How does Testopel work?

If your head was not already spinning learning about Axiron, Androgel, Aveed, and Testim, it now will, because you will also need to include Testopel in your analysis of potential Testosterone Replacement Therapy options.  At this time, because of my serious plan to use diet and exercise to boost my Testosterone levels, I am not considering a prescription medication.  Having said that, the idea of gel terrifies me because it can be a problematic for others around you.  Thankfully, we do not have kids, but I still worry about my wife.

Testopel eliminates the risk of transference:  Unlike the gels that need to applied to the skin, Testopel is actually a below the skin implant.  It is a tiny pellet (size is like that of a pill) that your doctor can implant under your skin during a brief visit to the office.  No stitches needed.  Then, you are free for up to six months with no fears of forgetting to apply the gel daily or making your kids not touch you when they want to jump on top of you.


Yes, Testopel has risks too:  In addition to all the risks of any type of TRT, Testopel has additional risks.  For instance, once the pellet is inside you, it is impossible to know exactly how much daily dosage is being released.  When you apply the gel, you can change the dose pretty quickly based on how you are reacting to it, but with a pellet that flexibility does not exist, so the doctor needs to do a blood test to make sure that nothing is out of the ordinary.  While rare, it might also come out of the skin.  Obviously, another visit to the doctor's office maybe needed if it is to be removed because it is not working for you. 

Testim an alternative to Axiron and Androgel

While most of the mainstream advertising has been by Androgel, Aveed, and Axiron, there is yet another product on the market by Auxiliam Pharmaceuticals called Testim or 1% Testosterone Gel.  After thoroughly reviewing the safety information, my conclusion is that this drug is no different than its competitors because the benefits and side effects are identical.  I am no molecular biologist, but I am tempted to conclude that all these three products are substitutable; in other words, you can take either one of them but you will need to take that decision in consultation with your physician and insurance provider.  Since I am seeing a huge improvement in my Testosterone with diet and exercise and the fact that Testosterone Replacement Therapy may not be so effective, for the time being, I will continue with my strength training, plenty of sleep, and zinc.

Get enough sleep

I have never had trouble getting enough sleep.  As a management consultant in my previous life, I had stressful nights and I might have popped a melatonin sleep once in a while but generally speaking, by 10PM I am in bed and sleeping 10 minutes later in a bedroom with no television or electronic device except for a humble alarm clock (that rings at 630AM on workdays and is off during the weekends -- definitely giving me a good 8 hours of sleep).  Thanks to my recent zinc supplement routine, I am sleeping even better.


However, if you are one of those middle aged men like me, but having difficulty sleeping, you need to work on it, not just for your overall health, but also to raise your Testosterone level.  University of Southern Denmark scientists have found that lack of sleep may lower Testosterone hormone levels and shrink testicular size.  It is important to remember that lack of Testosterone can also disturb sleeping, so you really need to pay attention to sleeping enough and better.  Daily exercises definitely help and so does having a spiritual attitude towards life so that you can disengage from the worldly troubles (I am an absurdist and happy because of it).

Oatmeal does improve libido among men

About ten years ago, my breakfast was boxed cereals.  Sometimes, we would get croissants from Costco or other delicious sweet breads and wash it down with black coffee.  Then, my wife watched on TV and read about the dangers of consuming too much white flour and we realized that in addition to that we were also consuming way too much sugar and fat.  That is when we heard about organic, steel cut oats (they are not easy to find but we buy ours at a Whole Foods and if you cannot find them in a health food store near you, buy online, or buy the rolled oats, which is a compromise, because they do not have as much fiber, but hey, they cook faster).  When we cooked them the first time, we loved it, and for some ten years we have eaten nothing for breakfast but oatmeal five days a week (during the weekend we might eat homemade pancakes or whole wheat bread toasts or French toast). 

How to cook oat meal?  My recipe for oatmeal is simple.  Put a teaspoon of organic butter in a pan and then add the oats (I used 3/4 cup for two people).  Let the oats get a bit toasty (look for a light brown color and a delicious aroma) and then add water.  Since we don't consume sugar, I throw in a few prunes at this point and let it come to a boil.  Cover it up and leave it as it is (I do this while I am brewing the morning coffee and leave it covered for almost two hours but you cook it longer if you plan to eat right away -- the advantage of cooking steel cut oats like this is that by leaving them covered after cooking they soak up a lot of water and become soft and that is why you might want to even cook them the night before in case you rush in the morning).  Just before eating, I add milk and let it come to a boil.  Just before serving, I throw in a dozen or so almonds that had been soaked the previous night, and it is the most delicious breakfast.  You can make this more exciting by topping it off with fruits like bananas or blueberries.

What are the benefits of oatmeal?  There are so many reasons to eat oatmeal (I encourage you to stay away from the processed oatmeal out of a box because yet again it is full of sugar and preservatives) including its power in extracting bad cholesterol out of your body, but it is also one of those foods that improve testosterone levels.  The only thing to remember is that it fights cholesterol so strongly that you can actually become deficient in cholesterol, small quantities of which are essential for producing Testosterone.  So I had to actually cut oatmeal from five to four days a week because my body simply did not have enough cholesterol and also increase the amount of fat in form of switching to whole milk.

Positive side effects of strength training

I am quite focused right now on making lifestyle changes primarily in diet and exercise to raise my Testosterone level.  One of the most remarkable changes for me has been to include more strength training in my exercise routine that was previously primarily cardio.  It wasn't as if I did not want to do weight training, it is just that it was so easy to just put your sneakers, put on your headphones, and start running.  Once you are done, you simply take a shower and go on with your day.  Combining weightlifting and stretching/bending exercises and then continue with my treadmill routine requires a slightly different approach, and while it felt a bit awkward initially, once I made up my mind to do it, things got easy.


Now, I am assuming that it is a combination of all of these things that I have done to see the results, but other than having improved my libido and performance in bed, I might have made even a bigger and more powerful change in how long I will live and how healthy.  It is widely known that as we age, we tend to lose muscle mass, and the only way to slow that down is to lift some weights several times a week.  You just can't eat protein and hope to build muscle; you have to make the muscles actually do the work.  So I am glad that I have include this very important step in my exercise routine that I should have added at least 10 years ago, but I also read that in addition to helping the body maintain muscle mass, endurance training also helps with improvement in brain health by making more neuron connections.  This can have an impact on when dementia sets in, and in general, keeps your brain healthy.  Is it, then, too much to dream that I will live longer, with my stamina, memory and libido largely intact?  Ha ha..

Going nuts for walnuts

In addition to adding fat to my diet (not everyone needs to do it, especially if you are already overweight or obese; I had to do it because I was consuming a very low fat vegetarian diet), I added avocado, and then started consuming a whey protein powder that is also full of minerals and vitamins.  In addition, I started a one-a-day multi-vitamins for men and zinc (as ZMA).  I also want to point out that since nuts are sources of some of the best fats and proteins, I have been consuming more of them as well.


I consume about a dozen almonds (soaked overnight and then added to my oatmeal in the morning) five days a week, but lately, I have been snacking on walnuts and sunflower seeds.  Walnuts are definitely my favorite and incidentally they are also the ones with the most nutrients.  Since I work from home, it is easy for me to eat them, but if you go outside to work, consider bringing a handful in a Ziploc bag.  In my ultimate goal is to bring my Testosterone levels to a normal for my age with the current aggressive plan, and then, try to maintain it there without the help of supplements and vitamins by simply adding more nutritious foods like nuts which have the good cholesterol that we need and lots of protein.

Vicious circle of perfomance anxiety and sexlessness

Previously, I offered an analysis of how a relationship can turn sexless, and I have been thinking about this a lot in recent weeks.  When I first started to experience reduced libido and erectile dysfunction, I was embarrassed and experienced low self esteem.  Since we guys tend to judge ourselves, among other things, by our virility, not being able to perform with a woman, is a low point in our lives.  Naturally, the first reaction is to avoid situations of intimacy.  No wonder so many women complain how their men are ignoring them in bed (and in most cases, wrongly assuming that it is because he is getting it elsewhere or that she is no longer attractive).

Performance anxiety is a huge problem:  Somehow from early youth it is drilled into our heads that we guys have to excel in bed and blow a woman's mind with our tricks and stamina.  This can work in a destructive way even when things are getting better.  After a well organized plan that included zinc supplements, multivitaimins, whey protein powder, avocado, and strength training, I noticed that I was feeling greater desire to make love with my wife and had no issues with getting erections and holding them, I was so nervous from the recent embarrassing events, that I got anxious if I will be able to make it all the way, or will simply end up embarrassing myself yet again.  That only lowered my confidence and as any doctor will tell you, it only exacerbates the problem.


What is the solution to alleviating performance anxiety?  I concluded that it is best to honestly discuss this with my wife.  She was already aware of my low Testosterone condition and was very supportive of using a natural path to raising the T level and delaying Testosterone Replacement therapy through drugs like Androgel and Axiron, but I further clarified my fear of embarrassing myself despite getting my libido back.  Her clever suggestion was that I should throw this idea out of my head that every time we are intimate, it should end with penetration and orgasms for both of us (the more normal course of events for couples).  She said that we should just try to have as much as sex as we can without having goals.  Once we talked about it, the feeling was very liberating, because I no longer had the pressure to impress my wife.  The great news is that once I fell free, everything fell into place, and since then I have performed every single time in bed.  Somewhere at the back of my mind, I still have a fear that what if I fail again, but I am hoping that doing what I have been doing will help me rebuild my confidence.

Whether to cool down after working out

It is amazing how much heat the body produces during a workout.  In the middle of the New England winter when the temperature often runs in single digits during winter, I work out in my gym in the basement which has no heating and even when I open the windows, I am hot.  From late spring to early fall, I actually use a fan to stay cool.  Despite all this, and taking a shower with lukewarm water (hey, that keeps my heating oil bill low), it takes forever for my body to cool down.  I have noticed that I can feel my body heat dissipating throughout the first half of the day, despite being in a tee shirt in my home office.  So I have been researching if I needed a proper cooling after my workout, because the way my day is structured, right after my workout, I take a shower, and by the time I get out, my wife is ready with the breakfast.  This does not give me a lot of time to just let the body cool naturally.  It turns out that I might be okay.  While Andrea Fradkin, associate professor of exercise science at Bloomsburg University is quoted in The Times as saying, “A cool-down has been shown to prevent venous pooling after exercise,” but Dr. Rob Herbert argues in the same article that “My feeling is that unless future science shows otherwise, people shouldn’t worry about it.  If they like to cool down, then it’s not going to hurt them. But if they don’t feel like it, then they shouldn’t feel a need to do it.”

Intensity not duration key to better workout

I have definitely added strength training to my workout (yeah, rather than cutting back my cardio and replacing it with strength training, I have simple added more exercises) but now my workout is obviously about an hour from the 35-40 minutes that I was doing daily.  As I have done this, I am in general feeling better and have a lot more energy, but I also started to wonder if exercising longer has additional benefits.  Well, it turns out that according to this article, more than a certain optimum level of exercise can be counter-productive.  What shocked me most about a study that found that "The fastest runners and those who completed the most miles every week did not live significantly longer, on average, than people who didn’t run at all."  Ouch, all that hard work for nothing!  Actually, according to this research, the best benefit comes from running somewhere between 5 and 20 miles per week at about 10 minutes a mile.  Right now I run about 12 miles a week, but maybe a bit slower, simply because I do my strength training routine prior to running and am a little bit burned out already.  I think the overall message I am getting is that as far as pushing my body to manufacture more Testosterone, I have to push the limits, which is better done by increasing the intensity rather than the duration. 

Is it worth taking Aveed?

The drug is called Nebido in other parts of the world and maybe available in the United States as an alternative to Axiron and Androgel.  As I have already discussed the Testosterone Replacement Therapy may be no better than engaging in strength training.  The skepticism among the medical professionals advising the FDA about approving this drug is very telling.  The doctors have been arguing whether the drug is safe enough, and despite their doubts I would not be surprised if Endo gets its way with the FDA, because the agency is terrified of the corporations, lacks resources to conduct its research, derives some of its budget from corporations, and doctors who advise are mostly in bed with pharmaceutical companies.  In any case, it is not encouraging to see that Aveed was approved despite such sharp differences among the members.

Why did she go with the hot dude instead of me?

Indeed it is so frustrating that your charm, impressive diplomas, wealth, nice car, designer clothes, etc. failed to impress her and instead she walked out of the bar with that handyman who had not even showered before coming to the bar after work.  Boys, blame it on your low-T.  Scientists have found that our Testosterone levels can be detected by women from our natural body scent and while women may not realize it they find that guys with high levels of Testosterone are more attractive to them.  I guess yet another reason to work out hard and eat right.

Does Testosterone Replacement Therapy really work?

You see, despite the fact that I am currently not taking any prescription medication and during my adult life, I might have taken prescription drugs here and there only occasionally for minor ailments like infections or allergies but only for a few days, as someone with a strong background in science and technology, I have a lot of respect for medicine.  In principle, I am not opposed to pharmaceutical products, and so I am not one of those Bohemian, Nature lovers who looks for treatments in herbs and spells.  However, as advocated by the folks on Food Hospital, I do believe that for many ailments, some relief (I am not so sure about actual cures) can be obtained through dietary and lifestyle changes.


So, indeed I am deliberately staying away from Axiron, Androgel, and Viagra, I do recognize that these are useful in some cases, and that is a decision between you and your doctor, but looks like my suspicion of these drugs may not be so out of the mainstream.  A study entitled "Effects of Testosterone and Progressive Resistance Exercise in Healthy, Highly Functioning Older Men With Low-Normal Testosterone Levels" and published in the Journal of Clinic Endocrinology & Metabolism has found that the improvements came only to those men who did not engage in exercise.  "Testosterone supplementation improved upper body strength only in nonexercisers compared with placebo," as the study puts it.  Indeed, these men were in their 60s, but it does show that a lot of drugs do nothing more than make us believe that the drug is doing the job so we can take it easy.  Now that my skepticism has been strengthened, I plan to continue with my strength training regimen, dietary changes, and supplements.

The power of saying Never in achieving goals

Having spent years in a boarding school, I am a man of discipline.  I like to follow simple routines, almost like someone from the military.  Obviously, having two degrees in engineering further reinforced my focus on following processes in life.  That is the approach I take for, among other things, my workout (Monday to Friday).  For many years, I have worked out in the morning (a cup of coffee in bed, morning bathroom routine, workout, shower, and breakfast).  My rule of thumb is that unless there is a very compelling reason to skip working out (like being sick or during travel), I will not miss it.  This sort of firm belief makes it easy for me not to second-guess my decision or postpone it for the next day. 

So the transition from jogging/running to also strength training was made using the same simple principle.  Yet again, about a month ago, I made one of those decisions that I am so familiar with: I have to include a series of weight lifting and flexibility exercises in my routine before running 2.5 miles on the treadmill.  There will no exceptions to avoiding lifting weights (my assumption is that if I am healthy enough to work out, I am healthy enough to lift weights as well, but if a situation arises that a particular muscle hurts, I might skip a certain exercise and either do others or simply run longer).  The good news is that once again this rigid discipline has paid off and I have been doing this without fail.  Surprisingly, I have not suffered any pain or discomfort from the routine.

I have found this sort of firm resolutions that do not have any flexibility to be extremely effective.  I recognize that life is not black and white and nothing travels in straight lines and that is why I am fairly flexible doing business or in social interactions, but when it comes to my health, military style discipline is the norm.