From the Guidelines
Men with low testosterone levels should prioritize lifestyle modifications, such as weight loss and increased physical activity, to potentially increase total testosterone levels and reduce associated symptoms. According to the American Urological Association guideline 1, lifestyle changes are recommended as a treatment strategy for testosterone deficiency, with a conditional recommendation and evidence level of Grade B.
Key Lifestyle Modifications
- Losing weight or maintaining a healthy weight to reduce the risk of cardiovascular events associated with high body mass index and low testosterone 1
- Increasing physical activity to stimulate testosterone production
- Other evidence-based changes, such as strength training, adequate sleep, a balanced diet, stress management, and maintaining a healthy body weight, can also support natural testosterone production.
Additional Considerations
- While supplements like vitamin D, zinc, ashwagandha, and fenugreek may have modest effects on testosterone levels, lifestyle changes should be the primary focus for increasing testosterone levels without testosterone replacement therapy.
- It is essential to consult with a healthcare professional before starting any new supplements or making significant lifestyle changes, especially for men with underlying medical conditions or concerns.
- By prioritizing lifestyle modifications and incorporating evidence-based changes, men can potentially increase their testosterone levels and improve overall health and well-being, reducing the risk of morbidity and mortality associated with low testosterone levels 1.
From the Research
Increasing Testosterone Levels in Men
To increase testosterone levels without testosterone replacement therapy (TRT), several strategies can be employed. These include:
- Weight reduction: Clinically significant weight loss can substantially reverse obesity-related reductions in serum testosterone and ameliorate non-specific symptoms resembling, but not due to, androgen deficiency 2
- Optimizing management of type 2 diabetes mellitus, obstructive sleep apnea, depression, and other obesity-related co-morbidities 2
- Rationalizing concomitant drug regimens 2
- Resistance exercise and training: Testosterone is important for the desired adaptations to resistance exercise and training, and its concentration is elevated directly following heavy resistance exercise in men 3
- Dietary adjuncts: Certain dietary supplements, such as DHEA (dehydroepiandrosterone) and herbal remedies like Tribulus terrestris, may be used to improve testosterone levels in hypogonadal males 4
Lifestyle Modifications
Lifestyle modifications play a crucial role in increasing testosterone levels. These include:
- Maintaining a healthy weight: Low testosterone levels are associated with increased fat mass and reduced lean mass in males 5
- Engaging in regular exercise: Resistance exercise and training can help increase testosterone levels 3
- Managing stress: High stress levels can negatively impact testosterone production
- Getting adequate sleep: Poor sleep quality and duration can disrupt testosterone production
Medical Considerations
It is essential to differentiate between hypogonadal men who are seeking to achieve or maintain fertility status and those who are not, as the treatment approach differs 6. Additionally, men with obesity-related low testosterone levels may not require testosterone replacement therapy, as weight loss and lifestyle modifications can be effective in increasing testosterone levels 2.