The provocative (and seemingly endless) ads for supplements to increase testosterone make it seem as though these products are the answer to a variety of symptoms affecting men as young as 35—sexual dysfunction, low energy and more. Problem: None of these over-the-counter (OTC) products have FDA approval, and they don’t contain any actual testosterone (a controlled substance), so their effects are uncertain. While prescription testosterone replacements can help men diagnosed with secondary hypogonadism—commonly known as low T—not everyone is a candidate for these medications or even wants to take them.
Good news: Lifestyle changes often are the answer to naturally increase testosterone. Bottom Line Personal spoke to endocrinologist Reina Villareal, MD, from Baylor College of Medicine, for the details.
Why Testosterone Matters
Testosterone is the primary male sex hormone. It is not only important for your sex drive…it’s essential to build and maintain strong muscles and maintain bone density, and it contributes to the production of red blood cells. Without enough testosterone, you lose bone and can experience fractures…and you can lose muscle, putting you at risk for sarcopenia and frailty. Testosterone also contributes to your overall well-being—men with appropriate levels appear to feel better in general than those with low testosterone.
Testosterone Levels by Age
Most testosterone is made in the testicles, the product of a complex communication between the hypothalamus, the pituitary glands and the testes. A surge in testosterone production signals puberty—that’s when levels go from 25 nanograms per deciliter (ng/dL) among six- to 10-year-olds up to 830 ng/dL through age 15 and, for some 16- and 17-year-olds, even higher. Facial and body hair and a deepening voice are among the notable changes brought on by the surge in testosterone.
After age 18, the “normal” range for testosterone is quite wide—from roughly 300 ng/dL to 1,000 ng/dL. Somewhere around age 30, the body’s natural production of testosterone starts declining by about 1% per year. Unlike women, who have an abrupt drop in production of the hormone estrogen when menopause occurs, for men, the drop in testosterone is gradual and happens over decades (it’s sometimes called andropause).
How to Naturally Increase Testosterone
Lifestyle steps that boost overall health also have a direct impact on testosterone. You can maintain or even raise your testosterone levels with the choices you make…
Lose excess weight
Obesity is at epidemic proportions and, in addition to a host of health threats, it’s linked to low testosterone. In fact, for men with a BMI greater than 30, risk for secondary hypogonadism was more than eight times higher than for men with a lower BMI. Losing weight may be the single most impactful thing you can do to improve your testosterone levels. Among men age 65 or older who were obese, losing 10% of their body weight raised testosterone appreciably. A review of existing studies by researchers at Larkin Community Hospital Palm Springs Campus in Florida and published in Cureus confirmed that weight loss, especially through fat reduction, has a positive influence on testosterone, and even moderate reductions in body mass index (BMI) are linked to increases in testosterone.
Follow the Mediterranean diet
Testosterone is synthesized from cholesterol, and men who follow a low-fat diet often have reduced testosterone levels. But it’s not heart-healthy to load up on saturated fats to boost testosterone. Better: Enjoy the healthy fats found in the Mediterranean diet. A study by researchers at Institute of Translational Pharmacology in Rome and published in Current Research in Food Science found that following the Mediterranean diet boosted testosterone levels significantly, and that choosing organically grown produce boosted the diet’s effects because it counteracts the negative effects of pollutants on testosterone. Participants ate green leafy vegetables and red fruits daily as well as primarily grass-fed meat and wild-caught seafood…reduced or eliminated dairy products…and replaced saturated fats with olive oil, avocados and nuts. The Mediterranean diet also is low in carbs (less than 130 grams per day) and does not include refined carbohydrates but does include whole grains.
Exercise
Resistance or weight-training exercise is particularly effective at boosting testosterone because it builds muscle. Weight-bearing exercises, such as walking and running, also help preserve bone. There’s a synergistic effect between muscle, bone and testosterone. Looking for some variation in your workouts? A study at Iran’s Tabriz University of Medical Sciences found that high-intensity interval training (HIIT) three times a week for eight weeks boosted testosterone in a group of young but sedentary men. HIIT involves shorts bursts of intense exercise followed by brief recovery periods.
Manage diabetes
Diabetes is linked with low testosterone—high blood sugar, or hyperglycemia, combined with insulin resistance and inflammation negatively impact the production of testosterone. The Italian study on the Mediterranean diet also found that the diet improves insulin sensitivity, reduces inflammation and helps stabilize blood sugar levels. Important: Exercising to boost testosterone naturally is also good for keeping blood sugar in check.
Get tested—and treated—for sleep apnea
Among the many health consequences of sleep apnea is reduced testosterone. If your sleep partner tells you that you’re snoring and seem to stop breathing or gasp for air at intervals throughout the night and if you have daytime sleepiness (from not getting enough restorative sleep), ask your doctor to order a sleep study.
Relieve stress
Stress typically leads to an increase in the hormone cortisol, the enemy of testosterone. The link is so strong that doctors don’t screen for testosterone levels when someone is in the hospital because they know that the level will be low. Being in the right state of mind is protective of testosterone.
Avoid opioids
These drugs have come under a lot of scrutiny because of the high risk for addiction, but even casual use can affect testosterone levels. Narcotics inhibit pituitary functioning…and pituitary hormones are needed to stimulate the testicles to produce testosterone. A study done at Oxford University in the UK reported that between 21% and 86% of men on opioids experience a drop in testosterone, and just one dose can cut testosterone concentrations in half within a few hours. While levels usually return to where they were 24 to 72 hours later, it may take up to a month depending on the dose. If you’ve been on opioids for any length of time, ask your doctor for help getting off them.
Avoid alcohol and smoking
Smoking cigarettes and drinking more than the recommended amount of alcohol—one to two drinks a day—are testosterone killers. Because excessive alcohol disrupts the signals between the pituitary and the testicles, heavy drinking, especially for a prolonged period, has been linked to lower testosterone levels. A study by researchers at Egypt’s Cairo University found that testosterone levels among smokers are significantly lower than in non-smokers. Apart from smoking’s link to other ills, it seems to damage Leydig cells in the testicles, which are involved in testosterone production. Important: The damage smoking does to blood vessels has an impact on erectile functioning, too.
Avoid forever chemicals
Per- and polyfluoroalkyl substances (PFASs) are known hormone- or endocrine-disruptors. Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) are the most widespread and most frequently detected in human blood. They disrupt testosterone as well as other hormones and have been linked to low fertility and infertility. Problem: PFASs are found in everything from personal-care products and water-resistant fabrics to nonstick cookware and cleaning products. Their prevalence may explain why secondary hypogonadism is more common now than it used to be.
Be cautious about supplements
Apart from the unknown results of products marketed for low T that have proprietary blends of herbs and extracts, some recognized supplements, such as zinc, quercetin, grapeseed extract and Indian ginseng (ashwagandha), could help but only in very minor ways. But there have been no rigorous studies on their effectiveness, and they haven’t been scrutinized by the FDA. Some people self-prescribe OTC dehydroepiandrosterone (DHEA), an androgen that is converted to testosterone in the body, but the FDA has not approved it for this use…and there are no large clinical trials to show that it’s safe or effective and no way to report and share adverse reactions. In all other developed countries, DHEA is a controlled substance.
If lifestyle changes don’t leave you feeling more energized, you might be a candidate for doctor-administered testosterone replacement therapy based on blood tests and a clinical evaluation.
