Testosterone

Most people don't know that fat produces estrogen, even in men, being fat, especially as you get older, can be a major cause of estrogen dominance & a loss of libido & erectile function.

"Libido is mainly a hormone deal, erections a plumbing issue. Weight loss helps with both- long as you're eating healthy, not just less. Don't forget your fish oil."

Some things to consider:

* Don't neglect fats. Fat, or more precisely cholesterol is necessary to the production of testosterone. And increased fat intake is correlated with higher testosterone levels. I obviously recommend mostly good fats like fish oil, coconut oil, borage oil as well as the fat found naturally in the meat you eat.

* Do not overdo aerobics. Excessive cardio has been linked to lowered testosterone levels.

* Avoid sugars and foods that is chemically enhanced (if you can't pronounce of the ingredients on the list, don't eat it!)

* Train heavy on compound movements. Lifting above 80% of your max has been shown to lead to higher test levels than lifting lighter. Similarly, compound movements, especially those involving the hips and that put you in a ''life or death'' situation (squats, deadlifts, power clean, for example) can lead to slightly higher testosterone levels

"according to medical norms. Heck, in the UK (and even the US I think) a testosterone count of 300 is considered ''normal'' (normal range is 300 to 1200ng/dl... quite a wide variation!!!) however when athletes are concerned, 300 = castration. For optimal gains you need to be in the thousand and he top athletes have a natural test level of 1300-1400ng/dl."

This is just to show that what is medically ''normal'' doesn't mean ''optimal'' and not even ''healthy'' in many cases!

And, of course, to an athlete, Testosterone is what stirs the competitive drink. It's what makes us win, and more importantly, makes us want to win. It is also what makes men look like men and the more you have, chances are the more man you are. It's the ultimate recreational drug; it's the nectar of the gods.

So will eating more saturated fat increase your Testosterone levels? Male vegetarians have been shown to have lower levels of plasma Testosterone compared to their meat eating counterparts(4).

Nice list for increasing T levels for better muscle growth/energy:

-Protein from whey and egg hydrolysates increase testosterone production
-Having erections increase testosterone
-Work out with weight that is 85% of your 1RM with three sets or more.
-Monosaturated fats increase testosterone (Hello, PB)
-indole-3-carbinol rich vegetables turns "bad" estrogen into "good" estrogen which restore testosterone production
-Sleep at least 7-8 hours.
-Skipping meals and/or waiting too long between meals can cause hormone levels to plummet. Eat when you're hungry.
-Excess body fat causes estrogen levels to rise.
-Reducing caloric intake by more than 15% can cause a large decrease in testosterone production.

Penis Trivia- Nocturnal Erections: 'Morning Wood'  indicates E2 levels are just about right. Males should have Nocturnal Erections as long as they are alive. They are the bodies way to keep your penis healthy.
 

Good list. Basically sleeping enough, eating the right foods (Fats), and lifting heavy weights.

FYI:  (Creve Discovered this during bloodwork for surgery-Deviated Septum):

"High-level endurance training (such as marathons and other type of long distance training) reduces testosterone levels by 15 - 40%."

Body Fat produces estrogen, even in men. Estrogen is a powerful testosterone antagonist.

Also:

-conflicting evidence suggest Soy Protein may increase estrogen in males - Prudent to Avoid till research shows otherwise

Symptoms of low T:

• Decreased bone mass
• Skin atrophy, along with paleness and fine wrinkles
• Anemia
• Muscle atrophy
• Erectile dysfunction
• Decrease in sperm count
• Decrease in volume of ejaculate
• Decrease in libido
• Shrinkage and softening of the testes
• Disappearance of spontaneous erections
• Prostate shrinkage (below normal)
 

"Male vegetarians have been shown to have lower levels of plasma Testosterone compared to their meat eating counterparts" - Howie BBJ, Shultz TTD. Dietary and hormonal interrelationships among vegetarian Seventh-Day Adventists and nonvegetarian men. The American journal of clinical nutrition 1985;42:127-34.

_______________________________________

1. If you are even slightly overweight consider starting immediately a diet and training routine, tailored toward fat loss and lean muscle retention. Fat tissue causes testosterone levels to plunge.

2. If you want your efforts in keeping test levels high to give results, consider also dropping the alcohol intake to absolute minimum. Alcohol decreases the rate your body removes estrogen from the system. That causes decline in testosterone levels as well.

3. Begin mastering some types of self-control or even meditation. These will take care of the excess stress levels. Stress promotes cortisol release, which, guess what, lowers test levels.

4. Take medications only if they are absolutely essential for your health and are prescribed by your doctor. Some medications act on the central nervous system and cause drop in the lutenizing hormone, the one, responsible for the steroid hormone production.

Talk to your personal physician to find out if there are any natural remedies to replace your current medications and if he recommends such approach for your health issue.

5. Keep your blood pressure and the serum cholesterol in check. These cause hardening of the arteries and that in turn prevents enough blood from reaching the hormone producing organs - causes lower testosterone.

6. Eat enough good fats in your diet. Good means monounsaturated and omega-3 and 6 polyunsaturated fats. Studies have shown that good fats stimulate testosterone hikes.

7. Don't ever overtrain. Overtraining increases stress hormone release. You know what happens next?  Sleep enough to promote good recovery. Signs of overtraining are loss of appetite, tiredness and irritability, lack of motivation, impaired mental focus, prolonged recovery periods.

8. Start relying more heavily on basic exercise movements. Train in the low rep range most of the time. 5 ? 8 reps will ensure that you're using weights that will eventually stimulate elevated testosterone levels.

9. It will only do you good if you decide to try some or all of these natural supplements: chrysin - piperine blend, nettle root extract, pygeum, avena sativa extract, and tribulus terestris. Some of them bind to SHBG, thus freeing up testosterone; others lower the testosterone conversion to estrogen.
Try to find them in your local health store. Follow the directions on the label for best results.

10. And you shouldn?t even consider training without supplementing your diet with enough vitamin C (at least 1g a day) and zinc (15mg min.).

Take vitamin C with your multivitamin formula after breakfast, and post-workout with your protein shake. Vitamin C suppresses the release of stress hormones, which? elevates testosterone in the system.

Zinc should be present in your multivitamin blend but this is not enough. It prevents the conversion of testosterone to estrogen. Take zinc with magnesium in the form of ZMA right before you go to bed on an empty stomach.

Get Your Mojo Back T-Nation Article

A Comprehensive Look at Lab Tests

BloodTest

Found this from another post:

-----------------------------
Total T : 15.2 NMOL/L (14-40)
SHBG: 26.0 NMLOL/L (20 - 45)
Free Androgen Index (FAI) : 58 (70 - 100)
Calculated FreeTestosterone (CFT) 356.7 PMOL/L (300 - 600)
FSH : 2.7 IU/L (0.7 - 6)
LH: 3.9 IU/L (0.8 - 6)
Estradiol (E2) : 73.0 PMOL/L (55 - 184)
TSH: 1.9 IU/L (0.4 - 5.5)
------------------------------

Total T is obvious.
I think Free test is what we can use to build muscle, and is related to libido, etc.
SBGH is hormone binding globulin which pulls T out of circulation.
LH is lutenizing hormone which stimulates the testes to make more testosterone.
Estradiol = estrogen

TRT

Male Hormone Modulation Therapy

Prices for meds:

Testosterone Cypionate 200mg/ml 10ml $40 incl. shipping
Testosterone cream 60grams 100mg/gram (max 100mg/gram) $40 lasts 2+ months depending on how much you use (1g 2 months, 1/2g 4 months, 1/4gram 8 months)
Women's International Pharmacy - Natural hormone replacement therapies - compounding specialists for women/men

HCG APP brand 10,000iu 10ml $32 incl. shipping lasts 60 days unlike Novarel which is 30 days.
Walmart speciality pharmacy 877-453-4566

prices at Sam's Club with a Business membership. Non-business memberships do not get these prices.

10 ml Watson's test cyp 200mg/ml $42 (around $100 at Walgreen's)
10,000iu HCG kit $16.25 (lasts 80 days @ 250iu EOD)
100 #29 .5" .5ml insulin syringes $12
100 #23 1.5" 3ml syringes $18

These costs are trivial. Blood work is the greatest cost.

Arimidex anastrozole is expensive from a pharmacy.

A 2003 study^[3] showed that serum testosterone levels reach a peak seven days after abstaining from ejaculation

Level With Me, Doc… How Long Have I Got?
A Comprehensive Look at Lab Tests
by Cy Willson

You just had some blood work done, and the friggin' doctor or his nurses are guarding the results as if they're state secrets. However, after much cajoling and explaining that you'd like to at least be an informed partner in your own goshdarn health care, they begrudgingly give you a copy of your lab tests.
Trouble is, as much as you've been posturing about how you've had more than a smattering of medical education, you still can't figure out what half the tests are for and whether or not those abnormal values are anything to worry about.
Well, in the following article, I'm going to go over each of the most common tests. I'll include why it's performed, what it tells you, and what the typical ranges are for normal humans. That way, you'll have something more to go on in assessing your health other than your family doctor saying, "Well, these few values are a little worrisome, but you'll probably be okay."
One note, though, before I get started. The values I'll be listing are merely averages and the ranges may vary slightly from laboratory to laboratory. Also, if there's only one range given, it applies to both men and women.

Lipid Panel — Used to determine possible risk for coronary and vascular disease. In other words, heart disease.

HDL/LDL and Total Cholesterol
These lipoproteins should look rather familiar to most of you. HDL is simply the "good" lipoprotein that acts as a scavenger molecule and prevents a buildup of material. LDL is the "bad" lipoprotein which collects in arterial walls and causes blockage or a reduction in blood flow. The total cholesterol to HDL ratio is also important. I went in to detail about this particular subject — as well as how to improve your lipid profile — in my article "Bad Blood".
Nevertheless, a quick remonder: your HDL should be 35 or higher; LDL below 130; and total to HDL ratio should be below 3.5. Oh and don't forget VLDL (very low density lipoprotein) which can be extremely worrisome. You should have less than 30 mg/dl in order to not be considered at risk for heart disease.
On a side note, I'm sure some of you are wishing that you had abnormally low plasma cholesterol levels (as if it's something to brag about), but the fact is that having extremely low cholesterol levels is actually indicative of severe liver disease.

Triglycerides
Triglycerides are simply a form of fat that exists in the bloodstream. They're transported by two other culprits, VLDL and LDL. A high level of triglycerides is also a risk factor for heart disease as well. Triglycerides levels can be increased if food or alcohol is consumed 12 to 24 hours prior to the blood draw and this is the reason why you're asked to fast for 12-14 hours from food and abstain from alcohol for 24 hours. Here are the normal ranges for healthy humans.
16-19 yr. old male
40-163 mg/dl
Adult Male
40-160 mg/dl
16-19 yr. old female
40-128 mg/dl
Adult Female
35-135 mg/dl

Homocysteine
Unfortunately, this test isn't always ordered by the doctor. It should be. Homocysteine is formed in the metabolism of the dietary amino acid methionine. The problem is that it's a strong risk factor for atherosclerosis. In other words, high levels may cause you to have a heart attack. A good number of lifters should be concerned with this value as homocysteine levels rise with anabolic steroid usage.
Luckily, taking folic acid (about 400-800 mcg.) as well as taking a good amount of all B vitamins in general will go a long way in terms of preventing a rise in levels of homocysteine.
Normal ranges:
Males and Females age 0-30
4.6-8.1 umol/L
Males age 30-59
6.3-11.2 umol/L
Females age 30-59
4.5-7.9 umol/L
>59 years of age
5.8-11.9 umol/L

The Hemo Profile
These are various tests that examine a number of components of your blood and look for any abnormalities that could be indicative of serious diseases that may result in you being an extra in the HBO show, "Six Feet Under."

WBC Total (White Blood Cell)
Also referred to as leukocytes, a fluctuation in the number of these types of cells can be an indicator of things like infections and disease states dealing with immunity, cancer, stress, etc.
Normal ranges:
4,500-11,000/mm3

Neutrophils
This is one type of white blood cell that's in circulation for only a very short time. Essentially their job is phagocytosis, which is the process of killing and digesting bacteria that cause infection. Both severe trauma and bacterial infections, as well as inflammatory or metabolic disorders and even stress, can cause an increase in the number of these cells. Having a low number of neutrophils can be indicative of a viral infection, a bacterial infection, or a rotten diet.
Normal ranges:
2,500-8,000 cells per mm3

RBC (Red Blood Cell)
These blood cells also called erythrocytes and their primary function is to carry oxygen (via the hemoglobin contained in each RBC) to various tissues as well as giving our blood that cool "red" color. Unlike WBC, RBC survive in peripheral blood circulation for approximately 120 days. A decrease in the number of these cells can result in anemia which could stem from dietary insufficiencies. An increase in number can occur when androgens are used. This is because androgens increase EPO (erythropoietin) production which in turn increases RBC count and thus elevates blood volume. This is essentially why some androgens are better than others at increasing "vascularity." Anyhow, the danger in this could be an increase in blood pressure or a stroke.
Androgen-using lifters who have high values should consider making modifications to their stack and/or immediately donating some blood.
Normal ranges:
Adult Male
4,700,000-6,100,000 cells/uL
Adult Female
4,200,000-5,400,000 cells/uL

Hemoglobin
Hemoglobin is what serves as a carrier for both oxygen and carbon dioxide transportation. Molecules of this are found within each red blood cell. An increase in hemoglobin can be an indicator of congenital heart disease, congestive heart failure, sever burns, or dehydration. Being at high altitudes, or the use of androgens, can cause an increase as well. A decrease in number can be a sign of anemia, lymphoma, kidney disease, sever hemorrhage, cancer, sickle cell anemia, etc.
Normal ranges:
Males and females 6-18 years
10-15.5 g/dl
Adult Males
14-18 g/dl
Adult Females
12-16 g/dl

Hematocrit
The hematocrit is used to measure the percentage of the total blood volume that's made up of red blood cells. An increase in percentage may be indicative of congenital heart disease, dehydration, diarrhea, burns, etc. A decrease in levels may be indicative of anemia, hyperthyroidism, cirrhosis, hemorrhage, leukemia, rheumatoid arthritis, pregnancy, malnutrition, a sucking knife wound to the chest, etc.
Normal ranges:
Male and Females age 6-18 years
32-44%
Adult Men
42-52%
Adult Women
37-47%

MCV (Mean Corpuscular Volume)
This is one of three red blood cell indices used to check for abnormalities. The MCV is the size or volume of the average red blood cell. A decrease in MCV would then indicate that the RBC's are abnormally large(or macrocytic), and this may be an indicator of iron deficiency anemia or thalassemia. When an increase is noted, that would indicate abnormally small RBC (microcytic), and this may be indicative of a vitamin B12 or folic acid deficiency as well as liver disease.
Normal ranges:
Adult Male
80-100 fL
Adult Female
79-98 fL
12-18 year olds
78-100 fL

MCH (Mean Corpuscular Hemoglobin)
The MCH is the weight of hemoglobin present in the average red blood cell. This is yet another way to assess whether some sort of anemia or deficiency is present.
Normal ranges:
12-18 year old
35-45 pg
Adult Male
26-34 pg
Adult Female
26-34 pg

MCHC (Mean Corpuscular Hemoglobin Concentration)
The MCHC is the measurement of the amount of hemoglobin present in the average red blood cell as compared to its size. A decrease in number is an indicator of iron deficiency, thalassemia, lead poisoning, etc. An increase is sometimes seen after androgen use.
Normal ranges:
12-18 year old
31-37 g/dl
Adult Male
31-37 g/dl
Adult Female
30-36 g/dl

RDW (Red Cell Distribution Width)
The RDW is an indicator of the variation in red blood cell size. It's used in order to help classify certain types of anemia, and to see if some of the red blood cells need their suits tailored. An increase in RDW can be indicative of iron deficiency anemia, vitamin B12 or folate deficiency anemia, and diseases like sickle cell anemia.
Normal ranges:
Adult Male
11.7-14.2%
Adult Female
11.7-14.2%

Platelets
Platelets or thrombocytes are essential for your body's ability to form blood clots and thus stop bleeding. They're measured in order to assess the likelihood of certain disorders or diseases. An increase can be indicative of a malignant disorder, rheumatoid arthritis, iron deficiency anemia, etc. A decrease can be indicative of much more, including things like infection, various types of anemia, leukemia, etc.
On a side note for these ranges, anything above 1 million/mm3 would be considered a critical value and should warrant concern and/or giving second thoughts as to whether you should purchase a lifetime subscription to Muscle Media.
Normal ranges:
Child
150,000-400,000/mm3
(Most commonly displayed in SI units of 150-400 x 10(9th)/L
Adult
150,000-400,000/mm3
(Most commonly displayed in SI units of 150-400 x 10(9th)/L

ABS (Differential Count)
The differential count measures the percentage of each type of leukocyte or white blood cell present in the same specimen. Using this, they can determine whether there's a bacterial or parasitic infection, as well as immune reactions, etc.

Neutrophils
As explained previously, severe trauma and bacterial infections, as well as inflammatory disorders, metabolic disorders, and even stress can cause an increase in the number of these cells. Also, on the other side of the spectrum, a low number of these cells can indicate a viral infection, a bacterial infection, or a deficient diet.
Percentile Range:
55-70%

Basophils
These cells, and in particular, eosinophils, are present in the event of an allergic reaction as well as when a parasite is present. These types of cells don't increase in response to viral or bacterial infections so if an increased count is noted, it can be deduced that either an allergic response has occurred or a parasite has taken up residence in your shorts.
Percentile Range:
Basophils
0.5-1%
Eosinophils
1-4%

Lymphocytes and Monocytes
Lymphocytes can be divided in to two different types of cells: T cells and B cells. T cells are involved in immune reactions and B cells are involved in antibody production. The main job of lymphocytes in general is to fight off — Bruce Lee style — bacterial and viral infections.
Monocytes are similar to neutrophils but are produced more rapidly and stay in the system for a longer period of time.
Percentile Range:
Lymphocytes
20-40%
Monocytes
2-8%

Selected Clinical Values

Sodium
This cation (an ion with a postive charge) is mainly found in extracellular spaces and is responsible for maintaining a balance of water in the body. When sodium in the blood rises, the kidneys will conserve water and when the sodium concentration is low, the kidneys conserve sodium and excrete water. Increased levels can result from excessive dietary intake, Cushing's syndrome, excessive sweating, burns, forgetting to drink for a week, etc. Decreased levels can result from a deficient diet, Addison's disease, diarrhea, vomiting, chronic renal insufficiency, excessive water intake, congestive heart failure, etc. Anabolic steroids will lead to an increased level of sodium as well.
Normal range:
Adults
136-145 mEq/L

Potassium
On the other side of the spectrum, you have the most important intracellular cation. Increased levels can be an indicator of excessive dietary intake, acute renal failure, aldosterone-inhibiting diuretics, a crushing injury to tissues, infection, acidosis, dehydration, etc. Decreased levels can be indicative of a deficient dietary intake, burns, diarrhea or vomiting, diuretics, Cushing's syndrome, licorice consumption, insulin use, cystic fibrosis, trauma, surgery, etc.
Normal range:
Adults
3.5-5 mEq/L

Chloride
This is the major extracellular anion (an ion carrying a negative charge). Its purpose it is to maintain electrical neutrality with sodium. It also serves as a buffer in order to maintain the pH balance of the blood. Chloride typically accompanies sodium and thus the causes for change are essentially the same.
Normal range:
Adult
98-106 mEq/L

Carbon Dioxide
The CO2 content is used to evaluate the pH of the blood as well as aid in evaluation of electrolyte levels. Increased levels can be indicative of severe diarrhea, starvation, vomiting, emphysema, metabolic alkalosis, etc. Increased levels could also mean that you're a plant. Decreased levels can be indicative of kidney failure, metabolic acidosis, shock, and starvation.
Normal range:
Adults
23-30 mEq/L

Glucose
The amount of glucose in the blood after a prolonged period of fasting (12-14 hours) is used to determine whether a person is in a hypoglycemic (low blood glucose) or hyperglycemic (high blood glucose) state. Both can be indicators of serious conditions. Increased levels can be indicative of diabetes mellitus, acute stress, Cushing's syndrome, chronic renal failure, corticosteroid therapy, acromegaly, etc. Decreased levels could be indicative of hypothyroidism, insulinoma, liver disease, insulin overdose, and starvation.
Normal range:
Adult Male
65-120 mg/dl
Adult Female
65-120 mg/dl

BUN (Blood Urea Nitrogen)
This test measures the amount of urea nitrogen that's present in the blood. When protein is metabolized, the end product is urea which is formed in the liver and excreted from the bloodstream via the kidneys. This is why BUN is a good indicator of both liver and kidney function. Increased levels can stem from shock, burns, dehydration, congestive hear failure, myocardial infarction, excessive protein ingestion, excessive protein catabolism, starvation, sepsis, renal disease, renal failure, etc. Causes of a decrease in levels can be liver failure, overhydration, negative nitrogen balance via malnutrition, pregnancy, etc.
Normal range:
Adults
10-20 mg/dl

Creatinine
Creatinine is a byproduct of creatine phosphate, the chemical used in contraction of skeletal muscle. So, the more muscle mass you have, the higher the creatine levels and therefore the higher the levels of creatinine. Also, when you ingest large amounts of beef or other meats that have high levels of creatine in them, you can increase creatinine levels as well. Since creatinine levels are used to measure the functioning of the kidneys, this easily explains why creatine has been accused of causing kidney damage, since it naturally results in an increase in creatinine levels.
However, we need to remember that these tests are only indicators of functioning and thus outside drugs and supplements can influence them and give false results, as creatine may do. This is why creatine, while increasing creatinine levels, does not cause renal damage or impair function. Generally speaking, though, increased levels are indicative of urinary tract obstruction, acute tubular necrosis, reduced renal blood flow (stemming from shock, dehydration, congestive heart failure, atherosclerosis), as well as acromegaly. Decreased levels can be indicative of debilitation, and decreased muscle mass via disease or some other cause.
Normal range:
Adult Male
0.6-1.2 mg/dl
Adult Female
0.5-1.1 mg/dl

BUN/Creatinine Ratio
A high ratio may be found in states of shock, volume depletion, hypotension, dehydration, gastrointestinal bleeding, and in some cases, a catabolic state. A low ratio can be indicative of a low protein diet, malnutrition, pregnancy, severe liver disease, ketosis, etc. Keep in mind, though, that the term BUN, when used in the same sentence as hamburger or hotdog, usually means something else entirely. An important thing to note again is that with a high protein diet, you'll likely have a higher ratio and this is nothing to worry about.
Normal range:
Adult
6-25

Calcium
Calcium is measured in order to assess the function of the parathyroid and calcium metabolism. Increased levels can stem from hyperparathyroidism, metastatic tumor to the bone, prolonged immobilization, lymphoma, hyperthyroidism, acromegaly, etc. It's also important to note that anabolic steroids can also increase calcium levels. Decreased levels can stem from renal failure, rickets, vitamin D deficiency, malabsorption, pancreatitis, and alkalosis.
Normal range:
Adult
9-10.5 mg/dl

Liver Function

Total Protein
This measures the total level of albumin and globulin in the body. Albumin is synthesized by the liver and as such is used as an indicator of liver function. It functions to transport hormones, enzymes, drugs and other constituents of the blood.
Globulins are the building blocks of your body's antibodies. Measuring the levels of these two proteins is also an indicator of nutritional status. Increased albumin levels can result from dehydration, while decreased albumin levels can result from malnutrition, pregnancy, liver disease, overhydration, inflammatory diseases, etc. Increased globulin levels can result from inflammatory diseases, hypercholesterolemia (high cholesterol), iron deficiency anemia, as well as infections. Decreased globulin levels can result from hyperthyroidism, liver dysfunction, malnutrition, and immune deficiencies or disorders.
As another important side note, anabolic steroids, growth hormone, and insulin can all increase protein levels.
Normal range:
Adult
Total Protein: 6.4-8.3 g/dl
Albumin: 3.5-5 g/dl
Globulin: 2.3-3.4 g/dl
Albumin/Globulin Ratio:
Adult
0.8-2.0

Bilirubin
Bilirubin is one of the many constituents of bile, which is formed in the liver. An increase in levels of bilirubin can be indicative of liver stress or damage/inflammation. Drugs that may increase bilirubin include oral anabolic steroids (17-AA), antibiotics, diuretics, morphine, codeine, contraceptives, etc. Drugs that may decrease levels are barbiturates and caffeine. Non-drug induced increased levels can be indicative of gallstones, extensive liver metastasis, and cholestasis from certain drugs, hepatitis, sepsis, sickle cell anemia, cirrhosis, etc.
Normal range:
Total Bilirubin for Adult
0.3-1.0 mg/dl

Alkaline Phosphatase
This enzyme is found in very high concentrations in the liver and for this reason is used as an indicator of liver stress or damage. Increased levels can stem from cirrhosis, liver tumor, pregnancy, healing fracture, normal bones of growing children, and rheumatoid arthritis. Decreased levels can stem from hypothyroidism, malnutrition, pernicious anemia, scurvy (vitamin C deficiency) and excess vitamin B ingestion. As a side note, antibiotics can cause an increase in the enzyme levels.
Normal range:
16-21 years
30-200 U/L
Adult
30-120 U/L

AST (Aspartate Aminotransferase, previously known as SGOT)
This is yet another enzyme that's used to determine if there's damage or stress to the liver. It may also be used to see if heart disease is a possibility as well, but this isn't as accurate. When the liver is damaged or inflamed, AST levels can rise to a very high level (20 times the normal value). This happens because AST is released when the cells of that particular organ (liver) are lysed. The AST then enters blood circulation and an elevation can be seen. Increased levels can be indicative of heart disease, liver disease, skeletal muscle disease or injuries, as well as heat stroke. Decreased levels can be indicative of acute kidney disease, beriberi, diabetic ketoacidosis, pregnancy, and renal dialysis.
Normal range:
Adult
0-35 U/L (Females may have slightly lower levels)

ALT (Alanine Aminotransferase, previously known as SGPT)
This is yet another enzyme that is found in high levels within the liver. Injury or disease of the liver will result in an increase in levels of ALT. I should note however, that because lesser quantities are found in skeletal muscle, there could be a weight-training induced increase . Weight training causes damage to muscle tissue and thus could slightly elevate these levels, giving a false indicator for liver disease. Still, for the most part, it's a rather accurate diagnostic tool. Increased levels can be indicative of hepatitis, hepatic necrosis, cirrhosis, cholestasis, hepatic tumor, hepatotoxic drugs, and jaundice, as well as severe burns, trauma to striated muscle (via weight training), myocardial infarction, mononucleosis, and shock.
Normal range:
Adult
4-36 U/L

Endocrine Function

Testosterone (Free and Total)
This is of course the hormone that you should all be extremely familiar with as it's the name of this here magazine! Anyhow, just as some background info, about 95% of the circulating Testosterone in a man's body is formed by the Leydig cells, which are found in the testicles. Women also have a small amount of Testosterone in their body as well. (Some more than others, which accounts for the bearded ladies you see at the circus, or hanging around with Chris Shugart.) This is from a very small amount of Testosterone secreted by the ovaries and the adrenal gland (in which the majority is made from the adrenal conversion of androstenedione to Testosterone via 17-beta HSD).

Nomal range, total Testosterone:
Male
Age 14
<1200 ng/dl
Age 15-16
100-1200 ng/dl
Age 17-18
300-1200 ng/dl
Age 19-40
300-950 ng/dl
Over 40
240-950 ng/dl
Female
Age 17-18
20-120 ng/dl
Over 18
20-80 ng/dl
Normal range, free Testosterone:
Male
50-210 pg/ml

LH (Luteinizing Hormone)
LH is a glycoprotein that's secreted by the anterior pituitary gland and is responsible for signaling the leydig cells to produce Testosterone. Measuring LH can be very useful in terms of determining whether a hypogonadic state (low Testosterone) is caused by the testicles not being responsive despite high or normal LH levels (primary), or whether it's the pituitary gland not secreting enough LH (secondary). Of course, the hypothalamus — which secretes LH-RH (luteinizing hormone releasing hormone) — could also be the culprit, as well as perhaps both the hypothalamus and the pituitary.
If it's a case of the testicles not being responsive to LH, then things like clomiphene and hCG really won't help. If the problem is secondary, then there's a better chance for improvement with drug therapy. Increased levels can be indicative of hypogonadism, precocious puberty, and pituitary adenoma. Decreased levels can be indicative of pituitary failure, hypothalamic failure, stress, and malnutrition.
Normal ranges:
Adult Male
1.24-7.8 IU/L
Adult Female
Follicular phase: 1.68-15 IU/L
Ovulatory phase: 21.9-56.6 IU/L
Luteal phase: 0.61-16.3 IU/L
Postmenopausal: 14.2-52.3 IU/L

Estradiol
With this being the most potent of the estrogens, I'm sure you're all aware that it can be responsible for things like water retention, hypertrophy of adipose tissue, gynecomastia, and perhaps even prostate hypertrophy and tumors. As a male it's very important to get your levels of this hormone checked for the above reasons. Also, it's the primary estrogen that's responsible for the negative feedback loop which suppresses endogenous Testosterone production. So, if your levels of estradiol are rather high, you can bet your ass that you'll be hypogonadal as well.
Increased estradiol levels can be indicative of a testicular tumor, adrenal tumor, hepatic cirrhosis, necrosis of the liver, hyperthyroidism, etc.
Normal ranges:
Adult Male
10-50 pg/ml
Adult Female
Follicular phase: 20-350 pg/ml
Midcycle peak: 150-750 pg/ml
Luteal phase: 30-450 pg/ml
Postmenopausal: 20 pg/ml or less

Thyroid (T3, T4 Total and Free, TSH)

T3 (Triiodothyronine)
T3 is the more metabolically active hormone out of T4 and T3. When levels are below normal it's generally safe to assume that the individual is suffering from hypothyroidism. Drugs that may increase T3 levels include estrogen and oral contraceptives. Drugs that may decrease T3 levels include anabolic steroids/androgens as well as propanolol (a beta adrenergic blocker) and high dosages of salicylates. Increased levels can be indicative of Graves disease, acute thyroiditis, pregnancy, hepatitis, etc. Decreased levels can be indicative of hypothyroidism, protein malnutrition, kidney failure, Cushing's syndrome, cirrhosis, and liver diseases.
Normal ranges:
16-20 years old
80-210 ng/dl
20-50 years
75-220 ng/dl or 1.2-3.4 nmol/L
Over 50
40-180 ng/dl or 0.6-2.8 nmol/L

T4 (Thyroxine)
T4 is just another indicator of whether or not someone is in a hypo or hyperthyroid state. It too is rather reliable but free thyroxine levels should be assessed as well. Drugs that increase of decrease T3 will, in most cases, do the same with T4. Increased levels are indicative of the same things as T3 and a decrease can be indicative of protein depleted states, iodine insufficiency, kidney failure, Cushing's syndrome, and cirrhosis.
Normal ranges:
Adult Male
4-12 ug/dl or 51-154 nmol/L
Adult Female
5-12 ug/dl or 64-154 nmol/L

Free T4 or Thyroxine
Since only 1-5% of the total amount of T4 is actually free and useable, this test is a far better indicator of the thyroid status of the patient. An increase indicates a hyperthyroid state and a decrease indicates a hypothyroid state. Drugs that increase free T4 are heparin, aspirin, danazol, and propanolol. Drugs that decrease it are furosemide, methadone, and rifampicin. Increased and decreased levels are indicative of the same possible diseases and states that are seen with T4 and T3.
Normal ranges:
0.8-2.8 ng/dl or 10-36 pmol/L

TSH (Thyroid Stimulating Hormone)
Measuring the level of TSH can be very helpful in terms of determining if the problem resides with the thyroid itself or the pituitary gland. If TSH levels are high, then it's merely the thyroid gland not responding for some reason but if TSH levels are low, it's the hypothalamus or pituitary gland that has something wrong with it. The problem could be a tumor, some type of trauma, or an infarction.
Drugs that can increase levels of TSH include lithium, potassium iodide and TSH itself. Drugs that may decrease TSH are aspirin, heparin, dopamine, T3, etc. Increased TSH is indicative of thyroiditis, hypothyroidism, and congenital cretinism. Decreased levels are indicative of hypothyroidism (pituitary dysfunction), hyperthyroidism, and pituitary hypofunction.
Normal ranges:
Adult
2-10 uU/ml or 2-10 mU/L
For more info on the thyroid in general, check out my article "The Thyroid Handbook."

Conclusion
Hopefully this article will help to shed some light on the questions you have or may have in the future in regards to a blood test. Now perhaps you can truly rest assured after viewing things yourself. Hell, you may even impress your doctor, but wait, this is the same guy who thinks walking for 20 minutes is plenty of exercise for the day!
Regardless, knowing how to interpret these tests can be a very valuable tool in terms of health and your body building and athletic progress. Use your new knowledge wisely!

Get Your Mojo Back!
A Guide to Testosterone Replacement
by Cy Willson

Have You Lost Your Mojo, Baby?
In that classic piece of celluloid, Austin Powers: The Spy Who Shagged Me, Dr. Evil almost defeats our hero by stealing his mojo. Luckily, Austin was able to get his mojo back, defeat Dr. Evil, and shag Heather Graham.
I don't know exactly what "mojo" is in the movie, but in the real world it can be only one thing: Testosterone. If a man's "T" level is low, he'll have a tougher time building and maintaining muscle, losing fat, and performing sexually. Basically, he just won't feel like a man should feel: virile and vigorous.
Luckily, for those who have a Testosterone level that falls below the normal range, there are medical options. For those with low-normal or normal T levels who just want a boost into the high-normal range – where muscle and strength gains will come easier – there are supplemental options. Below, I'll look at the drug options in detail and touch briefly on the supplement choices.
In my best text-based Austin Powers impersonation: Does that make you horny... baby? (Well, it should!)

Hypogonadal: Somethin' Just Ain't Right
If you go to the doctor suffering from symptoms of low Testosterone, the doctor will give you a blood test. If it comes back below normal, then you'll be diagnosed as hypogonadal, which is derived from a Latin word meaning "kicked in the nuts by an angry woman."
No, I'm kidding. What it means is that you'll be qualified to receive exogenous Testosterone by prescription. ("Exogenous" means originating from outside the body. "Endogenous" means produced inside the body. Got it? Good.)
The following is a list of choices for Testosterone supplementation. Before I begin however, let me make it clear that the following info is provided mostly for those wishing to achieve normal physiological Testosterone levels, not get "hyooooge." I'll address those who wish to get into the high-normal range later.
When choosing a system of T replacement, what you want is something that'll closely mimic natural, endogenous production. Also, you want to minimize the risk of side effects when it comes to achieving supraphysiological (above normal) levels.
Finally, you want to avoid subphysiological or below normal levels because that just won't work worth a flip. Ideally, the "perfect" product wouldn't cause supraphysiological levels for a significant period of time, or subphysiological levels prior to the next dose.
Going beyond that, it would also mimic the normal circadian rhythm seen where peak concentrations of endogenous Testosterone are reached around 8 AM and nadir (the lowest point) around 10 PM. Last but not least, the perfect product would be something that doesn't cost the person an unacceptable amount of pain and time, and allows him to easily adhere to the dosing instructions.

Okay, let's go T shoppin'!
Striant
This product utilizes the buccal (or cheek) route of administration. By placing a mucoadhesive tablet containing Testosterone against the gum, just above the incisor tooth (essentially in between the gum and cheek), the subject's saliva will begin to hydrate it and form a gel of sorts that contains Testosterone.
The Testosterone then crosses the buccal mucosal membrane that lines the oral cavity, eventually reaching small vessels and capillaries. These flow into the internal jugular vein, thereby reaching systemic circulation while avoiding first-pass hepatic metabolism.
Benefits: Average peak plasma concentrations generally don't exceed the physiological range, while steady-state concentrations are also respectable (i.e. 520-570 ng/dl). There's also no pain or discomfort associated with administration via intramuscular injection. Finally, there's no worry of transferring the Testosterone to loved ones, which might be an issue with certain creams or gels applied to the skin.
Drawbacks: You have to apply a tablet twice per day, once in the morning and once in the evening, which is kind of a nuisance. The tablets could also irritate your gums. Lastly, the pharmacokinetic properties don't exactly mimic the normal circadian rhythm.

Testoderm and Androderm

These products are essentially transdermal patches applied to the scrotum (known to us scientist-types as the "chicken sack") and non-scrotal skin respectively. As you'd expect, they allow Testosterone to permeate through the skin and into the bloodstream.
Benefits: Average peak and steady-state concentrations are within the physiological range. When applied either at night or early in the morning, depending on time to reach peak plasma concentrations, they can closely mimic the normal circadian rhythm seen in eugonadal (normal) men. Other benefits include lack of discomfort associated with injections and no risk of accidental transfer to other people.  

Drawbacks: Testoderm, specifically, can result in supraphysiological DHT levels, whereas the Androderm doesn't, due to the placement of the patch. (Androderm isn't applied to the nutsack, but to other areas of the body.) However, both patches may cause skin irritation where the patch is applied. Lastly, having a patch on your nutsack is kind of embarrassing if your date isn't prepared for it. Of course, you could always paint it black and tell her you're playing "pirate".
Testoderm requires shaven scrotal skin for application, but hey, doesn't everyone do that anyway? These patches must be applied daily, or nightly in the case of Androderm.

Androgel and Testim
These are both topical gel formulations containing Testosterone which, when applied, provide a reservoir of T which permeates through the skin and into the bloodstream, allowing a relatively sustained and controlled amount to enter systemic circulation over time.

Benefits: Average peak concentration and steady-state are generally within the physiological range with the usual dosage employed. Skin irritation isn't as much of a concern compared to the patches, and of course there's no need to have an unsightly patch on the skin. You don't have to shave your sack either. Finally, there are regimens available that can possibly mimic circadian rhythm.
Drawbacks: Skin irritation, while not as frequent as that seen with patches, can still occur. Gels require daily application and some men may not like the smell or "feel" of the gel. It's also possible to transfer significant amounts of Testosterone to loved ones when engaged in vigorous skin-skin contact. Lastly, you must wait 2-6 hours after application before sweating, swimming, or washing.
Side Note: While one pharmacokinetic study during short-term administration found that Testim produced approximately 30% and 38% higher peak plasma concentrations for total and free Testosterone as compared to Androgel, more long-term studies (i.e. 30 days) haven't found this to be true. In fact, Androgel had the higher average steady-state concentration.

Delatestryl and Depot-Testosterone (Or compounded products)

These are the esterfied derivatives of Testosterone, Testosterone enanthate and cypionate respectively, administered via intramuscular injection. Testosterone enanthate is the most popularly prescribed form of T for Testosterone replacement therapy.
The lipophilic derivatives are injected deep into the muscle where they're slowly released or absorbed into circulation. There, the esters are effectively cleaved, leaving the free Testosterone molecule to exert its biological effects.
Benefits: Doesn't require daily administration, relatively cheap, and generally lacks the main issues associated with transdermal and topical administration.
Drawbacks: Possible pain or irritation at injection site, plus there's the possibility of infection with improper injection technique. If you can't poke yourself with a needle, then you'll need to make frequent visits to your physician.
There's also a possibility of allergic reaction to sesame or cottonseed oil (solvents/vehicle) and supraphysiological peak concentrations, generally followed by subphysiological Testosterone levels prior to the next administration when 200-400 mg is administered every 2-4 weeks*. Once again, pharmacokinetic properties aren't conducive to mimicking the normal circadian rhythm.
*100 mg/week improves unfavorable pharmacokinetics.

Nebido (Not yet approved for use in the U.S.)
This is another esterfied derivative of Testosterone, in this case, using the undecanoate ester. The use of the much longer carbon-chained ester provides much greater lipophilicity and a much slower release of the molecule from the site of injection in the muscle to systemic circulation as compared to the enanthate and cypionate esters.
Benefits: Average peak and steady-state concentrations don't rise in to the supraphysiological range. A 1,000 mg dose had a half-life of approximately 34 days and allowed for 12 week dosing intervals, obviously making it the most advantageous in terms of frequency of administration.
Drawbacks: If adverse effects are noted, the long half-life is disadvantageous as you have to simply wait until enough half-lives have passed to reach baseline. Also, it's not conducive to mimicking the normal circadian rhythm and, of course, still requires injection.
Side Note: New Drug Application submission or filing is supposed to occur in 2006, so it's possible that Nebido may be on the market within the next few years.

High-Normal Utopia
As I stated earlier, there may be those who wish to achieve steady-state Testosterone concentrations, which allow them to be in the high-normal range. For those who wish to do so, 10 grams per day of either Androgel or Testim should suffice. However, this should be confirmed via blood draw over time.

SERM's and Aromatase Inhibitors
Drugs like clomiphene (Clomid) and tamoxifen (Nolvadex), in addition to aromatase inhibitors such as anastrozole (Arimidex) should be avoided unless supraphysiological estradiol levels are found over the course of therapy and/or symptoms of excess estradiol formation locally is found (e.g., gynecomastia).

It's important that we not unnecessarily antagonize estrogen receptors or decrease estrogen levels. Estrogens plays some very important roles in terms of cardiovascular function, libido, cognitive function, body composition, etc., not to mention the physiological effects which have yet to be elucidated.

5 Alpha-Reductase Inhibitors
Drugs such as dutasteride (Avodart) and finasteride (Proscar and Propecia) should also be avoided unless androgenic alopecia (hair loss) or prostate issues manifest, or perhaps if supraphysiological DHT concentrations are reached.

As a side note, I'd like to help dispel a common myth I hear from guys who really do need to use these drugs concurrently with exogenous Testosterone and are worried about them making the Testosterone less effective due to the inhibition of 5 alpha-reduction to DHT.
The fact is that skeletal muscle possesses little to no 5 alpha-reductase activity, and as would be expected when finasteride was administered concurrently with Testosterone, the positive effects on lean body mass weren't decreased or negated.

Normal Guys, Higher T Levels
For those who have normal Testosterone levels and/or don't qualify for Testosterone replacement, a supplement such as Alpha Male is a good choice. Alpha Male packs a potent one-two punch as one ingredient prompts the pituitary into pumping out more LH, which in turn causes the testes to produce more Testosterone, while another ingredient promotes the Leydig cells in the testes to start producing more Test without the urging of LH.

You could also consider using drugs which possess estrogen antagonistic effects, such as clomiphene or tamoxifen. Anastrozole, while decreasing estrogen levels enough to where an increase in endogenous Testosterone levels are seen, yet still allowing for estradiol to remain within the physiological range, is also a choice.
However, you need to be cautious when it comes to long-term use, as even that moderate decrease in estrogen can negatively affect endothelial function.

Technically, you should also avoid long-term use of the estrogen antagonists as well. As mentioned, while being receptor subtype selective, the long-term effects in men just aren't known.

Wrap-up
If you think you have low Testosterone, go to your doc and get tested. If you qualify, hopefully this article will guide you in selecting the best product for your needs. If you don't qualify, but feel you could benefit from a boost to high-normal, Austin Powers T-levels, consider the supplemental options.
Whatever you do, never lose your mojo, baby!

References
1. Lew R, et al. "Endogenous estrogens influence endothelial function in young men." Circ Res. 2003 Nov 28;93(11):1127-33.
2. Product Insert (Striant). Columbia Laboratories. Livingston, NJ, 2003.
3. Product Insert (Androderm). Watson Pharmaceuticals, Inc. Corona, CA, 1999.
4. Product Insert (Testoderm). ALZA Pharmaceuticals. Palo Alto, California, 1998.
5. Product Insert (Androgel). Unimed Pharmaceuticals. Marietta, GA, 2003.
6. Product Insert (Testim). Auxilium Pharmaceuticals, Inc. Norristown, PA, 2003.
7. Bouloux P. "Testim 1% Testosterone gel for the treatment of male hypogonadism." Clin Ther. 2005 Mar;27(3):286-98.
8. Product Insert (Delatestryl). BTG Pharmaceuticals. Iselin, NJ, 1996.
9. Product Insert (Depo-Testosterone). Pharmacia & Upjohn Company. Kalamazoo, MI, 2002.
10. Korbonits M, et al. "A comparison of a novel Testosterone bioadhesive buccal system, striant, with a Testosterone adhesive patch in hypogonadal males." JCEM. 2004 May;89(5):2039-43.
11. Schubert M, et al. "Intramuscular Testosterone undecanoate: pharmacokinetic aspects of a novel Testosterone formulation during long-term treatment of men with hypogonadism." JCEM. 2004 Nov;89(11):5429-34.
12. Jockenhovel F. "Testosterone therapy--what, when and to whom?" Aging Male. 2004 Dec;7(4):319-24.
13. Borst SE, et al. "Inhibition of 5alpha-reductase blocks prostate effects of Testosterone without blocking anabolic effects." Am J Physiol Endocrinol Metab. 2005 Jan;288(1):E222-7.
14. Page ST, et al. "Exogenous Testosterone (T) alone or with finasteride increases physical performance, grip strength, and lean body mass in older men with low serum T." JCEM. 2005 Mar;90(3):1502-10.
15. Longcope C, Fineberg SE. "Production and metabolism of dihydroTestosterone in peripheral tissues." J Steroid Biochem. 1985 Oct;23(4):415-9.
16. Kumar N, et al. "The biological activity of 7 alpha-methyl-19-norTestosterone is not amplified in male reproductive tract as is that of Testosterone." Endocrinology. 1992 Jun;130(6):3677-83.

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