Main health factors in ensuring optimum men's health.

1. Copyright © 2011 by Nelson Vergel
Latest Advances in Men’s Health Latest Advances in Men’s Health
Nelson VergelNelson Vergel
TestosteroneWisdom.comTestosteroneWisdom.com

2. This information (and any accompanying printedThis information (and any accompanying printed
material) is not intended to replace the attention ormaterial) is not intended to replace the attention or
advice of a physician or other health care professional.advice of a physician or other health care professional.
Anyone who wishes to embark on any dietary, drug,Anyone who wishes to embark on any dietary, drug,
exercise, or other lifestyle change intended to preventexercise, or other lifestyle change intended to prevent
or treat a specific disease or condition should firstor treat a specific disease or condition should first
consult with and seek clearance from a qualified healthconsult with and seek clearance from a qualified health
care professional.care professional.

3. Copies of these slides (plus a few more)
are available free online at
TestosteroneWisdom.com
on the “Lectures” page

4. ObjectivesObjectives
To Review:To Review:
– The most common causes of erectileThe most common causes of erectile
dysfunction (ED) and its treatment optionsdysfunction (ED) and its treatment options
– Best ways to diagnose and treatBest ways to diagnose and treat
testosterone deficiencytestosterone deficiency
– Best ways to increase lean body mass andBest ways to increase lean body mass and
decrease fatdecrease fat
– Supplements backed by dataSupplements backed by data
– Nutrition and Exercise tipsNutrition and Exercise tips
Questions and answersQuestions and answers

5. ED IncidenceED Incidence
20-30 million American men suffer ED20-30 million American men suffer ED
Age dependentAge dependent
– 2% men age <40 years2% men age <40 years
– 25% men age 6525% men age 65
– 75% men >75 years75% men >75 years
Not a necessary occurrence of theNot a necessary occurrence of the
aging processaging process

6. An Erection Requires a CoordinatedAn Erection Requires a Coordinated
Interaction of Multiple OrganInteraction of Multiple Organ
SystemsSystems
PsychologicalPsychological
HormonalHormonal
VascularVascular
NeurologicNeurologic

7. Cause of EDCause of ED
Psychogenic Causes:Psychogenic Causes:
– AnxietyAnxiety
– DepressionDepression
– FatigueFatigue
– GuiltGuilt
– StressStress
– Marital DiscordMarital Discord
– Excessive alcohol consumptionExcessive alcohol consumption
– Crystal MethCrystal Meth

8. Causes of EDCauses of ED
Organic CausesOrganic Causes
– Cardiovascular diseaseCardiovascular disease
– Diabetes mellitusDiabetes mellitus
– Surgery on colon, bladder, prostateSurgery on colon, bladder, prostate
– Neurologic causes (lumbar disc, MS, CVA)Neurologic causes (lumbar disc, MS, CVA)
– Hormonal deficiencyHormonal deficiency

9. Causes of EDCauses of ED
Risk FactorsRisk Factors
Massachusetts Male Aging StudyMassachusetts Male Aging Study¹¹
Treated heart diseaseTreated heart disease 39%39%
Treated diabetesTreated diabetes 28%28%
Treated hypertensionTreated hypertension 15%15%
¹Feldman Ha, J Urol 1994; 151:54-61¹Feldman Ha, J Urol 1994; 151:54-61

10. Causes of EDCauses of ED
Medication:Medication:
Most common cause of ED in men >50Most common cause of ED in men >50
Many men are polymedicatedMany men are polymedicated
Also have co-morbid conditionsAlso have co-morbid conditions

11. Causes of EDCauses of ED
Medications (cont.)Medications (cont.)
Anti-hypertensive drugsAnti-hypertensive drugs
– All capableAll capable
– Common: thiazides and beta blockersCommon: thiazides and beta blockers
– Uncommon: calcium channel blockers,Uncommon: calcium channel blockers,
alpha-adrenergic blockers, and ACEalpha-adrenergic blockers, and ACE
inhibitorsinhibitors

12. Causes of EDCauses of ED
Medications (cont.)Medications (cont.)
CNS drugs:CNS drugs:
– Antidepressants, tricyclics, SSRIsAntidepressants, tricyclics, SSRIs
– TranquilizersTranquilizers
– SedativesSedatives
– AnalgesicsAnalgesics
H1 and H2 receptor blockersH1 and H2 receptor blockers

13. Treatment OptionsTreatment Options
Oral medications – PhosphodiesteraseOral medications – Phosphodiesterase
Type 5 Inhibitors (PDE-5): Viagra,Type 5 Inhibitors (PDE-5): Viagra,
Levitra, CialisLevitra, Cialis
Urethral suppositories (MUSE)Urethral suppositories (MUSE)
Injection therapy - Caverject, Trimix,Injection therapy - Caverject, Trimix,
BimixBimix
Vacuum constriction deviceVacuum constriction device
SurgerySurgery
Sex therapy

14. Nonpharmacologic TreatmentNonpharmacologic Treatment
OptionsOptions
Lifestyle changes:Lifestyle changes:
Reduce fat and cholesterol in dietReduce fat and cholesterol in diet
Decrease or limit alcohol consumptionDecrease or limit alcohol consumption
Eliminate tobacco use and substanceEliminate tobacco use and substance
abuseabuse
Weight loss if appropriateWeight loss if appropriate
Regular exerciseRegular exercise

15. Medication Side EffectsMedication Side Effects
(PDE Inhibitors)(PDE Inhibitors)
Side effects:Side effects:
HeadacheHeadache
FlushingFlushing
DyspepsiaDyspepsia
Nasal congestionNasal congestion
Visual disturbancesVisual disturbances
Back ache (Cialis)Back ache (Cialis)

16. DrugsDrugs
DrugDrug Onset ofOnset of
ActionAction
DurationDuration
of Activityof Activity
ViagraViagra 60 minutes60 minutes 4-5 hours4-5 hours
LevitraLevitra 30 minutes30 minutes 4-5 hours4-5 hours
15 minutes15 minutes 36 hours36 hoursCialis*Cialis*
* No food effect* No food effect

17. MedicationMedication
(PDE Inhibitors)(PDE Inhibitors)
Contraindications:Contraindications:
Organic Nitrites:Organic Nitrites:
– OralOral
– SublingualSublingual
Severe cardiac diseaseSevere cardiac disease
– Obtain stress testingObtain stress testing
Careful with Norvir since it boosts PDECareful with Norvir since it boosts PDE
blood levelsblood levels

18. Penile Injection TherapyPenile Injection Therapy
Caverject, Edex, Tri/Bi-MixCaverject, Edex, Tri/Bi-Mix
Mechanism of action: smooth muscleMechanism of action: smooth muscle
vasodilatorvasodilator
Monotherapy (protaglandin E1) or combinationMonotherapy (protaglandin E1) or combination
of 2 or 3 agents (Papaverine+ Phentolamine +of 2 or 3 agents (Papaverine+ Phentolamine +
Alprostadil )Alprostadil )
Administration: 10, 20, 40ugAdministration: 10, 20, 40ug
Inject directly into corporeal bodies of the penisInject directly into corporeal bodies of the penis
Results: 70%-90%Results: 70%-90%
Dropout rates: 25%-60%Dropout rates: 25%-60%
Side effects: pain (36%), priapism (4%), fibrosisSide effects: pain (36%), priapism (4%), fibrosis

19. Trimix
(Papaverine+ Phentolamine + alprostadil)
Available by prescription from compounding
pharmacies

21. Signs and Symptoms of Low
Testosterone
 Loss of muscle mass and strengthLoss of muscle mass and strength
 Loss of libido and erectile dysfunctionLoss of libido and erectile dysfunction
 DepressionDepression
 Lethargy (fatigue, lack of focus)Lethargy (fatigue, lack of focus)
 Bone lossBone loss
 Some regression of secondary sexualSome regression of secondary sexual
characteristics (body hair loss, etc)characteristics (body hair loss, etc)
 Low or no sperm countLow or no sperm count
Tenover JL. Endocrinol Metab Clin North Am. 1998;27:969-987
Petak SM, et al. AACE Clinical Practice Guidelines. Available at: http://www.aace.com/clin/guides/hypogonadism.html

22. Hypothalamus

23. Testosterone and AgingTestosterone and Aging

24. Testosterone Deficiency
(Hypogonadism)
• Normal levels in blood:
Men... Total test. 300-1100 ng/dL,
Free test. 5 - 21 ng/dL
Women... Total test. 10-50 ng/dL
Free test. 0.10-0.85 ng/dL
• Symptoms of testosterone deficiency:
Fatigue, low or lack of sex drive, poor appetite,
loss of muscle mass & strength, depression

26. Albumin-bound T
38%
Free T
2%
SHBG-bound T
60%
T = testosterone
Only 2% is free
testosterone
and 98% is bound
Testosterone Fractions in the Blood

27. (binds testosterone)

28. Finasteride
Anastrozole
Tamoxifen

29. The HPT Axis

30. Testosterone
Replacement Benefits
Sexual function
Mental
focus
Stamina and Bone Strength
Lean
Body
Mass

31. Testosterone Options
Injections
Patch
Pellets
Buccal
Gels
Gels Armpit lotion Axiron
New: Fortesta (2 % gel)

32. To Be Potentially Approved by the FDA
in the Next 12-24 Months
To be called Aveed in the US
First FDA approved for women

35. Side Effect: Gynecomastia (breast enlargement in men)
Treatment: Estrogen Blocker Medications or surgery (in worst cases)

36. Side Effect: Increased number of red blood cells (polycythemia)
Watch out for
hematocrit over 52 !
Solution: Donate blood
or therapeutic phlebotomy
(4-5 units every 3-4 months)

37. Side Effect: Testicular Shrinkage (atrophy)
Treatment:
Human Chorionic Gonadotropin
(hCG)

38. Side Effect : Increased prostate size
(benign prostatic hypertrophy)
Prevention:
Digital Rectal Exam (DRE)
Prostatic Specific Antigen (PSA)
blood test

39. Side Effect: Acne
Treatment: Bezoyl Peroxide, salicilic acid lotions, soaps,
showering after exercising, 20 min of sun a day, Zinc supplements

40. For More Information:
TestosteroneWisdom.com

41. COMPREHENSIVE APPROACH TOCOMPREHENSIVE APPROACH TO
WELLNESSWELLNESS
MedicationsMedications
ExerciseExercise
Stress ReductionStress Reduction
NutritionNutrition

42. Protecting Your Heart

44. How To Minimize Heart DiseaseHow To Minimize Heart Disease
Do not smoke!Do not smoke!
Exercise and low animal fat/sugar dietExercise and low animal fat/sugar diet
Lose weight if you are overweightLose weight if you are overweight
Manage stress and keep blood pressure in checkManage stress and keep blood pressure in check
Decrease triglycerides with Omega 3 fatty acids (coldDecrease triglycerides with Omega 3 fatty acids (cold
water fish oils), low sugar intake, exercise.water fish oils), low sugar intake, exercise.
Improve HDL with Niacin 300-500 mg 3 x day.Improve HDL with Niacin 300-500 mg 3 x day. Start withStart with
lower dose to minimize “flushing” and take an aspirin 20 min beforelower dose to minimize “flushing” and take an aspirin 20 min before
(Niaspan is the prescription grade)(Niaspan is the prescription grade)
Soluble Fiber (oats, fiber supplemengts, etc)Soluble Fiber (oats, fiber supplemengts, etc)
If everything else fails, use prescription lipid loweringIf everything else fails, use prescription lipid lowering
agents (statins, fibrates, etc)agents (statins, fibrates, etc)
A baby aspirin a day (81 mg)A baby aspirin a day (81 mg)
Keep healthy blood levels of testosterone and thyroidKeep healthy blood levels of testosterone and thyroid
hormones.hormones.

45. Insulin Resistance: A Silent Health Threat
Keeping a healthy weight, exercising, low glycemic load diet, certain supplements
and medications can decrease Insulin resistance and glucose intolerance
Pre diabetes

46. Visceral Fat and Health

47. Potential Interventions for DecreasingPotential Interventions for Decreasing
Abdominal FatAbdominal Fat (visceral adipose tissue-VAT)(visceral adipose tissue-VAT)
Diet-Diet- Lower carbohydrate diets, Mediterranean dietLower carbohydrate diets, Mediterranean diet
ExerciseExercise- cardiovascular and resistance training-- cardiovascular and resistance training- SomeSome
pilot data with good resultspilot data with good results
Anti-diabetic drugs:Anti-diabetic drugs: Metformin (Glucophage)-Metformin (Glucophage)- conflictingconflicting
and inconclusive dataand inconclusive data
Testosterone gel-Testosterone gel- subcutaneous fat loss onlysubcutaneous fat loss only
Anabolic steroids-Anabolic steroids- Oxandrin, nandrolone?-Oxandrin, nandrolone?- limited VATlimited VAT
datadata
Human Growth HormoneHuman Growth Hormone
Human Growth Hormone Releasing Hormone-Human Growth Hormone Releasing Hormone- SermorelinSermorelin
and Tesamorelin-and Tesamorelin- Approved for the treatment of HIVApproved for the treatment of HIV
related visceral fat accumulationrelated visceral fat accumulation
SurgerySurgery-- Liposuction of visceral fat very difficult and riskyLiposuction of visceral fat very difficult and risky

48. How to Increase Lean BodyHow to Increase Lean Body
MassMass
Higher protein intake (whey, egg white protein
supplements, lean meats, nuts, fish, eggs, etc)
and more frequent snacking with right balance.
More in nutrition section
Resistance exercise. More in exercise section
Testosterone Replacement if needed
Growth Hormone replacement
Medical use of oxandrolone and nandrolone
Creatine Supplementation
Healthy sleep habits

49. Supplements- Snake Oil?

50. Supplements- What Works?Supplements- What Works?
Niacin 1000-3000 mg/day
– Increases good cholesterol (HDL). Caution with
“flushing”. Take a baby aspirin 20 min before taking
niacin
Selenium
– Glutathione production (anti-oxidant.) A study
showed people who took 200 mcg/day had better
immune function
Calcium Carbonate- 500-2000 mg/d
– Bone protection, diarrhea control
Vitamin D- Bone protection and other emerging
benefits (2000-4000 IU/d)
SAMe (S-Adenosyl-L-Methionine) – energy,
depression, liver detox

51. Supplements -Any data?Supplements -Any data?
Whey Protein 20-100 grams/day
– Popular with bodybuilders. HIV study found compensatory
response. People ate less food and no increased LBM was found
Creatine 5-15 grams/day
– Muscle voluminizer, strength enhancer. Caution with
diarrhea and kidney overload.
Omega 3 oils (fish oils) 3000- 6000 mg/day
– Decreases cholesterol/triglycerides, anti-inflammatory,
mood stabilizer?
L-Carnitine 1000-3000 mg/day
– Helps use fat for energy, cell protection, lowers lipids, anti-
catabolic, heart muscle protection, N-Acetyl Carnitine may
restore nerve damage in neuropathy
B Vitamins (100 mg each/day)- whole body processes,
possible prevention of mitochondrial toxicity

52. Great Web Site to Find Out
What Supplements to Trust
ConsumerLabs.com

54. What Your Plate Should Look Like….

56. The
ZONE
&
South
Beach
Diets
Modified Atkins

57. Low- Fat vs Mediterranean vs Low-Carbohydrate
Diets- Effect on Weight Loss

58. More Nutritional Tips
• Shop the perimeter of the store
• Do not skip breakfast (keep an eye on sugar and
refined flower products!)
• Try to eat several smaller meals or snacks instead of
2-3 large ones
• Eat more almonds, walnuts, pecans and pistachios
(good cholesterol lowering fats)
• Eat fruits and vegetables of all colors
• Avoid sweet drinks and fruits juices. Eat the fruit!
• Eat a high protein, complex carbohydrate- rich meal
after work outs
• Get a slow cooker
• Cook for the week and freeze

59. Nutritional Considerations
• Reduce saturated (animal) fats, fried foods
and hydrogenated oils
• Eat omega-3 fish oil-rich foods- salmon, tuna,
sardines or flax seed oil (alternative)
• Use good fats: olive oil, nuts, avocados,
flaxseed
• Minimize sugar, fructose (sweets, sodas,
foods with high fructose corn syrup )
• Eat adequate amounts (0.7-1 gm/lb/day) of
protein (fish, eggs, cottage cheese, lean
meats, chicken, whey, yogurt, nuts, etc)

60. Best Protein SourcesBest Protein Sources
Building block of muscle mass and food for theBuilding block of muscle mass and food for the
immune systemimmune system
Dairy proteins - best is cottage cheese (casein),Dairy proteins - best is cottage cheese (casein),
whey, yogurt…whey, yogurt… made to make mammals growmade to make mammals grow
biggerbigger . Be careful with milk allergies/lactose. Be careful with milk allergies/lactose
intoleranceintolerance
Whole eggs are better than egg whiteWhole eggs are better than egg white
Fish - cold water fish like salmon and tunaFish - cold water fish like salmon and tuna
Lean beefLean beef
Chicken (no skin)Chicken (no skin)
Natural almond butter (no added hydrogenated oilsNatural almond butter (no added hydrogenated oils
and fillers)and fillers)
Beans, rice -Beans, rice - vegetarian diet requires goodvegetarian diet requires good
knowledge of protein sourcesknowledge of protein sources

61. Good CarbohydratesGood Carbohydrates
Bad CarbohydratesBad Carbohydrates
Provide energy and nutrientsProvide energy and nutrients
Bad carbs can worsen insulin resistance andBad carbs can worsen insulin resistance and
triglyceridestriglycerides
Bad:Bad: Avoid/reduce high glycemic, high calorieAvoid/reduce high glycemic, high calorie
carbs – refined flour, especially milled grains,carbs – refined flour, especially milled grains,
sugar, high fructose corn syrupsugar, high fructose corn syrup
Good:Good: Eat more fiber, nutrient, and fluid-rich,Eat more fiber, nutrient, and fluid-rich,
low calorie, low glycemic carbs like: oatmeal,low calorie, low glycemic carbs like: oatmeal,
multi-grain breads, vegetables, fruits, roots,multi-grain breads, vegetables, fruits, roots,
greens, wild rice and beansgreens, wild rice and beans

62. Fat is not a Four LetterFat is not a Four Letter
WordWord
Fats are needed for energy, immuneFats are needed for energy, immune
function, vitamin absorption, andfunction, vitamin absorption, and
hormoneshormones
Good FatsGood Fats- monounsaturated- Olive Oil- monounsaturated- Olive Oil
Essential Fatty Acids- polyunsaturatedEssential Fatty Acids- polyunsaturated
Omega 3’s- cold water fish (salmon)Omega 3’s- cold water fish (salmon)
Omega 6’s- high oleic sunflower oil, walnuts,Omega 6’s- high oleic sunflower oil, walnuts,
almonds, pecans, avocadoalmonds, pecans, avocado
Omega 3’s and 6’s- Flaxseed mealOmega 3’s and 6’s- Flaxseed meal
Bad FatsBad Fats-processed/hydrogenated-processed/hydrogenated
oils,margarine, artificial creamers, anyoils,margarine, artificial creamers, any
man-made oil, burned oils, rancid oils, lardman-made oil, burned oils, rancid oils, lard

63. Grocery Shopping ListGrocery Shopping List
Almonds and other nutsAlmonds and other nuts
Beans and other legumesBeans and other legumes
Spinach and other green leafy vegetablesSpinach and other green leafy vegetables
Low fat dairy, yogurtLow fat dairy, yogurt
HummusHummus
Whey proteinWhey protein
OatmealOatmeal
EggsEggs
Lean meatsLean meats
Whole grain breads and pastaWhole grain breads and pasta
Peanut, almond , cashew buttersPeanut, almond , cashew butters
Olive oil and avocadosOlive oil and avocados
Raspberries and all berries. Fruits (avoid fruit juices)Raspberries and all berries. Fruits (avoid fruit juices)
One or two glasses of red wine per day (optional)One or two glasses of red wine per day (optional)
Flaxseed , pumpkin and sunflower seedsFlaxseed , pumpkin and sunflower seeds
Sweet potatoes and wild riceSweet potatoes and wild rice
Green tea (optional)Green tea (optional)

64. Exercise, the Best Therapy for Most Health Problems

65. Exercise: The Best MedicineExercise: The Best Medicine
Benefits:
↓↓ total and abdominal fattotal and abdominal fat
improves insulin sensitivityimproves insulin sensitivity
improves glucose toleranceimproves glucose tolerance
increases HDL cholesterolincreases HDL cholesterol
↓↓ triglycerides and LDLtriglycerides and LDL
increases muscle massincreases muscle mass
improves enduranceimproves endurance
improves strengthimproves strength
improves bone densityimproves bone density
improves moodimproves mood

66. EXERCISE FOR BEST RESULTS

67. Aerobic
(Cardiovascular)(Cardiovascular)
ExerciseExercise
Start with a brisk walk every day if tiredStart with a brisk walk every day if tired
Concentrate inConcentrate in low impact or no impactlow impact or no impact
exercises (e.g. Elliptical Trainers)exercises (e.g. Elliptical Trainers)
Do what you enjoyDo what you enjoy (bicycling, roller(bicycling, roller
skating, etc)skating, etc)
Good for burning fat, triglycerides, bloodGood for burning fat, triglycerides, blood
sugar, but it may decrease muscle masssugar, but it may decrease muscle mass
20 - 30 minutes 3-4 times a week is20 - 30 minutes 3-4 times a week is
enough for many peopleenough for many people

68. Resistance ExerciseResistance Exercise
Exercise using weighs, machines, your ownExercise using weighs, machines, your own
bodybody
Warm upWarm up by doing a light setby doing a light set
Lift maximum weight for muscular failureLift maximum weight for muscular failure
(exhaustion) at(exhaustion) at 8-12 repetitions8-12 repetitions
One body part per weekOne body part per week
One hour sessions 3-4 times a weekOne hour sessions 3-4 times a week
Three sets per body partThree sets per body part
If no access to a gym, start with crunches,If no access to a gym, start with crunches,
push ups, and squats at homepush ups, and squats at home

69. Resistance Exercise PrinciplesResistance Exercise Principles
Safety FirstSafety First - Stop if if hurts!- Stop if if hurts!
High IntensityHigh Intensity - Momentary- Momentary muscularmuscular
failurefailure to stimulate growthto stimulate growth
RecoveryRecovery = Rest, nutrition, and time= Rest, nutrition, and time
2 - 3 warmup, 2- 3 heavy sets per2 - 3 warmup, 2- 3 heavy sets per
exerciseexercise
45 to 60 minutes per session, 3 - 445 to 60 minutes per session, 3 - 4
sessions per week.sessions per week.
DO NOTDO NOT
OVERTRAIN!OVERTRAIN!

70. Resistance Exercise Principles
(continued)
Major muscle group first when energy is
highest
Do compound exercises first while
energy is up. They affect the most
tissue/mass for quickest growth
(squats, bench press)
Secondary/ancillary muscles follow
Important: Full range of motion -
recruits/builds the most muscle mass

71. Resistance Exercise PrinciplesResistance Exercise Principles
(continued)(continued)
Warm up sets: 50 - 60 % of the
heavy weight you can lift 6-12
times
Heavier sets: Weight you are
capable of lifting 6 - 12 times to
momentary muscular failure
When strength increases so you
can do 12 reps, increase weight 5
– 10 lbs so you can only lift about
6-8 reps to momentary muscular

72. Best Exercise SitesBest Exercise Sites
with videos, etcwith videos, etc
www.exrx.netwww.exrx.net
www.MyFit.ca
Ipod exercise routine downloads:
http://www.menshealth.com/download/

73. Final WordsFinal Words
There are several life style modifications in your control
to stay healthy and in shape as you age to prevent
lean body mass and bone loss, sexual dysfunction, and
heart disease.
You do not have to acceptYou do not have to accept sexualsexual dysfunction as adysfunction as a
reality of aging. There are several treatment options!reality of aging. There are several treatment options!
Find out your freeFind out your free testosterone and thyroid functiontestosterone and thyroid function ifif
you have fatigue, sexual dysfunction, etc. Supplementyou have fatigue, sexual dysfunction, etc. Supplement
if needed. Readjust the dose if you do not achieveif needed. Readjust the dose if you do not achieve
optimum levels.optimum levels.

74. Final WordsFinal Words
Do not waste your money and risk liver or medicationDo not waste your money and risk liver or medication
interaction problems with unproveninteraction problems with unproven supplementssupplements. Support. Support
the New York buyers’ club.the New York buyers’ club.
Combat loss of lean mass and increased fat withCombat loss of lean mass and increased fat with
resistance and cardiovascularresistance and cardiovascular exerciseexercise 3 to 4 times a week3 to 4 times a week
for an hourfor an hour
Diet: Avoid sweets, hydrogenated oils, high fructose corn
syrup, animal fats and consume more fruits, vegetables,
fish, lean meats, yogurt and nuts.
An informed man helps his doctor to give him the best care

75. For More InformationFor More Information
More details in ”Testosterone- A Man’s Guide” onMore details in ”Testosterone- A Man’s Guide” on
www.amazon.comwww.amazon.com
Nelson VergelNelson Vergel – nelsonvergel@yahoo.com
TestosteroneWisdom.com