Low Testosterone Treatment: Regain Your Energy and Strength

What are the symptoms of low testosterone? A comprehensive guide to hormone replacement therapy (TRT), testosterone injections and natural ways to boost testosterone levels in men. Andropause is not your destiny..

What Happens When the Engine Runs Out of Fuel?

Do you struggle to get out of bed in the morning, find yourself lacking the energy to go to the gym, or feel that the old passion is missing from your sex life? Most men dismiss these symptoms as a ‘natural part of ageing’ or ‘a result of work stress’. However, the culprit could be a chemical deficiency in your body: testosterone.

Testosterone is the fundamental hormone that makes a man a ‘man’. It governs everything from muscle strength to focus, bone health to libido (sexual desire) levels. It is normal for it to decrease by 1% each year after the age of 30; however, when this decrease falls below certain limits, hypogonadism (testosterone deficiency) or, as it is commonly known, andropause occurs.

In this guide, you will find hormone replacement therapies offered by modern medicine, the risks/benefits of these treatments, and how you can boost your hormones with simple changes to your lifestyle.

What is Testosterone and What Does it Do?

Testosterone is an androgen hormone produced in the testicles. Its production is controlled by signals sent from the pituitary gland in the brain.

The 5 Critical Functions in the Body:

Sexual Function: Supports libido (desire) and erection quality.
Body Composition: Increases muscle mass and accelerates fat burning.
Bone Health: Strengthens bones (deficiency increases the risk of osteoporosis).
Mood: Supports self-confidence, motivation and cognitive functions (memory).
Blood Formation: Triggers the production of red blood cells.

Symptoms of Low Testosterone: Silent Signals

Symptoms of low blood pressure can vary from person to person but are generally grouped into three main categories:

A. Sexual Symptoms

Loss of Libido: This is the most common symptom.
Loss of Morning Erections: A decrease in spontaneous erections during the night or morning.
Erectile Dysfunction: Hormone deficiency can weaken the signals sent to the penis.

B. Physical Changes

Muscle Loss and Weakness: Decrease in muscle mass despite exercise.
Fat Gain: Increase in fat, particularly in the abdominal area (visceral fat) and ‘female-pattern’ breast enlargement (gynaecomastia).
Hair Loss: Decrease in body and beard hair.
Hot Flashes: Sudden sweating.

C. Psychological and Mental Symptoms

Depressive Mood: Unhappiness, inability to enjoy life.
Concentration Difficulties: ‘Brain fog’ and memory impairment.
Chronic Fatigue: Feeling unable to rest no matter how much one sleeps.
Sleep Disorders: Insomnia or sleep apnoea.

Reasons: Why is it falling?

Low testosterone is divided into two main types:

Primary Causes: These stem directly from a problem in the testicles (trauma, infection, undescended testicles, etc.).
Secondary Causes: This is a condition where the pituitary gland in the brain is unable to send the command to the testicles to ‘produce hormones’.

The Most Common Triggers Today:

Obesity: Fat cells convert testosterone into oestrogen (the female hormone). As weight increases, testosterone decreases; as testosterone decreases, weight increases. This is a vicious cycle.
Type 2 Diabetes: The risk of deficiency is very high in diabetics.
Stress (Cortisol): When the stress hormone cortisol rises, the body suppresses testosterone production.
Alcohol and Medications: Excessive alcohol consumption and certain painkillers (opioids) disrupt production.

Diagnostic Methods: When Should a Blood Test Be Performed?

Do not diagnose yourself by reading online. A blood test is essential for a definitive diagnosis.

Timing is crucial: Testosterone levels are highest in the morning and lowest in the evening. Therefore, the blood test must be performed between 08:00 and 10:00 in the morning on an empty stomach.
Which Tests? It is not sufficient to check only ‘Total Testosterone’. ‘Free Testosterone’, SHBG, LH, FSH, and Prolactin levels should also be checked.

Normal Values: Generally, values below 300 ng/dL are considered low, but the patient’s symptoms are more important than the laboratory result.

Treatment Methods: Testosterone Replacement Therapy (TRT)

If your blood levels are low and you have symptoms, your doctor may recommend hormone replacement therapy. This is called TRT (Testosterone Replacement Therapy).

A. Testosterone Injections

It is the most commonly used and most effective method.

Short-acting: Administered into the buttocks every 2-3 weeks. May start at a high level and then drop to a low level (fluctuation) as the injection time approaches.
Long-acting: Depot injections administered every 10-12 weeks (e.g., Nebido). Maintains a more stable level.

B. Testosterone Gels

These are gels applied to the shoulders or abdominal area every morning.

Advantage: As it is used daily, hormone levels do not fluctuate; it mimics the natural rhythm.
Caution: Do not touch your partner or children until the gel has dried, as it may transfer to them.

C. Strips and Tablets

These are less preferred methods. Tablet forms are not recommended nowadays as they can strain the liver.

Side Effects and Risks of Treatment

Hormone therapy is not a ‘youth vaccine’; it is a medical treatment and should be administered under a doctor’s supervision.

Polycythaemia (Thickening of the Blood): Testosterone increases blood production. If the haematocrit value rises too high, blood flow is impaired and the risk of clotting increases. Therefore, regular blood donation or blood tests are required during treatment.
Infertility: When you take testosterone externally, the brain stops your own production in the testicles, thinking that it is already present. This can reduce sperm production to zero. TRT is not suitable for men who want children. (Instead, other drugs that trigger production are used).
Prostate Health: Testosterone therapy does NOT cause prostate cancer. However, it may accelerate the growth of an existing, undetected cancer. Therefore, a PSA test and prostate examination are mandatory before treatment.

How to Increase Testosterone Naturally?

Change your lifestyle before taking medication or as a supplement to treatment.

1. Lift weights

Cardio is good, but resistance training is best for testosterone. Exercises that work large muscle groups, such as squats and deadlifts, trigger hormone production.

2. Don’t be afraid of fat

Healthy fats (olive oil, avocado, nuts, butter) are the raw material for testosterone production. Excessively low-fat diets reduce testosterone.

3. Vitamin D and Zinc

Vitamin D: Deficiency is directly linked to low testosterone. Get some sun or take supplements.
Zinc: Found particularly in seafood and red meat. It is critical for hormone production.

4. Get your sleep

Most testosterone is produced while you are asleep (especially during REM sleep). Sleeping less than five hours a day can reduce your testosterone levels by 15%.

5. Cut out sugar and alcohol

Sugar raises insulin levels, and high insulin lowers testosterone. Alcohol (especially beer) can have an oestrogenic effect and increase belly fat.

Frequently Asked Questions (FAQ)

Question: Do testosterone medications cause hair loss? Answer: Testosterone converts to DHT in the body. If you are genetically predisposed to hair loss, treatment may accelerate this process. However, if you do not have a genetic predisposition, you will not go bald.

Question: How long does the treatment last? Answer: Hypogonadism is usually a chronic condition. This means that when you stop treatment, your levels will return to their previous low levels. It is generally a lifelong or long-term treatment.

Question: Which foods increase testosterone? Answer: Oysters, red meat, egg yolks, pomegranate juice, ginger, and broccoli (which helps eliminate oestrogen) are testosterone-friendly foods.

Question: Do women have testosterone? Answer: Yes, women also have testosterone, but at much lower levels than men. It is necessary for sexual desire and energy in women.

Conclusion: Take Action, Protect Your Manhood

Low testosterone is a result of the sedentary lifestyle and poor nutrition brought about by the modern age. However, you do not have to live with this condition.

If energy deficiency, loss of sexual desire, and a depressive mood have taken over your life, consult a urology or endocrinology specialist. With a simple blood test and the right treatment plan (whether natural or medical), you can regain the strength you have lost.

Listen to your hormones to become the best version of yourself.