As a specialist in men's reproductive health, I'm seeing more and more cases of guys who are on prescription testosterone replacement medication. Sales of testosterone have boomed in recent years thanks to new ways to get it into your body, such as gels, creams and injections. The current situation with testosterone replacement treatment is problematic for many reasons, including the fact that, by one estimate, nearly a quarter of the guys getting prescriptions have not even had their testosterone levels checked. In the words of one recent physician editorialist, this is "appalling." No man should be taking testosterone unless they have low testosterone levels and symptoms.
Many men are unaware that testosterone replacement treatment shuts down a man's natural production of the hormone, often causing the testosterone-producing cells to stop working and his testicles to soften and shrink. If a guy suddenly stops taking testosterone after using it for more than a month or so, he's very likely to feel terrible – he could have low energy, low sex drive, be irritable, and even feel depressed. These withdrawal symptoms powerfully motivate guys to keep refilling their "T" prescriptions!
What most patients – and many doctors – don't know, however, is that there's a safe, effective way to both wean men off of their testosterone replacement and raise T levels. Rather than replacing testosterone, clomiphene citrate, marketed as Clomid or Serophene stimulates the production of two key hormones: follicle stimulating hormone (FSH) and luteinizing hormone (LH). Both are vital to men. FSH stimulates sperm production in the testicles, and LH stimulates testosterone production.
A number of studies have demonstrated that clomiphene can effectively raise T levels – and it does so by working with the body rather than by tricking it with external testosterone. In one study, for example, the testosterone levels in the men taking clomiphene more than doubled after several months. Why haven't more men and doctors heard about clomiphene? It's been used for decades to help infertile men (and women), so it's available as an inexpensive generic. The other reason is that clomiphene is not approved by the FDA for use in increasing testosterone levels in men.
If you're on testosterone now and want to get off it, ask your doctor about clomiphene. If you're not using testosterone but are thinking about it, here's my advice: get your T level checked. If it's low, get it checked again to make sure it was an accurate reading. Then, if it's below normal and you have symptoms such as low libido, fatigue or depressed mood, do everything you can to raise your T levels naturally:
- Lose the belly. Fat can acts like a testosterone sponge, taking it out of the blood, where you want it!
- Cut the carbs: rule out bread, pizza, pasta, cookies or cake. Eliminate added sugar and regular soft drinks.
- Get more physically active – you don't have to spend a lot of money, just get up and move, walk more, take the stairs, get a pedometer and aim for 10,000 steps a day…any extra exercise will help kick-start testosterone production. (But don't go overboard – ironically, exercising too much can be as bad for your testosterone levels as not exercising enough!)
- Get enough sleep: testosterone is produced at night during the deeper phases of sleep. Guys who are sleep-deprived are testosterone-deprived as well!
- Have a physical exam. Some kinds of easily-correctable problems with the testicles, such as varicocele, can cause T levels to plummet.
- Avoid opioid pain killers – a known side effect of these drugs is disruption of normal hormone functioning, which includes hurting testosterone production.
If you have confirmed low testosterone (and symptoms) and you've tried changing your lifestyle along the lines I've just outlined, then and only then you might ask your doctor about using medications to increase your testosterone.