Testosterone: Elixir of youth or marketing gimmick?
Enter any nutrition store nowadays and you’ll see an aisle full of supplements claiming to boost testosterone. Do they really work? Do they contain testerone? And most importantly, do you need it?
These testosterone supplements vary widely in their contents. Some contain herbal substances or vitamins with very little or no evidence for increasing testosterone. Ashwaghanda and fenugreek, for example, have been associated with moderate increases in testosterone in small studies. However, an association does not necessarily mean a causation – there is simply insufficient evidence at this point to determine if any over-the-counter supplements reliably and safely increase testosterone.
You should exercise great caution when taking any supplements without your doctor’s guidance. Over-the-counter supplements are not FDA approved for treatment of low testosterone, nor are they FDA regulated – meaning that the contents can be unclear at best or contaminated at worst. Furthermore, taking supplemental testosterone can suppress your body’s ability to manufacture testosterone and sperm itself. Taking testosterone when you don’t need it is can lead to blood clots, heart disease, strokes, prostate cancer, mood swings, sleep apnea, and breast growth.
However, true testosterone deficiency is a serious condition, which should be addressed with your doctor. You may suspect a testosterone deficiency if you have any of the following symptoms/signs:
Erectile dysfunction and/or low libido
Weight gain, loss of muscle mass
Loss of facial or body hair
Changes in genitalia, such as testicular size
The first step is to confirm if testosterone levels are truly low. Next, your doctor needs to establish the cause – is there a problem at the level of the pituitary gland, the testes, or elsewhere? This may involve further lab testing and/or imaging.
Low testosterone is important to address as it can lead to conditions like diabetes, obesity, osteoporosis and perhaps even heart disease in the long term, if left untreated.
Fortunately, low testosterone (confirmed by laboratory testing) is relatively simple to treat. If your levels are significantly low, you may receive prescription testosterone replacement (which can come in the form of topical formulations or injections) or medications that boost testicular production of testosterone.
When it comes to testosterone, you want to be realistic with your expectations. Testosterone levels normally decline with age. They are also affected by systemic conditions like obesity. Taking testosterone, if appropriate and indicated, may help you feel better but likely will not fully restore the physical capacity, sexual function, or cognitive abilities of youth.