Testosterone gets a lot of hype, and rightly so. It has many diverse effects, functions and implications, having been associated with the following (mostly in males):

(Click on any of the topics above for a link to the study, for those interested)

While it has been widely researched, readers should keep in mind that there is still some lack of consensus on certain topics, partially due to a lack of long term studies and to some seemingly conflicting results in studies done so far.

General perception of the effects of testosterone seems measurably flawed as well, as was demonstrated by one interesting study showing that women who thought they were on testosterone when they were actually on placebo acted less fairly in a bargaining game than women who were on testosterone but thought they were on placebo. The women who were unknowingly on testosterone actually showed a substantial increase in fair bargaining behavior.

For the fitness-related purposes of this article though, I’ll address the following questions regarding T supplementation, risks vs benefits and optimizing natural T production.

How can I naturally increase testosterone?

 

It’s debatable whether or not this is really worth you dedicating any special effort to because, chances are, you’re more interested in the effects associated with higher testosterone, rather than higher T in and of itself. The best ways to achieve the effects you’re looking for are likely much more thoroughly studied than the methods of naturally increasing T, which is likely only a small part of your goal anyway.

For example, you might want to naturally increase your T in order to gain more muscle. Your time would be much better spent researching the best ways to build muscle, rather than spending countless hours researching one small component that won’t give you the whole picture.

The same would be true for other T-related goals, such as better athletic performance, long term physical and mental health, more energy etc..

However! In case it’s any extra motivation, here’s a list of a bunch of normal stuff (that you should be doing anyway) in order to optimize your testosterone levels naturally:

  1. Get at least 7 hours of uninterrupted sleep per night (some people might need more).
  2. Lose weight, if you’re overweight.
  3. Get your micronutrients in, as well as time in the sun: Zinc and Vitamin D deficiencies are associated with lower T, and almost half of US adults are Vitamin D deficient. Here, again, more is not necessarily better. Your body will generally use as much of these vitamins and minerals as it needs and flush the rest. So, getting 2000% of your recommended daily intake of Zinc won’t help you.
  4. Drink less alcohol.
  5. What about resistance training?

 

Studies are somewhat mixed on the matter, but at least five of the studies cited below showed short, medium and/or long term increases in T with resistance training.

It’s thought that some very heavy resistance training may cause less of a total increase, due to greater cortisol elevation (cortisol is a stress hormone that basically works against testosterone). Shorter rest periods and slightly higher repetitions at slightly lighter weight are sometimes considered better for testosterone production.

One interesting study also showed that resistance training in the afternoon and evening was potentially beneficial for creating a superior hormonal environment in the body, since cortisol tends to be higher in the morning and lower in the afternoon and evening. Therefore, the testosterone to cortisol ratio was higher in the PM than in the AM, and cortisol had a less negating effect on the testosterone.

Should I consider testosterone supplementation?

None of the literature supports the use of T supplementation in the absence of symptoms, and this isn’t because doctors are just big party poopers. There are serious risks associated with T supplementation, which must be outweighed by the seriousness of a testosterone related health condition in order to justify its use.

In other words, if you don’t have a serious health condition that could most effectively be treated with T supplementation, it’s not worth the risk.

What are the risks? Benefits?

Supplementing testosterone within the normal ranges is probably less risky than using steroids to elevate it well above normal levels, which is what most illegal steroid users might be likely to do. Supplementation for people with clinically diagnosed low testosterone (hypogonadism) has been shown to improve quality of life on many levels, but there are still potential risks, which probably increase in severity depending on the dose:

Potential Benefits: 

  • Increased lean muscle mass
  • Improved athletic performance
  • Increased bone density
  • Elevated mood

Potential Risks:

  • Psychiatric/cognitive decline
  • Liver dysfunction
  • Man boobs (gynecomastia)
  • Mood volatility
  • Worsened sleep apnea
  • Worsened prostate cancer
  • Hair loss
  • Acne
  • Withdrawal symptoms: depression, fatigue, decreased libido, inability to produce sex hormones in the future, infertility.

These are many of the risks that your doctor will likely tell you about, but it should be noted that long term studies of T supplementation well above the normal levels are sparse, due to the ethical concerns of producing such a study. The studies that do exist are usually based on self-report methods, but the results don’t bode well for steroid users.

(See “psychiatric risks of steroid use” below for links to a few of those studies.)

A few points in closing:

Don’t think  “more is better.” Testosterone is very complicated and not fully understood. More long term studies need to be done in order to better understand the positive and negative effects of higher or lower testosterone levels and of testosterone supplementation.

Don’t think you need to raise your testosterone to achieve other goals. Focus on learning the best way to achieve the goal, rather than getting bogged down in minutia.

I would highly recommend checking out Dr. Austin Buraki and Dr. Jordan Feigenbaum’s podcast on the topic, linked here.

STUDIES:

TESTOSTERONE AND STRENGTH TRAINING

(+) Neuromuscular and hormonal adaptations in athletes to strength training in two years

https://www.physiology.org/doi/abs/10.1152/jappl.1988.65.6.2406

 

“The present results suggest that prolonged intensive strength training in elite athletes may influence the pituitary and possibly hypothalamic levels, leading to increased serum levels of testosterone.”

(+) Comparison of serum testosterone and androstenedione responses to weight lifting in men and women

 

https://www.physiology.org/doi/abs/10.1152/jappl.1994.76.2.839

 

“T was increased significantly (p<0.01) in men (0.76 ng·ml−1, 21.6%), but nonsignificantly in women (0.06 ng·ml−1, 16.7%). Resting T levels were restored within 30 min.” (emphasis added)

(+) Skeletal muscle adaptations during early phase of heavy-resistance training in men and women

 

https://www.physiology.org/doi/abs/10.1152/jappl.1994.76.3.1247

 

“Resistance training also caused a significant decrease in the percentage of type IIb fibers after 2 wk in women and 4 wk in men, an increase in the resting levels of serum testosterone after 4 wk in men, and a decrease in cortisol after 6 wk in men.”

(+) Serum hormones during prolonged training of neuromuscular performance

https://link.springer.com/article/10.1007/BF00422840

 

“Testosterone/cortisol ratio increased during training. During the last 4 weeks of training changes in maximal strength correlated with the changes in testosterone/cortisol (P<0.01) and testosterone/SHBG (P<0.05) ratios. During detraining, correlative decreases were found between maximal strength and testosterone/cortisol ratio (P<0.05) as well as between the maximal strength and testosterone/SHBG ratio (P<0.05).”

Acute Hormonal Responses to Heavy Resistance Exercise in Men and Women at Different Ages

https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2007-973045

 

“The primary results indicate that the response of GH concentrations to the same relative heavy resistance work load is greatly lowered with increasing age both in men and women, while acute responses in testosterone levels are minor.”

Hormonal Responses and Adaptations to Resistance Exercise and Training

 

https://link.springer.com/article/10.2165/00007256-200535040-00004

 

“Resistance exercise has been shown to elicit a significant acute hormonal response. It appears that this acute response is more critical to tissue growth and remodelling than chronic changes in resting hormonal concentrations, as many studies have not shown a significant change during resistance training despite increases in muscle strength and hypertrophy.”

 

Neither load nor systemic hormones determine resistance training-mediated hypertrophy or strength gains in resistance-trained young men

 

https://www.physiology.org/doi/abs/10.1152/japplphysiol.00154.2016

 

“In congruence with our previous work, acute postexercise systemic hormonal rises are not related to or in any way indicative of RT-mediated gains in muscle mass or strength. Our data show that in resistance-trained individuals, load, when exercises are performed to volitional failure, does not dictate hypertrophy or, for the most part, strength gains.”

 

Influence of circadian time structure on acute hormonal responses to a single bout of heavy-resistance exercise in weight-trained men.

“Pre-exercise C concentrations were significantly lower (p < 0.05) in the PM session, which resulted in a lower peak value, and the accompanying increased T/C ratio suggested a reduced catabolic environment. These data demonstrate that the exercise-induced hormonal profile can be influenced by the circadian time structure toward a profile more favorable for anabolism, therefore optimizing skeletal muscle hypertrophic adaptations associated with resistance exercise.”

 

https://www.ncbi.nlm.nih.gov/pubmed/15129828

Postexercise hypertrophic adaptations: a reexamination of the hormone hypothesis and its applicability to resistance training program design.

https://www.ncbi.nlm.nih.gov/pubmed/23442269

 

“Studies show that hormonal spikes are magnified after hypertrophy-type exercise that involves training at moderate intensities with shortened rest intervals as compared with high-intensity strength-oriented training.”

 

SLEEP AND TESTOSTERONE:

Disruption of the Nocturnal Testosterone Rhythm by Sleep Fragmentation in Normal Men

 

https://academic.oup.com/jcem/article/86/3/1134/2847605

 

“Fragmented sleep disrupted the testosterone rhythm with a considerable attenuation of the nocturnal rise only in subjects who did not show REM sleep.”

 

Decreased serum levels of oestradiol, testosterone and prolactin during prolonged physical strain and sleep deprivation, and the influence of a high calory diet

https://link.springer.com/article/10.1007/BF00441295

“In conclusion, oestradiol, testosterone and prolactin are strongly reduced during prolonged strain. “

Sleep deprivation lowers reactive aggression and testosterone in men

https://www.sciencedirect.com/science/article/pii/S0301051112002037

 

“Sleep deprivation lowered reactive aggression and testosterone (but not cortisol) in men”

 

TESTOSTERONE AND BEHAVIOR

The social endocrinology of dominance: basal testosterone predicts cortisol changes and behavior following victory and defeat.

 

https://www.ncbi.nlm.nih.gov/pubmed/18505319

 

“High testosterone winners chose to repeat the competitive task, whereas high testosterone losers chose to avoid it. In contrast, low testosterone winners and losers did not differ in their task preferences.”

High-testosterone men reject low ultimatum game offers

 

http://rspb.royalsocietypublishing.org/content/274/1623/2327.short

 

“In this experiment, men who reject low offers ($5 out of $40) have significantly higher testosterone levels than those who accept.”

 

TESTOSTERONE AND OBESITY

Testosterone, body composition and aging.

 

http://europepmc.org/abstract/med/10442580

 

“In a subgroup of 57 men aged 70-80 years, testosterone levels correlated negatively with percentage body fat (r=-0.57), abdominal fat (r=-0.56) and plasma insulin levels (r=-0.40).” …”Moreover, increase in fat mass (obesity), as occurs in aging males, is in itself associated with low levels of free testosterone and GH which both normalize after weight reduction.”

 

TESTOSTERONE AND ALCOHOL

 

Moderate alcohol consumption in chronic form enhances the synthesis of cholesterol and C-21 steroid hormones, while treatment with Tinospora cordifolia modulate these events in men

 

“Alcohol also increased rate of steroid hormones clearance.”

 

https://www.sciencedirect.com/science/article/pii/S0039128X16000830

 

CONTROLLED STUDY ON THE COMBINED EFFECT OF ALCOHOL AND TOBACCO SMOKING ON TESTOSTERONE IN ALCOHOL-DEPENDENT MEN

 

https://academic.oup.com/alcalc/article/42/1/19/163114

 

“Results: While the testosterone level of alcoholic men did not differ from healthy controls at the onset of withdrawal, it was significantly higher for the alcoholics after 6 weeks of sobriety than for the healthy controls. “

 

PSYCHIATRIC RISKS OF STEROID USE

Brain and cognition abnormalities in long-term anabolic-androgenic steroid users

 

https://www.drugandalcoholdependence.com/article/S0376-8716(15)00219-7/fulltext

 

“Anabolic-androgenic steroids (AAS) cause psychiatric and cognitive abnormalities.”

Cognitive deficits in long-term anabolic-androgenic steroid users

 

https://www.drugandalcoholdependence.com/article/S0376-8716(12)00449-8/fulltext

 

“These preliminary findings raise the ominous possibility that long-term high-dose AAS exposure may cause cognitive deficits, notably in visuospatial memory.”

 

Neuroimaging and cognitive abnormalities in anabolic androgenic steroid abusers

 

https://www.drugandalcoholdependence.com/article/S0376-8716(15)00666-3/fulltext

 

…”consistent with prior findings”

 

IS HIGHER T ALWAYS BETTER?

 

A curvilinear relationship between testosterone and spatial cognition in humans: possible influence of hand preference.

 

https://www.ncbi.nlm.nih.gov/pubmed/8817730

 

“These results are consistent with prior literature suggesting a curvilinear relationship between spatial performance and circulating T concentrations, with intermediate levels of T being associated with better spatial functioning…”