Why testosterone matters for longevity

Maintaining normal testosterone levels is essential to feeling good and staying healthy as you age. 

Testosterone is a critical hormone for men, and clinically low levels are associated with medical problems that reduce your health span and life span, including diabetes, metabolic syndrome, cardiovascular disease, osteoporosis, sexual dysfunction, depression, dementia, and more. 

Put simply: If you have less testosterone, you may live a shorter life.

In fact, as reported in this article from Hone Health, a 2024 meta-analysis examined data from 11 high-quality human studies and found a strong link between testosterone levels and mortality risk. The study tracked the testosterone levels of men for five years, discovering that those with low testosterone were more likely to die. Most deaths were due to heart disease. 

Men's testosterone levels start to dip in their 30s and decrease by around one percent every year for the rest of their lives, according to the Endocrine Society. When your T levels drop, you're not just at risk for disease. You'll also feel old, thanks to symptoms like fatigue, decreased muscle mass, and a decimated libido. 

A blood test (through your healthcare provider or Hone) can tell you if your testosterone is below where it should be for your age. If it reveals a testosterone deficiency, your doctor may prescribe testosterone replacement therapy (TRT). 

Seems like an open and shut case. But leading longevity experts have different ideas of the best ways to boost your T and when you should consider TRT.

When should you consider TRT?

You hit the gym five times a week but feel fatigued after your first two sets. Or worse, even when you push through, you don't see the muscle gains you used to. That's the reality for many guys with low testosterone.

"I think there's a group of people who think, 'If I could just fix my testosterone, everything will be better,'" says longevity doctor Peter Attia, M.D. on the "Huberman Lab" podcast. "Really, the only purpose in my mind of fixing testosterone is to give you the capacity to work harder. It's really going to help you recover more from your workouts."

Starting hormone therapy can also help you feel young in other ways. Men who start TRT to treat hypogonadism—the clinical diagnosis for low T—can also expect relief from symptoms like low mood, energy, and libido.

That may be why biologist and Lifespan podcast host David Sinclair, Ph.D., supports men starting TRT to turn back the clock to their earlier T levels.

"I'm all for keeping your hormones at young levels. I'm all about keeping the body the way it was when it was 20," Sinclair says on the "Ed Mylett Show." "However you can do that, and it's safe, do that. I'm on board with hormone replacement therapy for men." 

Other ways to boost your T

Eat Healthy

Despite his enthusiasm for TRT, Sinclair isn't on it. He optimizes his testosterone levels with diet and exercise. In an Instagram post, he shared that switching to a plant-based diet and losing weight caused his testosterone levels to double: In 2015 they were around 500 ng/dL. By 2020 they'd shot up to roughly 1,000 ng/dL—the upper range for normal testosterone in a man of his age (54).

Why plant-based? While Sinclair acknowledges the short-term benefits of eating meat to increase protein and build muscle, he says the inflammation associated with a carnivorous diet makes a steak not worth it. 

Sinclair's longevity-boosting supplement stack, which contains vitamin D3, spermidine, and resveratrol, may have also contributed to his maintained half-decade spike in testosterone. 

Recent research found no significant difference in testosterone between meat eaters and vegetarians. But weight loss, associated with a healthy diet, is connected to boosted T levels. Overweight or obese men may be eight times more likely to have low testosterone, according to a 2014 study. 

Try Herbal Supplements

If you have a condition that disqualifies you from TRT (like sleep apnea) or plan on having kids, Andrew Huberman, neuroscientist and podcaster, suggests natty, herbal T-boosters.

"For people that aren't being prescribed TRT but want the increase in testosterone, there are plant compounds like tongkat ali," Huberman tells Joe Rogan on an episode of the "Joe Rogan Experience." "Herbal supplements can give a significant boost in free and active testosterone."

Supplemented tongkat ali increased men's T levels by 37% after four weeks of use, according to a 2013 study in the Journal of the International Society of Sports Nutrition. A more recent study found that the herb increased total testosterone levels by 15% and free testosterone levels by 34%.

Maintain An Active Lifestyle

If you aren't putting in the work to stay active and healthy, you won't catch doctors like Attia, whipping out the prescription pad.

"If I just give you a bunch of testosterone and you sit on the couch and your nutrition doesn't change and you're not exercising anymore, you're not going to experience any benefits of this thing," Attia says on an episode of "Huberman Lab."

Having a sedentary lifestyle—even if your weight is normal—can put you at risk for low testosterone. In fact, getting moving is one of the easiest ways to get an instant T boost. A study found that men's T levels increased significantly after a resistance workout at 5 and 15 minutes post exercise. 

And working out consistently may help keep your testosterone levels high, according to a study in the journal Clinical Endocrinology. Researchers found that men who exercise regularly have higher T than men who don't. HIIT and resistance training sessions give the biggest increase. 

HIIT

If you want to optimize your T and your workout routine, add high-intensity interval training (HIIT) to your next cardio set. 

Men aged 30 to 35 who participated in three sessions per week of one hour of high-intensity intervals and strength training clocked in an average of 36.7 percent increase in their testosterone, according to a 2021 study. 

Resistance training

Nutrition expert and bodybuilder Layne Norton, Ph.D., has a Rogan-esque machismo with the brains of a scientist—which is probably why he's gone mega-viral on longevity podcasts. 

"Every time I've ever had my testosterone checked (with the exception of contest prep) I've been between 800-1100 [ng/dL]," Norton says. "You know what increases testosterone? Lifting hard AF consistently."

Resistance exercises—like squats, deadlifts, and bench presses—have been shown to produce high serum testosterone increases compared to other workouts. But just like your post-workout pump, this boost in T isn't permanent. Your levels will begin to return to their baseline at 30 minutes post-workout.

Lower body, multi-joint movements are especially effective at boosting testosterone levels. A 2014 study found that free weight exercises like squats produced a larger increase in plasma testosterone concentrations than machine exercises. 

If you've optimized your lifestyle but your testosterone levels are still low, Norton says it may be time for medical intervention. 

"I want to be clear: if you are living a healthy lifestyle and your testosterone is low, I have zero issue with you getting TRT," Norton says. "So long as you don't compete in a drug tested organization that bans TRT. Go for it."