Medically Reviewed By Kelly Wood, MD
— Written By Dr Christopher Oseh Updated on August 15, 2022
This article is a repost which originally appeared on healthgrades.
Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.
Our Takeaways:
· Testosterone controls a number of physiological functions in adult males.
· Older males typically experience a reduction in testosterone levels due to a number of factors.
· There are many ways to naturally increase testosterone levels.
There are different interventions to increase testosterone. Testosterone naturally reduces in males as they grow older. Individuals with low testosterone may notice symptoms such as decreased sexual drive and unusual tiredness.
Read on to learn more about the treatment methods and natural remedies that could boost your blood testosterone level.
What is testosterone?
Testosterone is a male sex hormone produced in the testis — the male reproductive organ. Testosterone binds to albumin and sex hormone binding globulin as it circulates in the blood, while some exist in an unbound form. Regulatory hormones in the pituitary gland regulate the production of testosterone.
Testosterone production starts from the seventh week of gestation in a male embryo. The amount gradually rises and helps in the development of the male genitals in utero. A few months after birth, the blood concentration of testosterone in male infants drops and peaks again at puberty.
The liver, prostate, and reproductive tissues contain an enzyme called 5α reductase, which converts testosterone to its metabolite — dihydrotestosterone.
Testosterone and dihydrotestosterone are responsible for the development of male sexual characteristics.
Testosterone controls physiologic functions in adult males, such as:
‧ sexual drive
‧ muscular tone
‧ sperm production
‧ red blood cells
Adult males may notice a decline in these functions when their testosterone level drops.
What are the symptoms of low testosterone in males?
Symptoms of low testosterone levels are nonspecific. However, if you have low testosterone, sexual and nonsexual symptoms may manifest.
Here are some sexual symptoms you could notice:
‧ decreased sexual desire or libido
‧ reduced frequency or rigidity of nocturnal erections
‧ erectile dysfunction
Nonsexual symptoms include:
‧ unexplained fatigue
‧ decreased energy
‧ difficulty concentrating
‧ decreased sense of well-being
‧ depressed mood
These symptoms alone are not adequate to diagnose low testosterone. Your doctor will typically conduct a physical examination and order some investigations to identify the possible causes of low testosterone levels.
Low testosterone causes vary depending on the age of the individual. For instance, genetic and acquired conditions that affect the testis may lead to low testosterone levels in young males.
In addition to medical conditions affecting the testis, older males typically experience a natural reduction in blood testosterone. This is due to the gradual decline in regulatory hormones that influence testosterone production.
The combination of your clinical history and investigation findings is essential in diagnosing low testosterone.
However, if you experience any of these symptoms, contact your doctor.
How can doctors help increase testosterone?
After confirmation of low testosterone, your doctor will typically initiate a treatment called testosterone replacement therapy (TRT). TRT involves administering testosterone medication to boost testosterone concentration in your blood.
Testosterone medication exists in various preparations. Your doctor will generally carry out a clinical assessment to identify the most effective type of medication for your individual needs, best formulation, or route of delivery for you.
Oral testosterone replacement therapy
This type of medication involves the oral intake of testosterone capsules to boost the blood testosterone level. However, as a result of low absorption and liver toxicity, doctors do not typically prescribe testosterone capsules to individuals with low testosterone.
Buccal testosterone replacement therapy
Buccal testosterone preparations have adhesive features that enable adhesion to the gums in the mouth. After dissolving in the gums, the blood vessels in the gums absorb the medication. This allows the medication to bypass the liver and the gastrointestinal tract.
Because of the above characteristics, buccal testosterone formulations are generally more tolerable than oral capsules.
Nasal testosterone replacement therapy
This form of TRT involves self-administering nasal pumps to administer intranasal testosterone gel into the nasal cavity. The blood vessels in the nasal mucous membrane absorb the nasal gel into the systemic circulation. Some individuals who use Intranasal testosterone may have side effects, such as:
‧ sinusitis
‧ nasal discomfort
‧ rhinitis
‧ nose bleeds
If you use intranasal testosterone and you experience any of these symptoms, contact your doctor.
Intramuscular testosterone replacement therapy
This type of medication entails injecting oil suspensions of testosterone into the muscles. Your doctor may prescribe long-acting intramuscular testosterone preparations for weekly injections. This ensures convenience and also improves compliance and adherence to therapy.
Transdermal testosterone replacement therapy
This form of TRT involves administering transdermal testosterone gels or patches over the skin. Your doctor will typically apply transdermal patches or gels on the skin where the blood vessels absorb it.
These areas generally include:
‧ surfaces of your abdomen
‧ upper arm
‧ thigh
To reduce the onset of local skin irritations, rotate the skin area where you apply the transdermal gels or patches.
Contraindications to testosterone replacement therapy
Though testosterone replacement therapy is effective, it is not suitable for some individuals. Some contraindications to TRT include:
‧ hematocrit above 48%
‧ prostate cancer
‧ uncontrolled heart failure
‧ a recent episode of myocardial infarction or cerebrovascular accident
‧ untreated obstructive sleep apnea
‧ fertility planning in males
‧ elevated PSA above 4 ng/mL
How can you naturally increase testosterone?
A 2018 study showed that eating foods rich in specific vitamins and minerals can maintain testosterone. However, it may not be possible to increase it without medical intervention. Here are some foods and supplements that can support the blood testosterone level.
Natural cocoa products
Natural cocoa products such as cocoa powder contain flavonoids — plant-based antioxidants with potent anti-inflammatory properties. These flavonoids promote the formation of steroids required for testosterone production and support the testicular cells.
A few studies reveal that flavonoids facilitate the process of testosterone production in the testis.
Magnesium-rich foods
A 2011 study suggested that magnesium increases insulin-like growth factor 1, which stimulates the process essential for testosterone formation. Intake of some fruits such as avocados or leafy vegetables, which are sources of magnesium, may maintain your testosterone level.
Selenium foods
Animal and human studies of selenium demonstrate its potential benefits and support in the male reproductive system. Selenium has strong antioxidant properties that promote male fertility. However, more clinical studies are essential to show its potential benefits in humans.
Herbal extracts
Certain herbs may support the production of testosterone. A 2020 research review revealed that some leaf and root herbal extracts positively affected testosterone concentrations in male study respondents.
However, as a result of dosage variations and safety concerns, further studies are critical in establishing the efficacy of these herbal extracts.
Reduce alcohol intake
Frequent consumption of alcohol adversely impacts testosterone production in multiple ways. Firstly, a high intake of alcohol disrupts the balance in the pituitary hormones that regulate testosterone production.
Also, a high concentration of alcohol in the blood may cause damage to the testosterone-producing glands and cells in the testis.
Studies with male rats showed that chronic alcohol intake negatively impacted their overall fertility and the structures in their reproductive tracts.
Therefore, reducing your quantity and frequency of alcohol intake can have a positive reproductive health impact.
Summary
Testosterone is a male steroid hormone produced in the testis. In older males, blood testosterone levels typically drop naturally. However, young adult males may have low testosterone levels if they have medical conditions that damage the testosterone-secreting glands in the testis.
You may notice symptoms of low testosterone levels such as decreased sexual desire or libido, erectile dysfunction, unexplained fatigue, and reduced energy.
Even though intake of certain fruits like natural cocoa products or some herbal extracts may maintain testosterone levels, testosterone replacement therapies are typically the most effective treatment for low testosterone.
Contact your doctor for clinical evaluation and to discuss the most appropriate TRT intervention for you.
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