Low testosterone impacts 40% of men aged 45 and over, and it can have a significant negative impact on a man’s quality of life. Lower sex drive, lack of motivation, and a decrease in muscle and bone mass are just a few of the many issues that men with low testosterone can face.
Unfortunately, there’s still limited research and awareness surrounding testosterone deficiency, which means that doctors, employers, and families are not always able to provide men with the support they might need. This, along with outdated ideas that testosterone levels determine whether males are ‘manly’ or ‘masculine’ enough, needs to change. As Men’s Health UK reminds us, “No one has ever established a credible link between high testosterone levels and supposedly masculine traits such as assertiveness, bravery, or risk-taking.”
If you’ve been struggling with low testosterone levels, then it’s first important to remember that you’re not alone, and that there are many other men going through similar experiences. It’s also normal to find it tricky to talk about low testosterone levels – but this doesn’t mean that you shouldn’t. Talking about your symptoms can be an effective first step in getting the help that you need, and can also help to break the stigma for others.
As with any health concern, knowledge is power, and the more you understand about low testosterone levels, what the causes and symptoms are, and what your options are for improving them, the better position you’ll be in. We’ll cover these topics below…
What is testosterone?
Though both male and female bodies make testosterone, it’s widely referred to as the ‘male sex hormone’ because men have much higher levels of it than females (who only have a small amount).
Men produce testosterone in the testicles and it plays an important role in a number of different functions including:
- Penis and testicular development
- Sperm production
- Red blood cells production
- Sex drive
- Fat distribution
- Bone mass and strength
- Muscle size and strength
Testosterone is also responsible for the development of certain male characteristics during puberty such as facial and pubic hair, and a deep voice.
What causes testosterone levels to decline?
In males, testosterone levels will continue to rise throughout puberty, until they peak around the late 20s. According to the NHS, they will then steadily decline by less than 2% a year from the age of 30-40 onward.
Though all men will experience a decline in testosterone levels as they get older, certain lifestyle factors and health conditions can cause the production of testosterone to become even lower, resulting in a deficiency.
While there’s limited information and guidance available to the public on testosterone levels in the UK, research suggests that levels below 300ng/dL are considered low. Low testosterone levels might also be referred to as a testosterone deficiency, or hypogonadism. Hypogonadism can affect men of all ages but is more common in older men.
Causes of hypogonadism, aside from natural ageing, can include:
- Testicular injury
- Alcohol abuse
- Cancer treatments such as chemotherapy or radiotherapy
- Obstructive sleep apnea
- Uncontrolled type 2 diabetes
- Obesity or extreme weight loss
- High blood pressure
Many prescription drugs can also lower testosterone levels. So if you find out your levels are low, then it’s worth asking your doctor whether any medication you’re taking could be causing it. In some cases, your doctor might be able to suggest alternative medication that doesn’t interfere with testosterone levels.
What are the symptoms of low testosterone?
Symptoms of low testosterone are wide-ranging, and can include:
- Problems getting and keeping an erection
- Low sex drive
- Excessive sweating/night sweats
- An increase in breast tissue
- Loss of lean muscle mass and strength
- A reduction in bone mass
- An increase in body fat
- Loss of body hair
- Low mood/depression
- Difficulty with memory and concentration (brain fog)
- Loss of drive and determination
Many men also say that low testosterone levels have left them feeling flat and disconnected from life.
Symptoms of testosterone deficiency can be incredibly difficult to deal with both physically and mentally, and can affect all areas of a man’s life – at home, at work, and socially. This Metro story provides some interesting insight into what it can be like to live with low testosterone and is worth a read.
You might also find it helpful to use this free symptom checker from Tackle TD. You can print off your results and show them to your GP.
Is there a link between testosterone levels and prostate cancer?
Scientists are continuing to carry out research into the link between testosterone and prostate cancer. Over the years there has been much controversy about whether higher testosterone levels contribute to the development of prostate cancer, or encourage the growth of cancerous cells in men who have already been diagnosed with the disease.
A study carried out by the University of Oxford between 1959 and 2004 found that, though men who had lower testosterone levels were less likely to develop prostate cancer – if they did develop it, it was more likely to be an aggressive form. However, other research has contradicted this. For example, this 2015 review of the evidence so far details studies where prostate cancer rates were higher in men with low testosterone levels. This 2016 meta-analysis also found no link between testosterone levels and the development of prostate cancer.
In response to the uncertainty surrounding testosterone levels and prostate cancer, Prostate Cancer UK has suggested that testosterone levels alone may not explain the cause of prostate cancer and that more research is needed to unravel the complexity of the disease.
Dr Matthew Hobbs, Deputy Director of Research at Prostate Cancer UK said, “We still know too little about what causes prostate cancer cells to develop. We urgently need this knowledge to understand how we might prevent the disease in the future, which is why this is a key research priority for Prostate Cancer UK. Until we know more about the underlying causes of prostate cancer, it’s important that all men – and particularly black men, men with family history, and men over 50 – are aware of their risk of prostate cancer and go to the GP if they have any concerns.”
To find out more about prostate health, you might want to read our article here.
How can I find out whether my testosterone levels are low?
Your NHS doctor will be able to confirm whether your testosterone levels are low with a simple blood test.
Alternatively, Thriva is a credible blood testing service that allows you to collect your own blood sample at home, send it off in the post, and receive the results and a GP report within 48 hours. Thriva works with NHS doctors, data scientists, and clinicians to provide you with the most accurate and reliable information. There’s a fee for this service, but one of the perks is that you can receive results quickly, and can do everything from the comfort of your own home. If there are any abnormalities in your results, they will usually recommend that you discuss them with your regular GP.
It’s worth noting that even normal testosterone levels can fluctuate throughout the day, with levels typically being higher in the morning – so it’s recommended that tests are carried out earlier in the day.
9 ways to boost testosterone levels in men
Though more work needs to be done to break the taboo on testosterone deficiency and increase understanding of how it affects men – there is help out there if you are struggling with symptoms. There are also some things you can do to manage low testosterone levels yourself.
1. Speak to your GP
While there are many ways to increase testosterone levels naturally, it’s also important to make an appointment with your GP if you think your testosterone levels are low and you’re struggling with symptoms. You can request a male doctor if you’d feel more comfortable with this.
The first thing they will usually arrange is a blood test to confirm that levels are low. If they are, then you might be referred to an endocrinologist, who will run some more tests, and might offer you the option to have testosterone replacement therapy (TRT). TRT is designed to replace the testosterone you are lacking, and get levels back up to a normal level. It’s normally given as a tablet, gel, or patch.
In the past, TRT has been linked to prostate cancer. Though more recent reviews (like this 2015 review, and this one from 2016) have found there is no clear evidence to suggest that TRT will increase the risk of men developing prostate cancer, or that it will worsen prostate cancer in men who have already been diagnosed. There is however, evidence to suggest that TRT can reduce the risk of heart attack in men with heart disease.
If you don’t wish to speak with your NHS GP about low testosterone levels, then you could consider using a private GP through providers like Nuffield Health or Bupa – some of which might be more specialised in testosterone deficiency. Some men might also choose to visit men’s health clinics (though these can be pricey!).
Because of the lack of awareness and understanding of testosterone deficiency, it’s possible that you might not always get the answers you want from your GP the first time round. In this case, although frustrating, it’s important not to give up if you’re struggling with symptoms. Ask to speak to another doctor, or to be referred to an endocrinologist who can investigate further.
2. Make sure you’re getting enough vitamin D
Vitamin D – often known as the sunshine vitamin – plays an important role in a number of different bodily functions including stronger bones and muscles, improved oral health, and a stronger immune system. But scientists have also found a positive link between testosterone levels and vitamin D in men.
For example, in this 2011 study, 200 men were given either a dose of vitamin D or a placebo drug every day for a year. At the start of the year, all the men had low testosterone levels and were deficient in vitamin D, and at the end of the year, both their vitamin D and testosterone levels had increased.
There are a number of ways you can boost vitamin D levels including spending more time outside, eating more oily fish and mushrooms, or taking a vitamin D supplement (always consult a doctor before taking these, as consuming high doses can be harmful).
To find out whether you are deficient in vitamin D, you can arrange a blood test with your GP. They will be able to advise you on what your levels are, and how best to raise them if needed. Or, to learn more about vitamin D and why we need it to stay healthy, you might want to have a read of our article here.
3. Get some good quality sleep
Not getting enough sleep, or getting too much sleep can lead to a decrease in testosterone levels.
This 2015 study showed that across 1274 men aged 65 and over, getting close to 10 hours sleep led to an increase in testosterone. Another smaller study also suggested that sleep deprivation can decrease testosterone levels, after men who had five hours of sleep or less had 10-15% less testosterone than men who had eight or more hours of sleep.
The NHS advises that most adults need between six and nine hours of sleep as part of a healthy lifestyle. If this isn’t always possible due to a busy work schedule, then catching up on sleep on your days off can still be effective in boosting testosterone levels.
If you’re someone who struggles to get to sleep or stay asleep, then there are a few things you can do that might help. For example, limiting the use of blue-light emitting devices (smartphones, PCs etc) close to bedtime, finding ways to relax and wind down before sleeping, and making sure the conditions in your bedroom are right for sleeping.
For more sleep tips, you might find it helpful to visit the sleep and fatigue section of our site.
4. Research the benefits of ashwagandha supplements
Ashwagandha is a small, evergreen shrub that grows in areas of the Middle East, India, and Africa. It can be taken as a supplement, and is probably best known for its ability to relieve stress – but research has also shown that it can be used to boost testosterone and sperm count in men. To learn more about ashwagandha and its benefits, you might want to take a look at this article from Men’s Health UK.
As with any supplement, it’s important to consult your GP and do your own research before you consider taking anything – as it won’t be suitable for everyone. When buying, it’s also key to stick to reputable sellers, like Holland and Barrett.
5. Exercise regularly, but give yourself time to recover
Multiple studies have highlighted the positive effects of exercise on testosterone levels. A 2012 study showed that physically active men had higher levels of testosterone than sedentary men, while a further study suggested that for overweight men, doing aerobic exercise was more effective at boosting testosterone levels than weight loss diets alone.
There have also been links to higher testosterone levels and strength training, and studies show that lifting weights regularly is an effective way to boost testosterone in the long and short term. If you’d like to read more about the benefits of building strength in later life, then you might want to check out our article, The importance of building strength and balance in your 50s and 60s.
However, scientists have also noted that without adequate rest and recovery time in between sessions (overtraining), exercise can be counterproductive – leading to a decline in testosterone levels. As a general guideline, the NHS recommends that adults do at least 150 minutes of moderate-intensity exercise every week, and do strength activities on at least two days per week.
If you would like to start being more active, then you will hopefully find some inspiration over on the healthy body section of our site.
6. Eat magnesium-rich foods
Science has shown that if testosterone levels and magnesium levels are both low, raising magnesium levels can encourage testosterone levels to return to normal. According to the NHS, the recommended dailа y allowance for adult males is 300mg, and for females, it’s 270mg. Yet, a study of 8,000 British people by Mineral Check revealed that 70% weren’t getting enough.
As well as boosting testosterone levels, magnesium also plays a key role in regulating blood sugar levels, blood pressure, and muscle nerve and function. It also helps to maintain a healthy heartbeat.
Muscle twitches and cramps, high blood pressure, and fatigue are all signs that magnesium levels could be low – and your GP will be able to confirm whether they are by doing a blood test. If magnesium levels are very low, then your GP might recommend taking a supplement.
Magnesium levels can also be boosted naturally by eating foods that contain it. Some of the best sources of magnesium are almonds, dark chocolate, coffee, pumpkin seeds, chia seeds, lentils, chickpeas, oats, and quinoa.
7. Stay hydrated
Seeing as our body is made up of 75% water, it’s perhaps unsurprising that a lot can go wrong when we aren’t hydrated enough – and research shows that testosterone levels are no exception to this. For example, this 2015 study explored the connection between hydration, stress, and testosterone levels in wrestlers. It found that those who maintained hydration during competitions had higher levels of testosterone and lower levels of cortisol (stress hormones) than those who were dehydrated.
The NHS recommends that we should be drinking 6 to 8 glasses of fluid a day – which could include water, sugar-free drinks, tea, coffee, and lower-fat milk.
It’s also worth watching your alcohol intake, as alcohol can cause testosterone levels to fall as soon as 30 minutes after having a drink. The NHS recommends drinking no more than 14 units of alcohol per week (spread over several days). A 330ml bottle of lager, beer or cider for example is 1.7 units, while a 750ml bottle of wine contains 10 units. If you want to check how many units of alcohol you’re drinking per week, then you might consider using this calculator from Alcohol Change UK.
8. Eat a diet containing healthy fats
Science tells us that following calorie-restricted or low fat/fat-free diets can cause testosterone levels to decline in men. It also shows that eating healthy fats can increase testosterone levels in a fairly short space of time. The men in this 2013 study consumed either virgin olive oil or virgin argan oil for three weeks, after which it was found that their testosterone levels had increased by 17.4% and 19.99% respectively.
Healthy fats should always be consumed in moderation as part of a healthy diet, and can include seafood such as salmon, tuna, and sardines, seeds such as chia seeds and flaxseeds, and nuts such as walnuts. This article on Fats and oils that will keep your heart healthy from Heart UK has a few more ideas.
9. Find ways to manage stress
It might sound like a cliche, as we all know stress isn’t good for us – but it has been scientifically proven to lower testosterone levels. Studies show that when you’re stressed, cortisol (stress hormone) levels rise and testosterone levels fall.
Many of us accept and get used to stress as a normal part of daily life, but there are a number of ways that it can be reduced or managed. Sometimes this can mean making larger changes to our lives, like changing jobs or walking away from an unhappy relationship.
Other times, it can involve smaller changes like steering clear of unhealthy habits, learning to challenge negative thoughts, or connecting with others. For more tips and advice, you might want to have a read of our article 7 tips for coping with stress and anxiety.
Low testosterone levels can have a devastating effect on a man’s daily life from struggling with a low mood to having difficulty concentrating at work, through to having little or no interest in sex.
If this sounds familiar, then it’s important to remember that you don’t have to struggle in silence. While there are a number of ideas in this article that might help to boost testosterone levels, there are also medical treatments, such as TRT, which are available on the NHS.
If you’re finding it difficult to cope and need someone to talk to, then you can also contact the Samaritans free on 116 123 – they’re open 24 hours a day, 365 days a year.
Are you struggling with symptoms of low testosterone? Do you have any additional tips that you’d like to share with others? Leave a comment below, or join the conversation on the Rest Less community forum.