Low Testosterone, commonly referred to as Low-T, is a condition that peaks interest and concern among many as they age. It is characterized by a decrease in the levels of testosterone, the vital hormone responsible for defining many aspects of male health and development.

What is Low Testosterone & How Do You Fix It?
What Is Low Testosterone - Image/Shutterstock

From impacting muscle mass and sex drive to influencing mood and energy levels, the role of testosterone in one’s well being cannot be overstated[1]. With age, however, the natural production of this crucial hormone tends to wane, prompting a range of physical and emotional symptoms that can affect a man’s quality of life. This guide aims to shed light on what exactly Low Testosterone is, its signs and implications, and most importantly, how we can address it to restore balance and vitality to our lives.

Symptoms That Might Point to Low Testosterone

Spotting the signs of low testosterone is key to tackling the issue before it takes a toll on your quality of life. Known as low T, this condition can show up with a range of symptoms impacting your physical and mental well-being. A study published in Frontiers in Neuroscience explored the impact of testosterone on brain behavioral functions[2]. Here’s a breakdown to shed light on these telltale signs:

Physical Symptoms:

  • Decreased muscle strength and mass
  • Increased body fat, particularly around the waist
  • Reduced facial and body hair growth
  • Development of breast tissue
  • Fatigue even after sufficient rest

Sexual Health Symptoms:

  • Lowered libido or sex drive
  • Difficulties achieving or maintaining an erection (erectile dysfunction or ED)
  • Lowered sperm count which can affect fertility

Mental and Emotional Symptoms:

  • Mood swings, irritability, or unexplained mood changes
  • Increased feelings of depression
  • Sleep disturbances or insomnia

It’s essential to keep in mind that these symptoms might not solely indicate low T as they can overlap with other health conditions. However, if you’re experiencing a combination of these signs, it’s advisable to approach a healthcare professional for a proper diagnosis. They may suggest a simple blood test to measure your testosterone levels, ensuring an accurate assessment and appropriate treatment plan.

What Causes Low Testosterone?

Causes of Low Testosterone

Causes of Low Testosterone

Understanding the underlying causes and risk factors of low testosterone is crucial for identifying and addressing this condition. The decline in testosterone levels is a natural part of aging, with men typically experiencing about a 1% decrease per year after reaching the age of 30[3]. However, aside from aging, several other factors can contribute to lower testosterone levels:

Medical Conditions:

Conditions like obesity, type 2 diabetes, chronic liver or kidney disease, and heart failure can significantly impact testosterone production.

Injuries and Infections:

Damage or injuries to the testicles, as well as infections like mumps, can impair the body’s ability to produce testosterone.

Medications and Substances:

Certain medications, including chemotherapy drugs, corticosteroids, and opioids, along with substance abuse like alcohol, can lower testosterone levels.

Genetic Factors:

Genetic conditions such as Klinefelter syndrome and Kallmann syndrome can cause lower-than-normal levels of testosterone[4].

Other Factors:

Autoimmune diseases, chronic obstructive lung disease, metabolic disorders, and conditions affecting the pituitary gland like prolactinoma can also lead to reduced testosterone production.

It’s key to note that while some men have a clear reason for lower testosterone levels, others may have multiple contributing factors, and in some cases, the cause remains unknown. Recognizing these causes and risk factors empowers individuals and healthcare providers to approach low testosterone with a comprehensive understanding, enabling targeted interventions and treatment strategies.

Diagnosing Low Testosterone

Detecting low testosterone levels typically begins with a simple but crucial blood test. This test measures total testosterone levels in the body, providing valuable insight for healthcare professionals.

Diagnosing Low Testosterone

Diagnosing Low Testosterone

The Endocrine Society released results from a recent study that have played a crucial role in defining the typical ranges for testosterone levels in individuals identified as male at birth, ranging from 264 to 916 nanograms per deciliter (ng/dL)[5].

If testosterone levels are found to be below the normal range, it’s often the first indicator of low T, prompting further investigation to identify the root cause. The diagnostic process extends beyond a single test to include a comprehensive evaluation aimed at understanding the broader hormonal landscape:

  • Total Testosterone Level: The primary indicator checked to assess whether testosterone levels fall within a normal range.
  • Luteinizing Hormone (LH): Abnormal LH levels can hint at issues with the pituitary gland, which plays a significant role in hormone regulation and can affect testosterone production.
  • Blood Prolactin Level: Elevated prolactin levels may indicate the presence of pituitary gland tumors or other pituitary-related problems.
  • Blood Hemoglobin (Hgb): Critical for evaluating overall health and detecting conditions that could be linked with low T.

Additionally, healthcare providers may recommend further tests depending on individual symptoms and initial test results:

  • Follicle Stimulating Hormone (FSH): Checked to assess sperm production functionality.
  • Estradiol Hormone Test: Conducted when symptoms include enlarged breasts, which could suggest estrogen imbalances.
  • Glycosylated Hemoglobin (HgbA1C): This blood test screens for diabetes by measuring blood sugar attachment to hemoglobin.
  • Thyroid Hormone Levels: To rule out or identify thyroid-related hormone imbalances.
  • Cortisol Level: Investigates the possibility of other hormonal abnormalities.
  • Magnetic Resonance Imaging (MRI): An MRI of the pituitary gland might be performed if a pituitary problem is suspected[6].
  • Bone Density Tests: Given that low testosterone can lead to bone density loss, this test can be crucial for assessing bone health.
  • Karyotype (Chromosome Tests): Occasionally performed to identify any genetic contributions to low testosterone levels.

Establishing a diagnosis with such detailed hormonal and physiological evaluations allows for a comprehensive approach to treatment. With timely and appropriate intervention, individuals can look forward to a positive prognosis, including the reversal of symptoms and prevention of complications such as muscle and bone loss.

Treatment Options for Low Testosterone

Managing low testosterone levels involves a multifaceted approach that prioritizes safety and effectiveness. The primary treatment, known to provide significant benefits, is Testosterone Replacement Therapy (TRT). TRT aims to restore testosterone to normal levels, thereby improving various aspects of health and well-being[7].

TRT can be administered in several forms:

  • Gels: Applied directly to the skin, allowing testosterone to be absorbed into the body.
  • Patches: Worn on the skin and replaced regularly to provide a steady release of testosterone.
  • Injections: Periodic testosterone shots given by a healthcare provider.
  • Pellets: Implanted under the skin, these slow-release pellets deliver consistent testosterone levels for several months.

The benefits of TRT are substantial, offering:

  • Enhanced libido and improved erectile functions.
  • Increased energy levels and mood improvement.
  • Boosts in muscle mass and bone density.

However, it’s crucial to explore all avenues when considering treatment for low testosterone. Beyond TRT, other potential treatment options include:

  • Herbal Supplements: While some claim to boost testosterone levels, it’s essential to approach with caution due to a lack of consistent research backing their effectiveness[8].
  • Dietary Adjustments: Incorporating foods high in zinc and vitamin D can support the body’s natural testosterone production. Foods like oysters, fortified cereals, and fatty fish can be beneficial.

The importance of consulting with a healthcare professional cannot be overstressed. They can provide a thorough assessment, confirm testosterone levels through tests, and recommend a treatment plan tailored to individual needs. Always discuss potential treatments and their FDA approval status with your doctor to ensure safety and efficacy.

Lifestyle Changes for a Testosterone Boost

While not a direct fix, certain lifestyle changes might slightly elevate testosterone levels:

  • Weight loss and exercise: Maintaining a healthy weight and engaging in regular exercise, particularly weight training, can offer a slight testosterone boost. Research indicates that engaging in exercise, particularly cardiovascular activities, may aid in weight loss, potentially leading to elevated testosterone levels[9].
  • Adequate sleep: Aim for 7-8 hours of quality sleep each night, as sleep deprivation can lower testosterone.
  • Stress management: Chronic stress can negatively impact testosterone levels. Techniques like meditation or yoga may help manage stress[10].

Side Effects of Testosterone Replacement Therapy

To consider testosterone replacement therapy (TRT), understanding its side effects is crucial. While TRT has benefits, like any medical treatment, it has risks that need careful consideration.

  • Prostate Health Issues: There’s an increased risk of developing prostate problems, including the potential growth of existing prostate cancer.
  • Sleep Disturbances: Some individuals may experience sleep apnea, a condition that disrupts normal sleep patterns.
  • Reproductive Changes: TRT can lead to shrunken testicles and impact fertility by reducing sperm production.
  • Skin and Physical Changes: Users might notice acne or other skin irritations, enlarged breasts, and increased body hair.
  • Psychological Effects: Mood swings and irritability are potential psychological side effects of testosterone therapy.
  • Cardiovascular Risks: There’s a concern about the possibility of more severe complications like heart attacks, strokes, and blood clots due to overproduction of red blood cells.
  • Monitoring Requirements: Regular blood tests are necessary to monitor testosterone levels and side effects, including fluid retention, prostate enlargement, and increased red blood cells.

Recognize that TRT may not suit everyone. Consider personal health history, current status, and specific symptoms in decision-making. Discuss concerns and risks with a healthcare professional before starting testosterone replacement therapy.


In conclusion, addressing low testosterone is a critical step in enhancing men’s health. While facing challenges like symptoms affecting physical, sexual, and mental health, effective strategies like Testosterone Replacement Therapy (TRT) exist. Open discussions with healthcare providers and personalized treatment plans are crucial. By approaching low testosterone with awareness and proactive management, men can restore balance, vitality, and enjoy a healthier life. Remember, with proper support and treatment, low testosterone effects can be managed for a positive outlook on health and life.

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10 Sources

We review published medical research in respected scientific journals to arrive at our conclusions about a product or health topic. This ensures the highest standard of scientific accuracy.

[1] Physiology, Testosterone : https://www.ncbi.nlm.nih.gov/books/NBK526128/
[2] On the effects of testosterone on brain behavioral functions : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4330791/
[3] Testosterone for the aging male; current evidence and recommended practice : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2544367/
[4] Klinefelter Syndrome : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3674537/
[5] Harmonized Reference Ranges for Circulating Testosterone Levels in Men of Four Cohort Studies in the United States and Europe : https://academic.oup.com/jcem/article/102/4/1161/2884621
[6] Magnetic Resonance Imaging : https://www.urologyhealth.org/urology-a-z/m/magnetic-resonance-imaging-(mri)
[7] The benefits and risks of testosterone replacement therapy: a review : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701485/
[8] ‘Testosterone Boosting’ Supplements Composition and Claims Are not Supported by the Academic Literature : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920068/
[9] Cardiorespiratory fitness and the relationship between body fat and resting testosterone in men : https://www.tandfonline.com/doi/abs/10.1080/13813455.2018.1491996
[10] Chronic stress inhibits testosterone synthesis in Leydig cells through mitochondrial damage via Atp5a1 : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8743653/

Franz Gliederer, MD, MPH

Franz Gliederer (MD, MPH) is a specialist in Preventive Medicine with a Medical Doctorate from the University of Vienna, Austria, and a