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Other significant adverse effects of testosterone supplementation include acceleration of pre-existing prostate cancer growth in individuals who have undergone androgen deprivation; increased hematocrit , which can require venipuncture in order to treat; and, exacerbation of sleep apnea . [24] Adverse effects may also include minor side-effects such as acne and oily skin, as well as, significant hair loss and/or thinning of the hair, which may be prevented with 5-alpha reductase inhibitors ordinarily used for the treatment of benign prostatic hyperplasia , such as finasteride . [25] Exogenous testosterone may also cause suppression of spermatogenesis , leading to, in some cases, infertility. [26] It is recommended that physicians screen for prostate cancer with a digital rectal exam and prostate-specific antigen (PSA) level before starting therapy, and monitor PSA and hematocrit levels closely during therapy. [27]

Complementary and Alternative Medicine Products . Table 5 summarizes the herbal preparations that may be effective in adults. 10 , 14 , 18 , 20 , 35 – 38 An herbal solution containing P. sidoides was shown to reduce the duration and severity of 10 different cold symptoms in a randomized controlled trial. 37 Another randomized controlled trial demonstrated the benefit of Andrographis paniculata (Kalmcold) in improving symptom scores. 35 A systematic review also indicated that A. paniculata , alone or in combination with Acanthopanax senticosus , may be more effective for symptom relief than placebo. 36

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