Testosterone is the primary male sex hormone and is responsible for the development of male characteristics like muscle mass, body hair growth, and sperm production. While testosterone levels naturally decline with age, there are several lifestyle factors that can cause it to dip abnormally low. Low testosterone, also known as hypogonadism, can negatively impact your physical and mental health. Identifying what causes low testosterone is key to preventing or reversing this condition.
Age
Age is one of the most common causes of low testosterone in men. Testosterone levels peak during adolescence and early adulthood, when men are in their physical prime. After age 30, testosterone levels start to gradually decline by about 1% per year. It’s estimated that 30% of men over the age of 50 have low testosterone. While this decline is a normal part of aging, significant drops in testosterone can lead to troubling symptoms like loss of muscle mass, increased body fat, reduced libido, erectile dysfunction, depression, irritability, and low energy. If testosterone levels dip below a certain threshold, hormone replacement therapy may be recommended by your doctor.
Obesity
Carrying excess body fat, especially in the belly region, is associated with lower testosterone levels. The mechanisms behind this effect aren’t entirely clear, but it’s thought that fat cells metabolize and convert testosterone into estrogen. This reduces the amount of circulating testosterone in the body. A major study published in the European Journal of Endocrinology found that obese men were more likely to suffer from hypogonadism than men of normal weight. Losing weight through diet and exercise may help raise testosterone in obese men. According to research, weight loss of just 5-10% of body weight can increase testosterone dramatically.
Diabetes
Diabetes impairs the body’s ability to regulate blood sugar. High blood sugar levels and insulin resistance are both linked to lower testosterone in men. The mechanisms are not fully understood, but may involve damage to testicular Leydig cells, which produce testosterone. In one study, nearly half of diabetic men under 45 had low testosterone levels. Treating diabetes and maintaining good glycemic control can help normalize testosterone. If you have diabetes, monitoring your testosterone levels is important.
Metabolic Syndrome
Metabolic syndrome refers to a cluster of conditions like hypertension, high blood sugar, unhealthy cholesterol levels, and excess abdominal fat. Men with metabolic syndrome are more likely to have reduced testosterone levels compared to men without the condition, according to scientific reviews. Low testosterone is also predictive of developing metabolic syndrome later in life. The link may be due to the effects of chronic inflammation, insulin resistance, and obesity associated with metabolic syndrome. Treating components of metabolic syndrome like high blood pressure, blood sugar, and dyslipidemia may help raise testosterone.
Medications
Certain prescription drugs can lower testosterone as an adverse side effect. Medications that commonly interfere with testosterone production include:
Corticosteroids
Corticosteroids like prednisone and dexamethasone are powerful anti-inflammatory drugs used for treating conditions like asthma, arthritis, and inflammatory bowel disease. Long-term use can impair the function of the testes and pituitary gland, reducing testosterone synthesis.
Opioid Painkillers
Opioids like morphine, oxycodone, and fentanyl are highly effective analgesics, but long-term use often causes low testosterone. Research suggests opioids inhibit GnRH secretion from the hypothalamus, reducing stimulation of the testes.
Prostate Cancer Medications
Drugs that treat prostate cancer like leuprolide and goserelin work by directly suppressing testosterone production. Androgen deprivation therapy helps slow cancer growth in advanced prostate cancer. Aromatase inhibitors like anastrozole prevent the conversion of testosterone into estrogen to treat some types of breast cancer in postmenopausal women.
| Medication Class | Examples |
| Corticosteroids | Prednisone, Dexamethasone |
| Opioid Painkillers | Morphine, Oxycodone, Fentanyl |
| Prostate Cancer Drugs | Leuprolide, Goserelin |
If possible, doctors try to prescribe the lowest effective dose for the shortest time to limit adverse effects on hormone levels. Always discuss side effects with your physician and never abruptly stop prescribed medications unless directed by your healthcare provider.
Chemotherapy
Chemotherapy drugs kill rapidly dividing cancer cells but can damage other healthy tissues like the testes in the process. Alkylating agents like cyclophosphamide are particularly toxic to reproductive cells. The degree of testosterone suppression depends on the drug, dosage, and treatment duration. In many cases, testosterone production recovers after chemotherapy ends, but permanent infertility is possible. Potential medications effects on hormones and fertility should be discussed before starting chemotherapy.
Radiation Therapy
Radiation aimed near or directly at the testes can reduce testosterone production. The testes are very sensitive to radiation therapy. Even low radiation doses during treatment for cancers like rectal, prostate, bladder, and colon can lower testosterone levels. One study in prostate cancer patients found that testosterone levels decreased by 95% after radiotherapy but partially recovered after 12 months. Shielding reproductive tissues as much as possible and limiting radiation doses can help conserve testicular function.
Chronic Illness
Severe or chronic illness often causes reduced testosterone synthesis and elevated stress hormones like cortisol. Studies show that men hospitalized in intensive care units or with critical injuries like burns or trauma often develop very low testosterone. Chronic inflammatory conditions like rheumatoid arthritis, inflammatory bowel disease, HIV, and congestive heart failure are also associated with hypogonadism. While illness-related drops in testosterone typically resolve once health is restored, monitoring hormones in chronic illness is prudent. Optimizing overall health is key to maintaining normal testosterone.
Liver or Kidney Disease
The liver and kidneys play key roles in hormone metabolism. Liver diseases like cirrhosis impair the body’s ability to break down and eliminate sex hormone-binding globulin (SHBG), resulting in lower levels of free testosterone available to tissues. Advanced liver or kidney disease can shift the balance between testosterone and estrogen and cause deficiencies of testosterone and other anabolic hormones. Diagnosing and treating any underlying issues with liver or kidney function may help normalize testosterone.
HIV/AIDS
Studies show that low testosterone is a common complication in men with human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS). Testosterone deficiency tends to be greater in men with more advanced disease and higher viral loads. The reasons are multifactorial and may involve direct testicular infection, adverse effects of medications like opioids, or associated weight loss. Checking testosterone levels is advisable in men with HIV. Testosterone therapy may help counteract muscle wasting but should be used cautiously to avoid accelerating disease progression.
Alcoholism
Chronic excessive alcohol consumption is toxic to the testes and disrupts the HPG axis regulating testosterone synthesis. Studies indicate that hypogonadism affects up to one-third of alcoholic men. The degree of impairment correlates with the duration and severity of alcohol abuse. Complete recovery of testosterone levels usually takes weeks to months of sustained abstinence. Seeking treatment for alcoholism allows the testes to heal and restore normal hormone production.
Anabolic Steroid Abuse
Paradoxically, abusing anabolic steroids suppresses natural testosterone production. Exogenous androgens shut down signals from the hypothalamus and pituitary to the testes. This inhibits production of sperm and testosterone. Prolonged anabolic steroid use often causes persistent hypogonadism lasting months after drug withdrawal, sometimes requiring testosterone replacement therapy. Avoiding anabolic steroids altogether is recommended to maintain normal testosterone function.
Stress
While moderate stress can actually increase testosterone, chronic or severe stress often contributes to abnormally low levels. Sustained elevated cortisol from stress can suppress reproductive hormones through inhibition of GnRH. High cortisol also encourages conversion of testosterone into estrogen. Overtraining, extreme endurance exercise, and psychological stress are some of the top contributors to stress-related low testosterone. Stress management techniques like meditation, yoga, adequate sleep, and reducing overtraining may help restore testosterone balance.
Poor Sleep
Getting inadequate sleep disturbs the circadian rhythm governing testosterone release. Studies show that just one week of sleep restriction to 5 hours per night can reduce morning testosterone levels by up to 15%. Getting sufficient high-quality sleep consistently is key to maintaining healthy testosterone levels. Aim for 7-9 hours per night of uninterrupted sleep. Evaluate and treat any sleep disorders like sleep apnea which suppress deep restorative REM sleep.
Zinc or Vitamin D Deficiency
Certain vitamin and mineral deficiencies can negatively impact testosterone synthesis. Zinc and vitamin D are particularly important for modulating testosterone production and metabolism. Deficiency in either nutrient is associated with low testosterone in men based on research. Adequate zinc intake helps sustain testosterone levels, while vitamin D is needed convert testosterone precursors into testosterone. Checking levels and correcting any deficiencies through diet or supplementation may support healthy testosterone.
Diet
What you eat significantly influences testosterone and other hormone levels. Diets high in processed foods, refined carbs, and unhealthy fats can increase inflammation, promote weight gain, and reduce testosterone. However, research shows that limiting sugar, eating enough protein, consuming healthy fats, and increasing intake of micronutrients supports healthy testosterone function. A balanced, nutritious diet optimized for hormonal health provides the raw materials for robust testosterone production.
| Foods That Lower Testosterone | Foods That Increase Testosterone |
|---|---|
| Processed grains | Oysters |
| Sugar | Beef |
| Trans fats | Eggs |
| Soy protein | Beans |
| Excess alcohol | Olive oil |
| Mint | Garlic |
| Licorice root | Mushrooms |
| Low fat diets | Avocados |
Lack of Exercise
Failing to exercise regularly contributes to muscle loss, increased body fat, and weight gain – all of which influence testosterone levels negatively. However, overtraining and excessive endurance workouts have also been implicated in lowering testosterone. Aim for a balanced exercise program that provides sufficient physical activity without overtaxing the body. This helps maintain fitness and lean muscle mass which support robust testosterone production.
Genetic Conditions
Certain genetic disorders present at birth are associated with low testosterone. For example, Klinefelter’s syndrome is a chromosomal abnormality in which men carry an extra X chromosome. The condition is characterized by small, underdeveloped testes resulting in insufficient testosterone. Other congenital conditions like undescended testes, hemochromatosis, pituitary disorders, and androgen insensitivity syndrome can also impair testosterone synthesis. Genetic testing and hormone evaluation can help diagnose such disorders early.
Inflammation
Chronic low-grade inflammation appears to suppress testosterone levels based on emerging research. Conditions that increase inflammatory cytokines like IL-1, IL-6, and TNF-alpha seem to disrupt proper functioning of the hypothalamic-pituitary-testicular axis. Chronic inflammation also encourages conversion of testosterone to estrogen via increased aromatase enzyme activity. Identifying and addressing sources of inflammation through lifestyle, diet, and stress reduction may support healthier testosterone balance.
Environmental Toxins
Exposure to certain environmental toxins and chemicals may interfere with proper testosterone function. Pesticides, phthalates, parabens, and bisphenol-A (BPA) act as “anti-androgens” that block or suppress testosterone activity according to animal and human studies. Minimizing use of plastics, personal care products with harsh chemicals, and consumption of contaminated food when possible limits exposure to substances that may disrupt hormones.
Lifestyle Changes to Boost Testosterone
While many factors can reduce testosterone levels, making targeted lifestyle changes can often help reverse this downward trajectory and maintain youthful testosterone production. Key strategies for optimizing testosterone naturally include:
Achieve and Maintain a Healthy Body Weight
Carrying excess fat, especially abdominal fat, lowers testosterone and contributes to many associated health conditions. Losing weight if overweight or obese can significantly increase testosterone.
Follow a Nutritious, Hormone-Supporting Diet
Limit sugar, refined grains, and unhealthy fats. Increase intake of protein, healthy fats, and micronutrient-dense foods to provide the building blocks for robust testosterone synthesis.
Reduce Stress and Practice Stress Management
Chronic stress elevates cortisol and adversely affects testosterone over time. Stress-relieving practices like meditation, yoga, journaling, and spending time in nature can rebalance hormones.
Optimize Sleep Quantity and Quality
Aim for 7-9 hours per night, avoid sleep deprivation, and treat any sleep disorders causing disruption for healthy circadian testosterone rhythms.
Exercise Regularly But Avoid Overtraining
Engage in vigorous exercise most days of the week, but limit excessive endurance training that may suppress testosterone. Weight training helps build muscle and raise T.
Correct Nutrient Deficiencies
Check levels of key nutrients tied to testosterone like zinc, vitamin D, and magnesium. Address inadequacies through diet and/or supplementation.
Limit Alcohol Intake
Heavy drinking has deleterious effects on testosterone. Moderating alcohol consumption supports healthy T levels.
Quit Smoking
Tobacco smoking reduces testosterone synthesis. Kicking the habit can help restore normal testosterone function.
Minimize Exposure to Harmful Chemicals
Avoid plastics, parabens, phthalates, and other environmental anti-androgens that may disrupt testosterone activity.
Medical Treatment
In cases of clinically low testosterone with bothersome symptoms, testosterone replacement therapy may be warranted under the care of a physician. Options include:
Injections
Testosterone injections (cypionate, enanthate) directly supply the body with bioidentical testosterone and can rapidly restore levels. Injections are typically administered every 1-2 weeks.
Transdermal Gels and Patches
Gels supply testosterone through the skin. Patches worn on the arm or upper body provide sustained testosterone absorption over 24 hours.
Oral Capsules
Testosterone undecanoate, an oral form, is absorbed through the lymphatic system but offers less customizable dosing.
Implants
Testosterone pellets implanted under the skin supply steady hormone levels over 4-6 months.
Underlying health conditions leading to low testosterone should always be evaluated. Careful monitoring of T levels, side effects, and prostate health are important with testosterone replacement.
Key Takeaways
– Normal testosterone function is vital for men’s physical and mental health. Unfortunately, testosterone levels decline with age and may dip too low prematurely due to lifestyle factors.
– Obesity, diabetes, poor diet, alcohol excess, opioid painkillers, stress, and inadequate sleep can all suppress testosterone over time.
– Medical conditions like chronic illness, liver or kidney disease, radiation exposure, chemotherapy drugs, anabolic steroid abuse, and genetic disorders also lower testosterone.
– Environmental toxins, inflammation, and vitamin/mineral deficiencies negatively impact testosterone as well.
– Losing weight, reducing stress, optimizing sleep, limiting alcohol, exercising smarter, correcting nutritional inadequacies, and avoiding exposure to anti-androgens can help restore healthy testosterone balance.
– Testosterone therapy may be appropriate for persistently low levels under medical supervision, along with lifestyle optimization.