Middle Aged Man with Low Testosterone

What Causes Low-T? Why Do I Have Low Testosterone?

In this article, we will explore the potential causes of low testosterone, ranging from genetic factors to environmental influences and lifestyle choices.


Testosterone levels naturally decline as men age. Studies have shown that testosterone levels decrease by approximately 1% per year after the age of 30. This gradual decline is a normal part of the aging process and may be responsible for some of the symptoms associated with "male menopause" or andropause.

Genetic Factors

Some men may have a genetic predisposition to low testosterone levels. For example, Klinefelter Syndrome, a genetic disorder affecting approximately 1 in 500-1,000 men, is characterized by the presence of an extra X chromosome and can result in low testosterone production.

Environmental Factors

Exposure to certain environmental toxins, such as pesticides and heavy metals, can disrupt hormone production and contribute to low testosterone levels. A study published in the journal Human Reproduction Update found that exposure to endocrine-disrupting chemicals (EDCs) could adversely affect male reproductive health, including reduced testosterone levels.

Drug Abuse

The abuse of certain drugs, such as opioids and anabolic steroids, can negatively impact testosterone production. Long-term opioid use has been shown to suppress the hypothalamic-pituitary-gonadal axis, leading to decreased testosterone levels. Similarly, anabolic steroid abuse can suppress the body's natural testosterone production, resulting in low testosterone levels once steroid use is discontinued.


Elevated estrogen levels can suppress testosterone production in men. Aromatase, an enzyme responsible for converting testosterone into estrogen, can be overactive in some individuals, leading to an imbalance in hormone levels. Certain medications, such as aromatase inhibitors, can help address this issue by reducing estrogen production and supporting healthy testosterone levels.


A poor diet, particularly one high in processed foods and low in essential nutrients, can negatively impact testosterone levels. Research has shown that diets rich in healthy fats, such as monounsaturated and polyunsaturated fats found in olive oil, nuts, and fish, can support optimal testosterone production. Additionally, ensuring adequate intake of key nutrients, such as zinc and vitamin D, is essential for maintaining healthy testosterone levels.


Carrying excess body weight, particularly in the form of visceral fat, can negatively affect testosterone levels. A study published in the journal Clinical Endocrinology found that obese men had significantly lower testosterone levels compared to their non-obese counterparts. Losing weight through a combination of healthy diet and regular exercise can help improve hormone balance and support optimal testosterone production.

Low testosterone levels can result from a variety of factors, including age, genetics, environmental exposure, drug abuse, estrogen levels, diet, and weight. Understanding these potential causes can help individuals make informed decisions about how to address their low testosterone levels and improve overall hormonal health. If you suspect you have low testosterone, it is essential to consult a healthcare professional for a proper evaluation and guidance on the most appropriate course of action.

Angry about the US Healthcare System

A Testosterone Pellet Patient’s Review

I've tried it all: Gels, shots and pills. The gel was terrible. The pills will destroy your liver. The shots were OK for the first five years, but the weekly (or bi-weekly if you want to avoid the peaks and valleys) testosterone shots got old after awhile. Switching between shoulders, thighs and gluts each week felt like doing The Macarena and I still felt like a pin cushion.

That left only the pellets and, I gotta say, I was very disappointed. Had I opted for the name-brand Testopel version, things may have gone better. The ones I got from the Trader Joe's compounding pharamcy were not good at all.

The biggest problem with pellets is if it's not working for you, you'll still have to wait for them to dissolve to get another type of testosterone. That means 3-6 months of waiting. I lost muscle, got depressed and was super lethargic for a couple of months. My review of testosterone pellet therapy? It sucked.

Back to injections for me! "Heeeey Macarena!"

Sprinting to Boost Testosterone

Research has shown that short, intense workouts like sprinting can significantly impact muscle mass and hormone production, particularly when compared to long-distance running. Here we explore the science behind sprinting and testosterone production, providing you with valuable insights on how to optimize your workouts for maximum hormonal benefits.

Red Blood Cells in Vials

What to Do About High Red Blood Cell Count while on TRT

Give Blood Save Your LifeTestosterone replacement therapy can increase hemoglobin and hematocrit production beyond normal/safe levels, a condition known clinically as polycythemia. If you are on TRT it is important to be regularly tested for this condition, as it may increase the risk of thrombosis and stroke.

Hemoglobin is an iron-containing biomolecule that can bind oxygen, and is responsible for the red color of blood cells. Hematocrit levels refer to the percentage of blood volume occupied by red blood cells. The test I get is a red blood cell (RBC) count, which measures the number of red blood cells per volume of blood and includes readings for both hemoglobin and hematocrit.

How to Lower RBC while on TRT

If your RBC test results come back abnormally high, treatment options given by the doctor might involve lowering your testosterone dosage or discontinuing your hormone therapy. Personally, neither of these is an acceptable option so I opt for a third: Donating Blood. The doctor could theoretically prescribe a therapeutic phlebotomy (draining some of your blood, which would be destroyed instead of donated). However, it is not a widely adopted practice and is unlikely to be prescribed. Besides that, I'd rather my blood be donated to someone in need.

Can You Donate Blood if You Take Testosterone?
The RedDouble Red Blood Cell Donation Cross form you fill out will ask if you take any injectable drugs, and may even specifically mention testosterone, but the fine print says "Without a prescription" so you can answer "No" to that question. As long as you are taking doctor prescribed testosterone for hormone replacement (Not 500mg + every week like a bodybuilder) it should be OK to donate because there is only a normal amount of testosterone in the blood stream.

I donate blood to the Red Cross about once every three or four months. If they have the facilities at the donation center I'll even opt for a Double Red Blood Cell Donation, and it feels much like I'd imagine an oil change might feel to a sentient vehicle.

Click Here to find a Red Cross blood donation opportunity near you.

Couple in Bed

Does TRT Improve Sex Drive?

As any guy who has been struggling with low T for a long time will tell you, the difference testosterone makes for your sex drive is profound.

Sexy Black Car

I'm just happy that my mojo is back.

Over the years I've heard some great stories by people who profess that testosterone replacement has replenished their sex drive, or even saved their marriage. Some used to have problems with ED, while others just couldn't be bothered to deal with all the foreplay involved after a long day at work and an evening dealing with the kids. Sound familiar?

Does TRT improve your sex drive? In short, hell yes! And there are many studies and news stories that you can trust to back up that statement.

Studies on TRT and Male Libido

Learn more in our TRT eBook!
Chapter 10: Testosterone and Restoring Your Libido

It's All Good!

No News is Good News RE: Testosterone Replacement Therapy Update

It's All Good!

I just had my testosterone levels checked again and am at 1,151 Total. I've seen "normal range" scales say different things, usually from about 240 - 250 on the low end to anywhere from 800 - 1,080 on the high end. I like to be on the high end most of the time, but will occasionally lower the doses for awhile if I feel like I'm getting too much for too long. Lately I've been feeling good with my testosterone levels, as well as my thyroid levels now that we have that dialed in (I had my thyroid removed a couple of years ago during a cancer scare).

One thing I've learned this year is that if I feel a bit of gyno come on reducing the testosterone dose is NOT the answer, especially without some nolvadex or an aromatase inhibitor. I had this self-fulfilling crisis in which I lowered the testosterone because I felt a little bit of gyno and thought that would make it go away. But that only served to create a further imbalance (in favor of estrogen), which caused the symptoms to get worse. I called the doctor and asked for some Nolvadex and he said I should up the dose back up to what I was taking (200 mg per week) normally and if it didn't go away in a week he'd prescribe me some. Well it went away in a few days. However, I would very much like some Nolvadex on hand in case it pops up again (no pun intended).

The problem with aromatase inhibitors is that they suppress the conversion of testosterone into estrogen, which is good for "cycles" but maybe not for long-term HRT. The more suppressed your estrogen levels become (below normal) the more signals are sent to convert more testosterone to estrogen. Then when you stop taking an aromatase inhibitor (e.g. Arimidex) your body will be producing WAY more estrogen than it would have otherwise. That is, at least, how my endocrinologist explained it to me. He likes tamoxafin citrate (i.e. Nolvadex) because it just blocks the parking spot (receptors) that the estrogen would normally bind to, rather than keeping it from being produced in the first place.

At any rate, I don't currently have any gyno symptoms, my sex drive is great, I'm in awesome shape and I feel good. It has been like this for several months straight now so It's All Good!

How has your therapy been going lately?



How Some Health Supplements Can Drop Testosterone Levels

I was going to title this post:
How So-Called "Natural" Testosterone Boosters, Prohormones and Other Over-The-Counter Health Supplements for Building Muscle May Cause Hypogonadism

But that's a little long ;-)

4-chloro-17a-methyl-androst-1-4-diene-3b-17b-diolWhile the FDA does a pretty good job of regulating "medicines" they don't do such a good job of regulating health supplements, which generally fall under "food" guidelines, which are much more lenient than what prescription-grade pharmaceuticals have to deal with (e.g. years of laboratory testing, human trials, etc...). The FDA has tried several times to expand the definition of pharmaceutical drugs and thus their jurisdiction over health supplements. Some see this as a good thing; others see it as a bad thing. I'm going to stay out of that argument. But I will say this: There's a big difference between something like vitamin B, whey protein, or acai berries and things like 3,17-keto-etiocholetriene and 4-chloro-17a-methyl-androst-1,4-diene-3b,17b-diol.

Have you ever taken an over-the-counter, legal supplement - like pro-hormones - only to find out afterwards that you have low testosterone?
Did you gain  lose fat while taking a supplement, only to gain all of it - and more - back when you stopped taking it? Did you get steroid-like side effects (e.g. gynecomastia, hair growth...) from legal bodybuilding supplements? You may be surprised to find out that many of those so-called supplements actually break down into the same ingredients found in "real" illegal or prescription-grade steroids, aromatase inhibitors, estrogen blockers, erectile dysfunction drugs and other pharmaceutical substances. If you find this difficult to believe, just read some of these recalls, which are just the tip of the iceburg (those that got busted) when compared to how many are still out there:

Recalled Health "Supplements":

Gaspari Nutrition Recalls Novedex XT, Marketed as a Dietary Supplement Containing ATD
(AKA 3,17-keto-etiocholetriene, an anti-aromatase used to lower estrogen-related side-effects in men taking steroids.)
iForce Nutrition Recalls Reversitol, a Dietary Supplement Containing ATD
(See above description RE: ATD)
Bodybuilding.com Supplements Recalled: May Contain Steroids
(Big recall in 2009 involving dozens of supplements that the FDA said should have been classified as steroids like Trenbolone, Androstenedione and Turinabol.)
Good Health, Inc. Recalls Vialipro – Contains Prescription-Only Ingredients
(These recalls in which sexual enhancement drugs sold at gas stations, truckstops and online contain real erectil dysfunction medications like sildenafil -aka Viagra - or substances like Sulfoaildenafil, that break down into Sildenafil, are quite common.)
IDS Sports Conducts a Voluntary Nationwide Recall of Bromodrol, Dual Action Grow Tabs, Grow Tabs, Mass Tabs, and Ripped Tabs TR
(Similar to the Bodybuilding.com recall, there were several supplements that were found to contain ingredients the FDA deemed should have been classified as steroids.)

Want to see hundreds more like this? Check out US Recall News' Dietary Supplement section

If something is being marketed in the back of a bodybuilding magazine with steroid-sounding names like Bromodrol, Dbolz, Testosterone Booster Tripple X... you should think about what that marketing is trying accomplish. I'm not anti-steroids when it comes to adults making their own health decisions. And I certainly don't think the government should be telling us what vitamins we can take without a prescription. But neither should teenagers, women or unsuspecting male athletes be conned into taking health risks and job risks under the false pretense that they are taking "legal" supplements that don't have any side effects.

So if you've ever taken a health supplement that produce too-good-to-be-true results, only to find that you crashed when you came off, or that your testosterone levels were low after long-term use of these drugs, you may have actually been taking steroids, or something analogous to them in effects and side-effects. It makes me wonder how many guys end up on lifelong testosterone replacement because of these supplements, especially since they probably didn't take appropriate post-cycle-therapy precautions.


Testosterone Replacement Therapy B&W Logo

Three Month Update on TRT

Fight Club Hug - GynecomastiaI'm not sure exactly how long I've been on TRT now, but I think it's been about three months. I haven't done the blast-cruise thing because I ran into some other health problems (benign thyroid tumors that my doctor thought "could be" malignant at the time) that took awhile to figure out, and longer to heal from surgery. I figured it would be pointless to take more than prescribed if I can't make the best of it in the gym. Also, the wife is pregnant (WAY pregnant) so having a better libido is kind of superfluous unless I feel like jerking off more often. TMI? IDGAF.

I've been taking 100mg per week of testosterone enanthate and feel pretty good. I don't feel like I do when I take 200mg per week, but I don't feel like crap - which is how I feel when I'm not on TRT. The only problem is I think I'm developing a small case of gynecomastia. It's nothing you can see, but I can feel it under my skin and sometimes that area is itchy or sensitive. The doctor assured me that this wouldn't happen on normal doses - which was his reasoning for refusing to prescribe me Nolvadex or an aromatase inhibitor like Arimidex - so it should be an interesting conversation when I go in for my appointment in a few weeks and he feels the lumps.

I'm not all that concerned though. A: It's easily taken care of with a relatively simple surgery and B: I can probably keep it from progressing as long as I start taking Nolvadex or Arimidex.

Having been on just "normal" levels of testosterone, and having been out of the gym for several months, I'm not feeling in the greatest shape. The fact that your thyroid is responsible for your much of your metabolism (and mind has been completely removed) probably doesn't help matters. There's one more medication that I'm on for life, and that I haven't fully dialed in the dosage on yet. But I'm confident that I will be able to get the dosage right with time, afterwhich I look forward to getting in the best shape of my life by the age of 36. :-D

So that's my update. How are YOU doing?

DIY Testosterone Injection

502 – My Lucky Number

Normal Testosterone Levels for Me - 502After one month of testosterone injections of 100mg per week (.5 mil of 200mg/mil injectable oil) using testosterone enanthate my test levels are at 502. I wanted to take what was prescribed for awhile to see where that would put me. This was also near the end of the week so I'm guessing that is the lower end of the spectrum, although when injecting enanthate (generic form of Delatestryl) every week the spectrum probably isn't too wide. My guess is I'm anywhere from between 500 and 800 ng/dl. The government website Medline Plus puts the "normal" range for men at 300 to 1,200 ng/dL. Given that this includes 25-year-old guys at the peak of their physical condition, I think maintaining somewhere between 500 and 800 is going to work out well for me healthwise. I feel good in this range.

Now... with that said, I am hereby embarking on the "Blast" phase of my year, where I will be taking double that amount for several months before tapering back down to 100 mg per week. I believe at 200mg per week I will still be within safe-enough levels to avoid any major side effects (hopefully) associated with steroid use, as bodybuilders frequently start at a minimum of 500mg per week (up to more than 2 grams in some cases) in addition to several other androgenic / anabolic steroids like nandralone, stanozolol, dianabol and equipoise. At this point one needs to take a whole host of other medications to combat the side effects, both during the "cycle" and during the post-cycle-therapy (PCT) phase, including things like tamoxifen citrate (generic Nolvadex), clomophene (Clomid), and anastrozole (Arimidex). Since I don't plan on having any more children, I am not even taking HCG. Right now it's just testosterone, although I do plan on having some Nolvadex and/or Arimidex on-hand just in case I feel any estrogen-related side effects.

So that's the plan. If I'm going to be on testosterone for the rest of my life, I might as well enjoy the benefits of being able to have a great sex drive and physique for the rest of my life without having to hassle with the crashing testosterone levels experienced at the end of normal testosterone cycles for men who aren't on lifelong TRT.

Please keep in mind that A: I am not interested in being a bodybuilder and do not need to take 500mg of testosterone to be "in good shape". B: I want to avoid as much ancillary medication as I can without experiencing estrogen-related side-effects. C: I do plan on tapering from 200 mg/week, to 150 mg/week for one month before going to the normal 100 mg/week to give my body time to metabolize some of the estrogen and catabolic hormone build-up while staying in the proper balance of having more testosterone in relative amounts to the other hormones.

I'd appreciate any feedback you might have on this, especially if it sounds like something you have tried yourself in the past.

DIY Testosterone Injection

Getting Back on Track – Testosterone Enanthate Here I Come!

Delatestryl: Testosterone EnanthateAfter a three-month waiting list (I live out in the boonies) I finally got to see the only endocrinologist within 50 miles. We did some blood work that I haven't gotten back yet, and he said my thyroid was swollen so I have to get a sonogram done on that in a couple of weeks. Those two things aside, we're going ahead with testosterone replacement therapy and I'm looking forward to getting life back on track again and settling into some kind of rhythm.

While my primary care idiot physician was only prescribing me one 200mg shot of testosterone cypionate every month (fucking moron! Sorry, couldn't help it.) and made me come into his office for it (so they could charge me $85 and wait an hour to get stuck.) this new endo is prescribing 200mg of testosterone enanthate every other week, and is letting me take it from home. He said if I'd rather take 100mg every week and don't mind the shots then he's all for it. I get a three-month supply for under $100 and even that is tax-free since it gets paid out of my health savings account.

He said he wanted to try just the testosterone for six months and then do some blood work. His hope, and mine, is that I can just take the test without any other drugs (estrogen blockers, aromatase inhibitors, HCG...) I know my boys will shrink away without the HCG, but my wife is pregnant now and we were only planning on having one kid. I have some "spares" in the sperm bank just in case.

So that's that. Hopefully there'll be no more bitching and whining from me about having to take testosterone for the rest of my life. I'm pretty sure I've accepted it, at least for now. You have to understand that the last few months of posts have been while I'm trying to function without much testosterone (hovering around 200 +/-) so if I've been acting like a little bitch it's because I've been feeling like one too.

No more. Today I got my first 200mg shot of test in awhile, and will be on TRT regularly. Acceptance is a good thing. I feel good.

I'll keep posting updates; will let you know if any health issues pop up that other TRT guys should think about. I might even use the TRT dose as a "cruise" does and go up to 500mg per week for a few months out of the year. My HPTA is already all fucked up, so I might as well have the advantage of not crashing out after a cycle. The only immediate problem I can see is how to get my wife's libido on the same track as mine is going to be. Something tells me that won't be easy. ;-)