What adjustments are needed for elevated testosterone levels, specifically hypergonadism, after taking supplements for 3 months?

From the Guidelines

To address a testosterone level of 998 after taking supplements for three months, you should reduce your supplement dosage by 25-50% and retest your levels in 4-6 weeks, aiming to achieve a total testosterone level in the middle tertile of the normal reference range, as recommended by the American Urological Association guideline 1. When adjusting your supplement regimen, it's essential to consider the potential risks associated with high testosterone levels, such as cardiovascular problems, liver issues, mood swings, and sleep disturbances.

• If you're using prescribed testosterone replacement therapy (TRT), consult your healthcare provider before making any changes.
• For those using over-the-counter supplements like DHEA, tribulus terrestris, or fenugreek, consider stopping them completely until your levels normalize.
• Maintain a balanced diet, regular exercise, adequate sleep, and proper hydration, as these factors influence hormone regulation.
• Avoid alcohol and stress, which can affect hormone metabolism. The goal is to achieve testosterone levels within the normal range of approximately 300-1000 ng/dL, with optimal levels typically between 500-700 ng/dL, as suggested by studies on testosterone levels and health outcomes 1. Regular monitoring is essential to ensure your testosterone remains at healthy levels, and adjustments to your supplement regimen should be made under the guidance of a healthcare professional, taking into account the most recent and highest quality evidence available 1.

From the FDA Drug Label

The median circulating level of testosterone increased by approximately 10 to 20% but remained within the physiologic range In a separate study in healthy men treated with finasteride 1 mg per day (n=82) or placebo (n=69), mean circulating levels of testosterone and estradiol were increased by approximately 15% as compared to baseline, but these remained within the physiologic range

To adjust for a testosterone level too high (998) after taking supplements for 3 months, consider the following:

• Stop taking supplements: Discontinue the use of supplements that may be contributing to the elevated testosterone levels.
• Monitor testosterone levels: Regularly check testosterone levels to ensure they return to a normal range.
• Consult a healthcare professional: Discuss the elevated testosterone levels with a healthcare professional to determine the best course of action, which may include further testing or treatment. 2

From the Research

Adjusting Testosterone Levels

To adjust high testosterone levels after taking supplements for 3 months, consider the following options:

• Stop or reduce the supplements: High levels of testosterone can be caused by excessive supplementation, so stopping or reducing the dosage may help to lower levels 3.
• Consult a doctor: A healthcare professional can help to determine the cause of high testosterone levels and recommend appropriate treatment options.
• Consider aromatase inhibitors: Aromatase inhibitors, such as anastrozole, can help to lower testosterone levels by inhibiting the conversion of testosterone to estrogen 4, 3, 5.

Aromatase Inhibitors

Aromatase inhibitors can be used to lower testosterone levels, but their effectiveness and safety vary:

• Anastrozole: This aromatase inhibitor has been shown to increase serum testosterone levels, but its effects on cardiometabolic parameters are variable 5.
• Other aromatase inhibitors: Other aromatase inhibitors, such as 4-OHA, have been developed and tested, but their effectiveness and safety in humans are not well established 4.

Potential Side Effects

When using aromatase inhibitors to adjust testosterone levels, consider the potential side effects:

• Decreased bone mineral density: Aromatase inhibitors can decrease bone mineral density, particularly in older men 3.
• Changes in body composition: Aromatase inhibitors can cause changes in body composition, including decreased subcutaneous fat 5.
• Adverse effects on semen parameters: Aromatase inhibitors may have adverse effects on semen parameters, although the evidence is limited 3.