Introduction

You wake up unmotivated. Your workouts don't build muscle like they used to. Brain fog settles in by afternoon. And that drive you once had? It's fading.

What the research shows: testosterone isn't just about muscle and libido-it's essential for energy, cognition, mood, bone density, metabolic health, and longevity in both men and women.

The reality is that 40% of men over 45 have low testosterone (below 300 ng/dL), and levels have been declining across populations for decades. Women need optimal testosterone too-especially for energy, muscle maintenance, and cognitive function.

But there's good news. You can often raise testosterone naturally before considering hormone replacement therapy.

In this guide, you'll discover:

• Why testosterone matters for health, performance, and longevity

• 7 evidence-based methods to optimize levels naturally

• Lifestyle protocols from preventive health experts

• Testing frequency and target ranges for men and women

• When natural methods work versus when TRT/HRT may help

Want to understand your hormone status? Our comprehensive hormone panel measures testosterone, free testosterone, and related biomarkers-giving you the complete picture for optimization.

The Science

Testosterone is an anabolic hormone produced primarily in the testes (men) and ovaries (women), with smaller amounts from the adrenal glands. It circulates in three forms:

• Free testosterone (1-2%): Bioavailable, active form

• Albumin-bound (40-50%): Loosely bound, bioavailable

• SHBG-bound (50-60%): Tightly bound, not bioavailable

Total testosterone measures all three. Free testosterone measures the active fraction.

Health Impacts of Optimal Testosterone

In Men:

• Muscle Mass & Strength: Supports protein synthesis and muscle growth

• Bone Density: Helps maintain bone health and strength

• Fat Distribution: Can help reduce visceral fat and improve body composition

• Energy & Motivation: Critical for drive, ambition, and vitality

• Mood & Cognition: Supports mental clarity, focus, and confidence

• Libido & Sexual Function: Essential for desire and function

• Cardiovascular Health: Supports heart health when optimized

• Metabolic Health: Can improve insulin sensitivity and glucose metabolism

In Women:

• Energy & Vitality: Critical for daily energy and motivation

• Muscle Maintenance: Helps prevent age-related muscle loss

• Libido: Essential for sexual desire and satisfaction

• Mood & Confidence: Supports assertiveness and mental clarity

• Bone Health: Works with estrogen to help maintain bone density

• Metabolic Health: Can improve body composition and insulin sensitivity

What Happens With Low Testosterone

Men:

• Fatigue, low energy, lack of motivation

• Loss of muscle mass, increased body fat (especially belly)

• Brain fog, poor memory, difficulty concentrating

• Low libido, erectile dysfunction

• Depression, irritability, mood swings

• Reduced bone density, increased fracture risk

• Poor sleep quality

• Metabolic dysfunction, insulin resistance

Women:

• Persistent fatigue despite adequate sleep

• Loss of muscle tone, difficulty building strength

• Low libido, reduced sexual satisfaction

• Brain fog, memory issues

• Depression, lack of confidence Want to understand your hormone status? Our comprehensive hormone panel measures total testosterone, free testosterone, SHBG, estradiol, and related biomarkers. Data-driven insights for optimization. Individual panels at $349, comprehensive duo testing at $668.

• Difficulty losing weight, increased belly fat

• Reduced motivation and drive

Men's Testosterone Ranges

Total Testosterone:

• Low: <300 ng/dL - Clinical hypogonadism

• Low-Normal: 300-500 ng/dL - Standard "normal" but suboptimal

• Healthy: 500-700 ng/dL - Mid-range

• Optimal: 700-900 ng/dL ← Longevity experts target for men under 50

• Upper Optimal: 900-1100 ng/dL - Athletic, very healthy men

• Supraphysiological: >1100 ng/dL - Usually indicates TRT or PED use

Free Testosterone:

• Low: <7 ng/dL (70 pg/mL)

• Optimal: 15-25 ng/dL (150-250 pg/mL) - Test free testosterone

Women's Testosterone Ranges

Total Testosterone:

• Low: <15 ng/dL

• Optimal: 30-70 ng/dL for premenopausal women

• Postmenopausal: 20-40 ng/dL

• Note: Women's ranges are much lower than men's but equally important

Free Testosterone:

• Optimal: 1.5-4.5 pg/mL for premenopausal women

Expert Recommendations

• Peter Attia: Targets 700-900 ng/dL total for men under 50; considers TRT if consistently <500 ng/dL despite optimization

• Andrew Huberman: Recommends 700+ ng/dL for men; emphasizes free testosterone matters more than total

• Kyle Gillett (Huberman's hormone expert): Says 600-900 ng/dL is ideal for most men; >500 ng/dL minimum for vitality

Key Insight: Many men have "normal" testosterone (300-500 ng/dL) but feel terrible. Optimal for most men is 700-900 ng/dL, not just above 300 ng/dL.

Track Your Testosterone Levels

Mito Health tests 100+ biomarkers including total testosterone, free testosterone, SHBG, LH, and estradiol with physician-guided protocols to help you optimize energy, muscle mass, and cognitive function. Our comprehensive panels provide personalized interpretation to identify hormone imbalances early.

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The Science

Testosterone is produced primarily during deep sleep (stages 3-4 NREM). Just one week of 5-hour sleep reduces testosterone by 10-15%. Chronic poor sleep can drop levels by 30% or more.

How Sleep Affects Testosterone

• Production timing: 60-70% of daily testosterone is produced during sleep

• Peak production: Occurs during REM and deep sleep cycles

• Sleep debt: Cumulative; even 1 hour less per night compounds over weeks

• Recovery: Testosterone rebounds within 7-14 days of restoring sleep

Optimal Sleep Protocol for Testosterone

Sleep Duration:

• Minimum: 7 hours per night

• Optimal: 8-9 hours for most men

• Individual variation: Some need more; track subjective energy + biomarkers

Sleep Quality Matters More Than Duration:

• Deep sleep (NREM stage 3-4): 15-25% of total sleep (target 90-120 min)

• REM sleep: 20-25% of total sleep (target 90-120 min)

• Sleep efficiency: >85% (time asleep ÷ time in bed)

Actionable Steps

1. Consistent Sleep Schedule:

• Same bedtime and wake time ±30 minutes, even weekends

• Maintains circadian rhythm and hormone production

2. Evening Wind-Down Routine (90 min before bed):

• Dim lights (or use blue-light blocking glasses)

• Lower room temperature to 65-68°F (18-20°C)

• Avoid screens or use night shift mode

• No vigorous exercise within 3 hours of bed

• Avoid large meals within 2-3 hours

3. Sleep Environment:

• Dark: Blackout curtains or sleep mask (light suppresses testosterone)

• Cool: 65-68°F optimal for deep sleep

• Quiet: White noise machine or earpearings if needed

• Comfortable: Quality mattress and pillows

4. Caffeine & Alcohol:

• Caffeine cutoff: No caffeine after 12-2pm (half-life 5-6 hours)

• Alcohol: Avoid or minimize; disrupts REM and deep sleep, lowers testosterone 20-30% even moderate amounts

5. Morning Sunlight Exposure:

• 10-30 minutes of bright light within 1 hour of waking

• Signals circadian rhythm, improves nighttime melatonin and sleep quality

6. Track Your Sleep:

• Use Oura Ring, Whoop, or Apple Watch to monitor deep/REM sleep

• Correlate sleep quality with energy, mood, and testosterone levels (retest every 3-6 months)

Expected Impact: Improving from 5-6 hours to 8 hours can increase testosterone 50-100 ng/dL within 2-4 weeks.

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The Science

Resistance training is the most potent natural testosterone booster. Compound lifts with heavy loads stimulate acute testosterone release and improve long-term production.

Endurance training (excessive cardio) can suppress testosterone, especially when combined with caloric deficit or overtraining.

Optimal Exercise Protocol for Testosterone

Resistance Training (3-5x per week):

Best exercises (compound movements):

• Squats, deadlifts, bench press, overhead press

• Rows, pull-ups, lunges

• Why: Recruit large muscle groups, stimulate hormonal response

Optimal intensity:

• Heavy loads: 75-85% 1RM (6-10 reps per set)

• Moderate volume: 3-5 sets per exercise

• Rest periods: 2-3 minutes between sets for heavy lifts

• Progressive overload: Increase weight, reps, or volume over time

Training split examples:

• 3x per week: Full-body sessions

• 4x per week: Upper/lower split

• 5x per week: Push/pull/legs split

Acute testosterone boost: 15-30% increase immediately post-workout (transient)
Long-term effect: 20-40% increase in baseline testosterone over 3-6 months with consistent training

HIIT (High-Intensity Interval Training) (1-2x per week):

• Protocol: 30 sec sprint, 90 sec rest x 8-10 rounds

• Benefit: Acute testosterone spike, minimal cortisol elevation (if not overdone)

• Examples: Sprints, bike intervals, sled pushes, battle ropes

Avoid Excessive Endurance Cardio:

• Problem: Long-duration moderate-intensity cardio (60+ min) elevates cortisol and suppresses testosterone

• Evidence: Marathon runners, chronic endurance athletes often have low testosterone (300-400 ng/dL)

• Solution: Limit steady-state cardio to 20-40 min sessions, 2-3x per week max

• Exception: Zone 2 cardio for mitochondrial health (keep to 2-3x per week, 45-60 min)

Recovery Matters

• Overtraining suppresses testosterone: Monitor for fatigue, poor sleep, declining performance

• Rest days: 2-3 per week for nervous system recovery

• Deload weeks: Every 4-6 weeks, reduce volume/intensity 50%

Actionable Steps

1. Prioritize 3-5 resistance training sessions per week with compound lifts

2. Include 1-2 HIIT sessions for metabolic and hormonal benefits

3. Limit steady-state cardio to 2-3x per week, 30-40 min max

4. Track strength progress and correlate with testosterone levels (retest every 3 months)

Expected Impact: Consistent resistance training can increase testosterone 100-200 ng/dL over 6 months, especially in untrained or detrained individuals.

The Science

Dietary fat is the precursor to all steroid hormones, including testosterone. Low-fat diets (<20% calories from fat) consistently lower testosterone by 10-15%.

Body composition matters: Both obesity (high body fat) and being underweight (too lean) suppress testosterone.

Optimal Nutrition Protocol for Testosterone

1. Adequate Dietary Fat (30-40% of calories):

Why: Cholesterol converts to Pregnenolone, then to DHEA, then to Testosterone (steroidogenesis pathway requires fat)

Best fat sources:

• Saturated fats (10-15% of calories): Eggs, grass-fed beef, butter, coconut oil

• Monounsaturated fats (15-20%): Olive oil, avocados, nuts, olives

• Omega-3s (EPA/DHA): Fatty fish (salmon, sardines, mackerel), fish oil

• Avoid trans fats and excessive omega-6: Seed oils, processed foods

Testosterone-Boosting Foods:

• Eggs (especially yolks): High cholesterol, vitamin D, healthy fats

• Grass-fed beef: Zinc, creatine, saturated fats

• Oysters: Highest zinc content (critical for testosterone)

• Pomegranate: May increase testosterone 20-30% (via antioxidant effects)

• Ginger: Supports testosterone production (3g daily)

• Garlic: Increases testicular testosterone (via allicin, reduces cortisol)

2. Sufficient Protein (1.6-2.2g per kg body weight):

• Supports muscle mass, which correlates with higher testosterone

• Prevents muscle catabolism during caloric deficit

3. Adequate Calories (Don't Chronically Under-Eat):

• Caloric deficit: Prolonged deficits (>20%) suppress testosterone via increased cortisol and reduced LH

• Maintenance or slight surplus: Optimal for testosterone production

• Refeed days: If cutting, include 1-2 high-calorie days per week to prevent hormonal suppression

4. Micronutrients Critical for Testosterone:

Zinc (15-30 mg daily):

• Required for testosterone synthesis

• Deficiency common in athletes (sweat loss)

• Best sources: Oysters, beef, pumpkin seeds

• Supplement if deficient: Zinc picolinate 30 mg

Vitamin D (4,000-5,000 IU daily):

• Acts as a steroid hormone precursor

• Optimal levels (40-60 ng/mL) correlate with higher testosterone

• Deficiency (<30 ng/mL) suppresses testosterone 20-30%

Magnesium (300-500 mg daily):

• Increases free testosterone by reducing SHBG

• Glycinate form preferred (better absorption, no laxative effect)

Boron (6-10 mg daily):

• Increases free testosterone by reducing SHBG 10-15%

• Decreases estradiol

• Food sources: Raisins, almonds, avocados

Want to explore testosterone-boosting supplements in detail? See our comprehensive testosterone booster comparison guide for evidence-based supplement recommendations.

5. Body Composition Optimization:

Obesity (>25% body fat men, >32% women):

• Fat tissue converts testosterone to estradiol (via aromatase enzyme)

• Visceral fat especially problematic

• Goal: Reduce to 10-20% body fat (men), 20-28% (women)

• Expected impact: Losing 10% body weight can increase testosterone 100-200 ng/dL

Too Lean (<8% body fat men, <18% women):

• Chronic low body fat suppresses hypothalamic-pituitary axis

• Common in: Bodybuilders during prolonged cuts, chronic dieters

• Goal: Maintain sustainable body fat (10-15% men, 20-25% women)

Actionable Steps

1. Track macros: Ensure 30-40% fat, 1.6-2.2g/kg protein, adequate calories

2. Prioritize testosterone-boosting foods: Eggs, grass-fed beef, oysters, pomegranate

3. Supplement key micronutrients: Zinc 30 mg, vitamin D 4,000 IU, magnesium 400 mg, boron 6 mg

4. Optimize body composition: Target 10-20% body fat (men), 20-28% (women)

Expected Impact: Optimizing nutrition + body composition can increase testosterone 150-300 ng/dL over 3-6 months.

Ready to build your protocol? Test your testosterone, vitamin D, zinc, and metabolic biomarkers-then optimize nutrition based on your results. Individual testing at $349.

The Science

Cortisol (stress hormone) directly antagonizes testosterone production. Chronic elevated cortisol downregulates the hypothalamic-pituitary-gonadal (HPG) axis, reducing LH (luteinizing hormone) and testosterone synthesis.

High cortisol = Low testosterone. This relationship is dose-dependent and consistent.

How Stress Suppresses Testosterone

• Acute stress: Brief cortisol spike, minimal impact on testosterone

• Chronic stress: Sustained cortisol elevation suppresses HPG axis-reducing LH and testosterone production

• Mechanism: Cortisol and testosterone compete for the same precursor (pregnenolone); chronic stress "steals" pregnenolone for cortisol production

Expected impact: Chronic stress can reduce testosterone by 200-400 ng/dL (30-50% in severe cases).

Optimal Stress Management Protocol

1. Identify & Reduce Stressors:

• Work: Overwork, poor boundaries, toxic environment

• Relationships: Conflict, lack of support

• Financial: Chronic money stress

• Sleep deprivation: See Method 1

• Overtraining: Excessive exercise without recovery

2. Daily Stress-Reduction Practices:

Photo from Unsplash

Meditation & Breathwork (10-20 min daily):

• Evidence: Reduces cortisol 15-25%, improves testosterone

• Protocols: Box breathing (4-4-4-4), physiological sigh (2 inhales through nose, long exhale), mindfulness meditation

Nature Exposure:

• 20-30 min daily outdoors reduces cortisol 10-15%

Social Connection:

• Quality relationships buffer stress response

3. Adaptogenic Herbs (Optional):

Ashwagandha (KSM-66 or Sensoril):

• Dose: 300-600 mg daily

• Effect: Reduces cortisol 25-30%, increases testosterone 10-15% (40-100 ng/dL in some studies)

• Evidence: [PMID: 30854916] - 600 mg for 8 weeks increased testosterone 15% in stressed men

• Note: May cause mild sedation in some; take evening if so

Rhodiola Rosea:

• Dose: 200-400 mg daily

• Effect: Reduces stress-induced cortisol, improves energy, supports testosterone indirectly

Phosphatidylserine:

• Dose: 300-800 mg daily

• Effect: Blunts cortisol response to exercise (useful for athletes)

4. Avoid Chronic Stimulant Use:

• Caffeine >400 mg daily: Can elevate cortisol chronically

• Pre-workouts with high stimulants: Cortisol spike without benefit

• Limit caffeine to mornings: Avoid afternoon/evening for sleep quality

5. Test Cortisol:

• 4-point salivary cortisol test: Morning, noon, afternoon, evening

• Optimal pattern: High morning (12-20 mcg/dL), gradual decline, low evening (<2 mcg/dL)

• Abnormal patterns: Flat (chronic stress), elevated evening (poor sleep, overtraining)

Actionable Steps

1. Implement daily stress-reduction: 10-20 min breathwork or meditation

2. Prioritize recovery: 2-3 rest days per week, manage workload

3. Consider ashwagandha: 300-600 mg daily if chronically stressed (test cortisol + testosterone baseline and after 8 weeks)

4. Test cortisol pattern: 4-point salivary test to identify dysregulation

Expected Impact: Reducing chronic stress + lowering cortisol can increase testosterone 100-200 ng/dL within 2-3 months.

The Science

Endocrine-disrupting chemicals (EDCs) mimic or block hormones, directly suppressing testosterone production or increasing aromatization (testosterone to estrogen conversion).

Common Endocrine Disruptors

1. Plastics (BPA, BPS, Phthalates):

• Sources: Plastic food containers, water bottles, food packaging, receipts

• Effect: Lower testosterone 10-20%, increase estrogen

• Solution: Use glass, stainless steel, or BPA-free containers; avoid microwaving plastic; handle receipts minimally

2. Pesticides (Organophosphates, Glyphosate):

• Sources: Non-organic produce, contaminated water

• Effect: Suppress testosterone, disrupt endocrine function

• Solution: Buy organic (especially "Dirty Dozen"), filter water (reverse osmosis)

3. Personal Care Products (Parabens, Phthalates, Triclosan):

• Sources: Shampoos, lotions, deodorants, toothpaste, cologne

• Effect: Estrogenic activity, lower testosterone

• Solution: Choose "paraben-free," "phthalate-free" products; use natural alternatives

4. Alcohol (Excessive Consumption):

• Effect: Increases aromatase (converts testosterone to estrogen), damages Leydig cells (testosterone production)

• Dose-dependent: 2+ drinks per day significantly lowers testosterone

• Solution: Limit to 2-3 drinks per week max; consider eliminating entirely for 3 months to assess impact

5. Cannabis (THC):

• Effect: Suppresses LH and testosterone production (dose-dependent)

• Evidence: Daily use can reduce testosterone 20-30%

• Solution: Reduce frequency or eliminate; assess testosterone before/after

6. Soy & Phytoestrogens (Controversial):

• Moderate intake: Likely minimal impact on testosterone in most men

• Excessive intake: May suppress testosterone in susceptible individuals

• Solution: Avoid excessive soy protein isolates; whole food soy (edamame, tempeh) in moderation likely safe

Actionable Steps

1. Switch to glass/stainless steel: Food storage, water bottles

2. Buy organic: Prioritize "Dirty Dozen" produce

3. Clean personal care products: Check EWG's Skin Deep Database

4. Limit alcohol: Max 2-3 drinks per week

5. Reduce or eliminate cannabis: If using daily, trial 3-month break and retest testosterone

Expected Impact: Reducing EDC exposure can increase testosterone 50-150 ng/dL over 3-6 months.

The Science

Certain supplements have strong evidence for increasing testosterone naturally. Others are overhyped with minimal effect.

Evidence-Based Testosterone Supplements

1. Vitamin D (4,000-5,000 IU daily):

• Effect: Increases testosterone 20-30% if deficient (<30 ng/mL)

• Optimal level: 40-60 ng/mL

• Evidence: [PMID: 21154195] - 3,332 IU daily for 1 year increased testosterone 25%

• Pair with: K2-MK7 (100-200 mcg) and magnesium (400 mg)

2. Zinc (30 mg daily):

• Effect: Corrects deficiency (common in athletes), increases testosterone 20-30% if deficient

• Evidence: [PMID: 8875519] - Zinc depletion lowered testosterone 75%; repletion restored levels

• Form: Zinc picolinate or glycinate (better absorption)

• Do not exceed: 40 mg daily long-term (competes with copper)

3. Magnesium (400-500 mg daily):

• Effect: Increases free testosterone by reducing SHBG

• Evidence: [PMID: 21675994] - 750 mg daily increased free testosterone 24% in athletes

• Form: Glycinate, threonate, or malate (avoid oxide)

4. Ashwagandha (KSM-66 300-600 mg daily):

• Effect: Reduces cortisol, increases testosterone 10-15% (40-100 ng/dL)

• Evidence: [PMID: 30854916] - 600 mg for 8 weeks increased testosterone 15%, reduced cortisol 25%

• Best for: Chronically stressed individuals

5. Boron (6-10 mg daily):

• Effect: Increases free testosterone 10-15% by reducing SHBG; reduces estradiol

• Evidence: [PMID: 21129941] - 10 mg daily for 1 week increased free testosterone 28%

• Safe long-term: Yes, at 6-10 mg daily

6. D-Aspartic Acid (DAA) (2-3g daily):

• Effect: May increase testosterone 30-40% in men with low baseline (<400 ng/dL)

• Evidence: Mixed; works for some, not others

• Protocol: Cycle 2 weeks on, 1 week off

• Note: Minimal benefit if testosterone already >500 ng/dL

7. Creatine (5g daily):

• Effect: Increases DHT (dihydrotestosterone, potent testosterone metabolite) 20-50%

• Evidence: [PMID: 19741313] - Creatine loading increased DHT 56%

• Benefit: Improves strength, muscle mass, cognitive function (indirect testosterone support)

8. Tongkat Ali (Eurycoma longifolia) (200-400 mg daily):

• Effect: Increases testosterone 15-25%, especially in stressed or older men

• Evidence: [PMID: 22739422] - 200 mg daily for 1 month increased total testosterone 37%, free testosterone 16%

• Quality matters: LJ100 or Physta extracts standardized to eurycomanone

Supplements to AVOID (Overhyped or Dangerous)

Tribulus Terrestris: No consistent evidence for increasing testosterone in humans
Fenugreek: Minimal testosterone effect; may increase libido via other mechanisms
Maca Root: No direct testosterone increase (may improve libido)
Testosterone Boosters (multi-ingredient blends): Often under-dosed, proprietary blends, overpriced

Optimal Testosterone Stack

Daily Protocol:

Morning with breakfast: - Vitamin D3: 4,000-5,000 IU - K2-MK7: 100-200 mcg - Zinc: 30 mg - Magnesium: 400 mg (or split, 200 AM / 200 PM) - Boron: 6 mg - Creatine: 5 g Evening (if stressed): - Ashwagandha (KSM-66): 300-600 mg Optional (if low baseline testosterone): - Tongkat Ali: 200-400 mg daily - D-Aspartic Acid: 2-3g daily (cycle 2 weeks on, 1 off)

Expected Impact: Full stack can increase testosterone 150-300 ng/dL over 3-6 months if deficient in key nutrients + chronically stressed.

Data-Driven Wellness

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When to Test

Baseline:

• Test before implementing any protocol

Follow-Up:

• Retest after 8-12 weeks of lifestyle optimization or supplementation

Maintenance:

• Every 6-12 months once optimized

Optimal Testing Time:

• Men: 7-10am (testosterone peaks in morning)

• Women: Days 19-21 of menstrual cycle (luteal phase) for progesterone + testosterone

What to Test

Essential Panel:

• Total Testosterone - Overall production

• Free Testosterone - Bioavailable, active form (most important)

• SHBG (Sex Hormone-Binding Globulin) - Binds testosterone; high SHBG lowers free testosterone

• LH (Luteinizing Hormone) - Signals testes/ovaries to produce testosterone; low LH = central issue (pituitary)

• Estradiol (E2) - Should be balanced with testosterone; high estradiol suppresses testosterone

Advanced (Recommended):

• FSH (Follicle-Stimulating Hormone) - Assesses testicular/ovarian function

• Prolactin - Elevated prolactin suppresses testosterone

• DHT (Dihydrotestosterone) - Potent testosterone metabolite; low may indicate 5-alpha-reductase deficiency

• DHEA-S - Adrenal androgen; supports overall hormone production

• Cortisol (4-point salivary) - Assess stress impact on testosterone

• Thyroid panel (TSH, Free T3, Free T4) - Hypothyroidism suppresses testosterone

• Vitamin D, Zinc, Magnesium (RBC) - Critical cofactors

Interpreting Your Results

Men:

Total Testosterone: <300 ng/dL -> Consider TRT after exhausting natural methods 300-500 ng/dL -> Optimize lifestyle, retest in 3 months 500-700 ng/dL -> Good, aim for 700-900 ng/dL 700-900 ng/dL -> Optimal >1100 ng/dL -> Investigate (supraphysiological) Free Testosterone: <7 ng/dL -> Low, optimize SHBG + total testosterone 7-15 ng/dL -> Suboptimal 15-25 ng/dL -> Optimal >30 ng/dL -> High (investigate) SHBG: <10 nmol/L -> Low (may indicate insulin resistance, hypothyroidism) 10-50 nmol/L -> Optimal >50 nmol/L -> High (reduces free testosterone; investigate liver, thyroid) LH: 1.5-9.0 IU/L -> Normal <

Women:

Total Testosterone: <15 ng/dL -> Low, optimize 15-30 ng/dL -> Low-normal 30-70 ng/dL -> Optimal (premenopausal) 20-40 ng/dL -> Optimal (postmenopausal) Free Testosterone: <

Testing Options

• Lab draw: Quest, LabCorp (via doctor or direct-to-consumer)

• At-home: LetsGetChecked, Everlywell (convenient but may be less accurate)

• Comprehensive panels: Mito Health (includes testosterone, free testosterone, SHBG, LH, FSH, estradiol, prolactin, cortisol, DHEA-S, thyroid, vitamin D, zinc, magnesium, and 140+ biomarkers)

Indications for Testosterone Replacement Therapy (TRT)

Men should consider TRT if:

• Total testosterone consistently <300 ng/dL despite 6+ months of lifestyle optimization

• Symptoms persist (fatigue, low libido, brain fog, muscle loss) despite optimization

• LH is low (<1.5 IU/L) indicating central hypogonadism (pituitary issue)

• Age >50 with multiple optimization attempts failing

TRT is NOT appropriate if:

• Testosterone >500 ng/dL (optimize further naturally)

• Lifestyle factors not addressed (sleep, stress, exercise, nutrition)

• Young (<30) without clear hypogonadism diagnosis

• Trying to conceive (TRT suppresses sperm production; use hCG or clomiphene instead)

Peter Attia's TRT Philosophy

"If a patient is consistently below 500 ng/dL despite optimization, and they have symptoms, I'll consider TRT. But I exhaust lifestyle interventions first. Many men can get to 700-800 ng/dL naturally."

Women & Testosterone

• Low-dose testosterone therapy can be beneficial for postmenopausal women with low libido, fatigue, or muscle loss

• Typical dose: 2-10 mg daily (via cream or pellet)

• Must monitor: Avoid virilization (excess hair growth, voice deepening)

Mistake 1 - Not Testing Baseline

Problem: Guessing your levels; may already be optimal or need medical intervention
Solution: Test total testosterone, free testosterone, SHBG, LH before starting any protocol

Mistake 2 - Excessive Cardio

Problem: Long-duration endurance training elevates cortisol, suppresses testosterone
Solution: Prioritize resistance training; limit steady-state cardio to 2-3x per week, 30-40 min max

Mistake 3 - Chronic Sleep Deprivation

Problem: 5-6 hours of sleep reduces testosterone 10-15% per week
Solution: Prioritize 8 hours of sleep nightly; track deep/REM sleep

Mistake 4 - Low-Fat Diet

Problem: Fat is required for steroid hormone production; <20% calories from fat lowers testosterone
Solution: 30-40% of calories from healthy fats (eggs, beef, avocados, olive oil, fish)

Mistake 5 - Ignoring Stress & Cortisol

Problem: Chronic elevated cortisol directly suppresses testosterone
Solution: Implement daily stress management (breathwork, meditation, adaptogenic herbs)

Mistake 6 - Relying on Supplements Alone

Problem: Supplements won't fix poor sleep, chronic stress, or sedentary lifestyle
Solution: Optimize lifestyle first; use supplements to enhance, not replace

Mistake 7 - Not Retesting

Problem: No idea if interventions are working
Solution: Retest every 8-12 weeks during optimization; every 6-12 months once stable

Step 1 - Test Your Current Levels

Get a comprehensive hormone panel including total testosterone, free testosterone, SHBG, LH, FSH, estradiol, cortisol, vitamin D, zinc, magnesium.

Step 2 - Implement Foundational Methods (12 Weeks):

Sleep:

• 8 hours per night, consistent schedule

• Track deep/REM sleep with wearable

Exercise:

• 3-5x resistance training per week (compound lifts)

• 1-2x HIIT per week

• Limit cardio to 2-3x per week, 30-40 min max

Nutrition:

• 30-40% calories from healthy fats

• 1.6-2.2g/kg protein daily

• Optimize body composition (10-20% men, 20-28% women)

Stress:

• 10-20 min daily breathwork or meditation

• Reduce chronic stressors where possible

Step 3 - Add Targeted Supplementation:

• Vitamin D: 4,000-5,000 IU + K2 100 mcg

• Zinc: 30 mg

• Magnesium: 400 mg

• Boron: 6 mg

• Creatine: 5 g

• Ashwagandha: 300-600 mg (if stressed)

• Tongkat Ali: 200-400 mg (if baseline <500 ng/dL)

Step 4 - Reduce Endocrine Disruptors:

• Switch to glass/stainless steel

• Buy organic produce (Dirty Dozen)

• Clean personal care products

• Limit alcohol to 2-3 drinks per week max

Step 5 - Retest in 12 Weeks:

See if you're reaching 700-900 ng/dL (men) or 30-70 ng/dL (women). Adjust protocol as needed.

Step 6 - Maintain & Monitor:

Once optimized, maintain lifestyle + supplementation. Retest every 6-12 months to ensure stability.

Subjective Markers of Improvement (4-12 weeks)

• Increased energy and motivation

• Improved libido and sexual function

• Better mood, confidence, mental clarity

• Increased muscle mass and strength

• Reduced body fat (especially visceral fat)

• Better sleep quality

• Enhanced recovery from training

Objective Markers (Blood Work)

Men:

• Total testosterone: 700-900 ng/dL

• Free testosterone: 15-25 ng/dL

• SHBG: 10-50 nmol/L

• LH: 1.5-9.0 IU/L

• Estradiol: 20-30 pg/mL

Women:

• Total testosterone: 30-70 ng/dL (premenopausal)

• Free testosterone: 1.5-4.5 pg/mL

The Bottom Line

Raising testosterone naturally requires a multi-faceted approach:

1. Prioritize sleep (8 hours, high-quality)

2. Resistance train 3-5x per week (heavy compound lifts)

3. Optimize nutrition (30-40% healthy fats, adequate calories, key micronutrients)

4. Manage stress & cortisol (breathwork, meditation, adaptogenic herbs)

5. Limit endocrine disruptors (plastics, pesticides, alcohol)

6. Use evidence-based supplements (vitamin D, zinc, magnesium, boron, ashwagandha, tongkat ali)

7. Test regularly (baseline, 12 weeks, then every 6-12 months)

Target: 700-900 ng/dL for men under 50; 30-70 ng/dL for women.

Most men can increase testosterone 200-400 ng/dL naturally within 3-6 months with comprehensive optimization. If you've optimized for 6+ months and remain <500 ng/dL with symptoms, consult a hormone-focused physician about TRT.

Don't guess-test. Individual variation is significant, and the only way to know your personal response is through regular blood testing.

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Key Takeaways

Optimal testosterone is 700-900 ng/dL for men, not just >300 ng/dL
Sleep is the foundation: 8 hours of quality sleep is non-negotiable
Resistance training > cardio: Heavy compound lifts boost testosterone; excessive cardio suppresses it
Fat matters: 30-40% of calories from healthy fats required for hormone production
Cortisol is the enemy: Chronic stress can reduce testosterone 30-50%
Key supplements: Vitamin D, zinc, magnesium, boron, ashwagandha, tongkat ali (evidence-based only)
Test every 12 weeks during optimization; every 6-12 months once stable
Natural methods can increase testosterone 200-400 ng/dL in 3-6 months

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• Magnesium For Athletes

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Medical Disclaimer

This article is for educational and informational purposes only and does not constitute medical advice. The information provided should not be used for diagnosing or treating a health condition. Always consult with your doctor or qualified healthcare provider before starting any new supplement protocol, making changes to your diet, or if you have questions about a medical condition.

Individual results may vary. The dosages and protocols discussed are evidence-based but should be personalized under medical supervision, especially if you have existing health conditions or take medications.

References

1. Leproult R, Van Cauter E. Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA. 2011;305(21):2173-4. PMID: 21632481 | DOI: 10.1001/jama.2011.710

2. Pilz S, Frisch S, Koertke H, et al. Effect of vitamin D supplementation on testosterone levels in men. Horm Metab Res. 2011;43(3):223-5. PMID: 21154195 | DOI: 10.1055/s-0030-1269854

3. Prasad AS, Mantzoros CS, Beck FW, et al. Zinc status and serum testosterone levels of healthy adults. Nutrition. 1996;12(5):344-8. PMID: 8875519 | DOI: 10.1016/s0899-9007(96)80058-x

4. Cinar V, Polat Y, Baltaci AK, Mogulkoc R. Effects of magnesium supplementation on testosterone levels of athletes and sedentary subjects at rest and after exhaustion. Biol Trace Elem Res. 2011;140(1):18-23. PMID: 21675994 | DOI: 10.1007/s12011-010-8676-3

5. Lopresti AL, Drummond PD, Smith SJ. A randomized, double-blind, placebo-controlled, crossover study examining the hormonal and vitality effects of ashwagandha (Withania somnifera) in aging, overweight males. Am J Mens Health. 2019;13(2):1557988319835985. PMID: 30854916 | DOI: 10.1177/1557988319835985