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What lifestyle changes can help with low testosterone?

Updated

Certain lifestyle changes can significantly impact testosterone levels, particularly in aging men. Weight management is crucial; studies show that weight loss is associated with increased testosterone and sex hormone-binding globulin (SHBG) levels, while weight gain leads to a decrease in these hormones. Obesity-induced hypogonadism can be mitigated by weight loss, as shown by a meta-analysis indicating significant increases in testosterone levels in obese men who lost weight. Dietary changes also play a role; the effects of low-carbohydrate diets on testosterone levels are mixed, with short-term increases in cortisol levels possibly negatively impacting testosterone, while high-protein, low-carbohydrate diets have been shown to decrease resting testosterone levels. Additionally, diets low in fat combined with exercise can reduce serum hormones, including testosterone, but may also reduce prostate cancer cell growth.

Regular exercise, especially resistance training and high-volume moderate-intensity exercise, has been shown to increase testosterone levels. A study found that higher volumes of exercise significantly increased testosterone and improved sexual function in obese men. Combining exercise with dietary interventions, such as a very-low-calorie diet, enhances the benefits on testosterone levels and overall health by maintaining lean body mass and improving glucose tolerance. Smoking cessation is also important, as quitting smoking is associated with a greater decline in testosterone levels compared to non-smokers, suggesting a direct impact of smoking on testosterone levels. Metabolic and bariatric surgeries, such as Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), significantly increase testosterone levels in men with obesity and improve inflammatory and endothelial biomarkers. Managing comorbid conditions like metabolic syndrome and type 2 diabetes is also critical, as lifestyle interventions, including diet and exercise, can improve glycemic control and metabolic health, increasing testosterone levels. Regular monitoring and consultation with healthcare providers are essential to tailor these interventions to individual needs.

Further Reading:

  1. Camacho, E. M., Huhtaniemi, I. T., O’Neill, T. W., Finn, J. D., Pye, S. R., Lee, D. M., Tajar, A., Bartfai, G., Boonen, S., Casanueva, F. F., Forti, G., Giwercman, A., Han, T. S., Kula, K., Keevil, B., Lean, M. E., Pendleton, N., Punab, M., Vanderschueren, D., & Wu, F. C. W. (2013). Age-associated changes in hypothalamic–pituitary–testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study. European Journal of Endocrinology, 168(3), 445–455. https://doi.org/10.1530/eje-12-0890 
  2. Whittaker, J., & Harris, M. (2022). Low-carbohydrate diets and men’s cortisol and testosterone: Systematic review and meta-analysis. Nutrition and Health, 026010602210830. https://doi.org/10.1177/02601060221083079 
  3. Gie Ken‐Dror, Fluck, D., Christopher Henry Fry, & Thang Sieu Han. (2023). Meta‐analysis and construction of simple‐to‐use nomograms for approximating testosterone levels gained from weight loss in obese men. Andrology, 12(2), 297–315. https://doi.org/10.1111/andr.13484 
  4. Cobeta, P., Pariente, R., Osorio, A., Marchan, M., Blázquez, L., Pestaña, D., Galindo, J., & Botella-Carretero, J. I. (2022). The Beneficial Changes on Inflammatory and Endothelial Biomarkers Induced by Metabolic Surgery Decreases the Carotid Intima-Media Thickness in Men. Biomolecules, 12(12), 1827–1827. https://doi.org/10.3390/biom12121827 
  5. Heufelder, A. E., Saad, F., Bunck, M. C., & Gooren, L. (2009). Fifty-two-Week Treatment With Diet and Exercise Plus Transdermal Testosterone Reverses the Metabolic Syndrome and Improves Glycemic Control in Men With Newly Diagnosed Type 2 Diabetes and Subnormal Plasma Testosterone. Journal of Andrology, 30(6), 726–733. https://doi.org/10.2164/jandrol.108.007005 
  6. Ann-Cathrin Koschker, & Seyfried, F. (2023). Comment on: The male patient with obesity undergoing metabolic and bariatric surgery: changes in testosterone levels correlate with weight loss after one-anastomosis gastric bypass and Roux-en-Y gastric bypass. Surgery for Obesity and Related Diseases, 19(7), 705–706. https://doi.org/10.1016/j.soard.2023.01.009 
  7. Tymchuk, C. N., Barnard, R. J., Ngo, T. H., & Aronson, W. J. (2002). Role of Testosterone, Estradiol, and Insulin in Diet- and Exercise-Induced Reductions in Serum-Stimulated Prostate Cancer Cell Growth In Vitro. Nutrition and Cancer, 42(1), 112–116. https://doi.org/10.1207/s15327914nc421_15 
  8. Jedamzik, J., Bichler, C., Daniel Moritz Felsenreich, Brugger, J., Jakob Eichelter, Nixdorf, L., Krebs, M., Itariu, B., Langer, F. B., & Prager, G. (2023). The male patient with obesity undergoing metabolic and bariatric surgery: changes in testosterone levels correlate with weight loss after one-anastomosis gastric bypass and Roux-en-Y gastric bypass. Surgery for Obesity and Related Diseases, 19(7), 699–705. https://doi.org/10.1016/j.soard.2022.12.034 
  9. Khoo, J., Tian, H.-H., Tan, B., Chew, K., Ng, C.-S., Leong, D., Teo, R. C.-C., & Chen, R. Y.-T. (2013). Comparing Effects of Low- and High-Volume Moderate-Intensity Exercise on Sexual Function and Testosterone in Obese Men. The Journal of Sexual Medicine, 10(7), 1823–1832. https://doi.org/10.1111/jsm.12154 
  10. Krotkiewski, M., Toss, L., Björntorp, P., & Holm, G. (1981). The effect of a very-low-calorie diet with and without chronic exercise on thyroid and sex hormones, plasma proteins, oxygen uptake, insulin and c peptide concentrations in obese women. International Journal of Obesity, 5(3), 287–293. https://pubmed.ncbi.nlm.nih.gov/7024157/