From the Guidelines
To boost testosterone levels naturally, men with testosterone deficiency should be counseled regarding lifestyle modifications, such as losing weight, or maintaining weight within the recommended range, along with increasing physical activity, as this has the potential to increase total testosterone levels and/or reduce signs and symptoms associated with testosterone deficiency. According to the American Urology Association guideline 1, lifestyle modifications are recommended as a treatment strategy for men with testosterone deficiency. Some key lifestyle changes that can help increase testosterone levels include:
- Exercise: Engage in resistance training and high-intensity interval training (HIIT) 3-4 times per week, as recommended by various studies, including the Princeton III consensus recommendations 1.
- Sleep: Aim for 7-9 hours of quality sleep nightly, as sleep deprivation can lower testosterone levels.
- Diet: Consume adequate protein, healthy fats, and zinc-rich foods, and maintain a healthy body weight, as obesity is linked to low testosterone levels.
- Stress management: Practice stress-reducing techniques, such as meditation or yoga, for 15-20 minutes daily, as high cortisol levels can lower testosterone.
- Vitamin D: Get 15-20 minutes of direct sunlight daily or consider a supplement of 1000-2000 IU per day, as vitamin D deficiency is linked to low testosterone levels.
- Limit alcohol consumption to 1-2 drinks per week, as excessive alcohol consumption can lower testosterone levels. These methods work by optimizing hormonal balance, reducing cortisol, and providing necessary nutrients for hormone production. Consistency is key - maintain these habits for at least 2-3 months to see noticeable effects. If levels remain low despite these measures, consult a healthcare provider for potential underlying issues or medical interventions, as recommended by the American College of Physicians guideline 1.
From the Research
Evidence-Based Methods to Increase Testosterone Levels
- Nonpharmacologic interventions such as supplements, herbal medicines, diets, sleep, and exercise have been shown to have a modest effect on testosterone levels 2
- Certain nutraceuticals and functional nutrients, including zinc, vitamin D, l-arginine, mucuna, and ashwagandha, have been found to stimulate testosterone production in men with low testosterone levels 2
- Lifestyle modifications such as adequate sleep, exercise, and weight loss in patients with obesity are essential before implementing nutraceutical agents 2
- Exogenous testosterone replacement therapy is an effective treatment option for men with low testosterone and symptomatic hypogonadism, but it poses risks to fertility due to negative feedback mechanisms on the hypothalamic-pituitary-gonadal (HPG) axis 3
- Alternative pharmacologic therapies, including selective estrogen receptor modulators, gonadotropins, and aromatase inhibitors, can increase endogenous testosterone levels while preserving fertility and function of the HPG axis 3, 4
- Novel therapies, such as Natesto intranasal testosterone gel, have been shown to increase serum testosterone levels while maintaining semen parameters 4
- Testosterone therapy, including hydroalcoholic gel and intramuscular testosterone undecanoate, can restore normal hormonal values and correct the signs and symptoms of hypogonadism 5
- Testosterone supplementation therapy (TST) is a common treatment option for men with low testosterone levels, and healthcare professionals should be aware of the signs and symptoms, causes, diagnosis, and benefits and risks of TST 6
Nutraceuticals and Supplements
- Zinc, vitamin D, l-arginine, mucuna, and ashwagandha have been found to stimulate testosterone production in men with low testosterone levels 2
- Tribulus and ω3 fatty acids can improve some degree of sperm parameters in infertile men 2
- The use of nutraceuticals, if considered, must be personalized by physicians and/or registered dietitians 2