Do "testosterone boosters" really increase serum total testosterone? A systematic review.
Level 1 - systematic review of randomized trials
Systematic review of comparative trials evaluating supplement interventions against placebo.
PubMed 37697053 · doi:10.1038/s41443-023-00763-9
What was done
The authors systematically reviewed 20 years of published literature evaluating commercial testosterone boosters compared to placebo on total serum testosterone. They examined four populations: male athletes, healthy men, men with late-onset hypogonadism, and infertile men. A total of 52 studies evaluating 27 proposed supplement ingredients were included.
What was found
The abstract reports no numerical effect sizes or confidence intervals. Most evaluated ingredients failed to increase total testosterone. Across specific groups, the review identified few positive findings: β-hydroxy β-methylbutyrate (HMB) and betaine were rated effective for male athletes; Eurycoma longifolia, a Punica granatum/Theobroma cacao blend (Tesnor), and purified Shilajit extract (PrimaVie) were rated possibly effective for men with late-onset hypogonadism; Eurycoma longifolia and Withania somnifera were rated possibly effective for healthy men; and an aromatase inhibitor formulation (Novadex XT) was rated possibly effective for male athletes.
Why it matters
Despite widespread marketing and consumer use, the vast majority of over-the-counter testosterone supplements lack evidence of efficacy, providing clinicians with evidence to counsel patients against relying on unverified formulations.
Limits
The abstract provides qualitative ratings without reporting quantitative effect sizes, pooled estimates, or statistical significance metrics. Many evaluated supplements were supported by only one to three small trials, and the abstract does not report study quality, dosing consistency, or adverse event data.
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