Autopsy studies have found histological prostate cancer to be very common, with one series showing a prevalence of greater than fifty percent in men over age sixty (Holund 1980). The majority of histological cancers go undetected so that the clinical incidence of the disease is much lower, but it is still the most prevalent non-skin cancer in men (Jemal et al 2003). Prostate cancer is also unusual in comparison to other adult cancers in that the majority of those with the disease will die of other causes. Treatment of prostate cancer with androgen deprivation is known to be successful and is widely practiced, indicating an important role for testosterone in modifying the behavior of prostate cancer. In view of this, testosterone treatment is absolutely contraindicated in any case of known or suspected prostate cancer. The question of whether testosterone treatment could cause new cases of prostate cancer, or more likely cause progression of undiagnosed histological prostate cancer that would otherwise have remained occult, is an important consideration when treating ageing males with testosterone.
"I am very cautious about committing someone for life to medication," said Dr. Kathleen L. Wyne, who directs research on diabetes and metabolism at Houston's Methodist Hospital Research Institute and serves on the Sex Hormone and Reproductive Endocrinology Scientific Committee for the American Association of Clinical Endocrinologists. "That does frustrate patients because they have heard about [Low T] from TV and friends."

The reliable measurement of serum free testosterone requires equilibrium dialysis. This is not appropriate for clinical use as it is very time consuming and therefore expensive. The amount of bioavailable testosterone can be measured as a percentage of the total testosterone after precipitation of the SHBG bound fraction using ammonium sulphate. The bioavailable testosterone is then calculated from the total testosterone level. This method has an excellent correlation with free testosterone (Tremblay and Dube 1974) but is not widely available for clinical use. In most clinical situations the available tests are total testosterone and SHBG which are both easily and reliably measured. Total testosterone is appropriate for the diagnosis of overt male hypogonadism where testosterone levels are very low and also in excluding hypogonadism in patients with normal/high-normal testosterone levels. With increasing age, a greater number of men have total testosterone levels just below the normal range or in the low-normal range. In these patients total testosterone can be an unreliable indicator of hypogonadal status. There are a number of formulae that calculate an estimated bioavailable or free testosterone level using the SHBG and total testosterone levels. Some of these have been shown to correlate well with laboratory measures and there is evidence that they more reliably indicate hypogonadism than total testosterone in cases of borderline biochemical hypogonadism (Vermeulen et al 1971; Morris et al 2004). It is important that such tests are validated for use in patient populations relevant to the patient under consideration.


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.
The production of the stress hormone cortisol blocks the production and effects of testosterone. From a biological perspective, cortisol increases your “fight or flight” response, thereby lowering testosterone-associated functions such as mating, competing, and aggression. Chronic stress can take a toll on testosterone production, as well as your overall health. Therefore, stress management is equally important to a healthy diet and regular exercise. Tools you can use to stay stress-free include prayer, meditation, laughter, and yoga. Relaxation skills, such as deep breathing and visualization, can also promote your emotional health.
The diagnosis of late-onset hypogonadism requires the combination of low serum testosterone levels with symptoms of hypogonadism. Questionnaires are available which check for the symptoms of hypogonadism. These have been validated for the assessment of aging patients with hypogonadism (Morley et al 2000; Moore et al 2004) but have a low specificity. In view of the overlap in symptoms between hypogonadism, aging and other medical conditions it is wise to use a formal method of symptom assessment which can be used to monitor the effects of testosterone replacement.

We kept it simple, and followed the premise of testosterone boosters: testosterone affects muscle gain, weight loss, and libido, so by increasing the amount of testosterone in the body, we can improve on each of those goals. This meant that we looked for ingredients proven to increase testosterone levels, not ingredients that might increase libido or help build muscle mass independently of testosterone (like having a healthy diet and feeling good about yourself). In addition, we dove deep into the specific ingredient lists of our finalists and cross-checked them against WebMD and the National Institutes of Health (NIH) database to make sure that they did not contain ingredients known to be harmful.
The new beast super test formulation is something we have been looking forward to for quite some time! After having great results with the original beast super test booster (nearly 100% positive test booster reviews), we weren’t sure what Beast Nutrition could possibly do to make this stuff better. But don’t we feel stupid now, because they sure did it.
Overall, it seems that both estrogen and testosterone are important for normal bone growth and maintenance. Deficiency or failure of action of the sex hormones is associated with osteoporosis and minimal trauma fractures. Estrogen in males is produced via metabolism of testosterone by aromatase and it is therefore important that androgens used for the treatment of hypogonadism be amenable to the action of aromatase to yield maximal positive effects on bone. There is data showing that testosterone treatment increases bone mineral density in aging males but that these benefits are confined to hypogonadal men. The magnitude of this improvement is greater in the spine than in the hip and further studies are warranted to confirm or refute any differential effects of testosterone at these important sites. Improvements seen in randomized controlled trials to date may underestimate true positive effects due to relatively short duration and/or baseline characteristics of the patients involved. There is no data as yet to confirm that the improvement in bone density with testosterone treatment reduces fractures in men and this is an important area for future study.
If you are very weak, start with resistance bands. This gentle form of strength-training allows you to use a rubber strap to train weak muscles before lifting actual weights.[5] Do this 2 to 3 times per week for the first 3 to 4 weeks. If you have a joint or back problem, you may want to graduate to stronger bands and stick to this form of strength training.
Instead of turning to some drug that can only ameliorate symptoms and cause additional complications, I recommend using a natural saw palmetto supplement. Dr. Moerck says that there are about 100 clinical studies on the benefits of saw palmetto, one of them being a contributed to decreased prostate cancer risk. When choosing a saw palmetto supplement, you should be wary of the brand, as there are those that use an inactive form of the plant.
The new beast super test formulation is something we have been looking forward to for quite some time! After having great results with the original beast super test booster (nearly 100% positive test booster reviews), we weren’t sure what Beast Nutrition could possibly do to make this stuff better. But don’t we feel stupid now, because they sure did it.
However, testosterone is only one of many factors that aid in adequate erections. Research is inconclusive regarding the role of testosterone replacement in the treatment of erectile dysfunction. In a review of studies that looked at the benefit of testosterone in men with erection difficulties, showed no improvement with testosterone treatment. Many times, other health problems play a role in erectile difficulties. These can include:

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,[13] 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.[13] 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.
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.
Male hypogonadism is a clinical syndrome caused by a lack of androgens or their action. Causes of hypogonadism may reflect abnormalities of the hypothalamus, pituitary, testes or target tissues. Increases in the amount of testosterone converted to estrogen under the action of the enzyme aromatase may also contribute to hypogonadism. Most aspects of the clinical syndrome are unrelated to the location of the cause. A greater factor in the production of a clinical syndrome is the age of onset. The development of hypogonadism with aging is known as late-onset hypogonadism and is characterised by loss of vitality, fatigue, loss of libido, erectile dysfunction, somnolence, depression and poor concentration. Hypogonadal ageing men also gain fat mass and lose bone mass, muscle mass and strength.
A sedentary lifestyle is another scourge for modern civilization. And this is a serious danger for men. After all, if physical activity is minimal, the testosterone levels will decrease steadily. And in this situation, strength training exercises are a proven method for raising testosterone. Thus, sports exercises always helped raise the levels of male sex hormone. As a result, the testosterone levels elevate after every workout.
Regardless of the method of testosterone treatment chosen, patients will require regular monitoring during the first year of treatment in order to monitor clinical response to testosterone, testosterone levels and adverse effects, including prostate cancer (see Table 2). It is recommended that patients should be reviewed at least every three months during this time. Once treatment has been established, less frequent review is appropriate but the care of the patient should be the responsibility of an appropriately trained specialist with sufficient experience of managing patients treated with testosterone.
Popular through the centuries in Ayurvedic healing (a traditional practice of medicine in India) ashwagandha is what is known as an "adaptogen." This means the body may be able to use it to help adapt to stressors. While many people supplement with it for reducing cortisol, anxiety, and fatigue levels, ashwagandha also holds relevance for us here with potential testosterone boosting benefits.[8]
Male hypogonadism becomes more common with increasing age and is currently an under-treated condition. The diagnosis of hypogonadism in the aging male requires a combination of symptoms and low serum testosterone levels. The currently available testosterone preparations can produce consistent physiological testosterone levels and provide for patient preference.
If you are serious about losing weight, you have got to strictly limit the amount of processed sugar in your diet, as evidence is mounting that excess sugar, and fructose in particular, is the primary driving factor in the obesity epidemic. So cutting soda from your diet is essential, as is limiting fructose found in processed foods, fruit juice, excessive fruit and so-called "healthy" sweeteners like agave.
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
Before the ready availability of non-injectible testosterone preparations, and because of their ease of administration by the oral route, 17-alkylated steroids were popular surrogate agents for testosterone. These substances, however, were capable of inducing several risk factors for coronary artery disease (Kopera 1993; Hall and Hall 2005) and as a consequence, particularly after the revelations of extensive 17-alkylated anabolic steroid abuse by athletes, testosterone, became unjustly incriminated. The evidence, however, tends to suggest just the opposite; testosterone may even be cardioprotective. Dunajska and colleagues have demonstrated that when compared to controls, men with coronary artery disease tend to have: lower total testosterone levels and free androgen indices, more abdominal fat, higher blood sugar and insulin levels (Dunajska et al 2004).
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.
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.[37]
It doesn’t get more natural than getting a good night’s sleep. Research published in the Journal of the American Medical Association showed that lack of sleep can greatly reduce a healthy young man’s testosterone levels. That effect is clear after only one week of reduced sleep. Testosterone levels were particularly low between 2 and 10 p.m. on sleep-restricted days. Study participants also reported a decreased sense of wellbeing as their blood testosterone levels dropped.

How to increase testosterone levels quickly boost testosterone supplements. Buy this - http://amzn.to/2rotDBa How to boost testosterone levels in males older men by medicine food pills naturally with food.T is the male sex hormone; it is found in both genders and throughout many different species boost testosterone naturally after watching this video. It is no news that testosterone level in men begin to decline at a certain age, mostly 30. Therefore people search for how to boost testosterone levels in body with food for beard. It is produced primarily in the testicles in males and the ovaries in females even females ask for how to boost testosterone in women with supplements. However, not all supplements are created equal – there’s a lot of trash out there!
That testosterone decreases with age has been clearly established by many studies over many years in several different populations of men (Harman et al 2001; Feldman et al 2002; Araujo et al 2004; Kaufman and Vermeulen 2005). Of even greater significance is the steeper fall of the most biologically active fraction of total testosterone, non-sex hormone binding globulin (SHBG)- bound testosterone, or bioavailable testosterone (bio-T). The classical, but not the only approach to measuring bio-T, is to precipitate out SHBG (and hence the testosterone which is strongly bound to it as well) and measure the remainder as total testosterone (Tremblay 2003). Vermeulen et al (1999) have devised a less tedious and less expensive method of measuring a surrogate for bio-T, namely calculated bio-T, inserting total T, albumin, SHBG and a constant into a mathematical formulation. There is a strong correlation between actual bio-T and calculated bio-T (Emadi-Konjin et al 2003).
The partial synthesis in the 1930s of abundant, potent testosterone esters permitted the characterization of the hormone's effects, so that Kochakian and Murlin (1936) were able to show that testosterone raised nitrogen retention (a mechanism central to anabolism) in the dog, after which Allan Kenyon's group[186] was able to demonstrate both anabolic and androgenic effects of testosterone propionate in eunuchoidal men, boys, and women. The period of the early 1930s to the 1950s has been called "The Golden Age of Steroid Chemistry",[187] and work during this period progressed quickly. Research in this golden age proved that this newly synthesized compound—testosterone—or rather family of compounds (for many derivatives were developed from 1940 to 1960), was a potent multiplier of muscle, strength, and well-being.[188]

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.[1]
Your diet is the best source of zinc; along with protein-rich foods like meats and fish, other good dietary sources of zinc include raw milk, raw cheese, beans, and yogurt or kefir made from raw milk. It can be difficult to obtain enough dietary zinc if you're a vegetarian, and also for meat-eaters as well, largely because of conventional farming methods that rely heavily on chemical fertilizers and pesticides. These chemicals deplete the soil of nutrients ... nutrients like zinc that must be absorbed by plants in order to be passed on to you.
High intensity exercise is crucial to boost testosterone (13).  Exercises should be explosive in nature and maximize the resistant overload on the muscles.  Large muscle group compound lifts such as squats, deadlifts & burpees are some of the best testosterone boosting exercises.  The training session should be short (5-30 mins) and have very little rest periods between sets.
Michael T. Murray, ND, is widely regarded as one of the leading authorities on natural medicine. He is the author of many books, including the classic Encyclopedia of Nutritional Supplements. His latest book is What the Drug Companies Won’t Tell You and Your Doctor Doesn’t Know. Visit him online at doctormurray.com.   Article Courtesy of Better Nutrition  
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.
^ David KG, Dingemanse E, Freud JL (May 1935). "Über krystallinisches mannliches Hormon aus Hoden (Testosteron) wirksamer als aus harn oder aus Cholesterin bereitetes Androsteron" [On crystalline male hormone from testicles (testosterone) effective as from urine or from cholesterol]. Hoppe-Seyler's Z Physiol Chem (in German). 233 (5–6): 281–83. doi:10.1515/bchm2.1935.233.5-6.281.

For this reason I recommend doing your own research on this supplement before taking it. 5g of ground up dried powder is what was used in the studies. I recommend taking 1-2 capsules of the concentrated form from Paradise Herbs. Alternatively, the Aggressive Strength Test Booster also has MP in its formula so you may prefer to use that blend instead. 


Testosterone treatment is unequivocally needed in classical hypogonadism for reasons discussed in subsequent subsections. In classical hypogonadism, testosterone production is usually clearly below the lower limit of normal and patients are highly symptomatic; the various symptoms are easily related to the deficiencies in various bodily systems where testosterone action is important. Symptoms of testosterone deficiency are listed in Table 2. A few prominent causes of classical hypogonadism are listed in Table 3.
Even before the study yields its findings, Dr. Swerdloff said a few important points should be emphasized. "I want to make it clear that this is not a made-up disease," he said. "It is well known in younger men that if you have a failure to produce normal testosterone, there are certain signs and symptoms that create a kind of syndrome. Treatment for low testosterone has been documented to be beneficial."
This causes your body to burn fat for the next 36 hours to replace your body’s vital energy stores. It addition to increasing your T-levels, it can help burn between 3–9 times more fat, lower your resting heart rate, lower blood pressure, keep your brain young by increasing circulation, and aids in detoxification by stimulating the lymphatic system.
There have been case reports of development of prostate cancer in patients during treatment with testosterone, including one case series of twenty patients (Gaylis et al 2005). It is not known whether this reflects an increase in incidence, as prostate cancer is very common and because the monitoring for cancer in patients treated with testosterone is greater. Randomized controlled trials of testosterone treatment have found a low incidence of prostate cancer and they do not provide evidence of a link between testosterone treatment and the development of prostate cancer (Rhoden and Morgentaler 2004). More large scale clinical trials of longer durations of testosterone replacement are required to confirm that testosterone treatment does not cause prostate cancer. Overall, it is not known whether testosterone treatment of aging males with hypogonadism increases the risk of prostate cancer, but monitoring for the condition is clearly vital. This should take the form of PSA blood test and rectal examination every three months for the first year of treatment and yearly thereafter (Nieschlag et al 2005). Age adjusted PSA reference ranges should be used to identify men who require further assessment. The concept of PSA velocity is also important and refers to the rate of increase in PSA per year. Patients with abnormal rectal examination suggestive of prostate cancer, PSA above the age specific reference range or a PSA velocity greater than 0.75 ng/ml/yr should be referred to a urologist for consideration of prostate biopsy.

A number of epidemiological studies have found that bone mineral density in the aging male population is positively associated with endogenous androgen levels (Murphy et al 1993; Ongphiphadhanakul et al 1995; Rucker et al 2004). Testosterone levels in young men have been shown to correlate with bone size, indicating a role in determination of peak bone mass and protection from future osteoporosis (Lorentzon et al 2005). Male hypogonadism has been shown to be a risk factor for hip fracture (Jackson et al 1992) and a recent study showed a high prevalence of hypogonadism in a group of male patients with average age 75 years presenting with minimal trauma fractures compared to stroke victims who acted as controls (Leifke et al 2005). Estrogen is a well known determinant of bone density in women and some investigators have found serum estrogen to be a strong determinant of male bone density (Khosla et al 1998; Khosla et al 2001). Serum estrogen was also found to correlate better than testosterone with peak bone mass (Khosla et al 2001) but this is in contradiction of a more recent study showing a negative correlation of estrogen with peak bone size (Lorentzon et al 2005). Men with aromatase deficiency (Carani et al 1997) or defunctioning estrogen receptor mutations (Smith et al 1994) have been found to have abnormally low bone density despite normal or high testosterone levels which further emphasizes the important influence of estrogen on male bone density.
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

Include these foods in your diet. It is a sure shot and natural way of keeping and increasing your testosterone levels. Knowing that you have low testosterone can be bad. However, it is not the end of your manhood. If you eat these testosterone boosting foods and you keep a healthy lifestyle. This will make sure that you stay in good shape all the time.
Every vitamin, mineral, and ingredient that affects the human body can be taken in enough quantities that they are harmful, or toxic, even the ones that — at lower levels — are beneficial or necessary. Unfortunately, testosterone boosters contain a lot of ingredients that are not well understood. This means in addition to not being able to confirm whether certain ingredients increase testosterone, the scientific and medical communities also don’t know at what levels many ingredients become toxic. On the up side, you might need to eat several pounds of a particular leafy plant before it becomes harmful. On the down side, it could be significantly less that pushes you over your body’s limit. We simply don’t know how little or how much the human body can tolerate. We recommend keeping your doctor in the loop when you add any supplement with unproven ingredients into your diet — they’ll be able to help you find and track any undesired side-effects that these ingredients might cause.

Other side effects include increased risk of heart problems in older men with poor mobility, according to a 2009 study at Boston Medical Center. A 2017 study published in JAMA found that treatments increase coronary artery plaque volume. Additionally, the Food and Drug Administration (FDA) requires manufactures to include a notice on the labeling that states taking testosterone treatments can lead to possible increased risk of heart attacks and strokes. The FDA recommends that patients using testosterone should seek medical attention right away if they have these symptoms:
Sprinting has been shown numerous times that it has positive effects on testosterone levels. One 2011 study (ref 84) looked at weightlifters who performed 4x35m sprints twice a week. In contrast to the control group (who continued lifting but did not sprint), it was found that “After the 4-week training program, total testosterone and the total testosterone/cortisol ratio increased significantly in the (sprinters) EXP group”.

When females have a higher baseline level of testosterone, they have higher increases in sexual arousal levels but smaller increases in testosterone, indicating a ceiling effect on testosterone levels in females. Sexual thoughts also change the level of testosterone but not level of cortisol in the female body, and hormonal contraceptives may affect the variation in testosterone response to sexual thoughts.[51]
A study published in the Journal of Steroid Biochemistry studied the effects of diet on serum sex hormones in healthy men. Results showed that when men decreased their healthy fat intake, serum concentrations of androstenedione, testosterone and free testosterone also decreased. (8) This indicates you can add low testosterone to the list of low-fat diet risks.

6)  Take Cold Showers:  Cold showers have been known to stimulate and boost testosterone production and improve metabolism, detoxification and brain function.  Start your shower with warm/hot water and turn it to cold for the last 30-60 seconds while pumping your muscles and creating a big shiver as your muscles contract.  That will help to boost internal heat and boost testosterone production.  This article will help you.


Nutrient Optimization– Testosterone production can often be increased by nutrient optimization. This is the supplementation of excess key vitamins and minerals which are required to produce testosterone. This allows your test pathway to keep producing away, as opposed to someone with a key vitamin or mineral deficiency- which slows down or stops testosterone production.


Jason, if you look closer you will see that Test Freak did not make it onto our list. Both Test Freak and Zeus were only used in our introductory image to show diversity among test boosters. Despite this, I still would favor Test Freak over Anabolic Freak on the basis that Anabolic Freak’s primary active ingredient is D-Aspartic Acid, while Test Freak contains a wider spectrum of active ingredients including proprietary Testofen and Trigotest along with a good dose of Zinc.
Testosterone was first used as a clinical drug as early as 1937, but with little understanding of its mechanisms. The hormone is now widely prescribed to men whose bodies naturally produce low levels. But the levels at which testosterone deficiency become medically relevant still aren’t well understood. Normal testosterone production varies widely in men, so it’s difficult to know what levels have medical significance. The hormone’s mechanisms of action are also unclear.
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