How to Increase Testosterone Naturally
The most effective natural approach to increase testosterone is weight loss combined with increased physical activity, particularly in overweight or obese men, as this strategy raises testosterone levels and reduces cardiovascular risk without the significant risks associated with exogenous testosterone therapy. 1
Primary Intervention: Weight Loss and Exercise
Weight loss and increased physical activity are the first-line interventions for naturally optimizing testosterone levels. 1 These lifestyle modifications have the potential to increase total testosterone levels and reduce symptoms associated with testosterone deficiency in overweight and obese men. 1
Exercise Recommendations
Increased physical activity has a greater effect than calorie restriction alone on raising testosterone levels. 2 In a 12-week study of overweight and obese men, those with higher physical activity levels achieved significantly higher testosterone levels compared to those with lower activity, regardless of calorie restriction. 2
Regular dynamic exercise improves lipid profiles, blood pressure, glucose-insulin homeostasis, endothelial function, and reduces incident type 2 diabetes and coronary heart disease by 30-50%. 1
A significant positive correlation exists between increased step count and rising testosterone levels in overweight men. 2
Weight Loss Strategy
Weight loss through low-calorie diets can improve testosterone levels in men with obesity-associated secondary hypogonadism. 3
Untreated low testosterone levels are associated with insulin resistance, type 2 diabetes, metabolic syndrome, and increased visceral fat deposition, making weight loss particularly important. 1
Dietary Interventions
Adopt a Mediterranean diet pattern that emphasizes fruits, vegetables, beans and legumes, whole grains, nuts, fish, poultry, lean red meat, cheese, and yogurt. 1 This dietary approach can reduce death from coronary heart disease by up to 36% and improve established cardiovascular risk factors. 1
- Limit alcohol consumption to <21 units per week for men. 1
Sleep Optimization
Adequate sleep is imperative before implementing any nutraceutical agents. 4 Sleep quality and duration should be optimized as part of the foundational approach to testosterone management. 4
Smoking Cessation
Smoking cessation is essential, as it reduces total mortality by 36% in patients with coronary heart disease. 1 Smoking cessation should be prioritized alongside other lifestyle modifications. 3
Nutraceutical Considerations
The effects of nonpharmacologic interventions on testosterone levels are modest and do not directly translate into clinical benefits. 4 Most "testosterone booster" supplements lack evidence to support their claims. 5
Evidence-Based Supplements (Limited Support)
Only a select few nutraceuticals have shown promising results based on well-controlled randomized clinical trials in men with low testosterone levels:
- Zinc (in cases of deficiency) 4
- Vitamin D (only in cases of hypovitaminosis D) 4
- L-arginine 4
- Mucuna 4
- Ashwagandha 4
Critical Caveat on Supplements
90% of "testosterone booster" supplements claim to boost testosterone, but only 24.8% have data supporting these claims. 5
10.1% of supplements contain components with data suggesting a negative effect on testosterone. 5
Many supplements contain supra-therapeutic doses of vitamins and minerals, occasionally exceeding the FDA upper tolerable intake level. 5
61.5% of supplement ingredients have no published data on their effect on testosterone. 5
Clinical Context and Expectations
Lifestyle modifications should be the first-line treatment strategy for all men with testosterone deficiency before considering pharmacologic therapy, as they provide cardiovascular risk reduction benefits beyond testosterone optimization. 1
The modest increases in testosterone from natural interventions may not produce dramatic symptomatic improvements, as androgen receptor content, rather than endogenous androgens alone, has been regarded as the principal factor in muscle hypertrophy. 4
Algorithm for Natural Testosterone Optimization
Assess baseline status: Confirm low testosterone with morning measurements and evaluate for obesity, sedentary lifestyle, poor diet, inadequate sleep, and smoking. 1, 3
Implement exercise program: Prioritize increased physical activity (aerobic exercise training) over calorie restriction alone, as it has a greater effect on testosterone levels. 2
Initiate weight loss: Combine exercise with calorie restriction for overweight/obese men. 1
Optimize diet: Transition to Mediterranean diet pattern. 1
Address sleep and smoking: Ensure adequate sleep and complete smoking cessation. 1, 4
Consider targeted supplementation only if deficient: Measure vitamin D and zinc levels; supplement only if documented deficiency exists. 4
Avoid commercial "testosterone boosters": These products generally lack evidence and may contain harmful doses of ingredients. 5