Background: The aim of testosterone replacement therapy (TRT) is to improve symptoms and signs of testosterone deficiency including decreased libido, erectile dysfunction, depressed mood, anaemia, loss of muscle and bone mass, by increasing serum testosterone levels to physiologic range. TRT has been used in the last 70 years, and overtime, numerous preparations and formulations have been developed to improve pharmacokinetics (PKs) and patient compliance. The routes of delivery approved for use in the Western world include buccal, nasal, subdermal, transdermal and intramuscular (IM).

Objectives: The aim of this narrative review was to describe and compare all available and approved testosterone preparations according to pharmacology, PKs and adverse effects.

Materials and methods: We have performed an extensive PubMed review of the literature on TRT in clinical practice. Contraindications and monitoring of TRT were analyzed by comparing available guidelines released in the last five years. We provide a review of advantages and disadvantages of different modalities of TRT and how to monitor treatment to minimize the risks.

Results: TRT is associated with multiple benefits highly relevant to the patient. However, the recommendations given in different guidelines on TRT are based on data from a limited number of randomized controlled trials (RCTs), as well as non-randomized clinical studies and observational studies. This is the case for the safety of a long-term TRT in late-onset hypogonadism (LOH). No evidence is provided indeed on the effects of TRT on endpoints such as deterioration of heart failure suggesting a cautious approach to T replacement in older men with a history of heart failure.

Conclusion: Clinicians must consider the unique characteristics of each patient and make the necessary adjustments in the management of LOH in order to provide the safest and most beneficial results.

Keywords: androgen deficiency; hormonal therapy; late-onset hypogonadism; testosterone.

Go here to read the rest:
Testosterone replacement therapy - PubMed

Indian J Urol. 2014 Jan-Mar; 30(1): 27.

Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, Starr 900, New York, NY, USA

Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, Starr 900, New York, NY, USA

Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, Starr 900, New York, NY, USA

Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, Starr 900, New York, NY, USA

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Testosterone replacement therapy (TRT) is a widely used treatment for men with symptomatic hypogonadism. The benefits seen with TRT, such as increased libido and energy level, beneficial effects on bone density, strength and muscle as well as cardioprotective effects, have been well-documented. TRT is contraindicated in men with untreated prostate and breast cancer. Men on TRT should be monitored for side-effects such as polycythemia, peripheral edema, cardiac and hepatic dysfunction.

Keywords: Hypogonadism, side-effects, testosterone replacement therapy

Testosterone has many beneficial effects, including increasing bone strength and density, inducing hematopoiesis, driving sexual function and libido, providing a cardioprotective effect and increasing muscle strength.[1] Testosterone levels are known to decline as men age. The Baltimore Longitudinal Study of Aging reported the incidence of hypogonadism as 20% in men over 60 years of age, 30% in men over 70 years and 50% in men over 80 years of age.[2]

As men age, a decline in testicular production of testosterone are seen, as well as an increase in sex hormone binding globulin, both of which act to decrease bioavailable testosterone.[3] With this gradual decline, the beneficial effects of testosterone could be diminished and negatively affect physical and emotional well-being. Testosterone replacement therapy (TRT) is a reasonable treatment option often discussed for men with low testosterone levels and symptoms of hypogonadism. When replaced, many of the positive effects of testosterone are regained.[4] These positive results have led to a drastic increase in the use of testosterone replacement for men with symptomatic hypogonadism, though long-term data is lacking on the safety.

While the beneficial effects of testosterone are rarely disputed and widely publicized, there is a paucity of the literature on the risks of testosterone use. Any man who has a comorbidity that precludes TRT should be informed of all risks. Factors such as exacerbation of prostate cancer, male breast cancer, worsening benign prostatic hyperplasia (BPH), polycythemia and an increased risk of obstructive sleep apnea (OSA) should be considered when administering TRT to a patient. The goal of this review is to highlight the risks and summarize the current literature on safety of TRT.

One of the major risk factors associated with the administration of testosterone supplementation is its effect on the prostate. We know the prostate to be an androgen-dependent gland and conversely, anti-androgen agents can decrease prostate volume in patients with BPH. As the population continues to age, both the incidence of BPH and late-onset male hypogonadism will continue to rise and practitioners will need to be comfortable with counseling men on the effect of TRT on the prostate.[5]

In a landmark randomized, double-blind, placebo-controlled trial of 44 hypogonadal men, Marks et al. showed that TRT for 6 months improves serum androgen levels, but had little effect on prostate tissue androgen levels, tissue biomarkers and/or gene expression.[6] Testosterone supplementation has been shown to increase prostate size by 12%,[7] but lower urinary tract symptoms (LUTS) and urinary retention do not worsen in men on testosterone therapy.[8,9] Similarly, the presence of hypogonadism in 312 men with reportable LUTS was not predictive of worsening International Prostate Symptom Scores (IPSS) or maximal urinary flow rates.[10]

In fact, some series report an improvement in LUTS after 1 year of TRT.[11,12] In the most recent, randomized controlled trial, 52 men were randomly assigned to receive TRT. At 1 year, the 23 men randomized to 250 mg of testosterone enanthate every 4 weeks reported significant improvements in IPSS and maximal urinary flow rates compared with baseline and controls.[12] At no point in this trial did any patient require additional medication or suffer urinary retention.

While older men on testosterone therapy do have an increase in overall prostate size, this increase in size does not differ from the increase in prostatic hypertrophy seen in elderly men not on testosterone therapy.[13] Taken together, TRT does not appear to grossly worsen LUTS and is not contraindicated in men diagnosed with BPH.

It has been over 60 years since Hodges and Huggins described a relationship between serum testosterone levels and prostate cancer progression.[14] Later in 1982, Fowler and Whitmore reported that exogenous testosterone given to patients with metastatic prostate cancer had worse outcomes.[15] Today androgen deprivation therapy remains a cornerstone of treatment for men with advanced prostate cancer, so it is no surprise that TRT is contraindicated in men with diagnosed prostate cancer, as well as high-risk patients, which includes men with first-degree relatives with prostate cancer and African-Americans who have a prostate-specific antigen (PSA) >3 ng/mL.[4,16]

Recently, there has been a paradigm shift whereby TRT usage has increased despite this potential risk. Many longitudinal studies investigating the relationship of endogenous testosterone levels and subsequent risk of prostate cancer failed to find any association.[17] As such, prostate cancer incidence in men on testosterone therapy is similar to men not on testosterone therapy.[18,19] Similarly, in a 3-year prospective trial, the incidence of prostate cancer was similar among men receiving TRT and controls.[20] In a large meta-analysis of 18 prospective studies that included over 3500 men, there was no association between serum androgen levels and the risk of prostate cancer development.[21] Morgentaler et al. proposed a saturation theory where prostate growth becomes insensitive to changes at normal androgen levels due to saturation of the androgen-receptor; however, there is exponential growth at castrate levels.[22] This theory may explain why testosterone does not directly cause prostate cancer,[23] but it has been shown to accelerate the development of prostate cancer.[24,25]

For premalignancy, prostatic intraepithelial neoplasia (PIN) appears to be a risk factor for developing prostate cancer, however this association has been mostly demonstrated for high-grade disease.[26,27] There is a lack of long-term data on the use of TRT in men with PIN. In one study, 12 months after TRT, only one patient out of 20 men with previous PIN developed overt prostate cancer.[28]

For men who have previously undergone definitive treatment for prostate cancer, the usage of TRT is becoming more accepted. TRT does not appear to increase cancer recurrence in hypogonadal men following radical prostatectomy.[29] In the most recent study by Pastuszak et al., the authors retrospectively reviewed a cohort of 103 men who underwent prior radical prostatectomy and were treated with TRT. Despite a significant increase in PSA in men receiving TRT, there were twice as many cancer recurrences in the control group after 36 months of follow-up.[30]

For men with untreated prostate cancer on active surveillance, TRT remains controversial. However, several studies have shown that TRT is not associated with progression of prostate cancer as evidenced by either PSA progression or gleason grade upstaging on repeat biopsy.[31,32] In the most recent study by Morgentaler et al., 13 men with symptomatic hypogonadism and untreated prostate cancer received TRT for a median of 2.5 years and no local prostate cancer progression or distant disease was observed.[33]

While there have been reports of metastatic prostate cancer in older men who are on testosterone therapy,[20] these are mostly anecdotal. Because of this potential risk, practitioners are often reluctant to administer testosterone in patients they believe may be at high risk for prostate cancer or whom they suspect may have the low-grade disease. Men on TRT should have frequent PSA monitoring; any major change in PSA (>1 ng/mL) within the first 3-6 months may reflect the presence of a pre-existing cancer and warrants cessation of therapy.[34] Current guidelines on the frequency of PSA monitoring and role of pre-treatment transrectal ultrasound guided prostate biopsy are lacking.[35] Taken together, there has been consistent rejection that TRT causes development of prostate cancer in men, however administration of TRT for hypogonadal men previously treated for high-risk prostate cancer should be taken with caution.

While there is no known physiologic link of testosterone directly to the development of breast cancer, it has been suggested that high levels of testosterone may lead to increased aromatization to an active derivative of estrogen, which ultimately may stimulate breast tissue receptors and increase the risk of male breast cancer.[36]

The role of testosterone in breast cancer development is yet to be fully understood.[37] Currently, several case reports exist[38] and one retrospective review sites an incidence 11% in 45 men on long term TRT over 10 years.[39] Future prospective studies with longer follow-up will determine if such association between TRT and male breast cancer truly exists.

Testosterone leads to an increase in hemoglobin by as much as 5-7%[1,25] through its effect on the production of erythropoietin, which can dramatically improve symptoms of anemia in men.[40,41]

Studies looking at the occurrence of polycythemia as a negative side-effect in men on testosterone therapy are rare. Despite this, polycythemia is an accepted side-effect of TRT. While testosterone exerts a positive effect in men with baseline anemia, it can lead to polycythemia in over 20% of men treated on TRT.[42] Polycythemia may lead to an increased incidence of vascular events, including stroke, myocardial infarction and deep vein thrombosis with possible pulmonary embolus.[42] While these complications are all possible with polycythemia, their theoretical occurrence has not been demonstrated to occur in men on TRT.[43]

Because of this risk of polycythemia, men undergoing TRT should not only have their complete blood count (CBC) monitored during their therapy, but should also have a baseline CBC drawn before testosterone therapy is initiated. While on testosterone therapy, if the hematocrit (HCT) rises greater than 54%, testosterone therapy should be held until the HCT normalizes. If it is restarted after normalization, it should be performed so at a lower dose with continued careful monitoring.[16]

OSA is a risk associated with TRT in men, but its etiology is not particularly well understood. While some studies suggested that there is no association between OSA and TRT,[44] others have demonstrated that that OSA occurs in men undergoing TRT and when supplementation is stopped, the OSA resolves.[45]

While no clear link has been established, men on TRT should be counseled on the risk of potential OSA when therapy is started. They should be monitored for increased symptoms, such as snoring while sleeping or fatigue. If patients starting TRT already carry a diagnosis of OSA, physicians should counsel these patients that TRT may worsen their symptoms. While, OSA remains to be a relative contraindication to initiation of TRT, more research needs to be completed on this association in order to gain a better understanding of its etiology if there is one at all.

The systemic effects of TRT may be exacerbated in men with limited cardiovascular reserve. Previous dogma held that androgens could have atherogenic potential. In a randomized, placebo-controlled trial, Basaria et al. reported an increased risk of cardiovascular events in men randomized to TRT; however, this small cohort had a high prevalence of chronic disease.[46] Today, current literature suggests that TRT has a neutral to beneficial effect on reported cardiovascular events.[47,48] Because some men may have a limited cardiovascular capacity, clinicians prescribing TRT must be cautious with respect to its ability to cause edema.[49] Until date, no longitudinal studies examine the impact of TRT on the cardiovascular system, however some studies suggest that TRT may serve as an adjunct rehabilitative therapy in patients with congestive heart failure (CHF).[50,51,52]

While topical testosterone delivery systems avoid first-pass hepatic metabolism, there remains concern regarding TRT in patients with chronic liver disease. The majority of reports of liver toxicity and jaundice are limited to orally-administered alkylated forms of testosterone.[53] However, a small prospective study representing a cohort of cirrhotic patients demonstrated topical gels to be safe and efficacious.[54] It has also been shown that TRT may improve hepatic function in patients with end-stage liver disease.[55] Because of these mixed results, clinicians should be aware of the possible risks associated with TRT in men with hepatic dysfunction and counsel these men accordingly.

Because TRT is known to cause water retention, caution with testosterone use in patients with chronic renal insufficiency is often advised. In patients with end-stage renal disease (ESRD) on dialysis, fluid shifts are less of a concern in patients on TRT since the fluid retention can be handled with dialysis. While polycythemia may be an adverse side-effect, this is a potential benefit in patients with chronic renal failure and anemia.[56] Furthermore, the half-life of testosterone elimination after withdrawal appears similar between patients with and without ESRD.[56] Few studies have assessed the effects of TRT in patients with chronic kidney disease; however, small studies have suggested that TRT has anabolic effects among ESRD patients, even in the absence of hypogonadism. Aside from frequent monitoring of congestive symptoms and peripheral edema in this select population, TRT appears to be safe for patients with chronic kidney disease without dose adjustment.[57]

When testosterone reaches supra-therapeutic levels, aggressive behavior and increased rates of suicide among adolescent users have been reported;[58] however, no study has documented a negative impact on cognition in men patients receiving TRT. In fact, studies have shown that testosterone replacement to eugonadal levels may improve or stabilize cognitive function.[59,60,61] Lower levels of testosterone have a negative impact on spatial and verbal abilities, as well as cognitive function; therefore, it is no surprise that normalizing testosterone levels results in cognitive improvements.[62,63]

With exogenous testosterone supplementation, the pulsatile release of gonadotropin-releasing hormone is blunted and the release of follicle-stimulating hormone and luteinizing hormone are depressed. As such, a decrease in spermatogenesis is seen.[64] While this effect may not be of importance to many men who have completed their families, physicians prescribing TRT need to be aware.

When serum levels of testosterone are increased, a concurrent increase in the secretion of sebum occurs, which can lead to acne. Despite this known association, this effect is typically minimal.[65] Case reports regarding testosterone supplementation leading to changes in hair patterns have been documented; however no randomized, placebo-controlled trials exist. Various topical and intramuscular injectable forms of testosterone are associated with a variety of skin reactions, mainly erythema and pruritus in up to 60% of users.[20]

TRT is associated with external, physical changes in the men. Exogenous testosterone is known to cause an imbalance in the hypothalamic-pituitary axis. As such, testosterone can be converted to estrogen by aromatization. Excess estrogens may lead to gynecomastia and/or breast pain, both of which may be seen in 10-25% of men on TRT.[66] The ratio of estradiol to androgens is the key factor in the development of gynecomastia rather than absolute increases in androgens themselves.[66] Clinicians must be aware of non-iatrogenic causes of gynecomastia and therefore the appropriate work-up should be sought out to rule out other pathology, especially if there is any breast tenderness or unilateral gynecomastia. Only a few case-reports describe a relationship between male breast cancer and TRT.[38,39]

In addition, excess estrogens may cause an increase in visceral obesity. With vigilant monitoring of serum estrogen levels, TRT has been shown to promote weight loss.[67] Well-known to many prescribers of TRT is a risk of water retention and/or edema. The etiology of this association remains unclear to date.[68] The degree of retention is generally mild. As mentioned above, men on TRT with a history of CHF should follow closely[69].

TRT has numerous benefits that can great enhance a patient's quality-of-life. Before prescribing TRT, one must be conscientious of its adverse effects. Data on the safety of TRT specific to our aging population is not currently available; however TRT has been linked to prostate cancer, BPH, polycythemia and OSA. A full assessment of the morbidity of TRT would require a large-scale, randomized, controlled trial. To date, physicians remain in a quandary about the best approach to care for men with symptoms of hypogonadism. TRT, when given to appropriately selected patients with vigilant monitoring as outlined in this review and in , can bring improvements in quality-of-life, energy level, libido, muscle mass, cognition and bone density.

Potential risks of TRT and associated monitoring strategies

Source of Support: Nil

Conflict of Interest: None declared.

Go here to see the original:
Risks of testosterone replacement therapy in men - PMC

ReportLinker

Global Testosterone Replacement Therapy Market 2022-2026 The analyst has been monitoring the testosterone replacement therapy market and it is poised to grow by $ 402. 87 mn during 2022-2026, accelerating at a CAGR of 3.

New York, Sept. 13, 2022 (GLOBE NEWSWIRE) -- Reportlinker.com announces the release of the report "Global Testosterone Replacement Therapy Market 2022-2026" - https://www.reportlinker.com/p04046949/?utm_source=GNW 1% during the forecast period. Our report on the testosterone replacement therapy market provides a holistic analysis, market size and forecast, trends, growth drivers, and challenges, as well as vendor analysis covering around 25 vendors.The report offers an up-to-date analysis of the current global market scenario, the latest trends and drivers, and the overall market environment. The market is driven by initiatives to increase awareness about hypogonadism among population, rise in chronic diseases, and untapped potential in developing countries.The testosterone replacement therapy market analysis includes the product segment and geographic landscape.

The testosterone replacement therapy market is segmented as below:By Product Injectables Topicals Others

By Geographic North America Europe Asia Rest of World (ROW)

This study identifies the rise in novel therapeutic approaches as one of the prime reasons driving the testosterone replacement therapy market growth during the next few years. Also, patient assistance programs and the development of new therapies will lead to sizable demand in the market.

The analyst presents a detailed picture of the market by the way of study, synthesis, and summation of data from multiple sources by an analysis of key parameters. Our report on the testosterone replacement therapy market covers the following areas: Testosterone replacement therapy market sizing Testosterone replacement therapy market forecast Testosterone replacement therapy market industry analysis

This robust vendor analysis is designed to help clients improve their market position, and in line with this, this report provides a detailed analysis of several leading testosterone replacement therapy market vendors that include AbbVie Inc., Acerus Pharmaceuticals Corp., Acrux Ltd., Actiza Pharmaceutical Pvt. Ltd., Antares Pharma Inc., Aytu BioPharma Inc., Bausch Health Co. Inc., Bayer AG, BIOTE MEDICAL LLC, Cipla Ltd., Clarus Therapeutics Inc., Eli Lilly and Co., Endo International Plc, Novartis AG, Pfizer Inc., Sun Pharmaceutical Industries Ltd., Teva Pharmaceutical Industries Ltd., The Simple Pharma Co. UK Ltd., Upsher Smith Laboratories LLC, and Viatris Inc. Also, the testosterone replacement therapy market analysis report includes information on upcoming trends and challenges that will influence market growth. This is to help companies strategize and leverage all forthcoming growth opportunities.The study was conducted using an objective combination of primary and secondary information including inputs from key participants in the industry. The report contains a comprehensive market and vendor landscape in addition to an analysis of the key vendors.

The analyst presents a detailed picture of the market by the way of study, synthesis, and summation of data from multiple sources by an analysis of key parameters such as profit, pricing, competition, and promotions. It presents various market facets by identifying the key industry influencers. The data presented is comprehensive, reliable, and a result of extensive research - both primary and secondary. Technavios market research reports provide a complete competitive landscape and an in-depth vendor selection methodology and analysis using qualitative and quantitative research to forecast accurate market growth.Read the full report: https://www.reportlinker.com/p04046949/?utm_source=GNW

About ReportlinkerReportLinker is an award-winning market research solution. Reportlinker finds and organizes the latest industry data so you get all the market research you need - instantly, in one place.

__________________________

Story continues

Read more:
The Global Testosterone Replacement Therapy Market is expected to grow by $ 402.87 mn during 2022-2026, accelerating at a CAGR of 3.1% during the...

FROM NORTH AMERICA SYNDICATE, 300 W 57th STREET, 15th FLOOR, NEW YORK, NY 10019

CUSTOMER SERVICE: (800) 708-7311 EXT. 236

TO YOUR GOOD HEALTH #12345_20220929

FOR RELEASE WEEK OF SEPT. 26, 2022 (COL. 4)

BYLINE: By Keith Roach, M.D.

TITLE: Testosterone injections most likely led to a very severe stroke

---

DEAR DR. ROACH: My 75-year-old husband was frustrated with not being able to retain an erection. He talked to his doctor about it, and she prescribed 200 mg of testosterone cypionate, which he would inject into his bottom once a week. He did this for four months, and then had a severe bilateral stroke (as in, he does not know where he is, what happened to him, cannot read or write, cannot walk, etc.).

After spending two weeks in the ICU, he went to a rehabilitation hospital for three weeks. The hematologist there told me his hemoglobin level was up to 20, and there was no reason a 75-year-old should have been prescribed testosterone when it can elevate his hemoglobin so much. I looked at my husband's labs over the last three years, and his hemoglobin was never above 15. Of course, I had no idea testosterone would elevate hemoglobin, or that it should not be prescribed to a 75-year-old.

What are the normal protocols for testosterone with older men? Could his testosterone injections have led to his stroke? -- D.H.

ANSWER: I am very sorry to hear about your husband.

Testosterone replacement therapy is commonly prescribed to men in their 70s and 80s. Elevations of the hemoglobin levels are certainly well-described, but levels above normal only happen about 1% of the time. Experts recommend checking a blood count to look for these elevations three to six months after starting treatment. Testosterone should be stopped if the hemoglobin level is above normal.

Sometimes, there are other causes for the hemoglobin to go up, but a rise that high, when he had never had it before, makes it seem very likely to me that the testosterone was the cause. A hemoglobin level that high, from any cause, is a risk for stroke and heart attack. It is very possible the testosterone prescription led directly to the stroke.

I am publishing this in the column so that men who are taking testosterone know they should be periodically tested for this unusual complication.

DEAR DR. ROACH: I had carpal tunnel surgery two years ago. I now have trigger fingers in my index and ring fingers. I had cortisone injections but that didn't cure it. I, at one point, was not able to open my fingers. Now, my fingers are really stiff, and I can't bend them. When they get down too far, they lock, but usually, they're so stiff I can't bend them. Surgery was suggested. I'm hesitant, because I'm wondering if this will get better on its own with exercises. -- J.T.

ANSWER: Trigger finger is caused by the tendon getting stuck inside one of the pulleys of the hand. To the best of my knowledge, carpal tunnel surgery doesn't predispose to trigger finger, but there are some conditions that put people at risk for both conditions. Initial treatment of trigger finger is conservative, with splinting and anti-inflammatory drugs. If that doesn't work, injection of cortisone by a hand surgeon is usually successful.

Most of the hand surgeons I know will try injection three times before recommending surgery. People who have not gotten better with conservative treatment and injection generally do not get better on their own; though, a few people will. Unfortunately, postponing surgery too long can lead to the finger getting a contracture, where it will not straighten at all. It's best to have surgery before this complication occurs.

* * *

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

(c) 2022 North America Syndicate Inc.

All Rights Reserved

Visit link:
Testosterone injections most likely led to a very severe stroke - The Independent

Are you in your late 30s or beyond concerned about age spots, graying hair, and a sagging body? Or have trouble sleeping at night and face a harder time achieving orgasm? These are typical signs of low DHEA levels in your body.

What is Dehydroepiandrosterone (DHEA)? It is a parent sex hormone that your body naturally produces under stress. The production level of this hormone dips as you age. Since DHEA is converted into other sex hormones like testosterone and estrogen, there is a decline in their concentration as well.

Not only that but when your DHEA levels drop, so does your immune system. For this reason alone, maintaining a natural balance of sex hormones becomes imperative as we age.

Try the best DHEA supplements to get the energy, sex drive, and appearance you want without relying on harmful pharmaceuticals or other ineffective over-the-counter supplements.

Natrol is a leading brand in the health and wellness supplement niche, offering a range of supplements to improve sleep, anxiety, stress, and overall health. The brand has garnered a positive reputation due to its natural and clean supplement formulas.

It is an American brand that Elliot Balbert founded in 1980 with a vision of improving human wellness worldwide. Although the initial target of the brand was the cosmetic industry, the company eventually transitioned into a nutraceuticals (use of food ingredients for medicinal benefits) brand.

Over years of hard work, Natrol has developed into one of the top-notch supplement brands providing high-grade sleep products to the masses. Moreover, Natrol does not compromise on the quality and purity of its supplements.

Therefore, all of their products are USP-certified and non-GMO. Mainly, the brand has achieved an A rating from the Natural Products Association, adding to its reputation and supplements.

Furthermore, Natrol is a prominent award-winning supplement manufacturer, snatching Better Nutritions Best of Supplements Award 2017, and Delicious Living Award, among many others. The company has over 51.3K followers on Facebook, while 18.1K people follow them on Instagram, distinguishing its worth in the supplemental market.

Available In Different Strengths: The Natrol DHEA Mood & Stress supplement comes in various dosages. Whether you are starting your journey with DHEA or want to build your tolerance, Natrol provides options for all. These all-natural and safe DHEA supplements come in 10 mg, 25 mg, and 50 mg dosages. Apart from that, Natrol lets you choose between capsules and tablets, which consumers highly rate.

Ingredients & No Allergens: DHEA Mood & Stress contains all-natural ingredients like calcium and DHEA. It contains silicone dioxide, magnesium stearate, stearic acid, cellulose gum, gum arabic, microcrystalline cellulose, and maltodextrin. The supplement does not have synthetic dyes, preservatives, GMOs, artificial sweeteners, or flavors for the allergen profile.

Health Benefits: This supplement is 100% vegetarian and offers several health benefits with constant use. DHEA in the blend supports balanced hormone levels and promotes healthy mood, lively aging, and overall health. Most importantly, this supplement is not suitable for individuals under the age of 18. Also, if you are pregnant or nursing, do not consume it.

Recommended Dosage: According to the official website, you should take one tablet/capsule of this supplement once daily after having your meal.

=> Click here to visit the official website of Natrol

Life Extension is a brand in the natural supplement industry that manufactures supplements backed with scientifically researched ingredients. This health and wellness brand has been functioning for over 40 years since the 1980s.

With a broad catalog, Life Extension offers natural and nutritious supplements to improve brain function, energy, weight loss, and more. Everyone is sure to find a healthy and natural supplement for their personal needs on their convenient online store.

Life Extension has paved its way to outspread its vision of nutrition all around the globe. Based in Fort Lauderdale, FL, Life Extension is a US brand that manufactures high-quality supplements in cGMP-approved facilities.

With a simple mission to find new ways and empower people to live healthier and richer life, Life Extension strives to produce non-GMO supplements. To ensure the quality and potency of their supplements, the brand conducts experiments on the best ingredients in their in-house labs.

Life Extension has over 48K followers on Instagram and 344K on Facebook. With such a predominant social media impact, Life Extension is surely a brand many love. Life Extension has multiple options for first-time buyers as they have a team of personalized wellness specialists and magazine subscriptions to help you out.

Gluten-Free And Non-GMO: The experts at Life Extension scoured through the latest research and designed the formula for this DHEA supplement. The product contains DHEA as the main ingredient, while some other elements in the blend include cellulose, silica, gelatin, and microcrystalline. The product is non-GMO, gluten-free, and organic, offering the best pick for picky consumers. However, 15 mg, 25 mg, and 50 mg capsules contain gelatin obtained from animals. Thats why they are not suitable for vegans. Only 100 mg DHEA supplement by Life Extension comes in vegetarian capsules.

Available In 4 Strengths: Life Extension has formulated this supplement in capsule and tablet forms. Both are available in four potencies, with 15 mg, 25 mg, 50 mg, and 100 mg DHEA content per serving.

Dosage And Use: The brand recommends taking only one to three capsules in the morning. It strongly suggests that a physician should determine the exact number of servings after blood testing. Moreover, DHEA serum blood tests are recommended three to six weeks after starting DHEA replacement therapy.

Health Goals: The benefits of DHEA supplements by Life Extension include balancing youthful levels of bodily hormones and maintaining healthy sexual functions. Besides, it encourages healthy immune function and cardiovascular health.

=> Click here to visit the official website of Life Extension

PureFormulas is an online brand that manufactures and sells a wide variety of top-notch supplements from third-party brands. With a significant inventory of beauty, pet, and health supplements at affordable prices, PureFormulas is one of the best brands, according to TrustPilot.

To top it off, PureFormulas has also won the Bizrate Circle of Excellence Award, highlighting its superior retail experience. PureFormulas amazing customer support, free delivery, and accolades have captured the hearts of thousands of loyal customers and have a 10K Instagram following.

Established in 2007, PureFormulas is one of the brands having a successful history of customer satisfaction with its pure formulations. It is a Miami-based supplement brand that Jose Prendes founded.

Before he laid the foundation of PureFormulas, Prendes discovered VetAmerica, a leading store of pet supplies. Thanks to his commitment and conscientiousness, the Greater Miami Chamber of Commerce named Prendes as the CEO of the Year.

The brand operates with a mission to help people live a pure, happy life, PureFormulas is dedicated to earning your trust through its products and customer support. It is the go-to store for individuals to buy clean, third-party lab-tested products manufactured and wrapped in cGMP-approved facilities.

Quality Ingredients: Daily DHEA by PureFormulas contain 25 mg of pure DHEA. The strength is best suited for individuals who are initiating DHEA replacement therapy as this dose is tolerable by most individuals. Some other ingredients include microcrystalline cellulose, cellulose (capsule), and I-leucine. Since the company uses cellulose for its capsules instead of gelatin, it is best for vegans and non-vegetarians. Moreover, the supplement is GMP certified, non-GMO, and gluten-free.

Dosage: PureFormulas recommends taking one vegetarian capsule every day with your meal. If you have certain health conditions, you are pregnant, nursing, or under 18, you should not use this supplement and seek physician consultation.

Free Shipping: For individuals in the United States, PureFormulas offers standard free shipping on orders above $20. The company also offers an auto-ship program which provides you 10% off on specific products at regular orders.

Return Policy: You can use the hassle-free return policy of PureFormulas, according to which you can return your parcel within 30 days. This only applies to products that are unopened and unused.

=> Click here to visit the official website of PureFormulas

DHEA supplements are a boon for people who want to escape aging skin, bone, and cardiovascular problems and want to lead an energetic life.

Despite the effective results of using this product, there is no doubt that many users do not find it easy to pick up the best version. Most buyers are clueless about the difference between certain varieties, ingredients, etc.

This can be attributed to the lack of proper information regarding these natural hormone boosters available on the market. Here, we have tried to address all your queries with proper facts and figures in our dehydroepiandrosterone review and buying guide.

To have the best list of DHEA products, we followed strict evaluation criteria to probe other supplements on the market. Our team invested several hours in researching the DHEA market high and low.

With a primary goal to find out the safest and purest formula, we picked all the supplements brands offering DHEA supplements. Later, we looked into the company details, store policies, and health benefits of all the products on our list. We unhandled all the ineffective products and only picked the ones with the right formulas, dosage, and benefits.

The assessment criteria we designed for ranking the best DHEA supplements encompassed several factors. We check each product on our list against different benchmarks to ensure our just evaluation.

Brand Reputation: Brand reputation is one of the primary factors that helped our team to pick the best products. Primarily, we delved into the information of the supplement manufacturer offering DHEA products to learn if they opt for safe manufacturing.

For unbiased evaluation, we chose only brands with a prominent name in the industry with a wide portfolio of supplements. Additionally, we kept all the brands at arms length whose reputation was questionable. Hence, all the DHEA supplements on our list are from highly esteemed supplement manufacturers in the USA market.

Natural Ingredients: Prescription medications are great for instant benefits, but their effects are usually short-term. Contrary to that, natural health supplements offer long-term effects with constant use and often have minimal to zero side effects.

Therefore, our priority was to pick the DHEA supplements that contain a blend of natural and organic ingredients without unnecessary binders and fillers. Furthermore, we searched each ingredient in every product to know whether the company was using science-backed ingredients in the formula.

Safety: When there is low DHEA in the body, your immune systems ability to fight off the harmful chemicals also drops. Therefore, we confirmed the safety of all the ingredients and final products before referring the supplements to our readers.

Customer Reviews: DHEA supplements that received rave reviews from customers were our favorite. For this purpose, we visited official company websites and different forums to learn the pros and cons of each supplement. Hence, we preferred the products that were reviewed by hundreds of customers with a positive rating.

DHEA is great for fixing the natural declines in the concentrations of several human sex hormones. While DHEA supplements are great for boosting libido, they offer many health benefits that one cannot enjoy with growing age.

Similar to other health-boosting supplements on the market, hundreds of manufacturers are selling DHEA products. With that fact, the chances of buying risky and counterfeit DHEA supplements increase. Therefore, checking several important factors in a DHA supplement can be wise.

The first and foremost factor you should consider is what your body is trying to convey. Your body is the first to show symptoms in multiple ways, even before you realize something is wrong with you.

Generally, sexual function in the human body is of the least important as it is one of those functions you can live without. That is also why many forms of sexual enhancement have less than significant support from scientific studies.

When your body is under stress, the sexual system and related functions are one of the primary systems that collapse. Your bodys adrenal glands produce DHEA, which is the same gland that makes and secretes cortisol.

Both of these hormones are released as a response to your stress, increasing stress levels in the body. Therefore, sexual dysfunction is a common symptom obvious in people who handle high-stress levels. So, when you are stressed, your body will save energy and nutrients to build up stamina and protect you from the harmful effects of stress.

Several studies have concluded the positive health benefits of DHEA with doses of up to 200 mg. Therefore, the supplements that deliver up to 200 mg of DHEA to your system are considered safe.

Supplement manufacturers offer DHEA pills in different doses, but you should stick to lower doses (25 mg, 50 mg) only as a beginner. For instance, the featured supplements contain 25 mg to 100 mg of DHEA per capsule.

What we suggest is you should prefer DHEA supplements with 50 mg. Mainly, 50 mg DHEA capsules offer a strong enough dose to significantly change your DHEA levels with just one capsule per day.

However, most individuals will have to try and test these supplements by gradually increasing doses to find the best therapeutic amount. Another vital factor that can affect the DHEA dose is your age.

An important factor you must consider before purchasing any supplement with a stronger dose is the size of the capsules. Maximum strength DHEA supplements often come in large capsules and are difficult to swallow.

Also, if you intend to consume more products in your healthcare regimen, choosing such supplement with a smaller size is best. The good thing with safe and effective DHEA supplements is that the capsule size will be small enough if you choose a 50 mg dosage.

On the market, hundreds of DHEA supplements contain additional ingredients like minerals and vitamins. Many supplement manufacturers add them to the blend to boost the efficacy of the main ingredient.

However, it cannot always work out well as you might have insufficient DHEA dose to feel the effects. Moreover, the additional ingredients will be quite low in concentrations to cover your daily requirements.

You will probably have to invest in other products to get the ideal amount of both primary and secondary ingredients. Thats why we suggest you stick with the pure DHEA supplements only and consume other products for the health benefits you want.

DHEA is a shorthand for Dehydroepiandrosterone, a hormone produced by your adrenal glands. It acts as a precursor in synthesizing and releasing crucial male and female sex hormones in the human body.

For instance, it plays a great role in forming testosterone and estrogen. Both are vital hormones that boost the development of masculine and feminine secondary biological features. Not only that, but they also hold significant importance for your general health and well-being.

If you have excessive estrogen-like endocrine disruptors, your body will be disrupted by hormonal disruption, leading to reproductive weakening. Since testosterone and estrogen levels differ in both male and female bodies, their symptoms will differ.

Individuals with Y chromosomes will face many debilitating symptoms due to low testosterone production. This includes irrational mood swings, sudden weight gain, fatigue or low stamina, frequent memory failure, and underdeveloped muscle tone. Additionally, they might have underdeveloped testicles, low libido, erectile dysfunction, and joint/bone tissue loss.

Likewise, individuals who lack a Y chromosome will witness unwanted symptoms in response to low estrogen levels in the body. Some common signs are headaches, mental health problems, fatigue, mood swings, hot flashes, and trouble concentrating. Furthermore, many women have other symptoms like breast tenderness, irregular or absent menstrual cycle, lack of vaginal lubrication, and urinary tract infections (UTIs).

Other health effects of low DHEA levels that are common to both males and females are important, just like the regulation of sex hormones. DHEA synchronizes your energy levels, mental health, bone health, metabolic health, immune function, stress resistance, skin health, and cognitive and memory health.

Many double-blind, placebo-controlled research trials have shown the proven benefits that the human body can get from DHEA supplementation. Since DHEA levels dip with age, older men and postmenopausal women can greatly benefit by adding DHEA supplements into their regimens.

The research on DHEA supplementation mostly focuses on retrieving youthful health benefits as we age. Generally, DHEA has plenty of health benefits as it is involved in the complex process of hormonal production and balancing.

Science has proved that DHEA is good for the bones of postmenopausal women. If you are a gym-goer, adding DHEA supplements into your weight training routine can help to boost muscle strength.

Since its not only the muscle strength that counts for a youthful body, DHEA also plays a helpful role in shaping your body composition. While DHEA is thought to help you gain muscle strength, it also increases the fat-burning process.

One of the worst features of aging is the loss of sexual stamina and attraction, resulting in a lack of physical intimacy. In such situations, people can even try anti-aging products . However, sexual intercourse can help release the love hormone, oxytocin. So, as you age, you are not sexually interested in your partner, which keeps you from enjoying the benefits of oxytocin. No worries anymore; DHEA can help with that as it supports libido and sexual interest in both sexes.

Besides, DHEA can benefit adrenal insufficiency, healthy arteries, healthy glucose metabolism, youthful skin, optimal brain health, healthy inflammatory response, and more.

Scientific society considers DHEA an anabolic steroid. However, DHEA does not produce the typical results of anabolic steroids. While DHEA boosts testosterone levels, strength, and muscle mass, compared to steroids, it does so in much lower amounts. Therefore, DHEA has a nominal effect on your testosterone levels, and studies have not proven its benefits in boosting muscle size, strength or endurance yet.

Dosage is the primary factor that decides the effectiveness of DHEA supplementation. Some additional factors affecting its effectiveness are how consistently and for which health goals you are consuming it.

Still, the timeline for visible results from DHEA supplementation varies from a few weeks to a few months. Furthermore, not many scientific studies have analyzed the long-term effects of DHEA. Therefore, you should plan your DHEA consumption anywhere from a few months to a max of one year.

In the USA, DHEA was once banned for over-the-counter sales in 1985. Since then, all the DHEA supplements have been approved for retail distribution and are not forbidden in the United States. However, the World Anti-Doping Agency (WADA) has banned DHEA as it can alter user testosterone levels.

DHEA supplements are no longer just for people suffering from a low testosterone level or for postmenopausal women who want to reverse the effects of menopause. If you feel your health is declining and you know it has something to do with aging, DHEA supplements can be the best solution.

To help you ease your legwork, we have found the topmost DHEA supplement brands for you. Natrol, Life Extension, and PureFormulas offer effective DHEA supplements with the benefits of natural ingredients.

These products offer a safe, pure, natural alternative that can give your body all the hormones it needs to stay healthy and young, including DHEA and growth hormone. These are not aphrodisiac drugs, so there are no side effects or interactions with other drugs.

Multiplex Content Recommendation - 1

Go here to read the rest:
Best DHEA Supplement (2022 Updated) - The Island Now