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New: A 2-in-1 pill for sex + testosterone support
Whether you’re struggling with symptoms of low testosterone or trying to maximize your muscle gains, there are numerous reasons you might want to take something to increase your T levels. But are testosterone boosters safe?
If you’re needle-averse and doctor visit-averse, you might be on the fence about some of the dubious-sounding internet products claiming to improve libido or make it look like you spend hours a day pumping iron.
But not all testosterone boosters are created equal, and some are more effective — and safer — than others.
We’ll explain testosterone boosters in more detail, including how they work, what benefits they may offer, and the side effects and safety concerns to be aware of.
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Many products qualify as testosterone boosters or androgen boosters. They can technically be anything that elevates levels of this male sex hormone, which is primarily produced in the testicles and regulated by the pituitary gland.
There are therapies approved by the U.S. Food and Drug Administration (FDA) that a healthcare provider might administer. Then there are dietary supplements like packets of pills and ground spices you might pick up at a supplement store or your local gas station. You can probably guess which is safer.
Along with substances you ingest, testosterone boosters can be things you might inject with the aim of increasing your levels of testosterone.
Even healthy lifestyle modifications like following a balanced diet can help balance out your T levels.
Prescription testosterone boosters like exogenous testosterone (testosterone-replacement therapy or TRT) can help people with clinically low testosterone (hypogonadism).
Hypogonadism is associated with symptoms like low sex drive, reduced body hair, and testicular shrinkage.
Clinically low testosterone concentrations are also linked to erectile dysfunction (ED). That’s why you might see some testosterone boosters geared toward helping you get an erection.
The goal of most over-the-counter herbal supplements for testosterone is to treat symptoms of low testosterone — like fatigue, muscle weakness, and mood disturbances — without involving a healthcare professional.
They’re also commonly used to increase muscle mass and help guys perform better at the gym.
Over-the-counter products can include any of these active ingredients purported to increase testosterone:
Saw palmetto extract
Nettle extract
Ginseng
Magnesium
Vitamin D
As you can imagine, many of these products are sold on the internet.
But there’s scant reliable evidence that these herbs can actually help with lower testosterone levels or offer any of the other benefits. And there aren’t enough clinical trials showing they’re safe to consume regularly.
We’ve now come to the part of the conversation where we must distinguish between science and unsupported statements about the effects of testosterone boosters.
Do test boosters work? When used appropriately and under medical supervision, male testosterone boosters can be effective in increasing testosterone levels in individuals with low testosterone or certain medical conditions.
Testosterone-replacement therapy (TRT), for example, is a well-established and highly effective method for increasing testosterone levels in men with diagnosed hypogonadism. With TRT, exogenous testosterone is administered through injections, patches, gels, or pellets.
On the other hand, over-the-counter testosterone boosters and supplements marketed as natural ways to increase testosterone don’t have well-established records for their effectiveness.
Some studies suggest that certain ingredients found in these supplements (such as D-aspartic acid or fenugreek extract) may have a mild impact on testosterone levels. But the evidence is limited and inconsistent.
We should note that the effectiveness of all testosterone boosters can vary depending on individual factors, like the underlying cause of low testosterone and a person’s overall health status.
Also, the use of testosterone boosters should be supervised by healthcare professionals to ensure appropriate dosing and monitoring — even if they lack scientific backing for their benefits.
When used under appropriate medical supervision for folks with diagnosed low testosterone levels or specific medical conditions, testosterone boosters like TRT can provide several potential benefits.
This may include:
Increased muscle mass and strength
Improved libido and sexual function
Enhanced mood and sense of well-being
Increased bone density
Potential cardiovascular health benefits
Here’s what to know.
Do testosterone boosters work for muscle gain? Whether you’re part of the bodybuilding world or not, you probably know that if you want to build muscle, you need testosterone.
As with the rest of men’s health, T levels are directly related to muscle strength. In fact, testosterone is known to play a crucial role in muscle development and strength. Returning to healthy testosterone levels may enhance muscle protein synthesis and promote muscle growth.
Some research also shows that testosterone therapy may improve lean body mass and LDL (low-density lipoprotein, aka “bad cholesterol”) in men with obesity.
Sexual performance is a critical component of many men’s confidence. If you’re struggling with low libido or erectile dysfunction, you might try increasing your testosterone levels.
There’s a reason you’d want to start there — sexual energy levels and testosterone levels have a somewhat direct relationship. Testosterone is a key hormone involved in sexual desire and performance. So increasing testosterone levels can potentially boost libido and improve erectile function, as shown in a 2018 study.
Testosterone influences mood and mental well-being. Adequate levels of the hormone may contribute to improved energy, motivation, and a positive outlook on life.
Some studies show that boosting your testosterone with TRT improves symptoms of depression and increases the overall quality of life in men with low testosterone. Some guys also report better concentration, self-confidence, sociability, and energy levels.
Testosterone is vital for maintaining bone health and density. A testosterone booster like TRT may help prevent or slow down the loss of bone mass associated with conditions like osteoporosis or osteopenia.
Some studies suggest that optimal testosterone levels may support cardiovascular health in certain ways, including improving lipid profiles (better cholesterol) and decreasing the risk of heart disease.
However, more research is needed to find out if treating low testosterone with an intervention like TRT would help or further exacerbate cardiovascular risk.
A month’s supply of heightened hormone levels might just be a trip to the gas station away — but that may actually be a really bad idea.
The benefits of testosterone boosters can vary depending on individual factors and the underlying cause of low testosterone — and as you might have guessed, so can the side effects.
Some testosterone boosters, including prescription TRT, can have negative side effects like low sperm count, acne, mood changes, and an elevated risk of cardiovascular events.
Even natural so-called testosterone boosters, like vitamin D and magnesium, can cause side effects if used in excess.
For instance, too much vitamin D can cause hypercalcemia (too much calcium in the blood) and symptoms like weakness, fatigue, and confusion. And overdoing it on magnesium can result in hypotension (low blood pressure), nausea, vomiting, and facial flushing.
As for testosterone-boosting herbal supplements, more than one respectable source has called the “science” backing their claims “unsupported.” A 2018 case report suggested that even obtaining over-the-counter boosters from reputable-seeming sources carries health risks.
Meanwhile, herbs like ashwagandha have been found to boost testosterone, but there are still many unanswered questions, including some about safety.
We should note that the risks and side effects associated with testosterone boosters can vary depending on factors such as dosage, how long they’re used, a person’s individual health status, and the specific type of testosterone booster being used.
Seeking medical advice and supervision is crucial for mitigating these risks and ensuring the safest possible use of testosterone booster supplements.
It’s essential to use testosterone boosters under medical supervision to ensure appropriate dosing and monitoring, as excessive testosterone levels can have adverse effects on your health.
Even when used appropriately or under medical supervision, testosterone boosters like TRT carry potential risks and side effects. These can include:
Suppression of natural testosterone production
Decreased or absent sperm production and infertility
Decreased testicular size
Breast growth
Acne and oily skin
Potential Increased risk of cardiovascular problems
Liver toxicity
Mood changes and aggression
Sleep disturbances, including obstructive sleep apnea (OSA)
Prostate enlargement
Increased red blood cell count
Some of these, like acne, may not be such a big deal. But other side effects are serious, so definitely consult a healthcare professional for guidance and monitoring.
The use of exogenous testosterone, such as in testosterone-replacement therapy, can lead to a reduction in the body’s natural testosterone production.
This can result in testicular atrophy (shrinkage) and eventual long-term dependence on testosterone therapy. Exogenous testosterone can also result in compromised sperm production and infertility, so testosterone management should be discussed with a urologist.
Rapid changes in hormones like cortisol and estrogen can result in sudden breast growth (gynecomastia) in men. This is because testosterone converts to estradiol within peripheral fat and muscle tissue.
Increasing testosterone levels can stimulate sebum production, leading to acne and oily skin. It could also cause a greasy scalp and seborrheic dermatitis, a common cause of dandruff.
Low testosterone is one of the risk factors for cardiovascular disease. There’s some concern about elevated testosterone levels increasing the risk of heart problems like heart attack, stroke, heart failure, and blood clots. But we don’t currently have definitive evidence on this topic.
Certain oral testosterone-boosting supplements may pose a risk of liver damage, especially with long-term use or high doses.
Testosterone can influence mood and behavior. Some individuals may experience mood swings, increased aggression, or irritability while using testosterone boosters.
Testosterone supplementation can disrupt sleep patterns and potentially cause or worsen sleep apnea, a condition where breathing temporarily stops during sleep.
There’s some concern that long-term use of testosterone boosters may contribute to prostate enlargement (benign prostatic hyperplasia or BPH). However, more research is needed to understand this association. Recent studies have shown testosterone supplementation is not correlated with an increased risk for development of prostate cancer.
A study on men with opioid-induced androgen deficiency showed that TRT was linked to high blood pressure (hypertension) and an increase in red blood cells, called polycythemia.
Your healthcare provider will do a blood test to check your levels prior to starting testosterone therapy and check them periodically.
Are testosterone boosters safe? Anabolic steroids might sound like a free testosterone boost for reducing body fat or seeing gains at the gym, but they can have health consequences in the long term. The same is true of other boosters.
There’s no denying that testosterone levels are an essential part of men’s health and sexual health — and if you’re deficient in testosterone, it’s a problem you should address.
We’re just not sure so-called “boosters” are the way to do that.
Here’s the thing:
Testosterone-replacement therapy can be effective for people with conditions like hypogonadism, but there are caveats. TRT is very different from things like ginseng, magnesium, vitamin D3, and horny goat weed, none of which have FDA approval for treating testosterone deficiency.
Should healthy men use testosterone boosters? They shouldn’t need to, though some men might use them for muscle growth or other physical performance benefits. But this should only be done under the supervision of a medical provider.
While TRT has side effects, it’s a treatment overseen by a healthcare professional. You can do it safely, whereas supplements may not be effectively dosed for your needs.
If you really want to get more testosterone into your system medically, a healthcare provider is the person to see. Skip the gas station attendant and online sellers. This can save you from health complications down the line.
If you’re experiencing erectile dysfunction or low libido, consider whether it’s psychological or related to a different health condition. A healthcare professional (like a urology specialist) can help you figure this out.
Our advice? Schedule a consultation with a healthcare provider and ask about safe and effective sexual health solutions.
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown was previously Medical Director of a male fertility startup where she lead strategy and design of their digital health platform, an innovative education and telehealth model for delivering expert male fertility care.
She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.
Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.
Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.
Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.
Education & Training
Andrology Fellowship, Medical College of Wisconsin
Urology Residency, University of California San Francisco
M.D. Northwestern University Feinberg School of MedicineB.S. in Radiologic Science, Chemistry Minor, University of North Carolina at Chapel Hill
Published as Kelly Walker
Cowan, B, Walker, K., Rodgers, K., Agyemang, J. (2023). Hormonal Management Improves Semen Analysis Parameters in Men with Abnormal Concentration, Motility, and/or Morphology. Fertility and Sterility, Volume 118, Issue 5, e4. https://www.sciencedirect.com/journal/fertility-and-sterility/vol/120/issue/1/suppl/S
Walker, K., Gogoj, A., Honig, S., Sandlow, J. (2021). What’s New in Male Contraception? AUA Update Series, Volume 40. https://auau.auanet.org/content/update-series-2021-lesson-27-what%E2%80%99s-new-male-contraception
Walker, K., Shindel, A. (2019). AUA Erectile Dysfunction Guideline. AUA Update Series, Volume 38. https://auau.auanet.org/content/course-307
Walker, K., Ramstein, J., & Smith, J. (2019). Regret Regarding Fertility Preservation Decisions Among Male Cancer Patients. The Journal of Urology, 201(Supplement 4), e680-e681. https://www.auajournals.org/doi/10.1097/01.JU.0000556300.18991.8e
Walker, K., & Smith, J. (2019). Feasibility Study of Video Telehealth Clinic Visits in Urology. The Journal of Urology, 201(Supplement 4), e545-e545. https://www.auajournals.org/doi/10.1097/01.JU.0000556071.60611.37