Have you ever bought an over-the-counter Testosterone Booster? Boosters are easily accessible and sold at most major supplement stores. The marketing is flashy and promises to give you hulk-like muscles, make you Hugh Hefner in the bedroom, and even improved penile length.  Seem too good to be true? You are correct.

Despite the popularity of over-the-counter boosters, the scientific rationale often remains unproven. Over 90% of boosters claim to increase testosterone, however studies found that less than 25% had any research or data to support their claims. Shockingly, 10% of the supplements studied caused a NEGATIVE impact on testosterone.

Testosterone Boosters – More harm than good

Testosterone boosting supplements are not only a scam but can actually cause more harm than good. Unlike pharmaceutical medications the supplement industry is not regulated by a governing body. For the consumer this means that what’s on the bottle may not be what’s in the pill you are purchasing. Without regulations and rigorous laboratory testing, one cannot be confident in the quality or efficacy of the product.  Bad storage conditions and unreliable ingredient sourcing are often to blame for a poor product. The quantity of each ingredient has also been noted as a potential issue. One study found that many of the tested boosters had super doses (over the tolerable limit) of the vitamins and minerals.

Testosterone Boosters bought over the counter have gained popularity as consumers are looking for a way to “naturally” raise their own testosterone. In a society of instant gratification, popping a pill daily is much more convenient then going to a doctor, exercising, and eating right. The main concern with most of these supplements is that they are taken in the oral form.  When taken in the oral form, boosters have to go through the liver to be digested which in turn can lead to issues in the liver and kidneys. According to a study in 2019, about 13% of acute liver failures are a result of supplement-induced liver injury.

Research based ways to further optimize

The safest most effective way to optimize your hormones is through a physician monitored testosterone replacement therapy. If your hormones are already optimized, the following vitamins/hormones can be the next step in optimization. 

Vitamin D- What is known as the sunshine vitamin is not a vitamin at all! Vitamin D is actually a hormone that regulates the synthesis of testosterone. Researchers found that a vitamin D deficiency, defined by levels less than 20ng/ml, is independently associated with testosterone deficiency. Men with Vitamin D deficiency were 2.65 times more likely to have testosterone deficiency compared to those with levels above 20 ng/ml. Vitamin D effects production of natural and free testosterone along with formation of male sperm cells. Supplementation with Vitamin D has been associated with higher levels of testosterone and sex hormone binding globulin. 

Zinc– Zinc is a nutrient that is found in our cells that helps in making proteins, DNA, genetic material, and helps our immune system fight bacteria and viruses. At the peak of COVID19, most stores and online stores were sold out of zinc for this reason. Research shows that a deficiency lowers testosterone levels by inhibiting prolactin secretion (testosterone inhibiting hormone). Overtraining in the gym can also lead to a zinc deficiency. Zinc is present in most multi-vitamins but is also available independently. A true zinc deficiency would need to be determined by bloodwork.  Be sure to ask your physician about the correct form of zinc as most over the counter supplements are not available in best absorbing form. 

Magnesium– Magnesium is a mineral typically found in foods high in fiber like green vegetables, seeds, and nuts. Several studies suggest a correlation between magnesium and an increase in free testosterone. Free testosterone is the unbound, biologically active portion of testosterone, AKA available for our bodies to use. Like zinc, a blood test would need to be performed to determine if there is deficiency.

DHEA– Dehydroepiandrosterone (DHEA) is a steroid hormone secreted primarily by the adrenal glands and a small amount in the testes. This hormone is oftentimes referred to as the “mother of all hormones” because it fuels the hormone pathway. DHEA is the precursor to many other hormones which helps maintain health hormone levels and promotes the stress response, to reverse stress-induced physiological responses and supports healthy aging. 

DHEA is a precursor hormone the majority of other sex hormones including, testosterone, progesterone, estrone and estradiol. Clinical studies have demonstrated its ability to maintain hormonal balance and back fill hormonal pathways.

Pregnenolone– is a prohormone that is made in the brain and adrenal glands and small amounts in the liver, skin, brain, and testicles. Pregnenolone plays a key role in hormonal balance as a key precursor to cortisol, DHEA and progesterone, and helps maintain balance in the body’s stress response. Pregnenolone levels peak during youth and continue to decline with age. Nicknamed “The Father of all hormones” because it is a parent compound to other vital neuro-steroids such as DHEA. 

If you are starting to have symptoms of low testosterone getting tested and seeing a doctor is the best first step. Outside of a prescription for testosterone there is very little research to support over the counter testosterone boosters.   

Further References

[1] 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. 2014 Jan 20;13(1):192-9. eCollection 2014. 

[2] Maggio, Marcello, et al. “The Interplay between Magnesium and Testosterone in Modulating Physical Function in Men.” International journal of endocrinology2014 (2014).

Links: one, two, three

Welcome back to Testosterone Myths and Misconceptions; BUSTED Part 3. If you missed part 1 and 2, start here.

The goal of this blog series is to debunk some of the common, false ideas about testosterone replacement therapy (TRT). We believe men should have the option to tap into more youthful, healthy living. These testosterone myths BUSTED should give you a good start on digging into the truth about TRT.

Myth: Testosterone therapy is a fad, experimental, pseudo medicine, etc. 

Truth: Testosterone therapy is and has been the standard medical treatment for men suffering from low T symptoms and/or clinical testosterone deficiency for more than 70 years. 

There is an abundance of research that shows testosterone therapy provides substantial benefits with reasonable, manageable associated risk.

As with all areas of science and medicine, we learn more and more as time goes on. This means the medical providers who specialize in TRT are constantly learning and evolving to provide the best protocols for their patients as individuals. 

Myth: Testosterone therapy causes prostate cancer

Truth: Thankfully, this is simply not true.  The thought that TRT increases risk of prostate cancer is unfounded. It is not supported by evidence. Furthermore, there is now evidence that links low serum testosterone levels to aggressive prostate cancer. For men who have undergone treatment for aggressive prostate cancer, there is a lower rate of cancer reoccurrence if the patient receives testosterone therapy once cancer treatment is complete.  

Large prospective longitudinal studies have found no association between endogenous androgen concentrations and prostate cancer risk. Meta-analyses of placebo-controlled T therapy trials have documented no increased risk of prostate cancer in men receiving T therapy. In men who received T therapy, there was no increased risk of high-grade disease. (Baillargeon J, Kuo YF, Fank X, Shahinian VB. Long-term expo- sure to testosterone therapy and the risk of high grade prostate cancer. J Urol. 2015;194(6):1612-1616 & Kaplan AL, Hu JC. Use of testosterone replacement therapy in the United States and its effect on subsequent prostate cancer outcomes. Urology. 2013;82(2):321-326.)

Myth: Low testosterone is a normal part of the aging process and isn’t necessary to be treated in older men.

Truth: Well, let’s put it this way: cardiac disease, obesity, adult cancers, diabetes and other comorbidities are more common with older age too. Does that mean we shouldn’t treat them? Of course not!  Testosterone deficiency is an important medical condition affecting the health and well-being of men; the symptoms of low T result from low levels of testosterone regardless of whether an underlying condition is identified; the impact of testosterone deficiency is global; testosterone therapy is effective, rational, and evidence based.

Testosterone is a vital part of the health and well-being of a man. To avoid treatment based on age would be a disservice to the patient.

Our staff at Victory Men’s Health takes pride in staying up to date with the latest and proven means of therapy. Please reach out to learn more.

Further References

Wu FC, Tajar A, Pye SR, et al; European Male Aging Study Group. Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study. J Clin Endocrinol Metab. 2008;93(7):2737-2745. 

Abraham Morgentaler, MD (Chairman); Michael Zitzmann, MD (Cochairman); Abdulmaged M. Traish, PhD (writing group);
Anthony W. Fox, MSc, MD (writing group); T. Hugh Jones, MD (writing group); Mario Maggi, MD (writing group); Stefan Arver, MD; Antonio Aversa, MD; Juliana C.N. Chan, MD; Adrian S. Dobs, MD; Geoffrey I. Hackett, MD; 

Wayne J. Hellstrom, MD; Peter Lim, MD; Bruno Lunenfeld, MD;
George Mskhalaya, MD; Claude C. Schulman, MD; and Luiz O. Torres, MD  

Welcome to part 2 of Testosterone Myths and Misconceptions; BUSTED. If you missed part 1, start here.

Hopefully you will feel more equipped with the truth about testosterone after reading both parts of this blog series. It is our mission to help men everywhere obtain the information and tools to live their healthiest, most optimal life. Knowledge is power.

Myth: If I have low T, I should try testosterone boosters.

Truth: No! There are two main reasons to avoid these highly advertised products.

1. Buyer beware! Oral testosterone boosters do not raise testosterone a significant amount. In some cases, T boosters may cause a transient increase in total testosterone, but it will not sustain.
2. The most important reason to avoid oral testosterone boosters: they can be dangerous and toxic to internal organs, specifically the liver. 

You may wonder why testosterone boosters are on the market if they are dangerous. Good question. Dietary supplements are not regulated by the FDA. There is very limited monitoring and legal responsibility in producing T boosters, giving the producers of T boosters a lot of legal freedom and consumer demand for a “quick fix”. Companies who sell these products do a great job of preying on men desperately needing to feel better. Don’t fall for it. The best thing to do with symptoms of low testosterone is to find a highly trained medical provider that specializes in hormone optimization.  

Myth: Testosterone will make me angry.

Truth: This is simply not true. In fact, it is quite the opposite.  Some of the main symptoms of low testosterone include mental fog, decreased mood, depression, irrational thinking, and poor decision making. Emotional and mental well-being are expected to improvewhen testosterone is optimized. Remember, we are talking about optimal levels of testosterone, not super-physiological. There can be, in fact, too much of a good thing. It is vital to ensure your testosterone provider is well-trained on TRT and can manage levels to help you feel your best.

Myth: Testosterone therapy will negatively affect my heart heath.

Truth: Optimal testosterone levels are cardio protective. This topic has been controversial among medical providers for many years, but in contrast, there are more than 100 studies revealing cardiovascular benefits or improved cardiovascular risk factors with T therapy or with higher endogenous T levels. This appears to have been a largely media-driven phenomenon, since the science does not support it.

The natural conversion of testosterone into estrogen is also a large piece of this puzzle. As discussed in Part 1 of this blog series, it is absolutely vital to maintain natural aromatase of estrogen to protect cardiac tissue while on testosterone therapy.

Here’s what we do know:

Studies show low testosterone levels are associated with increased risk of cardiac events, endothelial dysfunction, increased coronary artery disease, dyslipidemia, increased atherosclerosis. Whereas testosterone treatment shows an increase in coronary blood flow, decrease in myocardial ischemia, increase in skeletal muscle mass, decrease in body fat, and an increase in coronary vasomotion.  Testosterone therapy is effective, rational, and evidence based.  

NOTE: Although testosterone is shown to be cardio protective, lifestyle and other comorbidities play a huge role. Proper diet and exercise are critical to achieve and maintain good heart health.

Further References

Prevention of coronary artery disease in men: male hormone, female hormone, or both? Click here

Role of Testosterone in the Treatment of Cardiovascular Disease. Click here

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. 2014 Jan 20;13(1):192-9. eCollection 2014. Click here

The Journal of Clinical Endocrinology & Metabolism, Feb 1 1999, 84(2):573-577, “Bioavailable Testosterone and Depressed Mood in Older Men: The Rancho Bernardo Study.” Click here

Fundamental Concepts Regarding Testosterone Deficiency and Treatment: International Expert Consensus Resolutions. Click here