Major Factors That Cause Low Testosterone, According to Doctors

IF YOU’RE NOTICING that your sex drive isn’t what it used to be, or that you’re struggling to get through your workouts, or that you’re just feeling down, your testosterone levels could be to blame. Low testosterone can cause many symptoms, and several factors can contribute to a deficiency.

As a refresher, testosterone is the main male sex hormone that’s mainly produced in the testicles, according to the American Urological Association (AUA). Maintaining testosterone levels is crucial for many bodily functions: “Maintaining muscle mass, maintaining bone density, libido, proper sex function, keeping your motivation and drive, proper mood stabilization, and also even red blood cell production, which is something a lot of people don’t think about,” says William Nall, D.O., an American Osteopathic Association board-certified physician in family medicine and neuromusculoskeletal medicine.

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Sometimes, the body doesn’t produce enough testosterone, a condition known as hypogonadism. You’re considered to have a testosterone deficiency or low testosterone (also known as low-T) when your levels are less than 300 nanograms per deciliter (ng/dL), according to AUA; other guidelines consider it low at 264.

Low-T is more common as you age, but several other things can lower your testosterone, too.

“The prevalence of testosterone deficiency ranges anywhere from 2 percent to 10 percent of the population and represents approximately 16 million men in the United State alone,” says Darshan Patel, M.D., assistant professor of urology at the University of California San Diego’s Men’s Health Center.

Here’s a look at some signs that your testosterone is low, factors that lower your testosterone, and what you should do if you think yours isn’t where it should be.

Signs That Your Testosterone Is Low

When your testosterone is low, you might experience a variety of symptoms, according to AUA. These include:

These can be signs of other health conditions, as well. So, if you’re experiencing any of these symptoms, it’s important to talk to your doctor about how you’re feeling and get your concerns investigated as well as get your testosterone levels checked.

What Can Lower Your Testosterone

Low testosterone can be caused by many different factors—some you’re born with, and some are influenced by your lifestyle or changes to your health over time. Here are some of the most common causes of low-T:

Getting older

Low testosterone is a natural part of aging. Dr. Nall says men tend to hit their hormonal peak in their 30s. After 40, testosterone starts to drop. “Then, it takes a pretty big dive around age 50 and starts to go down,” he adds.

Total testosterone levels tend to decline about 1.6 percent a year, and roughly 20 percent of men over 60 have levels that would qualify as low.

The reason for the drop is that aging can deteriorate hypothalamic-pituitary functioning, which keeps your hormones balanced, and may dim the number and responsiveness of cells in the testicles that are responsible for testosterone and sperm production.

It’s also possible that levels don’t drop in some men. Research from a while back found that testosterone levels might not decline in older men who are in good health.

Excess weight

Obesity and being overweight are linked to low testosterone. There are a few mechanisms at play, Dr. Patel says.

It’s thought that leptin, a hormone found in fat cells, inhibits testosterone production. Excess fat deposits also increase estradiol (an estrogen hormone), leptin, and adipokines (molecules produced by fat cells), which affect the pituitary gland that tells the testicles how much testosterone to make, he explains.

The relationship between weight and testosterone is a “vicious cycle,” Dr. Nall says. Low testosterone can cause fatigue and even depression, which likely decreases someone’s urge to work out or generally stay active, which can affect weight.

Testicular problems

Since the testicles are the main producers of testosterone, any damage or condition affecting the organs can affect testosterone.

This can include having undescended testicles from early childhood that were never corrected or Klinefelter syndrome, an abnormality of sex chromosomes, according to the Mayo Clinic.

Infections or injuries to the testicles can cause hypogonadism, too.

Pituitary disorders

Problems with the pituitary gland or hypothalamus, which are parts of the brain that tell the testicles to produce testosterone, can lower your levels of the hormone. This might include Kallmann’s syndrome, which is a brain development abnormality, or a pituitary disorder that might interfere with normal testosterone production, according to the Mayo Clinic.

Chronic health conditions

Some inflammatory diseases, like tuberculosis and sarcoidosis, as well as HIV and AIDS impact the hypothalamus and pituitary gland and can affect testosterone levels, according to the AUA. Autoimmune diseases, such as rheumatoid arthritis and lupus, are also linked with testosterone deficiency.

Not getting enough sleep

Testosterone levels peak between 3 a.m. and 8 a.m. for men with traditional sleep patterns, Dr. Patel says. When you don’t get enough sleep, a situation many Americans are chronically in, your testosterone levels can decline.

One small study of 10 healthy young men found that just one week of not getting enough sleep negatively affected testosterone levels. Getting just five hours of sleep a night decreased their T by 10 to 15 percent. Aim for seven or more hours of shut-eye a night.

What you eat

A healthy diet can help keep your testosterone levels in check and help prevent Low-T.

“I typically recommend my patients stick with a healthy, balanced diet avoiding saturated fats and processed sugars,” Dr. Patel says. “Eating a diet with high saturated fats and processed sugars can lead to caloric excess and weight gain that can lower testosterone.”

A 2022 analysis published in the journal Nutrition and Health found that high-protein and low-carb diets decreased testosterone by 37 percent. A low-carb, moderate-protein diet didn’t show consistent effects on T levels.

Certain drugs and medications

Chemotherapy and radiation therapy can cause testosterone deficiency.

Substance and drug abuse, such as alcohol, opioids, and anabolic-androgenic steroids, can affect testosterone production and interfere with testicular and hypothalamic-pituitary function, research shows. Nicotine and amphetamines also affect T levels. But hypogonadism is usually reversible when you stop using these substances.

What to Do if You Think Your Testosterone Is Low

If you suspect that your testosterone is low, talk to your doctor about any symptoms that you’re having, Dr. Nall urges.

Your doctor will likely check your T levels, which involves two blood tests performed in the morning when testosterone levels are highest. Most doctors diagnose low testosterone based on these test results and your symptoms and often prescribe testosterone replacement therapy, Dr. Patel says.

Erica Sweeney is a writer who mostly covers health, wellness and careers. She has written for The New York Times, HuffPost, Teen Vogue, Parade, Money, Business Insider and many more.