Disclaimer: Everything here is opinion only, and was written by a contributing author. This is not medical advise. Please consult with your doctor.
Most men over 40 have low testosterone. Furthermore, fat turns testosterone into estrogen, causing an even lower drop if you are fat. You will never know if that includes you unless you get a blood panel test. Make sure you include a “Free Testosterone” test with your blood panel, and not just a “Total Testosterone” test. The number that matters is the Free Testosterone. Total Testosterone usually tracks up or down in concert with the Free Testosterone, and the Free Testosterone test takes longer and is costlier, which is why doctors usually just order the “Total Testosterone” test. But it is not necessarily going to track together. Get a Free Testosterone test each time you do a full blood panel.
Doctors usually only order a “Total Testosterone” test, and often will say you are not low unless you score under 200. My last lab test specified a reference range of 264-916 for a healthy adult, and for Free Testosterone, it specified a reference range of 6.6-18.1. Mine was 4.2 (September 2024), which was VERY low!*
* Another common reference range quoted is 5-25, but many fitness coaches will say that you need a range of 25-50 if you want to feel the effects of good testosterone levels. If measurements are by pg/mL, the reference range is 34.7-150.3, while the “good” range is 250-500. I had a doctor tell me he likes to see above 200 pg/mL for Free Testosterone, and above 1000 ng/dL for Total Testosterone.
So I started taking the following supplements:
Look at the ingredients list in the picture. All of those ingredients are known to raise testosterone. After two months, mine increased to 5.7, and then a couple of months after that, it was 6.2, which is still below the low reference range of 6.6. Furthermore, I am sure that at least some of the increase is attributable to weight loss in those two months. But there is evidence that these supplements work– they just don’t work very well. Something else is needed.
The step up from supplements (Tongat Ali, et al) is peptide therapy (such as Kisspeptin-10), and the step after that is Enclomiphene (a prescription drug), with TRT the step of last resort after Enclomiphene. I think the peptides are safer and more natural than Enclomiphene, and can similarly raise testosterone.
Here is some research data on Kisspeptin-10:
Overall, for testosterone support, I think the most important thing is weight loss, followed by strength training. Then, from weakest to strongest, I think it stacks like this: (1) supplements, such as Tongat Ali, Boron, etc. (2) the peptides Kisspeptin-10 and Testagen, (3) Enclomiphene, (4) exogenous testosterone, or TRT (Testosterone Replacement Therapy). I think Enclomiphene has a place (as does TRT), but the peptides should be tried first.
Some men will go straight to TRT. Unfortunately, TRT will down-regulate your body’s natural testosterone production, and in doing so it will lower your fertility. The down-regulation is recoverable (primarily with HCG and peptides), but it takes a bit of effort to restore your natural testosterone production after TRT.
TRT Off Ramp
I recommend not attempting to discontinue TRT if you are simultaneously trying to cut weight. You cannot beat physics, and weight loss will always boil down to calories in vs. calories out, and losing weight almost always results in muscle loss. TRT can help minimize the muscle loss, so only address one problem at a time: (1) lose weight, or (2) stop TRT. Don’t try to do both at once.
The protocol described here is mostly as provided by Dr. Trevor Bachmeyer, with some additions from other sources:
This protocol is based on someone that had been doing 180mg of Testosterone weekly (regardless of injection frequency), and wants to quit TRT.
Measure Your Blood Work
Lab reference ranges say nothing about what is optimal, plus the reference ranges have been slowly being revised downward for the last several decades. The below numbers are what Dr. Bachmeyer considers to be optimal.
Total Testosterone should be between 900 and 1200, and typical lab reference range is 264-916. Free testosterone should be between 20 and 30, and typical lab reference range is 6.6 and 18.1. Estradial should be between 25 and 40, and typical lab reference range is 20 – 55 pg/mL (picograms per milliliter), or equivalently, 73 – 202 pmol/L
These values can vary slightly depending on the lab and the assay method used. Some labs use a narrower reference range of 10 – 40 pg/mL.
Cortisol in the morning should be 15 to 25, and cortisol in the evening should be less than 10. Cortisol is your biggest enemy when stopping TRT. It is the antitheses of testosterone. If cortisol is inverted, i.e. low in the morning, and high in the evening, your metabolism is stuck in “all gas, no brakes” threat mode that needs to be fixed first.
Fasting insulin: less than 6.
Run a mineral panel. If you are deficient in any mineral, supplement it.
Key Uptakes
Don’t stop TRT cold-turkey. Take 3 to 4 weeks to cycle down, and then take an additional 4 to 12 months to complete the process:
Week 1: go down to 140mg
Week 2: 100mg
Week 3: 50mg
Week 4: nothing
Also, when doing TRT your LH and FSH will go to zero. That can cause testicular Leydig cells to atrophy and die. To keep them from dying, you should have been doing HCG 500iu twice a week while doing TRT. That should keep your testosterone factory functional, even if otherwise not producing. If you haven’t been doing HCG, then start that now.
After stopping TRT (from 180mg, to 140mg, then 100mg, then 50mg, then nothing), begin the bridge protocol below. But be prepared that during the first 90 to 100 days you will not feel your best. Your mood is going to suffer, judgement will likely be impaired (as is typical when you don’t feel your best), your training is going to suffer, and recovery will tank. Be prepared for that.
Bridge Protocol
- You need growth hormone support. Without it, your insulin sensitivity during the “off ramp” protocol will plummet, and you will lose vital muscle. If you are currently on HGH, now is not the time to stop your HGH.
If you are not on HGH, begin growth hormone support peptides CJC-1295 no-DAC / Ipamorelin (200mcg daily) and Tesamorelin (1mg daily), taken before bed, and preferably 4 hours after the last meal (fewer hours than 4 after the last meal is better than skipping it altogether). - Increase HCG 500iu to 3 times per week, unless your estradial is above 50 (which it almost certainly will not be) in which case keep HCG 500iu at two times a week for a couple more weeks.
- Enclomiphene. 6.25 mg daily. Morning is best. If your LH doesn’t move after 4 weeks, increase it to 12.5 mg daily.
- Kisspeptin-10. 100mcg daily.
- Zinc Picolinate. 50mg/day
- Magnesium Glycinate. 500mg at end of day
- Vitamin D. 250mcg daily
- L-Theanine. 300mg daily
- DIM. 200mg capsule daily. This will help balance and control estradial (estrogen). It is an estrogen metabolism optimizer.
- Boron.
Boron Supplementation
Recommended Doses
- General health / dietary intake: 1–3 mg/day
- Therapeutic / hormonal support: 3–10 mg/day
- Upper tolerable limit (established by some researchers): ~20 mg/day
- The EU has set a safe upper limit of 10 mg/day
There is no official RDA (Recommended Dietary Allowance) for boron, as it hasn’t been classified as an essential nutrient, but research supports its biological importance.
Why People Take Boron
1. Hormone Regulation
- Studies suggest boron can raise free testosterone and reduce excess estradiol (E2) in men
- A notable study found that 10 mg/day of boron for one week significantly increased free testosterone and decreased E2
- May help optimize the testosterone-to-estrogen ratio
2. Bone Health
- Boron helps the body use calcium, magnesium, and vitamin D more effectively
- May reduce urinary excretion of calcium and magnesium, supporting bone density
3. Vitamin D Enhancement
- Boron appears to slow the breakdown of vitamin D, raising circulating levels
4. Anti-Inflammatory Effects
- Some research shows boron can reduce inflammatory markers like CRP (C-reactive protein), IL-6, and TNF-α
5. Brain & Cognitive Function
- Low boron intake has been associated with poorer attention and memory in some studies
6. Joint Health
- Populations with higher boron intake in their diet tend to have lower rates of arthritis