Low testosterone levels in men, particularly those over 40, are often indicative of broader health issues rather than isolated hormonal deficiencies, experts say. Dr. Channa Jayasena, an NHS endocrinologist and clinical professor at Imperial College London, emphasizes that low testosterone typically reflects poor health and fitness rather than a simple hormonal imbalance.
Testosterone levels naturally fluctuate, and while a small percentage of men—approximately two to three percent—may require testosterone replacement therapy (TRT) for clinically low levels, most can improve their hormone levels through lifestyle changes. One of the most effective strategies is weight loss, especially targeting abdominal fat.
A 2013 review analyzing 23 studies found a direct correlation between weight loss and testosterone increases, with men losing more weight experiencing larger hormonal gains. Dr. Jayasena advises men to monitor their waistlines, noting that excess fat around the midsection is linked to poorer metabolic and reproductive health. The NHS recommends keeping waist circumference to less than half of one’s height to reduce risks of type 2 diabetes, heart disease, and hypertension.
The concern centers on visceral fat, a deep abdominal fat surrounding organs that is hormone-active and can convert testosterone into estrogen, potentially lowering testosterone levels further. A 2018 study of over 300 men revealed that higher levels of abdominal fat were associated with testosterone levels 12 percent lower than those of men with more balanced fat distribution. This hormonal shift can contribute to symptoms such as decreased libido, erectile dysfunction, and additional weight gain.
Improving overall fitness is considered crucial for reducing visceral fat. Aerobic exercises like running, cycling, and swimming have been shown to be effective. Dr. Jayasena notes that no evidence conclusively points to one form of exercise as superior for boosting testosterone; instead, enhancing aerobic capacity and overall fitness level is key.
Sleep quality and duration are also vital factors in maintaining healthy testosterone levels. Much of the body’s testosterone is produced during deep sleep, making both the length and quality of rest critical. Disrupted or insufficient sleep—common among shift workers or parents of young children—can impair hormonal signals and reduce testosterone production. Research suggests that men aged 41 to 64 should aim for seven to eight hours of sleep per night to maintain optimal levels. One study indicated that sleeping only five hours per night could reduce testosterone by 10 to 15 percent.
Despite widespread promotion of supplements claiming to boost testosterone, experts caution that addressing foundational lifestyle factors remains the most effective approach. Adequate intake of macronutrients and overall calorie balance has the greatest impact on hormone levels. Some evidence links deficiencies in Vitamin D and zinc to lower testosterone, and preliminary research has suggested that compounds in certain foods, such as cacao, might modestly increase hormone levels. However, these findings are early-stage and should be interpreted with caution.
Dr. Jayasena and other specialists stress that no supplement can replace the benefits of a healthy diet, regular exercise, and sufficient sleep. Personal testimonies highlight that sustained lifestyle efforts can raise testosterone naturally to the upper range of normal without the risks associated with hormone therapy, despite social media narratives that often oversimplify the issue.