A notable study out of Wayne State University in Indiana found that older men who had a mild zinc deficiency significantly increased their testosterone from 8.3 to 16.0 nmol/L—a 93 percent increase—following six months of zinc supplementation. Researchers of the study concluded that zinc may play an important role in modulating serum testosterone levels in normal healthy men.6
To find the best testosterone booster, we collected every supplement available on BodyBuilding.com, and cross-checked our list against the top results on best of lists like MensFitness, BroScience, and BodyNutrition. We only looked at pills since some of the ingredients in testosterone boosters have a reputation for tasting bad, and powders just prolong the experience. There are a lot — 133 of them to be precise — and they all claim to boost testosterone levels. Testosterone (for men) is “thought to regulate sex drive (libido), bone mass, fat distribution, muscle mass and strength, and the production of red blood cells and sperm.” If a supplement can increase your natural testosterone levels, the rest should follow. As we mentioned above, it’s not that simple, and at best, you’ll experience only a short-lived boost.
I will never forget when we went to the locker room and showed me his poses for his upcoming contest. His lats were wider, his chest was thicker, his thighs had deeper cuts, and he had amazing striation in all three heads of his delts. He told me that he gained 12 pounds of pure muscle and lost 1 pound of body fat according to his doctor at the Cleveland clinic. I have never seen such drastic change in anyone in such a short time without steroids or prohormones.
Although the benefits of multivitamins are hotly debated, specific vitamins and minerals may be beneficial. In one study, zinc and vitamin B supplements increased sperm quality by 74%. Zinc also boosts testosterone in athletes and those who are deficient in zinc. Other studies also suggest vitamins A, C and E can play a role in your sex hormone and testosterone levels, although more research is needed. Out of all the vitamins and minerals available, the research on testosterone shows vitamin D and zinc supplements may be best.
In addition to weight training, combining this with interval training like burst training is the best overall combo to increase HGH. In fact, Burst training has been proven to not only boost T-levels, it helps keeps your testosterone elevated and can prevent its decline. Burst training involves exercising at 90–100 percent of your maximum effort for a short interval in order to burn your body’s stored sugar (glycogen), followed by a period of low impact for recovery.
Most studies support a link between adult criminality and testosterone, although the relationship is modest if examined separately for each sex. Nearly all studies of juvenile delinquency and testosterone are not significant. Most studies have also found testosterone to be associated with behaviors or personality traits linked with criminality such as antisocial behavior and alcoholism. Many studies have also been done on the relationship between more general aggressive behavior/feelings and testosterone. About half the studies have found a relationship and about half no relationship.
Dr. Anthony's Notes: When evaluating the efficacy of a product, it’s tough to balance the currently available human research with thousands of years of anecdotal evidence of efficacy. Tongkat Ali is a perfect example. All of the current studies are on animal models (not humans) – this DOES NOT mean that Tongkat Ali doesn’t work with humans. It simply means more research is needed. Personally, the strong experience of thousands of men (myself included) using this herb can confirm it’s libido enhancing effects. Also, this herb is DAMN BITTER. It makes Maca powder seem like a walk in the park. Hide in a smoothie or you will be sorry haha! How To Take Tongkat Ali: 200-300mg (of a 100:1 extract) 1-2 times per day. If you are using the raw powder (recommended below) that is NOT encapsulated, definitely hide the powder in a fat burning smoothie like the “Fit Father Fat Burning Shake Recipe” we recommend in FF30X. Again, I cannot understand how damn nasty this powder tastes. Beware!
Nearly 1 out of every 4 men over age 50 experience the pain of losing the ability to perform sexually as a result of erectile dysfunction (ED). Common causes of ED are atherosclerosis, diabetes, prescription drug use (namely high blood pressure, depression, and allergy drugs), and—you guessed it—low testosterone. Supplements that may help include the following:
Do low levels of testosterone produce symptoms in middle-aged men? Absolutely. In fact, the classic symptoms were first recognized more than 70 years ago when two American physicians, Carl Heller, MD, and Gordon Myers, MD, showed the effectiveness of testosterone treatment for symptoms of fatigue, depression, irritability, low sex drive, erectile dysfunction, night sweats, and hot flashes in men. Over the years, subsequent studies have found that some—but not all—men with low, age-adjusted testosterone levels exhibit symptoms consistent with andropause. All experience improvement with testosterone therapy.
Alpha-5-Reductase Inhibition– This method for test boosting reduces the concentration of Alpha-5-Reductase, which is an enzyme throughout the body which converts active testosterone to DHT. The effect of this inhibition prevents the degradation of testosterone and by doing so, raises testosterone concentrations in the body. This type of A5R inhibition is also the primary method for treating prostate enlargement, which is caused by high levels of DHT.
^ Jump up to: a b Sapienza P, Zingales L, Maestripieri D (September 2009). "Gender differences in financial risk aversion and career choices are affected by testosterone". Proceedings of the National Academy of Sciences of the United States of America. 106 (36): 15268–73. Bibcode:2009PNAS..10615268S. doi:10.1073/pnas.0907352106. PMC 2741240. PMID 19706398.
Your first step should be to see your doctor. If you think you have low testosterone, we cannot stress enough that you should proceed with caution and talk to a medical professional — taking a booster can definitely do more harm than good. Low testosterone can be a symptom of more serious problems, like a pituitary disorder or a side-effect of medication, and a booster can mask the root cause. A doctor will be able to evaluate your testosterone levels with a simple blood test, and if you both decide a booster is the way to go, give the ingredients of any supplement a once-over to make sure that they’re not at risk of making your personal health situation worse.
I was reading in the university health news daily website that a study performed by researchers at the University of Texas M.D. Anderson Cancer Center found that men with prostate cancer who ate 3 tablespoons of milled or ground flax seeds each day had decreased prostate cancer cell proliferation compared to similar men who did not eat flax seeds. According to the American Cancer Society, men who supplement their diets with flax seed have lower PSA levels and slower growth of benign as well as cancerous prostate cells.
In a placebo-controlled study, 27 Division II football players received either a placebo or a ZMA supplement for a total of seven weeks during their scheduled spring practice. At the end of the seven weeks, the players taking the ZMA supplement had a 30 percent increase in testosterone, while the placebo group had a 10 percent decrease. The ZMA group also saw an 11.6 percent increase in strength, compared to only 4.6 percent in the placebo group.
There are three categories of healthy fat. Number one is healthy saturated fat. The truth about saturated fat is it’s actually good for you if it’s the proper kind. Healthy saturated fat is found in coconut oil and raw, fermented dairy products like goat milk kefir, yogurt, or raw goat or sheep milk cheese. However, avoid conventional dairy because it will actually damper your testosterone.
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Anabolic–androgenic steroids (AASs) are synthetic derivatives of testosterone that are commonly used among athletes aged 18–40 years, but many reports have demonstrated the presence of numerous toxic and hormonal effects as a result of long-term use of an AAS. Testosterone-foods act as natural libido boosters. Due to the growing interest in herbal ingredients and other dietary supplements worldwide, the use of testosterone boosters is becoming more and more mainstream among athletes, but several side effects were documented. Hence, this study established to help in the assessment of the side effects and health risks which could occur among athletes consuming testosterone boosters.
Mínguez-Alarcón, L., Chavarro, J. E., Mendiola, J., Roca, M., Tanrikut, C., Vioque, J., ... Torres-Cantero, A. M. (2017, March–April). Fatty acid intake in relation to reproductive hormones and testicular volume among young healthy men [Abstract]. Asian Journal of Andrology, 19(2), 184–190. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27834316
Such sort of injuries varies in severity and extent of damage markedly from one person to the other and withdrawal of the drug/supplement coupled with proper medical attention suffice in terms of alleviating the symptoms.[8,12] This was observed in the present case. However, the liver injury observed here may not be confidently linked to product consumption as the subject later reported that the following recovery he consumed two more courses of the booster with no side effects. Tests performed following hospital discharge, and repeated use of the product showed AST and ALT to be slightly high, whereas the rest of the blood parameters tested appeared to be normal. The AST/ALT ratio is considered to be a very important parameter for the evaluation of liver diseases, such as non-alcoholic fatty liver disease, though it is rarely considered alone. Overall, the evidence was inconclusive in the present work in terms of linking the use of a testosterone booster with liver injury. However, even though a single case report cannot establish causality with statistical power. Further research on the usage of a commercial testosterone booster within large populations for a long period is necessary to investigate whether the symptoms shown in the present case were significantly present in other athletes consuming the same commercial product or not. To guarantee an optimal outcome with no severe side effects, further research is warranted to confirm the present findings and determine whether the effects observed in this case report would be statistically significant in larger samples.
Pine Pollen is an androgen, meaning in theory it can raise testosterone levels – effectively making it a naturally derived source of testosterone. Read more about this on the links below. But like I said I started taking it for a few weeks and did notice a bit more ‘up and go’ so to speak, but it did only last a few weeks. I have tried cycling it but haven’t noticed the same effects as I had when I initially started with it. I’m still experimenting and will keep this page updated. Therefore I recommend doing your own research.
Use dietary supplements in moderation. While moderate amounts of vitamin D and zinc can help your body produce more testosterone and stay healthy, excessive amounts of either nutrient can actually be toxic. It's usually best to get both nutrients from natural sources, but if you choose to take supplemental forms, simply make sure you follow the dosing instructions provided on the label.
Sweet potatoes, white potatoes, russets, red potatoes, purple potatoes, etc. If it’s a potato, you should be eating it. Potatoes are excellent no-gluten source of testosterone boosting carbohydrates, and also very dense in nutrients. Stock pile your pantry full of them, and make potatoes your main carbohydrate source. Heck, if you can find potato chips that haven’t been laden with polyunsaturated fats, go for those too.
But, there is still use for these products! For one, a lot of guys love supplementing with D-aspartic acid. With this in mind, T-Up is simply the D-aspartic acid product by Nutrex. Vitrix on the other hand, is an easy to take low-impact test booster. It’s not going to work miracles, but it should offer noticeable vitality with an arginine nitric oxide boost after supplementation.
As already indicated previously, testosterone levels, particularly bioavailable testosterone, fall with advancing age. This decline in testosterone availability may start to occur early in the forth decade but it usually becomes clinically manifest in the 50s and 60s. Although there is continuing debate about the best way to diagnose hypogonadism in the aging male, there appears to be a general consensus that symptomatic men with reduced levels of testosterone should be given a trial of testosterone therapy if there is no contraindication to do so (Bain et al 2007).
Dr. Anthony's Notes: I like Tribulus. It is a VERY common herb in almost all testosterone boosting products – again though, it may be more of a libido enhancer than anything. From my personal experience, it's effective when stacked with the other libido enhancing supplements in this guide. How To Take Tribulus: Take 200-400mg once per day of a 45-60% saponin extract product.
Hooper, D. R., Kraemer, W. J., Saenz, C., Schill, K. E., Focht, B. C., Volek, J. S. … Maresh, C. M. (2017, July). The presence of symptoms of testosterone deficiency in the exercise-hypogonadal male condition and the role of nutrition [Abstract]. European Journal of Applied Physiology, 117(7), 1349–1357. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28470410
Zaima, N., Kinoshita, S., Hieda, N., Kugo, H., Narisawa, K., Yamamoto, A., ... Moriyama, T. (2016, September). Effect of dietary fish oil on mouse testosterone level and the distribution of eicosapentaenoic acid-containing phosphatidylcholine in testicular interstitium. Biochemistry and Biophysics Reports, 7, 259–265. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613343/
Testosterone makes a contribution to nitric oxide formation. Nitric oxide, released from penile nerves stimulates guanylate cyclase which catalyzes the transformation of guanosine-5-triphosphate into 3′,5′-cyclic, guanosine monophosphate (cyclic GMP). Gyclic GMP causes vasodilatation and hence erection formation (Morelli et al 2005). The breakdown of cyclic GMP to GMP is mediated by the enzyme, phosphodiesterase type-5, the inhibitors of which (eg, sildenafil citrate) enhance erection formation and maintanence (Carson and Lue 2005).
Tribulus terrestris is an ingredient commonly presented as improving testosterone levels, but has not been found to be more effective than a placebo or possess any testosterone increasing properties. WebMD cautions that it interferes with Lithium and diabetes medications, and in general, not enough is known about tribulus terrestris to recommend a dosage for anyone.
Testosterone is a hormone that regulates the sex organs, metabolism, bone density, and other bodily functions. Though it affects primarily men, both sexes can experience low testosterone (Low T). Fortunately, lifestyle choices play the biggest part in testosterone levels, so you may be able to increase your testosterone. However, it’s best to see a doctor if your symptoms are new or you aren’t feeling better after making changes.
Testosterone is observed in most vertebrates. Testosterone and the classical nuclear androgen receptor first appeared in gnathostomes (jawed vertebrates). Agnathans (jawless vertebrates) such as lampreys do not produce testosterone but instead use androstenedione as a male sex hormone. Fish make a slightly different form called 11-ketotestosterone. Its counterpart in insects is ecdysone. The presence of these ubiquitous steroids in a wide range of animals suggest that sex hormones have an ancient evolutionary history.
The testosterone booster pills are effective from 4 to 8 hours. To maintain testosterone levels high during the whole day, you need a multiple daily dosing regimen. 2-times daily dosing still not always can improve hormone production to the greatest extent. 3-4-times daily dosing is the best solution to make your body normalize testosterone synthesis and prevent it from decreasing before you take another pill. Don’t forget that the regularity of daily supplement intake is crucial if you really aspire to give a boost to hormone production.
Like other steroid hormones, testosterone is derived from cholesterol (see figure). The first step in the biosynthesis involves the oxidative cleavage of the side-chain of cholesterol by cholesterol side-chain cleavage enzyme (P450scc, CYP11A1), a mitochondrial cytochrome P450 oxidase with the loss of six carbon atoms to give pregnenolone. In the next step, two additional carbon atoms are removed by the CYP17A1 (17α-hydroxylase/17,20-lyase) enzyme in the endoplasmic reticulum to yield a variety of C19 steroids. In addition, the 3β-hydroxyl group is oxidized by 3β-hydroxysteroid dehydrogenase to produce androstenedione. In the final and rate limiting step, the C17 keto group androstenedione is reduced by 17β-hydroxysteroid dehydrogenase to yield testosterone.
Low testosterone levels may contribute to decreased sex drive, erectile dysfunction, fragile bones, and other health issues. Having low testosterone levels may also indicate an underlying medical condition. See your doctor if you suspect you have low testosterone. A simple blood test is all it takes to check if your testosterone falls within the normal range.
Men can experience a range of symptoms if testosterone decreases more than it should. Low testosterone, or low T, is diagnosed when levels fall below 300 nanograms per deciliter (ng/dL). A normal range is typically 300–1000 ng/dL, according to the U.S. Food and Drug Administration. A blood test called a serum testosterone test is used to determine your level of circulating testosterone.
So, how does one ensure that testosterone levels remain in balance? Some doctors suggest that monitoring testosterone levels every five years, starting at age 35, is a reasonable strategy to follow. If the testosterone level falls too low or if the individual has the signs and symptoms of low testosterone levels described above, testosterone therapy can be considered. However, once testosterone therapy is initiated, testosterone levels should be closely monitored to make sure that the testosterone level does not become too high, as this may cause stress on the individual, and high testosterone levels may result in some of the negative problems (described previously) seen.
When you're under a lot of stress, your body releases high levels of the stress hormone cortisol. This hormone actually blocks the effects of testosterone,6 presumably because, from a biological standpoint, testosterone-associated behaviors (mating, competing, aggression) may have lowered your chances of survival in an emergency (hence, the "fight or flight" response is dominant, courtesy of cortisol).
The amount of testosterone synthesized is regulated by the hypothalamic–pituitary–testicular axis (see figure to the right). When testosterone levels are low, gonadotropin-releasing hormone (GnRH) is released by the hypothalamus, which in turn stimulates the pituitary gland to release FSH and LH. These latter two hormones stimulate the testis to synthesize testosterone. Finally, increasing levels of testosterone through a negative feedback loop act on the hypothalamus and pituitary to inhibit the release of GnRH and FSH/LH, respectively.
Alcohol should be avoided when trying to increase testosterone levels. Healthy normal men, consuming reasonable amounts of alcoholic drink, experience a 20% drop in their serum levels of testosterone. In chronic alcoholics with extensive liver damage those levels can be reduced by as much as 50% and they can become feminized (loose facial and pubic hair, become impotent, and fat deposits behind the nipples that give the appearance of breasts).
Like most supplements, Beast Sports contains several ingredients with little research about their long-term effects. WebMD describes Suma powder, Rhodiola Rosea, Cissus quadrangularis, Tribulus extract, and ashwagandha extract as possibly safe when taken for a short period of time (usually around 6-10 weeks). However, their long-term safety remains unknown. It also has a few ingredients, like cyanotis vaga root, safed musli, and polygonum cispidatum root extract for which there is a lack of data on even short term safety.
Bisphenol-A also known under the name of BPA is a chemical compound which is very widespread for manufacturing a wide spectrum of plastic items and aluminum cans. Many studies have already proven the fact that even the smallest amount of BPA is very harmful to the human health. This compound causes hormonal imbalance and even may lead to prostate cancer.
The second theory is similar and is known as "evolutionary neuroandrogenic (ENA) theory of male aggression". Testosterone and other androgens have evolved to masculinize a brain in order to be competitive even to the point of risking harm to the person and others. By doing so, individuals with masculinized brains as a result of pre-natal and adult life testosterone and androgens enhance their resource acquiring abilities in order to survive, attract and copulate with mates as much as possible. The masculinization of the brain is not just mediated by testosterone levels at the adult stage, but also testosterone exposure in the womb as a fetus. Higher pre-natal testosterone indicated by a low digit ratio as well as adult testosterone levels increased risk of fouls or aggression among male players in a soccer game. Studies have also found higher pre-natal testosterone or lower digit ratio to be correlated with higher aggression in males.
And then there’s also the fact that sodium bicarbonate tends to act as a molecular switch for the cyclic adenosine monophosphate (cAMP). And increased cAMP levels – as you might already know – correlate with increased T production since cAMP activates protein kinase A and serves as a secondary messenger between cells and hormones (study, study, study, study, study, study, study, study, study).
"By expanding the boundaries of this disease to common symptoms in aging males, such as fatigue and reduced libido, drug companies seek to increase their markets and boost their sales," wrote Barbara Mintzes, an assistant professor at the University of British Columbia School of Public Health, and Agnes Vitry, a senior research fellow at the University of South Australia, in a 2012 article in the Medical Journal of Australia .
Dr. Anthony’s Notes: Here's a funny little effect – fenugreek can make you sweet and your urine smell sweet like Maple Syrup. Hell, this could be a good thing for you! This supplement is commonly used for good reasons – it's quite effective for enhancing libido when stacked with the other herbs on this list. Medical Note: Fenugreek may interact with blood thinning medications (Warfarin, Coumadin, Xarleto). Check with your doctor before taking any of these supplements. How To Take Fenugreek: Take 400-600mg (capsule) with food; it's best to take a product standardized for fenuside.
Richard J. Wassersug, PhD, an adjunct professor of urology at the University of British Columbia, described his personal experience with androgen deprivation therapy (ADT). "If you are on ADT," he said, "and you see those Low T ads, what are you supposed to make of it? This produces a cognitive dissonance." He called the ads "hurtful" for suggesting that low testosterone makes a man less of a man.
What you eat has a major impact on testosterone as well as other hormone levels. Therefore, you must pay attention to your long-term calorie intake and diet strategy. Constant dieting or overeating may disrupt your testosterone levels. Eating enough protein can help maintain healthy levels and aid in fat loss, which is also associated with your testosterone. Carb intake also plays a role, with research showing carbs can help optimize testosterone levels during resistance training.
Ghlissi, Z., Atheymen, R., Boujbiha, M. A., Sahnoun, Z., Makni Ayedi, F., Zeghal, K., ... Hakim, A. (2013, December). Antioxidant and androgenic effects of dietary ginger on reproductive function of male diabetic rats [Abstract]. International Journal of Food Sciences and Nutrition, 64 (8), 974–978. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23862759
Testosterone boosters are a class of herbal supplements aimed at naturally increasing your testosterone levels. Usually, they contain micronutrients that men are commonly deficient in, such as zinc, and which have been connected in research to healthy testosterone levels. They also may contain adaptogens, which are a class of supplement that are thought to help the body adapt to stress, or ingredients which have been connected to improved sleep. Sleep restriction has been shown to reduce testosterone in healthy young men, and as Chris Lockwood, Ph.D., notes, disturbed sleep is a common symptom of low T-levels.
If you want to naturally boost testosterone and HGH then combining weight training with HIIT workouts (high intensity interval training). Go to the gym at least three days a week, ideally at least three days a week, and lift heavy weights. Lifting heavy weights 6–12 reps with larger muscle groups like your quadriceps, hamstrings, back, shoulders and chest will help your body pack on the maximum amount of muscle. Specifically, lifting at least 30 minutes up to as long as an hour or so can be very, very beneficial boost low testosterone levels.
Zinc plays a variety of roles in regulating the functions of enzymes and chemicals as well as your immune system. Zinc is also a potent antioxidant and can reduce the frequency of illnesses. Studies show that zinc may actually increase testosterone production. Large doses of zinc have actually been found to inhibit aromatase, thus reducing estrogen levels and increasing the effects of testosterone.
Testosterone is the main hormone associated with muscle mass, strength gains, and libido. But that's far from the only thing it does in the body. As Chris Lockwood, Ph.D., explains in the article "All About Testosterone," it impacts everything from mood and memory to bone health—but yes, to be clear, it also makes muscles bigger and stronger, and helps increase endurance and athletic performance.
Studies conducted in rats have indicated that their degree of sexual arousal is sensitive to reductions in testosterone. When testosterone-deprived rats were given medium levels of testosterone, their sexual behaviors (copulation, partner preference, etc.) resumed, but not when given low amounts of the same hormone. Therefore, these mammals may provide a model for studying clinical populations among humans suffering from sexual arousal deficits such as hypoactive sexual desire disorder.
A testicular action was linked to circulating blood fractions – now understood to be a family of androgenic hormones – in the early work on castration and testicular transplantation in fowl by Arnold Adolph Berthold (1803–1861). Research on the action of testosterone received a brief boost in 1889, when the Harvard professor Charles-Édouard Brown-Séquard (1817–1894), then in Paris, self-injected subcutaneously a "rejuvenating elixir" consisting of an extract of dog and guinea pig testicle. He reported in The Lancet that his vigor and feeling of well-being were markedly restored but the effects were transient, and Brown-Séquard's hopes for the compound were dashed. Suffering the ridicule of his colleagues, he abandoned his work on the mechanisms and effects of androgens in human beings.
Hoffman, J., Ratamess, N., Kang, J., Magine, G., Faigenbaum, A. & Stout, J. (2006, August). Effect of creatine and beta-alanine supplementation on performance and endocrine responses in strength/power athletes [Abstract]. International Journal of Sport Nutrition and Exercise Metabolism, 16(4), 430–46. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17136944
At the present time, it is suggested that androgen replacement should take the form of natural testosterone. Some of the effects of testosterone are mediated after conversion to estrogen or dihydrotestosterone by the enzymes aromatase and 5a-reductase enzymes respectively. Other effects occur independently of the traditional action of testosterone via the classical androgen receptor- for example, its action as a vasodilator via a cell membrane action as described previously. It is therefore important that the androgen used to treat hypogonadism is amenable to the action of these metabolizing enzymes and can also mediate the non-androgen receptor actions of testosterone. Use of natural testosterone ensures this and reduces the chance of non-testosterone mediated adverse effects. There are now a number of testosterone preparations which can meet these recommendations and the main factor in deciding between them is patient choice.
Directions — SUGGESTED USE: As a dietary supplement take 3 capsules daily, preferably with a meal, or as directed by a healthcare professional. — Take two capsules with a meal twice a day. On days that you are not training, take two capsules in the morning and two capsules at night. On days that you train, take two capsules about an hour before workouts and take two capsules in the morning or at night depending on when you train.
A 2010 study published in the journal Hormones and Behavior first suggested this when researchers evaluated the “dual-hormone hypothesis” clinically. (11) They discovered that when cortisol is elevated, testosterone responds by elevating as well but soon after bottoms out at a much lower level than before cortisol kicked in! That means you want to find ways to relieve stress to keep your testosterone levels up.
Hypogonadism is a disease in which the body is unable to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men. Doctors may prescribe testosterone as injections, pellets, patches or gels.