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In this systematic review, many studies were underpowered, making it difficult to obtain statistically significant, between-group differences. Moreover, fenugreek seed extracts also demonstrated a positive effect on BT concentrations. Similarly, in vitro studies demonstrated reishi's ability to inhibit the activity of 5α-reductase (79, 86, 87). For example, inflammation and oxidative stress have an inverse relationship with testosterone, as demonstrated by several human and animal trials (9, 81–83).