From the Guidelines
To increase testosterone levels, men should prioritize lifestyle modifications, including weight loss, increased physical activity, and a balanced diet, as these changes have the potential to increase total testosterone levels and reduce signs and symptoms associated with testosterone deficiency, as recommended by the American Urological Association guideline 1.
Key Recommendations
- Focus on regular strength training with compound exercises like squats and deadlifts to stimulate testosterone production.
- Maintain a balanced diet rich in protein, healthy fats, and micronutrients, particularly zinc and vitamin D.
- Ensure adequate sleep of 7-9 hours nightly, as testosterone production peaks during deep sleep.
- Manage stress through meditation or other relaxation techniques, since chronic stress elevates cortisol, which suppresses testosterone.
- Limit alcohol consumption and maintain a healthy body weight, as excess fat can convert testosterone to estrogen.
Medical Treatments
For those with clinically low testosterone, medical treatments include testosterone replacement therapy (TRT) in forms such as injections, gels, or patches. However, TRT requires medical supervision due to potential side effects like increased red blood cell production and possible fertility impacts, as noted in the Annals of Internal Medicine study 1.
Importance of Healthcare Provider Consultation
Before pursuing any testosterone-boosting strategy, especially medical interventions, it is crucial to consult with a healthcare provider for proper testing and personalized recommendations, considering the variability in testosterone levels and the potential for underlying medical conditions, as highlighted in the Diabetes Care study 1.
From the FDA Drug Label
Testosterone esters in oil injected intramuscularly are absorbed slowly from the lipid phase; thus testosterone enanthate can be given at intervals of two to four weeks. The FDA drug label does not answer the question.
From the Research
Increasing Testosterone Levels
To increase testosterone levels, several options are available, including testosterone replacement therapy (TRT) and alternative treatments.
- Testosterone replacement therapy (TRT) is a common treatment for low testosterone levels, but it may have disadvantages, such as affecting fertility and increasing the risk of prostate cancer and polycythemia 2, 3.
- Alternative treatments, such as clomiphene citrate, have been shown to increase testosterone levels and improve symptoms of hypogonadism 3, 4, 5, 6.
- Clomiphene citrate works by blocking the negative feedback of estrogen on the hypothalamus and pituitary glands, stimulating gonadotropin secretion and increasing endogenous testosterone production 4.
- Studies have compared the efficacy of clomiphene citrate with TRT, showing that clomiphene citrate can increase testosterone levels and improve symptoms of hypogonadism, although the long-term efficacy and safety of clomiphene citrate are not fully understood 5, 6.
Treatment Options
Treatment options for increasing testosterone levels include:
- Testosterone injections or gels, which can increase serum testosterone levels but may have side effects such as skin irritation and testicular atrophy 2, 5.
- Clomiphene citrate, which can increase endogenous testosterone production and improve symptoms of hypogonadism, with a potentially lower risk of side effects compared to TRT 3, 4, 5, 6.
- Gonadotropins, which can be used as an alternative to TRT when fertility is desired, although they require frequent injections 3.
Safety and Efficacy
The safety and efficacy of different treatment options for increasing testosterone levels vary:
- TRT has been associated with potential adverse effects, such as polycythemia and prostate cancer, and may not be suitable for men wishing to preserve fertility 2, 3.
- Clomiphene citrate has been shown to be effective in increasing testosterone levels and improving symptoms of hypogonadism, with a potentially lower risk of side effects compared to TRT, although its long-term efficacy and safety are not fully understood 4, 5, 6.