January 13, 2022 10 min read

When it comes to the idea of manliness, testosterone is the hormone that everyone knows. With enough testosterone come rippling muscles, broad chests, bulging biceps—and the strength to back them up.  This leads many men to think that if they don’t have these markers of manliness, they may be low in testosterone.

This question is very valid, especially if you’re over the age of 30 when T levels begin to fall dramatically. But there are a myriad of other factors that affect the levels of T in men, and if you’re interested in maintaining healthy levels of this hormone it’s a good idea to become aware of these factors.

Depending on the cause of low testosterone, you’re going to be able to resolve it in various ways. But the key is to know why exactly low testosterone is an issue for you. And even if you’re not necessarily plagued by any serious symptoms, it’s always a good idea to stay on top of things, lifestyle-wise. This means staying active, getting enough rest, and eating healthy foods.

Muscular male body and testosterone hormone formula

What is Testosterone?

Testosterone is the male sex hormone that helps with sperm production (and healthy sperm counts), sex drive, all body hair, bone strength, energy levels, and muscle mass. The amount of testosterone in your body changes throughout the day, from a high in the morning to lows at night. A normal range is anything from 300 nanograms per deciliter, all the way to 1,100 ng/dL. This measurement is taken from a blood sample.

Low testosterone is diagnosed by two blood tests that are done on separate days, both in the morning. Levels have to be abnormally low, at below 300 ng/dL for both tests in order to be diagnosed for low T. Male hypogonadism often occurs in older men, when low levels of T lead to low sex drive, issues getting erections, and potentially even osteoporosis.

What Causes Low Testosterone?

There are many, many different factors that can all affect the production of testosterone. In fact, it’s safe to say that almost every decision or aspect of health history will have some effect on the production of this hormone. The most common is aging since T naturally starts to decline after the age of 30 at about 1% per year. However, as you’ll see from the list below, that’s far from the only reason why T production might fall short. To get properly diagnosed, it’s important to talk to a doctor who’ll look at your symptoms and your health history. The only way to be sure is to do blood tests.

  • Aging
  • Injury or infection of the testicles
  • Obesity or extreme weight loss
  • Illnesses
  • Chemotherapy
  • Alcohol abuse
  • Cirrhosis
  • Metabolic disorders
  • Dysfunction of the pituitary gland
  • Medications such as opioids, hormones used to treat prostate cancer, and steroids
  • High levels of prolactin
  • Uncontrolled type 2 diabetes
  • Congenital defect
  • Obstructive sleep apnea
  • Excess of estrogen
  • Anabolic steroid abuse
  • Severe primary hypothyroidism
  • Delay of puberty
  • Trauma to the head
  • Exposure to radiation
  • Chronic kidney failure
  • HIV/AIDS
  • Inflammatory conditions such as sarcoidosis
  • Kallmann syndrome
  • Klinefelter syndrome

Two Main Causes

There’s a variety of causes that can contribute to low testosterone levels, and so it’s helpful to break them down into larger groupings. Not only does grouping help in terms of organization, but also when it comes to diagnosing what the potential root causes are. These two groupings are called primary hypogonadism and secondary hypogonadism.

Primary Hypogonadism

Also known as testicle failure, primary hypogonadism is exactly what it sounds like. Issues in the testicles can affect testosterone production, so it’s important to be aware of injuries to them. For example, trauma, radiation, or cancer can all harm testosterone production. Another issue may be undescended testicles from birth if they don’t move down from the abdomen. Klinefelter syndrome is also put under primary hypogonadism. While guys should have one X chromosome and one Y chromosome, those born with two X chromosomes might experience abnormal testicle development.

Secondary Hypogonadism

Secondary hypogonadism comes down to issues surrounding the pituitary gland (also called the hypothalamus). This gland is found in the brain and it links the endocrine system with the nervous system. If something is abnormal in this area, the brain might not be properly giving the signal to the testicles to produce testosterone. Secondary hypogonadism can either be caused by pituitary disorders such as tumors, or different medications.

Opioids especially can severely impact the production of testosterone. Type 2 diabetes and aging are also common culprits when it comes to secondary hypogonadism. However, these are just examples and not all causes will fall neatly into either of these two categories. That’s why it’s important to know the signs and symptoms of low testosterone levels and get correctly diagnosed by a doctor.

Signs and Symptoms of Low T

If you think you have low T, there are several symptoms to look out for. The causes of low T are diverse, and so the symptoms vary wildly as well. It’s important to be on the lookout for all of these, but especially a lowered libido, increased body fat and muscle loss, and erectile dysfunction. Here are the less serious signs of low T levels:

  • Low libido
  • Erectile dysfunction
  • Lenser sense of well-being
  • Depressed mood
  • Difficulties with concentration
  • Fatigue
  • Moodiness and brain fog
  • Decreased muscular strength

In some cases, symptoms can be more serious. This is especially true for those who’ve been experiencing low T for an extended period of time. The more serious signs include:

  • Losing body hair and less hair growth
  • Loss of muscle and strength
  • Weaker bones
  • Mood swings and increases in irritability
  • Depression
  • Hot flashes

If you’ve been experiencing one or more of these symptoms for a while, it’s a good idea to get tested for low T. However, it can also help to know how common low T is in males.

How Common is Low T

The answer to this question is largely dependant on the age group we’re talking about. For example, while statistics aren’t too widespread on this issue, a good estimate is that about 2% of men might have low T. But again, this differs a lot in age. One commonly cited statistic is that 40% of men over the age of 45 have low T, while this number jumps to 50% of men over the age of 80. Considering how quickly testosterone levels drop as we age past 30, this isn’t too big of a surprise.

However, experts have also found connections between men that maintain different lifestyles. For example, guys who exercise regularly are  less likely to have low testosterone levels. At the same time, another study looking at 125 guys found that the ones that ate the most refined carbs (pastries, bread, and desserts) had the lowest levels of testosterone. In fact, they were around six times more likely to have low T levels than those who kept healthier eating habits. This highlights how important a healthy lifestyle is when trying to maintain high T levels.

How is Low T Diagnosed

The best way to find out whether you have low T is through a blood test taken in the morning when T levels are at their highest. Usually, another blood test will be done at a different date to confirm the results of the first, since T levels have a wide range in individuals. Once low T is diagnosed, there are different tests that can be done in order to find out the potential causes. For example, testing luteinizing hormone (LH) to find abnormal levels might mean that there’s an issue with the pituitary glands. LH is the hormone that controls how you make testosterone. Another potential pituitary problem can be hinted at by high levels of the hormone prolactin, which is released by the pituitary gland.

Measuring the level of your blood hemoglobin is another method of testing for low T since hemoglobin and testosterone levels are linked, especially if they’re both low. However, at the end of the day, it’s going to come down to your symptoms, health history, and an examination to dictate what kind of tests will be done on you. As another example, a test to see if you have diabetes may be done since low T and diabetes are also linked. The causes of low T are wide and diverse, and so are the tests to diagnose.

Who Should Get Tested for Low T

The Endocrine Society released guidelines in 2018 stating that men who are healthy don’t need to be screened for low T. However, it is a good idea for some groups. If you’re experiencing many of the symptoms of low T or have narrowed down from other potential issues, then it’s probably a good idea to get tested. Furthermore, the American Urological Association advises testing testosterone in guys who are experiencing any of the following:

  • Infertility
  • Diabetes
  • Bone density loss
  • Unexplained anemia
  • Exposure to chemotherapy or testicular radiation
  • HIV/AIDS
  • Chronic narcotic users
  • Chronic corticosteroid use
  • Pituitary issues

Testosterone Treatments

Testosterone deficiency is when testosterone levels reach below 300ng/dL. At this point, it can be recommended that the patient either undergoes testosterone therapy or takes supplemental testosterone. However, it’s not a one-size-fits-all recommendation, It’s going to come down to why exactly you have low testosterone and what symptoms you’re experiencing (and want to relieve). If low T is caused by excessive drinking or obesity, testosterone therapy is likely not going to be the first thing recommended.

It also depends on what exactly the individual’s goals are. A younger man who isn’t fertile because of low T is going to undergo a different therapy than an older guy who wants to have more libido and energy. Any sort of medical therapy is going to be tailored to medical history and to the individual, so it’s necessary to talk to a doctor. If you’re simply looking to ensure that you have healthy amounts of T, having a healthy lifestyle is step number one.

Testosterone Replacement Therapy

There are various ways that low T can be treated therapeutically. These include:

  • Testosterone patches applied daily to different parts of the body
  • Injections into a muscle about every two weeks
  • Testosterone gels that are applied daily, making sure they’re not transferred to another person accidentally
  • Pellets that are placed underneath the skin on a bi-monthly basis

Although this therapy can be invasive in some cases, there are plenty of benefits that come along with it. For example, boys with low T can avoid issues that relate to delayed puberty. Other benefits include:

  • Increased bone density
  • An improvement in sexual function
  • Losing fat
  • Improvements in mood and a mental sharpness
  • Improved muscular strength and overall physical performance

However, there are also plenty of side effects that are important to watch out for. This is why it’s important to get tested for low T before diving into low T therapy treatments:

  • Acne and oily skin
  • Swelling in the ankle region
  • Urination problems
  • Breast enlargement and/or tenderness
  • Smaller testicles
  • Skin irritation
  • Worsening of sleep apnea

In spite of these potential side effects, testosterone replacement therapy is sometimes necessary or very recommended. All the benefits usually completely outweigh potential drawbacks. But once again, it is important to first find out whether it’s actually necessary or whether a simple lifestyle change can improve testosterone levels instead.

Increasing Testosterone Naturally

However, there’s a lot of room to work with before you go the therapy route. This is only really meant for cases where there are real medical issues around low T, or for older guys. If you’re young and think you have low T because you’re not experiencing the muscle gains you expect, there are a million other things to look at before considering low testosterone levels as the issue. Are you sleeping enough? Working out consistently? Eating right?

If you do want to ensure that your T levels are at a healthy level, the best way to do so is by eating the right foods. A diet consisting mostly of whole, clean foods is the only way to go. You need to get a wide range of nutrients while also avoiding sugars, refined carbs, and just junk food in general. These unhealthy foods actually promote increases in estrogen, which is the female hormone that lowers testosterone production. Alcohol is another big no-no if you’re looking to maximize your T levels.

While a healthy diet is the most important factor, it’s also important to be physically active on a regular basis while also maintaining a good sleeping schedule. Only once all these things are taken care of should we consider looking at other ways to boost testosterone. But while the medical therapeutic method is a good idea for more serious cases of low T, there are also supplements that can help.

3D illustration of "Testosterone Booster" title on pill bottle

What about T Boosters?

If maintaining a healthy lifestyle doesn’t fix any of your symptoms of low T levels, it might be time to look into other fixes. If your low T is seriously getting in the way of your health, it’s important to go to a doctor to get tested and prescribed a treatment. However, you might still be interested in increasing your T levels if you’re simply getting older or want to see if low T is getting in the way of your gym gains. For these problems, you can consider taking a T-boosting supplement.

However, make sure that it uses  high-quality ingredients that have some sort of basis in testosterone and science. But again, first, you have to make sure that all your bases are covered. Taking a supplement without first making sure all your ducks are in a row will either make very little difference or none at all. But if your genetic cards are stacked against you when it comes to T, boosters can be a great option.

Staying on Top of Testosterone Levels for Better Wellness

It’s obvious that testosterone is an extremely important hormone for guys—not only does it help us grow stronger with bigger muscles, but it’s also crucial for other important bodily functions. While T levels start to fall after the age of 30 naturally, there are plenty of other reasons that they might not be at the level they’re at. The only way to make sure is by getting a blood test done at a health clinic, but everyone can benefit from a lifestyle that serves to maximize T. Eating healthy, primarily, is the best way to go.You want to be balancing your macros between fats, carbs, and protein, while also getting plenty of micronutrients into you.

The best way to do this is by eating whole foods that aren’t overly processed and filled with sugar and processed carbs. Resistance training and getting enough rest are also crucial for anyone trying to keep a healthy level of testosterone. But if the cards are still stacked against you, there are plenty of options to try. Medically speaking, a doctor will have to find the root of the problem before prescribing any one treatment.

However, a  high-quality T booster can also work in a pinch if you’re simply trying to maximize gains or balance out falling T levels that come with age. A healthy level of testosterone usually comes with a healthy lifestyle. Keep your eye on the prize while implementing positive changes and you’ll be feeling like a new man in no time.