Testosterone 2/2: Supporting Healthy Levels, What Actually Matters

This article is Part 2 of our two-part series on testosterone. Part 1 covers what testosterone does, how it circulates in the bloodstream, and the signs that may suggest an imbalance.

This part answers a more practical question: can you support your testosterone naturally?

This question is particularly relevant for men. Several American studies have observed a decline in average testosterone concentrations across generations. In adolescents and young adults, one analysis reported a drop of close to 25% between 1999 and 2016.

This does not mean that all men are testosterone deficient today. What it mainly shows is that age does not explain everything. Sleep, metabolic health, body composition, energy intake, training, certain medications and certain medical conditions can also alter its production.

In men: identifying what holds production back

When testosterone is low, the first step is to identify what might explain the decline. The goal is not to “boost” it, but to remove the brakes where they exist.

1. Sleep enough, and sleep well

Why? Testosterone production follows the circadian rhythm, but also the course of sleep itself. It rises after falling asleep, in step with LH pulses, and generally reaches its highest level in the morning between 6am and 8am. Sleep that is too short or heavily fragmented can therefore disrupt this production.

Obstructive sleep apnea is particularly important to look for. It combines fragmented sleep, hypoxia, fatigue and often metabolic changes: several factors associated with lower testosterone. Studies on a few nights of restriction give variable results, however: what matters most is repeated sleep loss and overall sleep quality.

What to put in place:

• sleep at least seven hours a night, more depending on your needs

• keep a relatively stable wake-up time

• reduce alcohol in the evening, which fragments sleep

• avoid combining short nights with intense training

• seek advice in case of heavy snoring, breathing pauses, morning headaches or daytime sleepiness

• have blood drawn in the morning, after a usual night and outside any acute illness

2. Build muscle without accumulating fatigue

Why? Strength training builds muscle, improves insulin sensitivity and helps reduce abdominal fat: three factors that help preserve a metabolic environment favourable to testosterone production.

Conversely, a high training load combined with insufficient intake can reduce the signals sent from the brain to the testes. In men, RED-S (relative energy deficiency in sport) can then come with a drop in testosterone, libido, recovery and performance.

What to put in place:

• do two to three progressive strength sessions per week

• increase the loads progressively rather than adding more sessions

• keep one to two days of genuine recovery each week

• plan lighter weeks when fatigue accumulates

• adapt carbohydrate and energy intake to training volume

• monitor performance, sleep, libido and morning erections

3. Eat enough

Why? Testosterone is a steroid hormone made from cholesterol. That does not mean you should eat more cholesterol, but that diets very low in fat are not favourable to its production.

Above all, when energy intake becomes insufficient relative to needs and physical activity, the body reduces the hormonal signals that drive reproductive function. LH secretion falls, and with it the testicular stimulation needed to produce testosterone.

What to put in place:

• avoid aggressive calorie deficits and rapid weight loss

• increase portions on long or intense training days

• spread protein across your meals

• eat healthy fat sources: olive oil, eggs, oily fish, nuts and seeds

• reassess intake in case of persistent hunger, fatigue, dropping performance, unintentional weight loss or reduced libido

4. Improve metabolic health

Why? Abdominal obesity can lower SHBG, and therefore measured total testosterone, through hyperinsulinemia. It can also disturb the hormonal axis more deeply through inflammation, leptin signalling and increased aromatisation in adipose tissue.

The relationship works both ways: low testosterone makes it easier to lose muscle and accumulate fat, while a degraded metabolic terrain can reduce its production. In men living with obesity, losing fat mass is often accompanied by a rise in testosterone.

What to put in place:

• measure waist circumference as well as weight

• check glucose, HbA1c, triglycerides, liver panel and blood pressure depending on the context

• combine strength training, daily walking and cardiovascular activity

• look for sleep apnea when it is likely

• reduce excess fat mass progressively without sacrificing muscle

5. Correct the deficiencies that can limit production

Why? Hormone production and testicular function depend on several micronutrients. An insufficiency can become a limiting factor.

Zinc is involved in testicular function, sperm production and the mechanisms needed for hormone synthesis. A deficiency can reduce testosterone; supplementation appears mainly useful when baseline status is insufficient.

Vitamin D contributes to muscle, bone and reproductive health. A low status is often associated with lower testosterone, but supplementation does not systematically raise it when status is already adequate.

Magnesium is involved in energy metabolism, muscle contraction and sleep. It can be relevant when intake is low, particularly in athletes, without being a direct booster.

What to put in place:

• eat zinc-rich foods: oysters, seafood, meat, eggs, dairy, legumes and seeds

• measure 25-OH vitamin D if there is a risk of deficiency and adapt supplementation to the result

• increase magnesium sources: cocoa, nuts, seeds, legumes and green vegetables

• look for the causes of a deficiency: dietary restriction, digestive disorders, alcohol or medications

• avoid prolonged high doses of zinc without monitoring copper

6. Reduce accumulated stress

Why? Chronic stress activates the hypothalamic-pituitary-adrenal axis. When it is added to sleep loss, energy deficit and a high training load, it can disturb reproductive signalling and impair recovery.

The problem is not an occasional rise in cortisol, which is normal and useful. It is the accumulation of demands without sufficient recovery.

What to put in place:

• assess the total load: work, training, sleep and dietary restriction

• plan short daily periods without work or stimulation

• use walking, slow breathing or meditation to help you settle

• temporarily reduce training when sleep or performance deteriorate

• limit caffeine used to compensate for sleep debt

• keep genuine rest days

Which supplements are actually useful?

Supplements are where most of the marketing sits, and where the evidence is thinnest. Here is what the data actually supports.

Zinc. Can help in case of deficiency or low intake. High doses in the long term are no more effective and can cause copper deficiency.

Vitamin D. Mainly serves to correct a documented deficiency. The dose should be adapted to the blood result, not chosen for the sole purpose of raising testosterone.

Magnesium. Can be useful when intake is low or needs are high, particularly to support neuromuscular function and sleep.

Ashwagandha. Produced a modest increase in testosterone in some small trials, mainly in stressed men. The results do not support a universal recommendation. It also calls for caution in case of thyroid, autoimmune or liver disease, or ongoing medication.

Fenugreek. Has shown modest effects with certain standardised extracts. Results vary by product and population; it can also alter blood glucose and interact with anticoagulants.

Shilajit. Has shown interesting preliminary results on raising total and free testosterone in one small trial. The data remain limited for a general recommendation, however, and the quality of commercial products is highly variable, with documented risks of heavy metal contamination.

When lifestyle is not enough

Low testosterone can point to a problem in the testes, the pituitary or the hypothalamus, to hyperprolactinemia, a chronic illness, haemochromatosis, or the effect of a medication.

A medical cause should be investigated in the presence of:

• persistent loss of libido, erectile dysfunction or the disappearance of morning erections

• infertility, reduced testicular volume or gynecomastia

• unexplained muscle loss, fractures or low bone density

• hot flushes, unexplained anemia or marked fatigue

• headaches, visual disturbances

• low testosterone found on more than one occasion

In women

In women, 50% of testosterone comes from the conversion of precursors such as DHEA, 25% from the ovaries and 25% from the adrenal glands. It contributes in particular to sexual function, the maintenance of muscle and bone health.

But there is no “testosterone deficiency” defined by a precise number in women. A drop in desire, energy, strength or motivation can also be linked to estradiol, sleep, the thyroid, iron status, energy availability, medications, pain or relationship context.

What can reduce available androgens

• age and the progressive change in ovarian and adrenal production

• removal of the ovaries, which causes a more abrupt drop

• certain pituitary or adrenal disorders

• insufficient energy availability in female athletes

• certain treatments, glucocorticoids in particular

• combined oral contraceptives

These reduce ovarian androgen production and increase SHBG, which holds a greater share of testosterone in the bloodstream. In one meta-analysis, free testosterone fell by around 61% on average.

What to put in place

• eat enough, particularly if you train regularly

• do not combine dietary restriction, heavy cardio and insufficient recovery

• do two to three strength sessions a week to preserve strength, muscle and bone

• correct iron, vitamin D, zinc or magnesium deficiencies where they exist

• look for a thyroid cause, a lack of estrogen, a sleep disorder or RED-S before concluding this is a testosterone problem

• revisit the timeline of the symptoms: did they start after contraception, ovarian surgery, significant weight loss or the beginning of perimenopause?

• talk to the prescriber when a drop in desire or wellbeing appears after starting contraception

Should testosterone be measured?

Measuring it can help make sense of the context, particularly when it is interpreted alongside SHBG, DHEA-S, estradiol, LH, FSH, prolactin and thyroid function.

The result therefore has to be placed back in its hormonal, metabolic, medical and relational context.

What Lucis measures

Testosterone should never be interpreted in isolation.

Lucis analyses it alongside free testosterone, SHBG, DHEA-S, estradiol, LH, FSH, prolactin, thyroid function, glucose, HbA1c, insulin, vitamin D and iron status.

The goal is to understand:

• whether the result is consistent with the symptoms

• which fraction of testosterone is actually available

• whether the hormonal signalling is working properly

• which metabolic, nutritional, medication-related or medical factors may explain the variation

The podcast episode

Bastien Intartaglia is a PhD in cognitive neuroscience, a men's health specialist and the founder of Code Primal. In this episode we look at what testosterone really is, what makes it fall, how to read a blood panel properly, and which natural levers actually work.

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The information in this article is provided for educational purposes only and does not constitute medical advice. It is not a substitute for consultation with a qualified healthcare professional. Lucis is not a medical device and does not provide diagnoses.

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