Can You Boost Low Testosterone Naturally?

By Eric Metcalf, MPH
WebMD Feature

If you’re looking for ways to boost your testosterone level, you might start by looking at your lifestyle. Some changes that are good for the rest of you could also benefit your testosterone level, if it’s low.

“I never prescribe testosterone alone without talking to men about their lifestyle,” says Martin Miner, MD, co-director of the Men’s Health Center at the Miriam Hospital in Providence, R.I.

Here are six things that can affect your testosterone level:

1. Get Enough Sleep.

Poor sleep can have consequences for your testosterone level.

George Yu, MD, a urology professor at the George Washington University Medical Center in Washington, D.C., says poor sleep is the most important factor that contributes to low testosterone in many men. A lack of sleep affects a variety of hormones and chemicals in your bloodstream. This, in turn, can have a harmful impact on your testosterone.

Make sleep a priority, aiming for seven to eight hours per night, even if it means rearranging your schedule or dropping your habit of late-night TV. Prize your sleep, just like you’d prize a healthy diet and active lifestyle. It’s that important. 

If you’re having problems getting good sleep on a regular basis, talk to your doctor.

2. Keep a Healthy Weight.

Men who are overweight or obese often have low testosterone levels, says Alvin M. Matsumoto, MD, of the University of Washington School of Medicine in Seattle.

For those men, losing the extra weight can help bring testosterone back up, he says. Likewise, for men who are underweight, getting your weight up to a healthy level can also have a positive effect on the hormone.

3. Stay Active.

Testosterone adapts to your body’s needs, Yu says. If you spend most of your time lying on the couch, your brain gets the message that you don’t need as much to bolster your muscles and bones.

But when you are physically active, your brain sends out the signal for more of the hormone, he says.

If you’re getting little exercise now, Miner suggests starting by:

  • Walking briskly at least 10 to 20 minutes a day.
  • Building strength with several sessions of weights or elastic bands each week. Work with a trainer to learn proper form so you don’t injure yourself.

Don’t go overboard. Extreme amounts of endurance exercise, at the level of elite athletes, can actually lower your testosterone.

4. Take Control of Your Stress.

If you’re under constant stress, your body will be churning out a steady stream of the stress hormone cortisol. It will be less able to create testosterone. As a result, controlling your stress is important for keeping up your testosterone, he says.

Miner’s advice to the over-stressed men he sees in his office is to:

  • Cut back on long work hours. If you’re logging lots of overtime, try to whittle your workday down to 10 hours or less.
  • Spend two hours a day on activities that you enjoy that aren’t work- or exercise-related, such as reading or playing music.

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Low Testosterone Therapy Pros and Cons

Low Testosterone Therapy: Risks and Benefits

Low testosterone can dim a man’s sex drive, performance in bed, energy, and motivation. It can also have some harmful effects.

When needed, testosterone replacement therapy (TRT) can boost T levels back to normal and return him to the man he used to be.

“Despite all the recent advertising campaigns, awareness of low T and its importance for men’s health remains very poorly recognized by both the public and by physicians,” says Abraham Morgentaler, MD, director of Men’s Health Boston and author of Testosterone for Life: Recharge Your Vitality, Sex Drive, Muscle Mass, and Overall Health.

Still, there are also risks to TRT,  and the long-term safety isn’t clear. Here’s what men need to know.

What’s Normal

Normal levels of testosterone range from about 300 to 900 nanograms per deciliter (ng/dL), and there’s little to suggest that men whose levels fall within that range would benefit from therapy, says urologist Michael Eisenberg, MD, director of male reproductive medicine and surgery at Stanford Hospital and Clinics in Palo Alto, Calif. 

However, that range covers a man’s total amount of testosterone, which may not be the whole picture. 

Experienced doctors,  Eisenberg says, will also measure what’s called free testosterone, which is the amount of the hormone that is active in the body at a given time. A man with total testosterone in the normal range may still have the classic symptoms of low T if his free testosterone measurements come up short. 

“Free testosterone is more indicative of the true testosterone status,” Morgentaler says. He discloses consulting or research work for the drug companies Lilly, Auxilium, Slate Pharmaceuticals, and Endo Pharmaceuticals.

Benefits

Low free testosterone, says Morgentaler, has been almost exclusively linked to sex difficulties, and there’s no doubt that TRT can renew a man’s interest in sex as well as his ability to maintain an erection. It can also restore the “wow” factor to his orgasms, Morgentaler says.

For many men, treating the sexual symptoms of low T would be enough reason to start therapy. However, low testosterone influences a man’s health well beyond the bedroom. Bringing it back up to normal can have a positive impact on a variety of crucial health markers.

“Today, we recognize, based on dozens of studies, its importance relative to health issues such as diabetes, obesity, metabolic syndrome, and osteoporosis,” Morgentaler says.

Testosterone may also play a role in how long men live. Recent studies, Morgentaler says, show a link between low testosterone and shorter life expectancy.

“Men with low T die sooner than men with normal levels of testosterone,” he says.

It’s not clear if low testosterone, by itself, makes earlier death more likely. Many other factors could also be involved. It’s also not clear if boosting testosterone to normal levels will impact longevity.

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Male Breast Enlargement (Gynecomastia)

Experts explain the causes of and treatments for gynecomastia, or male breast enlargement.

By David Freeman
WebMD Feature

Elliot W. Jacobs, MD, knows a thing or two about enlarged breasts in men, and not just because he specializes in treating the condition. 

“My own breasts became enlarged when I was a teenager,” says the New York plastic surgeon. “It was very embarrassing. Once, I went to my locker after gym class and saw that a classmate had hung a bra on it.”

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Millions of men and boys know what it’s like to have enlarged breasts (sometimes called man boobs or “moobs,” or, in doctor talk, gynecomastia). In many cases, it doesn’t have to be a permanent condition.

Why It Happens

Male breast enlargement can start in puberty as hormone levels are shifting. In those cases, it typically doesn’t last long, ending without treatment as hormone levels settle down.

Enlarged breasts can also start  in adulthood. As men age, they tend to lose testosterone and gain weight. Lower testosterone can lead to enlargement of glands in the breasts. Extra weight adds fatty tissue under the breasts. That can leave a man with bigger glandular tissue and more fat in his breasts. Fat cells make small amounts of estrogen, which can further enlarge men’s breasts.

Though it can be embarrassing, male breast enlargement usually isn’t a health threat. But in some men, it can be a sign of  low testosterone, an overactive thyroid, cirrhosis of the liver, a genetic problem, or some cancers. Certain medications can also cause gynecomastia. Common culprits include anabolic steroids, as well as the stomach acid drug cimetidine (Tagamet), the heart drug spironolactone (Aldactone), the prostate cancer drug bicalutamide (Casodex), and several other drugs.

In many cases, stopping the offending drug and switching to another helps reduce enlarged breasts. 

Abusing alcohol and marijuana can also contribute to gynecomastia.

In many cases, the exact cause isn’t clear. It’s wise to make an appointment with a board-certified endocrinologist to make sure, even if your male breast enlargement hasn’t bothered you a lot.

How to Treat ‘Man Boobs’

The treatment depends on the cause.

If another health condition is causing your enlarged breasts, treating that underlying condition may help.

If the reason for enlarged breasts is being overweight, weight loss is often the first step, says Glenn Braunstein, MD. That’s good for your overall health, too. Braunstein is chairman of the department of medicine at Cedars-Sinai Medical Center in Los Angeles. 

If you have a lot of weight to lose, it may not shrink your breasts back to normal size, due to the stretched-out skin. Plastic surgery is an option for that.

Surgical options for enlarged breasts are to get liposuction to remove fat and scalpel surgery to remove glandular tissue. A plastic surgeon does the surgery, which takes 60-90 minutes. It’s an outpatient procedure, meaning no overnight stay, and it often dramatically improves appearance.

Jacobs has never sought treatment for his own breast enlargement.

“Over the years, I sort of got used to it,” he says. But he has done breast-reduction surgery on more than 1,500 men, transforming lives in the process. “For the first time in years, these men are standing up straight and wearing tight shirts,” he says. “Literally and figuratively, a weight has been lifted off their chests.”

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