If I could reduce male well-being to just one vital factor—it’s testosterone.
Not only has it made us into the men we are today—but this hormone also powers everything from our mood and strength through to libido and erection quality.
However, many of us, often unknowingly, possess insufficient levels of testosterone. This has negative impacts on our health, mental state, and personal relationships.
And, unless addressed, the problem will only exacerbate.
This article explains how to identify if you’re suffering from low testosterone levels—but most importantly, the simple steps you can take to solve this problem.
What Is Testosterone & Its Role in Men’s Health?
Testosterone is the primary male sex hormone (an androgen) and a naturally occurring anabolic steroid, with the chemical formula C19H28O2.1 You’ve been lucky enough to have this critical compound in your body for your entire life—ever since being a fetus.2
While women and most vertebrate animals also possess this hormone—it’s no overstatement to state that testosterone made you into a man. It was responsible for your testicular and penile growth, deep voice, and facial hair.3 4 5 6
But, on a day-to-day basis, testosterone affects our mood, sexual appetite, muscle mass, erection quality, bone growth, and weight regulation.
Where Is Testosterone Produced?
Testosterone is created naturally in the male body by chemically altering your existing cholesterol stores. The majority (around 95 percent) is produced by the Leydig cells within the testes—although, some is also formed by the adrenal glands.7 8 9
Women—naturally lacking testes, produce a small amount of testosterone in the adrenal glands and ovaries.10
In men, the production of testosterone follows a theoretically simple pathway—known as the HPTA (hypothalamic pituitary testicular axis).
In this process, the hypothalamus (in the brain) stimulates the pituitary gland to create LH (luteinizing hormone) and FSH (follicle-stimulating hormone).11
These two compounds encourage the testes to produce more testosterone—information which the body feeds back to the hypothalamus. This portion of the brain then “decides” whether to keep up production, or cease if testosterone has reached a sufficient amount.
However, numerous factors can impinge on this HPTA cycle—resulting in low testosterone levels.
What Is the Definition of Low Testosterone?
Medically speaking, clinicians diagnose low testosterone levels (T-levels) when the range drops below 280-300 ng/dl (nanograms per deciliter).12
To put this into context, when your T-levels are at their peak (around 19 years of age) they can hit 896 ng/dl and drop to about 400 ng/dl by the age of 40.13 However, while this is an accurate measure in science—in real-life, this may prove an inadequate definition.
The medical concept only really addresses what is required for health—not for complete male well-being or quality of life.
Different men may have individual testosterone needs—to elevate libido, improve erections, or build muscle, for example. In these particular circumstances, low testosterone levels can be described as that which is inadequate to meet your personal requirements.
What Causes Low Testosterone?
A combination of genetic, physiological, and environmental factors can cause low testosterone levels.
Here are the most common:
Testosterone Levels and Aging
Your T-levels hit their height during your teens—with a massive surge required to power your body through puberty. Sadly, from then onwards, it’s all downhill.
While you gradually experience a steady decrease over the years—it rapidly plummets around 50 years of age.
Previously, many experts believed that this decline was due to the elevated amount of disease suffered by more mature men. However, research indicates this is not the case. 14 15 The exact cause for this change, known as the male andropause, or late-onset hypogonadism, is still not fully understood.16
While scientists consider there may be numerous factors causing low testosterone levels in aging men—they suggest that the decline in Leydig cells have the most pronounced effect. These testosterone factories reduce in numbers over our lifespans—making them less efficient at creating the all-important male hormone.17
If you’re suffering from low testosterone levels—you may have to blame your parents.
Studies show that the make-up of our genes determines our testosterone production (T-production)—some men are more predisposed to creating large volumes of this hormone than others.18
Scientists have linked a poor diet—especially one which is low in specific vitamins and minerals—to low testosterone levels.
While generally exercise is considered a testosterone booster—pushing it to the extreme has the opposite effect.
Known as the exercise-hypogonadal male condition—researchers believe that extended endurance training interferes with the HPTA inhibiting androgen production, causing low testosterone levels.23
If you’re overweight—your hormone production could suffer.
Clinical papers show that obese men are more likely to have low testosterone levels than those of a “normal” weight.24 Carrying too many pounds can elevate insulin production (hyperinsulinemia)—which in turn negatively impacts the testes.
Men produce the majority of their testosterone during slumber—mainly during the REM (rapid eye movement) stage.
Poor quality and interrupted sleep prevents healthy androgen production.25
Testosterone is the original bodybuilding steroid—the one from which all the other synthetic versions are derived.26
Due to its ability to enhance muscle growth—some weightlifters use exogenous testosterone or illegal drugs to increase the volume circulating within their body— stimulating mass increases.
Yet while effective, it interferes with the HPTA.27
The body recognizes elevated T-levels after steroid injections—and hence either reduces or ceases natural production completely. This can take months to restart post-steroid use—sometimes never recommencing at all.
Illness and Disease
Specific health issues can impact testosterone creation in both the short and long term. The most prevalent ones are:
The good news is—having an alcoholic drink every now and again will elevate androgen production.31 However, taking your partying too far has the opposite effect—impinging on the testes and causing low testosterone levels.32
Who Are at Risk of Low Testosterone?
Those most likely to be affected by restricted testosterone production are men who are:
- Finding they suffer from insomnia or wake frequently during the night.
- Alcoholics and binge drinkers.
- Consuming a poor diet lacking in fruits and vegetables.
- Over 40 years of age.
- Currently, or have recently suffered from an illness.
- Predisposed to the condition through genetics.
Low Testosterone Levels Statistics
As declining T-levels are a necessary evil of aging—it’s highly prevalent.
Here are some brief numbers:
- In the United States alone—it affects between four to five million males.33
- Scientists estimate that 43 percent of men over 65 suffer from low testosterone levels.34
- After the age of 30—testosterone drops at the rate of one percent per year.35
- Low testosterone levels are becoming more common—in 1987, men had 17 percent more of this hormone compared to those of the same age today.36
Signs, Symptoms & How to Test Testosterone Levels?
Men commonly blame the symptoms of low testosterone levels on just “getting older”—not on the actual cause, which is usually a reduction in T-production.
The most common indicators are:
Lowered Sex Drive
If you were like me during your teenage years—you were a walking hormone. Just the sight of a pretty girl would stir the loins into movement. As mentioned earlier, during your adolescence, your testosterone levels were at their highest—fuelling this insatiable sex drive.
However, as the years pass, this appetite can decline—with sex appearing more of a chore than a pleasure. Testosterone is the driving force behind your libido—if it drops, so does your desire to get active in the bedroom.37
Yet, it’s not all bad news.
Scientists have shown that even a small elevation in T-production, as little as 3.4 ng/dl, reignites sexual interest.
Sometimes you have the desire for lovemaking—but your male member says no.
Known as erectile dysfunction, it’s the inability to either achieve or maintain a firm penis during sex. Experts have shown that men suffering from inhibited testosterone production are more likely to suffer from erection issues.38
Reduction in Testicle Size
While you may not consider the size of your testes as vital as that of your penis—it’s vital.
Low testosterone levels can lead to testicular atrophy—where your testes begin to shrink.39
This can result in three issues:
- Psychological trauma of a decrease in genitalia size.
- Reduction in fertility.
- Creating a vicious circle—smaller testes results in fewer Leydig cells—lowering testosterone production even further.
Reduction in the Amount of Semen
Declining testosterone levels lower sperm volume, fertility, quality, and motility (“swimming” ability).40
Not only can an unimpressive ejaculation make you feel demasculinized—but it also means you’re less likely to produce offspring.
Hence if your climax is more of a dribble than a fountain—it could be indicating low testosterone levels.
Decrease in Energy Levels
Even something as innocuous as a loss in vitality can be attributed to low testosterone levels.
Experts have concluded that flagging energy levels can be a symptom of reduced testosterone. They suggest that it could be due to the fact that this hormone is directly related to serotonin production—required for a feeling of well-being and vigor.41 42
Lowered Muscle Mass
The reason that some bodybuilders use steroids is that testosterone elevates mass by increasing muscle protein synthesis—the process by which muscles grow.43
Conversely, the lack of, or declining, muscle mass can be a signal of low testosterone levels.
Furthermore, the male body also contains the female hormone estrogen. In the ideal situation, the balance between male and female hormones is in testosterone’s favor. Declining T-production can make estrogen the most powerful—promoting catabolism (muscle loss).44
Reduced Bone Mass
When you fell over as a teen, you’d most likely dust yourself down and carry on with life. Nowadays, however, a trip could easily lead to a bone fracture or break.
Weak and frail bones are a sign of low testosterone levels. This hormone elevates bones density, increasing strength.45
Hair and Beard Loss
Testosterone was responsible for turning you from a boy into a man—by boosting body and facial hair—so it’s no surprise that low testosterone levels have the opposite effect. It causes body hair loss and premature balding (before the age of 30).46 47
However, it’s not quite that simple.
Male pattern baldness (also known as genetic or androgenic alopecia) works in the opposite way. In this condition, the hair follicles are over-sensitive to DHT (dihydrotestosterone)—a form of testosterone. It causes them to shrink—and stop producing hairs.48
Increase in Body Fat
Sufficient T-production plays an important role in influencing and regulating fat storage within your body.
Hence, low testosterone levels can result in men holding large volumes of fat around the abdomen. So, if you’re suffering from the so-called middle-aged spread—this could be a sign of declining T-production.49
Not only can a healthy testosterone volume prevent this excess poundage—but it can also encourage lipolysis (fat loss).50
As discussed, low testosterone levels can cause reduced libido, erection issues, shrinking testicles, and hair loss.
Probably enough to make anyone feel really down in themselves.
But furthermore, scientists have discovered a direct link between a lowered T-count and depression. An issue that a man can resolve by elevating testosterone again.51
When Should I See a Doctor?
If you’re witnessing any of the above symptoms—and you believe you’re suffering from low testosterone levels—a visit to the doctor for a blood test can confirm this. The procedure is straightforward.
Prior to your actual test, your health practitioner will most likely ask you to cease using medications which can affect the result. These can include:
Firstly, s/he will most likely perform a physical examination, checking for outward signs of low testosterone, including:
- Facial hair loss.
- Gynecomastia (male breasts).
- Abnormally high weight gain.
They will then conduct a blood test to determine your exact T-level—usually taken in the mornings when it’s at its peak.
Alternatively, there are home-testing kits—in which you take a sample of your saliva and mail to a laboratory to check your levels. Experts have concluded that while not as exact as the blood method—salivary exams are an adequate way of measuring hormone quantities.54
Treating Low Testosterone Levels
If your doctor diagnoses low testosterone levels, they may look to elevating your reserves by a process known as TRT (testosterone replacement therapy).
Testosterone Replacement Therapy
This treatment involves introducing exogenous (that is, from outside the body) testosterone directly into the bloodstream. There are numerous methods of application, the most common ones being:
Testosterone is delivered into the bloodstream via the muscle tissues through the use of a hypodermic needle.
Usually, depending on the extent of your low testosterone levels, they’re administered every 2-4 weeks. Blood tests are taken often, to continually monitor your T-count and ensure that the treatment is producing the desired effect.
Most frequently, they’re delivered by a health care practitioner, meaning that you’ll not only be paying for your medication—but also the cost of the clinic visit itself. This has led many people to self-administer.
Below is a quick “how-to” guide. Although, this is for information purposes only. Always ensure you’ve received instruction and approval from a doctor before injecting testosterone yourself.
How to Inject Testosterone?
- Check your dose as prescribed by your doctor and the concentration of your testosterone vial. Some pharmacies retail the bottles in 100 mg/ml, others as 200 mg/ml. Hence, one can be twice as potent as the other.
- Locate a sterile syringe and needle—usually, a 3 ml syringe is adequate.
- Wash your hands with an anti-bacterial wash and don surgical gloves.
- Pull air into the syringe to the same volume of your dose, then insert the needle into the vial top.
- Push the air inside the syringe into the bottle, invert, and then draw out the desired medication amount. Withdraw the needle.
- With the needle pointing upwards, “flick” the sides of the syringe to force any air bubbles to the top.
- Slowly squeeze the syringe plunger to expel any remaining air from the needle—stop when you see a little drop of medication on its tip.
- Wipe an alcohol pad around your injection site as recommended by your doctor (often, your thigh).
- Plunge the needle into the site at a 90-degree angle.
- Pull the plunger back a little—if large amounts of blood enter the syringe, you’ve hit a vein and need to relocate.
- Inject the testosterone at a steady pace.
- Remove the needle and apply a Band-Aid.
- Safely discard the needle.
While you can take testosterone in a swallowed-pill form—it’s very rare.
This method involves a tablet being digested by the stomach allowing the testosterone to enter the bloodstream. The issue is, it passes through the liver too—which can cause organ damage. Hence, doctors rarely prescribe it as a treatment for low testosterone levels.
A strip or tablet that sticks to the gums of the mouth behind one of your incisors. Usually applied once a day, it releases testosterone constantly into the bloodstream through the mouths thin tissues.
Testosterone Gels and Patches
The least invasive forms of treatment for low testosterone levels.
Whether applied as a patch or gel—the process is the same. You absorb the primary male hormone through your skin tissue, delivering the dose as recommended by your doctor. Less common is a nasal version which you can apply inside the nostrils.
How to Increase Testosterone Naturally?
TRT is a method of treating low testosterone levels by introducing this exogenous hormone into the body. However, a safer procedure is to encourage your physiology to elevate its own natural production.
The most effective techniques are:
Not only is exercise beneficial for our health and weight, but it can also boost T-production.
Studies indicate that fitness training, especially resistance work (weightlifting) elevates T-count and is an effective treatment for low testosterone levels.55
Scientists explored diet’s effect on testosterone production on 83 male twins.
They discovered that those who ate more nutritious foods had a higher T-count than those which did not.56
Foods which can have a positive effect on low testosterone levels are:
- Lean red meats.
- Sunflower seeds.
Unfortunately, avoiding being weighed down by the pressures of life isn’t that simple. However, methods such as mindfulness, walking in nature, and spending time with friends and family can help to take the strain.
As explained earlier, men produce testosterone during REM sleep.
Having too few hours beneath the sheets, waking frequently, or having non-beneficial slumber (such as after drinking alcohol) will play havoc with your hormones.
Attempt to have more relaxing sleep by avoiding stimulants before bedtime, have sex, and enjoy a warm bath before retiring.
Take Vitamin D
This vitamin is nature’s answer to low testosterone levels.59
The simplest way to boost your reserves is to get outside into the sunlight—which makes the body synthesize this essential element.60
However, elongated hours indoors during working hours, or even your geographical location, can make access to the sun difficult. In these circumstances, consider using vitamin pills or eating foods high in vitamin D such as fish, liver, and eggs.61
Often referred to as testosterone boosters or T-enhancers, these supplements contain a plethora of natural ingredients that stimulate the body into producing more testosterone.
Usually supplied in pill form, they’re taken daily with little to no side effects—unlike TRT.
However, be careful in your selection.
Many products contain unproven T-boosting ingredients—which will provide few benefits to beat low testosterone levels.
The key compounds for the best T-enhancing supplements are:
- Vitamin D3.
- Vitamin K2.
- Vitamin B6.
- D-aspartic acid.
Common Questions About Low Testosterone Levels
Here are the queries most frequently asked about testosterone:
“How Can I Be Sure I Have Low Testosterone?”
First, check the signs and symptoms of low testosterone levels listed earlier. Then, if you believe that you may be suffering from this condition, you can undergo a blood test with your doctor or complete a mail-salivary test which can be purchased online.
“Is Low Testosterone Linked to Infertility?”
Yes. Studies indicate that low testosterone levels reduce sperm count, motility, and fertility.
“Are There Any Side Effects of Testosterone Replacement Therapy?”
Although the most commonly prescribed treatment for low testosterone levels, it can have some severe side effects, including:
- Enlarged prostate.62
- Prostate cancer—or worsening of symptoms in those already with the disease.63
- Heart Disease.
- Deep vein thrombosis.
- Collapsing of the upper airway during sleep.65
- Male breast cancer.66
“Do Natural Testosterone Boosting Supplements Work?”
The best T-boosters on the market can be an effective treatment of low testosterone levels without the side effects of TRT.
Look for those that include vitamins D3, B6, and K2 as well as d-aspartic acid, magnesium, and zinc—all scientifically proven natural T-enhancers.
“Can Low Testosterone Fix Itself?”
Low testosterone levels are largely a symptom of aging—once the decline starts, it will never “right” itself.
However, a combination of diet, exercise, and supplementation can help to elevate male hormone counts.
This article has been medically reviewed by Dr. Biswadeep Das in August 2019