Supplements for Increased Testosterone

Supplements for increased testosterone (T)—such as ashwagandha, coleus, DHEA, and many more—are popular. They're being studied for their health effects such as increasing libido and erectile dysfunction. However, science has not yet proven definitively that they work.

Some of these supplements may offer other benefits, however. For example, ashwagandha has anti-inflammatory and antioxidant properties. Because some supplements can cause severe side effects or drug interactions, it's important to check with your healthcare provider before use.

What Is Low Testosterone?

Low testosterone, also known as hypogonadism and low T, is a hormonal condition that can cause a host of health effects for both men and women—among them, an increased risk for type 2 diabetes and heart disease. The American Urological Association defines low testosterone in males as testosterone levels below 300 nanograms per deciliter (ng/dl). In females, testosterone levels below 15 ng/dl are considered low.

Testosterone levels in both males and females start to decline at age 30. Twenty percent of males over 60 and 50% of males over 80 have low testosterone levels.

Some people with low T have no symptoms at all. However, others may experience:

• Low libido
• Erectile dysfunction (ED)
• Depression
• Fatigue
  

What Supplements Increase Testosterone?

Many supplements are marketed as testosterone boosters. Here's what you need to know about some of the heavy hitters.

Ashwagandha (Withania somnifera)

Several studies suggest that the adaptogen ashwagandha can combat low T in males.

Traditionally used in Ayurvedic medicine, ashwagandha has both anti-inflammatory and antioxidant properties. Because of this, the supplement can increase testosterone levels that have dipped due to inflammation or stress.

Ashwagandha can also lower cortisol levels, a hormone associated with the body's response to stress. Lower cortisol levels cause increased levels of testosterone.

The following doses have been shown to increase testosterone levels in small clinical trials:

• In males and females who were overweight aged 40–75 years: 200 milligrams of an ashwagandha root extract (Witholytin) twice daily
• In males who are overweight: an extract containing 21 milligrams of glycosides daily for eight weeks
• In young males: 600 milligrams daily for eight weeks
• In males with infertility: 675 milligrams daily for 90 days

In males using ashwagandha, testosterone levels in the body increased by at least 15% in the studies above.

In females, one trial found that taking 300 milligrams twice daily did not boost testosterone. However, another study suggested that 200 milligrams twice daily did increase testosterone levels.

Ashwagandha may cause sleepiness or stomach upset; some case reports have linked it to liver damage. This supplement shouldn't be taken before surgery.

Coleus (Coleus forskohlii)

Coleus is a supplement from the roots of a plant that grows in India.

More research is necessary before it can be recommended for low T.

One small study conducted in 30 young males who were overweight concluded that coleus increased testosterone levels by 13%. The dose used was 500 milligrams daily for 12 weeks. Larger clinical trials are necessary to verify this benefit.

Coleus may cause gastrointestinal symptoms like diarrhea.

DHEA

DHEA is a hormone that helps the body make other hormones like estrogen and testosterone.

DHEA may help regulate testosterone levels in females, but it has not proved effective for males with low T.

This popular supplement for sports performance has been studied at 50 milligrams daily in males and females. Only females had an increased testosterone concentration.

Keep in mind that athletes are banned from using DHEA by the following regulating bodies:

• The International Olympic Committee (IOC)
• The National Collegiate Athletic Association (NCAA)
• The World Anti-Doping Agency (WADA)

Ginseng (Panax ginseng)

There's very little evidence that ginseng can boost testosterone. Theoretically, it could work by decreasing cortisol levels, but more information is necessary.

One clinical trial showed that taking 3 grams a day for four weeks increased testosterone levels in a group of males who were overweight and had metabolic syndrome. Testosterone was increased by about 5% in those who took ginseng.

Ginseng did not increase testosterone levels in healthy males or those with infertility or erectile dysfunction, according to other trials.

Ginseng also didn't boost testosterone more than a placebo in a small clinical trial of 23 premenopausal females.

Some side effects of ginseng include high blood pressure, insomnia, and headaches.

It has a few notable drug interactions as well. Ginseng can decrease levels of the blood-thinner warfarin and increase levels of sedatives.

L-Arginine

The amino acid L-arginine is necessary to make nitric oxide in the body. Nitric oxide increases blood flow in the testes—and testosterone levels.

L-arginine at doses of 1,500–5,000 milligrams a day can improve ED and increase testosterone in males. It is particularly effective combined with supplements like yohimbe or citrulline or the prescription ED medication tadalafil.

Of note, long-term supplementation with L-arginine may be harmful. Some studies have shown it can increase the risk of heart or kidney disease.

Mucuna (Mucuna pruriens)

Mucuna is a bean that's used in the practice of Ayurveda for conditions ranging from infertility to Parkinson's disease.

Taking 5,000 milligrams a day of mucuna powder for 12 weeks significantly increased testosterone in 75 males with infertility. More robust data is necessary to confirm this effect.

And there's no evidence that mucuna helps females with low T.

It's important not to eat raw mucuna seeds, which may be toxic. Mucuna seeds can cause severe gastrointestinal side effects, confusion, and hallucinations.

Puncture Vine (Tribulus terrestris)

There is conflicting data regarding the use of puncture vine for testosterone enhancement.

It's been studied in healthy males at a dosage of 800 milligrams daily for 30 days. It's also been studied in males with erectile dysfunction at a dosage of 1.5 grams daily for 12 weeks. Neither study showed a difference in testosterone concentrations of the males taking puncture vine versus a placebo (sugar pill).

A clinical trial of 70 males who took 750 milligrams a day of puncture vine for 90 days reported increased testosterone levels.

Although more research is necessary, puncture vine has shown benefits for premenopausal females with low T. The dose most often used in clinical trials was 250 milligrams three times a day for three to four months.

Interestingly, puncture vine did not boost testosterone in females who were postmenopausal.

Tongkat Ali (Eurycoma longifolia)

There's no evidence that tongkat ali, also known as longjack, can increase testosterone concentrations.

Testosterone levels were not increased in a study of healthy males who took 300 milligrams of tongkat ali daily for 12 weeks.

In addition, tongkat ali is not recommended for people with the following:

• Weak immune system
• Heart disease
• Kidney disease
• Liver disease
• Sleep apnea
• Older age

Zinc

The mineral zinc may benefit males and females with low T.

According to research, taking 220 milligrams of zinc sulfate (the equivalent of 50 milligrams of elemental zinc) once or twice daily for at least a month may double testosterone levels in males.

Of note, the clinical trials for zinc have been conducted in males with the following:

• Infertility
• End-stage kidney disease
• Zinc deficiency

Whether these effects apply to all males generally is unknown.

In a clinical trial of 112 females who were postmenopausal, supplementing with zinc increased testosterone levels. It also improved aspects of sexual function like the following:

• Vaginal moisture
• Arousal
• Orgasm

Notably, 50 milligrams or more of elemental zinc doses for several weeks lowered the immune system and decreased levels of high-density lipoprotein cholesterol (HDL), also known as "good" cholesterol. Additionally, taking large doses of zinc (50 milligrams or more daily) for extended periods can result in copper deficiency and anemia. For this reason, taking high doses of zinc for a prolonged time is not recommended.

Conditions Related to Low Testosterone

The following conditions may be related to low T:

• Type 2 diabetes
• Obesity
• Metabolic syndrome
• Heart disease
• Chronic obstructive pulmonary disease (COPD)
• Malnutrition
• Alcohol use disorder
• Use of opioid pain medications or corticosteroids
• Surgical removal of the ovaries in females

Standard Treatment for Low Testosterone

The main treatment for low T in males is testosterone replacement therapy. However, it's not safe for everyone.

People with the following conditions should typically not take testosterone because it may worsen their health:

• Sleep apnea
• Prostate disease
• High risk of heart disease
• Increased red blood cell count

Testosterone treatment is also associated with infertility. Some prescription alternatives that increase testosterone production include the following:

• Clomiphene
• Tamoxifen
• Anastrozole

Testosterone is generally recommended to females only for hypoactive sexual desire disorder following menopause.

Summary

Before self-treating symptoms of low T, discuss your lifestyle and treatment goals with a healthcare provider .

Conditions such as diabetes and sleep apnea can cause testosterone levels to nose-dive; if left untreated, these may have serious consequences.

If you have low T, try lifestyle modifications such as getting adequate sleep, exercising, and maintaining a healthy body weight—all proven to be more effective in increasing testosterone levels and improving symptoms of low T than taking herbal supplements.

If you decide to try a supplement to boost testosterone, some, like zinc, may provide some benefit. Screen for drug interactions with your healthcare provider or pharmacist and watch for side effects.