Blood Work Series Part 4: Testosterone

Strength. Drive. Resilience. Longevity.

When most people hear “testosterone,” they think muscles and aggression.

That’s a tiny slice of the story.

Testosterone is a foundational hormone for both men and women. It influences how you look, how you perform, how you recover, how you think, and even how you feel about your life.

Let’s break it down in plain English.

Why Testosterone Matters (Men and Women)

1. Lean Mass & Staying Lean

Testosterone:

  • Increases muscle protein synthesis (your ability to build muscle tissue)

  • Improves nutrient partitioning (more calories go to muscle, fewer to fat)

  • Inhibits fat storage indirectly through better insulin sensitivity

More muscle = higher resting metabolic rate.
Higher metabolic rate = easier time staying lean.

Low testosterone?
Harder to build muscle. Easier to accumulate fat. Slower recovery.

2. Training Results in the Gym

Resistance training increases androgen receptor density in muscle tissue. Testosterone binds to those receptors and turns on the machinery that builds muscle.

If levels are optimal:

  • Strength increases faster

  • Recovery improves

  • Adaptation to training is amplified

If levels are low:

  • You can train hard… and spin your wheels.

3. Mood, Drive & Psychological Impact

Testosterone affects:

  • Dopamine signaling (motivation and reward)

  • Confidence and assertiveness

  • Energy levels

  • Resilience under stress

Chronically low testosterone is strongly associated with:

  • Low mood

  • Brain fog

  • Irritability

  • Reduced ambition

  • Decreased libido

This applies to women as well. Women produce testosterone in smaller amounts, but it still plays a meaningful role in vitality and drive.

4. Fertility & Reproductive Health

In men:

  • Necessary for sperm production (via stimulation of Sertoli cells)

  • Supports libido and erectile function

In women:

  • Supports ovarian function

  • Plays a role in sexual desire

  • Influences egg quality indirectly

Testosterone is not “just a male hormone.” It’s a human hormone.

Total Testosterone vs Free Testosterone

When we test testosterone, we usually measure:

Total Testosterone

All testosterone circulating in the bloodstream:

  • Bound to SHBG (sex hormone binding globulin)

  • Bound to albumin

  • Unbound (free)

Free Testosterone

The small fraction not bound to proteins.

Free testosterone is what can actually:

  • Enter cells

  • Bind to androgen receptors

  • Produce physiological effects

You can have normal total testosterone but low free testosterone if SHBG is high.

That’s why we test both.

Why We Test Testosterone in Women (Instead of Estrogen or Progesterone)

Estrogen and progesterone fluctuate dramatically across the menstrual cycle.

Testosterone fluctuates far less.

That makes it:

  • Easier to interpret

  • More stable

  • More clinically useful as a baseline marker

For women, low testosterone can show up as:

  • Low libido

  • Low energy

  • Reduced strength gains

  • Difficulty building lean mass

And it often goes overlooked.

My Recent Results

  • Total Testosterone: 783 ng/dL

  • Free Testosterone: 88.7 pg/mL

That places me solidly in an optimized range for my age bracket — not by accident, but by habit design.

Let’s talk about how we influence this naturally.

How to Improve Testosterone Naturally

We always start here before discussing medical intervention.

1. Improve Sleep Quality & Duration

Mechanism:

  • The majority of daily testosterone release happens during deep sleep.

  • Sleep restriction can drop testosterone by 10–30% in just one week.

Less sleep → higher cortisol → suppressed gonadal signaling → lower testosterone.

Non-negotiable habit.

2. Train Intelligently

Testosterone responds best to:

  • Progressive resistance training

  • Large compound lifts

  • Moderate training volume

  • Controlled use of HIIT

Chronic excessive high-intensity training without recovery?
That can elevate cortisol and suppress testosterone.

More is not better. Better is better.

3. Lower Excess Body Fat

Fat tissue contains aromatase — an enzyme that converts testosterone into estrogen.

More body fat → more aromatization → lower usable testosterone.

This is one of the most overlooked drivers of suboptimal levels in men.

4. Match Nutrition to Training

Testosterone production requires:

  • Adequate protein

  • Sufficient dietary fat (especially cholesterol as a precursor)

  • Strategic carbohydrate intake to manage cortisol and support training output

Chronic calorie deficits suppress testosterone.
Under-fueling high output training is a common mistake.

5. Optimize Vitamin D

Vitamin D acts more like a hormone than a vitamin.

Higher Vitamin D levels are correlated with:

  • Higher total testosterone

  • Improved androgen receptor sensitivity

Another reason we test and optimize. Check out more on Vit D here.

6. Manage Stress & Cortisol

Cortisol and testosterone have an inverse relationship.

Chronic sympathetic nervous system activation:

  • Suppresses GnRH (from the brain)

  • Suppresses LH (from the pituitary)

  • Reduces testicular testosterone production

Translation:
Live in fight-or-flight long enough, testosterone drops.

Stress management isn’t “soft.”
It’s hormonal optimization.

When Natural Optimization Isn’t Enough

With clients, we:

  1. Fix sleep

  2. Fix training

  3. Improve body composition

  4. Optimize nutrition

  5. Correct Vitamin D

  6. Normalize stress response

We push levels as high as physiology will reasonably allow.

But if:

  • Symptoms persist

  • Labs remain suboptimal

  • Lifestyle is truly dialed in

Then we guide the conversation toward testosterone replacement therapy (TRT).

For the right individual:

  • It’s safe.

  • It’s well-studied.

  • It’s extremely effective.

The key is doing it responsibly, with proper monitoring and physician oversight.

TRT should never be the first step.

But it also shouldn’t be demonized when clinically appropriate.

The Bigger Picture

Testosterone isn’t about vanity.

It’s about:

  • Strength

  • Metabolic health

  • Cognitive sharpness

  • Drive

  • Fertility

  • Longevity

It’s one of the clearest reflections of whether your lifestyle supports your biology — or fights it.

And the good news?

Most of the levers that raise testosterone also improve every other major health marker.

Which is why we test it.
And why we optimize it deliberately.

Next
Next

Blood Work Series – Part 3: Cholesterol (And Why It’s Not What You Think)