Low Testosterone is Associated with Depression, Decreased Muscle Mass, and an 88 percent Increase in Risk of Death

by Nils Osmar. Updated Dec. 26, 2022. Medical Disclaimer

As we age and our sex hormones drop, our quality of life declines.

Having normal youthful levels of testosterone, for example, is associated with having lower blood pressure, lower insulin, lower fasting glucose, more flexible arteries, a better lipid profile and better heart health (generally speaking). It’s also associated, at least under some circumstances, with a greatly decreased risk of dying.

Benefits of higher testosterone

A recent Science Daily article, “Low Testosterone Levels Associated With Increased Risk Of Death In Men”, summed up a review published in Archives of Internal Medicine, one of the JAMA/Archives journals:

…About 19 percent (166) of the men had a low testosterone level; 28 percent (240) had an equivocal testosterone level, meaning that their tests revealed an equal number of low and normal levels; and 53 percent (452) had normal testosterone levels.

One-fifth (20.1 percent) of the men with normal testosterone levels died during the course of the study, compared with 24.6 percent of men with equivocal levels and 34.9 percent of those with low levels. Men with low testosterone levels had an 88 percent increase in risk of death compared with those who had normal levels. When the researchers considered other variables that may influence risk of death, such as age, other illnesses and body mass index, the association between low testosterone levels and death persisted.

Risks and benefits

The study noted that there were both risks and benefits to increasing testosterone. Risks of hormone replacement therapy can (according to the authors) include worsening sleep apnea, acne or other skin reactions. There is also a risk of “stimulating noncancerous growth of the prostate (benign prostatic hyperplasia) and growth of existing prostate cancer.” And mortality rates do start climbing again when T levels go astronomically high.

It concluded, though, that low levels were clearly associated with the highest death rates. (Extremely high levels came in second.) Men with circulating testosterone levels between 9.8 to 15.8 nmol/L range tended to live the longest

Misleading headlines

It’s interesting and telling that many of the “news” articles informing people about the study ran with the headline that high testosterone is associated with health problems. This is true as far as it goes; very high levels can be problematic; but it ignores the study’s main point that low levels are the greater danger.

A Healthline article, for example, had the glaring headline, “Too Much Testosterone Linked to Shorter Life Spans.” But if you read the article itself, the author states that “Researchers found men with the lowest testosterone levels had the highest mortality rate... overall, men with circulating testosterone levels between 9.8 to 15.8 nmol/L range tended to live the longest.” (15.8 nmol/L is about 463 ng/dL.)

This article, entitled “Low Testosterone Levels Associated With Increased Risk Of Death In Men”, is a balanced summary of the actual conclusions of the study.

What I’m doing

I’m almost 70 at the time that I’m writing this, and my levels have dropped a bit over the years; I was able to raise them by working out and taking testosterone boosting supplements (see list below). If the supplements ever stop working, I’ll most likely go on hormone replacement therapy.

T boosting supplements

For those who are interested in raising their testosterone levels but cautious about HRT, there’s some evidence that taking supplements may be an alternative. (According to Andrew Huberman, supplements, when they work, tend to raise testosterone levels 200 to 400 points; not astronomically high, but also out of the “low T danger zone” highlighted in the study discussed above.

In my own case, I’ve found the supplements below helpful in raising testosterone:

  1. Tongkat Ali from Solaray. 400 mg every day. Studies suggest that Tongkat Ali is best taken with a large meal. See study: Effect of Tongkat Ali on stress hormones and psychological mood state in moderately stressed subjects
  2. DHEA from Life Extension (25 mg). I’m currently taking 1 capsule of DHEA per day (but taking one week a month off). DHEA appears to be most effective at increasing testosterone when taken while doing resistance training. Two cautions: (1) DHEA can raise both testosterone and estrogen levels, and (2) in large doses it’s associated with an increased risk of cancer. See study: Effect of acute DHEA administration on free testosterone in middle-aged and young men following high-intensity interval training
  3. Fish oil (I take two capsules of fish oil in the morning, and also eat lots of fatty fish) (fish oil raises T levels and has been found to increases the size of the testicles in human studies, in young men) See study: Associations of Fish Oil Supplement Use With Testicular Function in Young Men
  4. Fadogia agrestis from Barlow Herbal Elixers. I take one 600 mg. capsule every Monday, Wednesday and Friday. Studies in rats have shown that damage to the testes can occur at higher dose. There’s no evidence that I’m aware of, of similar damage in humans, but I limit it to three days a week as a precaution. See study: Effects of oral administration of aqueous extract of Fadogia agrestis (Schweinf. Ex Hiern). Note: Some people take this product with food; others take it on an empty stomach.
  5. Boron from Jarrow (5 mg) (increases free testosterone) (Don’t overdose on boron; it’s essential but can be deadly in large doses) Studies have shown that it “significantly increases” free testosterone. I take it three times a week. See study
  6. L. Reuteri 6475 from BioGaia (1 capsule) I actually don’t take the supplement, but instead make a yogurt from it; the yogurt is much richer in probiotics per serving. In animal studies, this particular strain raises T levels and increases testicle size in males, (See study: Lactobacillus reuteri  Consumption Increases Testicular Weight of Mice Fed with Normal Diet) In females, it’s been shown to slow the loss of bone after menopause. (See study: Lactobacillus reuteri reduces bone loss in older women with low bone mineral density: a randomized, placebo-controlled, double-blind, clinical trial)
  7. Male Libido from Gaia Herbs (2 capsules) (contains horny goat weed, tribulus, tongkat ali, oats, maca and some other herbs) I like it and get a boost from it, but one problem with this supplement is that it has a “proprietary blend’, meaning the label doesn’t state how much of each ingredient you’re taking.

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