Testosterone is the primary hormone involved in muscle-building, fat-burning, libido, and it also strongly affects mood and energy. Testosterone concentrations tend to decline with advancing age, both in men[i] and in women.[ii] Low testosterone, also known as androgen deficiency (AD), is associated with an increased risk of morbidity and mortality[iii] along with a whole array of symptoms ranging from persistent unexplained fatigue to decreased sexual desire.[iv]
However, certain aspects of testosterone are less desirable. Testosterone converts to dihydrotestosterone (DHT) by the action of the 5 alpha-reductase (5-AR) enzyme at target tissues.[v] DHT is the most potent natural androgen in humans.[vi] There has been an increasing interest in DHT and its potential roles in diseases including prostate and breast cancer and Alzheimer’s disease.[vii]
Understandably, achieving and maintaining an optimal testosterone and testosterone to DHT ratio is important for overall well-being. Currently, the primary medical treatment for AD is testosterone replacement therapy (TRT), which may exacerbate pre-existing medical conditions.[viii] 5-Alpha reductase inhibitors such as finasteride and dutasteride also raise safety concerns.[ix] Therefore, the use of scientifically proven, natural means to modulate androgens levels represents an exciting option.
Increasing Testosterone Levels
Physical exercise
According to a comprehensive evaluation published in a meta-analysis, acute physical activity acutely increases testosterone levels. The main determinant of this fluctuation was the exercise intensity.[x] Incorporating middle to intense physical activity to your lifestyle will not only help boost your testosterone levels, but it will also significantly reduce your risks of suffering from other conditions such as cardiovascular diseases[xi] and may also increase your self-esteem.
Vitamin D
Among the wide-ranging benefits of vitamin D on our health, we should not be surprised to find out that it can also increase testosterone levels! A 2011 study published in Hormone and Metabolic Research revealed that 3,332 IU of vitamin D supplementation taken daily for one-year increased testosterone levels in men.[xii] In women with polycystic ovary syndrome (PCOS), the co-administration of vitamin D and probiotic for 12 weeks showed beneficial effects on serum total testosterone and other aspects such as mental health parameters, hirsutism and C-Reactive protein, a marker of inflammation.[xiii]
Ashwagandha
Ashwagandha (Withania somnifera) is a well-known adaptogenic herb issued from the Ayurvedic tradition, but it has now been found to also exert a positive action on testosterone levels. A randomized, double-blind, placebo-controlled, crossover study published in the American Journal of Men’s Health in 2019 examined the hormonal and vitality effects of ashwagandha in aging, overweight males and concluded its efficacy.[xiv]
Modulating 5 alpha-reductase activity
Red Reishi
Red reishi (Ganoderma lucidum) has been shown to reduce levels 5-alpha reductase, the enzyme that facilitates conversion of testosterone to DHT. In a research study exploring the anti-androgenic effects of 20 species of mushrooms, reishi mushrooms had the strongest action in inhibiting testosterone.[xv]
Green Tea
Green Tea (Camellia sinensis) may also have an important anti-androgen effect because it contains epigallocatechins, which inhibit the 5-alpha-reductase conversion of normal testosterone into the more potent DHT.[xvi]
Pollen extract
A recent review published in the Journal of Ethnopharmacology (2019) concluded that pollen extract provided a rational approach to prostate health.[xvii] In an animal study, pollen was shown to inhibit the development of Benign prostatic hyperplasia (BPH) and these effects were closely associated with reductions in DHT, 5α-reductase and COX-2 levels.[xviii]
Conclusion
Given the importance of maintaining optimal testosterone levels and testosterone to DHT ratio for our overall health, incorporating the above measures should be a no brainer, whether you are a man or a woman. In spite of the fact that more scientific evidence – especially in the case of women – would be welcome, incorporating physical activity, achieving optimal amounts of vitamin D levels (through sun exposure or supplementation), adding red Reishi mushrooms and green tea to our diet, and adopting targeted supplements such as ashwagandha and pollen extract are all relatively easy, unexpensive and safe ways to modulate our testosterone efficiently and safely.
References
[i] Smith SJ, Lopresti AL, Teo SYM, Fairchild TJ. Examining the Effects of Herbs on Testosterone Concentrations in Men: A Systematic Review. Adv Nutr. 2021 Jun 1;12(3):744-765. doi: 10.1093/advances/nmaa134. PMID: 33150931; PMCID: PMC8166567.
[ii] Shifren JL. Testosterone for midlife women: the hormone of desire? Menopause. 2015 Oct;22(10):1147-9. doi: 10.1097/GME.0000000000000540. PMID: 26397145.
[iii] Smith SJ, Lopresti AL, Teo SYM, Fairchild TJ. Examining the Effects of Herbs on Testosterone Concentrations in Men: A Systematic Review. Adv Nutr. 2021 Jun 1;12(3):744-765. doi: 10.1093/advances/nmaa134. PMID: 33150931; PMCID: PMC8166567.
[iv] Burger HG, Papalia MA. A clinical update on female androgen insufficiency–testosterone testing and treatment in women presenting with low sexual desire. Sex Health. 2006 May;3(2):73-8. doi: 10.1071/sh05055. PMID: 16800391.
[v] Marchetti PM, Barth JH. Clinical biochemistry of dihydrotestosterone. Ann Clin Biochem. 2013 Mar;50(Pt 2):95-107. doi: 10.1258/acb.2012.012159. Epub 2013 Feb 21. PMID: 23431485.
[vi] Marchetti PM, Barth JH. Clinical biochemistry of dihydrotestosterone. Ann Clin Biochem. 2013 Mar;50(Pt 2):95-107. doi: 10.1258/acb.2012.012159. Epub 2013 Feb 21. PMID: 23431485.
[vii] Marchetti PM, Barth JH. Clinical biochemistry of dihydrotestosterone. Ann Clin Biochem. 2013 Mar;50(Pt 2):95-107. doi: 10.1258/acb.2012.012159. Epub 2013 Feb 21. PMID: 23431485.
[viii] Smith SJ, Lopresti AL, Teo SYM, Fairchild TJ. Examining the Effects of Herbs on Testosterone Concentrations in Men: A Systematic Review. Adv Nutr. 2021 Jun 1;12(3):744-765. doi: 10.1093/advances/nmaa134. PMID: 33150931; PMCID: PMC8166567.
[ix] Dhurat R, Sharma A, Rudnicka L, Kroumpouzos G, Kassir M, Galadari H, Wollina U, Lotti T, Golubovic M, Binic I, Grabbe S, Goldust M. 5-Alpha reductase inhibitors in androgenetic alopecia: Shifting paradigms, current concepts, comparative efficacy, and safety. Dermatol Ther. 2020 May;33(3):e13379. doi: 10.1111/dth.13379. Epub 2020 Apr 24. PMID: 32279398.
[x] D’Andrea S, Spaggiari G, Barbonetti A, Santi D. Endogenous transient doping: physical exercise acutely increases testosterone levels-results from a meta-analysis. J Endocrinol Invest. 2020 Oct;43(10):1349-1371. doi: 10.1007/s40618-020-01251-3. Epub 2020 Apr 15. PMID: 32297287.
[xi] Sequi-Dominguez I, Alvarez-Bueno C, Martinez-Vizcaino V, Fernandez-Rodriguez R, Del Saz Lara A, Cavero-Redondo I. Effectiveness of Mobile Health Interventions Promoting Physical Activity and Lifestyle Interventions to Reduce Cardiovascular Risk Among Individuals With Metabolic Syndrome: Systematic Review and Meta-Analysis. J Med Internet Res. 2020 Aug 31;22(8):e17790. doi: 10.2196/17790. PMID: 32865503; PMCID: PMC7490678.
[xii] Pilz S, Frisch S, Koertke H, Kuhn J, Dreier J, Obermayer-Pietsch B, Wehr E, Zittermann A. Effect of vitamin D supplementation on testosterone levels in men. Horm Metab Res. 2011 Mar;43(3):223-5. doi: 10.1055/s-0030-1269854. Epub 2010 Dec 10. PMID: 21154195.
[xiii] Ostadmohammadi V, Jamilian M, Bahmani F, Asemi Z. Vitamin D and probiotic co-supplementation affects mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome. J Ovarian Res. 2019 Jan 21;12(1):5. doi: 10.1186/s13048-019-0480-x. PMID: 30665436; PMCID: PMC6340184.
[xiv] Lopresti AL, Drummond PD, Smith SJ. A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha ( Withania somnifera) in Aging, Overweight Males. Am J Mens Health. 2019 Mar-Apr;13(2):1557988319835985. doi: 10.1177/1557988319835985. PMID: 30854916; PMCID: PMC6438434.
[xv] Fujita R, Liu J, Shimizu K, Konishi F, Noda K, Kumamoto S, Ueda C, Tajiri H, Kaneko S, Suimi Y, Kondo R. Anti-androgenic activities of Ganoderma lucidum. J Ethnopharmacol. 2005 Oct 31;102(1):107-12. doi: 10.1016/j.jep.2005.05.041. PMID: 16029938.
[xvi] Grant P, Ramasamy S. An update on plant derived anti-androgens. Int J Endocrinol Metab. 2012 Spring;10(2):497-502. doi: 10.5812/ijem.3644. Epub 2012 Apr 20. PMID: 23843810; PMCID: PMC3693613.
[xvii] Santos HO, Howell S, Teixeira FJ. Beyond tribulus (Tribulus terrestris L.): The effects of phytotherapics on testosterone, sperm and prostate parameters. J Ethnopharmacol. 2019 May 10;235:392-405. doi: 10.1016/j.jep.2019.02.033. Epub 2019 Feb 18. PMID: 30790614.
[xviii] Yang BC, Jin LL, Yang YF, Li K, Peng DM. Inhibitory effect of rape pollen supercritical CO2 fluid extract against testosterone-induced benign prostatic hyperplasia in rats. Exp Ther Med. 2014 Jul;8(1):31-37. doi: 10.3892/etm.2014.1680. Epub 2014 Apr 14. PMID: 24944593; PMCID: PMC4061240.