Reviewed by Denise Asafu-Adjei, M.D., MPH

A couple of years ago, PN co-founder John Berardi, PhD, shared a shirtless picture of himself to celebrate his 47th birthday.

He referred to it as his “anti-regress pic” and expressed gratitude for 30 years of squats, deadlifts, presses, and chin-ups—among other workouts—for his defined six-pack, muscular chest, and prominent biceps.

The question many commenters raised:

“Are you on testosterone?”

In a follow-up post, Dr. Berardi clarified that although he wasn’t against testosterone replacement therapy (TRT) for those who require it, he himself was not undergoing this therapy, and his testosterone levels were simply “normal.” He also shared some insightful thoughts on testosterone and aging.

Dr. Berardi’s perspective contrasts with the common narratives, particularly in today’s climate where…

• The prevailing view suggests that diminishing testosterone signifies aging, weakness, and impotence—not to mention a risk to masculinity.
• More and more middle-aged men are opting out of standard medical checkups for men-focused telehealth services that specialize in testosterone enhancement.¹
• Reddit communities have emerged solely to fixate on neuroscientist Andrew Huberman’s supplement suggestions for enhancing testosterone.
• Media outlets continuously produce article after article about “testosterone-boosting” foods recommended for consumption and “testosterone-lowering” foods to be avoided.

Whether you’re a coach answering the “How do I optimize testosterone?” inquiries from clients—or just a regular guy looking to age gracefully—it’s simple to feel overwhelmed and bewildered by the conflicting messages.

Are decreasing testosterone levels typical?

Do testosterone-enhancing supplement regimens truly yield results?

Who gains from testosterone therapy—and who does not?

In this article, we will delve into those inquiries and more.

What is testosterone?

Produced by the testes, testosterone is the hormone responsible for male sexual traits such as large muscles, deep voices, and hairy chests. It functions as a chemical messenger that is crucial for various bodily processes, including sperm generation and bone density.

(In women, who also require testosterone for regulating various functions, testosterone is produced by the ovaries and adrenal glands. Their bodies simply generate significantly less; about 10 to 20 times less than men.)

Likely due to its association with muscle development and sexual desire, many cisgender men view testosterone in binary terms, perceiving lower testosterone as negative and higher testosterone as positive.

Nevertheless, it is more precise to view the relationship between testosterone and health as a spectrum that ranges from too low (problematic) to too high (also problematic), with the healthy area positioned between the two extremes, according to Denise Asafu-Adjei, MD, MPH, urologist, men’s health specialist, and assistant professor of urology at Loyola University Chicago-Stritch School of Medicine.

The chart below illustrates that the perils of extremely low testosterone mirror those associated with excessively high testosterone levels (typically only attainable through the use of anabolic steroids).