Life Extension Magazine®

Older man using plant-based nutrients to boost testosterone blood levels

How Low Testosterone Harms Men's Health

Low testosterone in men increases age-related disease risk and death from any cause. Three plant-based nutrients have been shown to boost free testosterone blood levels.

Scientifically reviewed by: Dr. Gary Gonzalez, MD, in October 2024. Written by: Mack Graham.

Opened pomegranate that contain compounds that boost testosterone

Testosterone is an important hormone in men.

It supports muscle mass, while helping protect overall health, from bones to brain to heart.

Testosterone levels typically start to drop after early adulthood, getting lower every year.1,2

In men, low testosterone is associated with:3-9

Cocoa seeds on leaf that extract improve bioactive free testosterone

In one meta-analysis, men with low testosterone were on average 48% more likely to develop Alzheimer’s disease than those with normal levels.10

Scientists have found three plant-derived nutrients that were shown to increase testosterone levels in aging men.

Why Testosterone Is So Important

Man enjoying an increase of testosterone for whole body health benefits

Testosterone is a hormone that is produced in the testes in men. A small amount is also made in the adrenal glands.11-13

Testosterone and its derivatives are crucial to the normal development of male bodily structures, including the reproductive system and genitals.

The impact of testosterone continues throughout male adult life, affecting the healthy function of most organ systems.

While it is best known for its ability to promote muscle growth and stimulate libido, testosterone is required for the optimal function of many other tissues throughout the body.

The Dangers of Low Testosterone

Testosterone circulates in the blood bound to plasma proteins, most importantly sex hormone binding globulin (SHBG) and albumin.11,14 Only about 2% of the circulating testosterone is non-protein bound, or free.15

Free testosterone is the most biologically active form.

Beginning around age 30, testosterone drops by an average of about 1% each year.16,17

As testosterone levels drop, men begin suffering from well-known low testosterone symptoms, including loss of libido, erectile dysfunction, fatigue, and loss of muscle mass and strength.

But that’s only the beginning. Depressed mood, diminished brain function, and risk for cardiovascular disease and other illnesses also increase with lower testosterone levels.18-21

Low testosterone is associated with increased rates of all-cause mortality.22

Following is a closer look at just some of the worrisome effects of low testosterone.

Sexual Function

Testosterone is known as the male “sex hormone.” Unsurprisingly, low levels significantly diminish sexual function.

There are two reasons for this. Low testosterone:18-20

In other words, low testosterone reduces men’s ability to enjoy a healthy sex life physically and mentally.

This is one of the major reasons for the diminished quality of life reported in those with low levels of the hormone.19,20

Cognitive Decline

Rates of mild cognitive impairment and dementia rise as we get older. But men with lower testosterone have an even higher risk of developing cognitive dysfunction.10,19,23

In one study that pooled data from several previous trials, men with low testosterone were on average 48% more likely to develop Alzheimer’s disease than those with normal levels.10

What you need to know

Man curling wight to maintain muscle mass from low testosterone

The Effects of Testosterone on Male Health

  • Testosterone is known as the male sex hormone, produced primarily in the testes. It is crucial to healthy aging in men.
  • After about age 30, testosterone levels in men tend to drop steadily.
  • Low testosterone levels can cause loss of libido, erectile dysfunction, reduced muscle mass and strength, depression, and increased risk of metabolic abnormalities, cardiovascular disease, cognitive decline, osteoporosis, and type II diabetes.
  • Extracts of pomegranate and cacao seeds increased bioactive free testosterone by as much as 48% in one study, and improved measures of stress, hand grip strength, and more.
  • Preclinical studies support the use of the flavonoid luteolin in supporting healthy testosterone levels.

A recent systematic review and meta-analysis of 27 studies with over 18,000 participants found an increased risk of all-cause dementia with decreasing total testosterone levels. Researchers also point to an increased risk for Alzheimer’s disease with lower levels of free and total testosterone.24

Depression

A number of studies have reported a link between low testosterone and depression.25,26

In depressed older men with low testosterone, raising testosterone levels can have an antidepressant effect, helping to improve mood and better control depressive symptoms.27

Metabolic Syndrome and Obesity

Testosterone has a significant impact on metabolism. It increases lean muscle mass and reduces fat mass.28

As a result, having low testosterone increases the risk of developing conditions tied to excess weight and metabolic dysfunction, including metabolic syndrome and type II diabetes.29-33

Several studies show a correlation between low testosterone and the components of metabolic syndrome or diabetes:

  • Men with lower testosterone are more likely to have insulin resistance, higher fat mass, and less lean muscle mass.34
  • Low testosterone predicts the development of abdominal obesity and the accumulation of fat tissue in the abdomen.22
  • Diabetic men are more likely to have low testosterone levels than nondiabetic men.35

Cardiovascular Disease

Lower levels of testosterone are associated with higher rates of cardiovascular disease.36-40

In some studies, low testosterone has been able to predict future risk of death from cardiovascular disease in men, even when controlling for different risk factors that included age, obesity, diabetes, abnormal blood lipids, and lifestyle choices like smoking.36-38

In men with existing cardiovascular disease, there is a higher rate of death in those with lower testosterone.41 Men with low testosterone and cardiovascular disease were found to have a 75% higher chance of dying from any cause during follow-up, compared to men with normal testosterone.

In one meta-analysis, low testosterone levels were associated with an increased risk of death due to cardiovascular disease or any cause.3

When it comes to heart health, maintaining a healthy testosterone level can be lifesaving.

Osteoporosis

Low testosterone doesn’t just lead to loss of muscle mass and weakness. Bones are affected as well.

Studies show that testosterone levels are associated with bone mineral density and are predictive of fractures in older men.42,43

At higher testosterone levels, bones tend to have higher density and remain strong. Low testosterone is correlated with thinning of the bones, which can eventually lead to the bone disease osteoporosis.44

The combination of weak, thinned bones and poor muscle strength is a recipe for disaster, often culminating in falls and bone fractures. Severe injuries such as pelvic fractures or head injury can be fatal in the elderly.

Pomegranate and Cacao Boost Testosterone

Optimal Blood Levels of Testosterone

Lab technician taking blood vial with label saying testosterone test

The best way of checking testosterone status is with simple blood tests.

In men, the optimal ranges for free and total testosterone in the blood are:

  • Free testosterone: 15-25 pg/mL.
  • Total testosterone: 600-900 ng/dL.

In observational studies, it was discovered that pomegranate and cacao (the beans used to make chocolate) improve various aspects of health, including athletic performance and erectile function.45-49

Doctor and nurse discussing brain scans of man with increased testosterone

Scientists believed these benefits might be tied to higher testosterone levels. To test this possibility, researchers gave healthy adults pomegranate for two weeks.50 Testosterone levels rose by 23%-27%, while improving mood and sense of well-being.

In mouse studies, scientists confirmed that both pomegranate and cacao seed extract boost testosterone production by the cells of the testes.51

These extracts have an even greater effect when combined. In a rat study, the combination elevated testosterone levels by over 72% in just six weeks.52

In a human study, men aged 36 to 55 were given 400 mg of a pomegranate and cacao blend daily. After eight weeks, levels of bioactive free testosterone were 48% higher. Markers of stress, well-being, hand grip strength, and low testosterone symptoms all improved significantly.53

Even in younger men aged 21 to 35, free testosterone was boosted by about 25%. Hand grip strength and upper arm circumference increased as well.54

A third ingredient called luteolin has shown, in preclinical research, that it could favorably modulate testosterone in humans. Luteolin is a flavonoid found in many herbs, fruits, and vegetables. In one animal study, luteolin increased the production of a regulatory protein that is involved in the synthesis of testosterone in the testes.55

Luteolin also inhibits the enzyme aromatase in animal models. This enzyme converts testosterone into estrogen.56,57 By decreasing its synthesis and preventing its conversion to estrogen, luteolin might help support healthy levels of testosterone.

Scientists combined luteolin with pomegranate and cacao extracts to help support healthy free testosterone levels.

Summary

Man with increased free testosterone experiencing boosted cognitive function

Testosterone levels in men affect many areas of health, including reproductive function and libido, mood, energy, muscle mass, cardiovascular health, metabolism, body weight, and more.

Levels of testosterone drop steadily as men age, beginning around age 30. Low testosterone is associated with loss of libido, erectile dysfunction, weak muscles and bones, obesity, and increased risk for cardiovascular disease, type II diabetes, cognitive dysfunction, and early mortality.

Scientists have found that pomegranate and cacao seed extracts can boost testosterone production in the body. Preclinical evidence supports the use of the flavonoid luteolin for the maintenance of testosterone levels.

By supporting healthy levels of testosterone, a combination of these three nutrients may help aging men to maintain healthy vigor while reducing risk for conditions that lower quality of life and contribute to disease and risk of death.

If you have any questions on the scientific content of this article, please call a Life Extension Wellness Specialist at 1-866-864-3027.

References

  1. Santos MRd, Bhasin S. Benefits and Risks of Testosterone Treatment in Men with Age-Related Decline in Testosterone. Annual Review of Medicine. 2021;72(1):75-91.
  2. Zirkin BR, Tenover JL. Aging and declining testosterone: past, present, and hopes for the future. Journal of Andrology. 2012 Nov-Dec;33(6):1111-8.
  3. Araujo AB, Dixon JM, Suarez EA, et al. Clinical review: Endogenous testosterone and mortality in men: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2011 Oct;96(10):3007-19.
  4. Rizk PJ, Kohn TP, Pastuszak AW, et al. Testosterone therapy improves erectile function and libido in hypogonadal men. Curr Opin Urol. 2017 Nov;27(6):511-5.
  5. Bassil N, Morley JE. Late-life onset hypogonadism: a review. Clin Geriatr Med. 2010 May;26(2):197-222.
  6. Marin P, Arver S. Androgens and abdominal obesity. Baillieres Clin Endocrinol Metab. 1998 Oct;12(3):441-51.
  7. Nead KT. Androgens and depression: a review and update. Curr Opin Endocrinol Diabetes Obes. 2019 Jun;26(3):175-9.
  8. Seidell JC, Bjorntorp P, Sjostrom L, et al. Visceral fat accumulation in men is positively associated with insulin, glucose, and C-peptide levels, but negatively with testosterone levels. Metabolism. 1990 Sep;39(9):897-901.
  9. Travison TG, Morley JE, Araujo AB, et al. The relationship between libido and testosterone levels in aging men. J Clin Endocrinol Metab. 2006 Jul;91(7):2509-13.
  10. Lv W, Du N, Liu Y, et al. Low Testosterone Level and Risk of Alzheimer’s Disease in the Elderly Men: a Systematic Review and Meta-Analysis. Mol Neurobiol. 2016 May;53(4):2679-84.
  11. Available at: https://www.ncbi.nlm.nih.gov/books/NBK526128/. Accessed July 6, 2021.
  12. Burger HG. Androgen production in women. Fertil Steril. 2002 Apr;77 Suppl 4:S3-5.
  13. Available at: https://www.bumc.bu.edu/sexualmedicine/publications/testosterone-insufficiency-in-women-fact-or-fiction/. Accessed July 16, 2021.
  14. Edwards RZ. Testosterone Deficiency. In: Rakel D, ed. Integrative Medicine: Elsevier; 2018:630-7.e1.
  15. Hinson J, Raven P, Chew S. Hormonal Control of Reproduction Part I. In: Hinson J, Raven P, Chew S, editors. The Endocrine System: Churchill Livingstone; 2010:87-98.
  16. Brawer MK. Testosterone replacement in men with andropause: an overview. Rev Urol. 2004;6 Suppl 6(Suppl 6):S9-S15.
  17. Kazi M, Geraci SA, Koch CA. Considerations for the diagnosis and treatment of testosterone deficiency in elderly men. Am J Med. 2007 Oct;120(10):835-40.
  18. Jia H, Sullivan CT, McCoy SC, et al. Review of health risks of low testosterone and testosterone administration. World J Clin Cases. 2015 Apr 16;3(4):338-44.
  19. Maggi M, Schulman C, Quinton R, et al. The burden of testosterone deficiency syndrome in adult men: economic and quality-of-life impact. J Sex Med. 2007 Jul;4(4 Pt 1):1056-69.
  20. Moncada I. Testosterone and men’s quality of life. Aging Male. 2006 Dec;9(4):189-93.
  21. Yeap BB, Araujo AB, Wittert GA. Do low testosterone levels contribute to ill-health during male ageing? Crit Rev Clin Lab Sci. 2012 Sep-Dec;49(5-6):168-82.
  22. Wang C, Jackson G, Jones TH, et al. Low testosterone associated with obesity and the metabolic syndrome contributes to sexual dysfunction and cardiovascular disease risk in men with type 2 diabetes. Diabetes Care. 2011 Jul;34(7):1669-75.
  23. Carcaillon L, Brailly-Tabard S, Ancelin ML, et al. Low testosterone and the risk of dementia in elderly men: Impact of age and education. Alzheimers Dement. 2014 Oct;10(5 Suppl):S306-14.
  24. Zhang Z, Kang D, Li H. Testosterone and Cognitive Impairment or Dementia in Middle-Aged or Aging Males: Causation and Intervention, a Systematic Review and Meta-Analysis. J Geriatr Psychiatry Neurol. 2021 Sep;34(5):405-17.
  25. Seidman SN, Walsh BT. Testosterone and depression in aging men. Am J Geriatr Psychiatry. 1999 Winter;7(1):18-33.
  26. Chen Z, Shen X, Tian K, et al. Bioavailable testosterone is associated with symptoms of depression in adult men. J Int Med Res. 2020 Aug;48(8):300060520941715.
  27. Zarrouf FA, Artz S, Griffith J, et al. Testosterone and depression: systematic review and meta-analysis. J Psychiatr Pract. 2009 Jul;15(4):289-305.
  28. Mouser JG, Loprinzi PD, Loenneke JP. The association between physiologic testosterone levels, lean mass, and fat mass in a nationally representative sample of men in the United States. Steroids. 2016 Nov;115:62-6.
  29. Allan CA, McLachlan RI. Androgens and obesity. Curr Opin Endocrinol Diabetes Obes. 2010 Jun;17(3):224-32.
  30. Corona G, Monami M, Rastrelli G, et al. Type 2 diabetes mellitus and testosterone: a meta-analysis study. Int J Androl. 2011 Dec;34(6 Pt 1):528-40.
  31. Corona G, Monami M, Rastrelli G, et al. Testosterone and metabolic syndrome: a meta-analysis study. J Sex Med. 2011 Jan;8(1):272-83.
  32. Laaksonen DE, Niskanen L, Punnonen K, et al. Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men. Diabetes Care. 2004 May;27(5): 1036-41.
  33. Cheung KK, Luk AO, So WY, et al. Testosterone level in men with type 2 diabetes mellitus and related metabolic effects: A review of current evidence. J Diabetes Investig. 2015 Mar;6(2):112-23.
  34. Jones TH. Effects of testosterone on Type 2 diabetes and components of the metabolic syndrome. J Diabetes. 2010 Sep;2(3):146-56.
  35. Dhindsa S, Miller MG, McWhirter CL, et al. Testosterone concentrations in diabetic and nondiabetic obese men. Diabetes Care. 2010 Jun;33(6):1186-92.
  36. Haring R, Volzke H, Steveling A, et al. Low serum testosterone levels are associated with increased risk of mortality in a population-based cohort of men aged 20-79. Eur Heart J. 2010 Jun;31(12):1494-501.
  37. Khaw KT, Dowsett M, Folkerd E, et al. Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men: European prospective investigation into cancer in Norfolk (EPIC-Norfolk) Prospective Population Study. Circulation. 2007 Dec 4;116(23):2694-701.
  38. Laughlin GA, Barrett-Connor E, Bergstrom J. Low serum testosterone and mortality in older men. J Clin Endocrinol Metab. 2008 Jan;93(1):68-75.
  39. Nettleship J, Jones R, Channer K, et al. Testosterone and coronary artery disease. Front Horm Res. 2009;37:91-107.
  40. Shabsigh R, Katz M, Yan G, et al. Cardiovascular issues in hypogonadism and testosterone therapy. Am J Cardiol. 2005 Dec 26;96(12B):67M-72M.
  41. Malkin CJ, Pugh PJ, Morris PD, et al. Low serum testosterone and increased mortality in men with coronary heart disease. Heart. 2010 Nov;96(22):1821-5.
  42. Mellstrom D, Johnell O, Ljunggren O, et al. Free testosterone is an independent predictor of BMD and prevalent fractures in elderly men: MrOS Sweden. J Bone Miner Res. 2006 Apr;21(4):529-35.
  43. Golds G, Houdek D, Arnason T. Male Hypogonadism and Osteoporosis: The Effects, Clinical Consequences, and Treatment of Testosterone Deficiency in Bone Health. Int J Endocrinol. 2017;2017:4602129.
  44. Tuck S, Francis R. Testosterone, bone and osteoporosis. Front Horm Res. 2009;37:123-32.
  45. Corti R, Flammer AJ, Hollenberg NK, et al. Cocoa and cardiovascular health. Circulation. 2009 Mar 17;119(10):1433-41.
  46. de Nigris F, Williams-Ignarro S, Sica V, et al. Effects of a pomegranate fruit extract rich in punicalagin on oxidation-sensitive genes and eNOS activity at sites of perturbed shear stress and atherogenesis. Cardiovasc Res. 2007 Jan 15;73(2):414-23.
  47. Schroeter H, Heiss C, Balzer J, et al. (-)-Epicatechin mediates beneficial effects of flavanol-rich cocoa on vascular function in humans. Proc Natl Acad Sci U S A. 2006 Jan 24;103(4):1024-9.
  48. Trexler ET, Smith-Ryan AE, Melvin MN, et al. Effects of pomegranate extract on blood flow and running time to exhaustion. Appl Physiol Nutr Metab. 2014 Sep;39(9):1038-42.
  49. Wirtz PH, von Kanel R, Meister RE, et al. Dark chocolate intake buffers stress reactivity in humans. J Am Coll Cardiol. 2014 Jun 3;63(21):2297-9.
  50. Al-Dujaili E, Smail N. Pomegranate juice intake enhances salivary testosterone levels and improves mood and well being in healthy men and women. Presented at Society for Endocrinology BES 2012. Endocrine Abstracts. 2012;28:P313.
  51. Laila Nutraceutical Internal Study. Evaluating testosterone production activating capacity of herbal extracts in MA-10 mouse leydig cells. Data on file. 2018.
  52. Laila Nutraceutical Internal Study. Tesnor raises testosterone levels in rats: in vivo study. Data on file. 2018.
  53. Laila Nutraceutical Internal Study. A Randomized, Double-Blind, Placebo-Controlled Clinical Study to Evaluate the Efficacy and Safety of a Novel Herbal Composition Improving Testosterone Level in Healthy Young Males. Data on file. 2019.
  54. Laila Nutraceutical Internal Study. A randomized, double blind, placebo controlled study to evaluate the efficacy and safety of a novel herbal composition improving aging males’ symptoms. Data on file. 2018.
  55. Couture R, Mora N, Al Bittar S, et al. Luteolin modulates gene expression related to steroidogenesis, apoptosis, and stress response in rat LC540 tumor Leydig cells. Cell Biol Toxicol. 2020 Feb;36(1): 31-49.
  56. Li F, Wong TY, Lin SM, et al. Coadministrating luteolin minimizes the side effects of the aromatase inhibitor letrozole. J Pharmacol Exp Ther. 2014 Nov;351(2):270-7.
  57. Lu DF, Yang LJ, Wang F, et al. Inhibitory effect of luteolin on estrogen biosynthesis in human ovarian granulosa cells by suppression of aromatase (CYP19). J Agric Food Chem. 2012 Aug 29;60(34):8411-8.