Abstract
Purpose
Testosterone replacement and associated pharmacologic agents are effective strategies
to treat male hypogonadism; however, nutraceutical agents and lifestyle modification
approaches have gained medical interest. The purpose of this scoping review is to
highlight the evidence (or lack thereof) of nutraceuticals and lifestyle modification
approaches in the management of testosterone levels and sperm parameters.
Methods
A scoping review of nonpharmacologic interventions (supplements, herbal medicines,
diets, sleep, and exercise) with the potential to improve male health was undertaken
to elucidate changes in testosterone levels and sperm parameters in men with hypogonadism
or infertility compared with healthy patients.
Findings
A multitude of nutraceuticals and functional nutrients are purported to stimulate
testosterone production; however, only a select few have had promising results, such
as zinc, vitamin D (in case of hypovitaminosis D), l-arginine, mucuna, and ashwagandha, based on well-controlled randomized clinical trials
of men with low testosterone levels and related problems. Except for l-arginine, these natural agents, as well as tribulus and ω3 fatty acids, can improve
some degree of sperm parameters in infertile men. Before implementing these nutraceutical
agents, adequate sleep, exercise, and weight loss in patients with obesity are imperative.
The effects of nonpharmacologic interventions on testosterone levels are modest and
hence do not directly translate into clinical benefits. Correspondingly, androgen
receptor content, but not endogenous androgens, has been regarded as the principal
factor in muscle hypertrophy.
Implications
A limited number of supplements and herbal medicines can be considered as adjunctive
approaches in the management of testosterone levels and sperm parameters, primarily
in men with low testosterone levels and infertility, whereas most nonpharmacologic
supplements appear to lack evidence. Although proper physical exercise, sleep, and
diet are indisputable approaches because of the general benefits to health, the use
of nutraceuticals, if considered, must be personalized by physicians and/or registered
dietitians.
Key words
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Article info
Publication history
Published online: July 06, 2022
Accepted:
June 16,
2022
Identification
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© 2022 Elsevier Inc.
