Testosterone: A man's guide: practical tips for boosting physical, mental and sexual vitality; by Nelson Vergel

This is the second edition of a book by the US activist Nelson Vergel. It is a users guide to testosterone by an HIV positive man who has researched the subject over many years for his own care.

The non-technical sections include helpful tips about what not to do as well as the best approaches. This looks at how to assess potential testosterone deficiency, including what to measure (free vs total), when and how, and the impact of age on target ranges including fluctuation in levels throughout the day. The information is in the context of supplementary approaches being dependent on working with your doctor, not only to ensure that an appropriate dose and formulation are used (oral supplementation being the least useful), but that routine monitoring guides the safety of this approach.

Replacement therapy is discussed, usually recognising this as a lifelong treatment, as testosterone supplementation reduces the need and ability for the body to continue it own production. The risks from interrupting treatment and a period of testosterone depletion until the body adjusts include depression, weight loss, lack of motivation and reduced sex drive – often the symptoms that suggested treatment in the first place.

The guide also discusses side effects from testosterone and how to manage these, including the experimental use of Human Chorionic Gonadotropin (HCG) to maintain normal testicular function and reverse shrinkage. It discusses alternative treatment for low sex drive and erectile dysfunction including a review of data (or lack of it) for non-approved products. It also includes the importance of lifestyle modifications including diet and exercise, the importance of adherence and on finding a doctor that will monitor and prescribe treatment.

This is a users guide, written by an activist who has used many of the available approaches for over 16 years and he shares his experiences of different approaches. But the author professionally trained as a chemical engineer, and this informs his discussion on the chemistry behind a daunting range of formulations (including injections, topical creams, patches, implants, underarm products and sublingual and buccal preparations).

Although titled ‘a man’s guide’ the book includes information on testosterone use in women, including links for further reading, though for future editions this might be helpful if this was collated and compiled in a separate chapter.

Nelson is also co-author of Built to Survive, a similar guide to using anabolic steroids, nutrition and exercise to develop and maintain muscle mass for HIV positive men.

Nelson Vergel – Testosterone: a man’s guide: practical tips for boosting physical, mental and sexual vitality; 2nd edition, 2011.