Articles » Lifestyle » General Health » Guide To Low Testosterone: Symptoms, Dangers, & Causes

Guide To Low Testosterone: Symptoms, Dangers, & Causes

By Charlie Seltzer, MD / September 18, 2018

Testosterone is a very important hormone to help both men and women maintain proper health and performance. That’s why low testosterone can be so devastating and cause so many problems. In this comprehensive guide, you will learn about low testosterone along with common symptoms, dangers, and causes.

What Is Testosterone?

Testosterone is a steroid hormone responsible for the growth and development of male sex organs and maintenance of secondary sexual characteristics.1 It also influences mood, memory, metabolism, bone density, energy, and ability to burn fat and build muscle. Signals from the brain release testosterone from the testicles. In women, testosterone is produced in the ovaries as well as the adrenal glands. Testosterone binds to receptors inside the body’s cells where it exerts its effects.

What Are The Symptoms Of Low Testosterone?

Symptoms of low testosterone include decreased sex drive, erectile dysfunction, infertility, gynecomastia (enlarged breasts in men), impaired masculinization, decreased muscle mass, and increased body fat (especially abdominal fat), reductions in body and facial hair, and osteoporosis (low bone density). In addition, men with low testosterone report levels of anger, confusion, depression, and fatigue that are significantly higher than those reported by men with normal testosterone levels.

It is important to note that many of these symptoms are nonspecific, meaning they can be caused by things other than low testosterone. Therefore, if you are experiencing any of these symptoms, it is important to get a full evaluation by a knowledgeable healthcare professional. For example, low testosterone can cause erectile dysfunction, but so can vascular disease and unrecognized diabetes, both of which can be fatal.

What Are The Dangers Of Low Testosterone?

There is mounting evidence that low testosterone may predict other serious medical conditions, and that men with low testosterone have a greater chance of dying prematurely than men with higher levels.
A large research study published in the very highly-respected medical journal Circulation demonstrated an inverse relationship between blood testosterone levels and mortality from cardiovascular disease and “all causes.”2 Another study concluded that “testosterone insufficiency in older men is associated with increased risk of death over the following 20 year independent of multiple risk factors and several preexisting health conditions.”3

Additionally, there is a connection between low testosterone and sleep apnea (a condition in which a person essentially stops breathing during sleep) and diabetes. Low testosterone can even be used as a predictor of the development if prediabetes and diabetes.4

What Are The Causes Of Low Testosterone?

There can be several causes of low testosterone, which include:

  1. Aging: Testosterone levels tend to decrease as men get older. However, while a mild decline may be a natural part of aging, clinically low levels are generally associated with other illnesses.
  2. Having children: Fathers of newborns tend to show decreases in testosterone. One school of thought says this drop helps fathers be better caretakers. Other people argue the drop is secondary to the lack of sleep, poor eating habits, fat gain and stress associated with raising children. As of now there is no clear answer.
  3. Other medical conditions: Diabetes and sleep apnea, as mentioned above, are known to be associated with low testosterone. Treating sleep apnea will often dramatically raise testosterone levels, but the jury is still out on whether diabetes contributes to low testosterone or low testosterone increases the risk for diabetes. It is clear, however, that raising testosterone is helpful in lowering blood sugar.
  4. Environment: Two large studies have demonstrated that men today have significantly lower levels of testosterone than men in the past.56 This effect seems to be independent of health and lifestyle factors such as smoking and obesity. In one study, there was a 22% drop from 1987 to 2004. It is very possible that environmental factors such as pesticides and other toxins are at least partially responsible for this phenomenon.
  5. Lifestyle factors: Poor sleep and nutrition, high stress, excess body fat, and lack of exercise can all decrease testosterone. Opioid pain medications, like Vicoden and Percocet, lower testosterone. Marijuana can acutely lower testosterone, though it appears that chronic users do not have lower testosterone than non-users. There may be some sort of adaptation that occurs with regular use, though how this happens is not currently known.

What Is A Low vs. Optimal Testosterone Level?

Traditional medicine defines low testosterone (or hypogonadism) as a blood level less than 300 ng/dl. Thus, many doctors will only treat if the level is less than 300. A person with symptoms of low testosterone and a level of 350 will often be refused treatment. However, there are alternative medical practitioners who believe that anyone with less than a “healthy” level of testosterone should be treated. What constitutes a healthy level is not currently defined, but these practitioners often aim for levels above 700, and maybe even higher with a younger patient who “should” have levels even above that. As with all medical treatments, there is a risk to benefit ratio and it is up to the patient and his doctor to decide whether the benefits outweigh the risks.

What Are The Benefits Of Raising Low Testosterone?

Elevating testosterone, either by medicine, supplementation, or lifestyle modification brings numerous benefits.7 These include improving energy and mood, decreasing body fat and increasing muscle mass, increasing done density, increasing sex drive and erectile function and improving insulin sensitivity. Also, as noted above, it appears that men with higher testosterone levels live longer.

What Are The Risks Of Raising Low Testosterone?

The most troublesome potential risk of raising testosterone levels, and this relates primarily to medical replacement therapy, is that a silent prostate cancer may be “fed and unmasked” by supplying outside testosterone. Other risks include worsening of cholesterol, increased red blood cell counts and enlargement of the prostate. The connection between prostate issues and testosterone replacement therapy is not overly clear, and different research studies often yield conflicting results. Again, it is important to weight risks versus benefits when deciding on testosterone replacement therapy.

How Do You Raise Low Testosterone?

A combination of optimizing body composition, reducing stress, consistent exercise, and a focus on eating whole foods can help raise low testosterone levels. Other effective methods may include supplementation and medical hormone replacement.

For more information, check out 5 Scientifically Proven Ways To Increase Testosterone Levels.

Show 7 References

  1. Secondary sexual characteristics include voice deepening, body and facial hair, increased muscle mass and decreased body fat percentage as compared to females and increased sweat and oil secretion.
  2. Khaw, KT, Dowsett, M, Folkerd, E, Bingham, S, Wareham, N, Luben, R, Welch, A, Day, N. Endogenous Testosterone and Mortality Due To All Causes, Cardiovascular Disease, and Cancer In Men. Epidemiology. Nov 2007. 116; 2694-2701.
  3. Laughlin, G, Barrett-Connor, E, Bergstrom, J. Low Sreum Testosterone and Mortality in Older Men. Endocrine Care: JCEM. Oct 2007.
  4. Laaksonen, D, Niskanen, L, Punnonen, K, Nyyssonen, K, Tuomainene, T, Valkonen, Salonen, R, Salonen, J. Testosterone and Sex Hormone – Binding Globulin Predict the Metabolic Syndrome and Diabetes in Middle Aged Men. ADA. Diabetes Care May 2004 vol. 27no. 5 1036-1041.
  5. Travison, T, Aruajo, A, O’Donnell, Kupelian, V, McKinlay, J. A Population-Level Decline in Serum Testosterone Levels in American Men. The Journal of Clinical Endocrinology & Metabolism. Jan 2007 vol. 92 no. 1196-202.
  6. Testosterone replacement has great potential to help a lot of people, but there has to be caution. The serious side effects of the synthetic replacement in the normal middle aged and older population are serious — increased risk of deep venous thrombosis, pulmonary embolism and sudden death. These side effects are rare, but can be deadly. Be sure to consult your physician prior to taking any kind of testosterone therapy.


  • Sara K. says:

    Thanks for an informative article Dr Charlie! My husband went to his GP today to begin treating his low testosterone. Would I as a healthy female in her 50s benefit? I use an estrogen cream already but would like all the help can get building muscle. Any thoughts?

    • Charlie Seltzer, MD says:

      Hello Sara-
      Although women do not make a lot of testosterone, it does have significant beneficial effects, including enhancing energy, mood, memory, bone density and ability to build muscle and burn fat. In women (it has the opposite effect in men), testosterone MAY increase the risk of diabetes, but this caution must be taken in context (more muscle, less body fat = less risk of diabetes).

      It is reasonable to have your levels checked and discuss with your primary care provider whether replacement is a good idea for you. Of course, if you already happen to also be working with the best wellness physician in the universe you could always just ask him.

  • Tunji says:

    The risks of raising testosterone cited in this post occurs when drugs are used to increase testosterone level, or when some aromatase inhibitors are used.
    When the body is provided with what it needs in terms of nutrition, and when the risk factors for erectile dysfunction are minimized or eliminated, the body knows what to do to bring testosterone level up

    The body knows how to synthesize testosterone and make it available to jack up a man's libido.
    Testosterone drugs are being advertised heavily in all media. But these drugs are not safe.
    Their side effects are serious enough to get the attention of the FDA.
    The FDA issued safety warnings about the dangers of boosting testosterone with drugs

    Fortunately , there are natural ways to boost testosterone levels that do not subject men to the risks of drugs.

    It is ironic that the drug that's supposed to increase libido can actually cause you to start shooting blanks; testosterone drugs can cause infertility, lower sperm count and volume, and can make you develop man-boobs

    But here is another factor in low libido debate.

    New research has come out now that concludes that what some men with low sex drive need, is actually more estrogen, not testosterone!

    Which changes the debate.

    Do men still need testosterone to jack up their libido?
    Yes, they do, but they also need the female hormone estrogen.

    Fortunately, estrogen is made in the male body when some testosterone is converted to estrogen
    Low estrogen level is a risk factor for heart disease, loss of bone mass, and weight gain-in men!

  • Clark says:

    The most significant difference I noticed after starting injectable testosterone (prescribed after my GP noticed low T in my lab workup), was that I found that my mood was much improved. Little things that I KNOW used to set me off were just brushed off and I've been much happier and less stressed. Secondarily, I've been able to enjoy relations with my wife without the little blue pill, which is nice :) But the mood and lower stress was the biggest change for me.

  • Stevie says:

    Sara K, I have adrenal insufficiency so I get my testosterone from the pharmacist; doctors differ in their view of what is the optimal level of testosterone in women, but they are unanimous in the view that no detectable testosterone at all must be treated.

    It's important to bear in mind that it's not as good as the real thing; the subtle and complex feedback loops whereby the body generates more testosterone as a response to resistance training don't happen, so building muscle is harder.

    It's more difficult, but it can be done; I have found Built Lean to be a great resource and a constant source of encouragement to keep trying!

  • Mani says:

    Even though I am 19, I have very little facial hair (my mustache and beard are small) and they are usually not seen perfectly. All of my friends have them, but I don't. Without a beard and mustache, I am facing a very large mental problem. Do you have any advice? Please help me.

    • Marc Perry, CSCS, CPT says:

      Hey Mani, we all mature differently at different rates and some guys have more fascial hair than others. It's actually a good thing to have less fascial hair depending on how you look at it! I personally can't even grow a moustache and side burns are tough too. I definitely have a high testosterone level, I just am not that hairy. As long as you are not experiencing any health issues, it sounds like you are ok and must refocus your energies on what you do have and how you want to make progress on.

  • Lee says:

    Well I do think my test level is low I'm gonna contact my doc tomorrow

    • Kristin says:

      That's a great idea, Lee! If you suspect that you're experiencing low testosterone, having a check-up with your doctor is an excellent solution. I hope that all works out.
      -Kristin, BuiltLean Coach & Managing Editor