Testosterone boosters are heavily marketed on social media and marketplaces to men with claims to significantly increase testosterone. Lax industry regulation has allowed sales of supplements to thrive in the absence of verification of their purported benefits. Our primary objective was to systematically review all data published in the last two decades on testosterone boosters and determine their efficacy. Our outcome of interest was total testosterone increase versus placebo in four different populations: male athletes, men with late-onset hypogonadism infertile men and healthy men. Following search and screening, 52 studies were included in our review, relating to 27 proposed testosterone boosters: 10 studies of cholecalciferol; 5 zinc/magnesium; 4 Tribulus terrestris and creatine; 3 Eurycoma longifolia and Withania somnifera; 2 betaine, D-aspartic acid, Lepidium meyenii and isoflavones; while the remainder were single reports. Our findings indicate that most fail to increase total testosterone. The exceptions were β-hydroxy β-methylbutyrate and betaine, which can be considered effective for male athletes. Eurycoma longifolia, a blend of Punica granatum fruit rind and Theobroma cacao seed extracts (Tesnor™) and purified Shilajit extract (PrimaVie™) can be considered possibly effective for men with late-onset hypogonadism; Eurycoma longifolia and Withania somnifera possibly effective for healthy men; and a non-hormonal aromatase inhibitor (Novadex XT™) possibly effective for male athletes.
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The data that support the findings of this study are available from the corresponding author, AM, upon reasonable request.
Cui T, Kovell RC, Brooks DC, Terlecki RP. A urologist’s guide to ingredients found in top-selling nutraceuticals for men’s sexual health. J Sex Med. 2015;12:2105–17.
Herriman M, Fletcher L, Tchaconas A, Adesman A, Milanaik R. Dietary supplements and young teens: misinformation and access provided by retailers. Pediatrics. 2017;139:e20161257.
Balasubramanian A, Thirumavalavan N, Srivatsav A, Yu J, Lipshultz LI, Pastuszak AW. Testosterone imposters: an analysis of popular online testosterone boosting supplements. J Sex Med. 2019;16:203–12.
Clemesha CG, Thaker H, Samplaski MK. ‘Testosterone boosting’ supplements composition and claims are not supported by the academic literature. World J Mens Health. 2020;38:115–22.
de Lange RW. Testosterone boosters: a report of a supplement’s misleading labelling claims. S Afr J Sports Med. 2020;32:v32i1a7426.
Regan KS, Wambogo EA, Haggans CJ. NIH and USDA funding of dietary supplement research, 1999-2007. J Nutr. 2011;141:1–3.
Rahnema CD, Crosnoe LE, Kim ED. Designer steroids – over-the-counter supplements and their androgenic component: review of an increasing problem. Andrology. 2015;3:150–5.
Jedrejko K, Lazur J, Muszynska B. Risk associated with the use of selected ingredients in food supplements. Chem Biodivers. 2021;18:e2000686.
Qureshi A, Naughton DP, Petroczi A. A systematic review on the herbal extract Tribulus terrestris and the roots of its putative aphrodisiac and performance enhancing effect. J Diet Suppl. 2014;11:64–79.
Roshanzamir F, Safavi SM. The putative effects of D-Aspartic acid on blood testosterone levels: a systematic review. Int J Reprod Biomed. 2017;15:1–10.
Thu HE, Mohamed IN, Hussain Z, Jayusman PA, Shuid AN. Eurycoma longifolia as a potential adoptogen of male sexual health: a systematic review on clinical studies. Chin J Nat Med. 2017;15:71–80.
Santos HO, Howell S, Teixeira FJ. Beyond tribulus (Tribulus terrestris L.): the effects of phytotherapics on testosterone, sperm and prostate parameters. J Ethnopharmacol. 2019;235:392–405.
Fernandez-Lazaro D, Fernandez-Lazaro CI, Seco-Calvo J, Garrosa E, Adams DP, Mielgo-Ayuso J. Effects of Tribulus terrestris L. on sport and health biomarkers in physically active adult males: a systematic review. Int J Environ Res Public Health. 2022;19:9533.
Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021;372:n160.
Pilz S, Frisch S, Koertke H, Kuhn J, Dreier J, Obermayer-Pietsch B, et al. Effect of vitamin D supplementation on testosterone levels in men. Horm Metab Res. 2011;43:223–5.
Heijboer AC, Oosterwerff M, Schroten NF, Eekhoff EM, Chel VG, de Boer RA, et al. Vitamin D supplementation and testosterone concentrations in male human subjects. Clin Endocrinol (Oxf). 2015;83:105–10.
Lerchbaum E, Pilz S, Trummer C, Schwetz V, Pachernegg O, Heijboer AC, et al. Vitamin D and testosterone in healthy men: a randomized controlled trial. J Clin Endocrinol Metab. 2017;102:4292–302.
Mielgo-Ayuso J, Calleja-Gonzalez J, Urdampilleta A, Leon-Guereno P, Cordova A, Caballero-Garcia A, et al. Effects of vitamin D supplementation on haematological values and muscle recovery in elite male traditional Rowers. Nutrients. 2018;10:1968.
Saha S, Goswami R, Ramakrishnan L, Vishnubhatla S, Mahtab S, Kar P, et al. Vitamin D and calcium supplementation, skeletal muscle strength and serum testosterone in young healthy adult males: randomized control trial. Clin Endocrinol (Oxf). 2018;88:217–26.
Lerchbaum E, Trummer C, Theiler-Schwetz V, Kollmann M, Wolfler M, Heijboer AC, et al. Effects of vitamin D supplementation on androgens in men with low testosterone levels: a randomized controlled trial. Eur J Nutr. 2019;58:3135–46.
Zittermann A, Ernst JB, Prokop S, Fuchs U, Dreier J, Kuhn J, et al. Vitamin D supplementation does not prevent the testosterone decline in males with advanced heart failure: the EVITA trial. Eur J Nutr. 2019;58:673–80.
Michalczyk MM, Golas A, Maszczyk A, Kaczka P, Zajac A. Influence of sunlight and oral D(3) supplementation on serum 25(OH)D concentration and exercise performance in elite soccer players. Nutrients. 2020;12:1311.
Ramezani Ahmadi A, Mohammadshahi M, Alizadeh A, Ahmadi Angali K, Jahanshahi A. Effects of vitamin D3 supplementation for 12 weeks on serum levels of anabolic hormones, anaerobic power, and aerobic performance in active male subjects: a randomized, double-blind, placebo-controlled trial. Eur J Sport Sci. 2020;20:1355–67.
Maghsoumi-Norouzabad L, Zare Javid A, Mansoori A, Dadfar M, Serajian A. The effects of Vitamin D3 supplementation on Spermatogram and endocrine factors in asthenozoospermia infertile men: a randomized, triple blind, placebo-controlled clinical trial. Reprod Biol Endocrinol. 2021;19:102.
Neychev VK, Mitev VI. The aphrodisiac herb Tribulus terrestris does not influence the androgen production in young men. J Ethnopharmacol. 2005;101:319–23.
Roaiah MF, El Khayat YI, GamalEl Din SF, Abd El Salam MA. Pilot study on the effect of botanical medicine (Tribulus terrestris) on serum testosterone level and erectile function in aging males with partial androgen deficiency (PADAM). J Sex Marital Ther. 2016;42:297–301.
Roaiah MF, Elkhayat YI, Abd El Salam MA, Din SFG. Prospective analysis on the effect of botanical medicine (Tribulus terrestris) on serum testosterone level and semen parameters in males with unexplained infertility. J Diet Suppl. 2017;14:25–31.
Fernandez-Lazaro D, Mielgo-Ayuso J, Del Valle Soto M, Adams DP, Gonzalez-Bernal JJ, Seco-Calvo J. The effects of 6 weeks of Tribulus terrestris L. supplementation on body composition, hormonal response, perceived exertion, and CrossFit((R)) performance: a randomized, single-blind, placebo-controlled study. Nutrients. 2021;13:3969.
Koehler K, Parr MK, Geyer H, Mester J, Schanzer W. Serum testosterone and urinary excretion of steroid hormone metabolites after administration of a high-dose zinc supplement. Eur J Clin Nutr. 2009;63:65–70.
Ebisch IM, Pierik FH, FH DEJ, Thomas CM, Steegers-Theunissen RP. Does folic acid and zinc sulphate intervention affect endocrine parameters and sperm characteristics in men? Int J Androl. 2006;29:339–45.
Nematollahi-Mahani SN, Azizollahi GH, Baneshi MR, Safari Z, Azizollahi S. Effect of folic acid and zinc sulphate on endocrine parameters and seminal antioxidant level after varicocelectomy. Andrologia. 2014;46:240–5.
Shafiei Neek L, Gaeini AA, Choobineh S. Effect of zinc and selenium supplementation on serum testosterone and plasma lactate in cyclist after an exhaustive exercise bout. Biol Trace Elem Res. 2011;144:454–62.
Cinar V, Polat Y, Baltaci AK, Mogulkoc R. Effects of magnesium supplementation on testosterone levels of athletes and sedentary subjects at rest and after exhaustion. Biol Trace Elem Res. 2011;140:18–23.
Hoffman J, Ratamess N, Kang J, Mangine G, Faigenbaum A, Stout J. Effect of creatine and beta-alanine supplementation on performance and endocrine responses in strength/power athletes. Int J Sport Nutr Exerc Metab. 2006;16:430–46.
van der Merwe J, Brooks NE, Myburgh KH. Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players. Clin J Sport Med. 2009;19:399–404.
Fernandez-Landa J, Fernandez-Lazaro D, Calleja-Gonzalez J, Caballero-Garcia A, Cordova A, Leon-Guereno P, et al. Long-term effect of combination of creatine monohydrate plus beta-hydroxy beta-methylbutyrate (HMB) on exercise-induced muscle damage and anabolic/catabolic hormones in elite male endurance athletes. Biomolecules. 2020;10:140.
Samadi M, Askarian A, Shirvani H, Shamsoddini A, Shakibaee A, Forbes SC, et al. Effects of four weeks of beta-alanine supplementation combined with one week of creatine loading on physical and cognitive performance in military personnel. Int J Environ Res Public Health. 2022;19:7992.
Hoffman J, Ratamess NA, Ross R, Kang J, Magrelli J, Neese K, et al. Beta-alanine and the hormonal response to exercise. Int J Sports Med. 2008;29:952–8.
Durkalec-Michalski K, Jeszka J. The effect of beta-hydroxy-beta-methylbutyrate on aerobic capacity and body composition in trained athletes. J Strength Cond Res. 2016;30:2617–26.
Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: a randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98:e17186.
Chauhan S, Srivastava MK, Pathak AK. Effect of standardized root extract of ashwagandha (Withania somnifera) on well-being and sexual performance in adult males: a randomized controlled trial. Health Sci Rep. 2022;5:e741.
Lopresti AL, Drummond PD, Smith SJ. A randomized, double-blind, placebo-controlled, crossover study examining the hormonal and vitality effects of ashwagandha (Withania somnifera) in aging, overweight males. Am J Mens Health. 2019;13:1557988319835985.
Gonzales GF, Cordova A, Vega K, Chung A, Villena A, Gonez C, et al. Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men. Andrologia. 2002;34:367–72.
Gonzales GF, Cordova A, Vega K, Chung A, Villena A, Gonez C. Effect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing properties, on serum reproductive hormone levels in adult healthy men. J Endocrinol. 2003;176:163–8.
Leitao AE, Vieira MCS, Pelegrini A, da Silva EL, Guimaraes ACA. A 6-month, double-blind, placebo-controlled, randomized trial to evaluate the effect of Eurycoma longifolia (Tongkat Ali) and concurrent training on erectile function and testosterone levels in androgen deficiency of aging males (ADAM). Maturitas. 2021;145:78–85.
Chan KQ, Stewart C, Chester N, Hamzah SH, Yusof A. The effect of Eurycoma longifolia on the regulation of reproductive hormones in young males. Andrologia. 2021;53:e14001.
Tambi MI, Imran MK, Henkel RR. Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism? Andrologia. 2012;44:226–30.
Nobari H, Kargarfard M, Minasian V, Cholewa JM, Perez-Gomez J. The effects of 14-week betaine supplementation on endocrine markers, body composition and anthropometrics in professional youth soccer players: a double blind, randomized, placebo-controlled trial. J Int Soc Sports Nutr. 2021;18:20.
Arazi H, Aboutalebi S, Taati B, Cholewa JM, Candow DG. Effects of short-term betaine supplementation on muscle endurance and indices of endocrine function following acute high-intensity resistance exercise in young athletes. J Int Soc Sports Nutr. 2022;19:1–16.
Willoughby DS, Leutholtz B. D-aspartic acid supplementation combined with 28 days of heavy resistance training has no effect on body composition, muscle strength, and serum hormones associated with the hypothalamo-pituitary-gonadal axis in resistance-trained men. Nutr Res. 2013;33:803–10.
Crewther B, Witek K, Draga P, Zmijewski P, Obminski Z. Short-term d-aspartic acid supplementation does not affect serum biomarkers associated with the hypothalamic-pituitary-gonadal axis in male climbers. Int J Sport Nutr Exerc Metab. 2019;29:259–64.
Dillingham BL, McVeigh BL, Lampe JW, Duncan AM. Soy protein isolates of varying isoflavone content exert minor effects on serum reproductive hormones in healthy young men. J Nutr. 2005;135:584–91.
Lewis JG, Morris JC, Clark BM, Elder PA. The effect of isoflavone extract ingestion, as Trinovin, on plasma steroids in normal men. Steroids. 2002;67:25–9.
Abel T, Knechtle B, Perret C, Eser P, von Arx P, Knecht H. Influence of chronic supplementation of arginine aspartate in endurance athletes on performance and substrate metabolism – a randomized, double-blind, placebo-controlled study. Int J Sports Med. 2005;26:344–9.
Che WJ, He XZ, Jiang JP, Cai WY, Xie SJ. Preliminary study on treatment of partial androgen deficiency in aging males with Jingui Shenqi Pill. Chin J Integr Med. 2005;11:300–2.
Cinar V, Baltaci AK, Mogulkoc R, Kilic M. Testosterone levels in athletes at rest and exhaustion: effects of calcium supplementation. Biol Trace Elem Res. 2009;129:65–9.
Zhang ZJ, Tong Y, Zou J, Chen PJ, Yu DH. Dietary supplement with a combination of Rhodiola crenulata and Ginkgo biloba enhances the endurance performance in healthy volunteers. Chin J Integr Med. 2009;15:177–83.
Goto K, Maemura H, Takamatsu K, Ishii N. Hormonal responses to resistance exercise after ingestion of carnosine and anserine. J Strength Cond Res. 2011;25:398–405.
Giltay EJ, Geleijnse JM, Heijboer AC, de Goede J, Oude Griep LM, Blankenstein MA, et al. No effects of n-3 fatty acid supplementation on serum total testosterone levels in older men: the Alpha Omega Trial. Int J Androl. 2012;35:680–7.
Derouiche A, Jafri A, Driouch I, El Khasmi M, Adlouni A, Benajiba N, et al. Effect of argan and olive oil consumption on the hormonal profile of androgens among healthy adult Moroccan men. Nat Prod Commun. 2013;8:51–3.
Maheshwari A, Verma N, Swaroop A, Bagchi M, Preuss HG, Tiwari K, et al. Efficacy of Furosap(TM), a novel Trigonella foenum-graecum seed extract, in enhancing testosterone level and improving sperm profile in male volunteers. Int J Med Sci. 2017;14:58–66.
Santi D, Granata AR, Pignatti E, Trenti T, Roli L, Bozic R, et al. Effects of chronic administration of the phosphodiesterase inhibitor vardenafil on serum levels of adrenal and testicular steroids in men with type 2 diabetes mellitus. Endocrine. 2017;56:426–37.
Haidari F, Mohammadi-Asl J, Kavianpour M, Dadfar M, Haghighian HK. Effect of lipoic acid supplementation on gene expression and activity of glutathione S-transferase enzyme in infertile men. Hum Fertil (Camb). 2021;24:276–83.
Pandit SL, Yaligar D, Halemane M, Bhat A. A proprietary blend of standardized Punica granatum fruit rind and Theobroma cocoa seed extracts mitigates aging males’ symptoms: a randomized, double-blind, placebo-controlled study. Int J Med Sci. 2022;19:1290–9.
Pandit S, Biswas S, Jana U, De RK, Mukhopadhyay SC, Biswas TK. Clinical evaluation of purified Shilajit on testosterone levels in healthy volunteers. Andrologia. 2016;48:570–5.
Willoughby DS, Wilborn C, Taylor L, Campbell W. Eight weeks of aromatase inhibition using the nutritional supplement Novedex XT: effects in young, eugonadal men. Int J Sport Nutr Exerc Metab. 2007;17:92–108.
The author would like to acknowledge the support from the other members of the Young Academic Urologist (YAU) Male Sexual and Reproductive Health group who are not cited as authors.
The authors declare no competing interests.
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Morgado, A., Tsampoukas, G., Sokolakis, I. et al. Do “testosterone boosters” really increase serum total testosterone? A systematic review. Int J Impot Res (2023). https://doi.org/10.1038/s41443-023-00763-9