Condition
Low Testosterone
Low testosterone, or hypogonadism, happens when the body makes too little of the main male sex hormone, which supports muscle, bone, energy, mood and libido. Vitamin D and zinc have the most support among supplements, with moderate evidence, and small trials in men with late-onset low testosterone found erections went up with tribulus. Most studies were small, though, and testosterone replacement remains the most effective option for true hypogonadism.
Sources: PMID 21154195; PMID 30253697
- Supplements studied
- 16
- Graded outcomes
- 16
- Trials
- 23
- People studied
- 1,460
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Anxiety Symptoms Moderate Improvement | Improves (the measure goes down) | Moderate effect | 5 studies | 60 people | ||
Studies that measured anxiety symptoms | ||||||
| Testosterone | Improves (the measure goes up) | 5 studies | 135 people | |||
Studies that measured testosterone
| ||||||
| Cortisol | Improves (the measure goes down) | 1 study | 60 people | |||
| Sperm Quality | Improves (the measure goes up) | 1 study | 75 people | |||
| Follicle-Stimulating Hormone | Improves (the measure goes up) | 75 people | ||||
| Luteinizing Hormone | Improves (the measure goes up) | 75 people | ||||
Coenzyme Q10
- Follicle-Stimulating Hormone: worsens
- Seminal Motility: improves
- Luteinizing Hormone: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Follicle-Stimulating Hormone Small Decrease | Worsens (the measure goes down) | Small effect | 2 studies | 212 people | ||
| Seminal Motility | Improves (the measure goes up) | 2 studies | 212 people | |||
| Luteinizing Hormone | Improves (the measure goes up) | 212 people | ||||
| Sperm Quality | Improves (the measure goes up) | 212 people | ||||
| Testosterone | Improves (the measure goes up) | 212 people | ||||
Cannabis
- Cortisol
- Luteinizing Hormone: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cortisol Mixed effect | 1 study | 40 people | ||||
| Luteinizing Hormone | Improves (the measure goes up) | 1 study | 40 people | |||
Studies that measured luteinizing hormone | ||||||
Caffeine
- Cortisol: improves
- Power Output: improves
- Testosterone: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cortisol Small Increase | Improves (the measure goes down) | Small effect | 1 study | 16 people | ||
| Power Output | Improves (the measure goes up) | 3 studies | 16 people | |||
Studies that measured power output | ||||||
| Testosterone | Improves (the measure goes up) | 16 people | ||||
Boron
- Estrogen
- Testosterone: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Estrogen Mixed effect | 1 study | 13 people | ||||
Studies that measured estrogen | ||||||
| Testosterone | Improves (the measure goes up) | 1 study | 13 people | |||
Studies that measured testosterone | ||||||
Coleus forskohlii
- Body Fat: improves
- Weight: improves
- Muscle Mass: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Body Fat Small Decrease | Improves (the measure goes down) | Small effect | 30 people | |||
| Weight | Improves (the measure goes down) | 3 studies | 30 people | |||
Studies that measured weight
| ||||||
| Muscle Mass | Improves (the measure goes up) | 1 study | 30 people | |||
Studies that measured muscle mass | ||||||
| Bone Mineral Density | Improves (the measure goes up) | 30 people | ||||
| Testosterone | Improves (the measure goes up) | 30 people | ||||
Tongkat Ali
- Body Fat: improves
- Testosterone: improves
- Strength: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Body Fat Small Increase | Improves (the measure goes down) | Small effect | 45 people | |||
| Testosterone | Improves (the measure goes up) | 4 studies | 457 people | |||
Studies that measured testosterone
| ||||||
| Strength | Improves (the measure goes up) | 2 studies | 150 people | |||
Studies that measured strength
| ||||||
| Aerobic Exercise Metrics Small Detriment | Worsens (the measure goes down) | Small effect | 45 people | |||
| Cortisol | Improves (the measure goes down) | 105 people | ||||
| DHEAS | Improves (the measure goes up) | 105 people | ||||
| Estrogen | Changes; see studies | 32 people | ||||
| Fatigue Symptoms | Improves (the measure goes down) | 105 people | ||||
| Follicle-Stimulating Hormone | Improves (the measure goes up) | 32 people | ||||
| Free Testosterone | Improves (the measure goes up) | 137 people | ||||
| HbA1c | Improves (the measure goes down) | 105 people | ||||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 45 people | ||||
| IGF-1 | Improves (the measure goes up) | 105 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 45 people | ||||
| Luteinizing Hormone | Improves (the measure goes up) | 32 people | ||||
| Sex Hormone Binding Globulin | Improves (the measure goes up) | 137 people | ||||
| Thyroid-Stimulating Hormone | Improves (the measure goes up) | 105 people | ||||
| Triglycerides | Improves (the measure goes down) | 45 people | ||||
| Waist circumference | Improves (the measure goes down) | 45 people | ||||
Nicotine
- Luteinizing Hormone: improves
- Prolactin: improves
- Testosterone: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Luteinizing Hormone Small Increase | Improves (the measure goes up) | Small effect | 12 people | |||
| Prolactin | Improves (the measure goes up) | 1 study | 12 people | |||
Studies that measured prolactin | ||||||
| Testosterone | Improves (the measure goes up) | 12 people | ||||
Aspartate
- Serum Testosterone (Untrained Men): improves
- Serum Testosterone (Trained Athletes)
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Serum Testosterone (Untrained Men) 42% increase in testosterone after 12 days of 3.12g/day in untrained men; LH increased 33% | Improves (the measure goes up) | Moderate effect | 23 people | |||
| Serum Testosterone (Trained Athletes) No increase in testosterone in resistance-trained men; 6g/day actually decreased total and free testosterone | NoneNo effect | 100 people |
Saw Palmetto
- DHT
- Testosterone: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| DHT No effect | NoneNo effect | 1 study | 32 people | |||
| Testosterone | Improves (the measure goes up) | 32 people | ||||
Chrysin
- Testosterone
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Testosterone No effect | NoneNo effect | 1 study | 20 people | |||
Studies that measured testosterone | ||||||
Garcinia
- Estrogen
- Testosterone: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Estrogen No effect | NoneNo effect | 44 people | ||||
| Testosterone | Improves (the measure goes up) | 1 study | 44 people |
DHEA
- Body Fat
- Estrogen: changes; see studies
- Testosterone: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Body Fat No effect | NoneNo effect | 19 people | ||||
| Estrogen | Changes; see studies | 8 studies | 19 people | |||
| Testosterone | Improves (the measure goes up) | 3 studies | 98 people | |||
| Muscle Mass | Improves (the measure goes up) | 2 studies | 19 people | |||
| Serum DHEA | Improves (the measure goes up) | 2 studies | 98 people | |||
| Libido | Improves (the measure goes up) | 1 study | 79 people | |||
| Power Output | Improves (the measure goes up) | 1 study | 19 people | |||
| Erections | Improves (the measure goes up) | 79 people | ||||
| Follicle-Stimulating Hormone | Improves (the measure goes up) | 19 people | ||||
| Luteinizing Hormone | Improves (the measure goes up) | 19 people | ||||
| Prostate-Specific Antigen | Improves (the measure goes up) | 79 people |
Licorice
- Testosterone: improves
- Cortisol: improves
- Blood Pressure: worsens
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Testosterone | Improves (the measure goes up) | 4 studies | 9 people | |||
| Cortisol | Improves (the measure goes down) | 2 studies | 9 people | |||
| Blood Pressure Moderate Detriment | Worsens (the measure goes up) | Moderate effect | 1 study | 9 people | ||
| Luteinizing Hormone | Improves (the measure goes up) | 1 study | 9 people |
Vitamin D
- Testosterone: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Testosterone | Improves (the measure goes up) | 1 study | 165 people |
Key findings
- ErectionsImproves (the measure goes up)
- Anxiety SymptomsImproves (the measure goes down)
- Follicle-Stimulating HormoneWorsens (the measure goes down)
The Low Testosterone (Male Hypogonadism) protocol
2 primary supplements · 6 supporting supplements
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The supplement graded A or B for Low Testosterone. Each opens third-party tested products for that supplement.
- Grade B
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Studies cited
100 studies from PubMed
- Effects of Coenzyme Q10 Supplementation on Depressive Symptoms and Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
- Evaluation of in vivo supplementation of 2660 mg D-aspartic acid and 200 mg ubiquinol and 10 mg zinc on different semen parameters in idiopathic male infertility: a randomized double blind placebo controlled study
- Effect of vitamin D supplementation for major adverse cardiovascular events: a meta-analysis based on randomised controlled trials.
- Effects of Withania somnifera supplementation on cognitive function: A systematic review and meta-analysis
- Effects of Ashwagandha (Withania somnifera) Supplementation on Exercise Performance: A Systematic Review and Meta-Analysis
- Ashwagandha (Withania somnifera) and its withanolides attenuate oxidative and inflammatory signaling in the nervous system
- New Insights into D-Aspartate Signaling in Testicular Activity
- Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis of randomized controlled trials
- Clinical effects of Ashwagandha (Withania somnifera) root extract on human health: A systematic review of reviews
- A Comprehensive Review on Pharmacological Activity of Withania somnifera (Ashwagandha)
- Effects of Ashwagandha (Withania somnifera) on Testosterone Levels: A Systematic Review and Meta-Analysis
- Ashwagandha (Withania somnifera)-Current Research on the Health-Promoting Activities: A Narrative Review
- Withania somnifera (L.) Dunal: A review of chemical composition and pharmacological activities
- Efficacy of Ashwagandha (Withania somnifera) in Improving Cardiorespiratory Endurance and Recovery in Healthy Athletic Adults: A Systematic Review
- Safety of Ashwagandha Root Extract: A Randomized, Placebo-Controlled, Study in Healthy Volunteers
- Examining the Neuroprotective Effects of Ashwagandha: Brain-Derived Neurotrophic Factor in Rats
- Eurycoma longifolia Jack in Managing Idiopathic Male Infertility
- Tongkat Ali (Eurycoma longifolia): A Systematic Review of Hormonal Effects in Humans
- Safety and Efficacy of Eurycoma longifolia in Men: A Clinical Review
- Optimal Vitamin D Status: Evidence and Guidelines
- Vitamin D and Cancer Prevention: A Comprehensive Review
- Effects of oral d-aspartate on sperm quality in B6N mice
- Ergogenic and Androgenic Effects of Eurycoma longifolia Jack: A Comprehensive Review
- Tongkat Ali for Athletic Performance and Body Composition: A Review
- Phytochemistry and Pharmacology of Eurycoma longifolia: A Review
- Toxicological Assessment of Eurycoma longifolia Extract: Safety Profile
- Eurycoma longifolia in Hypogonadal Males: A Systematic Review
- Effects of Vitamin D Supplementation on Musculoskeletal Health: A Systematic Review and Meta-Analysis
- Vitamin D and Prevention of Respiratory Tract Infections: A Systematic Review and Meta-Analysis
- Effects of Vitamin D Supplementation on Depression: A Systematic Review and Meta-Analysis
- Vitamin D and Immune Function: A Review
- Vitamin D Supplementation for Prevention of Mortality: A Meta-Analysis
- Vitamin D Supplementation During Pregnancy: Safety and Efficacy Review
- The effects of d-aspartic acid supplementation in resistance-trained men over a three month training period: A randomised controlled trial
- The putative effects of D-Aspartic acid on blood testosterone levels: A systematic review
- Review: Tongkat Ali as a Potential Herbal Supplement for Physical and Sexual Well-Being
- Eurycoma longifolia and Male Sexual Health: Evidence from Clinical Trials
- Eurycoma longifolia Jack and Stress-Related Male Infertility: Evidence and Mechanisms
- Vitamin D Supplementation: A Comprehensive Review of Efficacy for Various Health Outcomes
- Vitamin D Deficiency: Global Health Perspective
- Vitamin D and Cardiovascular Disease: A Review of Evidence
- Vitamin D and Bone Health in Adults: A Systematic Review
- In vitro effects of zinc, D-aspartic acid, and coenzyme-Q10 on sperm function
- Eurycoma longifolia Jack (Tongkat Ali): A Review of Evidence for Its Testosterone-Enhancing Properties
- Vitamin D3 supplementation does not modify cardiovascular risk profile of adults with inadequate vitamin D status
- Evaluation of antioxidant potential of Rasayana drugs in healthy human volunteers
- D-aspartate affects NMDA receptor-extracellular signal-regulated kinase pathway and upregulates androgen receptor expression in the rat testis
- d-Aspartic acid supplementation combined with 28 days of heavy resistance training has no effect on body composition, muscle strength, and serum hormones associated with the hypothalamo-pituitary-gonadal axis in resistance-trained men
- An Overview on Ashwagandha: A Rasayana (Rejuvenator) of Ayurveda
- Association of A1C levels with vitamin D status in U.S. adults: data from the National Health and Nutrition Examination Survey
- D-Aspartic acid: an endogenous amino acid with an important neuroendocrine role
- Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey
- Occurrence of D-aspartic acid in human seminal plasma and spermatozoa: possible role in reproduction
- Occurrence of D-aspartic acid and N-methyl-D-aspartic acid in rat neuroendocrine tissues and their role in the modulation of luteinizing hormone and growth hormone release
- Effects of Withania somnifera in patients of schizophrenia: A randomized, double blind, placebo controlled pilot trial study
- Adjunctive Use of a Standardized Extract of Withania somnifera (Ashwagandha) to Treat Symptom Exacerbation in Schizophrenia: A Randomized, Double-Blind, Placebo-Controlled Study
- Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial
- Exploratory study to evaluate tolerability, safety, and activity of Ashwagandha (Withania somnifera) in healthy volunteers
- Effects of an Aqueous Extract of Withania somnifera on Strength Training Adaptations and Recovery: The STAR Trial
- Effects of eight-week supplementation of Ashwagandha on cardiorespiratory endurance in elite Indian cyclists
- Effects of Ashwagandha ( Withania somnifera) on Physical Performance: Systematic Review and Bayesian Meta-Analysis
- Body Weight Management in Adults Under Chronic Stress Through Treatment With Ashwagandha Root Extract: A Double-Blind, Randomized, Placebo-Controlled Trial
- Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta-analysis of randomized controlled trials
- A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults
- Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind, Randomized, Placebo-controlled Clinical Study
- Efficacy of Withania somnifera on seminal plasma metabolites of infertile males: a proton NMR study at 800 MHz
- Withania somnifera Improves Semen Quality in Stress-Related Male Fertility
- Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males
- Clinical Evaluation of the Spermatogenic Activity of the Root Extract of Ashwagandha (Withania somnifera) in Oligospermic Males: A Pilot Study
- Comparative evaluation of the effects of Withania somnifera with pentoxifylline on the sperm parameters in idiopathic male infertility: A triple-blind randomised clinical trial
- A double-blind, placebo-controlled evaluation of the anxiolytic efficacy ff an ethanolic extract of withania somnifera
- Naturopathic care for anxiety: a randomized controlled trial ISRCTN78958974
- Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta-analysis.
- Randomized placebo-controlled adjunctive study of an extract of withania somnifera for cognitive dysfunction in bipolar disorder
- Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions
- Effect of standardized aqueous extract of Withania somnifera on tests of cognitive and psychomotor performance in healthy human participants
- A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha ( Withania somnifera) in Aging, Overweight Males
- Efficacy of Ashwagandha (Withania somnifera Dunal. Linn.) in the management of psychogenic erectile dysfunction
- Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial
- An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study
- In vivo effects of Ashwagandha (Withania somnifera) extract on the activation of lymphocytes
- Evaluation of the efficacy of Withania somnifera (Ashwagandha) root extract in patients with obsessive-compulsive disorder: A randomized double-blind placebo-controlled trial
- Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis
- Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study
- Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study
- A randomized, double blind placebo controlled study of efficacy and tolerability of Withaina somnifera extracts in knee joint pain
- Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root
- Efficacy of Ashwagandha (Withania somnifera [L.] Dunal) in improving cardiorespiratory endurance in healthy athletic adults
- Effect of Withania somnifera (Ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients
- The adjuvant use of calcium fructoborate and borax with etanercept in patients with rheumatoid arthritis: Pilot study
- Effects of Calcium Fructoborate on Levels of C-Reactive Protein, Total Cholesterol, Low-Density Lipoprotein, Triglycerides, IL-1β, IL-6, and MCP-1: a Double-blind, Placebo-controlled Clinical Study
- Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines
- Effects of boron supplementation on the severity and duration of pain in primary dysmenorrhea
- Plasma boron and the effects of boron supplementation in males
- Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women
- Preliminary evidence hints at a protective role for boron in urolithiasis
- A double-blind, placebo-controlled pilot study to evaluate the effect of calcium fructoborate on systemic inflammation and dyslipidemia markers for middle-aged people with primary osteoarthritis
- Effect of boron supplementation on blood and urinary calcium, magnesium, and phosphorus, and urinary boron in athletic and sedentary women
- Oral resveratrol and calcium fructoborate supplementation in subjects with stable angina pectoris: effects on lipid profiles, inflammation markers, and quality of life
- Short-term efficacy of calcium fructoborate on subjects with knee discomfort: a comparative, double-blind, placebo-controlled clinical study