low testosterone

 If you have the symptoms of low testosterone and been tempted by commercials or supplement labels claiming to give you back your youth with their testosterone product, let’s consider another way. If you have considered hormone replacement therapy or over the counter supplement options for treating symptoms of lower testosterone in men, this article is for you.

First and foremost, we know that hormone replacement therapy when done well can be a necessary support to the body. We do a lot of hormone supplementing, and we also encounter a lot of people on hormone replacement therapy who do not need to be, and/or are not getting the results they expected. Men age 35+ is a group who is often very quickly offered testosterone supplementation in forms of creams, sprays, and pills with little or no lab testing, or understanding of why the testosterone is low. Articles 1 and 2 in our Men’s Hormone Health series cover reasons for lower testosterone and how treatment should be approached. Here we are specifically looking at lifestyle modifications that can improve testosterone levels. Avoiding or taking only minimal amounts of hormone replacement therapy is always beneficial when it can be achieved. Again, we are not against men needing supplemental testosterone, but simply adding testosterone onto a poorly functioning system that is not processing it effectively will not give you the results you want short term or long term. 

Primary Cause for Lower Testosterone

While much of this information is covered in previous articles, it is worth a quick recap that the primary cause of lower testosterone in men is lifestyle factors that are causing testosterone to be converted into estrogen. These lifestyle factors being out of balance cause the body to produce more aromatase enzyme which is how testosterone gets converted into estrogen. This is a “double whammy” so to speak, because it produces both the low mood, low libido, and loss of lean muscle mass from low testosterone, but also the weight gain, low libido, fatigue, urinary tract issues (BHP), etc associated with increased estrogen. Estrogen dominance and lower testosterone are kind of like two side of a teeter totter and need to be balanced. 

Low Testosterone | 6 Ways to Improve Testosterone and Balance Estrogen

Decrease chronic stress

OK, right out of the gate we’ve go to get really honest about how not admitting, recognizing, and responding to stress will cost you your health. Chronic stress disregulates your HPA-axis (hypothalamic-pituitary-adrenal) which is responsible for how your body physiologically responds to stress. This system also regulates your immune system, digestion, hormone production, metabolism and more. High cortisol from stress suppresses testosterone production. Lack of sleep is one example of chronic stress that is overlooked. One study found young men who slept 5 hours or less decreased testosterone by 10-15%. Sleep apnea has the same effect. Chronic stress is any situation that disrupts the HPA axis. This could be lack of sleep, work environment, relationship struggles, financial stress, and even over exercising. 

Your first temptation when reading this, even subconsciously may be to scoff and think “not me.” Yes- you. It very very much includes you, especially if you experience fatigue, weight gain, low mood. Or perhaps you’re not as interested in sex as you used to be or  you find yourself more easily irritable or provoked to anger. 

We get it. Life is full. Stress happens. We are not expecting you to eliminate stress, but we do think you need to deal with it. By “dealing with it” we do not mean doubling down on more caffeine, alcohol, work, or other addictive behaviors that allow us to not feel the immediate impact of stress. 

Perhaps what we mean is developing strategies to lessen the effect of stress on your body. This could be exercise (moderate), connecting with trusted people in honest open dialogue, doing some written reflections, taking an afternoon off to be outside or be alone. We can’t tell you how exactly you need to better support your body in stress and relieve stress when you can, but we can tell you that if you don’t your health will suffer, if it isn’t already. Most of the high functioning, high capacity men we work with only remain that way when they do the emotional work in their life as well. 

Another point regarding stress is that historically and generally speaking men tend to hold in emotions more than most women.  Emotional stress has the same impact on the body’s physiology as physical stress. Honesty, openness, vulnerability, connectedness, and compassion for yourself can be ways to engage the emotional space. Emotions need to be detoxed (let out) just as much as your liver, GI tract, or skin may need a detox. What do you have in place for emotional detox?

Improve insulin sensitivity/manage weight

There are many ways in which insulin sensitivity is diminished in men as they age. Stress and weight gain being primary contributors. However, decreased insulin sensitivity also causes weight gain, so there is a vicious cycle when stress begins to dysregulated hormones because insulin is part of the downstream effect of disruption to the HPA-axis. Higher levels of belly fat is associated with decreased testosterone levels due to the increased rate of conversion of testosterone to estrogen from more aromatase enzyme activity.  

Many people simply are simply unaware of how much processed, refined carbohydrates inhibit insulin sensitivity. For many people, two very simple diet changes can significantly improve insulin resistance and lead to better hormone balance. For others their metabolic system is a bit more stuck, or even more influenced by other factors like chemical toxins, so more changes are needed. If you want to improve your body’s natural ability to balance hormones, try making these two diet changes first: 

  1. Eliminate processed, refined sugars. As needed for something sweet use Stevia, organic maple syrup, or raw honey
  2. Make ½ your plate non-starchy vegetables at each meal (at least lunch and dinner). Then split the other ½ of your plate between an unprocessed starch (root vegetables, including potato, organic rice, quinoa, or millet), and a high quality animal protein (grass-fed beef, pastured chicken, wild salmon, pastured eggs). For most people, this will double their vegetable serving and cut the carbohydrate serving down by ½. 

These small shifts can take the load off the insulin and blood sugar system while eliminating many of the inflammatory and chemical toxicity factors associated with processed foods. 

Exercise effectively

Simply pushing for 30 minutes on the treadmill without some restorative exercise, weight lifting, or interval training can actually increase inflammation in the body, depending on the person. For men, interval training that includes weight lifting can increase testosterone while long distance or too high impact cardio can exhaust the adrenals and further impact low testosterone. In a study of men who were all regularly exercising, when they moved to interval training testosterone levels increased, and leptin (the hunger hormone) decreased. In another similar study, ghrelin levels were increased (feeling of fullness). The general conclusion in the exercise science and medical community is there are favorable hormone responses in interval training that promote hormone balance and weight loss. 

Omega 3 Fatty Acid supplementation

While the right functional medicine practitioner will have a more comprehensive supplement strategy available to you, most people will benefit from the antiinflammatory effects of omega 3 fatty acids through a high quality fish oil supplement. Quality is essential as a poor quality fish oil can actually INCREASE inflammation in the body. Check out the fish oil options here. 1,000 mg of EPA and DHA each is a general place most people can start for supplementing with fish oil, but we always suggest working with your practitioner to personalize your dose for optimal results. Decreasing inflammation in the body will take stress of all the hormone producing and regulating systems in the body. Underlying inflammation is a big part of why these systems get out of balance in the first place. 

Health the gut

At the end of the day, you can do all the tips and tricks available from all the great resources available, but if your gut isn’t healthy (or getting there), they simply won’t work. Nothing will replace gut health. For some, improving gut health can be a as simple as eliminating gluten, dairy, processed foods, and adding in fermented foods or probiotic supplements. For others, the damage to the gut has been extensive and long term and can take time to heal. The 4 gut helpers below may be enough to get you on the right track, but even if you need extra help from a functional medicine practitioner, these 4 things still will need to be in place, so it’s worth starting no matter where you are in your gut healing journey. 

4 Gut Helpers

  1. Eliminate gluten containing foods
  2. Eliminate dairy products (exceptions are raw hard cheese and grass-fed butter when well tolerated)
  3. Take a quality probiotic supplement
  4. Eat fermented foods daily if possible (2-3x a week is a start)

Thinking you may not have gut problems? A compromised gut shows up in many ways including joint pain, anxiety, headaches, and of course the expected symptoms of gas, bloating, cramping, diarrhea, constipation and irregular color/consistency of stools. Generally speaking, you should not have pain, discomfort, or fatigue after eating. Your stools should be 1-2x daily, formed, and medium brown color without evidence of undigested food. If these things are not occuring, you would benefit from more gut support. 

Increase phytonutrients

Phytonutrients are the parts of plant foods that really pack in the nutrition. Each different color of fruit or vegetable represents different types of phytonutrients. This is why adults learning to “eat the rainbow” in vegetables like kids is very beneficial. These nutrients have been shown to help decrease the aromatase activity that converts testosterone into estrogen producing hormone imbalances. There are many good supplemental forms of phytonutrients, but these should never be used to replace daily, generous intake of a variety of colors of organic vegetables and fruits. 


Contact in2GREAT today for more information. 

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Effect of 1 Week of Sleep Restriction on Testosterone Levels in Young Healthy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445839/

Estrogen-gut microbiome axis: Physiological and clinical implications https://www.ncbi.nlm.nih.gov/pubmed/28778332

The Role of Estrogens in Control of Energy Balance and Glucose Homeostasis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660717/

Effects of high-intensity exercise on leptin and testosterone concentrations in well-trained males https://www.ncbi.nlm.nih.gov/pubmed/14515011

Brief, high intensity exercise alters serum ghrelin and growth hormone concentrations but not IGF-I, IGF-II or IGF-I bioactivity. https://www.ncbi.nlm.nih.gov/pubmed/14515011

Dr Corey Priest, DC - Functional medicine practitioner

About the author

Dr. Corey Priest has been practicing functional medicine since 2001. in2GREAT was founded in 2014 by Dr Priest after 13 years of experience with his other practices. Over his career, Dr. Priest has worked with and helped well over 10,000 patients under a functional medicine model.