FoundMyFitness Podcast #106: How To Increase Your Testosterone Levels Naturally

Host: Rhonda Patrick, Ph.D.
Guest: Derek, “More Plates, More Dates” (MPMD; co-founder of Merrick Health)
Date: September 5, 2025
Theme: Comprehensive, science-backed discussion on testosterone—its measurement, interpretation, optimization, lifestyle determinants, natural boosting strategies, supplements, TRT, women’s health, and hair loss.

Episode Overview

In this episode, Dr. Rhonda Patrick and Derek (More Plates More Dates) do a deep dive into the multifaceted world of testosterone. They explore testosterone's critical importance in men and women, how to accurately measure and interpret testosterone levels, lifestyle and environmental factors affecting hormones, natural and supplemental intervention strategies, the realities of testosterone replacement therapy (TRT), and address the complexities of testosterone’s role in women's health and hair loss. The conversation is practical and evidence-driven, integrating both the scientific literature and clinical/personal experience.

1. The Fundamental Roles of Testosterone (Men & Women)

[Timestamp: 05:25–08:54]

• Men:
  • Critical for muscle mass, bone density, neurological health, insulin sensitivity, libido, cognitive function, and sexual differentiation during puberty.
  • Testosterone’s metabolite DHT (dihydrotestosterone) is vital for full maturation and sexual differentiation.
• Women:
  • Functions overlap with men's but at far lower concentrations (~1/10th).
  • Supports bone/muscle integrity, cognitive health, cardiovascular function, and serves as a substrate for estrogen production (via aromatization).
  • Notable for its role in fertility and overall vitality.
• Quote:

  “In women, the main function of testosterone still overlaps with males... but its main intragonadal function is to serve as a substrate for estrogen production.”
  — Derek ([07:34])

• Notable moment:
  • Historical reference to the “castrati” (male singers castrated pre-puberty), demonstrating the essentiality of testosterone/DHT for normal male development and bone health ([12:20]).

2. Testosterone & Longevity and Trade-Offs

[Timestamp: 08:54–14:58]

• Longevity Disparity:
  • Females of nearly all mammals outlive males, possibly due to size, metabolic resource demands, and hormonal profiles.
  • High levels of androgens (testosterone) at supraphysiological levels can induce neurotoxicity, cardiac remodeling, and dyslipidemia.
• Quote:

  “Larger humans are going to die quicker... requires more hormone production in general, more intensive on organ systems.”
  — Derek ([09:54])

• Takeaway:
  • While optimizing testosterone is vital for health, excessively high or persistent supraphysiological levels pose longevity and health risks.

3. Accurate Measurement & Interpretation of Testosterone

[Timestamp: 15:51–24:51]

• Testing Basics:
  • Total Testosterone: Represents the sum of both bound and free testosterone in plasma.
  • Free Testosterone: The ~2-3% not bound to SHBG or albumin, actively available to tissues.
  • SHBG is a key modulator—higher SHBG = less free testosterone.
• Best Practices:
  • Morning testing (highest daily peak).
  • Fasted state, hydrated, and avoid supplements that may confound labs (e.g., biotin).
  • Repeat testing before decisions—high day-to-day variability.
• Reference Ranges & Symptoms-First Approach:
  • Reference ranges are not personalized; two men with the same T can have different symptoms.
  • Interpretation should always combine lab values and clinical symptoms.
• Quote:

  “You'll have some individuals who have insensitivity at the androgen receptor... it's not just about the levels on paper.”
  — Derek ([22:30])

4. What Drives Low Testosterone?

[Timestamp: 26:49–42:47]

• Underlying causes:
  • Primary hypogonadism: Testicular problems; often see high LH/FSH.
  • Secondary hypogonadism: Pituitary/hypothalamic dysfunction; low/normal gonadotropins.
  • Structural factors: e.g., varicocele (present in ≈15% of men).
• Lifestyle/External Factors:
  • Alcohol, smoking, poor sleep, being overweight or obese, micronutrient deficiencies (zinc, magnesium, vitamin D).
• Assessment cascade:
  1. Symptoms? (Low libido, fatigue, loss of muscle, ED, mood disturbance)
  2. Blood values (total and free T, LH/FSH, SHBG, estradiol, DHT)
  3. Address lifestyle/environmental factors
• Quote:

  “A lot of these symptoms are general and vague... often a constellation of things with a vicious circle effect.”
  — Derek ([40:10])

5. Lifestyle & Environmental Factors Impacting Testosterone

[Timestamp: 43:53–56:02]

What To Minimize/Avoid:

• Alcohol & Tobacco: Dose-dependent negative effect on testicular function and hormone production.
• Poor Diet:
  • Extremely low or no fat diets; insufficient protein; absence of carbohydrates (shuts down insulin signaling needed to liberate free T).
  • Obesity is dramatically harmful due to excessive aromatization of T to estradiol, escalating negative feedback to the brain.
• Chronic Stress & Poor Sleep:
  • Big suppressors of T production.
• Excessive endurance training coupled with calorie restriction (e.g., extreme runners, bodybuilders in deep prep).
• Environmental Endocrine Disruptors:
  • Minimize plastic exposure, use glass, secure clean air/water, but lifestyle outweighs environmental exposures.
• Quote:

  “Obesity is probably the single worst factor for men... significant elevations in body fat dramatically impact hormonal feedback.”
  — Derek ([44:35])

6. Evidence-Based Strategies to Boost Testosterone Naturally

[Timestamp: 61:12–67:55]

Diet:

• Fat: Needed for cholesterol-derived steroid synthesis.
• Carbohydrates: Required for adequate insulin signaling, which helps suppress SHBG and liberate free testosterone.
• Protein: Supports muscle repair and mass.
• Micronutrients: Most impactful are zinc, magnesium, vitamin D; vitamin D should be converted to active form.
• Deficiency correction in these can increase total T by 100+ ng/dL.

Exercise:

• Resistance/strength training is the highest-yield activity for increasing testosterone.
• Consistency beats perfection in diet/exercise adherence.
• Energy balance is essential: being lean but not malnourished maximizes hormonal health.
• Quote:

  “Calories trump everything... but optimizing protein, fat, and carb balance in the context of your activity level is next most important.”
  — Derek ([65:28])

7. Supplements: What Works, What’s Hype?

[Timestamp: 67:55–84:01]

Effective Supplements (When Deficient):

• Zinc, Magnesium, Vitamin D: Well-studied, bring meaningful increases when correcting deficiencies.
• Boron: Can suppress SHBG; use as an adjunct if you have high SHBG.
• Ashwagandha: Effective (e.g., 600mg/day standardized to withanolides); primarily via stress/cortisol modulation; best for anxious types. Caution: can blunt emotions if overused.
• Tongkat Ali: Suppresses SHBG, may upregulate steroidogenic activity in the testes; look for HPLC-tested products high in eurycomanone. Efficacy: 100–200 ng/dL increase possible.
• Shilajit: May boost intratesticular antioxidant capacity; less robust supporting data.

Debunked/Suspect Supplements

• Fenugreek, D-aspartic acid, tribulus, saw palmetto: Little to no meaningful impact in controlled trials.
• Quote:

  “If you don’t look to [zinc, magnesium, vitamin D] as part of your micronutrient optimization, you could be missing low-hanging fruit.”
  — Derek ([44:35])

8. Testosterone Replacement Therapy (TRT): Who, When, & How

[Timestamp: 87:19–119:38]

Indications

• True necessity: Men with primary or secondary hypogonadism, where all lifestyle, dietary, and non-pharmacological boosts have been exhausted.
• Best practice: conduct thorough investigation before starting hormones (e.g., rule out pituitary adenoma, varicocele, severe deficiencies).

Candidate Assessment

• HCG “challenge” can test testicular responsiveness (can be used as an alternative to direct T for some men).

Expected Benefits

• Symptom relief—libido returns, muscle mass increases, mood improves, bone health stabilizes; don’t expect “Superman” effect.
• Referenced Peter Attia’s personal N=1 with HCG therapy.

Key Risks/Monitoring

• Potential Risks:
  • Cardiovascular: Careful dosing, avoid sustained supra-physiological peaks. Cited Traverse trial (Androgel, mild T restoration, neutral CV risk); injectables may carry different risks due to peaks.
  • Erythropoiesis/Polycythemia: Increased red blood cells/thicker blood, elevated stroke/VTE risk—especially at higher doses or bolus injections.
  • Lipid profile: Lowered HDL at higher doses.
  • Prostate: Increases to baseline/normal range unlikely to cause BPH/cancer; no strong evidence it “spawns” cancer.
  • Infertility: TRT alone suppresses spermatogenesis; addition of HCG + FSH can preserve or restore testicular function.
  • Others: Increased sleep apnea risk, acne, hair loss, (esp. at supra-physio levels).
• Delivery Methods & Adherence:
  • Cream (scrotal): Most physiologic, requires 2x/day, potential transference risk.
  • Frequent subcutaneous micro-injections: Most stable blood levels, best risk profile.
  • IM (1x/week): Non-physiologic peaks and troughs; adherence better but risks higher.
  • Oral undecanoate forms: Effective but expensive and newer.
  • Other forms (nasal, pellets): Less commonly used.
• Quote:

  “The closer the delivery is to natural testicular production, the less unintentional consequences... more stable you can get those levels, the safer.”
  — Derek ([127:05])

9. Women & Testosterone

[Timestamp: 146:57–159:44]

• References ranges: ~15–70 ng/dL (LabCorp)
• Symptoms of low T: Overlaps with men—low libido, difficulty building/retaining muscle, low mood, bone health, etc.
• Testing is trickier: Low absolute levels, need LC-MS/MS assays for accuracy. Suppressed further by oral contraceptives.
• TRT for women is off-label in the US: Extreme care required with dosing; risk of irreversible side effects (eg, voice deepening, facial hair, alopecia).
• Safer starting interventions: DHEA (when DHEAS is low), low-dose supplementation; start on the low end and titrate, watching for androgenic side effects.
• Quote:

  “For women, there’s no FDA-approved testosterone—you’re basically using a male product off label, and that comes with risks.”
  — Derek ([154:13])

10. Testosterone & Hair Loss (Androgenic Alopecia)

[Timestamp: 159:44–193:36]

• Mechanism:
  • DHT (from 5α-reductase conversion of testosterone) triggers hair follicle miniaturization in genetically susceptible individuals.
  • “Miniaturization” is slow and accumulative—by the time you notice thinning, you’ve lost >25% of hair in the area.
• Prevention/Treatment:
  • Best evidence: Systemic DHT suppression with finasteride or dutasteride; both have small but real risk of sexual/neuropsychiatric side effects (incidence is similar to placebo in trials, but individual variation).
  • Topical minoxidil: Useful as a growth stimulant; works via a separate pathway and does NOT prevent further loss if androgen activity is unchecked.
  • Microneedling: Enhances topical drug absorption and growth factor signaling. Emerging evidence supports combination with minoxidil (esp. for “non-responders”).
  • Ketoconazole shampoo: Mildly antiandrogenic, good adjunct.
• Supplemental options (minimal robust data): Saw palmetto/pumpkin seed/etc. ineffective.
• Notable quote:

  “If you don’t attenuate miniaturization potential through androgenic activity in the scalp, you’re not going to prevent hair loss, period.”
  — Derek ([171:42])

• Personal disclosure: Derek has used dutasteride for years with no noticeable side effects. Emphasizes a personalized risk–reward calculus and warns not to take his case as medical advice.

11. Biomarker Monitoring & Ongoing Management

[Timestamp: 137:40–146:57]

• Suggested Biomarkers:
  • CBC (hematocrit, RBCs, hemoglobin)
  • Comprehensive metabolic panel (CMP)
  • Fasting insulin, HbA1c (metabolic health)
  • SHBG, LH, FSH, total T, free T (measured via LC/MS or equilibrium dialysis)
  • Estradiol (sensitive assay, LC/MS)
  • Lipid panel
  • PSA (for men)
  • Kidney markers: cystatin C, SDMA
  • Thyroid: TSH, T3, T4, free levels
  • IGF-1, DHEA/DHEAS
  • Genetic/LPa and clotting markers if at risk
• Get a thorough baseline; repeat regularly after any intervention.
• Quote:

  “If you don’t have a comprehensive baseline before starting therapy, you won’t know what your changes mean.”
  — Derek ([138:02])

12. Memorable Quotes & Moments

• On reference ranges and individual biology:

  “It’s not always the number on a piece of paper. It’s your genetics, your response, how many muscle fibers you have at birth.”
  — Derek ([96:56])

• On the perils of lifestyle obsession with environmental toxins:

  “Don’t worry about your shower filter until you’ve dialed in everything else first. You’re probably worrying about the wrong thing if you’re still not getting enough sleep, eating like crap, and don’t exercise.”
  — Derek ([61:12])

• On women and therapy risk:

  “If you get irreversible voice deepening, that is quality of life–destroying for some women—and you can’t just fix it.”
  — Derek ([153:56])

• On supplementing wisely:

  “Check your blood first.”
  — Derek ([84:59])

13. Episode Timeline (Major Segments)

• [03:47] Introduction of guest and episode scope
• [05:25–08:54] Fundamentals of testosterone functions (in men and women)
• [08:54–14:58] Longevity, trade-offs, and evolutionary context
• [15:51–24:51] Testosterone measurement, free vs. total, SHBG, and best practices
• [26:49–42:47] Interpretation, diagnosis, and structure/lifestyle factors
• [43:53–56:02] Environmental and lifestyle detriments (alcohol, sleep, stress)
• [61:12–67:55] Diet, micronutrients, and the reality of natural optimization
• [67:55–84:01] Supplements: what moves the needle versus hype
• [87:19–119:38] TRT—candidate selection, benefits, risks, and responsible practices
• [127:05–137:07] Delivery methods, preserving fertility while on TRT
• [137:40–146:57] Biomarker monitoring and best-practice panels
• [146:57–159:44] Women, measurement difficulty, off-label use, DHEA, unique risks
• [159:44–193:36] Hair loss, DHT blockade, minoxidil, micro-needling, side effect realities

14. Tone & Style

• Language/Tone: Evidence-focused, data-driven, occasionally technical and direct; practical, forthright, with Derek’s signature candor and Rhonda’s informative, thoughtful moderation.

15. Final Takeaways

• Personalization is key: Laboratory reference ranges, supplementation, and hormones must be interpreted in context of symptoms, genetics, and individual lifestyle.
• Natural before pharmacological: Always address diet, sleep, exercise, and deficiencies before considering TRT or “boosting” agents.
• TRT is lifelong: Not a lifestyle experiment; requires ongoing monitoring and a sophisticated, symptom-guided approach.
• Hair loss: don’t delay intervention if it matters to you; only DHT blockade is robustly effective.
• Women: Extreme caution with testosterone supplementation; off-label, often unnecessary, and watch for irreversible side effects.
• “Know your numbers, know your options, know your risk profile—and always work with a trusted, knowledgeable provider.”

This episode provides a nuanced, balanced, and highly practical masterclass on testosterone—from basics to complex clinical frontiers.
Highly recommended for anyone seeking clarity on testosterone optimization, therapy, and the broader hormonal health landscape.