The complications no one talks about
Testosterone is often reduced to one thing, sexual health. But that’s only a part of the picture. This hormone plays a role in muscle strength, bone density, mood, memory, and even how the body stores fat.
So when levels drop, the effects don’t stay limited. Men may notice fatigue that doesn’t go away with rest. A gradual loss of muscle. Weight gain, especially around the abdomen. Some experience low libido or erectile issues, but others feel it more mentally, irritability, lack of focus, even symptoms linked to depression.
Left unaddressed, low testosterone can affect long-term health in ways many don’t expect. It’s been linked with reduced bone strength, increasing the risk of fractures over time. There’s also a connection with metabolic issues like type 2 diabetes and heart-related concerns.
But men rarely connect these dots early.
Because the symptoms don’t point clearly in one direction. They blur into everyday life—work stress, poor sleep, aging. So instead of asking questions, most just adjust and carry on.
Why awareness is still low
And this is where the gap shows.
Men’s health conversations still tend to focus on visible or urgent problems. Hormonal health doesn’t come up as often. There’s also a cultural layer to it. Talking about fatigue, low libido, or emotional changes isn’t always easy. It gets brushed aside or joked about.
So many don’t get tested. They don’t even consider it.
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There’s also the assumption that testosterone decline is “normal” with age, and therefore not worth addressing. But normal doesn’t always mean harmless.
TOI Health connected with Dr. Hetashvi Gondaliya, Diabetes & Endocrinology, CK Birla Hospitals, Jaipur to discuss low testosterone level, the early symptoms and if relying on supplements work.
At what age does testosterone typically start to decline, and how noticeable is it?
Dr. Hetashvi Gondaliya: In healthy males, the total testosterone level generally starts to decline gradually from the age of around 35, 40, with an average decrease of about 1% per year. This phenomenon is frequently mentioned in literature as Andropause or the decline of testosterone with age. The initial descent is usually so slight that it might not result in any noticeable symptoms for a good number of years. The levels vary greatly among individuals; thus, some men can have strong levels even at an old age, while others might experience a symptomatic shortage of testosterone at an earlier age. If the testosterone levels drop below the normal ranges adjusted for age, especially in combination with other health problems, then the clinical symptoms will become quite evident.
What are the subtle early signs of low testosterone that men often ignore?
Dr. Hetashvi Gondaliya: At the onset, the symptoms are quite vague and can be easily mistaken for the effects of stress or simply getting older. It involves lower sexual desire or interest and only occasional erectile issues, tiredness that seems to go on, less energy or drive, getting easily annoyed, slight depression or having difficulty concentrating, more fat accumulated around the belly, less physical strength and trouble getting muscles even when you do exercise. These initial symptoms tend to be ignored or blamed on lifestyle, stress, or other conditions. If symptoms continue without relief or even worsen, then it is time to consider getting these checked.
How do lifestyle factors like diet, sleep, and stress affect testosterone levels?
Dr. Hetashvi Gondaliya: Eating a balanced diet containing sufficient healthy fats, proteins, zinc and vitamin D can help to produce hormones. Testosterone production can be affected by deficiencies or incorrect nutrition. Good sleep quality and longer duration of sleep decrease stress hormone, thus help testosterone production. Stress management techniques, such as meditation, relaxation, and regular physical activity, can be effective in counteracting the negative effects of stress. Obesity, excessive alcohol consumption and smoking are three of the lifestyle factors that most directly relate to the drop male hormone levels.
How does testosterone drop impact metabolism, weight gain, and muscle mass?
Dr. Hetashvi Gondaliya: Lower testosterone levels have been linked to increased fat accumulation, especially in the abdominal area, and decreased basal metabolic rate. Thus, the individuals are prone to gaining weight and developing insulin resistance if these factors occur together with other metabolic risk factors. Testosterone hormone plays a crucial role in the growth of muscles because it supports the synthesis of muscle proteins. When their levels are low, it results in a decrease of muscle mass and strength. If testosterone remains low for a long time, it may not only cause bone loss but also increase the risk of falls and fractures.
Are over-the-counter supplements effective in boosting testosterone?
Dr. Hetashvi Gondaliya: There is very little data demonstrating that over the counter supplements have any significant impact on testosterone regulation. A number of supplements indicate little or no beneficial effect in clinical trials. It is possible that some products may not contain the potency or purity as claimed. Since pharmaceuticals are regulated, the benefits of over-the-counter supplements tend to be small, with the major concern being safety; therefore, it is important to exercise caution. Since supplements can interact with medications or cause side effects, it is advisable to consult a doctor before taking them.
Medical experts consulted
This article includes expert inputs shared with TOI Health by:
Dr. Hetashvi Gondaliya, Diabetes & Endocrinology, CK Birla Hospitals, Jaipur
Inputs were used to explain the signs of low testosterone, the symptoms seen and if supplements work.
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