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Now I don’t need to tell you that knives and the penis just don’t mix. Surprisingly though, over 250,000 men have undergone penis enlargement surgery. While having a bigger penis can truly change your life, surgery is not your only option. What is penis enlargement surgery? This type of surgery, called phalloplasty, or penis augmentation surgery is one of the most well known ways to enlarge the penis. For this type of surgery, there are usually two separate operations: one for adding length, and another for adding girth. Length is typically added by cutting a ligament that connects the penis to the pubic bone. This pushes forward part of the penis that was previously hidden inside the body. Girth, or thickness, can be enlarged by inserting fat strips from other parts of the body inside and running up along the penis shaft. Usually for a steep $10,000, you can undergo this type of operation that only “tries” to add 1-3 inches to your penis. Surgery is popular because its effects are almost instant (the operation can take around 4-6 hours). The downside to this is the healing time which can take up to a year, not to mention the possibility of problems arising which can lead to more surgery being needed to fix them. The drawbacks of this procedure are that your results are not guaranteed, and other problems like discomfort, complications and side effects can bring you right back into the ER. Some side effects from penis enlargement surgery are discomfort, swelling, and bruising. Others include infections, loss of sensation and function, a curved penis, scarring and bleeding can also occur. After the surgery, men undergo a whole program designed around healing from this type of operation. This special program uses a method called traction to help the patient heal, or avoid any scars. It also helps the patient add even more length and thickness to the penis size gains added from the surgery. Because of all the details of this type of surgery, a rigorous screening process is done to see whether a guy is a good candidate, and some guys just don’t cut it. Recently though, doctors have started prescribing the method of traction by itself so these guys, and any guy with a less than average sized penis, can enlarge their penis naturally without surgery at all. How penis traction devices work Traction devices are commonly used after penis enlargement surgery to even out the length and girth gains and make them permanent. Instead of going under the knife, men are now using penis stretchers to add growth right at home, resulting in natural penis enlargement size gains for much less the cost of surgery. Research has proven that these stretchers can help you gain a full inch to your penis size within 6 months. My own use of the stretcher confirms the research currently available. The device is usually worn for up to 8 hours per day, and the gains are permanent. Visible results can be seen in under one month. While the traction device is the new guy on the block in the penis enlargement world, it’s proving itself to be an affordable, extremely effective method of natural penis enlargement. free magna rx pennis enlargement system prosolution penis enhancement pills elargement forum free matter penis size enhancement manhattan penis surgeon free exercise tip for pennis enlargement truth about penis enlargment penis enargement tool

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22 March, l968 As it turned out, Johnny would visit Jill’s room off and on during the following weeks. And that strange woman that left the Belmont’s room brought along another woman, and on occasion, he’d catch her on her way down the steps and invite her into his room, although she’d had preferred ‘Jill,’ so she said. Tasma was not aware of most of this, but a little. Also, she had received at this time several letters from home by her parents, in particular her father, but she did not respond back. She was not certain what to say, she loved them, and Jill assured them she was fine, but it was too stressful for her to talk or write them. She did have a profound desire to please her father, and wishful thinking to please her mother, but it seemed she needed to learn how to please herself first, and to Jill, she did not blame them for anything, not anymore anyway. And had she started a communicational dialogue, they may have persuaded her to return, the one thing she did not want at this time. —Jill was in the kitchen—the ironing board was pulled out from an inner-cabinet built into the wall, a wall-unite if you will, it was kept snugly in, in which there was a door attached to it; Jill was ironing Tommy and Johnny’s cloths, another lover circle had stared. Both were arranged in separate piles. Mrs. Belmont was sitting at the table talking seriously to her; it was most unusual thought Tasma, for seldom did she see Mrs. Belmont other than at the bar talking to Jill. As Tasma neared them to join them, the subject—whatever it was—changed, and what appeared on Mrs. Belmont’s face was an un-cheerful smile, not unusual, but quite sudden, and it was apparent. Consequently, feeling a little awkward she left the kitchen to work on her diary-novel (some poems), in the living room in her usual spot; in effect, she could overhear bits and pieces now of their conversation. It didn’t occur to her to get up and leave, rather the opposite; she actually pretended to be busy writing and was simply drawing a picture undiscernibly. “It’s been going on for a while mom, I didn’t think it was, I mean it would end up like this.” “Get rid of him, or all of them.” “No, no, I don’t think Johnny will go so easy. He likes me, and thinks he can have me, and he has me of course.” “What about Tommy?” “I like him, I like him a lot, but that’s the problem, I don’t love him, I just like him.” “He’s what you need though. He’s more anchored.” [With scorn] “What the hell does anchored mean!” said Jill. “Ok, ok, I could have used a better term, Tommy likes to work and go to school, he’ll be somebody someday.” “Tommy doesn’t pay you a dime; Johnny does and Johnny works hard.” “Yes, he works hard all right, hard at drinking, screwing you and god knows who else—smoking that weed.” “So Tommy was screwing me and working.” “You’re going to lose him to that cousin of yours if you don’t hang on to him.” “Tasma,” she looked at Tasma reading, “you got to be kidding, she’s as naïve as a sparrow.” “So you say: does a pineapple come from a pine tree?” “No,” said Jill apprehensive, “now what does that mean?” “She’s not the little girl she was three, four months ago, or is it five or more? She has a good shape, and pretty face, and if Tommy can’t see it, I can. And so can a lot of men at the bar. Anyhow, Tasma is not the issue, Johnny and Tommy are.” (A long pause came, then with a cracking voice, and an almost whisper, she leaned over to her mother, and Tasma leaned over the arm of her chair): “I think I’m pregnant…” “Ay caramba,” she said in a sigh that slurred all the way to Tasma’s ears, “…now what?” “It’s Johnny’s, not Tommy’s, Tommy uses a rubber, and Johnny thinks it is not manly to do so.” It was momentarily hard for Jill to look her mother in the face; she was at this time, pacing the floor in a small circle as her mother followed her with her eyes. “Listen Jill, Johnny’s drinking with all the gang members at the bar, and he’s gambling, it’s just a matter of time before he gets in trouble with them.” (Some of the gang members had motorcycles, others cars, it was somewhat an unofficial bunch of criminals, in that they were but twenty of them that hung out at a number of bars). 23 Shan’t be a Minute Tasma found herself walking upstairs to her room, it was quieter in the kitchen, and figured, she had heard enough, a voice said, “Where are you going?” it was Jill, polite but to the point. “Shan’t be a moment,” was her answer. She wanted to tuck away her diary-novel, she had written some exposing things in it. And so she tucked away, under her pillow, as if it was safe, and her place was off limits to others, which in presumption it seemed to be. For the most part, she did not want to leave it laying about for someone to pick up accidentally. Life had seemed uncomplicated she thought, and now with Jill’s mother it seemed somewhat speculative, if not downright disjointed. It had now crossed her mind Tommy would find out the secret, the secret being Johnny’s behavior and her being pregnant, or so she said she was, and ‘I know about it,’ she felt as if she was a betrayer, be it to Jill or Tommy, or even Johnny. Down the stairway, into the living room she went. She looked outside through the bay-window and there was Mrs. Alice Whitehead getting into the car, she looked at Tasma, Tasma waved at her, she was a nice old lady, and it always seemed to her she had concern on her face for her. As she turned around looking towards the kitchen she noticed Mrs. Belmont sorting out bills: ‘I suppose she’s done talking to Jill now,’ was her thinking. “I talked to your mother a few days ago Tasma, she’s doing well and I told her likewise, you were doing well.” Tasma simply made a polite gesture, no verbal adjectives. “I want to do something today, a surprise, come with me,” asked Tasma, for some odd reason something had popped into her head. “What, may I ask, is on that devious mind of yours?” laughed Jill. —Tasma and Jill were gone for several hours, and arrived back home at about 6:00 PM. Johnny and Tommy were sitting in the living room watching TV. As they both walked into the house, both the boys were somewhat taken back a bit at Tasma’s appearance—if not down right, star-struck. Her long reddish hair was cut to where it reached only the nape of her neck. And she was wearing more makeup than she had before, the result: she looked a little fresher and less school-girlish, than before. Thought Tommy, ‘…before she seemed more delicate and fragile..,’ as he glanced at the poise she displayed as she smiled and stood in the middle of the room awaiting the verdict of the two young throbbing hearts, the heart breakers themselves. Johnny noticed her slender bones, and her nicely shaped neck was more defined (front and back). Tommy for some reason noticed her neatly-set breasts, small as they were—just above her small waist they were a hand full no more. Yet her slyness somewhat removed, still left her with a harmless effect. Her nervousness was repressed for the most part. Along with all that, with all the money she had saved up, she also purchased some bath salts, talcum powder and a small mirror, which she duplicated for Jill as a gift for allowing her to stay. She had spent her $100-dollars she had saved. For some odd reason, Tasma had glanced back into the kitchen, expecting to see Mrs. Belmont, but of course was not surprised when she was not there, she usually would go to the bar around this time, either she had missed her, or she was in her room preparing to go. The boys looked at one another in jest, and laughed. Said Johnny with his normal side joking way, “So now you’ve grown up, welcome to the real world kid, looks like you’re willing to join us.” Tasma knew Johnny’s ways and knew that was better left alone. “It makes you feel good,” commented Jill; meaning spending money on oneself for preservation purposes, or simply for a change in one’s life. But there was concern in Jill’s unseen eyes, in her cerebellum. She was no psychologist, like Skinner or Pavlov with his salivating dogs (who worked on association), but the boys were kind of salivating, restlessly slobbering might be a better way of putting it, if not downright uneasy, with this new Tasma look. Everyone had gone to bed now, it was Jill’s turn to sit downstairs in the sofa-chair for once, wondering, thinking, not sure of her next move. ‘I just don’t get it,’ she asked herself, ‘why am I so attracted to Johnny, and going with Tommy? Tasma wouldn’t have the answer even if I asked her, nor mom, facts are facts, feelings are feelings, I don’t sense they are neither right or wrong, they just are. Johnny makes love as if he was a mad man and seems almost barbaric, and I think of him when I make love to Tommy—it’s just unthinkable. I wonder how Tommy’s new book will turn out. Can you love two people at once, at one time? A good question; I think I do, or maybe it is lust, how do I know, I’m just…(pause) will be nineteen in a month. Mom said: love is a choice. I say love is a feeling. I wonder what Tasma would say. I know Tommy feels love through his penis, like Johnny, all men do, kind of, sort of—most of the time; but Tommy is more willing to be dedicated, I think. I have learned men are attracted by looking, but I like touch.’ On her way to her bedroom, she stopped at Tasma’s room, knocked lightly, “Can I come in just for a moment?” she asked. “Why sure you can,” answered Tasma with a thoughtful voice. “I had a great day with you today, and thanks again for the things you bought me (this was a good lead-in she thought to bait her for a question to be soon asked), but I have a question, somehow I think you’re going to oversimplify the answer but I’ll ask it anyhow. How do you know if you’re in love with a person?” Surprisingly, Tasma answered Jill with foreknowledge, “You mean you are having a hard time trying to figure who you want, Tommy or Johnny?” (A tight look went over Jill’s face.) “Yes, yes, that is where I’m coming from; I didn’t know it was so obvious.” “It’s becoming obvious Jill, it was the first day Johnny came through the door, and it has progressively taken a greater shape to it. But in regards to your answer, I’ve never been in love so I might be the wrong person to ask, but I do know this, as simple as it may be: if I wanted to go out with Johnny, I couldn’t be in love with Tommy—that much. I mean, I’d think whoever you were in love with—you’d not want to go out with anyone else; you’d kind of want to stop shopping around for another person, or so I believe. If I was to get married, I’d not want to go out with anyone else: and if I did, I’d know that I was not ready for marriage, to him or anyone, if that makes any sense.” But to Jill it made all the sense in the world. She was sleeping with Tommy at night, and wanted to be with Johnny. “What do you think I should do?” asked Jill. “I think you already know; I don’t think I need to say anymore. My heart is with you, no matter what the outcome is.” Then Tasma hugged her tightly. 24 Reset As the next two weeks passed a kind of silence took over the house, people talked less to one another, I suppose you could say, Jill was the life of the house, and now she was deep in thought. Everyone tried to keep busy and pretend things were normal, but they of course knew they were not. The Belmont’s kept their normal schedule, and the pretense lingered. Tasma had finished up with Tommy’s book on San Francisco, and had explained to him how she liked the ending of ‘Bustling,’ by his fake name Colleen Grant; she commented to Tommy: “The younger woman fell in love with the older man, but she had psychological issues, and she was too fragile for him to care for her emotional illness, and he was too sick biologically for her to care for him. It was a sad ending I thought, but had they married: love would not have been enough, as they wished, they’d both had ruined the life of the other. Yet they remained friends as they parted, matter of fact they remained friends until he died at the age of eighty-years old, and her, at eighty-two.” She then read a poem she was working on for him: “I haven’t put it in my book or diary yet, but here it is I’ll read it to you from the paper (Tommy sat inquisitively on the edge of her bed): The Maiden from Seattle When she walked into the light The door to life, grew black as Night, And her earth began to swell (This youthful beauty of Seattle); At first glance— Fell this youth from high Aching to touch the morning sky. Who dare take this maiden’s hand? To help her though this silent land! Ah! From hair, to heart, to breast: Like faded flowers in the ground Fleshless alms, could not be found, And so she remains—bound! Said Tommy in surprise, “I like it, I think a little or maybe a lot of you is in the poem; I think you’re going to be a Mrs. Plath, or Dickinson some day.” —The following day Tommy had come into Tasma’s room unexpectantly, “Are you still writing your story?” he asked. She looked at Tommy, “Just some poems, and dairy notes, really haven’t gotten into the plot or theme of anything in particular yet; not sure how to get it going.” “Let me see, maybe I can help you” he said. Yet Tasma was still bewildered of his rudeness to just kind of enter at will; she liked him and didn’t want to scare him away, on the other hand, she was not going to join any love-circle. She leaped quickly to her pillow, then it dawned on her, she had much information in it about Johnny, Jill, Tommy and, none other but the: The Lady in Black, as she referred to her in the diary. But had she not jumped, she thought afterwards, had she not jumped she’d had not given away her hiding place, although it was no vault for sure—I mean, a mouse could have found it had it looked for it. “I, I have too many personal things in it, private things, I’d rather you not see,” said Tasma as she currently held the book in the middle of her chest; as she got off the bed with her one knee, fully turning about now, she tripped on her shoe and the book fell, Tommy quickly grabbed it and opened it. Tasma saw him reading it, and needed to do something quick, she grabbed it out of his hands and jumped on the bed, her dress flying above her waist showing her underwear and all. Somehow Tommy found the child in him, and jumped on her bed trying to grab the diary from her as they rolled around in the bed; now Tommy hovering over her, his legs between hers. “What are you two up to?” questioned a voice in the background, it was Jill: she had heard the ruckus. “My fault, I was trying to get her diary from her, I started to read something quite interesting,” he looked at Jill halfheartedly. Had he gone back any farther, thought Tasma: The Lady in Black was there. Jill looked at Tasma in an indefatigably way, “I see I wasn’t invited to the party—”and slipped off to her bedroom where she just looked out the window aimlessly. In a way it didn’t bother her about what she’d seen, but on the other hand, she was jealous. When Tommy left the bedroom to join Jill he didn’t know whose child it was; he had only read up to ‘I overheard her say to her mother she was pregnant today by….” He could not ask Tasma to betray Jill, it would be too much to ask, if anything, Jill might be betraying him, it was indicative of her. —In the following days, Tasma noticed Tommy and Jill fought quite a lot; and Tommy was not a person to be irritated easily, it must be that she was leading Tommy to believe it could be his child, Tasma thought. Then one evening she noticed Tommy sleeping on the coach, and Johnny still remaining in his bedroom. During this interval, Johnny entertained himself in his bedroom, hoping Tommy and Jill would sort things out—thus he remained in kind of a queue, waiting for Jill’s signal to return, somehow he had come to that conclusion she would. He found himself pacing the floor at night, saying, ‘I wish, whatsitsname, would…’ and never ended the sentence. —I must make this awkward at this point, his mind broke off the subject of Jill and Tommy after the first week, his insides became external. He looked at himself, pretending he was not feeling this serge; he had not guessed at this until it engulfed him, there was stern on his face—and, toil in his hand. A cold shower might work he thought, but it was too far away. He felt he was on a fast run; he hardened his body like a weightlifter, a boxer ready to take a punch. This lasted two weeks, finally an agreement came about, Jill would sleep with Johnny, and Tommy would sleep in Johnny’s room, and in due time Tommy would have to leave, approximately in a few months, considering once she started to show it would only provoke issues within the household, or so she felt. The real problem was that Johnny did not have the heart to tell Jill he liked the way things were, and he really liked Lorie to a higher degree. He wanted his sex, but could find it elsewhere if need be, now he’d have to resort to living in her bedroom, and his alone time would be altered. In addition, Lorie was somewhat out of the picture for he had not seen her in weeks as he waited for this all to settle, but he’d see her again is what he was planning. Again, everything seemed in the air now. But to resist the plan would be too premature at the moment he deliberated out. In spite of the tension, things appeared to move about on a regular base for a few more weeks. However, Johnny was starting to hang out with the gang more often now, with their motorcycles, and customized old cars. He was doing a lot more drinking and gambling with the gang members. They had even stopped on a few occasions at Jill’s house looking for Johnny, taking pains to find him, going out of their way it would seem. It came to her attention; Johnny owed them money, how much it wasn’t said (but it was close to $6,000-dollars). They’d not go to his work; it was one thing the groups forbid: that being, to endanger a man’s livelihood was not being a man at all. They could do almost anything else, even kill you, but not jeopardize your job: that was considered a low blow. Out of nervousness, Tasma started to keep her distance from the group at the bar, if she could, she would have vanished into thin air. free penis enhancement video penis enargement system herbal penis enlagement pnis enlargement technique penis enhancement system penis enlargment pill pro solution com enlargement pnis pnis pump vimax plastic surgery penis enlargement free penile enlargment exercise

Today, here, and around the world, many people have considered having Cosmetic Surgery, or Plastic Surgery performed. Many more have had plastic surgery done, some with multiple procedures. Plastic Surgery, by definition, is a broad term for operative manual and instrumental treatment which is performed for functional or aesthetic reasons. Medical treatment for Facial injuries dates back over 4,000 years. The word "plastic" is a derivative of the Greek word plastikos meaning to mould or shape; however, contrary to common belief, the term “plastic surgery” is not related to modern plastics at all. Cosmetic Surgery was first known to have been performed in Roman times. The Romans had the ability to perform simple procedures such as repairing damaged ears, in modern times referred to as Otoplasty, this is one of the most simple of procedures. One report discusses a patient getting his earlobes repaired after years of wearing heavy earrings. The excess lobes were trimmed and the hole sewn together. One of the more expensive plastic surgeries performed at the time, the removal of branding and scars, was a commonly executed procedure. Freed slaves paid a high price indeed for this type of surgery. It was felt that this common practice reduced the stigma of having been a slave in this ancient times. In ancient India physicians were able to use skin graft reconstruction techniques as early as 800 B.C. From ancient times to the early nineteenth century, we find a living tradition of plastic operations of the nose, ear and lip. The Kangra (correctly pronounced as 'Kangada') district in Himachal Pradesh was most famous for its plastic surgeons. Some scholars are of the opinion that the word 'Kangada' is made from 'Kana + gadha' (ear repair). The British archaeologist Sir Alexander Cunningham (1814-93) had written about the tradition of Kangra plastic surgery procedures. We also have information that in the reign of Akber ,a Vaidya named Bidha used to carry out plastic operations in Kangra. The Charaka-Sanhita and the Sushruta-Sanhita are among the oldest known manuscripts on Ayurveda (the Indian science of medicine). Chronologically speaking, the Charaka-Sanhita is believed to be the earliest work, and deals with medicine proper and containing a few passages on surgery. The Sushruta-Sanhita, a work of the early centuries of the Christian era, mainly deals with surgical knowledge rather than medicine. The extant Sushruta-Sanhita is, according to its commentator Dalhanacharya (of twelth century AD), a amendment by Nagarjuna. The original Sushruta-Sanhita was based on a series of lectures between Kashiraj Divodas (or Dhanvantari) and his disciples, Sushruta and others. In 15th Century Europe, a man by the name of Heinrich von Pfolspeundt , a German physician and a member of the Teutonic Order of Knights was one of the first known Europeans to have performed cosmetic surgery. Dr. Pfolspeundt was one of the first doctors of the late medieval and early Renaissance period to take medical practices beyond the very crude conditions that had existed through much of the Middle Ages. During his time, a good number of German physicians, especially those in Strasbourg, helped to serve the advancement of the study of medicine. Dr. Pfolspeundt described a procedure to make a new nose for a person who lacks one. He stated that by removing skin from the back of the arm and suturing it into place a new nose could be created. From Italy we have records that would indicate that in the year 1442, Branca, a surgeon of Catania in Sicily, carried out plastic surgery of the nose, Also known as rhinoplasty, using a skin flap from the face. This procedure was very similar to the one described in the Sushruta-Sanhita, an Ayurvedic compendium composed in the early centuries of the Christian era. His son Antonio continued his work and was the first known to use a skin flap from the arm for reconstructing the nose. The Boinias family carried on with his work. The plastic operations carried out by the Boinia brothers are described in a book published in 1568 by Fioravanti, a doctor of Bologna, Italy. At the hands of Gasparo Tagliacozzi (1546-99), a professor of surgery and of anatomy at the Bologna University, that plastic surgery attained wide fame in Europe. His book De curtorum chirurgia per insitionem (The surgery of defects by implantation), printed in 1597, was the first scientific composition on plastic surgery. Tagliacozzi had described a method of substitution of the nose by skin from the arm and of replacement of the ears and lips, demonstrating his work throughout his manuscript by way of a large number of illustrations. The Church dignitaries of the time regarded cosmetic surgery as an interference in the affairs of the Almighty. After his death they not only excommunicated Tagliacozzi, but also had his corpse exhumed from its church grave, and placed it in unconsecrated ground. The great Voltaire (1694-1778) wrote a satirical poem on Tagliacozzi and his operation on the nose, using flap from the buttocks. However, due to the many dangers of surgery in those times, cosmetic surgery was rarely performed until around the 1900’s. The United States first plastic surgeon was Dr. John Peter Mettauer, born in Virginia in 1787, who in 1827 performed the first cleft palate surgery on record with instruments he himself designed. There are two very broad fields of aesthetic surgery, Cosmetic Surgery and Reconstructive Surgery. Reconstructive surgery, including microsurgery, focuses on undoing or masking the destructive effects of trauma, previous surgery or disease. Examples of such operations are the rebuilding of amputated or damaged arms or legs; repairing cleft palates or lips, badly formed noses, and ears; and reconstructing a breast after mastectomy. Reconstructive surgery may include moving tissue from other parts of the body to the affected area. Cosmetic surgery however, is an elective surgery, usually done more for aesthetic reasons rather than to repair an injured area. In many cases, however, there are medical reasons for having some procedures done, such as breast reduction (for back pain relief) and Mastopexy (also known as a “breast lift). Cosmetic Surgery includes, but is not limited to, Abdominoplasty, or “tummy tuck”, Blepharoplasty, or “eyelid surgery”, Augmentation Mammaplasty, or "breast enlargement”, and Rhytidectomy, or "face lift". There are many more procedures not listed here that are commonly performed as well. The top five surgical procedures in 2004 Liposuction (325,000), nose reshaping (305,000), breast augmentation (264,000), eyelid surgery (233,000), and facelift (114,000). As you can see, Plastic Surgery has a longstanding history across the ages. It has helped not only in the reconstructive plastic surgery field but also has allowed people to feel more comfortable with their bodies and more confident about themselves. pennis enlargement forum penis enlargement pill magna rx herbal penis enlargment penis enargement testimonials penis enlarement information penis enlarement surgeon penis enhancement review truth about penis enlargement pill free penile enlargment exercise

Being a natural athlete I’ve always sought to find more ways to increase testosterone levels naturally. The question I’ve always asked myself was what are the variables, which determine how much testosterone is boiavailable. I’ve read articles before, giving some advice on what in my every day life causes my test levels to go up and what causes them to go down. But after an extensive research I couldn’t find an article, explaining in detail how and actually what exactly I should manipulate directly in my system to achieve the effects I desired – namely not only higher levels of circulating testosterone but also how much of it will be available to the corresponding receptors in the cell walls. Moreover, I wanted to know all this in regards to natural bodybuilding… So, I decided to do some good digging and reading and then if I manage to put things together, to lay that in writing form so that others can benefit as well. Without wasting even a minute more I will start this off by describing what testosterone is and what it does in the human body. Testosterone is a steroid hormone with anabolic and androgenic properties. It is the main hormone, responsible for the increase in lean muscle tissue, increased libido, energy, bone formation, and immune function. Testosterone is secreted in the testes in men and in the ovaries in women. Small amounts are also secreted in the adrenal glands. Testosterone is derived from cholesterol. The levels of testosterone in men range between 350 and 1,000 nanograms per deciliter (ng/dl). After the age of 40 these normal levels start dropping by roughly 1 per cent a year. In the blood stream testosterone circulates in great percentage bound to so called binding proteins. Sex Hormone Binding Globulin or SHBG is the one that concerns us the greatest. Why? Because this is the main reason why testosterone might not be available to reach the cell receptor. When testosterone gets attached to SHBG, it is no longer able to perform its anabolic functions. What elevates SHGB: Anorexia nervosa, Hyperthyroidism, Hypogonadism (males), Androgen insensitivity/deficiency, Alcoholic hepatic cirrhosis (males), Primary biliary cirrhosis (females). What suppresses SHGB: Obesity, Hypothyroidism, Hirsutism (females), Acne vulgaris, Polycystic ovarian disease, Acromegaly, Androgen-secreting ovarian tumors Less than 1% of the circulating testosterone is in a free form in males (less that 3% in females). Only when in a free form this hormone can exhibit its properties by connecting to the androgen receptors on the cell walls. Based on a study 14 to 50 per cent of the testosterone is bound to SHBG in males and 37 to 75 in females. It is worth mentioning that SHGB poses very high affinity for binding to testosterone. Therefore, changes in the SHGB levels noticeably influence the level of bioavailable testosterone. Let’s discuss for a moment what exactly a testosterone bioavailability is. Other than SHGB there are two more testosterone-binding proteins, also called carriers. One of them is albumin. It is a low-affinity binding protein, thus testosterone bound to it is considered “bioavailable”. Albumin binds to testosterone in the range 45 to 85 per cent in men (25 – 65 in women). The third carrier is the cortisol binding globulin, which binds also with low-affinity to less that 1 % of the testosterone in circulation. The free androgen index (FAI) indicates the amount of bioavailable testosterone. FAI is the sum of the free testosterone and the albumin and cortisol binding globulin. Or it’s the total serum testosterone minus the SHGB-bound testosterone. It is now clear why we should focus our attention on the properties of SHGB. The levels of this binding protein increase when there is excess estrogen present. Conversely, SHGB levels drop if the testosterone levels are elevated. Here I should mention the fact that SHGB exhibits higher affinity to testosterone than to estrogen. Now, pay close attention… It’s a well-known fact that testosterone is an estrogen precursor – it will convert to estrogen under the influence of the enzyme aromatase. Nothing that we don’t know so far. Here is where it gets interesting. Suppose that we have normal testosterone levels and we don’t suffer from any of the health ailments, which influence the SHGB levels. That means that SHGB levels are normal, too. Bare with me now. If more of this testosterone is converted to estrogen due to abnormal aromatase levels, the SHGB I will increase as well. SHGB, being more readily bound to testosterone, will leave us with excess estrogen levels in the system, which in turn will stimulate increased production of the SHGB protein from the liver. This whole process ultimately amplifies estrogen levels. Estrogen readily binds to the androgen receptors in cells thus leaving less opportunity for the free testosterone. Even more important, estrogen is the messenger molecule that signals the brain to decrease testosterone production. Another thing of great importance is the fact that over 40 per cent of the SHGB protein circulates unbound in the blood stream in man (over 80 per cent in women), and albumin circulates unbound almost all of the time. Thus increase in the total testosterone levels does not produce any noticeable changes in the free testosterone levels unless there is a significant increase like the one seen after synthetic steroid hormone administration. Well, this whole story brings us to the conclusion that the main approach should be - to keep the testosterone bioavailability high. In this regard a natural athlete should strive to: · Prevent testosterone levels from getting low · Attempt to increase the total testosterone as a means of keeping the testosterone levels from plunging · Block the testosterone-binding effects of SHBG · Lower the levels of the enzyme aromatase - less testosterone conversion to estrogen 1. How to prevent testosterone levels from getting low? - Obesity. Based on the way the testosterone-estrogen mechanism works, increased levels of estrogen will ultimately decrease the circulating testosterone. Excess fat causes more estrogen production due to the fact that fat cells are those, which manufacture estrogen. So, the more fat cells, the more estrogen in the blood and the less testosterone. - Drug and alcohol abuse. Alcohol has the property to inhibit your ability to remove estrogen from the blood stream by acting as a central nervous system depressant and also by decreasing zinc levels. - Stress elevates corticosteroid levels in the blood steam, which causes the testosterone levels to decrease. - Medications. Some medications, including estrogen and progesterone, lower the lutenizing hormone (LH) levels. LH is the hormone, responsible for the steroid hormones production. - Diabetes. Studies suggest that there is a link between type 2 diabetes and lower testosterone levels. - Hypertension and high cholesterol levels. These both cause the arteries to harden, this way decreasing the blood flow to the sex hormone producing organs. That of course leads to low sex hormone levels. - Aging. Fact is after the age of 40 test levels drops by roughly one per cent per year. We can’t do too much about that. The clock keeps ticking for all of us. However, we can try to manipulate testosterone levels in any other possible way. - Low fat diet. Low fat consumption causes increase of the SHGB, which means one thing – less free testosterone. It is considered that monounsaturated fats play an important role in testosterone levels and bioavailability. - Overtraining can contribute to as much as 40 per cent drop in testosterone levels. That is why it’s important to notice early the signs of overtraining and give the body a week or two well-deserved rest. - Not enough sleep. If you are not getting enough sleep the body is not recuperating well, which causes less testosterone and more corticosteroids to be released. Just to mention corticosteroids like cortisol are in fact catabolic hormones meaning they use up muscle tissue to provide the brain and the heart with energy. - Vitamin C. It suppresses the release of the stress hormone cortisol. Cortisol decreases testosterone levels. So, ultimately less cortisol, more testosterone. 2. How to boost testosterone levels - Incorporate basic movements that involve several muscle groups in your training routine. Good ones are squats, dead lifts, and military presses. Basic (compound) exercises have been shown to play an important role in the testosterone levels. - The greatest workout related testosterone production occurs with the use of heavier weights and lower rep range. A study shows that the best is 85 per cent of your one-rep max. - Tribulus terestris is a natural supplement, which has been shown in some studies to have the ability to increase the leutenizing hormone (LH) levels. As we already mentioned above, one of the functions of LH is to stimulate testosterone production by the testes. 3. Block the testosterone-binding effects of SHBG - Nettle root as a highly concentrated extract has shown to be effective at binding to SHBG and therefore it permits more free testosterone to circulate the system. It also acts as a 5-alpha reductase inhibitor. This is the enzyme, responsible for the conversion of testosterone to dihydrotestosterone (DHT), a more potent form of the male sex hormone, which causes prostate enlargement and ultimately cancer. Methanolic extract of nettle can also cut down the SHBG levels, which is another form of elevating the free testosterone in the blood stream. - Pygeum (prunus africana) is another herb, known to block the testosterone-binding effects of SHBG. Nettle root and pygeum extracts also benefit the prostate gland as a preventive treatment for benign prostatic hyperplasia (BPH) both by blocking the 5-alpha reductase action. - Avena Sativa is an extract from the straw of oats. It has somewhat different properties. It works by freeing bound testosterone, which increases the free testosterone in circulation. 4. Lowering aromatize levels - Zinc. The mineral zinc inhibits the aromatase enzyme that converts testosterone into excess estrogen. The recommended dose for inhibiting aromatase is 80mg daily. However, be sure the combined zinc quantity of all the daily supplements you are taking does not go over this benchmark. - Chrysin is a bioflavonoid that has shown a potential as a natural aromatase inhibitor. Chrysin is poorly absorbed in the system. It is found that when taken along with piperine, chrysin exhibits a lot better absorption. Supplementation with chrysin and piperine together might bring good results in reducing aromatase levels. How does this all apply to the sport of natural bodybuilding Let’s assume you are an individual, who exercises regularly and who doesn’t consider taking exogenous steroid hormones. With other words you are a natural athlete or enthusiast, who desires to keep his natural testosterone levels in the range, favoring good health and lean muscle mass build up. Here is what you do: 1. If you are even slightly overweight consider staring immediately a diet and training routine, tailored toward fat loss and lean muscle retention. 2. Consider also dropping the alcohol intake to absolute minimum if you want your efforts in keeping test levels high to give results. 3. Begin mastering some types of self-control or even meditation. These will take care of the excess stress levels. 4. Take medications only if they are absolutely essential for your health and are prescribed by your doctor. Talk to your personal physician to find out if there are any natural remedies to replace your current medications and if he recommends such approach for your health issue. 5. Keep your blood pressure and the serum cholesterol in check. 6. Eat enough good fats in your diet. Good means monounsaturated and omega-3 and 6 polyunsaturated fats. 7. Don’t ever overtrain. Sleep enough to promote good recovery. Signs of overtraining are loss of appetite, tiredness and irritability, lack of motivation, impaired mental focus, prolonged recovery periods. 8. Start relying more heavily on basic exercise movements. Train in the low rep range most of the time. 5 – 8 reps will ensure that you’re using weights that will eventually stimulate elevated testosterone levels. 9. It will only do you good if you decide to try some or all of these natural supplements: chrysin - piperine blend, nettle root extract, pygeum, avena sativa extract, and tribulus terestris. Try to find them in your local health store. Follow the directions for best results. 10. And you shouldn’t even consider training without supplementing your diet with enough vitamin C (at least 1g a day) and zinc (15mg min.). Take vitamin C with your multivitamin formula after breakfast, and post-workout with your protein shake. Zinc should be present in your multivitamin blend but this is not enough. Take zinc with magnesium in the form of ZMA right before you go to bed on an empty stomach. References: Ron Geraci, Men's Health, December 25, 2000; 13 Ways to Naturally Boost Your Testosterone Levels LE Magazine January 2000; Replenish Testosterone Naturally Plant extracts favorably alter hormone metabolism and improve sexual desire in men Jennifer A. Kelly, Ph.D. and Leo Vankrieken, Eur. Eng. Diagnostic Products Corporation; Sex Hormone Binding Globulin and the Assessment of Androgen Status Cockatoo.com; Avena Sativa - are oats an aphrodisiac? Gabe Mirkin, M.D.; High Cholesterol Causes Low Testosterone Bodybuilding.com, Chrysin Info And Products - Block Estrogen, Increase Testosterone