Natural Testosterone Supplements: Safety and Effectiveness
There are no safe and effective natural testosterone supplements that have been proven to significantly increase testosterone levels in clinical studies. 1, 2
Evidence on "Natural" Testosterone Supplements
- Despite marketing claims, most commercially available "testosterone booster" supplements lack scientific evidence to support their effectiveness in raising testosterone levels 1
- A systematic review of 52 studies examining 27 different proposed testosterone boosters found that most fail to increase total testosterone levels 2
- Analysis of 50 testosterone booster supplements found that only 24.8% of their ingredients had any data supporting claims of increasing testosterone, while 10.1% actually showed evidence of decreasing testosterone levels 1
- Many supplements contain supra-therapeutic doses of vitamins and minerals, with some exceeding the FDA's upper tolerable intake levels for zinc, vitamin B3, and magnesium, posing potential health risks 1
Limited Evidence for Specific Supplements
- For healthy men, only Eurycoma longifolia (Tongkat Ali) and Withania somnifera (Ashwagandha) showed possible effectiveness in raising testosterone levels 2
- For men with late-onset hypogonadism, Eurycoma longifolia, a blend of Punica granatum fruit rind and Theobroma cacao seed extracts (Tesnor™), and purified Shilajit extract (PrimaVie™) showed possible effectiveness 2
- Zinc supplementation may help improve testosterone levels, but only in cases of zinc deficiency 3
- Vitamin D supplementation may have benefits, but only in men with documented hypovitaminosis D 3
Medical Testosterone Therapy vs. Supplements
- For clinically diagnosed low testosterone (below 300 ng/dL), FDA-approved testosterone replacement therapy is the only proven effective treatment 4, 5
- Testosterone therapy should only be initiated after proper diagnosis with two separate morning testosterone measurements both showing low levels 5
- Testosterone replacement therapy has shown small but significant improvements in sexual functioning and quality of life in men with documented low testosterone 4
- Available testosterone formulations include transdermal gels/patches, intramuscular injections, subcutaneous pellets, and buccal tablets, each with different advantages and disadvantages 4
Safety Concerns
- Many "testosterone booster" supplements contain ingredients that exceed recommended daily allowances, sometimes by over 1000% for certain vitamins 1
- Testosterone prohormone supplements (androstenedione, androstenediol, DHEA) have not demonstrated anabolic or ergogenic effects in men and may pose health risks 6
- Medical testosterone therapy carries potential risks including cardiovascular events, though evidence is mixed and inconclusive 4
- The FDA required labeling changes in 2015 to inform healthcare professionals and patients about possible increased risks of heart attack and stroke with testosterone therapy for age-related hypogonadism 4
Lifestyle Approaches for Optimizing Natural Testosterone
- Adequate sleep, regular exercise, and weight loss in patients with obesity are more effective than supplements for supporting healthy testosterone levels 3
- Physical activity, particularly resistance training, can help maintain testosterone levels more effectively than most supplements 3
- Weight loss in overweight or obese men can significantly improve testosterone levels by reducing the conversion of testosterone to estrogen in adipose tissue 3
Recommendations for Those Concerned About Testosterone Levels
- Proper diagnosis of low testosterone requires two separate morning measurements below 300 ng/dL 5
- Focus on lifestyle modifications (sleep, exercise, weight management) before considering supplements 3
- If testosterone levels are clinically low, consult with a healthcare provider about FDA-approved testosterone replacement options rather than unregulated supplements 4
- Be aware that many marketed "testosterone boosters" contain ingredients without scientific evidence of effectiveness 1, 2