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Morgado A, Tsampoukas G, Sokolakis I, Schoentgen N, Urkmez A, Sarikaya S. Do "testosterone boosters" really increase serum total testosterone? A systematic review. Int J Impot Res 2024; 36:348-364. [PMID: 37697053 DOI: 10.1038/s41443-023-00763-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023]
Abstract
Testosterone boosters are heavily marketed on social media and marketplaces to men with claims to significantly increase testosterone. Lax industry regulation has allowed sales of supplements to thrive in the absence of verification of their purported benefits. Our primary objective was to systematically review all data published in the last two decades on testosterone boosters and determine their efficacy. Our outcome of interest was total testosterone increase versus placebo in four different populations: male athletes, men with late-onset hypogonadism infertile men and healthy men. Following search and screening, 52 studies were included in our review, relating to 27 proposed testosterone boosters: 10 studies of cholecalciferol; 5 zinc/magnesium; 4 Tribulus terrestris and creatine; 3 Eurycoma longifolia and Withania somnifera; 2 betaine, D-aspartic acid, Lepidium meyenii and isoflavones; while the remainder were single reports. Our findings indicate that most fail to increase total testosterone. The exceptions were β-hydroxy β-methylbutyrate and betaine, which can be considered effective for male athletes. Eurycoma longifolia, a blend of Punica granatum fruit rind and Theobroma cacao seed extracts (Tesnor™) and purified Shilajit extract (PrimaVie™) can be considered possibly effective for men with late-onset hypogonadism; Eurycoma longifolia and Withania somnifera possibly effective for healthy men; and a non-hormonal aromatase inhibitor (Novadex XT™) possibly effective for male athletes.
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Affiliation(s)
- Afonso Morgado
- Serviço de Urologia, Centro Hospitalar Universitário São João, Porto, Portugal.
| | | | - Ioannis Sokolakis
- 2nd Department of Urology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nadja Schoentgen
- Urology Department, University Hospital Center Bichat Claude Bernard, Paris, France
| | - Ahmet Urkmez
- Department of Urology, St. Elizabeth's Medical Center, Boston, MA, USA
| | - Selcuk Sarikaya
- Department of Urology, Gülhane Research and Training Hospital, Ankara, Turkey
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Santos HO, Cadegiani FA, Forbes SC. Nonpharmacological Interventions for the Management of Testosterone and Sperm Parameters: A Scoping Review. Clin Ther 2022; 44:1129-1149. [PMID: 35810031 DOI: 10.1016/j.clinthera.2022.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/23/2022] [Accepted: 06/16/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Testosterone replacement and associated pharmacologic agents are effective strategies to treat male hypogonadism; however, nutraceutical agents and lifestyle modification approaches have gained medical interest. The purpose of this scoping review is to highlight the evidence (or lack thereof) of nutraceuticals and lifestyle modification approaches in the management of testosterone levels and sperm parameters. METHODS A scoping review of nonpharmacologic interventions (supplements, herbal medicines, diets, sleep, and exercise) with the potential to improve male health was undertaken to elucidate changes in testosterone levels and sperm parameters in men with hypogonadism or infertility compared with healthy patients. FINDINGS A multitude of nutraceuticals and functional nutrients are purported to stimulate testosterone production; however, only a select few have had promising results, such as zinc, vitamin D (in case of hypovitaminosis D), l-arginine, mucuna, and ashwagandha, based on well-controlled randomized clinical trials of men with low testosterone levels and related problems. Except for l-arginine, these natural agents, as well as tribulus and ω3 fatty acids, can improve some degree of sperm parameters in infertile men. Before implementing these nutraceutical agents, adequate sleep, exercise, and weight loss in patients with obesity are imperative. The effects of nonpharmacologic interventions on testosterone levels are modest and hence do not directly translate into clinical benefits. Correspondingly, androgen receptor content, but not endogenous androgens, has been regarded as the principal factor in muscle hypertrophy. IMPLICATIONS A limited number of supplements and herbal medicines can be considered as adjunctive approaches in the management of testosterone levels and sperm parameters, primarily in men with low testosterone levels and infertility, whereas most nonpharmacologic supplements appear to lack evidence. Although proper physical exercise, sleep, and diet are indisputable approaches because of the general benefits to health, the use of nutraceuticals, if considered, must be personalized by physicians and/or registered dietitians.
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Affiliation(s)
- Heitor O Santos
- School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Flávio A Cadegiani
- Applied Biology Inc, Irvine, California; Department of Endocrinology, Corpometria Institute, Brasilia, Brazil
| | - Scott C Forbes
- Faculty of Education, Department of Physical Education Studies, Brandon University, Brandon, Manitoba, Canada
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Samadi M, Askarian A, Shirvani H, Shamsoddini A, Shakibaee A, Forbes SC, Kaviani M. Effects of Four Weeks of Beta-Alanine Supplementation Combined with One Week of Creatine Loading on Physical and Cognitive Performance in Military Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137992. [PMID: 35805647 PMCID: PMC9265371 DOI: 10.3390/ijerph19137992] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/21/2022] [Accepted: 06/25/2022] [Indexed: 01/25/2023]
Abstract
The purpose was to investigate the effects of a 7-day creatine (Cr) loading protocol at the end of four weeks of β-alanine supplementation (BA) on physical performance, blood lactate, cognitive performance, and resting hormonal concentrations compared to BA alone. Twenty male military personnel (age: 21.5 ± 1.5 yrs; height: 1.78 ± 0.05 m; body mass: 78.5 ± 7.0 kg; BMI: 23.7 ± 1.64 kg/m2) were recruited and randomized into two groups: BA + Cr or BA + placebo (PL). Participants in each group (n = 10 per group) were supplemented with 6.4 g/day of BA for 28 days. After the third week, the BA + Cr group participants were also supplemented with Cr (0.3 g/kg/day), while the BA + PL group ingested an isocaloric placebo for 7 days. Before and after supplementation, each participant performed a battery of physical and cognitive tests and provided a venous blood sample to determine resting testosterone, cortisol, and IGF-1. Furthermore, immediately after the last physical test, blood lactate was assessed. There was a significant improvement in physical performance and mathematical processing in the BA + Cr group over time (p < 0.05), while there was no change in the BA + PL group. Vertical jump performance and testosterone were significantly higher in the BA + Cr group compared to BA + PL. These results indicate that Cr loading during the final week of BA supplementation (28 days) enhanced muscular power and appears to be superior for muscular strength and cognitive performance compared to BA supplementation alone.
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Affiliation(s)
- Mohammad Samadi
- Exercise Physiology Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran 14155-6437, Iran; (M.S.); (A.A.); (H.S.); (A.S.); (A.S.)
| | - Ali Askarian
- Exercise Physiology Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran 14155-6437, Iran; (M.S.); (A.A.); (H.S.); (A.S.); (A.S.)
| | - Hossein Shirvani
- Exercise Physiology Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran 14155-6437, Iran; (M.S.); (A.A.); (H.S.); (A.S.); (A.S.)
| | - Alireza Shamsoddini
- Exercise Physiology Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran 14155-6437, Iran; (M.S.); (A.A.); (H.S.); (A.S.); (A.S.)
| | - Abolfazl Shakibaee
- Exercise Physiology Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran 14155-6437, Iran; (M.S.); (A.A.); (H.S.); (A.S.); (A.S.)
| | - Scott C. Forbes
- Faculty of Education, Department of Physical Education Studies, Brandon University, Brandon, MB R7A 6A9, Canada;
| | - Mojtaba Kaviani
- School of Nutrition and Dietetics, Faculty of Pure and Applied Science, Acadia University, Wolfville, NS B4P 2R6, Canada
- Correspondence:
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Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, Rawson ES, Smith-Ryan AE, VanDusseldorp TA, Willoughby DS, Ziegenfuss TN. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 2021; 18:13. [PMID: 33557850 PMCID: PMC7871530 DOI: 10.1186/s12970-021-00412-w] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/28/2021] [Indexed: 01/01/2023] Open
Abstract
Supplementing with creatine is very popular amongst athletes and exercising individuals for improving muscle mass, performance and recovery. Accumulating evidence also suggests that creatine supplementation produces a variety of beneficial effects in older and patient populations. Furthermore, evidence-based research shows that creatine supplementation is relatively well tolerated, especially at recommended dosages (i.e. 3-5 g/day or 0.1 g/kg of body mass/day). Although there are over 500 peer-refereed publications involving creatine supplementation, it is somewhat surprising that questions regarding the efficacy and safety of creatine still remain. These include, but are not limited to: 1. Does creatine lead to water retention? 2. Is creatine an anabolic steroid? 3. Does creatine cause kidney damage/renal dysfunction? 4. Does creatine cause hair loss / baldness? 5. Does creatine lead to dehydration and muscle cramping? 6. Is creatine harmful for children and adolescents? 7. Does creatine increase fat mass? 8. Is a creatine 'loading-phase' required? 9. Is creatine beneficial for older adults? 10. Is creatine only useful for resistance / power type activities? 11. Is creatine only effective for males? 12. Are other forms of creatine similar or superior to monohydrate and is creatine stable in solutions/beverages? To answer these questions, an internationally renowned team of research experts was formed to perform an evidence-based scientific evaluation of the literature regarding creatine supplementation.
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Affiliation(s)
- Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, Florida, USA.
| | - Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Canada
| | - Scott C Forbes
- Department of Physical Education, Faculty of Education, Brandon University, Brandon, MB, Canada
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group; School of Medicine, FMUSP, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Andrew R Jagim
- Sports Medicine Department, Mayo Clinic Health System, La Crosse, WI, USA
| | - Richard B Kreider
- Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, Texas A&M University, College Station, USA
| | - Eric S Rawson
- Department of Health, Nutrition, and Exercise Science, Messiah University, Mechanicsburg, PA, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Trisha A VanDusseldorp
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Darryn S Willoughby
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA
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Calleja-González J, Mielgo-Ayuso J, Ostojic SM, Jones MT, Marques-Jiménez D, Caparros T, Terrados N. Evidence-based post-exercise recovery strategies in rugby: a narrative review. PHYSICIAN SPORTSMED 2019; 47:137-147. [PMID: 30369286 DOI: 10.1080/00913847.2018.1541701] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In the sport of rugby, athletes need a multitude of sport-specific skills along with endurance, power, and speed to optimize performance. Further, it is not unusual for athletes to play several competitive matches with insufficient recovery time. Rugby requires repeated bouts of high-intensity actions intermixed with brief periods of low-to-moderate active recovery or passive rest. Specifically, a match is characterized by repeated explosive activities, such as jumps, shuffles, and rapid changes of direction. To facilitate adequate recovery, it is necessary to understand the type of fatigue induced and, if possible, its underlying mechanisms. Common approaches to recovery may include nutritional strategies as well as active (active recovery) and passive recovery (water immersions, stretching, and massage) methods. However, limited research exists to support the effectiveness of each strategy as it related to recovery from the sport of rugby. Therefore, the main aim of the current brief review is to present the relevant literature that pertains to recovery strategies in rugby.
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Affiliation(s)
- Julio Calleja-González
- a Faculty of Sport Sciences - Physical Education and Sports Department , University of the Basque Country (EHU-UPV) , Vitoria , Spain
| | - Juan Mielgo-Ayuso
- b Department of Biochemistry, Molecular Biology and physiology , Universidad de Valladolid , Soria , Spain
| | - Sergej M Ostojic
- c Center for Health, Exercise and Sport Sciences , Belgrade , Serbia
| | - Margaret T Jones
- d Health and Human Performance , George Mason University , Manassas , VA , USA
| | - Diego Marques-Jiménez
- e Physical Education and Sports Department , University of the Basque Country (EHU-UPV) , Vitoria , Spain
| | - Toni Caparros
- f INEFC Barcelona (Institut Nacional d'Educació Física de Catalunya) , Barcelona , Spain
| | - Nicolas Terrados
- g Biomedical Sciences Department , University of Oviedo , Oviedo , Spain
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DUŠKOVÁ M, POSPÍŠILOVÁ H. The Role of Non-Aromatizable Testosterone Metabolite in Metabolic Pathways. Physiol Res 2011; 60:253-61. [DOI: 10.33549/physiolres.932080] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Dihydrotestosterone (DHT) originates via irreversible reduction of testosterone by catalytic activity of 5α-reductase enzyme and it is demonstratively the most effective androgen. Androgens influence adipose tissue in men either directly by stimulation of the androgen receptor or indirectly, after aromatization, by acting at the estrogen receptor. DHT as a non-aromatizable androgen could be responsible for a male type fat distribution. The theory of non-aromatizable androgens as a potential cause of a male type obesity development has been studied intensively. However, physiological levels of DHT inhibit growth of mature adipocytes. In animal models, substitution of DHT in males after gonadectomy has a positive effect on body composition as a testosterone therapy. Thus, DHT within physiological range positively influences body composition. However, there are pathological conditions with an abundance of DHT, e.g. androgenic alopecia and benign prostatic hyperplasia. These diseases are considered as risk factors for development of metabolic syndrome or atherosclerosis. In obese people, DHT metabolism in adipose tissue is altered. Local abundance of non-aromatizable androgen has a negative effect on adipose tissue and it could be involved in pathogenesis of metabolic and cardiovascular diseases. Increased DHT levels, compared to physiological levels, have negative effect on development of cardiovascular diseases. Difference between the effect of physiological and increased level brings about certain paradox.
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Affiliation(s)
- M. DUŠKOVÁ
- Institute of Endocrinology, Prague, Czech Republic
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Cook CJ, Crewther BT, Kilduff LP, Drawer S, Gaviglio CM. Skill execution and sleep deprivation: effects of acute caffeine or creatine supplementation - a randomized placebo-controlled trial. J Int Soc Sports Nutr 2011; 8:2. [PMID: 21324203 PMCID: PMC3049131 DOI: 10.1186/1550-2783-8-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 02/16/2011] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND We investigated the effects of sleep deprivation with or without acute supplementation of caffeine or creatine on the execution of a repeated rugby passing skill. METHOD Ten elite rugby players completed 10 trials on a simple rugby passing skill test (20 repeats per trial), following a period of familiarisation. The players had between 7-9 h sleep on 5 of these trials and between 3-5 h sleep (deprivation) on the other 5. At a time of 1.5 h before each trial, they undertook administration of either: placebo tablets, 50 or 100 mg/kg creatine, 1 or 5 mg/kg caffeine. Saliva was collected before each trial and assayed for salivary free cortisol and testosterone. RESULTS Sleep deprivation with placebo application resulted in a significant fall in skill performance accuracy on both the dominant and non-dominant passing sides (p < 0.001). No fall in skill performance was seen with caffeine doses of 1 or 5 mg/kg, and the two doses were not significantly different in effect. Similarly, no deficit was seen with creatine administration at 50 or 100 mg/kg and the performance effects were not significantly different. Salivary testosterone was not affected by sleep deprivation, but trended higher with the 100 mg/kg creatine dose, compared to the placebo treatment (p = 0.067). Salivary cortisol was elevated (p = 0.001) with the 5 mg/kg dose of caffeine (vs. placebo). CONCLUSION Acute sleep deprivation affects performance of a simple repeat skill in elite athletes and this was ameliorated by a single dose of either caffeine or creatine. Acute creatine use may help to alleviate decrements in skill performance in situations of sleep deprivation, such as transmeridian travel, and caffeine at low doses appears as efficacious as higher doses, at alleviating sleep deprivation deficits in athletes with a history of low caffeine use. Both options are without the side effects of higher dose caffeine use.
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Affiliation(s)
- Christian J Cook
- UK Sport Council, 40 Bernard St London, UK
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College, London, UK
- Department for Health, University of Bath, Bath, UK
| | - Blair T Crewther
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College, London, UK
| | - Liam P Kilduff
- Sport and Exercise Science Research Centre, Swansea University, Swansea, UK
| | | | - Chris M Gaviglio
- Queensland Academy of Sport and Gold Coast SUNS, AFL Franchise Gold Coast, Brisbane, Australia
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Current Opinion in Endocrinology, Diabetes & Obesity. Current world literature. Curr Opin Endocrinol Diabetes Obes 2010; 17:293-312. [PMID: 20418721 DOI: 10.1097/med.0b013e328339f31e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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