TRT Fact or Fiction

There are a lot of claims about testosterone and testosterone replacement therapy (TRT) out there. Figuring out what is true and proven by science and what is fiction can be difficult.  

Fiction: Testosterone levels should stay consistent, forever

Your T levels, or testosterone levels, change often and vary throughout the day. You may know that your sleep follows a 24-hour circadian rhythm: your T levels follow a 24-hour cycle as well. T levels are highest in the morning (around 8am) and lowest in the evening (around 7pm).  

Your T levels also change as you age, peaking in your twenties, and starting to slowly decline in your thirties. This decline is very slow, only decreasing by about 1% per year. 

Also, what you do each day can impact your T levels: medications you take or the amount of alcohol you drink may be different from one day to the next and affect your T levels.

Fact: You can boost your T levels naturally

You might think that there’s nothing you can do to increase your T levels, but that’s not true! Living a healthy lifestyle is critical to increasing your T levels. This includes getting enough sleep (7-8 hours), maintaining a healthy weight, and reducing stress. Avoiding alcohol, smoking and recreational drugs is also important. If you’re taking prescription medication, review it with your doctor to ensure it’s not lowering your T levels.

There are also some vitamins and supplements that could help increase your T levels. These include vitamin D, magnesium, and zinc. If you’re deficient in any one of these (which most Canadian men are) taking a supplement could be helpful. 

Fiction: The main symptom of low T is erectile dysfunction.

While it’s true erectile dysfunction (ED) can be a symptom of low T, you may not have ED and still have low T. Or you may have ED and have normal or high T. Low T has a wide range of symptoms that include low sex drive, reduced muscle mass, fatigue, irritability, and depression. You may also have poor memory, poor focus, or less energy. 

If you have low T, you likely only have a few of these symptoms. 

Fact: Low T is on the rise

Studies have been showing that male testosterone levels have declined over the past few decades. A 2007 study showed a ‘substantial decline’ in T that were not linked to factors such as smoking or obesity. A large study done in 2020 showed a “highly significant” decline in total testosterone in the 2000s and 2010s. The authors say that higher obesity rates don’t explain the lowering T levels in the general population. 

The exact cause of the declining T levels remains unclear. Since T levels are declining overall, it makes sense that needed Testosterone Replacement Therapy is becoming more common.

Fiction: Low T levels are the male menopause

Sometimes low T levels are called ‘male menopause’ or ‘andropause’. These aren’t accurate terms to describe the low T levels men experience. Menopause is a sudden drop in hormone levels over a brief period, like what women deal with over the course of a year or two in their early 50’s. Men experience a slow decline in T over their lifetime. The results of this drop also aren’t as clear as in menopause. Many men continue to live normally and chalk up the symptoms to just getting older. The steady decline in men also doesn’t mean their T levels go below normal. Only an estimated 25% of men aged 40-69 have low T levels. The last thing to note is that some men that do have low levels of testosterone don’t experience any symptoms.