Patients ask frequently about how to improve testosterone levels naturally. I love this question because I would always prefer this approach rather than testosterone supplementation when feasible.

Obesity is a T killer. For overweight patients weight loss is beneficial for so many reasons. In terms of testosterone levels, obesity has multiple negative effects. For example, it can negatively affect the release of luteinizing hormone (LH) from the pituitary gland. LH is responsible for stimulating testosterone production by the testes. Additionally, obesity increases conversion of testosterone to estrogen (yes, men have estrogen too!). Lower testosterone to estrogen ratios can have several bothersome effects in men, including gynecomastia (man boobs) and sexual dysfunction. A weight loss plan is often a better bang for the buck solution to low T than is a shot of testosterone.

Untreated obstructive sleep apnea (OSA), which means stopping breathing during sleep, can also lower testosterone levels. For men who snore, wake up tired or with a headache, or wake up suddenly at night, OSA should be ruled out by doing a sleep study. OSA can profoundly affect health. It turns out that OSA is also more common in overweight people.

What lifestyle factors can have a positive impact? It probably comes as no surprise that regular exercise, good sleep habits, and a balanced diet with portion control have been linked to higher testosterone levels.

A lot of people ask about dietary factors that can decrease or increase testosterone levels. One thing I have learned over the years is that most foods that are good for one body function may not be good for others. For instance, dark leafy greens such as kale, collards or spinach are super healthy, but can also cause kidney stones due to high oxalate content.

Testosterone-affecting diets can be similarly confusing. For instance, flaxseed, which is a heart healthy food due to its high omega-3 levels, also has a component called lignan which can reduce testosterone levels. Additionally, while some heart-healthy nuts have no effect on testosterone levels, walnuts and almonds can reduce testosterone levels. Other surprising foods that may reduce testosterone levels include licorice root and mint.

One healthy food that has gotten a bad rap is soy. It has been proposed that the high phytoestrogen levels in soy can throw a monkey-wrench in testosterone production. But despite rumors to the contrary, it turns out that soy probably has no effect on testosterone levels.

Then there are testosterone-reducing foods that probably come as no surprise. These include sugar, trans-fats, breads and pastries, and alcohol. A ribeye, a coke, dessert and an old fashioned makes for a pretty good evening is but not going to do you any favors in terms of testosterone levels.

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