Is Low Testosterone A Risk Factor For Severe Covid 19?

Testosterone is a widely known sex hormone, but it has many other roles in the human body. 

It stimulates tissue proliferation, which is why males naturally have a higher red blood cell count than women. 

It modulates human behavior and influences various health parameters. Moreover, studies show that it might be involved in immunity, too.

This article will discuss the association between testosterone and covid (SARS COV 2 infection). Is it possible that testosterone level variations change the severity of this ailment? 

Can low testosterone increase your risk of more severe covid 19?

If you are up to date with the latest health news, you have probably heard about one of the most recent studies about COVID 19 infection. It was published in St Louis School of Medicine under Professor Abhinav Diwan. He noticed that male COVID 19 patients with low testosterone levels usually require intensive care medicine.

Then, he presented a study to ascertain the clinical outcome and COVID 19 severity of these patients according to their testosterone levels. He found out that there is indeed an association between testosterone and COVID. Patients with hypogonadism required more frequent hospital admission.

In a nutshell, the evidence so far suggests that low testosterone could increase the risk of more severe COVID-19. But let’s take a closer look at this and other related scientific articles.

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What the studies say

The implication of testosterone in infectious diseases is not a new topic. It was covered by studies previous to the recent COVID 19 pandemic. 

The rationale is that testosterone promotes cell proliferation. It increases red blood cell count in males, and something similar could be happening in the immune system. This hypothesis was tested, and it turned out that the association was a bit more complex.

Testosterone interacts with the immune system, but it sometimes enhances or inhibits an immune response. The effect depends on the type of immune response. Thus, we can say that it modulates immunity (1). Still, other studies suggest no immune changes dependent on testosterone (2).

A more recent study in males and females showed that higher testosterone levels improved salivary mucosal immunity. This would increase the risk of getting an infectious disease. 

Immunoglobulin A changes concentrations in the oral mucosa depending on the patient’s testosterone level. In contrast, patients with higher estradiol levels had lower mucosal immunity (3).

How does it apply to COVID 19 in male patients?

One study published in the journal Andrology may hold the answer. This is a respected publication of the European Academy of Andrology. 

The researchers studied testosterone levels in males and their COVID 19 outcome (disease severity). All the patients needed hospital attention. However, those with lower free testosterone and total testosterone had more severe COVID 19. 

Their need for intensive care unit transfer and their mortality risk was higher. Patients with hypogonadism and very low testosterone level (lower than 5 nmol/L) were particularly affected (4).

The study we mentioned above was published in the journal JAMA Network Open. It included a larger cohort of patients and confirmed the outcomes discussed above. 

In this case, they measured testosterone levels at the patient’s presentation and three days after. Then, the researchers related these measurements with disease severity. 

They found that low testosterone levels were associated with a worse outcome. Patients with severe symptoms had 65 to 85% lower testosterone levels than patients with mild symptoms. Their inflammation levels were higher, and they experienced more complications. Interestingly, their hormone signaling pathways did not change due to hormone imbalances (5).

After considering the evidence, what can we say about it?

They are all observational studies. As such, they have many limitations because there could be a secondary cause triggering both conditions (testosterone deficiency and severe disease in COVID 19 patients). Still, the fact that one study confirms the outcomes of the other shows that there is something worth investigating.

Hormone measurements could predict COVID 19 outcome depending on serum testosterone levels. However, more research is required in this field to apply these findings.

How you can protect yourself 

An interesting aspect of the study mentioned above is that most male patients who required intensive care had very low T levels. 

A natural hormone level in healthy adults should be around 250 ng/dL. They had an average of 53 ng/dL. Moreover, by day 3 of hospitalization, this level dropped to 19 ng/dL. We still don’t know if this is a cause or a consequence of severe COVID 19 symptoms. We know that low T can potentially predict morbidity and mortality rates in these patients.

If this is the case, and you already have testosterone problems, correcting them is essential to stay safe. Testosterone replacement therapy is offered in hypogonadism to increase total testosterone levels. 

Alternative testosterone therapy may also include testosterone booster supplements. They are more useful in patients with borderline or low T levels that do not reach the lower threshold.

If you are trying to increase your testosterone levels, you should know something. Prostate cancer is sometimes worse when testosterone levels are high. Thus, be sure to talk to your doctor about it before deciding on any form of testosterone treatment.

testo booster

How to naturally boost your testosterone levels

One of the benefits of natural therapy is that it is usually not contraindicated. It won’t harm your body as long as you do not overdo it, and it is generally associated with additional health benefits. 

To correct low testosterone levels, you could try the following natural boosters:

1. Engage in physical activity

Exercise is essential to increase your testosterone levels. Resistance training is known to influence testosterone to a higher degree than cardio. The most effective exercises involve large muscle groups such as the legs and the back.

2. Keep a healthy weight

There is an enzyme in your fatty tissue called aromatase. This enzyme turns testosterone into estrogens and reduces your circulating levels of this hormone. Testosterone and excess body fat are usually not on very good terms.

3. Cope with stress

Stress and anxiety release cortisol, which takes up the resources your body needs to synthesize testosterone. The more stressed and anxious you are, the more likely it will reduce your testosterone levels.

RELATED: 15 Simple Ways To Relieve Stress And Anxiety.

4. Do not hide from the sunlight

It is essential to protect from UV rays, but it is also healthy to receive a small dose of the sun every day. That is how the body creates vitamin D, which then modulates testosterone levels, among other things.

5. Get enough sleep

Not sleeping well can drop your testosterone levels by 15% or more. This is a function your body needs to recover and produce several enzymes and hormones.

6. Consider a few natural testosterone boosters

There are various testosterone boosters we can consider. Some of them are minerals such as zinc and boron. Others are herbs and plants such as red ginseng and horny goat weed

Regardless, it is vital to consider the ingredients of your testosterone booster and read about their health benefits to stay well informed.

7. Follow a healthy diet

You should get your requirements of calories, carbohydrates, proteins, and fat. You should also make sure that you hit the daily requirements of vitamins and minerals. 

Besides, it is always good to add antioxidants and anti-inflammatory foods. They protect your testis and other structures of the body.


Testosterone levels are critical in male patients after puberty. This hormone is involved in the classic secondary sexual traits such as body hair and penis length. 

However, it might also influence immunity in ways that science has not yet fully understood. This is why recent studies describe a link between testosterone and COVID.

A low level of this hormone in males is associated with symptomatic COVID 19 disease that may rapidly evolve into severe disease. According to studies, a very high proportion of male patients in intensive care units have hypogonadism or alarmingly low T levels.

The link has not been fully elucidated, and studies are so far observational only. However, correcting testosterone levels in these patients should be a part of natural therapy. Talk to your doctor if you have low testosterone problems. You could benefit from several options, including natural testosterone boosters.

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  1. Trumble, B. C., Blackwell, A. D., Stieglitz, J., Thompson, M. E., Suarez, I. M., Kaplan, H., & Gurven, M. (2016). Associations between male testosterone and immune function in a pathogenically stressed forager‐horticultural population. American journal of physical anthropology, 161(3), 494-505. 
  2. Nowak, J., Pawłowski, B., Borkowska, B., Augustyniak, D., & Drulis-Kawa, Z. (2018). No evidence for the immunocompetence handicap hypothesis in male humans. Scientific reports, 8(1), 1-11. 
  3. Hodges‐Simeon, C. R., Asif, S., Gurven, M., Blackwell, A. D., & Gaulin, S. J. (2019). Testosterone is positively and estradiol negatively associated with mucosal immunity in Amazonian adolescents. American Journal of Human Biology, 31(5), e23284. 
  4. Rastrelli, G., Di Stasi, V., Inglese, F., Beccaria, M., Garuti, M., Di Costanzo, D., … & Vignozzi, L. (2021). Low testosterone levels predict adverse clinical outcomes in SARS‐CoV‐2 pneumonia patients. Andrology, 9(1), 88-98. 
  5. Dhindsa, S., Zhang, N., McPhaul, M. J., Wu, Z., Ghoshal, A. K., Erlich, E. C., … & Diwan, A. (2021). Association of circulating sex hormones with inflammation and disease severity in patients with COVID-19. JAMA network open, 4(5), e2111398-e2111398. 

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