How to Fix Low Testosterone: Treatment & Lifestyle Changes

how to fix low testosterone

How to Fix Testosterone

Whether you are experiencing symptoms of testosterone deficiency or have received an official diagnosis of hypogonadism, you likely want to know how to fix low testosterone levels. Raising your testosterone levels to a normal range will combat symptoms and help you feel like yourself again.

However, a one-size-fits-all solution doesn’t exist—the best way to increase testosterone levels depends on what’s causing the drop in your hormones. This article discusses everything you need to know about potential causes and treatments, including lifestyle changes and testosterone replacement therapy (TRT).

What Happens When a Man’s Testosterone Is Low?

When a man’s testosterone levels are low men experience various symptoms and related health issues.

These include, but aren’t limited to:

  • low mood
  • low energy
  • depression
  • poor sleep
  • reduced muscle mass
  • poor erection quality
  • reduced hair growth
  • body fat increases
  • low bone density
  • reduced height
  • hot sweats
  • increased heart issues
  • poor digestion
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ADAM Questionnaire

Low Testosterone Test

The ADAM questionnaire has been shown to have 88% sensitivity in testing for low testosterone.

What Causes Low Testosterone in Males?

If your symptoms match those of low testosterone, you need to determine the cause. This enables you to follow appropriate actions to fix your testosterone levels effectively. Below are the most common causes of testosterone deficiency in men.

Testicular Problems

Primary hypogonadism refers to low testosterone caused by problems in the testes, the primary site of testosterone production in men. These testicular issues can be present at birth, occur in puberty, or result later in life. Several conditions can cause primary hypogonadism:

  • Genetic conditions like Klinefelter syndrome
  • Undescended testicles
  • Testicular injury (one or both testicles)
  • Mumps orchitis in adolescence
  • Elevated blood iron (haemochromatosis)

Issues with the Hypothalamic-Pituitary Axis

Secondary hypogonadism refers to low testosterone caused by problems with the hypothalamus or pituitary gland, two centres in the brain that regulate blood testosterone levels. They tell the testes to produce testosterone through a signalling pathway that involves two hormones: follicle-stimulating hormone (FSH) and luteinising hormone (LH).

In men with secondary hypogonadism, the testes are capable of functioning normally but fail to work properly due to signalling issues. Some of the causes of secondary hypogonadism are:

  • Genetic conditions like Kallmann syndrome
  • Pituitary tumours or tumours in nearby brain regions
  • Inflammatory diseases like sarcoidosis and tuberculosis
  • HIV (human immunodeficiency virus) and AIDS

Certain Therapies & Medications

The use of certain drugs may affect testosterone production in men. Cancer treatments like chemotherapy or radiation therapy can impact the testes and cause primary hypogonadism. Meanwhile, opiate pain medications and hormonal therapies can affect the hypothalamic-pituitary axis and cause testosterone deficiency.

Obesity & Weight Gain

Blood testosterone levels and body weight are closely interlinked through a bi-directional relationship. Low testosterone levels can change your body composition, causing a reduction in muscle mass and an increase in fat. Meanwhile, overweight and obese men have up to 30% less testosterone than men of a healthy weight.

It is hard to determine whether low testosterone causes weight gain, weight gain causes low testosterone, or a combination of both. However, eating an unhealthy diet, being inactive, and gaining weight are thought to be potential causes of testosterone deficiency.

Drug & Alcohol Usage

Recreational drugs and alcohol consumption can interfere with the functions of the testes, pituitary, and hypothalamus. For example, alcohol is known to negatively affect the Leydig cells of the testes (the cells that produce and secrete testosterone) and decrease the release of LH and FSH from the pituitary gland, leading to low testosterone.

Type 2 Diabetes

If you have diabetes, your blood testosterone levels aren’t always impacted. However, the risk of low testosterone is twice as likely in people with diabetes compared to non-diabetic men.

This is partially due to an increase in obesity among diabetics, but recent research suggests that testosterone deficiency can be a risk factor for diabetes—with or without weight gain. This highlights the importance of healthy diet and exercise in maintaining healthy testosterone levels.

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How Can I Fix Low Testosterone Levels?

There are several ways to fix low testosterone and overcome any symptoms you’re experiencing. From testosterone replacement therapy to everyday lifestyle improvements, here are the main ways to increase testosterone levels.

Testosterone Replacement Therapy

Testosterone replacement therapy (TRT) is the most common treatment for low testosterone. This involves administering exogenous testosterone into the body, raising testosterone levels to fall within the healthy range. There are a variety of delivery methods for TRT:

  • Skin Patches: Patches are applied to the skin (back, stomach, thighs, or upper arms) at night and replaced every 24 hours. You need to apply the patch in a new spot each time. They slowly release testosterone into the skin to be absorbed by the bloodstream.
  • Gels & Creams: Gels and creams are a topical treatment applied directly to the skin. Like patches, testosterone is absorbed through the skin and into the bloodstream. Unfortunately, this delivery method comes with a risk of transfer to women and children.
  • Oral Tablets: Capsules containing testosterone can be swallowed and are absorbed into the bloodstream through the gut. These pills contain actual testosterone and are only available on prescription, not to be confused with testosterone supplements or boosters.
  • Pellets: Testosterone pellets are implanted under the skin near the hip or buttocks by a healthcare professional. The pellets slowly and steadily release testosterone over three to six months, after which they are replaced.
  • Injections: Testosterone can be injected intramuscularly or subcutaneously. Depending on the formulation, you may need to inject anywhere from every seven days (testosterone cypionate and testosterone enanthate) to every 12 weeks (testosterone undecanoate).

Lifestyle Changes

Factors such as weight gain, activity levels, alcohol consumption, and use of medications can lead to low testosterone. Therefore, appropriate lifestyle changes can naturally increase testosterone levels without prescription therapy. Examples include:

  • Healthy Diet: Eating a balanced diet helps to maintain a healthy weight and lowers your risk for diabetes. According to some studies, certain foods are specifically known to boost testosterone, including seafood, ginger, oysters, pomegranates, and leafy greens.
  • Regular Exercise: Exercising several times a week can reduce fat and raise testosterone independently of weight loss. Resistance training is preferred for boosting testosterone, increasing your levels short-term and long-term through building more muscle.
  • Alcohol Consumption: Quitting alcohol or reducing the amount you drink can help fix testosterone levels after a few months. Stick with a maximum of 1-2 drinks per to avoid a major impact on your hormone levels.

Stress can also affect testosterone production by increasing cortisol production and inhibiting testosterone production in the Leydig cells. Therefore, limiting your stress levels can help maintain a healthy testosterone balance. You can manage stress through exercise, nutrition, meditation, and mindfulness practices.

Increased stress and sleep disturbances are strongly linked, as are poor sleep and low testosterone. Ensure you sleep well each night to help fix your testosterone levels. Aim for at least seven hours every night and practice good sleep hygiene to help improve your sleep quality.

Treat Underlying Health Conditions

When an underlying health condition causes testosterone deficiency, your testosterone levels can be restored by treating the disease responsible.

For example, pituitary tumours can impact serum testosterone concentrations. Removing or shrinking these tumours should restore normal pituitary functioning and signalling, raising testosterone levels. The treatment options include surgical removal, radiation therapy, or medication therapy.

How is Low Testosterone Treated on the NHS?

If you’re experiencing the symptoms of low testosterone, the initial approach on the NHS is to see if lifestyle changes can improve your symptoms. Your doctor will recommend exercise and a balanced diet, alongside recommendations for stress management and improved sleep quality.

If your symptoms don’t improve, your GP might order a blood testosterone test to measure your testosterone serum concentration. Men with low testosterone results from two blood tests may be referred to an endocrinologist and offered testosterone replacement therapy.

TRT is given either as an injection or gel on the NHS. Testosterone undecanoate (brand name Nebido) is the most commonly used type of TRT. This is an intramuscular injection administered every 12 weeks. Other treatment options include Sustanon injections and topical treatments like Trostan, Testogel, and Testavan.

What is the Best Treatment for Low Testosterone?

The best treatment for low testosterone depends on your situation. All individuals are different—they have different lifestyle and genetic factors, and all respond to treatment differently. The varying causes of testosterone deficiency also make finding the single “best treatment” impossible.

TRT is the most effective therapy and usually the go-to treatment for men with low testosterone, especially for men whose testosterone levels have declined prematurely. However, the optimal protocol and delivery method varies between men. For example:

  • Testosterone gels and patches are great for injection-adverse patients. They’re also a good option for frequent travellers who might struggle to attend regular injection appointments, but they need to be reapplied daily and aren’t as effective as other types of TRT.
  • Weekly or monthly testosterone injections are better for the busy and forgetful who don’t have time for daily administration. However, the injection route can cause testosterone spikes in some men, causing unwanted side effects.
  • Daily testosterone injections provide steady testosterone levels with fewer unwanted side effects, yet daily administration is usually too much for most men to consistently stick with. If not adhered to, this will limit the effectiveness of treatment.
  • Testosterone pills containing testosterone undecanoate are as effective as testosterone injections and a good alternative to gels and patches for needle-adverse patients. However, they aren’t approved for age-related testosterone decline.

There are also cases where TRT isn’t the best approach. It is usually recommended that men with age-related hypogonadism initially make lifestyle changes, as there are risks of testosterone therapy that some argue outweigh the benefits. The same is true for men with prostate cancer, as TRT can increase the risk of reoccurrence.

Making lifestyle changes is also recommended for obese, inactive, or alcoholic men with low testosterone. Healthy lifestyle changes might be sufficient to fix testosterone levels without therapeutic intervention.

Is Testosterone Replacement Therapy Right for You?

TRT is the most effective treatment for low testosterone. But as mentioned, it isn’t for everyone. Even if you do go on TRT, there are different types of medication and administration routes to consider to ensure you get the full benefits of testosterone replacement therapy. You might also need combination therapy with hCG if maintaining fertility is important.

Therefore, working out whether testosterone replacement therapy is right for you should be a conversation you have with a doctor. Not only do they know how to fix testosterone levels, they know the most effective methods for this based on your individual situation.

To discuss your suitability for TRT, book a call with our in-house medical team. You won’t be able to start treatment unless you have a blood test showing low or no testosterone, but we also offer testing through our clinic. Order your blood test here, and view our FAQ section for more help and advice.

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