What the Testosterone Boom Is Doing to the Men You Love
What raises testosterone naturally, and what supplementing quietly shuts down
Posted May 19, 2026 | Reviewed by Kaja Perina
Almost 12 years ago, I wrote an op-ed in the New York Times called "Don't Ask Your Doctor About Low T." Testosterone patches and pills were being marketed to men who didn't need it. They still are.
What's new since 2014 is who is paying the price. Women are paying attention because the men in their lives are on gels or pellets that change their moods, tempers, and sexual appetites. Partners are noticing the mood swings and relationship problems. Men who wish they were not the problem in a couple trying to have a baby are showing up at fertility clinics. Sometimes they have no sperm. This is a side effect that is predictable and an accident of retail medicine.
Today this conversation is louder because clinics can ship testosterone to almost any man willing to fill out a five minute form and the Times just reported that there were almost 12,000,000 prescriptions for testosterone last year. That's up 25 times since the year 2000. Men who are ages 35 to 44 are the biggest recipients. But the American Urological Association says that about a third of men who are prescribed testosterone are not deficient. I think it's probably much more than that.
So here is what I would add to what I wrote in 2014.
First, there is a real difference between men with actual testosterone deficiency and men without. Men who are genuinely low in testosterone need the prescriptions they're getting. No questions asked.
Men who want to optimize and whose labs are normal, and are tired of feeling tired, need a different solution.
Second, there is a side effect that almost no one talks about but almost everyone gets. When a man takes testosterone, his body thinks that he has enough. So the brain no longer tells the testes to make it. So they don't. A man's body shuts down testosterone production, and what happens? The testes get smaller. The sperm count can drop dramatically.
Third, to improve performance, men will supplement, biohack and shortcut. No one should blame them. Most don't know there is a more reliable, scientifically sound way to the goal.
Most men, and most doctors, men and women, have not been trained to understand that four different systems in the body govern how we sleep, think and how long we live. Those are the circadian system, the mitochondrial system, the gut brain axis , and the glymphatic system. Each one of them responds, immediately and measurably, to four specific inputs: food, light, movement and sleep.
Food: You want real protein, healthy fats, and plants that look like they came out of the ground.
Light: Most men miss this and it is the single easiest thing to do to right your hormones . If you get a skyview any time in the first hour for ten minutes or more, you can set your circadian clock for the day: use the sun’s schedule before your screen’s. This works identically for women, especially those in perimenopause and menopause, improving sleep, energy and mood, and sometimes better than prescriptions for estrogen and progesterone.
Movement: The minimum effective dose, as I describe in Indoor Epidemic , is 17 minutes per day of intentional time outdoors. The timing is as important as the time, and the details matter. Often you can just repurpose intentional minutes. Your mitochondria need the movement to burn calories.
Sleep: You clean your brain at night if you get enough deep sleep. Otherwise, your brain accumulates the trash of the day. Optimally, your bedroom is cool, dark, quiet and has no bright blue light to shine on you an hour before bed.
None of this requires a prescription, or for that matter, money. All of it has been demonstrated to raise testosterone in men whose levels have declined with age, weight gain, stress , and poor sleep. Also well-known: men who lose visceral fat, even 10% of body weight, raise their own testosterone. Testosterone levels drop as a man gains weight.
I run a regenerative organic farm in Santa Barbara, and last year developed and co-taught the first skills-based nature-as-medicine Continuing Medical Education course for physicians in the country there, with the David Geffen School of Medicine at UCLA. The male physicians were not low in testosterone. They were low in sunlight, sleep, real food and intentional time and activities outdoors. Most of the female physicians already knew this.
I do not think most men chasing testosterone are vain or foolish. They are responding rationally to a culture that has told them that the slowing they feel can and should be pumped up with pharmaceuticals. And that aging means that they don't perform. That's not true for most men. What is true has virtually no side effects and for them, is more effective. It is the answer above, and I am offering it again now.
It still works. It is still free. And it does not shrink or shut anything off.
La Puma J. (2014). Don't Ask Your Doctor About Low T. New York Times https://www.nytimes.com/2014/02/04/opinion/dont-ask-your-doctor-about-l…
Lincoff AM, Bhasin S, Flevaris P, et al. Cardiovascular Safety of Testosterone-Replacement Therapy. New England Journal of Medicine. 2023;389(2):107-117. https://www.nejm.org/doi/full/10.1056/NEJMoa2215025
Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. Journal of Urology. 2018;200(2):423-432. https://www.auanet.org/guidelines-and-quality/guidelines/testosterone-deficiency-guideline
Leproult R, Van Cauter E. Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA. 2011;305(21):2173-2174.
Twohig-Bennett C, Jones A. The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes. Environmental Research. 2018;166:628-637.
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John La Puma, M.D., is a board-certified internist, trained chef, two-time New York Times bestselling author, and a regenerative farmer who pioneered the culinary medicine movement.
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.