Where does low testosterone come from?

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Low testosterone levels, or hypogonadism, are not just a problem of age-related decline. In clinical practice, two broad groups are distinguished:

In most cases in bodybuilding and in practically healthy men, we encounter secondary hypogonadism, in which a disruption of the hypothalamic-pituitary-testicular (HPT) axis plays a key role.

⚠️ Important: If low testosterone levels don't cause any symptoms, treatment may not be necessary. Before starting any treatment, be sure to consult an endocrinologist or urologist-andrologist.

🧠 Diagnosis: How to tell if your testosterone levels are truly low

Normal values and threshold levels

According to international recommendations:

💡 When to take the test Since testosterone secretion is pulsatile and depends on circadian rhythms, the blood test is taken strictly in the morning (from 7 to 10) with a subsequent confirmatory repeat test.

What tests are needed?

• Total testosterone (morning, fasting)

• Free testosterone is especially important in obesity, when a lot of the hormone is bound to proteins.

• LH – helps determine the type of hypogonadism (low LH indicates secondary, high – primary)

• FSH, prolactin, estradiol

• SHBG – sex hormone binding protein (sometimes)

Clinical symptoms

The main signs of deficiency:

• 🔻 Decreased libido and erectile/ejaculation problems

• 🧠 Impaired memory, concentration, irritability

• ⚡ Loss of energy, chronic fatigue, lack of motivation

• ⚖️ Increased fat mass (especially in the abdominal area), osteoporosis

• 😴 Sleep disturbances (difficulty falling asleep, frequent awakenings), daytime sleepiness

🌿 Natural ways to increase testosterone

Physical activity

• Strength training with weights —especially multi-joint exercises (squats, deadlifts, bench press). Intensity and heavy weight training produce a better hormonal response than sheer volume.

• High-intensity interval training (HIIT) – short bursts of exercise effectively stimulate testosterone production.

• Reduce excess cardio – Long cardio sessions (long distance running, cycling) can increase cortisol and suppress androgen function.

Nutrition

Sleep and stress management

• Normalizing sleep : go to bed before midnight, sleep for at least 7–8 hours, ensuring complete darkness.

• Stress management – mindfulness practices, light meditation, breathing exercises.

• Limit caffeine – More than 400 mg of caffeine per day increases cortisol.

Weight correction

Excess fat, especially visceral fat, is an active endocrine tissue where androgens are aromatized into estrogens. Even a 5-10% weight loss can lead to a significant increase in testosterone.

💊 Supplements with proven effectiveness

Scientific research highlights just a few nutrients that can actually help:

1. Zinc

• Form: picolinate, bisglycinate, gluconate (not oxide)

• Dosage: 15–30 mg elemental zinc per day

2. Magnesium

• Form: bisglycinate, citrate, malate

• Dosage: 300–400 mg per day (preferably in the evening to improve sleep)

3. Vitamin D3

• Dosage: 2000–5000 IU per day (proven to increase testosterone in men with underlying testosterone deficiency)

4. Adaptogens

• Ashwagandha (Withania somnifera) – good data on increasing testosterone, decreasing cortisol.

• Tribulus terrestris – controversial: in some athletes it has an effect, but in a number of studies it is useless.

5. Boron

• Participates in the metabolism of vitamin D and estrogens; some data show an increase in free testosterone.

⚠️ Be careful

• D-aspartic acid (DAA) – with long-term use, in a number of studies, it reduced testosterone; it is not recommended as monotherapy.

• DHEA – works only with proven precursor deficiency; do not take without testing.

🏥 Medical methods for testosterone restoration

Testosterone replacement therapy (TRT)

Indicated for persistent decrease in testosterone (<8 nmol/l) with clinical symptoms that do not respond to conservative correction.

Side effects of TRT

• ✅ Increased risk of polycythemia – increased hematocrit (risk of thrombosis)

• ✅ Worsening of sleep apnea – if you already have it

• ✅ Androgen-dependent processes – prostate growth, acne

• ✅ Effect on fertility – a marked decrease or complete inhibition of spermatogenesis (through suppression of FSH)

How to preserve fertility on TRT

• Addition of hCG (human chorionic gonadotropin) – supports intratesticular testosterone and spermatogenesis.

• Refusal of replacement therapy in favor of clomiphene therapy where appropriate.

• Cryopreservation of sperm before starting TRT.

🔄 Post-steroid cycle testosterone recovery (PCT)

Why is this the most severe form of hypogonadism?

After discontinuing anabolic steroids (AAS), the HPTA's own hormonal axis is deeply suppressed across the board:

📌 Spontaneous recovery is possible. In 67% of men, spermatogenesis is restored within 6 months, in 90% within 12 months, and 100% within 24 months . However, PCT significantly accelerates normalization and restores quality of life much more quickly.

Common mistakes during PCT

1. Lack of hCG during and after the course → severe testicular atrophy and prolonged suppression.

2. Starting PCT with SERM immediately after stopping steroids → high risk of estrogen rollback and side effects.

3. Concomitant use of hCG and SERMs in PCT → hCG itself can maintain axis suppression if used incorrectly.

4. Insufficient duration of PCT – less than 4 weeks of SERM is usually not enough.

5. Taking “extreme” doses of SERMs → increased risk of thrombosis, worsening of lipid profile, fatigue.

6. Ignoring estradiol control – SERMs only block its action on receptors, but do not reduce estradiol levels per se.

A Smart PCT Strategy: A Step-by-Step Protocol

Step 1. Using hCG at the final stages of the course (not after)

• Objective: To prevent testicular atrophy and prepare the axis for subsequent SERM initiation.

• Dosage: 250–500 IU 2–3 times a week during the last 2–4 weeks of the course .

• For long courses (>12 weeks): adding hCG mid-course is a reasonable preventative measure.

• The total dosage of hCG for the entire period of use should not exceed ~5000–6000 IU to avoid receptor desensitization.

Step 2. A break (2-5 days) after the last hCG injection and a 2-week “window” after stopping steroids

This interval is necessary for a partial “washout” of exogenous androgens and to prevent estrogen rollback when starting SERM.

Step 3. Apply SERM for 4-6 weeks

💡 Clomiphene or tamoxifen? Clomiphene is considered a more potent LH stimulator due to its selective blockade in the hypothalamus, but has more side effects (mood swings, visual impairment). Tamoxifen is more biologically active at a lower dose and is often better tolerated. Its effectiveness is comparable, but its safety is higher.

Recovery control

• Tests (2–4 weeks after the end of SERM): total/free testosterone, LH, FSH, estradiol, prolactin.

• When should PCT be discontinued? If after 6 weeks testosterone levels are significantly below normal and there is no improvement in LH levels, repeat the SERM cycle or consult an endocrinologist to rule out organic pathology.

Post-PCT: retention of results

• A maintenance dose of tamoxifen (5–10 mg daily) is sometimes used for a month after the main course to consolidate the effect.

• Lifestyle modification (nutrition, sleep, stress management) to prevent recurrence of hypogonadism.

• The use of natural boosters (zinc, magnesium, D3) is a good preventative measure against recurrent decline after successful PCT.

🧪 Other causes of low testosterone

Age-related andropause

A gradual physiological decline in free and total testosterone levels with age after 30–40 years is normal, but not always pathological. If symptoms are present, gentle treatments are possible.

Obesity and metabolic syndrome

Excess weight, especially visceral obesity:

• Increases aromatase activity in adipose tissue.

• Reduces levels of SHBG (sex hormone binding protein).

• Leads to hyperinsulinemia, which further suppresses the HPA axis.

Weight loss is one of the most powerful non-drug ways to increase testosterone.

Chronic diseases

• Type 2 diabetes mellitus

• Kidney and liver diseases

• Obstructive sleep apnea syndrome (snoring with pauses in breathing)

• HIV infection

Taking medications

• Opioids (tramadol, morphine, codeine) – strongly suppress the HPA axis.

• Glucocorticoids (prednisolone, dexamethasone).

• Ketoconazole and some antibiotics.

• Antiepileptic drugs, neuroleptics.

🧪 The role of HEISEN st products in testosterone restoration

Our brand offers scientifically proven products to support the male hormonal system, both during PCT and during natural age-related decline.

💡 How to create a PCT protocol with HEISEN st. The line includes both essential PCT products and supporting nutrients to consolidate results. Using them together is the key to rapid and safe HPTA axis recovery.

❓ Frequently Asked Questions

How long does it take to restore testosterone without PCT?

From 6 to 24 months depending on the duration of steroid use, their dosage and individual characteristics.

Can hCG be used instead of SERMs during PCT?

No. HCG is unable to "wake up" the pituitary gland, as it mimics, rather than stimulates, LH. Using HCG without SERMs can even worsen suppression.

Do I need to get tested for estradiol during PCT?

Yes. Symptoms of high estradiol (fluid retention, gynecomastia, emotional instability) may require the addition of aromatase inhibitors, such as Anastrozole.

Will a testosterone booster supplement with tribulus help me?

Probably not. Most fitness boosters containing tribulus have failed to show significant increases in testosterone in placebo-controlled studies.

📋 Conclusion

Your health is in your hands. Don't wait for symptoms to worsen. Get tested, consult with a doctor, and choose the optimal testosterone restoration strategy. HEISEN st offers products and supplements to help you every step of the way—from safe PCT to maintaining peak performance without steroids.

👉 Go to the HEISEN st catalog and choose testosterone restoration products

This article is for informational purposes only. Before taking any medications or supplements, be sure to consult a qualified endocrinologist or andrologist.