Testosterone Support Therapy, by Nevin Pratt

Disclaimer: Everything here is my opinion only. I am not a medical doctor, and this is not medical advise.  Please consult with your doctor.

Please read the Overview page before reading this page.  It sets the context for everything else.

Most men over 40 have low testosterone. Furthermore, fat turns testosterone into estrogen, causing an even lower drop if you are fat.  You will never know if that includes you unless you get a blood panel test.  Make sure you include a "Free Testosterone" test with your blood panel, and not just a "Total Testosterone" test.  The number that matters is the Free Testosterone.  Total Testosterone usually tracks up or down in concert with the Free Testosterone, and the Free Testosterone test takes longer and is costlier, which is why doctors usually just order the "Total Testosterone" test.  But it is not necessarily going to track together.  Get a Free Testosterone test each time you do a full blood panel.

Doctors usually only order a "Total Testosterone" test, and often will say you are not low unless you score under 200.  My last lab test specified a reference range of 264-916 for a healthy adult, and for Free Testosterone, it specified a reference range of 6.6-18.1.  Mine was (September 2024), which was VERY low!* 

* Another common reference range quoted is 5-25, but many fitness coaches will say that you need a range of 25-50 if you want to feel the effects of good testosterone levels.  If measurements are by pg/mL, the reference range is 34.7-150.3, while the "good" range is 250-500.  I had a doctor tell me he likes to see above 200 pg/mL for Free Testosterone, and above 1000 ng/dL for Total Testosterone.

So I started taking the following supplements:

Look at the ingredients list in the picture.  All of those ingredients are known to raise testosterone.  After two months, mine increased to 5.7, and then a couple of months after that, it was 6.2, which is still below the low reference range of 6.6.  Furthermore, I am sure that at least some of the increase is attributable to weight loss in those two months.  But there is evidence that these supplements work-- they just don't work very well.  Something else is needed.

Some men will go straight to TRT (Testosterone Replacement Therapy).  Unfortunately, TRT shuts down your body's natural testosterone production, plus lowers your fertility.  So I would say, do not do TRT, except as a life and death last resort.  I have never done TRT, and never plan to.

The step up from supplements (Tongat Ali, et al) is peptide therapy (such as Kisspeptin-10), and the step after that is Enclomiphene (a prescription drug), with TRT the step of last resort after Enclomiphene.  I think Kisspeptin-10 peptide is safer and more natural than Enclomiphene, and can similarly raise testosterone. 

Overall, for testosterone support, I think the most important thing is weight loss, followed by strength training.  Then, from weakest to strongest, I think it stacks like this: (1) supplements, such as Tongat Ali, Boron, etc. (2) Kisspeptin-10, (3) Enclomiphene, (4) TRT.  I think Enclomiphene has a place (as does TRT), but Kisspeptin should be tried first.  And of course, TRT is only a last resort.

I have managed to raise my testosterone levels up to the high reference range without TRT.  Right now I am going back to only using Mars Men supplement, and I expect my testosterone level will fall.  I want to see how far it falls before I decide what to do next.

The above stated reference ranges are for a 25 to 39 year old.  I am sure that someone my age (67 in 2025) would have a lower reference range.