Factors That Increase Testosterone Levels
The most effective natural approach to increase testosterone is weight loss combined with increased physical activity, particularly in overweight or obese men, with vigorous-intensity exercise providing the greatest benefit. 1
Primary Lifestyle Interventions
Weight Loss and Physical Activity
- The American Urological Association recommends lifestyle modifications as the first-line treatment strategy for all men with testosterone deficiency, as these interventions can increase total testosterone levels and reduce associated symptoms. 2, 1
- Weight loss combined with increased physical activity has been shown to raise testosterone levels while simultaneously reducing cardiovascular risk without the significant risks associated with exogenous testosterone therapy. 1
- Increased physical activity has a greater effect on raising testosterone levels than calorie restriction alone during lifestyle modification programs. 3
Exercise Specificity
- Vigorous-intensity physical activity is independently associated with increased serum testosterone levels in overweight/obese men. 4
- A 12-week aerobic exercise intervention significantly increased serum total testosterone, free testosterone, and bioavailable testosterone levels in overweight/obese men. 4
- Resistance exercise with high volume and metabolic demand can induce acute testosterone responses, particularly in men. 5
- The acute testosterone response to resistance exercise is largely determined by training intensity, duration of resting periods, and the individual's baseline characteristics (age, sex, training status). 6
Dietary Modifications
Mediterranean Diet Pattern
- A healthy diet pattern emphasizing the Mediterranean approach (fruits, vegetables, beans, legumes, whole grains, nuts, fish, poultry, lean red meat, cheese, and yogurt) should be implemented, as this can reduce death from coronary heart disease by up to 36% and improve cardiovascular risk factors. 1
- Moderate alcohol consumption should be limited to <21 units per week for men. 1
Smoking Cessation
- Smoking cessation is essential, as it reduces total mortality by 36% in patients with coronary heart disease and supports overall hormonal health. 1
Clinical Context and Mechanisms
Metabolic Relationships
- Untreated low testosterone levels are associated with insulin resistance, type 2 diabetes, metabolic syndrome, and increased visceral fat deposition, creating a bidirectional relationship where obesity lowers testosterone and low testosterone promotes obesity. 1
- Regular dynamic exercise improves lipid profiles, blood pressure, glucose-insulin homeostasis, and endothelial function, reducing incident type 2 diabetes and coronary heart disease by 30-50%. 1
Population-Specific Considerations
- Until puberty, children do not experience acute increases in testosterone from resistance exercise; after puberty, some acute increases can be found in boys but not in girls. 5
- Aging beyond 35-40 years is associated with a 1-3% decline per year in circulating testosterone concentration in men, resulting in reduced acute testosterone response to resistance exercise. 5
- In overweight/obese men specifically, baseline testosterone levels are significantly lower than in normal-weight men, but these men show significant increases with aerobic exercise interventions. 4
Important Clinical Caveats
- The testosterone response to exercise varies significantly based on exercise type (endurance vs. resistance), training intensity, study population characteristics (young vs. elderly, lean vs. obese, sedentary vs. athletes), and timing of measurement. 6
- While acute testosterone increases occur immediately following resistance exercise, this response is brief, though its effects are seen for several hours through upregulation of the androgen receptor. 7
- Lifestyle modifications provide cardiovascular risk reduction benefits beyond testosterone optimization alone, making them the preferred initial approach before considering pharmacologic therapy. 1