In transdermal therapy, timing matters differently. One reason lab conversations around TRT become confusing is that testosterone values are not independent of timing. It does mean that physiologic replacement should look physiologic, not pharmacologic enhancement (Travison et al., Journal of Clinical Endocrinology & Metabolism, 2017). Chronic illness, obesity, sleep problems, and certain medications can also lower levels. The goal is clear information to help decide whether to discuss supplements with a clinician. This typically occurs slowly over time and is considered a normal part of aging. Testosterone levels naturally decline as men get older. Assess thyroid function with a free T4 and TSH blood test. Assess thyroid, nutrition, and heart health for lifelong wellness. The US Food and Drug Administration (FDA) clearly states that, "Unlike drugs, supplements are not intended to treat, diagnose, prevent, or cure diseases. However, one study found that 87.8% men with low T were not receiving treatment, despite adequate access to care . The reasons for this decline may be related to failure of the testes to produce T, impaired function of the hypothalamic-pituitary-gonadal axis, comorbid medical issues, exogenous medications or other factors. Adam S. Baumgarten, M.D., assistant professor in the University of Alabama at Birmingham Department of Urology, shares insights on the causes, symptoms and treatment options for low testosterone in men. Low testosterone, or hypogonadism, in men can often go unnoticed without an understanding of the symptoms and causes. Testosterone is a vital hormone that supports male characteristics and overall health. The best types of exercise to increase your testosterone levels are weightlifting and high-intensity interval training (HIIT). Supplements aren't the only way to increase your testosterone levels naturally. In one yearlong study, 65 men who took 3,300 IU of vitamin D daily increased their testosterone levels by 20% over those who didn't. Long-term zinc supplementation may lead to increased testosterone levels. These are supplements that contain things like vitamins, minerals, and herbs that are meant to increase your body's natural production of testosterone. More than 33% of men over 45 may have lower than normal testosterone levels. If testosterone rises above the female physiologic range, the risk of androgenic adverse effects increases and the treatment logic starts to break down (Parish et al., Climacteric, 2021; Parish and Kling, Menopause, 2023). While not specified in the FDA warning, this potential risk may extend to herbal T supplements as well. Illustrating this, a 2017 case report described new-onset, bilateral pulmonary embolisms secondary to over-the-counter fenugreek-extract-containing T supplements . TRT has a well-defined risk profile, with clear guidelines for indications, contraindications, dosing, treatment goals, and monitoring during treatment . TRT is a well-established treatment option for those with symptomatic T deficiency. Two supplements had greater than or equal to the UL of zinc (40 mg), 2 had greater than the UL of vitamin B3 (35 mg), and 9 were greater than the UL of magnesium (350 mg). Interestingly, the supplements contained a mean 3.1% of the RDA of calcium. We then surveyed the RDA and UL for each of the individual supplements.
