and none are considered to be the best for every single guy – each individual will have different preferences.

What is the best natural supplement for low testosterone?

There may be no one best natural supplement for low T, but often a combination of multiple ingredients working together. Some of the most powerful natural supplements include Fenugreek and Ashwagandha, both of which have a notable history of being used in traditional medicine and both can potentially lead to improved testosterone levels. Other must-have natural supplements are zinc and magnesium, especially if you feel you are not getting enough of these testosterone boosting minerals in your diet

My Conclusion and Recommendation

There are plenty of options to look at when you need to boost your testosterone levels and keep them healthy long term. Most of us would love to boost testosterone naturally, without the risk of side effects and preferably without the inconvenience and cost of medical therapies.

The best recommendation is to focus on natural therapies: including natural supplements that include all the key testosterone booster ingredients like zinc, magnesium and D-Aspartic Acid as well as well established herbal extracts that are known to have testosterone benefits, such as ginseng.

There are some excellent testosterone booster supplements available, and many questionable ones. The key is to use one where the ingredients are clearly stated and where you know each ingredient is going to play a role in enhancing testosterone and/or addressing the symptoms of low testosterone. Combined with regular exercise that includes resistance training, a good sleep schedule, and the inclusion of some key foods in the diet, you can tackle low testosterone head on naturally.

If all else fails, or if your doctor strictly recommends it, TRT may be the only option for some men in certain situations.