Honey, where is my Boron?

Insofar as boosting Testosterone is concerned, my research and experience shows that zinc is the mother of all minerals.  Now you got to take copper, not because it does something to Testosterone, but taking more than normal amount of zinc can cause depletion of copper (an essential element) and must, therefore, be supplemented.  Another metal that is critical is selenium.

Now, I have concluded some more research and found that Boron is another metal that regulates Testosterone in the body and I am not aware if any of the multi-vitamins and mineral caps have it, but apparently, honey has just enough.  The right way to consume honey is to simply lick a spoonful or add it to yogurt or oatmeal.

How do real men sit?

I have written in previous blog posts that having a little bit of aggression, or watching competitive sports, or wearing red colored clothes, etc. can boost your Testosterone level without even trying.  In other words, because the brain is the one deciding how much Testosterone to make, it is all about how you think.  I am assuming it is important to be healthy and eat right but apparently these things work regardless.

Now, another study “The Ergonomics of Dishonesty,” led by Andy Yap of Massachusetts Institute of Technology (MIT) has found that just the way we sit and how much space we occupy when we sit, stand, and walk can have an impact on our Testosterone.  Another study from Harvard Business School says, sitting for just 2 minutes a day in the power pose can raise Testosterone by 20% and reduce Cortisol by 25% (by the way, Cortisol is the stress hormone and extremely toxic to overall health and deadly to Testosterone).

Image of a middle aged confident man enjoying himself reading a paper in the power pose

So how do you sit in the power pose?  Look at the picture above.  Lean back in your chair, put your feet up on the table/desk, push your chest out, and hold your head high while feeling good about you.  Remember that it does not matter whether you are a millionaire or a minimum wage worker or even a loser; it is the story you tell yourself daily.  If you are a millionaire and keep comparing yourself to the multimillionaires out there, you will feel less than them and might even think of yourself as a loser, but if you are a hardworking dude who makes a good, honest living and feel good about it, you will feel like a million bucks. 

Reaction from women after high Testosterone

If you are a single man and working to raise your Testosterone hormone level, most likely the transition to a new you will not be difficult.  As you gain more muscle or lose the belly fat, maybe you will need a new wardrobe, but with that and your new-found confidence and libido, I would say that go out there and hit on some babes

Why do women resist it when their husbands look better than them?  Interestingly enough I have been speaking to some guys like me who are married or in serious, committed relationships, and while like me, their partners have been very supportive all along and delighted to see that we have regained most of our libido back and sex is so much better, but for some of the guys things have not been so easy.  You see, if you are in a relationship with a woman in the same age bracket, chances are that she too is struggling with her hormones and has her own libido issues.  In addition, when libido and frequency of sex declines gradually, it is easy to get used to that without even realizing it.  Now, that you want sex again, and even more often than you did a few years ago, she is not ready or resists it. 


What if my wife refuses to change bad habits and resists my desire to become healthy?  I have also been told that guys who are with women who are themselves in poor health, do not workout, eat bad, and even have health concerns are having the most difficulty in marching in harmony.  They want to make healthy choices and she resists.  They want to find time to hit the gym and she wants to go out to eat at Red Lobster.  They want to squeeze fresh juice from kale and carrots and she wants her Doctor Pepper.  They want to get active in bed but she wants her fix of Real Housewives of Wherever (aren't they all equally vulgar?).  Some guys even tell me that their wives are concerned that they will end up divorcing them or get a fit when they come home late or a woman calls (suspecting that he is already cheating).  Many have started to make fun of them suggesting to their friends that their husbands are going through a midlife crisis. 

What to do if my wife refuses to accept a much more youthful, energetic me?  Guys, if you are not with a supportive partner, there is no reason to get distracted.  The world expects us to be a certain way and it is not easy to have partners who will support you in every change that you are making.  While I will not suggest that you consider a breakup or divorce and it is best to talk this through with women that you are doing it for good health, that you have no intention of finding a younger woman, that you are not having some kind of mid-life crisis, you expect her to just accept you the way you are, and that you do not expect her to make the same change.  Having said that, if a woman wants to be stuck in an unhealthy lifestyle and wants you to do the same, after all it is your life, and you might need to make some hard choices.

How many calories to eat?

Recognizing that vegetarians are at great risk of low-T, I have been crunching numbers to see if I have been eating enough.  In fact my theory is that I need to eat more in order for my body to make more Testosterone and reduce my waist size, which is strange because I do have a belly despite being quite slim (I am currently at 143 pounds for a height of 5 feet and 8 inches).  I am convinced that my larger than normal waist size is due to low Testosterone (we are talking relative terms here because my pant size is merely 29 and the lowest it has been is 28, but it still sticks out because of my small frame).  Believe it or not my research shows that for someone in such good health the fall in Testosterone is a result of extremely low fat diet.  I know, most people have the opposite problem.  So in order to nail it down, I sat down to estimate my total calories and fat consumption on a daily basis and below is the chart that I came up with.

So I did some more research to find out how many calories should a very active man in his late 40s who works out one hour daily (both strength training and cardio) should consume and looks like there is no consensus.  My best conclusion is that someone like me should consume at least 2,200 kcals and about 75 grams of fat every day.  That means that I am eating just about two thirds of what I should be eating, but then, why is my weight still in the normal range?  What if I add more calories and particularly fat to my diet, will my weight no go up even more?  I realize that I can be in the healthy range even if I gain another 20 lbs but it is a scary thought since I have never been that heavy.

How to get TRT?

Of course the easiest and simplest option is to buy Testosterone without prescription from an overseas pharmacy, if you still want the sense of comfort and security of seeing a doctor and getting a prescription they are pretty easy to get.  In any case, a test for Testosterone is useless and the doctor does it just to make you feel good and to milk the health insurance company.

I have been able to research two companies which have made it ever easier to get your Testosterone Replacement Therapy.  If you are like me, the process to get will be complicated.  I will call my primary care physician and be put on hold to speak to someone to schedule an appointment with him, which could take days or weeks since it is not an urgent matter.  When I go in, and probably waste half a day, I might be told to come back for a blood test (those are best done first thing in the morning) and that is another few hours.  Then I wait for the doctor to call me with an update and yet another appointment.  In the meantime, I might be referred to an endocrinologist or urologist and after running around experts scattered all over the area (I live in a town of just 25,000), I might be finally prescribed a gel or injections or I might be turned away because some poorly paid clerk based in a Third World country gets to decide what is covered and what is not.


Alternatively, you could simply call Low Testosterone LLC and they will arrange something right away so that you can do it all in one visit (you go once for a blood sample to a lab).  Then, for $199 a month, you are all set.  There is nothing more to pay and you see a doctor twice a year and blood tests three times a year.  This could go on for your whole life.

Another company called Ageless Men's Health literally has brought Testosterone therapy to a mall near you.  Indeed, their locations are conveniently located so that you can even schedule a visit during office hours on the pretext of going to grab a coffee.  The clinics are one-stop shop for guys desperately seeking a Testosterone boost.  You make an appointment, there is no need to wait unlike a doctor's office, get your blood done, meet casually with a doctor, and you are now all set, be it an injection or gel.  These folks even accept health insurance.

Does alcohol cause low-T?

During my youth, I rarely drank alcohol.  I know!  In fact even in my 30s, alcohol was always a treat, but during my 40s, we discovered red wine.  And thanks to incredibly cheap Charles Shaw red wine from Trader Joe's (and many other great wines, even from France, that cost less than $7 a bottle), we started consuming it with dinner.  Not a lot, maybe half a glass, but definitely almost every night.  On hot days -- which here in New England are few -- I might even drink a beer at lunch time.  I would not say that my alcohol consumption is excessive, but it is a lot more than ever before in my life.

Wondering if alcohol might have anything to do with low-Testosterone, I started to research this topic.  What I found is that drinking moderate amounts of red wine has many health benefits for guys.  Obviously excessive beer or wine gives us a lot of empty calories giving us the beer belly, waist fat that is deadly for TestosteroneWhat caused me panic was that alcohol increases estrogen levels (and that is great news for my wife but awful for us dudes).  In other words, the more estrogen we guys have the lower the Testosterone we will have.


I have accordingly decided not to drink any alcohol Monday to Friday (I think this is a reasonable goal and easy to accomplish).  During the weekends, I may not drink at all either but I will not feel guilty for doing so (mind you, in order to see real damage you must drink a lot of alcohol, not a small glass of red wine like me).  I am also going to keep my options open in case for a special occasion during the week so I can still enjoy myself.  With my enormous will power, I am hoping to eliminate 90% of alcohol from my diet and I will watch this for three months to see what happens.  I want to clarify that it will be nearly impossible for me to pinpoint the result because as I revealed in my book The Testosterone Challenge, the improvement in my hormone level has been a combination of strength training, better diet, zinc, and vitamins.  I am hoping that I will improve even further and in the process, develop a lifelong habit of drinking only rarely.

Is it possible to avoid low-T?

I wish I knew it was not inevitable because I would have never wasted a few years of my life having bad sex if I had known that as I entered my 40s, I could no longer get away with things that I could get away with during my youth.  For example, I worked out regularly but only ran and avoided weightlifting and strength training because I did not like them.  I also did not realize that eating a primarily vegetarian diet I was not getting enough essential minerals like zinc.  In addition to that, by eating an extremely low fat diet to keep my weight in check and not get diseases like high cholesterol and blood pressure, I was depriving my body of even the minimum amount of cholesterol that every man needs in order to produce enough Testosterone.

Now a study by Zumin Shi, Andre B. Araujo, Sean Martin,  Peter O’Loughlin, and Gary A. Wittert titled "Longitudinal changes in testosterone over five years in community-dwelling men" published in The Journal of Clinical Endocrinology & Metabolism has found that you can stop the decline in T levels if you do not smoke, gain weight around the waist, become obese, or become depressed.  Interestingly enough it also found that single men were more likely to see Testosterone fall because as I have written before actions like having regular sex or trying to seduce women keep the body producing Testosterone.  So guys, the message here is that if you lose weight, stay healthy, push your body, and eat well during middle age, chances are that you will have much better sexual health and old age will not set in prematurely

Testosterone gel without prescription

The popular low-T medications available in the United States like Androgel, Axiron, Depo-Testosterone Injection, Testopel, Testim, and Aveed are all available by prescription only.  While the prescriptions are easy to get if you have health insurance and the test for low Testosterone is merely a show by doctors.  Tests are highly unreliable and physicians seem to prescribing these gels aggressively due to a huge push by drugmakers.

Testosterone supplements:  For those of you who do not have insurance coverage or do not think that your doctor will prescribe it for you, the option is to buy one of those supplements online, which because they are not making any health claims (and hence not covered by FDA oversight) can be sold without a prescription.  Unfortunately, there is a lot of fraud in these products and they may not always have what they claim to have and may have stuff that they do not disclose.  For example, some Testosterone supplements contain Viagra without disclosing and when you start to experience good erections with them you think that the supplement is effective, but if you have ever paid attention to the health warning that Viagra is not for someone who takes nitrates for chest pain.  Sadly, many people in our age bracket are also on nitrates for their cardiovascular diseases and they have ended up in hospital.

OTC Testosterone:  Well, now an Australian company called Testomeds (a subsidiary of an Israeli firm called ILS Limited) is selling AndroForte 5% and 2% to Americans without a prescription.  The cream is approved by the Therapeutic Goods Administration in Australia (TGA), an agency that would compare to our Food & Drug Administration (FDA).  Because it is legal for Americans to import drugs for personal use from overseas, you can buy medications like this from abroad.  This is a gel applied to the scrotum instead of the shoulder area, and thus, is more easily absorbed, according to the manufacturer, and is also safer because the chances of the gel transferring to others is minimal.  At this point, I am not sure how good an idea it is to buy this prescription strength medicine without medical supervision but it is definitely an option.  As I have written in my book The Testosterone Challenge, I have taken the path of lifestyle change approach to raising Testosterone, and it has worked for me.

At home test for low-T

The scientific test for low-T is highly unreliable and that is why when men complain about the symptoms of low Testosterone to their physicians they simply prescribe them Androgel or Axiron.  So basically we are at point where it is simply not easy to find out if you have low Testosterone hormone levels, but Dr. Patricia Deuster, a professor and scientific director at the Uniformed Services University of the Health Sciences actually warns that guys should not be swayed by television commercials and self diagnose.  However, I found advice from Pharmacist Mary PreFontaine of Keystone Pharmacy in Grand Rapids simple and easy to use.  She says, "Most men with adequate amounts of testosterone have an erection every morning."  If I recall the experience of my youth correctly, they might not happen daily but do happen a lot more frequently, so if you stop having them altogether you now know what to do.

Best time to take zinc?

When I first complained that taking zinc supplement made me woozy, and while I realized subsequently that the body gets somewhat used to more zinc in the diet, I have something more to share.  You see, it is common knowledge that medications should be taken with a meal unless instructed otherwise (the idea is that when food enters the digestive system and enzymes are released, it is much easier for the medicine, vitamins, and supplements to be absorbed during this process and a lot more difficult when you simply pop a pill because all by itself the body does not see this as food and refuses to release any digestive fluids).


So I started popping my multi-vitamin (which also has 20 mg Zn) and zinc pills with my dinner between 6 and 7 PM but I don't go to bed until 10 PM.  During this time while I do not do much except read or chat or watch television, I still felt groggy.  Eventually, I tried popping the pills with my late night snack (I usually will have a cup of milk or yogurt or fruits because it is not good to keep a very long gap between meals since my next meal will be breakfast at 9 AM and the gap from 6 PM to 9 AM is unacceptable).  That has worked really well.  I take my snack around 9 PM and I have experienced that it is only around 10 PM that I start to feel the sleeping effect and it is perfect timing to simply go to bed.

How does Testosterone reduce weight and waist size?

In a very peculiar twist, I am trying to eat more and healthy to actually reduce my waist size, which I am convinced is a bit higher than it should be.  So why would I be doing something that sounds counter-intuitive.  Well, the answer is that fat gain and low Testosterone have a two-way relationship.  If you have low-T you start gaining weight.  Also, if you are fat, then, your Testosterone falls.  Also both trends put you in a downward spiral.  So if you are obese, your Testosterone falls and that leads to even more weight gain, causing further reduction in Testosterone.  In fact even the little Testosterone you have left gets eventually converted by belly fat into the female estrogen giving you those ugly moobs.


So how does Testosterone reverse this?  Australian endocrinologist Dr Mathis Grossmann explains, "Testosterone increases muscle mass and reduces body fat by 'instructing' stem cells to become muscle cells."  That's what makes you bulk up and become more muscular, as I have over last three months.  What is very encouraging is that you have to make only a slight improvement in Testosterone and as I explained in the previous paragraph, the process now works backwards.  So the more Testosterone you have the more of it the body makes.  Not bad!

Can lifestyle Testosterone approach work?

You see, primarily because of my general aversion to prescription medications to the extent possible, I chose to make lifestyle change to improve my Testosterone level.  As I have repeatedly declared I clearly see the need for Testosterone Replacement Therapy for many men either because they are unwilling to engage in strength training like me and make dietary changes, or they have other medical condition that is impeding the production of Testosterone hormone.

As I have documented in my book The Testosterone Challenge, I am happy that I have made enormous improvement in my libido.  I actually now wonder why I did not do this earlier on.  In addition, I am looking a lot more muscular, actually, more than ever considering that I am that nerdy guy who spent more time in the library than the gym.  For the first time in my life, I actually have bulked up around my shoulders and chest because of the weights that I have been lifting five days a week.


So is this approach a solution for low-T?  Apparently, many doctors who still have their ethics standard, this does work.  Australian endocrinologist Dr Mathis Grossmann is quoted as saying, "A weight loss of up to 10 per cent of body weight achieved by lifestyle changes, increases testosterone by three to four nanomoles per litre [nmol/L].  This means if you have moderately low testosterone levels, you can normalize them through lifestyle alone."  What he is saying that if you were in the gray zone like me, and you make small changes in your weight alone, you could easily move into the normal category.  By the way, a slimmer you will make your partner happy and if you are single, much more attractive to women.

Dr Carolyn Allan, the medical adviser for Andrology Australia also seems to endorse my approach.  She says, "...if you are overweight with an unhealthy lifestyle, I'll say … 'In terms of lifestyle changes, there are no downsides. Let's do that first, and see what happens.'"

Are vegetarians at higher risk of low-T?

And that in effect means low-libido, erectile dysfunction, sexless marriage, Alzheimer's Disease, diabetes, obesity, graying/falling of hair, low energy, premature aging, and a host of other symptoms that we often associate with aging.  Now, I am not a strict vegetarian and do enjoy chicken, fish (how could I ever stop eating my sushi?), and seafood (all of which, by the way, do not provide much zinc), but almost never eat red meat (it is unhealthy and unless you pay big bucks to find organic, grass-fed version, you are only hurting your health), and if I could become a victim, how about all those people who never eat animals, or even worse, the vegans who avoid even dairy, a good source of zinc.  Are vegetarians and vegans walking around with no libido?  It will be nice to know.


I am not a proponent of one or the other form of eating and you are welcome to eat whatever makes you happy, but if you are a vegetarian or vegan and in your middle ages like me, if you experience loss of desire for sex or low energy, you really need to get some blood work done to find out if you have low levels of Testosterone.  The good news is that you do not have to abandon your eating preferences, you just may have to eat more of nuts, avocado, oats, etc. (pretty much what I successfully did as I have talked about in my ebook The Testosterone Challenge without adding any more animal products into my diet) and then supplement it with zinc, selenium, and copperGuys, don't give up on sex so early just because you are kinder to animals or your religion prohibits you from eating animals.

Obesity, low-T, diabetes, and Alzheimer's Disease

If you were not already terrified of being obese, there is more bad news.  In addition to decline in Testosterone hormone level (with resulting fall in libido and erectile dysfunction), you are not only going to get Type II diabetes, but also Alzheimer's Disease.  Ouch!  My mother is a diabetic and my father-in-law died from Alzheimer's so both diseases scare the hell out of me.  Anusha Jayaraman, PhD, of the University of Southern California in Los Angeles has found that, “... obesity and low testosterone combine to not only increase the risk of diabetes but also damage the brain.”

As I have already shared earlier, there is nothing worse than getting fat as far as Testosterone is concerned.  So guys, this should be enough motivation for you to get off that couch because not only will that special someone in your life appreciate a man who knows how to please her, but eventually you benefit by living a healthier life (my philosophy is that I don't necessarily want to live a longer life, but howsoever long I live, I want to be healthy and hopefully keep having sex).

Dating while having low-T

Remember that in addition to supplements like zinc, strength training, healthy eating (nuts, oats, avocado, etc.), there are other small things that you can do raise your Testosterone: being a little aggressive, feeling a sense of achievement and self confidence, wearing red, and watching/playing competitive sports, but one of the things that all men do when they have low libido and erectile dysfunction is to abandon dating (for married -- and those in relationships -- men it manifests itself in form of avoiding sex).

Well, it turns out that the idea of approaching a woman and pursuing her is enough to raise your Testosterone.  If you look in the previous paragraph, trying to woo a woman even to talk to you, requires you to be just a bit more aggressive than other guys, you need to feel that you can do it and that you have done this before, and it brings out the competitive spirit in you.


I totally understand the part that if you are successful but unable to have sex, it will feel like such a downer, but you never have to let this go so far.  For instance, rather than feeling sorry for yourself and staying at home watching television or surfing the web, try going to a bar just to talk to girls (not all women want to go to bed with any random guy they meet but they sure like to talk), attend parties and try to chat up women, and if this is not an option, go online.  There are literally thousands of chat rooms online (mostly free) where you can just chat up with people, including on your webcam.  Remember that you will be competing very hard because so many men are competing to talk to women and some of these girls are chatting up several men at the same time, so when you score a win, it will really help your Testosterone.

What is the highest amount of zinc that I can take?

Zinc has done wonders for me in raising my Testosterone and improving my libido, not to mention the normalcy of erections and being able to have sex normally, but I have always worried about zinc toxicity.  That is why during the 3-month period that I have taken zinc supplements, I have limited it to just about 20 mg at the most, being fully aware that the recommended daily allowance (RDA) for zinc for an adult male is just 11 mg (you might end up taking a lot more naturally if you eat a meal rich in zinc, say, oysters or beef, and it is also understood that not all the zinc from a supplement is actually absorbed by the body).

So at what point does zinc becomes toxic to your health?  This was a question that was bothering me for some time and I finally nailed the answer by visiting the websites of National Institute of Health, Mayo Clinic, and other med schools.  The consensus among doctors is that the upper safe limit for zinc is 40 mg.  A lot more can be prescribed to you by your doctor but the point is that you should not go beyond 40 mg without a word with your family physician, who might even conduct a test to assess if you have a deficiency.


Starting today, I am raising it to 35 mg, not because I have come up with this magic number through a lot of analysis, but simply because the Trader Joe's Men's Once Daily Multivitamin and Mineral Supplement that I take has 20 mg and the zinc supplement that I have (it is actually zinc plus magnesium and calcium supplement) has 7.5 mg pills and while I could take 3 pills and still be at 42.5 mg but in my opinion it is better to keep it at 35 mg because despite being (mostly) vegetarian, I get some zinc naturally from milk, cheese, nuts, beans, oats, etc.  My hope is that the excess zinc will help me even more.

How long can you take zinc safely?  That was another question I had and I found that you can do so for years as long as you keep it below the upper safe limit of 40 mg (and ensure that you are taking copper in a supplement as well).  So this is my plan.  While my Testosterone level is so much higher than it used to be when I first noticed symptoms of low-T, I will keep this regimen for next six months (again no complex analysis here except that it will be the end of the year as well) and after that simply switch to the one-a-day supplement that has enough zinc for a healthy adult.  I will then evaluate how I do and if I can maintain my erections and libido, and if not, I might start with one pill of 7.5 mg or even two.

Lack of morning erections during middle age

As a young man, I found morning wood to be an annoyance, because it was embarrassing, uncomfortable, and sometimes, interrupted my sleep.  Actually, I did not notice (and that is the sad part about aging that you do not realize it is happening but it creeps up on you gradually) that I was getting fewer of them until they completely disappeared (and stupid me, I thought that it was because I was doing a better job of managing my daily water intake).

Well, after I realized that I was facing loss of libido and erectile dysfunction due to low level of the hormone Testosterone, I researched that night time sweating and disappearance of morning erections was a sign of low-T and was not something to be celebrated.  I have noticed that since my Testosterone level improved and while I can make love without any problem, the number of morning erections is still not 100%.  Hey, let me stop writing now because I should go pump iron and take my zinc pills.

Why do middle aged men sweat at night?

I have already discussed this on the topic of hot flashes among guys and it was very enlightening to find out that in the middle of New England winter, I was sweating.  Rather than blaming poor heating in my bedroom as I initially suspected, the blame was to be put on low-T

So why does this happen?  Well, what happens is that a part of the brain called hypothalamus controls the body temperature and when there is not enough Testosterone in the body, the brain receives a false signal that the body is getting overheated, and as everyone knows, the brain decides to cool down the body by forcing it to sweat.  If you are able to raise your Testosterone level through diet, exercise, and supplements, you will stop sweating, as I did after about three months of working on it.

Best complete multivitamin for men with low-T

In general, everyone should take a multi-vitamin supplement because even the healthiest eaters (I am one of them) don't always get all the vitamins and minerals they need.  See, even someone like me who is so careful, did not realize that as a (mostly) vegetarian, I was not getting enough zinc (which in youth may do only minor harm like poor hair or immunity but can wreck havoc in middle age by lowering the amount of Testosterone) and cholesterol (in an attempt to not gain weight and be healthy, I was consuming a very low fat diet and that does not work so well for forming Testosterone).

Now, as much as zinc is critical for Testosterone, too much of zinc can be toxic.  I have done enormous research and there simply is no consensus on how much zinc can one take safely for how long.  While the recommended daily allowance (RDA) is something less than 20 mg, those who are deficient may take a lot more, but that is where no one has a clue.  There are people suggesting that you could go up to 35 mg while others are taking more than 100 mg.


What is downside of taking too much zinc?  Copper deficiency.  So in my opinion, you don't want to overdose on zinc because I believe that it is better to let the Testosterone rise gradually (mine improved tremendously in about three months after taking 20 mg and you can read about journey in my ebook) and even though mine must have been low because I have eaten mostly vegetables my whole life (except for some seafood and chicken a few times a month), I am not going to cross 30 mg (right now I am taking 27.5 mg daily but plan to do so only for a month more and then stop taking zinc supplement and simply rely on a multivitamin pill that contains zinc).

It was in this context that I wanted to mention Men's Once Daily multivitamin and mineral supplement from Trader Joe's that has zinc (20 mg) and copper so even if I am losing some copper, I am supplementing it.  I was also pleasantly surprised to see that it has selenium (not as critical but still important for Testosterone) and I found that it was more complete in that sense.  If you do not where to buy this brand, try to look for a supplement that has zinc, magnesium, copper, calcium, and selenium.  Take it as recommended.

Eat more to reduce waist size

So I have been discussing this dilemma that I am facing.  Despite being a slim man my waist size is larger for my body.  I am 5'8", 140 lbs, with a 29" waist.  I eat extremely healthy and spend up to an hour five days a week working out, that includes cardio and weight training.  Still, it seems that I have belly fat.  Now, as I previously said, I found out from research that this phenomenon happens because of my low-T (that is largely cured but it will take some time to get the body back). 

Farid Saad, Ph.D., of Bayer Pharma highlights the vicious circle, "Obesity is associated with reduced testosterone, and low testosterone induces weight gain." Yes, in case you did not know, overweight and obese people have low-T and as the waist size increases more of (whatever little of) their Testosterone is converted into female hormone estrogen.


Granted that this dude works for a drug company that makes a slow-release, injectable form of the drug (testosterone undecanoate), so I am going to take this piece of research with some degree of skepticism, but what the researchers found was that Testosterone therapy actually made men lose weight and lower their waist circumference even if they made no changes in their diet or exercise regimen.

As you might know, while age is a big contributor, my Testosterone deficiency was primarily due to malnutrition.  So the big and scary challenge for me is to eat more fat to raise my Testosterone level but not have even a bigger belly  -- hopefully, the science will help me; as my Testosterone level rises further my belly fat will actually disappear.  Sounds too good to be true but I am hoping that the scientists are right.

Generic version of Testosterone medication

While most of the spotlight is focused on Androgel and Axiron because of the intense advertising by the manufacturers, Depo-Testosterone is another drug that is directly injected into a muscle for treating among others Testosterone deficiency.

The big news is that now an Indian pharmaceutical firm Sun Pharma is going to make dirt-cheap generic version of the Depo-Testosterone Injection, Testosterone Cypionate Injection USP.  I am generally skeptical of all medication manufactured outside the US, particularly in corrupt and lawless countries like India, where there is absolutely no quality control and there is no way to know if it is real medication or contaminated water from one of their polluted rivers.  So unless you are saving a ton of money on the generic version, you might want to stick to the American brand, but for those of you on tight budgets or if your insurance plan forces you to take the generic version, then, this is good news.

How do Testosterone makers target middle aged men?

The study published in JAMA Internal Medicine entitled "Trends in Androgen Prescribing in the United States, 2001 to 2011" by Jacques Baillargeon, Randall J. Urban, Kenneth J. Ottenbacher, Karen S. Pierson, and James S. Goodwin, has found that it is extremely easy to get a prescription for a Testosterone gel often without a proper blood test or even if the test is done, it is merely a formality done to make you and your insurance company happy. 

Marketing strategy for TRT cures:  That's not all.  In a shocking paper "Promoting Low T, A Medical Writer's Perspective" by Stephen R. Braun, he has disclosed that "...patient education materials continue to be created that, while factually accurate, subtly shift attitudes by including only selected facts and/or omitting ideas that would undermine the funder's preferred paradigm." 


How do drug companies target men undergoing a mid life crisis?  This explains how the television commercials for Androgel and Axiron not only convince you that you have low-T (by merely watching the ad) but also make it appear that choosing TRT is a simple fix (not really disclosing that rectifying the chemical balance in the body is a complex process).  I clearly remember when I first saw the advertisements and could immediately identify myself as someone who was observing those symptoms.  With my low self esteem due to poor performance in the bedroom, I was tempted to consider this as quick fix (I am still not opposed to medicine as a matter of principle and because I am in excellent health otherwise, I take no medicine at this time, but I understand that in the future, I might need to take drugs), but did decide to try food and lifestyle changes, deriving inspiration from British TV series Food Hospital.  I can totally empathize guys who are already feeling low due to being in their middle age, not having achieved their dreams, being constantly reminded of their getting old by kids and younger colleagues, and on top of that, even having difficulty in impressing a woman.

I must also add that in an episode of The Colbert Report, he addressed low-T marketing, and his words were so funny but also true, "A man on TV is selling me a miracle cure that will keep me young forever. It's called Androgel ... for treating something called Low T, a pharmaceutical company–recognized condition affecting millions of men with low testosterone, previously known as getting older."

Weight gain on the waist during middle ages

I am 5 foot 8 inches tall and have always been somewhat slim (food does not give me any special joy and I am quite committed to eating healthy not just because my mother is diabetic and my father died at the age of 32 due to several illnesses, but also because I want to live a long, healthy life).  If I recall it right, the heaviest that I had been in the past was around 140 lbs.

Waist size higher even for skinny person:  Around the time that I experience hot flashes or poor erections or loss of libido, I noticed something else: growth in my waist size.  I typically wore a 29 inch size but my waist became more like 31".  Not much of a problem but the worst part was that for my very slim frame, I had a tummy.  A few times my wife teased me about it in a mean way, and I decided to take action.  I was already active but I increased intensity of my workouts and cut back on calories in the hope that with my determination to eliminate it, I will.  Eventually, my weight dropped to 120 pounds and my waist to 28" but since I lost weight everywhere else as well, it still seemed that I had a belly.  Ouch!  In fact, I have since concluded that by eating a very low fat diet and becoming excessively skinny, I might have expedited the rate of Testosterone decline.

Middle age  weight gain is hard to get rid of:  Since I embarked on this mission to eat more and improve my Testosterone level through diet and exercise, I am back to around 140 pounds, but again it seems that most of the weight has gone to my mid section and my waist size is around 30.  Granted I work on a desk all the time, but still this is very troubling.  My wife has been harassing me again but this time I am trying not to be swayed by it and lose more weight, because I know it is not going to work.  After doing some research, I found out that low-T and mid section weight gain are related.  And here is the interesting part: if you are overweight or obese and have a lot of belly fat, your Testosterone will go down at any age because this fat converts Testosterone to estrogen, but also if you have low-T during middle age, your waist will grow.

I am doing many exercises and trying to eat healthy, but this is very frustrating.  I have been advised to consume more fat because that helps in raising the Testosterone level but then I am afraid of accumulating even more fat in the waist.  So the big challenge for me is to consume more cholesterol (yes, there are men like me who hardly eat any fat) to raise my Testosterone but not end up with a big tummy.  It is going to be an ongoing challenge and is probably one of the downsides of aging that I might end up accepting some day.

Hot flashes in men

So a couple of years ago when I did not realize that I may have been seeing initial symptoms of low-T, I would sometimes realize that my t-shirt was somewhat wet from sweat when I would get up in the night.  My initial reaction was to adjust the heat in the bedroom (being in New England, we are with heat in the house pretty much all the way from October to April (and even beyond depending on how cool some nights can get even in early fall and late spring) and use a lighter comforter, but it was not much of a relief.

Now, I don't know if these are hot flashes as well, but I also noticed that unlike in the past, after a workout, I took a shower, and then I would feel just normal through the day.  It also happens that I work from home and my home office is not centrally heated, so I heat it up when I am at work with a space heater.  In other words it never gets too warm and I found that was comfortable enough, but still I was sweating during the day.  I made some changes, like opened the window even during the peak of winter during my workout (my home gym is also in the basement), or took somewhat cooler showers, and wore short-sleeves during the day without any warm clothes.  I still sweated.

So if you experience symptoms like the above and in combination with other symptoms of low-T, this is not about your air-conditioner gone bad; it is just that you maybe either middle aged or just experiencing lower level of the hormone Testosterone.  To manage these, I am still doing what I mentioned above, but after raising my Testosterone level through diet and exercise (if you want to read more of my journey in an ebook form please buy it on Amazon) I am noticing that my hot flashes are pretty much gone.

Is it easy to get low-T prescription?

If you look at the data on the growth and size of Testosterone drug business, it is fairly easy to conclude that the business has exploded and growing rapidly.  In fact, it appears that the prescriptions for Testosterone gels are as easy to get as are for most other prescription drugs in America (we are the most medicated nation in the world but the WHO ranks us 37 in overall health).  The Times is reporting that doctors are conducting blood tests for low-T not to figure out if you have low levels of Testosterone and if it low enough to warrant Testosterone Replacement Therapy but to merely provide a cover for the prescription.  After all, Testosterone does decline naturally with age, especially during middle age, and what man would answer no if you ask him whether he has less energy than in the past or is losing his zest for life or is having sex less often.


Dr. Jacques Baillargeon, an associate professor of epidemiology at the University of Texas Medical Branch at Galveston, and author of a comprehensive study on Testosterone deficiency, tells The Times, “I think these relatively healthy men who are starting testosterone at age 40 are potentially going to be exposed for a very long time, and we don’t know what the risks are.”  Yes, it does sound great that you have that libido back, you feel full of energy, you are not reluctant to have sex (especially if you are single, because it is well documented that guys with libido and/or erectile dysfunction are less likely to date) but aside from the known side effects, many experts are concerned that there are too many other unknowns.

Do I need a test for low-T?

You know for me to find out if I had low T was to simply see for myself what I could not do in bed: either difficulty in getting or maintaining an erection was evidence enough that I had a problem.  Now mind you, many of you might know other symptoms of falling levels of Testosterone like overall decline in level of energy, lack of libido, difficulty in working long hours, and some loss of desire to just live life to the fullest.  However, I must warn that you may not see all of them.  For instance, except for some erectile dysfunction, I had no other symptoms.

Since I am a big believer in using food to cure illnesses, I never went to my doctor.  I know as an engineer myself that the best thing to do to find something out is to measure it and I support the choices that physicians make in ordering a blood test to find out your Testosterone level.  After all, they have no other reliable means of finding out how we feel, other than asking us questions.   But for instance, if you do not engage in massive physical labor like lifting weights or shoveling snow manually (I do it just to be fit but I know all my younger neighbors with shorter driveways use a high power snow blower) the doctor may not really conclude if you have problem with intense physical activity.


Is the low-T blood test useful?  I am glad you asked. I have wondered about this as well because I never took one.  You see, unlike many other hormones in the body (and all the other things that we have in our blood), Testosterone fluctuates a lot.  For example, I have a crush on Nicki Minaj, and according to scientists, if I watch her music video and let me fantasies go from there, my Testosterone level will go up.  It can also go up if I swear at someone who cuts me off on the highway.  Testosterone is also naturally high in the morning and since I workout in the morning, it goes up even more.  In other words, it is nearly impossible to get a good reading of this hormone.

According to Marvin M. Lipman, M.D., chief medical adviser for Consumer Reports and a specialist in endocrinology, "The tests are notoriously inaccurate, especially at the lower end of the normal range, and that makes it hard to tell the difference between results that are 'low normal' and those that are abnormally low."  Experts also believe that merely having a low reading in the test does not mean that you have a problem and it needs to be cured with prescription drugs because the whole thing is a lot complicated.  I am glad that using a combination of diet, exercise, and supplements that are otherwise harmless and are good for overall health any way is a better choice than rushing to embrace Axiron or Androgel.