Hormone Guide (Men) · Spoke 3

How to Raise Testosterone Naturally: What the Evidence Really Shows

Powders, roots, miracle tips. When it comes to raising testosterone naturally, there is a lot of noise and little proof. This article soberly separates what studies support from what stays a myth. The focus is on sleep, strength training, weight and micronutrients in the case of a deficiency.

Shukri Jarmoukli · Physician, Integrative Medicine · ViveCura Berlin
My starting point

Hardly any question comes up in the men's consultation as often as this one: "What can I do to raise my testosterone naturally?" And hardly any question is surrounded by so much marketing. I prefer to keep it honest. There are real levers, but no miracle cures. What truly carries is unspectacular: sleep, weight, exercise, a calm blood sugar. These levers can bring a suppressed value back into its natural range. A powder, by current data, cannot. This article shows you what the research supports and where you can save your money.

Maybe you know the feeling. You type "boost testosterone" into the search bar and get steamrolled. Booster powders, tribulus, maca, exotic roots, tips with exclamation marks. Every promise sounds convincing, every one contradicts the next. In the end, confusion remains. This is exactly where the sober look pays off. Because science does have something to say on this question, only more quietly and more honestly than the advertising.

This article sorts out the most important natural levers. We look at what sleep, strength training, body weight and insulin, as well as zinc and vitamin D in the case of a deficiency, can really do. We clearly separate what is well supported by studies from what stays a myth. And we stay realistic throughout. This is not about pushing an already healthy value ever higher, but about taking the load off a suppressed system.

What "raising it naturally" actually means

Before we talk about levers, a clarification helps. "Raising testosterone naturally" does not mean pushing a healthy man past his biological range with tricks. It means bringing a low or suppressed value back to where it naturally belongs. That is an important difference. In a man with marked excess weight, poor sleep and chronic stress, there is often a lot of room. In a lean, well-rested man without a deficiency, the room is small.

From the view of clinical psychoneuroimmunology, or KPNI for short, testosterone is anyway not an isolated number. It is one voice in an orchestra of the nervous system, immune system, metabolism and hormone system. Anyone who wants to influence testosterone naturally is really turning these four dials. That is why the most effective levers are rarely spectacular. They are called sleep, weight, exercise and calm.

Reframe

A low testosterone value is rarely an isolated defect of the testes. It is often the body's answer to what is going on around it. Too little sleep, too much belly fat, chronic stress, too little exercise. That is not bad news. It means there are more points to act on than just turning one hormone dial. You do not raise testosterone directly. You take the load off the system, and testosterone follows.

The four KPNI lenses on raising it naturally

In KPNI we do not look only at the testes. We look at four interwoven layers that together explain why natural levers can work at all. Each lens describes a part at the cellular level. Together they form the picture of why sleep, weight and exercise move more for testosterone than a powder.

Nervous system and sleep

A large part of testosterone is made during sleep, steered through the rhythm of the hypothalamus and pituitary. At the cellular level, the pulsed release of the control hormones needs undisturbed deep-sleep phases. If sleep is missing, this beat falls out of step, and the signal chain to the testes can weaken. Restful sleep is therefore not an add-on but a foundation of nightly hormone production.

Immune system and inflammation

Inflammatory messengers stream out of belly fat that can, at the cellular level, disturb hormone signals and dampen the control in the brain. Anyone who reduces belly fat lowers this silent inflammatory load. That is one reason why weight loss can act on testosterone, without any direct intervention at the hormone itself. Inflammation is the link here between lifestyle and hormone status.

Metabolism and insulin

Insulin is itself a hormone. With insulin resistance, that is when cells respond less well to insulin, testosterone also comes under pressure. Strength training and weight loss improve insulin sensitivity at the cellular level. A calm blood sugar thus takes the load off not only metabolism but also hormone production. Metabolism and testosterone are closely linked.

Hormone system and aromatase

This is where the threads come together. The enzyme aromatase in fat tissue converts testosterone into estrogen. More belly fat means more conversion. At the cellular level, the hormone balance shifts this way. Anyone who lowers fat mass reduces this conversion. Anyone who wants to influence hormones naturally has to think of these layers as a connected whole, not as separate switches.

These four lenses are not a theoretical model. They are the reason why the proven levers all act on lifestyle and metabolism and not on a secret ingredient. And now we look at the levers one by one, starting with the strongest.

Weight and insulin: the strongest natural lever

If there is one factor that weighs most heavily on male testosterone, it is body weight itself. Being overweight is the condition most closely linked to low testosterone in men. The good news: this link can be used. Anyone who loses weight can often measurably raise their testosterone.

Study · overweight men, weight-loss diet

Weight loss raised testosterone and free testosterone

RCT, n=118 Lisa Moran and colleagues followed 118 overweight and obese men over 52 weeks in PLOS ONE in 2016. The men followed either a higher-protein or a higher-carbohydrate weight-loss diet. In both groups, total testosterone, the binding protein and free testosterone rose, with no difference between the diets. What mattered was the weight loss itself, not the exact composition. This suggests that for raising it naturally, the path runs through weight, and less through a particular miracle nutrient profile.

Moran LJ, Brinkworth GD, Martin S, et al. PLoS One. 2016;11(9):e0161297. doi:10.1371/journal.pone.0161297 · PMID: 27584019

Why this works so well is described in a review by Mathis Grossmann in Clinical Endocrinology in 2018. In moderate excess weight, the low total value mainly reflects a reduced binding protein. In marked excess weight, a genuine dampening of the higher-level control is added, mediated through inflammatory messengers and disrupted leptin signals. The direction matters: the effect of weight on testosterone is larger than the other way around, and marked weight loss can reactivate the control (doi:10.1111/cen.13723, PMID: 29683196).

Common mistake

"I first need more testosterone, then I will lose weight." This order turns the link upside down. The data suggest the path usually runs the other way. First the weight, then the hormone follows. Anyone who waits for testosterone in order to finally be able to lose weight gives away the most effective lever. In marked excess weight, losing weight is itself the most natural way to support testosterone.

Sleep: why testosterone is made at night

A large part of testosterone is made during sleep, above all in the early morning hours. Anyone who chronically sleeps too little or poorly is sawing at one of the foundations of their own hormone production. That is not a guess but is supported by controlled studies, even if the picture is more nuanced than often claimed.

Study · young men, sleep lab

A week of short sleep lowered daytime testosterone

Controlled lab study, n=10 Rachel Leproult and Eve Van Cauter studied young healthy men in the journal JAMA in 2011 who were restricted to around five hours of sleep per night for a week. Daytime testosterone fell by roughly ten to fifteen percent. The men also reported less energy and worse mood. This suggests that even a week of marked sleep loss can burden the male hormone system. Sleep is therefore a real lever, not a wellness extra.

Leproult R, Van Cauter E. JAMA. 2011;305(21):2173-2174. doi:10.1001/jama.2011.710 · PMID: 21632481

Here honesty matters to me, because the data are not uniform. Another controlled study by Isaac Smith and colleagues in Sleep Health in 2019 found that a milder and longer sleep restriction did not clearly lower testosterone in young men (doi:10.1016/j.sleh.2019.07.003, PMID: 31416797). What seems decisive is how severe the sleep loss is. A third study shows why poor sleep still does harm.

Study · sleep loss and metabolism

The shift in cortisol and testosterone burdens metabolism

RCT, crossover, n=34 Peter Liu and colleagues studied 34 healthy young men in a double-blind crossover trial in the Journal of Clinical Endocrinology and Metabolism in 2021. After four nights with only four hours of sleep, a measurable insulin resistance developed. When cortisol and testosterone were held artificially at a normal level, this insulin resistance was about half as large. This suggests that the shift in these two hormones is a central mechanism through which sleep loss burdens metabolism.

Liu PY, Lawrence-Sidebottom D, Piotrowska K, et al. J Clin Endocrinol Metab. 2021;106(9):e3436-e3448. doi:10.1210/clinem/dgab375 · PMID: 34043794

And now you know why good sleep is no side matter when it comes to testosterone. Snoring and breathing pauses in sleep in particular, so-called sleep apnea, are a common and checkable cause of exhaustion and low values in men. Anyone who sleeps poorly over the long term should take that seriously.

Strength training: the true mechanism lies in the remodeling

Hardly any myth holds on as stubbornly as this one: heavy training gives a testosterone surge, and that builds the muscles. The first half is true, the second is questionable. Right after a demanding session, testosterone does rise briefly. But this short rise is probably not the reason why muscles grow.

Study · trained young men

Acute hormone spikes did not predict muscle and strength gains

RCT, n=49 Robert Morton and colleagues followed 49 strength-trained young men over twelve weeks of whole-body training in the Journal of Applied Physiology in 2016. They found no link between the acute rise of testosterone or other anabolic hormones after training and the later gain in muscle mass or strength. This suggests that the short hormone spikes after exercise are overrated. Muscle growth follows other paths, above all the direct training stimulus at the muscle cell.

Morton RW, Oikawa SY, Wavell CG, et al. J Appl Physiol (1985). 2016;121(1):129-138. doi:10.1152/japplphysiol.00154.2016 · PMID: 27174923

Does that mean strength training does nothing for testosterone? No, on the contrary. It just acts on a different path. A review by Jakob Vingren and colleagues in Sports Medicine in 2010 describes how closely testosterone and muscle building are linked and how training changes the muscle cell's sensitivity to anabolic signals (doi:10.2165/11536910-000000000-00000, PMID: 21058750). The decisive point for practice: strength training builds muscle, lowers belly fat and improves insulin sensitivity. These three factors are exactly the ones linked to healthier testosterone values. So the lever is the long-term remodeling of body composition, not the short spike after the set.

Zinc, vitamin D and boosters: myth and measure

Now to the part that is advertised the most and holds up the least. Micronutrients and boosters are sold as the easy way. The data are more sober. The distinction matters: with a genuine deficiency, topping up can make sense, because a deficiency can burden hormone production. In a man without a deficiency, the added benefit is usually small to not measurable.

Study · men with low testosterone

Vitamin D did not measurably raise testosterone

RCT, double-blind, n=100 Elisabeth Lerchbaum and colleagues studied 100 healthy men with low testosterone and a low vitamin D level in the European Journal of Nutrition in 2018. Over twelve weeks, one half received high-dose vitamin D, the other a placebo. The result was clear: vitamin D had no measurable effect on total testosterone or the other hormone values. This suggests that topping up vitamin D in men without a marked deficiency is not a reliable way to raise testosterone.

Lerchbaum E, Trummer C, Theiler-Schwetz V, et al. Eur J Nutr. 2018;58(8):3135-3146. doi:10.1007/s00394-018-1858-z · PMID: 30460609

With zinc the picture is similar. A controlled study by Yan-Ling Liu and colleagues in the Asian Journal of Andrology in 2017 gave men with a particular form of hormone deficiency zinc in addition to the standard treatment. The added benefit on sperm production and hormone status was, according to the authors, very small (doi:10.4103/1008-682X.189621, PMID: 27768007). Zinc is important for hormone production, but extra zinc in already-supplied men brings little according to the study.

Study · analysis of 50 boosters

Most testosterone boosters do not keep their promise

Product analysis, literature comparison Chase Clemesha and colleagues examined fifty over-the-counter testosterone boosters in the World Journal of Men's Health in 2019. Ninety percent promised more testosterone, yet only around a quarter had any data at all supporting a rise. Around ten percent contained ingredients for which the opposite effect was described. Many products were dosed with vitamins and minerals far above the daily requirement, in part above the upper safety limit. This suggests that such products usually do not keep their promise and need not be harmless.

Clemesha CG, Thaker H, Samplaski MK. World J Mens Health. 2019;38(1):115-122. doi:10.5534/wjmh.190043 · PMID: 31385468

Common mistake

"More zinc or vitamin D means more testosterone." That is not how it works. A deficiency can burden hormone production, and then topping up can make sense. But a surplus does not drive testosterone any higher. Micronutrients are gap-fillers, not an accelerator. The sensible step is to first have a doctor check whether a deficiency exists at all, rather than dosing high on the off chance. High doses without a deficiency can even do harm.

The honest limit: what lifestyle can and cannot do

Natural levers can do a lot, but not everything. When excess weight, poor sleep and lack of exercise are in play, the room is large. When the basics are already in order and the symptoms remain, a workup belongs in the picture. A large lifestyle study makes the limit nicely clear.

Study · lifestyle and testosterone

Lifestyle is the base but does not replace every assessment

RCT, n=1007 Gary Wittert and colleagues studied more than a thousand overweight men with early stages of diabetes over two years in The Lancet Diabetes and Endocrinology in the T4DM study in 2021. All took part in a lifestyle program. This shows two things: lifestyle is the foundation and should come at the start. At the same time, some men needed more, and the additionally given testosterone treatment had side effects such as a thickening of the blood. This suggests that lifestyle comes first, but medical assessment remains important when symptoms persist.

Wittert G, Bracken K, Robledo KP, et al. Lancet Diabetes Endocrinol. 2021;9(1):32-45. doi:10.1016/S2213-8587(20)30367-3 · PMID: 33338415

There is a larger frame that belongs to honesty. Data suggest that men's testosterone values have fallen over generations, independent of the individual's aging, as a prospective cohort study by Thomas Travison and colleagues in the Journal of Clinical Endocrinology and Metabolism showed in 2007 (doi:10.1210/jc.2006-1375, PMID: 17062768). This means: some of it is not in the individual's hands alone, but also depends on environment and living conditions. All the more reason to use the levers that truly are in your hands.

Three levers that can support the whole system

Before you spend money on powders, the look at the basics pays off. They are not spectacular, but they support the whole connected system. These three levers are a start, not a treatment plan. You find the individual path with medical guidance.

1

Go after weight and belly fat, not symbols

Because belly fat can lower testosterone through aromatase and inflammation, a sustainable weight loss in excess weight is the strongest natural lever. This is not about quick diets but about a diet that keeps blood sugar calm, with enough protein and fiber. Even a moderate weight loss could reactivate the control of the testes and improve metabolism at the same time.

2

Protect your sleep like a treatment

Since a large part of testosterone is made during sleep, restful sleep is not a nicety but hormone work. A fixed rhythm, a dark, cool bedroom and taking snoring and breathing pauses seriously can make a difference. Sleep apnea is a common and checkable cause of exhaustion and low values in men and belongs investigated.

3

Move, above all with resistance

Strength training and regular exercise can improve insulin sensitivity, build muscle and lower belly fat, exactly the factors linked to testosterone. The acute hormone spikes after training matter less here than the long-term remodeling of body composition. You do not have to become an athlete. Regular, demanding exercise can already help the whole system.

And if the symptoms remain despite good basics, a workup belongs in the picture, one that looks at the whole picture and not only at a single value. Testosterone should be measured in the morning and ideally more than once, together with control hormones, blood count, thyroid, iron and blood sugar. This helps find treatable causes instead of pinning symptoms prematurely on one hormone. A good assessment takes your symptoms seriously.

The core

You do not raise a hormone, you unload a system

There is no secret ingredient and no shortcut. What the data support is unspectacular and, exactly for that reason, reliable. Sleep, weight, exercise and a calm blood sugar can take the load off a suppressed testosterone. You are not chasing a number. You are giving your body back the conditions under which it can find its own rhythm.

Frequently asked questions about raising testosterone naturally

Can you really raise testosterone naturally?

Partly yes, but with sober expectations. The best-supported finding is that low testosterone can improve through lifestyle when there is a recognizable trigger. Above all, marked weight loss in overweight men, sufficient and restful sleep and regular strength training can take the load off the male hormone system. These levers do not work overnight and not equally in everyone. In a man with normal weight, good sleep and no deficiency, the extra room is small. So it is less about pushing an already healthy value ever higher, and more about bringing a suppressed value back into its natural range. Miracle promises about powders or single foods, by contrast, usually do not hold up to scrutiny.

What role does sleep play for testosterone?

Sleep is one of the foundations of male hormone production, because a large part of testosterone is made at night. One controlled study showed that a week with only five hours of sleep can clearly lower daytime testosterone in young men. Sleep is therefore not a wellness extra but hormone work. The nuance matters, though: the data are not uniform, and milder or shorter restrictions showed no clear effect in other studies. What seems decisive is how severe and how lasting the sleep loss is. Anyone who chronically sleeps too little or poorly should take that seriously, especially because snoring and breathing pauses are a common and checkable cause.

Does strength training help raise testosterone?

Strength training can support the male hormone system, but in a different way than many think. Right after a demanding session, testosterone rises briefly. Studies suggest, however, that these short spikes are not the reason for muscle growth. More important is the long-term remodeling of body composition. More muscle, less belly fat and better insulin sensitivity are exactly the factors linked to healthier testosterone values. So strength training works less through a direct hormone surge and more through the detour of metabolism and body composition. You do not have to become a competitive athlete. Regular, demanding resistance exercise can already help the whole system.

Why is losing weight the strongest lever for testosterone?

Being overweight is the condition most closely linked to low testosterone in men. Several mechanisms interlock. Belly fat contains the enzyme aromatase, which converts testosterone into estrogen. At the same time, inflammatory messengers and disrupted leptin signals from fat tissue can dampen the higher-level control in the brain. A controlled study showed that weight loss in overweight men can measurably raise total testosterone and free testosterone. The direction of the link matters: the effect of weight on testosterone is larger than the other way around. That is why, in overweight men, weight is often the first and most effective lever, not the last.

Do zinc and vitamin D give you more testosterone?

Only within a narrow frame, and often less than advertised. With a genuine, marked deficiency, topping up can make sense, because a deficiency can burden hormone production. In men without a clear deficiency, the effect is usually small to not measurable. A controlled study found that high-dose vitamin D did not measurably raise testosterone in men with a low baseline. For zinc too, the added benefit in already-supplied men is rather subtle in studies. This suggests micronutrients are not a booster but a gap-filler. The sensible step is to first have a doctor check whether a deficiency exists at all, rather than supplementing on the off chance.

Are testosterone boosters from the internet worth it?

With over-the-counter testosterone boosters, the evidence is thin and often disappointing. An analysis of fifty advertised boosters found that only a small share had any data at all supporting a rise in testosterone. Some products contained ingredients for which the opposite effect was described, and many were dosed with vitamins and minerals far above the daily requirement. That is not harmless, because micronutrients too can cause problems in high doses. The sober conclusion: a powder does not replace the basics. Sleep, weight, exercise and stress regulation, by current data, usually work more strongly than an advertised product.

Are there foods or home remedies that raise testosterone?

A single food or home remedy that reliably raises testosterone is not convincingly proven scientifically. What the data do support is the detour through the bigger picture. A diet that keeps blood sugar calm, provides enough protein and fiber and helps reach a healthier weight can indirectly take the load off the hormone system. In a controlled study, both a higher-protein and a higher-carbohydrate weight-loss diet improved testosterone, as long as weight was lost. This suggests that no magic food is what counts, but the overall effect of the diet on weight and metabolism. Home-remedy promises about single roots or spices should be read with caution.

How long does it take for testosterone to change naturally?

That depends on the lever and cannot be pinned to a fixed time. With weight loss, studies showed changes over weeks to months, with values in part continuing to improve over a year as long as the weight was kept off. With sleep, hormone patterns can shift over days to weeks. Strength training works through the slow remodeling of body composition and needs more like months. The honest expectation matters: this is not about a quick jump but a gradual unloading of the system. Anyone who expects a dramatic effect after a few days will be disappointed. Anyone who stays with it gives the body the chance to find its rhythm.

When is lifestyle not enough and medical assessment is needed?

Lifestyle is the foundation, but no substitute for a workup when symptoms remain. You should seek medical assessment for persistent fatigue and low drive, marked loss of libido, newly arising erection problems, an unfulfilled wish to have children, as well as low moods that do not pass. Treatable causes can hide behind such symptoms, for example a thyroid disorder, sleep apnea, iron deficiency, depression or a genuine hormone deficiency. Testosterone should be measured in the morning and ideally more than once, together with the control hormones and further values. This helps tell apart whether the basics are enough or whether more is needed. A good assessment takes your symptoms seriously instead of pinning them prematurely on a single hormone.

Is more testosterone always better?

No. The idea of driving testosterone ever higher is a misunderstanding. The sensible aim is to bring a suppressed value back into its natural range, not to over-steer a healthy man. Externally supplied testosterone is something different from natural levers and belongs in medical hands, because it can have side effects such as a thickening of the blood. The holistic view therefore asks not only about the number but about the whole system of sleep, weight, metabolism and stress. A good value in a poorly regulated system brings little. A smoothly running system with a value in the natural range is the actual goal.

Connections to other topics

When the value stays lowUnderstanding testosterone deficiency

The deeper take on when a low value is really a deficiency and when lifestyle alone is no longer enough.

When stress is the topicCortisol and the HPA axis in burnout

The honest take on cortisol and the stress axis, which is closely interwoven with sleep and the control of your testosterone.

When energy is missingIron deficiency and iron infusions

Iron deficiency amplifies many symptoms that look like a pure hormone problem, from exhaustion to reduced stamina.

When the gut is involvedGut reset: holistic gut treatment

Through the immune system and silent inflammation, the gut helps shape how well your hormone balance stays in equilibrium.

SJ
Written by

Shukri Jarmoukli

Physician, Integrative Medicine, Clinical Psychoneuroimmunology · ViveCura Berlin, Skalitzer Straße 137 · Focus: male hormones as a connected system. On the topic of raising it naturally, I deliberately keep it sober and separate what studies support from what marketing promises. This spoke draws on controlled studies on weight loss (Moran 2016, PLOS ONE), on sleep (Leproult 2011, JAMA; Liu 2021, Journal of Clinical Endocrinology and Metabolism), on strength training (Morton 2016, Journal of Applied Physiology) and on micronutrients and boosters (Lerchbaum 2018, European Journal of Nutrition; Clemesha 2019, World Journal of Men's Health). My aim is a men's consultation that takes the whole system seriously, speaks honestly about limits and promises no miracles.

Sources and further reading

  1. Moran LJ, Brinkworth GD, Martin S, et al. Long-Term Effects of a Randomised Controlled Trial Comparing High Protein or High Carbohydrate Weight Loss Diets on Testosterone, SHBG, Erectile and Urinary Function in Overweight and Obese Men. PLoS One. 2016;11(9):e0161297. doi:10.1371/journal.pone.0161297 · PMID: 27584019 [RCT]
  2. Grossmann M. Hypogonadism and male obesity: Focus on unresolved questions. Clin Endocrinol (Oxf). 2018;89(1):11-21. doi:10.1111/cen.13723 · PMID: 29683196 [Review]
  3. Leproult R, Van Cauter E. Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA. 2011;305(21):2173-2174. doi:10.1001/jama.2011.710 · PMID: 21632481 [RCT]
  4. Smith I, Salazar I, RoyChoudhury A, St-Onge MP. Sleep restriction and testosterone concentrations in young healthy males: randomized controlled studies of acute and chronic short sleep. Sleep Health. 2019;5(6):580-586. doi:10.1016/j.sleh.2019.07.003 · PMID: 31416797 [RCT]
  5. Liu PY, Lawrence-Sidebottom D, Piotrowska K, et al. Clamping Cortisol and Testosterone Mitigates the Development of Insulin Resistance during Sleep Restriction in Men. J Clin Endocrinol Metab. 2021;106(9):e3436-e3448. doi:10.1210/clinem/dgab375 · PMID: 34043794 [RCT]
  6. Morton RW, Oikawa SY, Wavell CG, et al. Neither load nor systemic hormones determine resistance training-mediated hypertrophy or strength gains in resistance-trained young men. J Appl Physiol (1985). 2016;121(1):129-138. doi:10.1152/japplphysiol.00154.2016 · PMID: 27174923 [RCT]
  7. Vingren JL, Kraemer WJ, Ratamess NA, et al. Testosterone physiology in resistance exercise and training: the up-stream regulatory elements. Sports Med. 2010;40(12):1037-1053. doi:10.2165/11536910-000000000-00000 · PMID: 21058750 [Review]
  8. Lerchbaum E, Trummer C, Theiler-Schwetz V, et al. Effects of vitamin D supplementation on androgens in men with low testosterone levels: a randomized controlled trial. Eur J Nutr. 2018;58(8):3135-3146. doi:10.1007/s00394-018-1858-z · PMID: 30460609 [RCT]
  9. Liu YL, Zhang MN, Tong GY, et al. The effectiveness of zinc supplementation in men with isolated hypogonadotropic hypogonadism. Asian J Androl. 2017;19(3):280-285. doi:10.4103/1008-682X.189621 · PMID: 27768007 [RCT]
  10. Clemesha CG, Thaker H, Samplaski MK. 'Testosterone Boosting' Supplements Composition and Claims Are not Supported by the Academic Literature. World J Mens Health. 2019;38(1):115-122. doi:10.5534/wjmh.190043 · PMID: 31385468 [Review]
  11. Wittert G, Bracken K, Robledo KP, et al. Testosterone treatment to prevent or revert type 2 diabetes in men enrolled in a lifestyle programme (T4DM). Lancet Diabetes Endocrinol. 2021;9(1):32-45. doi:10.1016/S2213-8587(20)30367-3 · PMID: 33338415 [RCT]
  12. Travison TG, Araujo AB, O'Donnell AB, et al. A population-level decline in serum testosterone levels in American men. J Clin Endocrinol Metab. 2007;92(1):196-202. doi:10.1210/jc.2006-1375 · PMID: 17062768 [Cohort]
A note on the evidence: This article connects well-supported relationships with areas where research is still in flux. It is solidly supported that weight loss in overweight men can raise testosterone (Moran 2016, Grossmann 2018) and that marked sleep loss can lower testosterone (Leproult 2011, Liu 2021), while milder restrictions are less clear-cut (Smith 2019). For strength training, data suggest that not acute hormone spikes but the remodeling of body composition is what counts (Morton 2016, Vingren 2010). For micronutrients and boosters, the expectation is usually larger than the proven effect (Lerchbaum 2018, Liu 2017, Clemesha 2019). This text is for information and does not replace medical examination, diagnosis or treatment. Dietary supplements in high doses can have side effects. Testosterone replacement therapy is prescription-only and belongs in medical hands. For persistent, new or unusual symptoms, for newly arising erection problems or for an unfulfilled wish to have children, a medical assessment should take place. For low moods that do not pass, or for thoughts of no longer wanting to live, please seek medical or psychotherapeutic help right away (in Germany, the free helpline Telefonseelsorge is available at 0800 111 0 111 or 0800 111 0 222).

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