From sports performance enhancement to simply improving mood, testosterone is always a hot topic. Like most physiological functions, balancing the hormone can make things work optimally. The hot topic aspect is about how to increase and maintain levels to improve body composition, energy levels, mood, and more. If you turn on the radio chances are you will hear commercials on testosterone therapy for men and the wonderful benefits it has as a fountain of youth of sorts. Before going the therapy route, however, are there ways to increase and maintain levels naturally? With all the promises appealing to a man’s ego, are there any downsides to therapy?

First, let’s take a look at non-invasive ways to slow testosterone decrease and even increase the hormone. The following list looks quite familiar when it comes to overall health.

• Quality Sleep: Lack of sleep, even in the short term, can reduce levels. In one study, men were limited to 5 hours of sleep for only 8 nights in a lab setting (after 1 week of 8 hour sleep at home and 11 nights of 10-hour sleep in a lab setting). Comparing daytime levels after the 10-hour nights and 5-hour nights, there was a decrease of 10%-15% after the 5-hour nights. Does this mean there should be time for 8-10 hours of quality sleep every night? No, but it does show that sleep, particularly quality sleep, has an effect.
• Balanced Diet: No surprise here. A balanced diet reduces inflammation (a testosterone killer) and provides essential vitamins. More specifically, though, there are foods that have been linked to testosterone levels. Seafood, leafy greens, eggs, and even cocoa products are part of a testosterone healthy diet. Foods that have been linked to inhibiting testosterone include soy products and refined grains (the good stuff like cakes and pastries).
• Vitamin Supplements: If all the nutrients aren’t being consumed via diet, a multivitamin can help fill in the blanks. Vitamin D, magnesium, and zinc deficiency have all been linked to lower testosterone levels. Sometimes simply adding this to your routine is enough, especially if you have never considered a multivitamin supplement or worked with a dietician to pinpoint deficiencies.
• Reduce Stress: Like most healthy habits this is easier said than done. Reducing stress is even more challenging as it can be outside stressors over which you have no control. The key here is to reduce the stress hormone, cortisol. High cortisol levels negatively affect testosterone levels.
• Reduce Alcohol Intake: Removing alcohol from your life may not be how you want to live. Yours truly certainly sympathizes. However, avoiding high levels and abuse of alcohol is a positive testosterone-increasing step. Removing alcohol intake altogether is the most optimal step.
• Exercise: Simply being more active can improve testosterone levels. Strength training, in particular, is key in naturally increasing free testosterone in the blood. The visual connection of bodybuilders to high levels testosterone is no coincidence. Yes, those that resemble a comic book character are most likely taking additional steps (invasive action) to create that physique, but there is no denying that the act of moderate to high intensity strength training by itself will increase testosterone.
• Lose Weight: This is a “chicken or the egg” conversation. The findings are that men who are overweight (overfat) have lower testosterone levels. Simply losing weight, however, is a product of taking all the previous steps in this list. So, which came first, the weight gain or low testosterone due to a less than healthy lifestyle?

As mentioned, the above list should look familiar. These are healthy choices that all of us can strive toward no matter the specific goal. Testosterone therapy in addition to (and in lieu of) healthier lifestyle choices is becoming a popular route, but are there downsides? The overall answer is yes. For men, therapy is an attractive option. The hormone naturally decreases with age (about 1% each year after 40). The promised benefits of therapy is definitely luring. The negative effects, however, may include visual risks such as acne, enlarged breasts, and reduced size of testicles. Other unseen effects include prostate enlargement, worsening of sleep apnea, and blood clot risk due to too much red blood cell production. All of these or none of these negative effects may be observed form one individual to another.

The many variables, benefits, and risks of testosterone therapy are unique to each individual. The best way to address the hormone is through lifestyle choices first. There is divide on whether therapy actually benefits a healthy male, regardless of age.  Before pursuing therapy, it is important to talk testosterone with your doctor.