Low Testosterone in Men
Low testosterone affect many organ systems and significantly reduce quality of life
Common Symptoms
Fatigue, Low motivation, Low libido
Loss of muscle mass, Brain fog, Erectile dysfunction
Weight gain (especially belly fat), Depression or apathy
Reduced morning erections, Joint aches, Anxiety or irritability
Infertility, Hair thinning, Sleep issues, Poor orgasm intensity
Causes of Low Testosterone
Primary Hypogonadism (testicular failure)
Mumps orchitis, Trauma, surgery, radiation to testes
Secondary Hypogonadism (pituitary/hypothalamic)
- Pituitary tumors
- High prolactin
- Obesity
- Opioid use
- Steroid use
- Sleep apnea
- Head trauma
๐น Functional Causes
- Chronic stress
- Insulin resistance
- Chronic illness
- Excess alcohol
- Overtraining or extreme dieting
๐ฌ
Nutrient & Vitamin Deficiencies That Lower T
Vitamin D Needed for T production and LH sensitivity
Zinc Inhibits aromatase, boosts testicular function
Magnesium Increases free T by lowering Sex Hormone Binding Globulin
Vitamin B6 & B12 Needed for HPA axis and hormone metabolism
Selenium Supports testicular and thyroid health
Omega-3sAnti-inflammatory, support Leydig cells
๐งช
Systems and Labs to Check
EndocrineTotal & free testosterone,
SHBG, LH, FSH,
ProlactinThyroidTSH, free T3, free T4
Adrenal, AM cortisol, DHEA-S, Metabolic,
Fasting glucose, insulin, HbA1c, lipid panel
InflammatoryCRP, Ferritin, Vitamin D, Zinc, Magnesium, B12
๐ฉบ Medical Treatment Options
๐ 1.
Testosterone Replacement Therapy (TRT)
- Forms: Injections (cypionate/enanthate), gel, pellets
- Pros: Rapid symptom relief
- Cons: Fertility suppression, lifelong therapy
๐ 2
Clomiphene Citrate or Enclomiphene
- Stimulates natural T production via LH/FSH
- Best for younger men or fertility preservation
๐ 3
hCG (Human Chorionic Gonadotropin)
- Stimulates testicles directly
- Used alone or with TRT to preserve fertility and testicular size
โ ๏ธ
Add-on: Anastrozole (aromatase inhibitor)
- Used if estradiol rises too much on TRT
- Use cautiously; over-suppression of estrogen can worsen mood/libido
๐
Home Remedies & Lifestyle Management
โ 1. Diet
- High in healthy fats (avocados, olive oil, eggs)
- Anti-inflammatory foods (berries, leafy greens, fatty fish)
- Reduce processed carbs, sugar, alcohol
- Optimize protein (for LH and dopamine production)
โ 2. Exercise
- Resistance training boosts testosterone and reduces insulin resistance
- Moderate HIIT also beneficial
- Avoid overtraining → can suppress T
โ 3. Sleep
- Aim for 7–9 hours; deep sleep supports LH pulses
- Address sleep apnea
โ 4. Stress Reduction
- Chronic cortisol suppresses LH
- Meditation, breathing exercises, cold exposure can help reset HPA axis
๐
Suggested Supplement Stack (if deficient or symptomatic)
Vitamin D3 4,000–5,000 IU/day Improves T production
Zinc25–50 mg/day Cofactor for T synthesis
Magnesium glycinate300–500 mg/dayImproves sleep, mood, BP
T binding Boron3–6 mg/day Lowers SHBG, boosts free T
Ashwagandha600 mg/day Lowers cortisol, increases T
Tongkat Ali 200–400 mg/day Supports Leydig cell function
Omega-3s 1–2 g/day Anti-inflammatory, supports testicular membranes
Myo-inositol 2–4 g/day Improves insulin sensitivity, LH signaling
๐๐
Combining Medications + Supplements
Example Protocol for a Young Man with Low T & Fertility Concerns:
- Enclomiphene 12.5–25 mg/day
- Zinc + Vitamin D + Magnesium
- Ashwagandha or Tongkat Ali for HPA support
- Omega-3s + Myo-inositol for metabolic support
Example Protocol for Middle-Aged Man, Low T, No Fertility Need:
- Testosterone cypionate 100–150 mg/week
- Monitor estradiol, hematocrit
- Add vitamin D, zinc, fish oil, and magnesium
๐ Summary Chart
Low T Causes Obesity, stress, insulin resistance, vitamin D/zinc deficiency, pituitary dysfunction
Symptoms: Fatigue, low libido, ED, brain fog, depression
Labs to Order: T, Free T, SHBG, LH, FSH, estradiol, progesterone, insulin, DHEA-S, cortisol, vitamin D, zinc
Home Remedies: Resistance training, sleep, low-sugar diet, stress management
Medications: TRT, Clomiphene, Enclomiphene, hCG
SupplementsVitamin D, zinc, magnesium, boron, ashwagandha, omega-3s
