If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Let’s get right to what you can do to boost testosterone and then talk about why it might behoove you to do such a thing. Without taking testosterone replacement therapy (TRT,) there are a few changes you can make to improve your testosterone levels and your overall health.
Exercise has repeatedly been shown to increase testosterone levels. In obese and overweight people, a three-month exercise program was able to significantly increase testosterone levels (Kumagai, 2016). Research has shown that resistance training, also known as strength training, has been particularly helpful in increasing testosterone levels (Kraemer, 1998). And it’s never too late to start. In older men, people who exercise have higher testosterone levels than people who don’t (Ari, 2004).
Losing weight can make a big difference on your testosterone levels. In large European studies, being obese increases your risk of having low testosterone by 8.7 times (Tajar, 2010). Researchers have found a causal relationship between body-mass index (BMI) and testosterone, meaning that as your BMI goes up (increased weight) your testosterone goes down (Eriksson, 2017).
Improving your sleep hygiene
Getting adequate amounts of sleep can also improve your testosterone levels. In a study published in the Journal of the American Medical Association (JAMA), young men who had their sleep restricted to five hours a night had significant declines in their testosterone levels (Leproult, 2011). Sleep deprivation has also been linked to obesity (Cooper, 2018), low sex drive (Reed, 2007), and mortality (Gallicchio, 2009).
Managing your stress levels
Stress can also play a role in testosterone levels. Physiologically, glucocorticoid stress hormones can decrease testosterone production (Whirledge, 2010). This association has been shown in studies in patients undergoing surgery (Aono, 1976) and in military trainees (Bernton, 1995). Although it hasn’t been proven in clinical trials, it’s possible that reducing stress levels can increase your levels of testosterone. Research has shown that stress reduction programs can benefit both your physical and mental health (Grossman, 2004).
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Finally, there are dozens of supplements on the market that claim to be “natural” testosterone boosters. Supplements, in general, are extremely popular, with approximately half of all Americans using dietary supplements on a regular basis to improve their health. So do they work? A 2019 study by researchers at the University of Southern California (USC) published in the World Journal of Men’s Health examined common over-the-counter testosterone supplements on the market (Clemesha, 2020). They included ingredients like dehydroepiandrosterone (DHEA), fenugreek, tribulus terrestris, D-aspartic acid, vitamin B6, and vitamin D, among others. The researchers found that only 25% of the ingredients in popular testosterone supplements had scientific research showing that they boosted testosterone, 61.5% of the ingredients had no data, and 18.3% of the ingredients had conflicting data about whether or not they worked. 10.1% of the ingredients had studies showing decreases in the levels of testosterone! Overall, the researchers concluded that testosterone boosting supplements on the market weren’t supported by research. And as with all supplements, the Food and Drug Administration’s (FDA) position is that, unlike drugs, they are not intended to treat, diagnose, prevent, or cure diseases.
- Testosterone is an important sex hormone. In men, it’s responsible for libido, bone health, building muscle, increasing strength, and producing sperm.
- If you think you have low testosterone, tell your healthcare provider so you can get tested.
- Testosterone replacement therapy can be helpful for people with low testosterone, but it has risks, including the possibility of loss of fertility, shrunken testicles, cancer, heart attacks, and strokes.
- Exercise, sleep, and weight loss are great ways to improve testosterone levels.
- Most testosterone supplements contain ingredients that aren’t proven to work.
What’s testosterone and why is it important?
Now that we’ve learned about how testosterone may—and may not—be boosted, let’s talk about why you’d want to do so. Simply put, testosterone is an important hormone with positive effects across the human body. It’s often thought of as the male hormone, but it’s present in both males and females. In both sexes, it contributes to bone health and libido (sex drive). In males especially, it’s responsible for developing the penis and testicles, deepening the voice, facial and pubic hair development, building muscle, increasing strength, and producing sperm. It also contributes to maintaining your red blood cell levels in the blood. It may also play a role in regulating mood and cognitive function.
What are the signs that I might have low testosterone levels?
Let’s start with some terminology. Hypogonadism is the medical term for having low testosterone (also called “low T”). It refers to the gonads—testicles in males and ovaries in females—not working properly.
In rare cases, some males are born with low testosterone. Depending on when this develops, they might lack any or all of the outward characteristics of being male, including have sex organs. In other cases, males develop low-T levels as adolescents. They will, unfortunately, be unable to go through puberty without treatment.
More commonly, problems with low testosterone crop up as males get older. One large study from the National Institutes of Health (NIH) reported that low testosterone affected 20% of men in their 60s, 30% of men in their 70s, and 50% of men over 80 (Harman, 2001). Males with low testosterone in adulthood experience decreased sex drive, erectile dysfunction (including decreased morning erections), fatigue, loss of muscle mass, increased fat gain, anemia, and osteoporosis (weak bones). Before you jump out of your chair screaming, “That’s me!”, please keep in mind that a bunch of other health conditions can cause these symptoms, ranging from depression to iron deficiency.
How do I know whether or not I have low testosterone?
Simple answer to this one: get tested. First, tell your healthcare provider about your symptoms and your concerns about your testosterone levels. Then, they’ll be able to test you for low testosterone. Your testosterone levels are highest in the mornings, so you’ll usually be asked to take a blood test between 7 and 9 a.m. Two low readings (<300 ng/dL), along with clinical symptoms, are usually required for the diagnosis of hypogonadism.
Your healthcare provider may also test your levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), among others, in order to figure out whether or not another medical condition is causing your low testosterone.
If I have “low T,” what do I do about it?
Once you’ve been diagnosed with hypogonadism or “low T,” your health care provider will be able to prescribe testosterone replacement therapy (TRT) for you. Also called androgen replacement therapy, TRT can come in many different forms. You can get topical gels (brand names AndroGel, Testim, and Fortesta), patches (brand name AndroDerm), and solutions (brand name Axiron), injections, buccal (cheek) testosterone systems (brand name Striant), implanted testosterone pellets (brand name Testopel), and oral testosterone tablets (brand name Andriol, Restandol) are all available in the United States. Some forms of TRT can have higher risks of side effects including increases in blood pressure and liver damage. A more detailed breakdown is available here.
Most healthcare providers will typically suggest using topical gels first because they give you stable, normal levels of testosterone, while being relatively easy to use and convenient. A study looking at patient satisfaction with TRT showed that there wasn’t a big difference between gels, injections, or pellets and that people were happy with any of those options (Kovac, 2014).
What are some potential risks and side effects of testosterone therapy?
Receiving TRT is not risk-free. TRT suppresses spermatogenesis, the process of creating new sperm, which can lead to male infertility. TRT also suppresses your body’s ability to make its own testosterone, which can make you feel worse if you stop taking TRT. TRT should be avoided in people with severe and untreated sleep apnea as it can make it worse. People with high levels of red blood cells should not get TRT because testosterone can stimulate production of more red blood cells. Having too many red blood cells can increase the risk of blood clots. TRT should also be avoided in people with a history of prostate or breast cancer. There is a theoretical increased risk of prostate cancer and benign prostatic hyperplasia (BPH) as testosterone can drive prostate growth and increased prostate-specific antigen (PSA). This hasn’t been proven by clinical trials, but most healthcare providers agree that this needs to be studied further (Boyle, 2016) (Ponce, 2018) (Bhasin, 2018). Other theoretical risks include cardiovascular problems including heart attacks or strokes, but this is also unproven in clinical trials (Fernández-Balsells, 2010).