What supplements can help increase testosterone levels?

Supplements to Increase Testosterone Levels

There are no supplements that have been conclusively proven to significantly increase testosterone levels in men with normal testosterone levels, and most marketed "testosterone boosters" lack scientific evidence to support their claims. 1, 2

Evidence-Based Non-Pharmacological Approaches

• Weight management is critical as excess adipose tissue increases aromatization of testosterone to estradiol, lowering testosterone levels 3, 4
• Regular physical activity helps maintain healthy testosterone levels and improve overall metabolic health 3, 4
• Sleep optimization is essential as sleep disorders like sleep apnea are associated with reduced testosterone levels 3
• Addressing nutritional deficiencies may help in specific cases:
  • Zinc supplementation may be beneficial only in men with zinc deficiency 4
  • Vitamin D supplementation may help only in cases of hypovitaminosis D 4

Limited Evidence for Specific Supplements

• Ashwagandha (Withania somnifera) has shown some promise in well-controlled trials for men with low testosterone 4, 2
• L-arginine has demonstrated some potential benefits for testosterone levels in limited studies 4
• Mucuna has shown some promising results in controlled trials 4
• Eurycoma longifolia (Tongkat Ali) may be possibly effective for men with late-onset hypogonadism and healthy men 2

Caution Regarding Testosterone Boosting Supplements

• A systematic review found that 90% of marketed "testosterone booster" supplements claimed to boost testosterone, but only 24.8% had any supporting evidence 1
• 10.1% of these supplements contained components with data suggesting they might actually decrease testosterone levels 1
• Many supplements contain supra-therapeutic doses of vitamins and minerals, sometimes exceeding the upper tolerable intake level (UL) 1
• Testosterone prohormones such as androstenedione, androstenediol, and DHEA have not shown anabolic or ergogenic effects in men and may pose health risks 5

When to Consider Medical Evaluation

• Men with significant symptoms of testosterone deficiency should undergo proper medical evaluation before relying solely on non-pharmacological approaches 3
• The American Urological Association recommends measuring morning total testosterone levels between 8-10 AM on at least two separate occasions to confirm testosterone deficiency 6
• If non-pharmacological approaches fail to improve symptoms after 3-6 months, medical intervention may be necessary 3
• Men with very low testosterone levels (total testosterone <300 ng/dL) may require medical intervention beyond lifestyle modifications 3, 6

Special Considerations for Fertility

• Traditional testosterone replacement therapy suppresses the hypothalamus-pituitary-gonadal axis and can impair fertility 7
• Men wanting to preserve fertility while treating testosterone deficiency should consider specialized approaches such as selective estrogen receptor modulators, human chorionic gonadotropin, or anastrozole inhibitors 7

Monitoring

• Men implementing non-pharmacological interventions should have testosterone levels measured every 6-12 months to assess effectiveness 3, 8
• Regular monitoring of cardiovascular parameters is recommended for those using any testosterone therapy 8