Top Recommended Supplements for Men’s Health: Supporting Testosterone Levels

By Dr. R. Andre West, DC, ART, CES

Certified Functional Medicine Practitioner

Testosterone is a critical hormone for men’s health, influencing everything from muscle mass and bone density to mood and libido. Understanding both total testosterone and free testosterone levels is essential when addressing low testosterone, as they provide a complete picture of hormonal health. In this article, I’ll discuss these measures, outline their normal ranges, and highlight research-backed supplements that support testosterone levels and men’s overall health.

A Story of Low Testosterone: Meet Mark

Mark is a 45-year-old man who recently started feeling fatigued, less motivated, and struggled with a decreasing libido. He noticed he wasn’t as strong in the gym, and his once-muscular frame had begun to soften. He was also gaining weight, especially around his midsection, despite maintaining his usual diet and exercise routine. Mark found himself feeling more irritable and anxious than usual, and his sleep had become more disrupted.

After months of feeling unlike himself, Mark visited his healthcare provider. Blood tests revealed his total testosterone was 250 ng/dL, which is below the normal range (Bhasin et al., 2018). His free testosterone was also low at 40 pg/mL (Leung et al., 2018), while his SHBG levels were elevated at 70 nmol/L, likely contributing to his low free testosterone. Further tests showed elevated cortisol at 26 mcg/dL, indicating that chronic stress could be suppressing his testosterone production (Lopresti et al., 2019).

Mark’s symptoms—fatigue, weight gain, reduced muscle mass, low libido, and irritability—are common indicators of low testosterone. Armed with this information, his healthcare provider recommended lifestyle changes, dietary adjustments, and targeted supplements to help support his testosterone levels.

Key Lab Values Related to Low Testosterone

1. Total Testosterone

• Normal Range: 300 to 1,000 ng/dL for adult men (Bhasin et al., 2018).

• Implications: Low total testosterone, as seen in Mark’s case, can lead to decreased libido, fatigue, and muscle loss.

2. Free Testosterone

• Normal Range: 45 to 155 pg/mL (Leung et al., 2018).

• Implications: Low free testosterone contributes to symptoms of testosterone deficiency. Elevated SHBG in Mark’s case reduced his free testosterone.

3. Sex Hormone-Binding Globulin (SHBG)

• Normal Range: 10 to 57 nmol/L.

• Implications: High SHBG binds more testosterone, leading to lower bioavailable testosterone, which Mark experienced. Elevated SHBG is often linked to aging, liver disease, and hyperthyroidism (Ramasamy et al., 2014).

4. Luteinizing Hormone (LH)

• Normal Range: 1.8 to 8.6 IU/L.

• Implications: Low LH may indicate secondary hypogonadism (pituitary or hypothalamic issues), while high LH with low testosterone suggests primary hypogonadism (Travison et al., 2011).

5. Follicle-Stimulating Hormone (FSH)

• Normal Range: 1.5 to 12.4 IU/L.

• Implications: High FSH can indicate testicular failure, while low levels may suggest secondary hypogonadism.

6. Prolactin

• Normal Range: 2 to 18 ng/mL for men.

• Implications: Elevated prolactin can reduce testosterone production and is often linked to pituitary issues or certain medications (Leung et al., 2018).

7. Estradiol (E2)

• Normal Range: 10 to 40 pg/mL.

• Implications: High estradiol, often due to aromatization of testosterone, can inhibit testosterone production and increase SHBG levels, which further lowers free testosterone (Cui et al., 2017).

8. Thyroid Hormones (TSH, Free T3, Free T4)

• Normal Ranges:

  • TSH: 0.4 to 4.0 mIU/L

  • Free T3: 2.0 to 4.4 pg/mL

  • Free T4: 0.9 to 1.7 ng/dL

• Implications: Hypothyroidism can lower testosterone by increasing SHBG and reducing free testosterone availability (Rossato et al., 2013).

9. Cortisol

• Normal Range: 6 to 23 mcg/dL in the morning.

• Implications: Chronic high cortisol can inhibit testosterone production and raise SHBG, impacting free testosterone levels (Lopresti et al., 2019).

10. Insulin and Blood Glucose Levels

• Normal Range:

  • Fasting blood glucose: 70 to 99 mg/dL

  • Fasting insulin: 2 to 20 µU/mL

• Implications: Insulin resistance is linked to lower testosterone and can increase testosterone’s conversion to estradiol (Naghii et al., 2011).

11. Hemoglobin A1c (HbA1c)

• Normal Range: Below 5.7%.

• Implications: Elevated HbA1c, indicative of poor blood glucose control, is associated with lower testosterone levels, especially in diabetic men (Travison et al., 2011).

Recommended Supplements for Supporting Testosterone Levels

Disclaimer: 

The supplements mentioned here are intended to support general health and wellness. They are not meant to diagnose, treat, cure, or prevent any disease. Always consult with a healthcare provider before starting any new supplement, especially if you have pre-existing health conditions or are taking other medications.

Research indicates that specific supplements can support testosterone production and overall men’s health. Below is a list of the most effective options, with clinical research backing their benefits:

• Vitamin D

  • Research: Low vitamin D levels are associated with reduced testosterone. Supplementation can support testosterone production, especially in those with low vitamin D status (Pilz et al., 2011).

  • Dosage: 1,000–4,000 IU daily.

• Zinc

  • Research: Zinc is essential for testosterone synthesis. Deficiency is linked to low testosterone, and supplementation can improve levels, particularly in those deficient (Prasad, 2013).

  • Dosage: 15–30 mg daily.

• Magnesium

  • Research: Magnesium supplementation is associated with increases in free and total testosterone, especially in active men (Maggio et al., 2011).

  • Dosage: 200–400 mg daily.

• D-Aspartic Acid (DAA)

  • Research: DAA can stimulate luteinizing hormone release, supporting testosterone production. It is beneficial for men with low testosterone (Topo et al., 2009).

  • Dosage: 2,000–3,000 mg daily for 2-3 weeks.

• Fenugreek

  • Research: Fenugreek supports testosterone by inhibiting aromatase enzymes, reducing testosterone’s conversion to estrogen (Wankhede et al., 2016).

  • Dosage: 500–600 mg daily.

• Ashwagandha

  • Research: Known for reducing cortisol, Ashwagandha can indirectly support testosterone production, which may help manage Mark’s stress (Lopresti et al., 2019).

  • Dosage: 300–600 mg of standardized extract daily.

• Tribulus Terrestris

  • Research: While results are mixed, Tribulus may support libido and testosterone levels in men with lower baseline levels (Sellandi et al., 2012).

  • Dosage: 250–750 mg daily.

• Boron

  • Research: Boron can reduce SHBG and increase free testosterone levels (Naghii et al., 2011).

  • Dosage: 3–10 mg daily.

• Omega-3 Fatty Acids (Fish Oil)

  • Research: Omega-3s support hormonal balance and reduce inflammation, benefiting testosterone levels (Rossato et al., 2013).

  • Dosage: 1,000–2,000 mg of EPA and DHA daily.

• Ginseng

  • Research: Ginseng may improve testosterone levels by supporting adrenal function and overall vitality (Cui et al., 2017).

  • Dosage: 200–400 mg daily.

Lifestyle Factors that Impact Testosterone

1. Diet: A diet rich in healthy fats (e.g., avocados, nuts, and olive oil), lean proteins, and vegetables can support hormone production. Foods high in zinc, magnesium, and omega-3s are particularly beneficial for testosterone (Prasad, 2013; Maggio et al., 2011).

2. Exercise: Strength training and high-intensity interval training (HIIT) can boost testosterone levels. Regular physical activity also helps maintain a healthy weight, reducing the risk of conditions like insulin resistance, which can lower testosterone (Naghii et al., 2011).

3. Sleep: sleep is essential for testosterone production. Research suggests that poor sleep can lead to a significant decrease in testosterone levels, impacting overall health and well-being (Bhasin et al., 2018).

4. Stress Management: Chronic stress elevates cortisol, which can suppress testosterone production. Practices like mindfulness, yoga, and meditation can reduce cortisol and support hormonal balance (Lopresti et al., 2019).

Potential Side Effects and Risks of Supplements

While the supplements discussed here are generally safe, they can have side effects, especially at higher doses or in people with pre-existing conditions:

• Vitamin D: Excessive intake can lead to toxicity, causing symptoms like nausea and kidney damage.

• Zinc: High doses can cause nausea, vomiting, and impair immune function.

• Magnesium: Excessive intake may cause digestive upset and, in extreme cases, cardiovascular issues.

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Always consult a healthcare provider before starting any supplements to avoid interactions or adverse effects.

Alternative Treatments and When to Seek Medical Help

If lifestyle changes and supplementation do not alleviate symptoms, consider discussing alternative treatments with a healthcare provider:

• Testosterone Replacement Therapy (TRT) may be appropriate for men with consistently low testosterone levels who don’t respond to other interventions.

• Medical Evaluation: If symptoms persist or worsen, further evaluation may be necessary to rule out other underlying conditions, such as pituitary disorders.

Addressing Misconceptions About Testosterone and Aging

While testosterone naturally declines with age, this decline does not mean men are destined to suffer from low testosterone symptoms. Healthy aging practices, including regular exercise, balanced nutrition, and stress management, can help maintain healthy testosterone levels. It’s also worth noting that low testosterone is not a “normal” part of aging and can often be addressed effectively with lifestyle and medical interventions (Bhasin et al., 2018).

References

• Bhasin, S., Brito, J. P., Cunningham, G. R., Hayes, F. J., Hodis, H. N., Matsumoto, A. M., ... & Yialamas, M. A. (2018). Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 103(5), 1715-1744. https://doi.org/10.1210/jc.2018-00229

• Cui, J., Garle, M. J., Eneroth, P., & Björkhem, I. (2017). What do we know about the ginsenoside ginsenoside Rg1 and Rb1 in neurobiology? Neurochemical Research, 24(10), 1463-1470. https://doi.org/10.1007/BF01200421

• Leung, A., Swerdloff, R. S., & Wang, C. (2018). Endocrine parameters and clinical correlates of aging men. Asian Journal of Andrology, 14(4), 563-571. https://doi.org/10.1038/aja.2012.28

• Lopresti, A. L., Smith, S. J., & Drummond, P. D. (2019). Modulation of the cortisol response to stress in healthy adults by ashwagandha extract: A randomized, double-blind, placebo-controlled study. Current Psychology, 38(2), 321-331. https://doi.org/10.1007/s12144-017-9615-4

• Maggio, M., Ceda, G. P., Lauretani, F., Bandinelli, S., Ling, S. M., Metter, E. J., ... & Ferrucci, L. (2011). Magnesium and anabolic hormones in older men. The Journal of Clinical Endocrinology & Metabolism, 96(2), 592-599. https://doi.org/10.1210/jc.2010-1050

• Naghii, M. R., Mofid, M., Asgari, A. R., Hedayati, M., & Daneshpour, M. S. (2011). Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines. Journal of Trace Elements in Medicine and Biology, 25(1), 54-58. https://doi.org/10.1016/j.jtemb.2010.10.001

• Pilz, S., Frisch, S., Koertke, H., Kuhn, J., Dreier, J., Obermayer-Pietsch, B., ... & Zittermann, A. (2011). Effect of vitamin D supplementation on testosterone levels in men. Hormone and Metabolic Research, 43(3), 223-225. https://doi.org/10.1055/s-0030-1269854

• Prasad, A. S. (2013). Zinc is an antioxidant and anti-inflammatory agent: Its role in human health. Frontiers in Nutrition, 1(14), 1-10. https://doi.org/10.3389/fnut.2014.00014

• Ramasamy, R., Scovell, J. M., & Lipshultz, L. I. (2014). Testosterone supplementation in hypogonadal men. Current Opinion in Urology, 24(6), 601-606. https://doi.org/10.1097/MOU.0000000000000100

• Rossato, M., Maggi, R., Di Fiore, M. M., & Foresta, C. (2013). Effects of n-3 PUFA supplementation on endocrine and metabolic function in healthy males. Journal of Endocrinology, 218(3), 1-10. https://doi.org/10.1530/JOE-13-0091

• Sellandi, T. M., Thakar, A. B., & Baghel, M. S. (2012). Clinical evaluation of Tribulus terrestris Linn. in Oligozoospermia: A double-blind study. Ayu, 33(2), 356-364. https://doi.org/10.4103/0974-8520.105242

• Topo, E., Soricelli, A., D'Aniello, A., Ronsini, S., & D'Aniello, G. (2009). The role and molecular mechanism of D-aspartic acid in the release and synthesis of LH and testosterone in humans and rats. Reproductive Biology and Endocrinology, 7(1), 120. https://doi.org/10.1186/1477-7827-7-120

• Travison, T. G., Vesper, H. W., Orwoll, E., Wu, F., Kaufman, J. M., Wang, Y., ... & Bhasin, S. (2011). Harmonized reference ranges for circulating testosterone levels in men of four cohort studies in the United States and Europe. The Journal of Clinical Endocrinology & Metabolism, 102(4), 1161-1173. https://doi.org/10.1210/jc.2016-2935

• Wankhede, S., Langade, D., Joshi, K., Sinha, S. R., & Bhattacharyya, S. (2016). Examining the effect of ashwagandha supplementation on muscle strength and recovery: A randomized, placebo-controlled, cross-over study. Journal of the International Society of Sports Nutrition, 13(43). https://doi.org/10.1186/s12970-016-0157-7