Here Are the Top Causes of Low Testosterone

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Updated on February 18, 2021

In this post, we’ll go over the causes of low testosterone. We’re one of the oldest health optimization clinics in Miami specializing in helping men optimize their testosterone levels through our Testosterone Replacement Therapy program as part of our Hormone Replacement Therapy treatments. Through our decades of combined experience, we’ve seen men with drastically low levels of testosterone start on our TRT program and experience a breakthrough physically, mentally, and at times even financially due to the overall effects of having optimal levels of T (results may vary).
Many patients have had low-t most of their adult life and never realized it until getting a low-t test, but what was it that led to this deficiency in testosterone levels? Possible factors may be the result of a single medical impairment, injury, or a multitude of factors that have contributed to the condition over many years.
While this article has citations from medical sources, this article is not intended to replace medical advice. If you have any questions or would like to consult with a medical doctor specializing in hormones for men and women, please call one of our locations for a phone call or facetime consultation with our own Dr. George Herrera, M.D.

What can affect your testosterone levels?

Did you know Testosterone levels fall naturally every year by 1 to 2 percent? This is the case especially for men after 30 years of age. Your natural testosterone production may be affected by one or more factors: Injury, Medical Conditions, Poor Nutrition, Use of Alcohol or Drugs, Lack of Quality (REM) Sleep, and Lifestyle Choices like frequency of physical activity and exercise.


Testosterone Production can be limited by injury and infection. Injuries to the testes or inflammation of the testes caused by an infection called Orchitis. This infection can be caused by bacteria traveling in the blood system throughout your body but is most often caused by a Sexually Transmitted Infection (STI).
Spinal cord injuries and other chronic conditions related to spinal cord damage are reported to cause low testosterone in patients. Read more:

Medical Conditions


Hypogonadism is prevalent among cancer patients, and while the cause may involve multiple factors, inflammation and use of chemotherapy may be the most obvious causes for low testosterone levels in cancer patients.
Read more about Hypogonadism in male cancer patients:

Metabolic disorders such as hemochromatosis (too much iron in the body)

Hemochromatosis is often diagnosed at a late stage when complications are shown, one of the most common complications being Hypogonadotropic hypogonadism (HH).

  • Dysfunction or tumors of the pituitary gland
    Medications, including opioids, hormones used to treat prostate cancer, and steroids (such as prednisone)
  • Acute (short-term) or chronic (long-term) illness
  • Alcohol abuse
  • Cirrhosis of the liver
  • Chronic renal (kidney) failure
  • Inflammatory conditions such as sarcoidosis (a condition that causes inflammation of the lungs and other organs)
  • Kallman syndrome (abnormal development of the hypothalamus, a gland in the brain that controls many hormones)
  • Klinefelter syndrome (a genetic condition in which a male is born with an extra copy of the X chromosome). Also called XXY syndrome
  • High levels of the milk-producing hormone prolactin
  • Obesity or extreme weight loss
  • Uncontrolled type 2 diabetes mellitus
  • Congenital defect (present at birth)
  • Obstructive sleep apnea
  • Aging
  • Estrogen excess (usually from an external or environmental source)
  • Previous anabolic steroid abuse
  • Severe primary hypothyroidism
  • Pubertal delay
  • Trauma (head injury)
  • Radiation exposure or prior surgery of the brain

Poor nutrition

While many people know that poor nutrition can contribute to serious chronic health problems, it is not as widely known that some foods may actually lower the natural production of testosterone in your body, and may even increase levels of estrogen, the female hormone which can lead to gynecomastia in men. Avoid foods like Soy, Milk, Alcohol, and Processed Foods.

Read more about how foods can lower your testosterone

Alcohol / Drugs

Alcohol has been shown by medical studies to negatively affect not just the reproductive system in humans, but the entire endocrine system. This system is responsible for all of the most important functions in your body such as metabolism, reproductive health, growth, and development.

A study published on the National Institutes of Health (NIH) website titled “Alcohol and the Male Reproductive System” shows the negative effects on the Hypothalamic-Pituitary-Gonadal (HPG) axis:

Research with animals has consistently demonstrated an association between both acute (i.e., one time, one occasion) and chronic (i.e., long-term) alcohol consumption and low testosterone. As testosterone levels decrease, levels of LH and FSH would be expected to increase to stimulate the production of more testosterone. However, studies with young (i.e., pubertal) male rats indicate that both acute and chronic alcohol exposure result in profound testosterone suppression accompanied by lower or normal LH and FSH levels, when elevated levels are expected (Hadley 1988; Yen and Jaffe 1991). This suggests that the hypothalamic cells which produce LHRH do not function correctly when the feedback normally provided by testosterone is removed (i.e., when testosterone levels decrease). Thus it appears that alcohol’s damaging effects on reproduction are mediated at all three levels of the male reproductive unit: the hypothalamus, pituitary, and testes.

Lack of quality sleep

The quality of your sleep is important and can help your body regenerate and reset in many ways. Men with low testosterone have been shown in studies to suffer from sleep apnea or sleep disorders. 

Lifestyle Choices

Lack of exercise and a sedentary lifestyle can also lead to obesity and even low testosterone. Greater physical activity can reduce the odds of men having low testosterone and obesity.

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