testosterone therapy

Testosterone therapy – cure all – or snake oil?

Low testosterone is an increasingly common factor in our lives.  It is not clear why this is so, but it is possibly linked to current lifestyles and increasing longevity.   Low levels can have effects that range from irritating – loss of sex drive – to severe – bodily complications.   The number of prescriptions for testosterone supplements has increased fivefold.


What is testosterone?

Testosterone is a male hormone and it has several very important functions: it regulates fertility; it helps improve muscle mass; it helps fat distribution; it helps bone density and it helps red blood cell production.  Without testosterone a man can become fertile and this is because it assists the development of sperm, so all in all, quite an important hormone for men.  It is also produced in women, but to a much lesser extent.

It is mainly producing the testicles in cells called Ladig cells and it is controlled by the brain and pituitary gland and, once produced, it is carried through the body by the blood stream.


Why does it decrease?

It decreases naturally during age, but it decreases to different degrees, depending on the person – i.e. how fit they are, what their lifestyle is, their weight etc.  There are a number of tests to determine why your testosterone has decreased and whether you should be worried about it.


What are the effects of low testosterone levels?

It can have some very negative impacts e.g. – reduced sex drive, erectile dysfunction, lower sperm count and, in some cases, enlarged breast tissue, loss of body hair, loss of muscle mass leading to loss of strength and increased fat.  These can, in turn, lead to osteoporosis, reduced energy, testicular shrinkage, and depression – and thus it is important to understand if you have been affected and then to what degree.

Signs of low testosterone infographic

Signs of low testosterone infographic. Credit: MasculineNotion.com


What causes it?

Apart from the natural ageing process other causes of unusually low testosterone can include injury to the testicles (such as castration!), testicle infection, some opiates and some disorders of the body or chronic diseases, including type 2 diabetes, kidney and liver disease, and obesity.  It can also be caused by Hypogonadism which is a condition which hampers the body’s ability to produce testosterone – usually due to a problem with the testicles or with the pituitary gland that controls the testicles.


What can you do about it?

There are three different things you can do:

  • You can change your lifestyle
  • You can change your diet or
  • you can have medication or you can have testosterone therapy in either case.

A blood test is needed to diagnose testosterone levels and you may be offered testosterone replacement therapy which usually takes the form of injections, pellets, patches or gels – and it has been seen to improve testosterone levels.  This treatment is only prescribed for specific instances and not to counteract the effects of the normal ageing process.

Some also believe that testosterone therapy will make you feel younger (it can’t make you younger of course) and more vigorous, but there is no evidence support this.

It is very important that you talk to your doctor before taking any therapy, and the doctor will measure your testosterone at least twice before recommending any testosterone therapy.

What is more likely, than prescribing medication is that they will recommend natural ways to boost testosterone such as losing weight and/or increasing muscle mass, changing diet and generally having a more healthy lifestyle.

In terms of testosterone supplements. One drug, methyl testosterone, has received approval from The United States Food and Drug Administration Agency; however, the guidelines (bizarrely) advise Doctors not to prescribe this, because it can lead to liver toxicity and therefore Doctors try to avoid prescribing it.


Better diet

Changing your diet is an easy and risk free way of improving testosterone levels.  Studies have shown that eating foods with high levels of flavonoids, which can be found in many fruits and vegetables, is a] good for your health, and b] assists in producing testosterone.  Some studies have also shown that flavonoids can prevent, or delay, hypogonadism.  Foods high in flavonoids include:

  • Onions
  • Hot peppers
  • Kale
  • Broccoli
  • Rutabagas
  • Spinach
  • Oysters


Herbal remedies

There are many herbal offerings on the market which claim testosterone-boosting effects but there is, unfortunately, little evidence backing up those claims.   In 2021, however, meta-analysis found four herbs that might be useful, but more research is needed:

  • Fenugreek seed (extract)
  • Ashwagandha (root and leaf extract)
  • Asian red ginseng
  • Forskohlii (root extract)


Other Ways To Raise Testosterone Levels Naturally

Changing lifestyle is more likely to help than herbal remedies and this includes:


More Exercise

It is a well-known medical fact that the fitter you are the better your body can cope with changes.  Benefits include weight control and thus toning fat into muscle – especially using cardio and endurance training leading to a fitter body – and thus you will be better able to fight off ill-events; a better mental attitude; and general all-round better feelings about yourself – which will help increase your testosterone levels.


Weight Loss

Those who are overweight or are obese often have lower testosterone.  In addition, being at a healthier weight will also improve overall health as well as testosterone levels.  This is also about a balanced diet – not starvation (see foods) – as you require adequate protein, fat etc to generate testosterone.   Cholesterol comes from some types of fat, and that is what the body uses to make testosterone – a good level is usually no more than 25% of your calories from fat.


Get Enough Sleep

It is important for a number of reasons to get enough sleep – sleep is when the body repairs itself and rests.  Several studies have shown that lack of sleep leads to lower testosterone levels.  Thus, ensuring a good night’s rest consistently is an important way to increase your testosterone.


Risks from testosterone therapy

Unfortunately, testosterone therapy can come with certain various risks, including:

  • sleep apnoea — a sleep disorder in which breathing repeatedly stops and starts intermittently – which can be severe
  • adverse skin reactions
  • stimulating noncancerous growth of the prostate and also potentially worsening any existing prostate cancerous growths
  • reducing sperm production (which paradoxically is the opposite reason from why you might wish to undergo it) or causing testicles to shrink.
  • red blood cell over-production – which could increase the risk of blood clots
  • there is also some research which has shown that testosterone therapy could increase your risk of heart disease.


Sometimes people use a prohormone supplement to treat it.  This is a steroid and it is not recommended and research has not found that it in fact assists in testosterone improvement.



It is clear that more research is needed in this area and that the other two options – of changing lifestyle and diet may be more effective and less risky.