What supplements can help support natural testosterone production?

Supplements for Natural Testosterone Production

The evidence does not support using supplements to meaningfully increase testosterone production in healthy men, and most over-the-counter testosterone "boosters" lack scientific validation. 1

Primary Recommendation: Lifestyle Modification First

Weight loss through low-calorie diets and regular physical activity are the only evidence-based non-pharmacological interventions that can reverse obesity-associated low testosterone, though increases are modest (1-2 nmol/L). 1

Specific Lifestyle Interventions:

• Weight loss in obese men can normalize gonadotropins and improve testosterone levels through metabolic improvement 1
• Regular exercise shows benefits correlating with exercise duration and weight loss achieved 1
• Adequate sleep is imperative before considering any supplementation 2

Limited Evidence for Select Supplements

Only a few supplements have shown any promise in well-controlled trials, and only in men with documented low testosterone or specific deficiencies:

Supplements with Modest Supporting Evidence:

• Vitamin D supplementation - only beneficial in men with documented vitamin D deficiency 1, 2
• Zinc - may help in deficient states 2
• Ashwagandha root/leaf extracts - demonstrated positive effects in some trials 2, 3
• Fenugreek seed extracts - showed positive effects in limited studies 3

Important Caveat:

These supplements produce modest effects at best and do not directly translate into clinical benefits such as improved muscle mass, energy, or sexual function. 2

Supplements to Avoid

Testosterone prohormones (androstenedione, androstenediol, DHEA) do not produce anabolic or ergogenic effects and may increase health risks. 4 These substances:

• Are now controlled substances in the United States 4
• Do not increase testosterone or muscle mass in men 4, 5
• May cause adverse health consequences 4

Herbal products like Tribulus terrestris lack convincing evidence for testosterone enhancement despite marketing claims. 5, 3

When Medical Intervention Is Needed

If you have symptoms of low testosterone (decreased libido, erectile dysfunction, fatigue, decreased muscle mass), you need laboratory confirmation with two fasting morning total testosterone levels before any treatment consideration. 1

Diagnostic Threshold:

• Testosterone levels below 10.41 nmol/L (300 ng/dL) on two separate morning measurements indicate hypogonadism requiring medical evaluation 1

Medical Treatment Options (Not Supplements):

For confirmed hypogonadism with symptoms, prescription testosterone therapy is the evidence-based treatment, not supplements. 1 However:

• Do not use testosterone therapy in eugonadal (normal testosterone) men - this is a strong recommendation 1
• Testosterone therapy is contraindicated in men seeking fertility 1

Critical Warnings

Commercially available "testosterone boosters" are largely unregulated and lack quality control. 1 The evidence shows:

• Most supplements claiming to boost testosterone have no scientific support 2, 4
• Compounded testosterone products should be avoided when FDA-approved options exist due to variable potency and quality 1
• Never use alkylated oral testosterone due to liver toxicity risk 1

Bottom Line Algorithm

1. If you have symptoms: Get proper medical evaluation with two morning testosterone measurements 1
2. If overweight/obese: Focus on weight loss and exercise as primary intervention 1
3. If vitamin D deficient: Supplement with vitamin D (800 IU/day) 1
4. If confirmed hypogonadism: Seek prescription medical therapy, not supplements 1
5. If normal testosterone: Supplements will not help and testosterone therapy should not be used 1