The Skinny on Testosterone (With Dr Bhavsar)

Written by Bony to Beastly on February 1, 2017

In the Beastly community, we get a ton of questions about testosterone. It’s a tricky hormone that has a huge effect on our physiques, and there’s a lot of misinformation out there. In the past, we stuck to the standard advice: get good sleep, eat well, eat a lot, follow a good lifting program, and make sure you’re getting enough sun or supplemental vitamin D.

Then we got lucky. Dr Bhavsar joined.

Dr Bhavsar, or DoctorB, as he’s known around the community, is a urologist. We had to look that last word up. A urologist is a doctor who specialises in the male reproductive system, aka, the type of doctor you’d see about any issues relating to testosterone.

He started by writing an article in the community about sleep (member link here), then he gained 30 pounds, and then he wrote an article about testosterone. Both of his articles were big hits in the community, and we thought the testosterone one could be great as a blog post.

In his article, he talks about the link between skinniness and testosterone, how to raise your testosterone naturally, and how that may help you bulk up more quickly and leanly. He’ll also briefly go over both the pros and cons of taking testosterone (aka “steroids”), just so that you can better understand what’s going on with so many guys in the fitness industry.

The information on raising your testosterone naturally is so simple and healthy that I think it’s something that everyone who wants to build muscle should take advantage of.

This is where we hand the article over to the expert.

INTRODUCING DR BHAVSAR

Hey, all. I’m going to be making a lot of gross simplifications to keep this easy to follow and useful for you guys. That said, I have a fair amount of knowledge in this area. I’m by no means the definitive resource, as I’m constantly learning about new things, but I have studied testosterone quite extensively as a urologist, and I have a lot of experience doing testosterone replacement therapy for my patients.

As a urologist, I got quite a bit of general medical training, and also more specifically about testosterone. The greatest thing that helped me build muscle was discipline, but I did find that it helped to know how to boost my testosterone naturally.

MY TRANSFORMATION SO FAR

I was skinny my entire life. 5′ 10″ and fluctuating between 125 to 130 pounds. For most of high school, I was around 120 lbs.

I really wasn’t happy with the way I looked, but I used to believe that no one could change their body shape. That it was primarily determined by genetics, and there was little one could do about it. I always thought bodybuilding was for those “big guys” I saw, and that I could never do that.

After medical school, I learned all about the physiology of metabolism, weight gain, and the obesity epidemic in this country (USA) and many others. This was always changeable. If obese people can lose weight, even against impossible odds, then why couldn’t I gain weight?

But even with the knowledge that I could change my body type, I still struggled.

Some time later, during one of my short-lived periods of motivation, I stumbled across this website. I don’t know what it was, but everything clicked. The people who created this website, being former skinny guys themselves, seemed to hit every nail regarding the struggle that I had gone through and how I felt. After reading almost all of their free content, I decided to go ahead and buy the program. Then I read the entire eBook. Twice.

By this point in my life, I was a newly practicing physician with 2 small children at home. Going to the gym wasn’t feasible, so I brought the gym home by making my own. I initially started with 1 set of adjustable-weight dumbbells (5-52.5 lbs), a pull-up bar, and a bench. I completed all 4 phases of the program with just these 3 things.

At the end of the b2B program, I weighed in at around 160 lbs or so. I cut afterwards and then bulked again, and just finished another cut to get rid of some excess body fat. Here I am 2–3 days ago at the end of my cut:

DoctorB Ectomorph Transformation: How to Raise Testosterone Naturally

DOES BEING SKINNY MEAN I HAVE LOW TESTOSTERONE?

There is no relation between being skinny and having low testosterone unless there are other medical conditions at play.

If anything, the opposite is true. Fat cells convert testosterone to estrogen; therefore obese people tend to have lower testosterone levels and higher estrogen levels. Skinny people, however, tend to have fairly healthy testosterone levels. Not necessarily higher, per se, but normal.
The main benefit skinny people have is that with their normal testosterone, they are in good shape to build muscle, and with their naturally high metabolisms, they are usually able to do so quite leanly.

Case in point, me. I had high testosterone during puberty, but I was skinny as a twig. I also never did any weight bearing exercises, and I ate like a mouse. But had I done the right things, my high testosterone production could have helped me build a nice body more easily.

The same is true with most skinny people.

THE POWER OF TESTOSTERONE

Testosterone itself is a steroid. In men, 90% of testosterone production is generated by the testicles and 10% is made by the adrenal glands.

It plays a lot of critical roles in both men and women and is an essential hormone in both, but, obviously, it does more in men and is needed in greater quantities. Here, I’ll just go over how testosterone affects men.

Testosterone is associated with the following benefits:

  • Increased lean muscle mass
  • Increased metabolism
  • Increased memory
  • Slight improvement in lipid profile (lowers LDL and raises HDL)
  • Increases libido (sex drive)
  • Assists in spermatogenesis
  • Indirectly helps with bone density
  • Assists in expression of male genetic traits (facial hair, body and pubic hair, baldness, and prostate growth)
  • Decreased adipose tissue (less fat)

Symptoms of low testosterone include:

  • Low sex drive
  • Less energy
  • Fatigue
  • Loss of appetite
  • Fat gain
  • Loss of muscle
  • Difficulty maintaining muscle
  • Decreased concentration
  • Erectile dysfunction
  • Infertility

If a person has low testosterone, the symptom that is by and far the most common is a low sex drive.

A lot of my patients want to know if they should be on testosterone because they suspect their testosterone levels are low. As physicians, we don’t treat the number; we treat the symptoms. So if someone has low T but no symptoms, we will often discourage treatments, but if these symptoms are also present, then we may treat with testosterone.

TAKING TESTOSTERONE FOR BODYBUILDING

As a beginner, building muscle is relatively quick and easy with or without steroids. Over time, progressing becomes slower and harder. Eventually, if training and diet are good enough, people reach their genetic ceiling.

One of the ways that a body limits growth is by regulating how much testosterone it will release. By using testosterone, one can blow way past one’s genetic potential by increasing the rate at which muscle fibres can pull in new myonuclei from satellite cells (more on that here). Calories are then directed into the muscles to feed this growth. Taking testosterone also greatly diminishes the time needed for recovery, allowing people to work out far more frequently. All of this speeds up muscle growth while reducing fat accumulation.

However, there are several adverse side effects to taking testosterone, and people who take testosterone for bodybuilding often do so with illegally acquired testosterone products and little to no knowledge of what it will do to them.

The side effects of testosterone use are not inconsequential:

  • Lifelong dependency on testosterone (screwing up your hormones permanently)
  • Acne
  • Increased risk of breast development and tenderness
  • Increased risk of blood clots and pulmonary embolisms
  • Increased risk of strokes and heart attacks
  • Structural changes in the heart
  • Higher risk for prostate enlargement
  • Fluid retention and swelling
  • Infertility

Also, when people start testosterone, they usually end up on it for life.

When the brain sees that our testosterone is getting low, it produces luteinizing hormone, signalling the testicles to produce more testosterone. Then, when testosterone levels start getting high, it stops production of luteinizing hormone, telling the body to stop testosterone production. This maintains balance.

If a person takes testosterone, the brain thinks there is plenty being produced and cuts back on luteinizing hormone production. However, testosterone levels don’t go down because the testosterone is being given externally. Luteinizing hormone production then drops to almost zero, which still has no balancing effect.

Over the course of a few months, the testicles begin to shrink and stop producing both sperm and testosterone. This is reversible in the short term, but the longer one continues to use testosterone, the more permanent it becomes, eventually causing permanent infertility and permanent cessation of the body’s ability to make its own testosterone. At that point, the person is nearly sterile and will be reliant on external testosterone forever.

When taking T for bodybuilding, it must be cycled to attempt to minimise effects of shutting down natural testosterone production. (I am not going to lay out how to cycle it because I don’t want people trying to do it on their own. Remember, this guide leaves a lot of details out and grossly oversimplifies things.)

Overall, I don’t recommend using testosterone for bodybuilding. You can build muscle without it. Besides, the Bony to Beastly program already has great tips to assist in boosting testosterone production naturally.

For those who want more, I would consider using an herbal testosterone booster like ashwagandha (member guide here), which may help with natural testosterone production in the body (study), or tribulus, which may increase your libido.

If you still want to use external testosterone, it would be best done under a physician’s guidance to monitor labs and ensure safety. Doing it on your own can have serious health consequences.

HOW TO INCREASE YOUR TESTOSTERONE PRODUCTION NATURALLY

People can raise their testosterone quite a lot through lifestyle. I have seen people raise their testosterone from 260 (low) to 550 (normal) and others go from low normal (350 or so) to high (800) just through lifestyle changes.

It is something you can do on your own. Granted, a lot of factors matter.

The first step is to make sure you aren’t limiting testosterone production unnecessarily, and there are multiple factors that can significantly lower testosterone production.

Some common examples of things that limit testosterone production:

  • Being overweight
  • Being overly sedentary
  • Eating a poor diet
  • Having diabetes
  • Using prescription narcotics
  • Illness
  • prior testosterone abuse

The 3 pillars of raising testosterone naturally revolve around lifting heavy things, eating healthy, and getting adequate sleep.

The Bony to Beastly program will help with the lifting and eating, and for help improving your sleep, I wrote a guide for Beastly members here.

(It’s not a bad idea to see a doctor to make sure any other factors are properly treated, and trying to raise testosterone naturally doesn’t always work, but I have seen plenty of cases of people raising their testosterone significantly on their own.)

FREQUENTLY ASKED QUESTIONS

Some of these are common testosterone questions from patients; others come from members of the Beastly community.

Q: How do I find out my level of testosterone?

A: See your GP and ask for a blood draw. Testosterone levels should be drawn between 6 AM and 10 AM, when testosterone is at it’s natural highest levels.

Q: What should my testosterone level be if I get it checked?

A: A normal testosterone level is between 350 ng/dl and 700 ng/dl for most adults. Between 700 and 1500 ng/dl is considered high testosterone and is usually seen in teenagers undergoing puberty. Over 1500 ng/dL is generally considered supraphysiologic and is usually not achievable unless someone is using pharmaceutical testosterone or has a testosterone producing tumor.

Remember that we tend to treat people with low testosterone only if they also have symptoms.

Testosterone circulates in 3 forms in the body. It can be bound to sex hormone binding globulin (SHBG), albumin, or in free form. The testosterone measurements you would get from a standard lab test would measure all of these together. Interestingly, only a portion of it is actually available to the body. None of the testosterone bound to SHBG is available, about 20% of that bound to albumin is available and all of the free testosterone is available. 60-70% of testosterone circulates bound to SHBG, roughly 25% circulates bound to albumin, and just the remaining few percent is free testosterone.

In medicine, we only care about available testosterone, and it is very hard to measure reliably. Furthermore, no established normals have been set for bioavailable testosterone. This is why some people can have borderline low testosterone, feel just fine, have a good sex drive, be muscular, and have no issues packing on more muscle.

Q: Does testosterone go down as I get older and will that affect my gains?

A: Yes and no. Yes, testosterone goes down with age. A 40-year-old will not have the same testosterone as a 20-year-old. However, much of the testosterone decline is attributable to decreased physical activity and weight bearing exercise, increased fat, and a more sedentary lifestyle. Following b2B or another active lifestyle into middle age will allow you to retain a relatively high testosterone level late into life, and one can maintain a high level of muscle mass, or even build muscle, at any age.

Q: Should I work out in the morning when my testosterone is at its highest?

A: No. Work out whenever you want. Testosterone goes up and down throughout the day. What matters is your overall level of testosterone, not hourly fluctuations. Your body is equipped to build muscle at any time of day, provided you get enough to eat and get a good night’s sleep. The daily circadian rhythms in your body have no bearing on when is the best time to work out.

Q: I heard if I take high doses of testosterone, I can turn into He-Man by just sitting on my couch without exercise. Is that true?

A: No. While it is true that boosting testosterone to supraphysiological levels can cause fat loss and muscle growth with zero exercise, the gains are not that significant. Once body fat stores get low enough, muscle growth will stop without a caloric surplus. Also, without exercise, a lot of that excess testosterone will begin to get converted to estrogen since it isn’t being used, putting one at risk for all sorts of adverse side effects.

Q: Does marijuana affect my testosterone levels?

A: This is a tricky one. The short answer is yes, it can. The long answer is that it depends on a lot of factors. Light marijuana use has never been shown to affect testosterone use. Moderate to heavy THC levels in lab animals can cause significant testosterone and estrogen problems, but this doesn’t seem to correlate well with humans.

It appears that some humans can smoke a ton of MJ with no ill effects on their hormones, and others can start to develop estrogen excess and testosterone deficiencies. A lot of this seems to be genetic, but the jury is still somewhat inconclusive on this.

Q: What about other drugs, like alcohol, caffeine, cigarettes, etc?
A: A few other things can cause low testosterone, notably chronic narcotic use (like vicodin, percocet, etc), and alcohol abuse (not just drinking once in a while at bars). Cigarettes can affect sperm counts, but it hasn’t really been associated with low testosterone.

Q: You can’t get huge like those bodybuilders on TV without testosterone, can you?

A: There may be truth to this, but a lot depends on your genetics. Those with North African, Nordic or German heritage seem to have a better genetic ability to become massive, whereas Asians seem to have a harder time getting huge. Obviously, there are plenty of exceptions. The reality is, yes you can get huge on your own, but your definition of what defines being huge depends largely on your perception. To become ridiculously large, oftentimes some type of hormone manipulation is necessary.

Q: Does masturbating or having sex spike testosterone levels? Will this affect my ability to build muscle?

A: Yes to the first question, no to the second. This is the same reasoning as why working out in the morning, when your testosterone is at its highest, won’t impact your ability to build muscle. The testosterone spike associated with masturbation or sex is too short-lived to have a meaningful impact on your muscle gains.

Q: You say that a low sex drive is the most common symptom of low testosterone. What’s considered a high or low sex drive for a man?

A: A normal male sex drive is dependent on age, but a male will tend to think about sex several times a week or respond positively toward an erotic stimulus or person. People with low libido often don’t get that response.

Q: I saw a study about testosterone levels increasing post-vasectomy. Do you know much about this?

A: Yes, testosterone levels can elevate some after a vasectomy, but this is a statistical finding, not a clinical one. In other words, the number is higher, but not enough to mean anything relevant for your body. Usually, changes over 150 ng/dL are needed before clinical changes become apparent.

Q: With testosterone and the circadian rhythm, I think I remember reading something about the consumption of carbs in the morning lowering the natural morning testosterone peak. Any truth to that? And if so, would it be negligible?

A: Carbs are considered essential for the production of testosterone, and low carb diets have been linked to lower free testosterone (study). So quite the opposite, generally.

Specifically, this study showed that athletes undergoing high-stress activities like exercise showed lower testosterone and higher cortisol levels if starting in a carb deficient state (study). So I’m not sure that you would want to avoid carbs. Maybe refined sugars, but not carbs altogether.

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  • Tiredness, distractions, stress, and busyness throwing your routine out the window

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So, what'd you think? 24 responses below.

Aaron

Thanks for the good read

Shane Duquette

Our pleasure, Aaron 🙂

Andy

Does anxiety have any kind of correlation with testosterone levels? If you have general anxiety does this mean you have low testosterone? Does being anxious and stressed lower testosterone?

Phil

Most likely, stress is a factor that has negative influences on many bodily functions

Shane Duquette

Quoting DoctorB here:

To answer your question, anxiety won’t directly lower testosterone. But it can indirectly. In other words, short term or temporary anxiety would be fine, but if someone was always anxious, it may lead to poor diet and sleep habits which in turn may lower testosterone. Does that make sense?

Ravi Soni

Great article, Dr B & Shane!

Shane Duquette

Thank you, Ravi 😀

Vlad

Masterburation is my new favorite word! x )

Shane Duquette

Noooo, I corrected that mistake and then uploaded a version of the post without the mistake fixed!

Dave Francis

Fascinating read. I was wondering how I can adapt my curent eating plan to boost my metabolism (similar to the Doc, I’m shredding in prep for another bulk) so this information is perfectly timed. I’ll be looking more into ashwagandha studies and the potential effects it can have.

Shane Duquette

Glad you liked it, Dave! Let us know how you find ashwagandha if you decide to try it 🙂

vasanth

hey shane very nice post ,i have a requests for u
can u do a article on sleep and how to improve or maximize sleep

Shane Duquette

That’s a good idea, Vasanth 🙂

It’s so important with building muscle that it really does merit its own post. (And it’s already a component of our program, and a popular article of DoctorB’s in the community.)

vasanth

and shane i have one more question
do u believe weight lifting can increase testesterone levels in a person
are there any studies for the same

i am 24 ,i have only started bodyweight exercises and i believe that i am getting some acne very mildly though ,is there any correlation between testerone levels and weightlifting ??do they tend to increase??
i would like to know ur opnion on this???

Shane Duquette

It should, yeah! Both acute and longer term positive changes. Lots of studies to this effect, and DoctorB notices good improvements with lifestyle changes like this as well… but it’s one of many factors. You’d want to combine good exercise with good nutrition and good sleep.

Brad Zinser

Thank you for this extremely valuable resource, Shane and Dr. B! I’ve read many articles on this topic and am grateful for a fully-qualified one I can trust.
Question: Re: Prescription narcotic use/misuse. I was on large doses of pain killers for early onset arthritis from 2007 til 2011, and then again (for 6-8 weeks at a time) following two shoulder surgeries in May 2014 and July 2015 (I’ve been 100% off them since). Given that by 2009 I’d developed dependence and was taking large doses… may I have caused permanent damage to body and crippled my ability to produce testosterone normally? And if so, is there any special way I can reverse the damage (in addition to the lifestyle changes mentioned above). I’m a 46 year old guy and member of the B2B community. Thanks!

Shane Duquette

Our pleasure, Brad! Quoting DoctorB here:

The best thing to do initially would be to go to your primary doctor and ask for a morning testosterone level drawn between 6 AM and 10 AM. If your testosterone levels are fine (above 400), you should be fine and not have much problem in terms of sx or inability to put on mass. However, if it is borderline (350-399) or low (less than 350) then you need to have a repeat in 6 weeks. If both are low, you can either attempt to raise it naturally as in the article or via pharmaceutical testosterone. There aren’t any proven methods to increase testosterone via herbals or other treatments other than what I wrote about in the article. There are many claims but little evidence. If testosterone really is hampered, you may want to consider bioidentical hormone replacement or just straight pharmaceutical testosterone replacement under the supervision of an endocrinologist or urologist.

Krsiak Daniel

Thanks DoctorB! … and Shane 😉

Shane Duquette

Our pleasure, DanielK!

Patrick

Very informative Dr. B! And thanks for the great read guys! I noticed that you didn’t really touch on supplements, Doc. So I was wondering if you had any advice in that realm since actual, proper treatments are typically reserved for those who are exhibiting symptoms and have a more sincere medical need. In particular, I know there’s been some talk about things like Tongkat Ali and Maca being superb for raising T-levels. I know there’s always the concern about the authenticity of the herbs/roots, so I know brands like Herbolab go to great lengths to prove that their supplements are genuine. Any thoughts?

Shane Duquette

Hey Patrick,

We briefly mention supplements in the article, and the only reason we don’t go into more detail there is because they can’t really do all that much. Tribulus (aka horny goat weed) seems to be good for increasing libido, but it won’t do much for your efforts in the gym. Of the available testosterone-related supplements, our favourite is ashwagandha. Not only can it boost testosterone a little bit, but it also helps with managing stress and even with building muscle. The research is still preliminary, it seems, but it’s one of those reasonably priced ancient supplements where the side effects tend to be positive ones 🙂

James Michael

Wow! Very useful information. I was wondering though, how do statins affect someone with low testosterone? Let’s say they were taking them to control their cholesterol, but they also presented symptoms of low testosterone. Would one have to pick between healthy T levels or healthy cholesterol? What would you recommend for that situation?

Shane Duquette

That’s a very good question and unfortunately I have to say that you should ask your doctor. Unfortunately, with a post like this one, I’m not really qualified to answer all of the questions.

Alex

This is a good read , thank for the doctor B sharing this valuable article with us. From this article you get good knowledge about testosterone and can you it for good like gain weight, good sex drive etc.

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