Can you trust the claims testosterone supplements make?

Balanced testosterone is important for both men and women.

Often when we, meaning doctors, talk about testosterone you only hear about it from the point of view of how it benefits male health.

Today, I need to address that, but I hope the women in my audience will be patient with me because I plan to talk about how it affects you in my next post.

But keep this in mind: men are the worst about taking care of their own health. So this information may be helpful to a special man in your life that may be experiencing problems with his testosterone levels.

How can I raise my testosterone level?

This is what a male patient asked me recently. But before I could answer, I had to ask him a question:

“What symptoms of low testosterone do you have?” I asked because I wanted to know his real reason for wanting to raise his T level.

He listed just a few of the following symptoms of low testosterone:

• Decreased sex drive or interest in sex, erectile dysfunction, infertility
• Sex refractory period (time it takes to have sex again) delays
• Increased body fat, gynecomastia (enlarging breasts)
• Reduced muscle mass and strength
• Fatigue, overall lack of energy
• Difficulty with concentration and memory; brain fog
• Loss of motivation at work and in life, mild depressed mood
• Irritability (increased anger, agitation, or loss of patience)
• Insomnia
• Decreased body hair

Some of these symptoms are shared by both sexes, including:

• Decreased interest in sex
• Difficulty concentrating
• Fatigue, exhaustion
• Difficulty losing weight
• Mood swings, low mood
• Anxiety
• Hair loss

What are my options?

My first thought was to just prescribe testosterone replacement to my patient. Why not?

Because testosterone supplementation always drops a man’s sperm count, interfering in his fertility. It can also increase estrogen causing secondary low testosterone and making him feel worse. Moreover, there can be unwanted side effects in men and women who supplement with just testosterone to raise testosterone levels:

• Acne
• Disturbed breathing while sleeping
• Breast swelling or tenderness
• Swelling in the ankles
• High red blood cell counts (aka polycythemia) which increases clotting risk

For these reasons my second thought went to ways to naturally increase testosterone.

More people are a little adverse to these suggestions because they are mostly old-fashioned lifestyle changes — probably not what someone wants to hear when they are under the impression that a quick-fix pill will do the trick.

The lifestyle changes that can naturally increase testosterone levels are:

• Eliminating refined sugar from your diet and if needed, lose weight. This means eating more nutrient-rich foods
• High-intensity exercise and strength training
• Taking vitamin D to maximize your level (and then have it tested by your doctor)
• Taking Zinc 25 mg daily
• Reducing stress
• Consuming plenty of healthy fats (not only from avocados and nuts, but also saturated fats at 50-60 percent of your diet. Examples are olive oil, coconut oil, grass-fed meats, real butter).
• Taking a protein powder supplement daily; from whey, rice, or pea protein.

Another option I could offer him is “testosterone booster” supplements. But before I could do that, I had to do my homework and find out if they actually work? They will tell you these products contain natural ingredients that “should” help trigger your body to naturally increase testosterone production.

That is somewhat encouraging, but I wanted to see some scientific proof to support what they were saying… So, I searched pubmed.com to learn more.

I discovered that D-Aspartic Acid (2000 mg), an amino acid, is touted as the most important ingredient to naturally increase testosterone. We know that animal testis contains high levels of D-aspartate and that D-Aspartate indirectly stimulates sperm development through the hypothalamic-pituitary-gonadal axis.

We also know that it up-regulates testosterone production in Leydig (in testis) cells as shown in test tube studies.

But unfortunately, no clinical trials have been reported to show that D-Aspartate can naturally increase testosterone levels in humans.

Note the difference between what is reported online about these ingredients by those whose aim is to sell you a product, and the much more legitimate reports in the scientific literature on the effectiveness of an ingredient.

For example…NMDA (N-Methyl-D-Aspartic Acid) is marketed as “The Most Potent NMDA Testosterone Product on the Market!” But in a study of NMDA reported on pubmed.com, the authors concluded that, “The supplementation of NMDA had no preferential effect on augmenting testosterone or decreasing estrogen, cortisol, and prolactin… when compared to placebo.”

In other words, taking the supplement didn’t appear to help any more than taking a placebo, which you know is typically a harmless pill that won’t provide benefits other than psychological ones.

There are other supplements reported to naturally increase testosterone, with varying levels of scientific research to support their use. You may find these products in a “proprietary blend,” in which the dosages are not revealed. You can find more detail on some of them listed below in a previous post I wrote on erectile dysfunction, or you can read more online about the testosterone-boosting value of each of these:

• Vitamin K
• Mucuna Pruriens
• Stinging Nettle Root
• Coleus Forskohlii
• Fenugreek
• Oyster Extract
• Siberian Ginseng
• Tribulus Terrestis
• Luteolin
• L-citrulline
• horny goat weed
• Korean ginseng
• Catuaba bark
• Cnidiu
• Damiana
• Dodder seed
• Ginkgo biloba
• Muira Puama
• Passion Flower
• Suma
• Rehmannia
• Shilajit
• Tongkat Ali
• Tribulus Terrestris

Clomid (clomiphene citrate) and Androxal (enclomiphene citrate)

You may have heard of this for enhancing ovulation in women seeking to become pregnant. But for men with a low testosterone level, it has some real advantages over testosterone supplementation, or along with testosterone.

Let me explain why…

First off, for men who need a testosterone boost and who want to preserve fertility, Clomid boosts natural testosterone levels and also preserves sperm production.

Second and more importantly, for the many men who are past their child-raising years who need more testosterone, Clomid blocks the rise of estrogen that often occurs when taking testosterone. Testosterone is naturally converted into estrogen, which then secondarily turns off the natural hormones (FSH, LH) that stimulate testosterone production. This is called secondary hypogonadism, one of the most common causes of low testosterone in men, along with obesity which stimulates excess estrogen in men. Clomid is the answer to this problem. Clomid is relatively inexpensive and can be taken at 25 mg daily.

A similar molecule to Clomid, enclomiphene (Androxal), is also an oral therapy that treats the cause of secondary hypogonadism (which is inadequate pituitary hormones) and preserves reproductive status, plus improves overall metabolic blood test profiles.

Now you have more options if you are seeking to naturally increase testosterone levels. In my next article, I will discuss safe and effective ways for women to boost testosterone and get the best combination of overall hormone balance.

To feeling good often,

Michael Cutler, M.D.

Sources:

1. http://thesupplementreviews.org/testosterone-boosters/

2. http://thesupplementreviews.org/testosterone-boosters/testotek-review/

3. Tomita K, Tanaka H, Kageyama S, Nagasawa M, Wada A, Murai R, Kobayashi K, Hanada E, Agata Y, Kawauchi A. The Effect of D-Aspartate on Spermatogenesis in Mouse Testis. Biol Reprod. 2016 Feb;94(2):30. PubMed PMID: 26658710. https://www.ncbi.nlm.nih.gov/pubmed/26658710

4. Santillo A, Falvo S, Chieffi P, Di Fiore MM, Senese R, Chieffi Baccari G. D-Aspartate Induces Proliferative Pathways in Spermatogonial GC-1 Cells. J Cell Physiol. 2016 Feb;231(2):490-5. PubMed PMID: 26189884.

5. https://www.ncbi.nlm.nih.gov/pubmed/26189884

6. https://www.apsnutrition.com/products/nmda-100

7. Willoughby DS, Spillane M, Schwarz N. Heavy Resistance Training and Supplementation With the Alleged Testosterone Booster Nmda has No Effect on Body Composition, Muscle Performance, and Serum Hormones Associated With the Hypothalamo-Pituitary-Gonadal Axis in Resistance-Trained Males. J Sports Sci Med.

8. 2014 Jan 20;13(1):192-9. PubMed PMID: 24570624. https://www.ncbi.nlm.nih.gov/pubmed/24570624

9. Katz DJ, Nabulsi O, Tal R, Mulhall JP. Outcomes of clomiphene citrate treatment in young hypogonadal men. BJU Int. 2012 Aug;110(4):573-8. PubMed PMID: 22044663. https://www.ncbi.nlm.nih.gov/pubmed/22044663

10. Liel Y. Clomiphene citrate in the treatment of idiopathic or functional hypogonadotropic hypogonadism in men. A case series and review of the literature. Endocr Pract. 2016 Nov 16. Pubmed PMID: 27849376. https://www.ncbi.nlm.nih.gov/pubmed/27849376

11. Kaminetsky J, Werner M, Fontenot G, Wiehle RD. Oral enclomiphene citrate stimulates the endogenous production of testosterone and sperm counts in men with low testosterone: comparison with testosterone gel. J Sex Med. 2013 Jun;10(6):1628-35. PubMed PMID: 23530575. https://www.ncbi.nlm.nih.gov/pubmed/23530575