Testosterone

What Does Testosterone Do?

Testosterone is a hormone replacement therapy used to treat low testosterone levels in men and certain hormone-related conditions, supporting muscle growth, bone density, mood, and sexual health.

Many men who have taken high-levels of steroids in the past (e.g. through body building) may experience reduced levels of testosterone. Testosterone levels also naturally decline with age. 

How Does Testosterone Work? (the complicated stuff!)

Testosterone works by binding to androgen receptors in various tissues, including the brain, muscles, and reproductive organs. This binding activates transcription factors that regulate gene expression, leading to increased protein production for muscle growth, enhanced bone mineralisation through osteoblast stimulation, and improved sexual function by promoting the release of gonadotropins from the pituitary gland. Overall, testosterone influences multiple biological pathways that contribute to male sexual characteristics, muscle repair, and bone density.

Drug Type and Category of Testosterone

Testosterone is a hormone classified as an androgen.

What dosage of Testosterone should you be taking?

The National Institute for Health and Care Excellence (NICE) provides guidance on testosterone replacement therapy (TRT) for both men and women, with specific dosage recommendations varying based on individual needs and the formulation used.

For Men with Hypogonadism ¹:

• Transdermal Gel: A common starting dose is 50 mg of testosterone applied once daily, preferably in the morning. This can be adjusted based on serum testosterone levels and clinical response. The gels don’t make a significant difference and may have a very low effect.  
• Intramuscular Injection: Testosterone undecanoate is administered as 1,000 mg every 10–14 weeks via deep intramuscular injection. To achieve rapid steady-state plasma testosterone levels, a second dose may be given after 6 weeks.

For Women with Hypoactive Sexual Desire Disorder (HSDD) ²:

Testosterone supplementation may be considered for women who have not responded to conventional hormone replacement therapy (HRT). The British Menopause Society recommends a starting dose of 5 mg per day, which is approximately one-tenth of a standard 50 mg testosterone gel sachet. This equates to applying a pea-sized amount daily.

Getting Support for Taking Testosterone

Alphagenix is a health and wellness company dedicated to helping men optimise their hormone health, with a primary focus on testosterone support and therapy. The company offers tailored treatment plans designed to address symptoms of low testosterone, such as fatigue, reduced muscle mass, weight gain, low libido, and mood changes.

At Alphagenix, the approach combines comprehensive medical testing, expert clinical guidance, and ongoing support to help men restore optimal testosterone levels and improve their overall vitality, confidence, and quality of life. The company’s mission is to empower men to take control of their health through evidence-based hormone optimisation therapies, promoting better energy, sharper focus, and improved physical performance.

For more information go to www.alphagenix.co.uk 

What are the side-effects of Testosterone?

Common side effects of testosterone include acne, skin irritation, hair loss, and changes in libido. Additionally, there may be risks of fluid retention, increased red blood cell count, and mood swings. Some users may experience breast enlargement or tenderness, as well as a higher likelihood of sleep apnoea. Long-term use could potentially lead to more serious health issues, such as cardiovascular problems and liver dysfunction. Regular monitoring by a healthcare provider is recommended to manage these side effects effectively.

Interactions

Drug Interactions

Anticoagulants (e.g., Warfarin, Heparin)

• Testosterone can enhance the effects of anticoagulants, increasing the risk of bleeding. Close monitoring of prothrombin time (PT) or international normalised ratio (INR) is recommended.

Insulin and Oral Hypoglycemics

• Testosterone may reduce blood glucose levels, necessitating adjustments in insulin or diabetes medication dosages.

Corticosteroids (e.g., Prednisone)

• Combined use with testosterone may exacerbate fluid retention, increasing the risk of edema, particularly in patients with heart, liver, or kidney disease.

Cyclosporine

• Testosterone may increase cyclosporine levels, raising the risk of nephrotoxicity.

Androgens (e.g., Anabolic Steroids)

• Combining testosterone with other anabolic agents can amplify side effects, including cardiovascular risks, liver damage, and hormonal imbalances.

Medical Conditions That May Interact

Prostate Conditions

• Testosterone can stimulate the growth of prostate tissue, potentially worsening benign prostatic hyperplasia (BPH) or accelerating the progression of prostate cancer. Regular prostate monitoring is essential.

Breast Cancer (Male)

• Testosterone therapy is contraindicated in individuals with breast cancer due to the risk of tumor growth.

Polycythemia

• Testosterone can increase red blood cell production, potentially worsening polycythemia and increasing the risk of thromboembolic events.

Sleep Apnea

• Testosterone may worsen or trigger obstructive sleep apnea by affecting respiratory drive and muscle tone.

Heart, Liver, or Kidney Disease

• Fluid retention induced by testosterone can exacerbate conditions such as heart failure, hepatic impairment, or renal dysfunction.

Substance Interactions

Alcohol

• Alcohol use can exacerbate liver strain and counteract testosterone's therapeutic effects, particularly in those with pre-existing liver conditions.

Caffeine

• No direct interaction, but testosterone can influence energy levels, potentially affecting caffeine sensitivity.

Food Interactions

• High-fat meals can influence the absorption of oral testosterone undecanoate. It's best to take the medication with food for optimal absorption.

Laboratory Test Interactions

• Testosterone therapy can affect:
• Hematocrit and Hemoglobin: Increased levels may signal polycythemia.
• Prostate-Specific Antigen (PSA): Elevated levels may indicate prostate changes.
• Lipid Profile: Can alter cholesterol levels, increasing cardiovascular risk.

Natural Alternatives to Testosterone

1. Regular Exercise

• Resistance Training: Weightlifting and strength training are effective at boosting testosterone levels in men, particularly when performed regularly³.
• High-Intensity Interval Training (HIIT): Short bursts of intense exercise followed by rest can also stimulate testosterone production⁴.

2. Healthy Diet

• Zinc-Rich Foods: Zinc is essential for testosterone production. Foods like oysters, beef, pumpkin seeds, and spinach are excellent sources⁵.
• Vitamin D: Low levels of Vitamin D are linked to reduced testosterone. Sun exposure and foods like salmon, fortified milk, and egg yolks can help maintain healthy levels⁶.
• Healthy Fats: Consuming healthy fats, such as those found in avocados, nuts, and olive oil, can support testosterone synthesis⁷.

3. Ashwagandha (Withania somnifera)

• Ashwagandha is an adaptogenic herb that has been shown to increase testosterone levels and improve sperm quality in men experiencing stress⁸. A typical dose is 300–600 mg of root extract daily.

4. Fenugreek (Trigonella foenum-graecum)

• Fenugreek supplements can help increase testosterone levels and improve libido. It works by inhibiting enzymes that break down testosterone⁹. The recommended dose is 500–600 mg per day.

5. D-Aspartic Acid

• D-aspartic acid is an amino acid that plays a role in the regulation of testosterone synthesis. Studies show that it can increase testosterone in men with low levels¹⁰. The typical dose is 2–3 grams daily.

6. Tribulus Terrestris

• Tribulus terrestris is a herbal supplement traditionally used to enhance libido and testosterone levels, though its effects may be more pronounced in men with low testosterone¹¹. A standard dose is 750–1,500 mg daily.

7. Adequate Sleep

• Sleep is critical for maintaining hormonal balance, including testosterone production. Aim for 7–9 hours of quality sleep per night¹². Studies show that poor sleep can drastically reduce testosterone levels.

8. Stress Reduction

• Chronic stress increases cortisol levels, which can inhibit testosterone production. Stress management techniques like meditation, yoga, and deep breathing can support hormonal health¹³.

9. Reduce Alcohol and Sugar Intake

• Excessive alcohol and sugar consumption can suppress testosterone production and contribute to hormonal imbalances¹⁴. Moderation is key to maintaining healthy levels.

10. Magnesium Supplementation

• Magnesium plays a role in testosterone production and muscle function. Supplementing with 200–400 mg of magnesium daily has been shown to support testosterone, especially in physically active individuals¹⁵.

Interesting facts about Testosterone

Testosterone levels in men peak during late adolescence (around ages 16–18) and start to decline gradually after the age of 30, typically by 1–2% per year.

Testosterone is closely linked to mood regulation. Low levels can lead to irritability, depression, and fatigue, while normal levels support mental well-being and energy.

Testosterone levels follow a diurnal rhythm, peaking in the morning and declining throughout the day. This is why blood tests for testosterone are usually done in the early morning.

Synthetic testosterone was first developed in 1935 and has since been used for a variety of medical purposes, including hormone replacement therapy.

It’s not just about sex - while testosterone plays a role in sexual function and libido, it also affects numerous other systems, including bone health, cardiovascular function, and cognition.

Disclaimer

This article is generated for informational purposes only. It was created in January 2025. Medications and medical guidance can change over time. Therefore, it is essential to consult with your general practitioner or healthcare provider before making any decisions regarding medications or treatment plans. Your GP can provide personalised advice based on your specific health needs and conditions.

References

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8. Wankhede S, et al. Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial. Journal of the International Society of Sports Nutrition. 2015;12:43.
9. Rao A, et al. Effect of fenugreek extract on strength and body composition: a randomized, double-blind, placebo-controlled study. Journal of Sports Science & Medicine. 2010;9(2):254-259.
10. Topo E, et al. The role and molecular mechanism of D-aspartic acid in the release and synthesis of LH and testosterone in humans. Reproductive Biology and Endocrinology. 2009;7:120.
11. Neychev VK, Mitev VI. The aphrodisiac herb Tribulus terrestris does not influence the androgen production in young men. Journal of Ethnopharmacology. 2005;101(1-3):319-323.
12. Leproult R, Van Cauter E. Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA. 2011;305(21):2173-2174.
13. Rivier C, Rivest S. Effect of stress on the activity of the hypothalamic-pituitary-gonadal axis: peripheral and central mechanisms. Biology of Reproduction. 1991;45(4):523-532.
14. van Thiel DH, Gavaler JS. Alcohol and hormone levels in the hypothalamic-pituitary-gonadal axis. Endocrine Reviews. 1983;4(2):165-180.
15. Cinar V, et al. The effect of magnesium supplementation on testosterone levels of athletes and sedentary subjects at rest and after exhaustion. Biological Trace Element Research. 2011;140(1):18-23.