Top 3 Ways to Increase Testosterone


There are several ways for a man in andropause to increase testosterone levels in the blood. The top three uses are: testosterone, clomiphene, and human chorionic gonadotropin (HCG). Each is discussed in light of risks and benefits, to aid in your decision-making process. Nothing replaces your individual history, physical exam and laboratory findings, so the final decision should be made with professional medical and personal attention to your own individual needs analysis. After hormone replacement, body composition can be optimized with diet and exercise.

Hormone balance works like a thermostat: when it’s too high on testosterone, LH turns off. When testosterone is low, LH turns on.

First, let us review how testosterone is produced by the Leydig cells in the testes: through feedback inhibition by the brain, specifically in the pituitary gland that is seated in the hypothalamus. Like a thermostat, when the pituitary gland “sees” more testosterone in the blood stream, it decreases its own Lutenizing Hormone (LH) in the blood stream, and  conversely, when there isn’t any to “see”, LH is automatically released to increase testicular testosterone production.


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Figure 1. Testosterone Feedback Loop. When Lutenizing Hormone (LH) is released from the brain, it “talks” to the testes, telling them to produce testosterone.

When the testes produce testosterone, it tells in the brain not to release more LH. In contrast, when testosterone levels are low, LH goes up to stimulate more testosterone production by the testes.

3 Ways to Increase Testosterone Levels

1. Testosterone injection

Pharmaceutical testosterone cypionate works for male andropause by binding testosterone receptors. It is an oil-based solution injected into the muscle or under the skin. A starting dose may be 50 mg, dosed twice per week, or every 3.5 days. It’s not the dose alone that counts: its the sensitivity of the testosterone receptors. That explains why some men are on lower doses than others (i.e., they have a sensitive receptor).


Benefits. Beneficial side effects that testosterone injections may cause are: improvement in morning erections, increased penis size, increased duration of sexual activity, more sexual desire or libido, smoother skin, increased muscle mass and strength, improved mental acuity, less depression and more motivation.

Side Effects. Providing supplemental testosterone is a good choice to increase blood levels, but several things bear consideration: the boost in testosterone levels tells the brain not to secrete LH. In turn, the testes’ Leydig cells stop producing testosterone. The testicles shrink and the man becomes infertile.

BEST T Mechanism COPY

Image 1. Testosterone Replacement Therapy (TRT). Testosterone injections take away the ability for the testes to make their own testosterone, leading to infertility. It may cause male-pattern baldness (a bald spot on the back of the head), shrinkage of the testes (because they no longer make testosterone), and female breasts (because the new testosterone may increase estradiol levels).

Testosterone increases red blood cells and oxygenation and the extra cells may lead to clotting. One may consider donating blood when counts are high, but many opt not to and do very well. Other side effects include acne and aggression. Side effects can be managed by the patient and doctor, who may consider everything from stopping testosterone, decreasing the dose, and/or adding another drug to inhibit testosterone’s conversion to estradiol (e.g., for male breasts).

2. Clomiphene Citrate Pill

Clomiphene has been successful in treating infertility. It works by blocking estrogen in the pituitary. It fools the brain into thinking estrogen is low, and LH increases, which tells the testes to make more testosterone. Clomiphene citrate is a 12.5 mg, 25 mg, or 50 mg pill that can be taken every other day.

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Benefits. Because the testes keep producing testosterone, clomiphene preserves fertility. The testes may actually increase in size because they are working to increase testosterone.

Side Effects. Usually well tolerated, clomiphene citrate’s side effects include headache and blurry vision. Closer inspection reveals that because the pituitary gland sits near the eye’s optic nerve in the brain cavity, changes in vision could signal increased pituitary growth in a closed space; therefore it is perhaps best to treat visual side effects by stopping clomiphene citrate and/or following up on pituitary size.

All the other side effects are the same as seen with increased testosterone, including a possible need to add another drug that halts the conversion of testosterone to estradiol.


3. Human Chorionic Gonadotropin (HCG) Injection

A peptide, HCG is commonly used in The HCG Diet, and in combination with testosterone therapy. Found in placenta and in the urine of pregnant women, HCG is a molecule that “looks” like LH so it talks to the testes and tells them to increase their own testosterone production.  A starting dose for andropause is 1000 IU, increasing up to 1500 IU. The frequency may be twice a week or every 3.5 days intramuscularly (in contrast, the dose and frequency for the HCG Diet can be 200 IU daily).

Courtesy Scripps Labs

Benefits. HCG is popularly used when one wants to increase testosterone and preserve fertility and testicular size, either alone or in conjunction with testosterone. It allows a man to “keep using” his testes for sperm and testosterone production. It is reasonable to start replacement with HCG, see the response to it, then further refine treatment options.

Side Effects. HCG is usually very well tolerated (hence its popularity), the most common complaint is pain on injection. HCG decreases appetite and may lead to abdominal pain or bloating. Seek immediate medical treatment if rare effects occur: allergic hives, rash, itching, wheezing, chest pain, leg swelling, shortness of breath, arm or leg numbness, visual changes.

All the other side effects are the same as seen with increased testosterone, including a possible need to add another drug that halts the conversion of testosterone to estradiol.





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If you are considering hormone replacement, remember that your body is complicated and you deserve a solid talk with your doctor and a thorough discussion of all possibilities for testosterone replacement therapy (TRT). Informed consent means knowing all the options for general information, and understanding specific side effects like the risk of infertility, baldness, testicular shrinkage, or blurry vision.

Get back your quality of life and renew your zest for living instead of doing what most others are doing: nothing about diet or exercise. If you’re doing diet and exercise to the best of your ability and are not seeing proportional results, it could be that you are aging and need hormone replacement.

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Other articles by Dr. Margaret Aranda:

What’s a Normal Testosterone Level?

What is Andropause?

5 Supplements and Prostate Cancer

The Effects of Aging

Top 5 Statistics on Aging in America

Aging Over 50

Your Health is Your Wealth

The Cost of US Healthcare

10 Health Benefits of the Low-Glycemic Diet

Getting Started: Being Practical

I Might Have Prediabetes

10 Complications of Diabetes

What is High-Intensity Interval Training?

10 Health Benefits of High-Intensity Interval Training

I Might Have Prediabetes

Correcting Chronic Metabolic Syndrome


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