Low testosterone impacts around 39% of men aged 45 and over, and it can affect quality of life. Lower sex drive, lack of motivation, and a decrease in muscle and bone mass are just a few of the issues that those with low testosterone may 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This, along with outdated ideas that testosterone levels determine whether males are ‘manly’ or ‘masculine’ enough, needs to change.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 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, it’s important to remember that you’re not alone, and there are many other men going through a similar experience.
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 may need, and can also help to break the stigma surrounding this topic.
As with any health concern, knowledge is power, and the more you understand about low testosterone levels, the better position you’ll be in.
What is testosterone?
Though both male and female bodies produce testosterone, it’s widely referred to as the ‘male sex hormone’ because men have much higher levels than women.
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 cell production
- Sex drive
- Fat distribution
- Bone mass and strength
- Muscle size and strength
Testosterone is also responsible for the development of certain 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 during the late-20s. According to the NHS, levels then steadily decline by around 1% a year from the age of 30 to 40.
Though all men will experience a decline in testosterone levels as they get older, certain lifestyle factors and health conditions can reduce the production of testosterone and sometimes result 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 (nanograms per deciliter) 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
- Hyperthyroidism
- Obesity or extreme weight loss
- High blood pressure
Many prescription drugs can also lower testosterone levels. So if you find out your testosterone levels are low, 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.
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
- Anaemia
- An increase in body fat
- Loss of body hair
- Infertility
- Fatigue
- Low mood/depression
- Difficulty with memory and concentration (‘brain fog‘)
- Loss of drive and determination
Many men also say that low testosterone levels leave 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 an 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 take this free and confidential low testosterone symptom test from the Centre of Men’s Health. Each test result comes with recommendations for next steps, and you can print off your results to show them to your GP.
Is there a link between testosterone levels and prostate cancer?
Scientists are continuing to carry out research into a potential link between testosterone and prostate cancer. Over the years there has been much controversy about whether or not 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, 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. While this 2016 meta-analysis 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 complexities 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 find it helpful to read our article; Prostate health over 50 – signs and symptoms to look out for.
How can I find out whether my testosterone levels are low?
Your GP 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 a 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 do everything from the comfort of your own home. If there are any abnormalities in your results, Thriva 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 can affect men, there’s still help out there if you are struggling with symptoms.
There are also some things you can do to manage, and potentially boost, 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’ll usually arrange is a blood test to confirm whether or not your levels are low. If they are, you might be referred to an endocrinologist, who’ll run some more tests and might offer you testosterone replacement therapy (TRT).
TRT is designed to replace the testosterone you’re lacking. 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 no clear evidence to suggest that TRT will increase the risk of men developing prostate cancer, or that it’ll worsen prostate cancer in men who’ve been diagnosed.
There is, however, evidence to suggest that TRT can reduce the risk of a heart attack in men with heart disease. You can find out more about testosterone replacement therapy on the Centre for Men’s Health website.
If you don’t wish to speak with an NHS GP, you could consider using a private GP through providers like Nuffield Health or Bupa – some of who may be more specialised in testosterone deficiency. Some men also choose to visit men’s health clinics, such as the Centre for Men’s Health (though these can be pricey).
Because of the lack of awareness and understanding surrounding testosterone deficiency, it’s possible that you might not always get the answers you want from your GP the first time around. In this case, while frustrating, it’s important not to give up if you’re struggling with symptoms. Ask to speak to another doctor, or 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. And scientists have also found a positive link between testosterone levels and vitamin D in men.
For example, in this 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, but by 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.
To find out whether you’re deficient in vitamin D, you can arrange a blood test with your GP. They’ll 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 like to read our article, here.
Note: It’s always a good idea to speak to your GP before adding any supplements to your diet. In extreme cases, consuming too much vitamin D can lead to vitamin D toxicity, so it’s worth learning about the risks and following the advice of your doctor.
3. Get good quality sleep
Not getting enough sleep – or getting too much sleep – can lead to a decrease in testosterone levels.
This study showed that across 1,274 men aged 65 and over, getting close to 10 hours of sleep led to an increase in testosterone. Another smaller study also suggested that sleep deprivation can decrease testosterone levels, as men who had five hours of sleep or less were found to have 10-15% less testosterone than men who had eight or more hours of sleep.
The NHS advises that most adults need between seven and nine hours of sleep a night as part of a healthy lifestyle. If this isn’t always possible, catching up on sleep when you can is still effective in boosting testosterone levels.
If you’re someone who struggles to get to sleep or stay asleep, 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 can all help.
For more sleep tips, you might find it helpful to visit the sleep and fatigue section of our website.
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, check out this article from Men’s Health UK.
Note: 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.
This study showed that physically active men had higher levels of testosterone than sedentary men, while another 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 between higher testosterone levels and strength training, and studies show that lifting weights regularly is an effective way to boost testosterone in both the long and short term. If you’d like to read more about the benefits of building strength in later life, 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 and lead 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’d like to start being more active, you’ll find plenty of inspiration over on the fitness and exercise section of our website. Or, for guided fitness workouts, why not check out Rest Less Events? There’s everything from Tai Chi and yoga to aerobic fitness and dance classes.
6. Eat magnesium-rich foods
Studies have shown that if testosterone levels and magnesium levels are both low, raising magnesium levels can encourage testosterone levels to increase.
According to the NHS, the recommended daily allowance of magnesium for adult males is 300mg. Yet, research suggests that around 70% of the UK population aren’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 your magnesium levels are very low, your GP may recommend taking a supplement.
Magnesium levels can also be boosted naturally by eating magnesium-rich foods. Some of the best sources of magnesium are almonds, dark chocolate, coffee, pumpkin seeds, chia seeds, lentils, chickpeas, oats, and quinoa.
If you’d like to learn more about magnesium, check out our article; Magnesium – what it is and why it’s important.
7. Stay hydrated
Seeing as the body is made up of 75% water, it’s not surprising that a lot can go wrong when we aren’t hydrated. And research shows that testosterone levels are no exception to this.
For example, this study explored the connection between hydration, stress, and testosterone levels in wrestlers. It found that those who were well hydrated during competitions had higher levels of testosterone and lower levels of cortisol (the stress hormone) than those who were dehydrated.
The NHS recommends that we should be drinking six to eight glasses of fluid a day – which can include water, sugar-free drinks, tea, coffee, and lower-fat milk.
It’s also worth watching your alcohol intake, as research shows that 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, you can use this calculator from Alcohol Change UK.
For more tips on hydration, our articles, How to make healthier drink choices and 9 healthy and hydrating alternatives to water, are worth a read.
8. Eat a diet containing healthy fats
Research 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 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 (like chia seeds and flaxseeds), and nuts (such as walnuts). Heart UK’s article on fats and oils that will keep your heart healthy has a few more ideas.
9. Manage stress
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, levels of cortisol (the stress hormone) 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 switching 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 like to have a read of our article; 7 tips for coping with stress and anxiety.
You may also like to browse the health and wellbeing events running on Rest Less Events. Classes such as laughter yoga or The soothing season: relaxation and art making may be helpful ways to begin managing stress.
Final thoughts...
Low testosterone levels can significantly affect a man’s daily life; from struggling with a low mood and having difficulty concentrating at work to having little or no interest in sex.
If this sounds familiar, 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.
There are also various resources available where you can find further help and support, such as the Men’s Health Forum, ManHealth, Men’s Health UK, and the Centre for Men’s Health.
If you’re finding it difficult to cope and need someone to talk to, you can also contact the Samaritans for free on 116 123. They’re available 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? We’d love to hear from you in the comments below.
