How to increase testosterone levels naturally

Name: Dr (TCM) Attilio D'Alberto
Brand: Dr (TCM) Attilio D'Alberto
SKU: hd-local-wokingham-rg-40
Rating: 5 (228 reviews)

Overview
Testosterone and male fertility
Causes of low testosterone
Signs of low testosterone
Why testosterone replacement therapy reduces fertility
Diet and nutrition
Supplements
Lifestyle factors
What to avoid
Low testosterone in Chinese medicine
How acupuncture can increase testosterone
Chinese herbal medicine for testosterone
Frequently asked questions
References

1. Overview

Low testosterone is one of the most common and most underdiagnosed contributors to male infertility. Testosterone is essential for sperm production, and when levels fall below the normal range, sperm count, motility and morphology can all be adversely affected. At the same time, many men with low testosterone are treated with testosterone replacement therapy (TRT) — a treatment that is highly counterproductive for fertility and can cause sperm production to stop entirely.

I am Dr (TCM) Attilio D'Alberto, a fertility specialist with over 25 years of clinical experience treating male infertility. This page explains the relationship between testosterone and fertility, the causes of low testosterone, why TRT is not the right approach for men wanting to conceive, and the natural approaches — including diet, supplements, lifestyle, acupuncture and Chinese herbal medicine — that can safely and effectively raise testosterone levels and improve sperm quality.

2. Testosterone and male fertility

Testosterone is the primary male sex hormone, produced mainly in the Leydig cells of the testes under the influence of luteinising hormone (LH). It plays a central role in male reproductive health: without adequate testosterone, normal spermatogenesis cannot occur.

The hormonal cascade governing male fertility works as follows. The hypothalamus releases gonadotropin-releasing hormone (GnRH), which prompts the pituitary gland to secrete LH and FSH. LH travels to the testes and stimulates the Leydig cells to produce testosterone. Testosterone, in turn, works together with FSH to drive spermatogenesis — the continuous production of sperm in the seminiferous tubules. Crucially, the concentration of testosterone within the testes is far higher (up to 100 times higher) than that circulating in the blood, because sperm production requires a very high local testosterone environment. A man can therefore have blood testosterone levels that appear normal on a standard test but still have insufficient intratesticular testosterone to support full spermatogenesis.

Low testosterone — clinically defined as a serum total testosterone below 300 ng/dL (10.4 nmol/L) on two separate measurements — can reduce sperm production, impair sperm motility and morphology, reduce libido and cause erectile dysfunction, all of which negatively affect a man's ability to conceive with his partner. Low sperm count, poor sperm motility and abnormal sperm morphology are the main semen abnormalities associated with low testosterone.

3. Causes of low testosterone

Testosterone levels decline naturally with age, beginning from the mid-30s at a rate of approximately 1% per year. However, low testosterone in younger men is increasingly common and is usually attributable to one or more of the following causes:

Primary hypogonadism — the testes themselves fail to produce adequate testosterone, typically associated with elevated LH and FSH as the pituitary attempts to compensate. Causes include testicular injury or trauma, varicocele, undescended testes, genetic conditions (such as Klinefelter syndrome), and prior chemotherapy or radiation.
Secondary hypogonadism — the testes receive insufficient stimulation from the pituitary, resulting in low LH, low FSH and low testosterone. Causes include pituitary disorders, hyperprolactinaemia, obesity (excess adipose tissue converts testosterone to oestrogen via aromatase), chronic stress, opioid use, anabolic steroid use, and testosterone replacement therapy itself.
Obesity and metabolic syndrome — excess body fat, insulin resistance and metabolic dysfunction all suppress the HPG axis and increase aromatase activity, driving the conversion of testosterone to oestrogen.
Diabetes — both type 1 and type 2 diabetes are associated with lower testosterone levels. Insulin resistance disrupts the HPG axis and reduces Leydig cell function.
Chronic illness — systemic conditions including chronic kidney disease, liver disease and inflammatory conditions can suppress testosterone production.
Vegetarian or vegan diet — men following vegetarian or vegan diets may be more vulnerable to zinc deficiency, which plays a critical role in testosterone synthesis. Adequate dietary planning can mitigate this risk.
Overtraining — excessive endurance exercise, particularly in combination with caloric restriction, suppresses LH and testosterone in a similar way to the female athlete triad.
Sleep deprivation — the majority of testosterone is produced during sleep. Consistently poor sleep quality or less than five hours per night is associated with significantly reduced testosterone levels.
Environmental endocrine disruptors — widespread exposure to chemicals such as bisphenol A (BPA), phthalates, pesticides and synthetic oestrogens found in plastics, pesticides and personal care products interferes with testosterone synthesis and sperm production.

4. Signs of low testosterone

Symptoms of low testosterone in men may include:

Reduced libido and sexual interest
Erectile dysfunction
Reduced ejaculatory volume
Low sperm count or poor sperm quality on semen analysis
Fatigue and low energy
Reduced muscle mass and strength despite regular exercise
Increased body fat, particularly around the abdomen
Reduced body and facial hair
Low mood, depression or irritability
Reduced bone density
Poor sleep quality

If you are experiencing several of these symptoms, a blood test measuring total testosterone, LH, FSH, oestradiol and SHBG (sex hormone-binding globulin) is the appropriate starting point. Two tests on separate mornings are required for a reliable result, as testosterone levels fluctuate throughout the day and are highest in the early morning.

5. Why testosterone replacement therapy reduces fertility

This is one of the most important things a man trying to conceive needs to know: taking exogenous (externally administered) testosterone suppresses sperm production, often severely, and sometimes to the point of azoospermia (no sperm in the ejaculate at all).

The reason is straightforward. When testosterone is introduced from an external source — whether by injection, gel, patch, implant or any other route — the brain senses that circulating testosterone levels have risen and responds by reducing its own stimulation of the testes. GnRH output falls, LH and FSH production drops, and the testes receive less stimulation both to produce testosterone and to produce sperm. The intratesticular testosterone environment collapses, and spermatogenesis is severely curtailed. Research has shown that regular TRT can suppress spermatogenesis to the point of azoospermia within as little as ten weeks in some men.¹

In many cases, sperm production recovers after stopping TRT — but recovery is not guaranteed, and for older men, men who have been on TRT for extended periods, or men who have used high doses, the recovery may be incomplete. Men who want to preserve their fertility should never begin TRT without first discussing the implications with a reproductive urologist, and should ideally bank sperm before starting.

The natural approaches described below do not carry this risk — they work by supporting the body's own testosterone production through the HPG axis, rather than bypassing it.

6. Diet and nutrition

Diet is a major modifiable influence on testosterone levels. The following principles are most relevant:

Eat adequate healthy fats

Testosterone is a steroid hormone synthesised from cholesterol. Diets very low in fat — particularly diets low in cholesterol and saturated fat — have been associated with reduced testosterone levels. Healthy fat sources including olive oil, avocado, eggs, full-fat dairy, oily fish, nuts and seeds provide the raw materials for testosterone synthesis. This does not mean a high-fat or high-cholesterol diet; it means avoiding the ultra-low-fat dietary approaches that were prevalent in the 1980s and 1990s and that research has since shown to be counterproductive for male hormonal health.

Eat sufficient protein

Adequate protein intake supports muscle mass, metabolic health and hormonal balance. It also helps to maintain healthy body weight, which is important because obesity is a major suppressor of testosterone. Aim for regular meals with quality protein at each — eggs, fish, poultry, lean red meat, dairy, legumes and nuts.

Emphasise zinc-rich foods

Zinc is essential for testosterone synthesis in the Leydig cells and for healthy spermatogenesis. A 2022 systematic review confirmed the well-established positive relationship between zinc levels and male testosterone, and found that zinc deficiency leads to impaired testosterone synthesis and testicular structural damage.² The best dietary sources of zinc are oysters and other shellfish, red meat, poultry, pumpkin seeds, hemp seeds, chickpeas and lentils. Men who do not eat red meat or shellfish may need to pay particular attention to zinc intake.

Include selenium-rich foods

Selenium is an antioxidant mineral that supports testicular function and sperm quality. Good sources include Brazil nuts (two per day provides an adequate intake), fish, shellfish, eggs and whole grains.

Eat foods that support testosterone production

In traditional Chinese medicine, testosterone is yang in nature — warming, activating, driving. Foods that nourish yang include oats, spelt, quinoa, walnuts, chestnuts, pistachio nuts, pine nuts, sunflower and sesame seeds, sweet potato, winter squash, parsnip, onion, garlic, kale, mustard greens and red peppers. These foods also have strong nutritional profiles supporting male reproductive health from a western perspective.

Limit processed and ultra-processed foods

Ultra-processed foods, trans fats, refined carbohydrates and sugar promote systemic inflammation, insulin resistance and obesity — all of which suppress testosterone. Reducing these is as important as increasing the beneficial foods.

7. Supplements

Several supplements have evidence supporting their use in men with low testosterone who are trying to conceive. They should be considered in conjunction with dietary and lifestyle changes, not as a substitute for them.

Zinc

For men with confirmed or suspected zinc deficiency, zinc supplementation is one of the most well-evidenced interventions for supporting testosterone and sperm quality. A meta-analysis of studies on zinc and male infertility found that zinc supplementation significantly increased semen volume, sperm motility and the percentage of normal sperm morphology in infertile men.³ A typical supplementation dose is 25–50 mg of elemental zinc daily — zinc citrate or zinc gluconate are well absorbed forms. Zinc should not be taken in excess of this range as very high doses can be counterproductive.

Vitamin D

Vitamin D receptors are present throughout the male reproductive system, including in Leydig cells, Sertoli cells and mature spermatozoa. A 2023 systematic review found significant correlations between vitamin D levels and sperm parameters, particularly sperm motility, and partial evidence of a positive relationship between higher vitamin D and testosterone levels in men.⁴ Vitamin D deficiency is extremely common in the UK. A blood test is the best way to establish current levels; if deficient, supplementation with 1000–2000 IU of vitamin D3 daily (with vitamin K2 for optimal absorption) is appropriate.

DHEA

DHEA (dehydroepiandrosterone) is a precursor hormone produced by the adrenal glands from which both testosterone and oestrogen are synthesised. In men with low testosterone associated with poor adrenal function or age-related decline, DHEA 25–75 mg daily may help to support testosterone production. DHEA should be used under medical supervision as it can affect hormonal balance and is best guided by baseline DHEA-S blood levels.

CoQ10

Coenzyme Q10 is a mitochondrial antioxidant with a particularly high concentration in sperm mitochondria — the energy-producing organelles that power sperm motility. Research supports CoQ10 supplementation for improving sperm motility and reducing oxidative damage to sperm DNA, making it an important supplement for men with poor sperm quality even when testosterone levels are within range. A typical dose is 200–400 mg daily.

Ashwagandha (Withania somnifera)

Ashwagandha is an Ayurvedic adaptogen with growing evidence for improving testosterone levels, sperm count and sperm motility in infertile men. Multiple clinical trials have found significant improvements in testosterone and semen parameters with ashwagandha supplementation, attributed partly to its cortisol-lowering and stress-adaptogenic effects. A typical dose is 300–600 mg of standardised root extract daily.

Omega-3 fatty acids

Omega-3 fatty acids support the structural integrity of sperm cell membranes, improve sperm motility and reduce testicular inflammation. If dietary oily fish intake is low (fewer than two portions per week), a fish oil supplement providing at least 1000 mg of combined EPA and DHA daily is a reasonable addition.

8. Lifestyle factors

Prioritise sleep

The majority of daily testosterone production occurs during sleep, and the peak of testosterone secretion is closely linked to the onset of REM sleep. Research consistently shows that men who sleep fewer than five hours per night have significantly lower testosterone levels than those sleeping seven to nine hours.⁵ Improving sleep quality and duration is one of the most impactful — and most overlooked — ways to raise testosterone levels naturally. Prioritising a consistent sleep schedule, reducing blue light exposure in the evening, and addressing any sleep disorders such as sleep apnoea are all important steps.

Resistance training and exercise

Resistance (weight) training is the form of exercise most consistently associated with increased testosterone levels. Compound exercises — squats, deadlifts, bench press, rows — involving large muscle groups produce the most significant acute and chronic testosterone response. Regular moderate-intensity aerobic exercise also supports healthy testosterone levels by improving insulin sensitivity and metabolic health. Excessive endurance training, particularly in combination with caloric restriction, can paradoxically suppress testosterone.

Maintain a healthy body weight

Obesity is one of the strongest suppressors of testosterone. Excess adipose tissue converts testosterone to oestrogen via the aromatase enzyme, and the resulting oestrogen further suppresses LH production, creating a vicious cycle of falling testosterone. Weight loss — particularly through increased physical activity rather than severe caloric restriction — is associated with meaningful increases in testosterone levels.

Manage stress

Chronic stress elevates cortisol, which directly suppresses LH secretion and testosterone production. The hypothalamic-pituitary-adrenal (HPA) axis and the HPG axis are in direct competition — when stress activates the HPA axis, the HPG axis is suppressed. Active stress management — whether through exercise, meditation, therapy, adequate time off, or acupuncture — is an important component of any programme to improve testosterone and fertility.

Reduce heat exposure to the testes

The testes are located outside the body because sperm production and testosterone synthesis are optimised at a temperature slightly below core body temperature. Prolonged exposure to heat — from hot baths, saunas, tight synthetic underwear, laptop computers on the lap, or sedentary occupations — impairs both testosterone production and spermatogenesis. Switching to loose-fitting cotton underwear and avoiding excessive heat exposure are simple practical steps.

9. What to avoid

Testosterone replacement therapy (TRT) — as explained above, TRT suppresses spermatogenesis and should not be used by men wanting to conceive.
Anabolic steroids — anabolic androgenic steroids (AAS) suppress the HPG axis in the same way as TRT, and their use is associated with severe impairment of spermatogenesis, sometimes lasting years after cessation.
Alcohol — alcohol directly impairs Leydig cell function and reduces testosterone production. Heavy chronic alcohol use is a significant cause of male hypogonadism and impaired fertility.
Smoking — tobacco smoke generates oxidative stress in the testes, reduces testosterone levels and impairs sperm quality across all parameters.
Cannabis — regular cannabis use has been associated with reduced LH, reduced testosterone and impaired spermatogenesis.
Opioids and certain medications — opioids are a well-established suppressant of the HPG axis. Other medications including corticosteroids, antiandrogens and some antidepressants can also reduce testosterone. Discuss any medications with your doctor if you have concerns.
BPA and endocrine disruptors — reducing exposure to BPA (found in some plastics and food can linings), phthalates (found in some plastics, cosmetics and fragrances) and pesticide residues helps to protect testosterone levels and sperm quality.

10. Low testosterone in Chinese medicine

In traditional Chinese medicine, testosterone is understood as an expression of Kidney yang — the warming, activating force that drives all reproductive and metabolic function. The Kidney stores the body's fundamental reproductive essence (jing), which determines sperm quality and quantity as well as testosterone production. Kidney jing declines naturally with age, but can be conserved and supported through appropriate lifestyle and treatment.

Low testosterone in TCM most commonly reflects one of the following patterns:

Kidney yang deficiency

The most common pattern in men with low testosterone. Manifests as fatigue, cold lower abdomen, cold extremities, low libido, frequent urination, reduced drive and motivation, and low or absent morning erections. The sperm in this pattern are often low in count and motility. Treatment warms and strengthens Kidney yang using acupuncture points such as CV4 (Guanyuan), BL23 (Shenshu) and DU4 (Mingmen), and tonic herbal formulae.

Kidney jing deficiency

A deeper constitutional depletion, often associated with ageing, overwork, excessive sexual activity or constitutional weakness. Manifests as premature greying, thinning hair, lower back weakness, poor memory, reduced reproductive vitality, and low sperm count and quality. Treatment tonifies Kidney jing and essence.

Damp-heat in the lower jiao

A pattern associated with inflammation, often caused by poor diet (alcohol, greasy or spicy foods), infection or chronic stress. Manifests as heavy, sticky sensation in the lower body, reduced libido, and in some cases seminal viscosity. This pattern is associated with testicular inflammation and elevated scrotal temperature, which impair testosterone production and sperm function. Treatment clears heat and dampness.

Liver qi stagnation

Chronic stress stagnates Liver qi, disrupting the smooth flow of qi and blood through the reproductive system. This can manifest as hypersensitivity around the testes, variable libido, and disrupted sleep — all of which impact testosterone production. Treatment moves Liver qi and resolves stagnation.

11. How acupuncture can increase testosterone

Acupuncture, particularly electroacupuncture and moxibustion, has research support for increasing testosterone levels and improving sperm quality in men.

Electroacupuncture and moxibustion increase testosterone

A clinical study found that both electroacupuncture and mild moxibustion applied to acupoints BL23 (Shenshu) and CV4 (Guanyuan) for eight weeks significantly increased both total testosterone and free testosterone in ageing men with low testosterone levels. Moxibustion produced superior results to electroacupuncture, possibly because it delivers warmth — a yang quality — directly to the Kidney yang acupoints.⁶ A 2022 study found that electroacupuncture enhanced sperm quality, increased serum testosterone, FSH and LH levels, and attenuated oxidative damage and mitochondrial injury in testicular tissue.⁷

Improving semen parameters

A 2022 literature review of acupuncture for male infertility found that acupuncture modulates the HPG axis, stimulates endogenous GnRH release from the hypothalamus, and promotes LH and FSH secretion from the pituitary — resulting in increased intratesticular testosterone and improved spermatogenesis.⁸ A meta-analysis published in 2023 found that acupuncture significantly improved sperm concentration, motility and morphology in men with infertility.⁹

Increasing blood flow to the testes

Acupuncture increases blood flow to the testes, improving the delivery of oxygen, nutrients and hormones to Leydig cells and Sertoli cells, which support testosterone production and spermatogenesis respectively. This improved microcirculation is an important mechanism behind acupuncture's beneficial effects on male reproductive function.

Reducing stress and cortisol

By reducing cortisol and activating the parasympathetic nervous system, acupuncture directly counteracts the HPG axis suppression caused by chronic stress — one of the most common causes of low testosterone in men of reproductive age.

I offer fertility acupuncture for men at my Wokingham, Berkshire clinic. I treat both partners wherever possible, as addressing male factor issues alongside female treatment consistently improves outcomes for the couple as a whole.

12. Chinese herbal medicine for testosterone

Chinese herbal medicine offers some of the most powerful tools available for addressing low testosterone and improving sperm quality. Formulae are prescribed individually based on each patient's TCM pattern, and are adjusted as treatment progresses. This personalised approach produces better results than single-supplement approaches, as it addresses the underlying constitutional imbalance rather than a single biochemical marker.

Research has identified specific Chinese herbal formulae that improve sperm quality and testosterone in men with oligozoospermia (low sperm count) and asthenospermia (poor sperm motility). Yi Jing Tang, for example, has been shown in clinical research to improve sperm quality in men with oligozoospermia. Formulae that warm Kidney yang and tonify Kidney jing — including herbs such as Rou Cong Rong (Cistanche), Tu Si Zi (Cuscuta), Ba Ji Tian (Morinda) and Lu Jiao Jiao (deer antler gelatin, where appropriate) — are frequently used to support testosterone production and sperm health.

Herbs are prescribed as pharmaceutical-grade granules manufactured by Sun Ten (Taiwan) to strict quality and safety standards. Chinese herbal medicine for male fertility is available in person and via online consultation.

13. Frequently asked questions

Can I take testosterone supplements to improve fertility?

This depends entirely on what is meant by "testosterone supplements." Supplementing with exogenous testosterone — whether prescribed TRT or over-the-counter testosterone products — will suppress sperm production and reduce fertility. However, supplements that support the body's own testosterone production — such as zinc, vitamin D, DHEA, and ashwagandha — are safe and can be beneficial. The distinction is critical: supporting endogenous production versus replacing it externally are completely different approaches with opposite effects on fertility.

How long does it take to see improvements in testosterone and sperm quality?

Because spermatogenesis takes approximately 74 days, changes to testosterone levels and lifestyle need at least three months to produce measurable improvements in sperm parameters. Most of the natural approaches described above — dietary changes, supplements, acupuncture and herbal medicine — begin to influence testosterone levels more quickly, often within four to eight weeks, but sperm quality improvements will be seen three months later. Beginning treatment at least three months before a planned conception attempt is ideal.

Should my partner also be investigated and treated?

Yes, absolutely. Male factor infertility accounts for approximately 40–50% of all infertility cases, but it is almost always treated in the context of a couple. I treat both partners wherever possible. While the male partner is improving testosterone and sperm quality over the three months before conception, the female partner can be working on egg quality, cycle regulation and uterine receptivity in parallel — maximising the chances of successful conception for the couple as a whole.

Can low testosterone cause complete infertility?

Severe low testosterone — particularly secondary to hypogonadotropic hypogonadism (where LH and FSH are also low) — can result in azoospermia (no sperm in the ejaculate). However, this is typically reversible with appropriate treatment that stimulates endogenous testosterone production. Even when sperm counts are very low, treatment can produce meaningful improvements. A reproductive urologist and fertility specialist should be consulted in cases of azoospermia.

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