Obese and overweight men see the greatest improvement in their testosterone levels if they lose weight with a combination of exercise and a restricted-calorie diet, according to research in the July Journal of Diabetes and Obesity. Aim to lose at least 15 percent of your weight — an amount that triggers a significant rise in testosterone, according to the results of the European Male Aging Study, which followed more than 2, men aged 40 and older for about four years.
The results were published in the February European Journal of Endocrinology. Sitting around. Being physically inactive could also lower your testosterone. When researchers had 30 sedentary young men participate in a week exercise program, they found that the participants' testosterone levels increased, according to a study in the April-June Indian Journal of Physiology and Pharmacology. Using narcotic pain medications. A review article in the May-June Journal of Opioid Management found a strong link between long-term use of narcotic pain medications and hypogonadism, but cautioned that researchers do not yet know whether there's a link between chronic pain management and low testosterone.
Talk with your doctor about how to stop using these medications, Saadeh advises. Using anabolic steroids. Make sure you let your doctor know if you're now using, or have ever used, steroids for bodybuilding. Using hair-loss medications. Not getting enough sleep. Hayes says. A review of research underscores the complicated relationship among excess weight, sleep disturbance, and low testosterone, and examines the recommendation that men both lose weight and use a CPAP machine to correct sleep apnea.
Current steroid users had lower levels of serum insulin-like factor 3 INSL3 compared with those who never used steroids 0. Former steroid users also had suppressed INSL3 compared with controls 0. No association was found between INSL3 and total testosterone. INSL3 levels remained lower in former steroid users compared with controls after adjusting for serum total testosterone, luteinizing hormone, sex hormone-binding globulin, age, body fat percentage, smoking and use of illicit drugs mean difference, —0.
In linear regression analysis adjusted for duration since steroid use stopped, longer steroid use was associated with lower INSL3. However, there was no recovery of INSL3 or total testosterone in men who formerly used steroids. Rasmussen said the lack of INSL3 recovery raises questions about what kind of treatment former anabolic androgenic steroid users may need to increase Leydig cell capacity.
Anabolic steroids disturb the hypothalamic-pituitary-gonadal axis, resulting in low levels of gonadotropins, leading to decreased endogenous testosterone production and reduced spermatogenesis. In the testicles, Leydig cells produce testosterone in response to luteinizing hormone released from the pituitary gland, but these cells also secrete INSL3. Rasmussen and colleagues showed that current users of anabolic steroids had approximately 15 times lower serum concentrations of INSL3 than healthy controls.
This indicates that anabolic steroids have a profound impact on Leydig cell function, but the prognostic and clinical relevance of subnormal levels of INSL3 still needs to be determined. Former users of anabolic steroids are more frequently diagnosed with infertility and also have a higher prevalence of medically prescribed testosterone supplementation. However, in a relatively large cohort of Danish men sanctioned for using anabolic steroids, the overall fertility rate and the prevalence of assisted reproduction was close to that in the background population, although associated with a temporary decline in fertility Windfeld-Mathiasen J, et al.
J Clin Endocrinol Metab. Furthermore, studies of seminal fluids from past users of anabolic steroids indicate that spermatogenesis tend to normalize. In spite of the uncertainties related to the reversibility of hypogonadism associated with anabolic steroids, these drugs cause a range of unpleasant and sometimes irreversible side effects, which do not encourage their use.
Healio News Endocrinology Hormone Therapy. By Michael Monostra. Source: Rasmussen JJ, et al. Disclosures: The authors report no relevant financial disclosures. Read next. March 20,
Rasmussen, M. Researchers at the hospital have identified a hormone made by Leydig cells -- cells in the testicles that produce testosterone -- as a promising biological marker of testicular function, Rasmussen said. Because blood levels of testosterone can vary greatly during the day and vary by body composition, Rasmussen and his co-workers are investigating a more stable marker than testosterone, called serum insulin-like factor 3 INSL3.
For this study, supported by Anti Doping Denmark, the research team included participants from another study: men who did recreational strength training. Their ages ranged from 18 to 50 and averaged Three study groups consisted of 46 men currently using anabolic steroids, 42 former steroid users and 44 who had never used these steroids.
On average, former users had reportedly not taken anabolic steroids for 32 months. Among current steroid users, INSL3 was markedly suppressed compared with former users and never-users, Rasmussen said. Compared with never-users, the former steroid users had lower INSL3 concentrations: 0. Furthermore, the longer the duration that the men reportedly used steroids, the lower their INSL3 levels, the researchers found.
Although the clinically relevant difference in INSL3 levels is not yet known, because INSL3 measurement is primarily for research, he said their findings indicate that prior steroid users may have an increased risk of hypogonadism later in life. This therapy would include drugs used to block estrogen production or its conversion to testosterone, such as aromatase inhibitors and selective estrogen receptor modulators, he noted.
Materials provided by The Endocrine Society. Note: Content may be edited for style and length. Science News. Serum insulin-like factor 3 levels are reduced in former androgen users suggesting impaired Leydig cell capacity. The participants in this study are guaranteed to remain completely anonymous.
Data contain explicit details on demographics of each participant in the study. If the dataset would be made publicly available, we fear some of the participants could be recognized and risk legal prosecutions or even retaliation from criminal distributors of anabolic androgenic steroids.
Abuse of anabolic androgenic steroids AAS is highly prevalent among male recreational athletes. The objective of this study was to investigate the impact of AAS abuse on reproductive hormone levels and symptoms suggestive of hypogonadism in current and former AAS abusers. All participants were aged 18—50 years and were involved in recreational strength training. Symptoms of hypogonadism depressive symptoms, fatigue, decreased libido and erectile dysfunction were recorded systematically.
Former AAS abusers exhibited significantly lower median 25 th —75 th percentiles total and free testosterone levels than control participants total testosterone: Overall, The group of former AAS abusers had higher proportions of participants with depressive symptoms Former AAS abusers exhibited significantly lower plasma testosterone levels and higher frequencies of symptoms suggestive of hypogonadism than healthy control participants years after AAS cessation.
Anabolic androgenic steroids AAS comprise testosterone and its synthetic derivatives. These compounds have been used for decades by professional athletes to enhance muscle strength and performance [ 1 , 2 ]. The setting of AAS abuse has changed within recent years. A recent meta-analysis estimated the lifetime prevalence of AAS abuse worldwide is 6.
These findings indicate AAS abuse is now prevalent in the broader population. Ongoing AAS abuse causes dramatic increases in plasma androgen levels that ultimately facilitate severe hypothalamic-pituitary-gonadal HPG -axis suppression due to negative feedback mechanisms involving testosterone and its metabolites [ 5 ]. However, information regarding the impact of AAS abuse on these reproductive hormones is very limited [ 6 , 7 ]. Anabolic androgenic steroid-induced hypogonadism ASIH is common among former AAS abusers and usually presents as hypogonadotropic hypogonadism due to abrupt decreases in plasma androgen levels following AAS cessation [ 1 , 2 , 5 , 8 ].
Scientific data on ASIH are limited, but the condition is characterised by symptoms and signs of hypogonadism such as: testicular atrophy, low plasma testosterone levels, impaired spermatogenesis, erectile dysfunction, fatigue, decreased libido and depressive symptoms; and is considered to resolve spontaneously within 6 to 12 months [ 2 , 5 ]. Studies investigating the recovery phases of young men with ASIH are, to our knowledge, virtually non-existent.
This emerging group of young men may become a considerable public health concern in the coming years. The objective of this study was to compare the reproductive hormone levels and symptoms suggestive of hypogonadism in young men with histories of current and former AAS abuse with those of healthy age-matched men. We conducted a community-based cross-sectional case-control study in the greater Copenhagen area from November to December We did not apply specific inclusion criteria regarding weekly hours of recreational strength training, nor did we apply inclusion criteria pertaining to the extent of AAS abuse.
Exclusion criteria for the three groups were: congenital hypogonadal conditions, medically prescribed testosterone therapy, known cardiovascular disease and diabetes mellitus. Participants were recruited primarily from fitness centres in the greater Copenhagen area and by internet advertising. The fitness centres included weightlifting gymnasiums which are not under surveillance by the Danish Antidoping Agency and are known to be frequented by AAS abusers.
The advertisement did not disclose the study entailed assessments of: androgen levels, fertility biomarkers, libido, erectile function or symptoms of depression or fatigue. The study was performed in accordance with the Declaration of Helsinki and all relevant legal regulations in Denmark. Oral and written informed consent was obtained from all participants prior to inclusion. Participants attended the research lab between and a. They were placed in the supine position for a minimum of 30 minutes.
All blood samples were then collected via a cannula in the right median cubital vein. One investigator JJR obtained a detailed AAS abuse history total duration, compounds, doses, use of other performance enhancing drugs during a clinical interview, using a structured questionnaire. We did not calculate overall average AAS doses in the AAS participants because the pharmacodynamics and pharmacokinetics of AAS compounds can vary considerably depending on their chemical structures [ 1 ].
Other information such as medical history, illicit drug use, smoking habits, alcohol use, strength training history total duration and weekly hours of training and demographics were also obtained. Free testosterone was calculated using the method suggested by Bartsch [ 19 ]. Low reference limits 2. Therefore, we assessed proportions of the control group and group of former AAS who exhibited low total testosterone levels using lower reference limits for both a subgroup of eugonadal nonobese healthy subgroup of young men The BDI-II is a question multiple-choice self-reported psychometric test, and each of its questions is scored using a scale ranging from 0 minimum to 3 maximum.
The questionnaire is highly validated and consists of five questions scored using a scale ranging from 1 to 5. Lower scores were suggestive of more pronounced fatigue symptoms [ 30 ]. The non-parametric Cochran-Armitage trend test was used to assess trends in hypogonadal symptoms and impaired spermatogenesis across the groups. The ordinal ordering of the groups for trend analyses was specified a priori. Assumptions of normal distributions with respect to numerical variables were evaluated by histograms and by assessing the linearity of residuals in a quantile plot.
Numerical variables were compared across the groups by analysis of variance ANOVA and presented as mean standard error if the assumptions of a normal distribution and equality of variance were fulfilled. These variables are presented as medians 25 th — 75 th percentiles. We used piecewise linear regression linear splines , allowing varying slopes, to model nonlinear associations.
All data were analysed using SAS version 9. A total of 37 current AAS abusers, 33 former AAS abusers and 31 control participants volunteered to participate in the study. One participant from the control group was excluded due to cryptorchidism which was diagnosed during the study, so 30 control participants were included in the final analyses.
The two groups reported previous and current experience with varying doses of numerous AAS compounds, of which testosterone esters, trenbolone, nandrolone, stanozolol, sustanon and boldenone were the most widely used S1 Table. None of these participants reported having used AAS within six months and only Eleven former AAS abusers had previously been referred to an endocrine clinic for gynaecomastia, but none had been treated for gynaecomastia, hypogonadism or infertility.
These participants did not differ from other former AAS abusers in terms of demographic characteristics, AAS abuse, laboratory results or frequency of hypogonadal symptoms. Testicular size differed significantly among the three groups. Current AAS abusers had the smallest testicular volume Plasma total and free testosterone levels were significantly lower among former AAS abusers than among control participants and current AAS abusers, the latter of whom exhibited significantly increased plasma testosterone levels, as expected.
The 2. Results are medians 25 th — 75 th percentiles unless otherwise stated. A high percentage of participants in the group of former AAS abusers Further, among former AAS abusers 3. We did not observe any significant associations between plasma total testosterone levels and accumulated duration of AAS abuse log2 coefficient B : 0. Among current AAS abusers, increasing accumulated duration of AAS abuse was associated with decreasing serum inhibin B levels, which reached a plateau after 64 weeks of accumulated AAS abuse spline function, log2 coefficient B : Footnote: AAS, anabolic androgenic steroids; s- , serum.
Former AAS abusers exhibited the highest frequencies of participants with depressive symptoms We did not observe any significant associations between symptoms and hormonal levels or extent of AAS abuse among former AAS abusers. Footnote: T bars show standard errors.
AAS, anabolic androgenic steroids. The key findings of this study were that the group of former AAS abusers exhibited significantly lower plasma total and free testosterone, smaller testicular sizes, and featured a higher proportion of participants with depressive symptoms, fatigue, erectile dysfunction and decreased libido than the control group more than two years after AAS cessation.
These results indicate that a considerable proportion of former AAS abusers exhibited persistent ASIH features, such as biochemical and functional hypogonadism, years after AAS cessation. We assessed percentages of the groups of control participants and former AAS abusers below the reference limit for plasma total testosterone using reference ranges for both a subgroup of nonobese eugonadal healthy young men Our findings were that a high proportion of former AAS abusers were below the reference limit for eugonadal nonobese healthy young men compared with none of the control participants, but only 3.
These findings suggest a rather high proportion of former AAS abusers exhibit testosterone levels in the low area of the normal range years after AAS cessation, whereas only a small proportion of former AAS abusers exhibit persistently marked low testosterone levels. Nevertheless, accumulated duration of AAS abuse was strongly associated with decreasing levels of inhibin B and AMH, suggesting the extent of AAS abuse may be important with respect to spermatogenesis recovery and that it may increase the risk of permanent fertility impairment as shown in previously reported cases [ 10 , 12 — 15 ].
A higher percentage of former AAS abusers exhibited inhibin B levels suggestive of impaired spermatogenesis than control participants, although the difference was not statistically significant. Nevertheless, this difference may have impacted fertility among former AAS abusers at a population level. Furthermore, it is possible that post-cycle therapy may have reduced the frequency of impaired spermatogenesis in the group of former AAS abusers. We noted a high proportion of former AAS abusers exhibiting symptoms suggestive of functional hypogonadism.
We did not observe any associations between these symptoms and reproductive hormone levels. The symptoms we observed among former AAS abusers may have been a consequence of abrupt decreases in plasma androgens, from supraphysiologic levels to low or normal levels, following AAS withdrawal, as opposed to specific plasma testosterone levels.
Kanayama et al. Declines in muscle mass resulting in a more normal body composition, may have caused body image concerns among former AAS abusers in this study as well as functional symptoms of hypogonadism, after AAS cessation. It is also a possibility that former AAS abusers exhibited symptoms consistent with depression and sexual dysfunction before they started using AAS and their symptoms relapsed following AAS cessation. The results of the present study are generally consistent with those of the recent study by Kanayama et al.
To our knowledge, no studies have previously investigated the fertility or biomarkers of Sertoli-cell function in former AAS abusers. Two smaller studies measured serum inhibin B in current AAS abusers and reported levels similar to those measured in current AAS abusers in this study [ 6 , 7 ]. A few minor studies have investigated sperm counts and morphology in current AAS abusers only and noted severe impairment [ 35 , 36 ].
This study had several limitations which should be addressed. We interpreted the results in this study using a pseudo-longitudinal approach, but the cross-sectional study design limited our ability to determine causality. Longitudinal participant androgen level monitoring and repetitive urine testing for AAS metabolites would have been ideal, as intermittent AAS abuse is not uncommon among individuals who have stopped using AAS, and we cannot exclude the possibility that the decreased testosterone levels and higher frequencies of hypogonadal symptoms, noted among former AAS abusers in this study, were signs of intermittent AAS abuse and thus indicative of the fact that a much shorter time interval had elapsed since AAS cessation than those reported by the participants.
We also have no evidence that participants in the groups of current and former AAS abusers were similar to the control group before starting AAS abuse. Therefore, the results of this study may simply reflect differences among three groups that were already present at baseline. However, the characteristics of the three groups were generally comparable with respect to important demographic parameters.
Additionally, participants were recruited from the same communities, which were primarily located in the greater Copenhagen area. The participants volunteered from the community and were not patients from our clinic, but we cannot exclude the possibility that this study may have been affected by selection bias. Recall bias may also have affected our results, as considerable amounts of data were obtained via self-reported histories. We did not screen the urine of the participants for AAS metabolites, but plasma SHBG levels have previously been shown to decrease rapidly during short-term supplementation with the oral AAS, stanozolol, in young healthy men and women [ 37 , 38 ].
In this study all former AAS abusers exhibited plasma SHBG within the normal reference range and excludes that oral AAS were abused in this group while injections with testosterone could possibly still have been used. We did not obtain sperm samples which could have provided valuable information regarding fertility among the participants. Sexual dysfunction was frequently noted among former AAS abusers and could have biased the semen results, as these participants would likely not have been able to provide semen samples or may have even refused to participate in the study.
Current AAS abusers exhibited biochemical abnormalities suggestive of impaired spermatogenesis, which were associated with increasing accumulated duration of AAS abuse. ASIH may become a public health concern with respect to male infertility and hypogonadism. The authors are grateful to all who participated in the study.
For many men low testosterone is not something they give a lot of thought to; its not because they dont care, its because they simply dont know. Every man alive notices as he ages he slows down, he has less energy, his sex drive isnt what it used to be and his physique really begins to suffer and generally its all shrugged off as part of the aging process. If thats not enough many men as they age begin to suffer from insomnia, they experience greater stress and the ability to adequately deal with it goes out the window; it is very common for a man to become very complacent.
While there can be many factors that lead to this end most commonly is that of low testosterone and if any of this rings a bell, if this sounds like you in any way you need to have your testosterone levels checked. If you suffer from any of the following symptoms we can almost guarantee you have a low testosterone problem; they include but are not limited to:. While none of the listed symptoms are of a life threatening nature one could hardly call them inconsequential and when we look at the physique related ones such symptoms can lead to and promote a host of other varying health related problems.
Further and of interesting note, in recent years several studies have found low testosterone may indeed be one of the leading causes of dementia and ailments such as Alzheimers disease. As you can see, when all things are considered low testosterone is no joking matter.
If you suffer from low testosterone and its important to note, if you do you may not suffer from all the above symptoms, many men will only display a few in the beginning but blood work is the only way to know with certainty. Once your levels are determined remedy is a very simple process as you will be prescribed pure testosterone.
While this prescription can come in many various forms in-terms of application the hormone itself is the same within each; in that, testosterone is simply testosterone but varying forms will be more effective and efficient than others. To receive treatment for your low testosterone condition you must consult with your doctor and take the proper steps to remedy the problem.
For most men, testosterone levels will begin to decrease dramatically in their 40's and drop faster and faster each and every year; while age 40 and beyond is a common place to see dramatic drops many men in their 30's often have a problem and far more than you might expect. As testosterone is an essential hormone, one of the most important hormones we produce many problems can begin to occur as our levels go down.
Such problems will not only affect our physique but our sexual function, mental clarity and simply our overall quality of life. For many men the symptoms of low testosterone start out very mild; it is rare for a man's testosterone to drop dramatically all at once; it's usually a slow and gradual process.
As this occurs so slowly many men become accustomed to the problems and symptoms; in-fact, they get a little lethargic about it. The good news is there is a remedy for low testosterone symptoms; no, we cannot cure low testosterone but we can treat it and the process is very simple. While low testosterone symptoms may appear very slowly, they can be very problematic and bothersome to say the least.
Low testosterone itself is not a life-threatening condition, as we examine the symptoms we cannot call any of them fatal. However, as we will see, if the condition is ignored low testosterone can be a gateway to many far more serious complications; many of which can be life-threatening indeed.
Such Symptoms include:. These are the common low testosterone symptoms, and as lethargy is one of them it's no surprise so many men ignore the problem. Regardless it's hard to put a positive spin on any of the above symptoms and as mentioned if low testosterone is ignored it can lead to many far more serious conditions such as:.
If you suffer from low testosterone, the first step is examining the general low testosterone symptoms listed above. You do not have to suffer from the entire list; if left ignored you more than likely will at some point but initially most physicians will want to examine you if you show two or more. Most commonly one of the two will be sexually related; erectile dysfunction or decreased libido plus another from the list; in any case, to determine your condition blood work will need to be done, and your testosterone levels will be checked via this route.
In truth, if you suffer from any of the low testosterone symptoms, especially those of a sexually related nature the odds are strong you suffer from low testosterone but the blood work is still necessary to make an absolute determination. There are several options available to treat low testosterone. If it is determined that your LH levels are low there is a chance your doctor may take the SERM or AI route, but in most cases this will be inefficient.
There is truly only one definite way to treat low testosterone, and that is with Anabolic androgenic steroids; specifically the Anabolic steroid testosterone. While this may surprise you it shouldn't; after all, if you're deficient in testosterone it only makes sense to give your body what it needs. The reason many physicians take alternate routes to begin with is due to a misplaced fear revolving around anabolics. Most general practitioners know very little about anabolics, as until recent years it has been something that was rarely discussed in medical school, but times are changing.
You've seen the commercials talking about "Low-T" and treatment of the condition. Low-T refers to low testosterone, and the treatment they're speaking of is the Anabolic steroid testosterone. To get the best help you can get, you are encouraged to seek out hormone specialist such as an endocrinologist but the best option of all is seeking out a Hormone Replacement Clinic HRT. HRT clinics specialize in conditions of this nature, and you will get the best advice and treatment.
To treat your low testosterone symptoms most effectively, as mentioned you're going to need testosterone. Most commonly you have four options for treatment of this nature:. Of the four forms, we have listed them in order of effectiveness and efficiency in treating a low testosterone condition.
All four forms may work, but in many cases, only the last two will do with the final injectable testosterone method being absolutely assured. This is a common question many men have; after all, you've been told all your life anabolics are dangerous, and now you're being told to treat a low testosterone condition you not only need anabolics but the primary Anabolic steroid.
Let's be clear, abundantly clear and allow the garbage to remain there; in the garbage. Testosterone is a hormone you naturally produce; it is not a foreign substance your body is unfamiliar with. If you suffer from low testosterone you are in need of one of the most important hormones the body produces; in your case, you're simply not producing enough.
This means you are going to need exogenous testosterone; specifically synthetic testosterone that was not made by your body.