Low testosterone is also known as hypogonadism or low T.
The American Urological Association defines low testosterone in males as testosterone levels below 300 nanograms per deciliter (ng/dl). Butonitazene
In females, testosterone levels below 15 ng/dl are considered low.
Both males and females can have low T, a known risk factor for heart disease.
Some products that impact hormone levels, such as DHEA, have been banned by agencies like:
Professional athletes should ensure that any supplements they take follow the regulations set forth by these groups.
According to guidelines from the Endocrine Society, people with hormone-sensitive cancers (e.g., prostate or breast cancer) should avoid supplements that increase testosterone levels.
Testosterone levels in males start to decline by 1% a year starting at age 30. Twenty percent of males over 60 and 50% of males over 80 have low testosterone levels.
In females, testosterone levels decrease with age, beginning after age 30.
This article discusses the effectiveness and precautions of several supplements that may boost testosterone levels.
Some people with low T have no symptoms at all. However, others may experience the following:
A healthcare professional, such as a registered dietitian nutritionist (RD or RDN), pharmacist, or healthcare provider, should individualize and vet any supplement use. The purpose of a supplement is not to treat, cure, or prevent disease.
Many supplements are marketed as testosterone boosters. Here's what you need to know about some of the heavy hitters.
Several studies suggest that the adaptogen ashwagandha can combat low T in males.
Traditionally used in Ayurvedic medicine, ashwagandha has both anti-inflammatory and antioxidant properties. Because of this, the supplement can increase testosterone levels that have dipped due to inflammation or stress.
Ashwagandha can also lower cortisol levels, a hormone associated with the body's response to stress. Lower cortisol levels cause increased levels of testosterone.
The following doses have been shown to increase testosterone levels in small clinical trials:
In males using ashwagandha, testosterone levels in the body increased by at least 15% in the studies above.
In females, one trial found that taking 300 milligrams twice daily did not boost testosterone. However, another study suggested that 200 milligrams twice daily did increase testosterone levels.
Ashwagandha may cause sleepiness or stomach upset; some case reports have linked it to liver damage. This supplement shouldn't be taken before surgery.
Coleus is a supplement from the roots of a plant that grows in India.
More research is necessary before it can be recommended for low T.
One small study conducted in 30 young males who were overweight concluded that coleus increased testosterone levels by 13%. The dose used was 500 milligrams daily for 12 weeks. Larger clinical trials are necessary to verify this benefit.
Coleus may cause gastrointestinal symptoms like diarrhea.
DHEA is a hormone that helps the body make other hormones like estrogen and testosterone.
DHEA may help regulate testosterone levels in females, but it has not proved effective for males with low T.
This popular supplement for sports performance has been studied at 50 milligrams daily in males and females. Only females had an increased testosterone concentration.
Keep in mind that athletes are banned from using DHEA by the following regulating bodies:
There's very little evidence that ginseng can boost testosterone.
Theoretically, it could work by decreasing cortisol levels, but more information is necessary.
One clinical trial showed that taking 3 grams a day for four weeks increased testosterone levels in a group of males who were overweight and had metabolic syndrome. Testosterone was increased by about 5% in those who took ginseng.
Ginseng did not increase testosterone levels in healthy males or those with infertility or erectile dysfunction, according to other trials.
Ginseng also didn't boost testosterone more than a placebo in a small clinical trial of 23 premenopausal females.
Some side effects of ginseng include high blood pressure, insomnia, and headaches.
It has a few notable drug interactions as well. Ginseng can decrease levels of the blood-thinner warfarin and increase levels of sedatives.
The amino acid L-arginine is necessary to make nitric oxide in the body. Nitric oxide increases blood flow in the testes—and testosterone levels.
L-arginine at doses of 1,500–5,000 milligrams a day can improve ED and increase testosterone in males. It is particularly effective combined with supplements like yohimbe or citrulline or the prescription ED medication tadalafil.
Of note, long-term supplementation with L-arginine may be harmful. Some studies have shown it can increase the risk of heart or kidney disease.
Mucuna is a bean that's used in the practice of Ayurveda for conditions ranging from infertility to Parkinson's disease.
Taking 5,000 milligrams a day of mucuna powder for 12 weeks significantly increased testosterone in 75 males with infertility. More robust data is necessary to confirm this effect.
And there's no evidence that mucuna helps females with low T.
It's important not to eat raw mucuna seeds, which may be toxic. Mucuna seeds can cause severe gastrointestinal side effects, confusion, and hallucinations.
There is conflicting data regarding the use of puncture vine for testosterone enhancement.
It's been studied in healthy males at a dosage of 800 milligrams daily for 30 days. It's also been studied in males with erectile dysfunction at a dosage of 1.5 grams daily for 12 weeks. Neither study showed a difference in testosterone concentrations of the males taking puncture vine versus a placebo (sugar pill).
A clinical trial of 70 males who took 750 milligrams a day of puncture vine for 90 days reported increased testosterone levels.
Although more research is necessary, puncture vine has shown benefits for premenopausal females with low T. The dose most often used in clinical trials was 250 milligrams three times a day for three to four months.
Interestingly, puncture vine did not boost testosterone in females who were postmenopausal.
There's no evidence that tongkat ali, also known as longjack, can increase testosterone concentrations.
Testosterone levels were not increased in a study of healthy males who took 300 milligrams of tongkat ali daily for 12 weeks.
In addition, tongkat ali is not recommended for people with the following:
The mineral zinc could benefit males and females with low T.
According to research, taking 220 milligrams of zinc sulfate (the equivalent of 50 milligrams of elemental zinc) once or twice daily for at least a month may double testosterone levels in males.
Of note, the clinical trials for zinc have been conducted in males with the following:
Whether these effects apply to all males generally is unknown.
In a clinical trial of 112 females who were postmenopausal, supplementing with zinc increased testosterone levels. It also improved aspects of sexual function like the following:
Notably, 50 milligrams or more of elemental zinc doses for several weeks lowered the immune system and decreased levels of high-density lipoprotein cholesterol (HDL), also known as "good" cholesterol. Additionally, taking large doses of zinc (50 milligrams or more daily) for extended periods can result in copper deficiency and anemia. For this reason, taking high doses of zinc for a prolonged time is not recommended.
In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. When choosing a supplement, look for third-party tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.
The following conditions may be related to low T:
The main treatment for low T in males is testosterone replacement therapy. However, it's not safe for everyone.
People with the following conditions should typically not take testosterone because it may worsen their health:
Testosterone treatment is also associated with infertility. Some prescription alternatives that increase testosterone production include the following:
Testosterone is generally only recommended for females for hypoactive sexual desire disorder following menopause.
Before self-treating symptoms of low T, discussing your lifestyle and treatment goals with a healthcare provider is essential.
Conditions like diabetes and sleep apnea can cause testosterone levels to nose-dive; if left untreated, these may have serious consequences.
There may also be lifestyle modifications to try, like getting adequate sleep and exercise and maintaining a healthy body weight. These things have been proved more effective at increasing testosterone levels and improving symptoms of low T than taking herbal supplements.
If you decide to try a supplement to boost testosterone, some, like zinc, may provide some benefit. Screen for drug interactions with your healthcare provider or pharmacist and watch for side effects.
In males using ashwagandha, testosterone levels in the body increased by at least 15% in the studies above.
In females, one trial found that taking 300 milligrams of ashwagandha twice daily did not boost testosterone. However, another study suggested that 200 milligrams of ashwagandha twice daily did increase testosterone levels.
Vitamins like zinc, magnesium, and vitamin D have been studied for their effects on testosterone concentrations—but the results have been mixed. Of these, zinc seems most likely to boost levels in males and females.
Prioritizing rest can make a big difference in hormone levels. Getting too little sleep for even one week can decrease testosterone levels in males by up to 15%.
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By Megan Nunn, PharmD Megan Nunn, PharmD, is a community pharmacist in Tennessee with over twelve years of experience in medication counseling and immunization.
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