Low Testosterone: Causes, Effects and Treatments
Testosterone is a powerful androgen hormone and anabolic steroid all humans have.
Even though both sexesproduce it, testosterone is the most abundant in men, where it drives their masculine traits and impacts a whole spectrum of health markers.
When it comes to a man’s wellbeing, there aren’t many hormones more important.
Low testosterone can appear at any age – it’s not just exclusive to older men. Symptoms span from a drop in mood or muscle to infertility and a complete loss of libido.
Left untreated it can even contribute to serious life-threatening diseases. There are no positives to below baseline T, which makes spotting the warning signs vitally important.
In this article, we’ll cover everything you need to know about low testosterone.
We’ll break down what roles T plays in your body, before equipping you with the tools to detect symptoms of low levels, and what you can do to treat them.
By the time you’ve finished reading, you’ll have a comprehensive understanding of your powerful androgen hormone and what you can do to keep it healthy.
First, let’s look at what testosterone is and its functions.
What is testosterone
Testosterone is a potent anabolic hormone that’s present in both men and women. However, levels can be ten times higher in males, where it’s integral for a whole host of functions. Read more about what testosterone is HERE.
Production starts to accelerate during puberty, triggering vast changes and turning pre-pubescent boys into adolescent men.
T is responsible for the development of masculine traits such as voice deepening, testicle and penis size, bone growth and sexual awareness. It also plays a part in increased muscle mass.
After taking a dramatic awakening during your teens, testosterone continues to rise and hits its peak around age 19[1].
The hormone then levels out throughout your twenties before turning toward a natural decline around age 30[2]. Most men experience a drop of around 1% per year[3].
The roles of testosterone go far beyond helping you build an impressive physique. Healthy production is intrinsically connected to bone health, sexual function and mental wellbeing too.
Testosterone influences[4]:
- Muscle mass and strength
- Bone density
- Fat distribution
- Sexual function
- Sperm quality
- Libido
- Energy
- Mood
- Assertiveness
- Penis and testicle growth during puberty
- Facial and body hair growth during puberty
Testosterone also has lesser known but important roles in female health[5]. These include; fertility, sex drive, muscle mass, fat distribution and red blood cell production.
Women can still experience low testosterone, even though they produce much smaller quantities than men.
Low testosterone in men
Normal testosterone levels in men range between 300-1000 ng.dL. Anything below the 300 ng.dL baseline, however, is considered low[6].
Hypogonadism is the proper clinical term for testosterone deficiency.
Experts say that the modern man’s testosterone doesn’t quite match up to the generation before him. According to two studies, one from the US and another from Scandinavia, low testosterone is a growing epidemic across the globe[7][8].
The research teams behind them say there’s many factors that contribute to their findings, but our 21st century high-stress indoor lifestyles aren’t serving us well.
A lack of exercise, good food choices, vitamin D and relaxation are all taking a tax on our masculine hormones. It’s up to you to make a conscious effort to support yours.
A man can experience low testosterone at any age. While father time is an inevitable contributor to your natural decline, your lifestyle and habits have a huge contribution too.
For some men, low testosterone can be a sudden shock; whereas in others it might just go unnoticed, as they think they’re experiencing the usual signs of aging.
Either way, learning what warning signs to look for early could help you resolve the situation before it escalates further.
Signs & Symptoms of low testosterone
Low testosterone can manifest itself in the following symptoms[9]:
- Low libido
- Irritability
- Low mood
- Muscle loss
- Fat gain
- Frailty
- Reduced bone density
- Erectile dysfunction
- Depression
- Poor sleep
Some of these could also be associated with opioid use and obesity too, which can both contribute to below baseline T[10][11].
Spotting any of the warning signs early may help you tackle issues sooner.
You’ll notice that a lot of these symptoms are things men brush under the rug as a part of getting older. It’s considered normal to start to feel tired and you expect to lose a little muscle mass.
But little do some men know that they could be putting in the work to prevent this happening, or at least slow things down.
Low testosterone isn’t just a side effect of aging alone – keep reading to learn other common causes.
Causes of low testosterone
Testosterone is an intricate hormone that relies on many aspects of your body functioning properly. As a result, low T can be caused from numerous medical conditions, not just age or lifestyle.
1. Medical conditions
Unfortunately, some people are born with conditions that cause testosterone deficiency from birth. These include Klinefelter syndrome, Noonan syndrome, and ambiguous genitalia.
Others may also develop conditions later in life that cause low testosterone. These include testicular damage, testicle removal, pituitary gland disease, metabolic syndrome (including diabetes), infection, and autoimmune disease.
If a man has undergone chemotherapy, he might also experience side-effects of low testosterone.
2. Obesity
Age is the one certainty all men must face. However, there’s a clear connection between obesity and low T, which is something we can try to control.
Being overweight and low testosterone work together in a viscous cycle with one influencing the other – you want to avoid this trap at all costs[12][13][14][15].
Because testosterone helps promote energy, lean muscle, and healthy fat distribution, low levels make T deficient men more prone to gaining weight. As a result, they have a higher chance of becoming obese.
3. Stress
Whenever you face stress your body goes into fight-or-flight mode. Your number one priority is to either run or defend yourself, not produce testosterone.
Instead your levels of cortisol (stress hormone) surge and stay elevated when stress become chronic.
Studies show that cortisol and testosterone can’t coexist and thrive in each other’s company. When blood levels of cortisol increase, your T drops, making continual high-stress situations a possible cause of low testosterone[16].
Some scientists speculate that this may be because testosterone alters how rationally you might react in a fatal situation like staring down a rival.
Others suggest it might be because actions like mating can become deadly if you ignore the warning signs of a predator approaching. However, association isn’t always a cause of causality.
4. Drug & alcohol use
In a recent review, researchers say they’ve detected a progressive deterioration of male reproduction function in the Western world.
According to their 2019 paper published in the Journal of Clinical Medicine, substance and drug abuse is a recognizable contributor to a downward turn in our testosterone health[17].
Alcohol, opioids, and anabolic steroids seem to have the most negative impact on fertility and production.
Yet, even nicotine, cannabis, and amphetamines are suggested to make an impression on your T too. Fortunately, the researchers also believe substance abuse-induced hypogonadism (low-T) is potentially reversible.
5. Nutrient deficiencies
Nutrient deficiencies can have a lasting impact on your body’s ability to create testosterone. Unfortunately, the standard western diet doesn’t always cover all bases, especially some vital micronutrients for your T.
Vitamin D, Zinc, and Magnesium are just a handful of the most common under-consumed nutrients. It just so happens that all four can play a role in how much testosterone you produce[18][19][20].
To avoid deficiencies, it’s vital to consume a well-balanced diet rich in variation and wholefoods. Taking a high-quality vitamin or support supplement can also help to fill in any gaps and bulletproof your diet plan.
Health effects of low testosterone
It’s clear from the symptoms listed above there’s no benefit from suffering with low testosterone. Underperforming T can impact your health both mentally and physically too.
1. Weight gain
Obesity is one of the largest contributors to mortality in the modern world and is the highest cause in the USA[21].
Cancer Research UK says that obesity can even cause four major forms of cancer more than smoking[22].
Experts say you should try to maintain a healthy weight all through adulthood to lower your risk of premature death[23].
Unfortunately, low testosterone can have a hand in how easily you gain body fat or how hard a time you have losing it.
Fat cells metabolize testosterone into estrogen, which in turn promotes the accumulation of more body fat.
Low testosterone can also cause your energy to diminish, possibly making routine exercise difficult. This is the dangerous cycle we touched on earlier.
Low T is also related to diabetes and the same can be said in return. But scientists aren’t completely sure which one causes the other.
2. Impact on sex life
Your sex life can quickly become impacted when testosterone levels drop. Sex drive, erectile function, and fertility are all primary functions of the potent androgen hormone. So, when it diminishes, so do they.
Unfortunately, low testosterone can cause you to lose some or all your sex drive. Erectile dysfunction is another side-effect that might make you unable to have satisfying sex, even if you want to[24].
Naturally, erectile dysfunction and low libido can have a significant impact on your relationships, mental health and quality of life[25].
Speak to your doctor in confidence if you suffer from either of these symptoms.
3. Impact on mental health
Testosterone is a neuroactive steroid, which means it can impact your overall mood.
Not only that but given the dramatic symptoms of low testosterone (like low libido and poor energy), underperforming T can have a knock-on effect for your mental wellbeing.
Seek your doctor’s advice if you have concerns about your own mental health. Recent research suggests that testosterone status may only impact sub-threshold symptoms of anxiety and depression[26].
4. Risk of disease
Experts believe that a decline in testosterone leads to an increased risk in all-cause mortality.
According to some research, low T levels in men could hike up their chances of developing coronary heart disease, type two diabetes, frailty, hypertension, metabolic syndrome and more[27].
Scientists aren’t totally certain if it’s low testosterone that causes increased heart disease risks or if they’re just associated with one another.
However, current research does evidence there’s a major underlying relationship between testosterone and cardiovascular health[28].
Treatment of low testosterone
Treating low testosterone is usually a conservative process. A trained professional like your doctor can offer you the best advice for combating it.
Lifestyle changes
First, a doctor might suggest simple lifestyle changes. These could include things like:
- Eating healthier
- Getting more sleep
- Exercise
- Reducing stress
1. Eating healthier
Earlier we discussed how a bad diet can contribute to underperforming androgens.
Poor high-processed food choices can quickly increase risk for weight gain[29], while low-quality sugars cause T-inhibiting cortisol spikes[30], which can become chronic with constant abuse.
You’ll remember from earlier how destructive cortisol can be to hormone balance.
You also need to factor in the possible threat of deficiencies caused by lackluster nutrition – something amplified when you become obese[31].
If you’re overweight and don’t have an optimal diet, your doctor might suggest you try losing weight and fixing your nutrition before undergoing any treatment.
A high-quality multivitamin or testosterone booster could help you fill in any holes and bullet proof your diet plan. Some of the best T production promoting supplements include:
- Vitamin D[32]
- Zinc[33]
- Magnesium[34]
- D-Aspartic Acid[35]
- Ashwagandha[36]
- Boron[37]
One thing to note is that some supplements like vitamin D, Zinc, and D-AA seem to offer the most benefit to men with certain deficiencies and/or low T – you might not necessarily boost your testosterone if it is already healthy and you’re getting enough key nutrients.
You can find any of these supplements as single products or as part of a dedicated testosterone booster.
2. Getting more sleep
Still think sleep is for the weak? Not according to science, it isn’t. The truth is, sleep quality plays a major role in your overall health and wellbeing – especially your hormones.
Studies show that sleep deprivation and low-quality rest can sever testosterone levels almost overnight, which is bad news if you’re one for burning the midnight oil[38].
Giving yourself seven to eight quality hours of sleep per night should be a high priority.
Create an optimal environment by turning off all screens an hour before bed and set your dark room to a cool temperature. You might even see your stress and energy levels take a positive turn too.
3. Exercise
Exercise is a key component of any healthy lifestyle. Staying active helps you to maintain an optimal weight, build muscle, increase bone density, reduce stress, and improve your overall fitness levels.
As a result, you’re better equipped to handle whatever life throws at you. You’re not just building your body for now but prepping it ready for your senior years too.
Research suggests that all kinds of exercise in sensible quantities can increase testosterone. Yet, it’s hitting the free weights section that seems to reign supreme for hiking up T levels. Hire a reputable trainer to write you a workout plan if you’re new to weight training.
According to studies, pumping iron and lifting heavy weights can boost T in both the short and long term[39][40].
There’s also evidence out there showing that stronger people tend to live longer than their weaker peers[41].
Bottom line – get on first names term with your local gym staff and lift consistently to improve your T.
4. Reducing stress
Lowering stress levels can go a long way in combating low testosterone. Some symptoms like low libido, anxiety, and tiredness might have been augmented by it in the first place.
Great stress management techniques include:
- Physical exercise[42]
- Reading[43]
- Visiting green and natural spaces[44]
- Meditation[45]
- Achieving a better work to life balance[46]
- Better time management
Start with small manageable changes and make time to work on yourself.
Testosterone therapy
If your doctor thinks your situation requires medical intervention you might be prescribed testosterone therapy.
However, the long-term health impact of testosterone therapy currently isn’t known and not all cases of hypogonadism are treated with it.
Testosterone therapy, also known as testosterone replacement therapy, is a type of hormone replacement therapy where your T is replaced.
You won’t be given a natural form of testosterone, but a synthetic, lab created version to increase the levels you have inside your body.
By bringing your testosterone levels up a healthy amount you can usually reverse the symptoms associated with low T[47].
TRT is administered in the form of gels, patches, injections, mouth patches, or implants. It must only ever be prescribed by a doctor and is illegal to buy or sell without a prescription.
When people talk about testosterone being abused as a performance enhancing drug, it’s this synthetic variation.
Taking testosterone therapy isn’t without its side effect risks, many experts say they’re concerned about the negative impact TRT has on cardiovascular health and prostate safety[48].
As a result, if you’re at risk of or have a history of heart disease, strokes, or prostate cancer you may not be offered treatment.
Remember, as we mentioned earlier, the long-term health impacts of using testosterone replacement therapy are unknown.
FAQs
How do I know if I have low testosterone?
You may see one of more of the above symptoms emerging and assume they’re being influenced by a testosterone deficiency.
However, the only true way to know if you have low testosterone is to have a blood test. Your doctor will most likely test you multiple times, as levels can fluctuate throughout the day.
Is it dangerous to have low testosterone?
Yes, it is dangerous to have low testosterone. Below baseline T can be accompanied by several side effects ranging from mildly uncomfortable to severe.
Men with low testosterone are at a higher risk of depression, anxiety, frailty, obesity, type II diabetes, and increased all-cause mortality.
How do you fix low testosterone?
You may be able to make a positive impact on your testosterone production by making simple lifestyle changes.
Eating a well-balanced diet, exercising, maintaining a healthy weight, and sleeping better can all contribute to healthy T.
However, in some cases, your doctor may prescribe testosterone replacement therapy. The long-term health effects of TRT are currently unknown.
What are the main causes of low testosterone?
The main causes of low testosterone include:
- Injury to testicles
- HIV/AIDS
- Type II diabetes
- Obesity
- Age
- Chronic kidney/liver disease
- Testicular cancer and treatments
- Infection
- Nutrient deficiencies
- Drug and alcohol abuse
What happens if low testosterone goes untreated?
Untreated low T can leave a lasting impression on your health.
Symptoms include fatigue, low mood, irritability, loss of muscle mass, frailty, low libido, obesity and increased mortality risk.
See the above lists of low testosterone symptoms and risks for more information.
Conclusion
Low testosterone – aka hypogonadism – is a growing concern among modern men. It appears that our 21st century lifestyles and stressors are having a negative impact on our hormone health.
Spotting the warning signs of underperforming testosterone production can help you act and treat the symptoms early.
Although age-related testosterone decline is inevitable, your lifestyle choices can all contribute to how well your hormones thrive.
Eating a well-balanced diet, exercising regularly, sleeping well, and reducing stress are all proven ways to turn your body into an optimized T producing environment. Most men are more in control than their realize.
If you think you might need testosterone replacement therapy, visit your doctor for a blood test. Only they will be able to prescribe TRT by assessing your age, medical status, and lifestyle factors.
Keep in mind that not all cases of hormone deficiency qualify for therapy. It is always at your doctor’s discretion.
Don’t let low T take control of your life without a fight. Start applying the preventative measures today and look out for your hormones.
