The Association Between Popular Diets and Serum Testosterone Levels Among Men in the United States

• A greater than 10% decrease in weight, significantly improves testosterone levels by 85ng/dL.

• 15% of weight loss can increase testosterone by 180ng/dL

Keywords: Diet, Testosterone Levels, Free Testosterone Levels, Fat Restrictive Diet

Ketogenic Diet, Androgen, Cholesterol, Statins, Testosterone, Diabetes, Weight Loss,

Introduction

While many men who have low testosterone look to androgen replacement as solitary treatment option, a multifaceted approach is best. To enhance and expedite testosterone replacement therapy results and rise serum testosterone levels more efficiently patients should be advised to incorporate a healthy diet, exercise and weight loss routine while on therapy. As mentioned in prior posts a man can improve their serum testosterone levels exponentially by weight loss alone. Weight loss is associated with a 72% decrease in fat free mass and loss of fat free mass increases testosterone levels. Testosterone can increase resting basal energy expenditure promoting the weight loss cycle. With the addition of a testosterone enhancing diet and exercise routing, the cycle of weight loss and rise in serum testosterone is amplified.

Fat Restrictive Diet

Prior studies examining diet and serum testosterone levels revealed that low fat diets (less than 25% caloric consumption) had no effect on Testosterone levels. Even a diet restricting caloric consumption of less than 10% had no effect on increasing serum testosterone levels. With this information one may consider that a nonrestrictive diet or a diet that does not restrict calories may be best for enhancing serum testosterone. We know from many studies that weight loss in the obese population from a fat restrictive diet can an increase serum testosterone levels of 182 to 240ng/dL. In normal weight males who adhere to a fat restrictive diet, we do not see this same increase in serum testosterone level. One theory to explain this phenomenon may be that fat is a precursor to steroid and testosterone production. Significant caloric and fat restriction may prevent the necessary precursors to make testosterone.

Ketogenic Diet

The Ketogenic diet consists of ingesting high fat and low carbohydrates. The ketogenic diet aids in weight loss by the mechanism that utilizes ketones and glucose restriction. This replicates the effects of fasting on the body. The Ketogenic diet has been used for centuries, primarily to aid in seizure control in patients with epilepsy. Today, the ketogenic diet is used by many individuals for weight loss and hunger control.

As it relates to an increase in serum testosterone, a study by Wilson et. al examined a Ketogenic Diet in resistance training athletes may increase serum testosterone levels from 570ng/dL to 690ng/dL after a 12-week regiment. While robust evidence and well controlled studies may be lacking, considering that steroidogenesis relies upon a healthy intake of fat, the ketogenic may increase testosterone in this manner.

Cholesterol Medication Usage (Statins)

Cholesterol lowering medication such as Statins appear to reduce the production of testosterone in men. While the degree of such testosterone reduction may be negligible, it is worth mentioning in the following context of this article.

A meta-analysis of 11 placebo-controlled randomized trials of statins effect on testosterone levels by School et. al, in 2013, revealed that statins may decrease testosterone production. Statins inhibit cholesterol synthesis and cholesterol is the key component of testosterone. While the impact of statins on the broader health of the individuals may be more relevant, it’s worth understanding how statins can and may lower testosterone for any man desiring to raise their serum testosterone levels. Also, one must consider that any individual on statin medication may already have other underlying comorbidities such as obesity, diabetes and hypertension that can lead to reduced testosterone production as a result of metabolic syndrome. The use of statin medication most certainly would outweigh (no pun intended) the negligible decrease in testosterone production.

The Ideal Testosterone Enhancing Diet

For any man who desires to enhance serum testosterone naturally without any medication, a multi modal approach consisting of diet, exercise and adequate sleep (greater than 8 hours) should be undertaken. While there is not specific diet, supported through research, that has shown a significant improvement in serum testosterone levels, one may consider a diet with moderate amount of fat (not restrictive) and includes high protein intake. Men who restrict protein intake may impair the hypothalamic pituitary- gonadal axis (HPG), necessary for proper signaling for the production of testosterone in men. In addition, a case-controlled study examining a vegetarian diet on testosterone levels revealed no significant increase in serum testosterone levels.

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Sources

Fantus et.al., The Association between Popular Diets and Serum Testosterone among Men in the United States. Journal of Urology. Vol 203, 398-404, February 2020.

Schooling, C.M., Au Yeung, S.L., Freeman, G. et al. The effect of statins on testosterone in men and women, a systematic review and meta-analysis of randomized controlled trials. BMC Med 11, 57 (2013). https://doi.org/10.1186/1741-7015-11-57