How to Raise Testosterone Naturally: The Real Effect of Weight, Sleep, Exercise and Supplements

A man in his forties who has gone back to the gym but does not feel as energetic as he used to types a question into a search engine: how can testosterone be raised naturally? What comes up is mostly capsules, powders and blends that promise to “boost the male hormone”. Do they really work, and how much difference do weight, sleep and exercise make?

Testosterone is the main male sex hormone, produced largely in the testicles; its level is set by signals between the brain and the testicles and fluctuates over the day. This article looks at the size of the decline with age, the effect of weight loss, sleep, exercise and alcohol, what “testosterone booster” supplements contain, vitamin D and zinc, and the situations in which lifestyle is not enough.

How much does testosterone fall with age, and how much of that is age itself?

The Massachusetts Male Aging Study in the United States enrolled 1,709 men who were aged 40–70 at the start and reassessed 1,156 of them 7–10 years later. When the same men were followed over time, total testosterone fell by about 1.6% a year, which makes the decline real but slow. When men of different ages were compared at a single point in time, the difference was 0.8% a year.

In the same study, apparent good health, defined as the absence of chronic illness, prescription medication, obesity and excessive drinking, added 10–15% to the level of several androgens.

The European Association of Urology (EAU) guideline takes a similar position: the main causes of functional low testosterone are obesity, accompanying illnesses and ageing; the first two account for most cases, and the role of ageing up to the age of 80 seems relatively small. Age cannot be changed, but body weight and some of the accompanying illnesses can be.

How much does losing weight raise testosterone?

Among lifestyle factors, weight loss has the most consistent evidence. In a meta-analysis pooling 24 studies, total testosterone in obese men rose by an average of 2.87 nmol/L with a low-calorie diet and by 8.73 nmol/L after bariatric (weight-loss) surgery. According to a review reporting this analysis, average weight loss was 9.8% of body weight in the diet group and 32% in the surgery group.

The best predictor of the rise is the amount of weight lost; the increase is more marked in men who are younger, do not have diabetes and were heavier to begin with. The EAU guideline recommends weight loss and lifestyle change as the first step for overweight men with low testosterone, but it also tempers expectations: the increase achieved with diet and physical activity is small, in the order of 1–2 nmol/L.

In short, losing weight can raise testosterone measurably in a man who is overweight; the same effect is not expected in a man of normal weight. The effect of weight-loss injections on sexual health is covered in a separate article on our site.

Does lack of sleep lower testosterone?

Most of the testosterone released over the course of a day is released during sleep. In a small study at the University of Chicago, 10 healthy men with a mean age of 24 were monitored in the laboratory, first in a rested condition and then for one week with 5 hours in bed per night. Average daytime testosterone fell from 18.4 nmol/L to 16.5 nmol/L, a drop the authors summarised as 10–15%.

The authors set this against the 1–2% yearly decline seen with ageing. The study is small, includes only young men and does not show the effect of sleep loss lasting months. It still has a practical implication: a blood sample taken after short sleep may show a level lower than the usual one. Sleep apnoea is also associated with low testosterone and is assessed separately.

Does exercise raise testosterone permanently?

Two different effects need to be separated here. Immediately after a heavy resistance (weight) training session, testosterone generally rises in men; according to one review, this response appears with sessions of high volume and metabolic demand and weakens with advancing age. It is, however, a short-lived fluctuation that follows the session; it does not mean the resting level has gone up.

A meta-analysis that looked at the lasting level pooled 11 randomised controlled trials covering 421 healthy, insufficiently active men aged 19–75. Aerobic, resistance or combined training lasting a median of 12 weeks did not change resting total testosterone compared with the control group (standardised mean difference 0.00).

This finding applies to men whose testosterone is already normal. The EAU guideline reports that the rise seen with physical activity in overweight men is linked to the duration of exercise and to the weight lost.

How does alcohol affect testosterone?

In the Massachusetts study, excessive drinking was one of the factors associated with lower androgen levels. In a meta-analysis covering 21 studies and 10,199 participants, total and free testosterone were significantly lower in men who drank alcohol than in those who did not, while oestradiol (a type of oestrogen) was higher.

According to the authors, this difference is evident with sustained (chronic) consumption in healthy men; it was not shown after a single episode of drinking. Cutting down regular, heavy drinking is reasonable for hormone balance; how much of a rise this brings is not known.

What is in “testosterone booster” supplements?

In a study of 50 “testosterone booster” products found through an internet search in the United States, 90% claimed to raise testosterone. The products contained 109 different components. Published data showing an increase in testosterone existed for only 24.8% of these components; 10.1% had data showing a decrease, and for 61.5% there were no data at all. In 13 products, zinc, vitamin B3 or magnesium exceeded the tolerable upper intake level.

A systematic review that screened 52 studies and 27 substances from the past two decades likewise concluded that most do not raise total testosterone. For fenugreek extract, a meta-analysis pooling 4 clinical trials reported a significant effect; the number of trials is small, however, and this finding does not mean the blended products on the shelf have been tested. The risk of hidden drugs in herbal sexual enhancement products and the effect of ejaculatory abstinence on testosterone are covered in separate articles on our site.

Do vitamin D and zinc help?

In a randomised, double-blind trial in Austria, 100 men with total testosterone below 10.4 nmol/L were given vitamin D or placebo for 12 weeks, and 94 completed the study. Vitamin D had no significant effect on testosterone. Correcting a vitamin D deficiency may be needed for other reasons, but this trial does not support vitamin D as a way of raising testosterone.

With zinc, the picture depends on deficiency. A review summarising 8 clinical and 30 animal studies reports that zinc deficiency lowers testosterone and that the effect varies with baseline zinc and testosterone levels. By contrast, in 14 regularly exercising men aged 22–33 who were getting enough zinc from their diet, a zinc-containing supplement raised blood zinc but did not change total or free testosterone. The study is small; even so, extra zinc taken when there is no deficiency has not been shown to bring a benefit.

When is lifestyle not enough, and how should testosterone be measured?

Tiredness, low desire and loss of strength are not specific to testosterone; the diagnosis is not made on symptoms alone or on a single blood result. According to the EAU guideline, it rests on consistent symptoms together with a low morning total testosterone on at least two separate occasions. The blood sample should be taken between 07:00 and 10:00 in the morning and in the fasting state; a non-fasting measurement can underestimate the true level by more than 30%. The threshold the guideline uses for late-onset hypogonadism is 12 nmol/L.

Symptoms, tests and testosterone therapy are covered in a separate article on our site. One point is enough to recall here: testosterone and anabolic substances taken from outside can suppress the body's own production and sperm production; men who want to have children need to discuss this with a doctor before using them. If symptoms persist even though weight, sleep and alcohol have been addressed, the underlying cause needs to be investigated.

When should you see a doctor?

Assessment is advisable in these situations:

• Reduced sexual desire, fewer morning erections or difficulty with erections
• Tiredness and low drive that have lasted for weeks and do not improve with sleep and rest
• Symptoms that persist despite weight loss and better sleep
• A low testosterone value on a fasting morning measurement
• Loud snoring or pauses in breathing during sleep
• Having used testosterone, anabolic substances or supplements of uncertain content while wanting children
• Low desire and fatigue that began after stopping a supplement or a hormone-containing product

The most consistent evidence on influencing testosterone naturally belongs to weight loss in men who are overweight; adequate sleep and limiting alcohol may help to maintain the level, whereas the effect of exercise and supplements on the resting level is limited or has not been shown. If symptoms persist, a correctly timed measurement takes the place of guesswork. Assoc. Prof. Dr. Zülfü Sertkaya practises urology and andrology in Istanbul; assessment of low testosterone and male hormonal health is individualised and carried out in confidence.

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