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.

In my opinion, most men over 40 have low testosterone—not necessarily ‘clinically low’ by current medical guidelines, but low relative to the levels they had when they were younger and, for some men, lower than the level at which they function and feel their best.

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.  

In a blood panel test, Total Testosterone is generally the best starting measurement. I used to think that it was the Free Testosterone number that mattered most, and not the Total Testosterone.  If you want a more complete picture, I would rather have Total Testosterone, SHBG and albumin than Total Testosterone plus a poorly characterized ‘Direct Free Testosterone’ test. Those measurements allow Free Testosterone to be calculated, and equilibrium dialysis can be used when a more definitive Free Testosterone measurement is warranted.

Free Testosterone can provide additional information, particularly when Total Testosterone doesn't match the symptoms or when SHBG is unusually high or low. But Free Testosterone is much more method-dependent than Total Testosterone, so you need to know how it was measured or calculated before comparing results.

Doctors usually only order a "Total Testosterone" test, and often will say you are not low unless you score under 300.  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 4.2 (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. During this time, my Total Testosterone increased from 401 to 510 and ultimately to 764 ng/dL, all well within the lab reference range.  I am sure that at least some of the increase is attributable to weight loss in those four months, but there is evidence that these supplements work.  They just didn't work well enough to pull the Free T up into the reference range.  Something more was needed.

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 the peptides are safer and more natural than Enclomiphene, and can similarly raise testosterone.

Here is some research data on Kisspeptin-10:

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) the peptides Kisspeptin-10 and Testagen, (3) Enclomiphene, (4) exogenous testosterone, or TRT (Testosterone Replacement Therapy). 

Some men will go straight to TRT.  Unfortunately,  TRT will down-regulate your body's natural testosterone production, and in doing so it will lower your fertility.  The down-regulation is recoverable (primarily with HCG and peptides), but it takes a bit of effort to restore your natural testosterone production after TRT.  See this page for more information on how to do that.

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. UPDATE 5/24/25: my testosterone did indeed drop (by about 40%), so I am now trying peptide therapy to bring it back up.

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.