Boost Your Testosterone with GLP-1 Drugs: New Hope for Men with Obesity, Diabetes

Shellsea Portillo Canales and her team conducted a retrospective analysis using electronic health records of individuals with obesity and type 2 diabetes to examine the impact of GLP-1 medications on testosterone levels over 18 months.

The study included 110 males, predominantly white and in their mid-50s. Their average body mass index (BMI) was 35, classifying them as clinically obese, and 86 participants had type 2 diabetes. Those who had received testosterone or other androgenic therapies were excluded from the study.

Initially, slightly more than half of the participants had total testosterone levels exceeding 300 nanograms per deciliter (ng/dL).

According to the American Urological Association, values below this level are considered indicative of low testosterone. After 18 months of treatment with GLP-1 receptor agonists, the proportion of men with healthy testosterone levels increased to 77%.

The average weight loss among participants was about 26 pounds, decreasing from 255 to 229 pounds, which represents around a 10% reduction in body weight. Concurrently, total testosterone levels rose by approximately 18% (from 322 to 380 ng/dL), while free testosterone increased by 17%.

“This is consistent with expectations based on how weight loss influences testosterone levels,” noted Beverly Tchang, MD, an endocrinologist and obesity medicine specialist at Weill Cornell Medicine, who was not involved in the study.

Substantial weight loss from interventions like bariatric surgery has also been linked to enhanced testosterone levels and overall hormonal balance.

Although GLP-1 medications do not directly stimulate testosterone production, the increase in testosterone resulting from their weight loss effects seems to be comparable to other weight loss methods.

Low testosterone, or low-T, in males happens when the testicles don’t produce sufficient amounts of the hormone. Signs of low testosterone include:

• reduced sexual desire (libido)
• decreased muscle mass
• erectile dysfunction
• fatigue/low energy
• increased body fat

The most severe form of low-T is termed pathologic hypogonadism, which indicates a persistent decrease in testosterone levels due to an irreversible condition. However, in many instances, testosterone levels can be restored through lifestyle and medical interventions.

Low testosterone related to obesity is one such example.

“Obesity is linked to a type of ‘pseudo’ hypogonadism—not pathological. Excessive body fat can disrupt the hypothalamic-pituitary-testicular axis, effectively causing brain centers to lower testosterone in cases of obesity,” explained Sun Kim, MD, an associate professor of Endocrinology at Stanford Medicine, who was not part of the study.

In fact, obesity and low testosterone can create a feedback loop where obesity lowers testosterone, which then leads to decreased muscle mass and further weight gain.

“Muscle mass is a key driver of metabolism. So, when you have low testosterone and reduced muscle-building capability, this slower metabolism predisposes you to further weight gain,” said Tchang.

Given their significant impact on weight loss, GLP-1 drugs also have notable effects on testosterone levels. Kim suggested that, for people with obesity considering hormone replacement therapy for low-T, weight loss should be a priority.

“Men with obesity and low testosterone, if not caused by other conditions, should focus on weight loss to increase testosterone levels rather than taking exogenous testosterone,” she advised.

The preliminary results are promising regarding the potential role of GLP-1 drugs in improving sexual health.

“Anecdotally, we’ve heard from some men who report that GLP-1s have enhanced their libido and sexual performance,” Tchang mentioned.

“If these drugs can have a positive effect on testosterone levels along with promoting healthier blood vessels and increased blood flow, then we’re looking at a medication that could significantly aid sexual health as well,” she added.

Sarwer noted that this recent study adds to the evidence supporting another health benefit from GLP-1 drugs.

“In recent years, there’s been a lot of excitement around the use of incretin therapies for weight loss, which is significantly more than what is achieved through diet and exercise alone,” he stated.

“This weight loss leads to improvements in several critical health areas. This study suggests that we may soon be able to confidently include increased testosterone in that list of benefits,” he concluded.