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

๐Ÿ”น Functional Causes

  • Chronic stress
  • Insulin resistance
  • Chronic illness
  • Excess alcohol
  • Overtraining or extreme dieting

๐Ÿ”ฌ

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


๐Ÿงช

 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


๐Ÿฉบ Medical Treatment Options


๐Ÿ’‰ 1.

Testosterone Replacement Therapy (TRT)

  • Forms: Injections (cypionate/enanthate), gel, pellets
  • Pros: Rapid symptom relief
  • Cons: Fertility suppression, lifelong therapy


๐Ÿ’Š 2

Clomiphene Citrate or Enclomiphene

  • Stimulates natural T production via LH/FSH
  • Best for younger men or fertility preservation


๐Ÿ’‰ 3

 hCG (Human Chorionic Gonadotropin)

  • Stimulates testicles directly
  • Used alone or with TRT to preserve fertility and testicular size


โš ๏ธ

Add-on: Anastrozole (aromatase inhibitor)

  • Used if estradiol rises too much on TRT
  • Use cautiously; over-suppression of estrogen can worsen mood/libido


๐Ÿƒ

Home Remedies & Lifestyle Management

โœ… 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)

โœ… 2. Exercise

  • Resistance training boosts testosterone and reduces insulin resistance
  • Moderate HIIT also beneficial
  • Avoid overtraining → can suppress T

โœ… 3. Sleep

  • Aim for 7–9 hours; deep sleep supports LH pulses
  • Address sleep apnea

โœ… 4. Stress Reduction

  • Chronic cortisol suppresses LH
  • Meditation, breathing exercises, cold exposure can help reset HPA axis


๐Ÿ’Š

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


๐Ÿ’Š๐Ÿ”„

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



๐Ÿ“‹ 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

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