Written by: Jeff Phillips, MD, DipABLM
There’s a lot of talk about testosterone out there, both in medical circles and (especially) on everyone’s social media feed. And rightly so- testosterone plays a key role in muscle mass, bone density, energy, mood, cognition, and sexual function. Symptoms such as low libido, fatigue, reduced motivation, or changes in body composition may reflect low testosterone, although they have many possible causes.
Testosterone levels decline gradually with age, but for most men age is not the primary driver. Nutrition, physical activity, sleep, and stress have a greater influence, and all of these are modifiable.
Metabolic health and body composition
Of the lifestyle factors, body composition has the strongest association with testosterone. Adipose tissue (fat), particularly visceral (abdominal) fat, contains an enzyme called aromatase, which converts testosterone to estradiol (a form of estrogen). Higher estradiol levels signal brain areas called the hypothalamus and pituitary to reduce testosterone production. Insulin resistance and chronic inflammation are also associated with lower levels.
This relationship is reversible. In clinical studies, a reduction of about 10% in body weight was associated with an average increase in testosterone of roughly 85 ng/dL, a larger effect than most other interventions.
Physical activity
Exercise supports testosterone in more than one way. Strength training builds muscle and improves insulin sensitivity and body composition, while interval and aerobic training are associated with modest increases in resting testosterone. A combination is recommended, including two to three strength sessions per week. Consistency matters more than intensity.
Sleep
Most testosterone is produced during sleep, and sleep restriction lowers levels. In one study, one week of sleep limited to five hours per night reduced testosterone by 10–15% in healthy young men. Seven to nine hours on a consistent schedule is recommended.
Snoring, waking up gasping, or persistent daytime fatigue may indicate that you have obstructive sleep apnea. It is common and treatment can meaningfully improve testosterone levels.
Nutrition and alcohol
No single food raises testosterone. A Mediterranean-style eating pattern built around fish, vegetables, legumes, nuts, and olive oil supports metabolic health and reduces inflammation, which indirectly supports healthy testosterone levels. Severe caloric restriction and very low-fat diets may lower testosterone. We also know that a diet heavy in ultra-processed foods will lower your testosterone levels.
Regular alcohol intake is also associated with lower levels and poorer sleep quality. Several alcohol-free days each week may be a reasonable place to start, depending on what is clinically appropriate for you.
Stress
Chronic stress raises the hormone cortisol which suppresses testosterone production, adversely affects metabolic health, and disrupts sleep. Breathwork, regular exercise, social connection and other techniques that support relaxation can help lower cortisol. Daily time outdoors has also been associated with higher testosterone levels.
When further treatment is considered
For some men, lifestyle changes alone are not sufficient. If symptoms persist, be sure to discuss this with your physician. Certain herbal or other supplements may be appropriate in specific cases, and testosterone replacement therapy (TRT) can be effective for men with confirmed low levels. Both work best alongside healthy habits, not in place of them.
Support at Synergy
At Synergy, we can help you make the lifestyle choices that optimize your testosterone. Work with our expert health coaches to help you build and sustain strength training, obtain individualized nutrition guidance, and lean in to stress management.
Along with appropriate testing and TRT when indicated, our integrative approach to men’s testosterone and hormonal healthcare can help you thrive. Schedule a visit with your Synergy physician to learn more about what may be right for you.