Testosterone, the Foundations-First Way
Peter Attia's foundations-first approach to testosterone fixes sleep, training, body fat and alcohol before ever considering therapy. He treats testosterone replacement therapy as a genuine medical decision made with a physician and full bloodwork, not a default or an over-the-counter supplement fix.
Sleep, strength training, and muscle mass 7 to 9h sleep; regular resistance training
Sleep and muscle are the foundation of healthy testosterone and metabolic health. Attia treats strength as non-negotiable for aging well.
Reduce visceral fat and limit alcohol Improve body composition; minimize alcohol
Excess visceral fat and alcohol both lower testosterone. Improving body composition often raises it without any supplement.
Correct vitamin D, zinc and magnesium Dose to blood levels
Correcting genuine deficiencies supports normal hormone production. Beyond correcting a deficiency, more does not mean higher testosterone.
Be wary of OTC testosterone boosters Treat tongkat, fadogia and similar as unproven
Attia is skeptical of over-the-counter boosters; the human evidence is weak and quality control is poor. This protocol intentionally does not build around them.
Get comprehensive bloodwork Total & free testosterone, SHBG, LH, FSH, estradiol
Attia's rule is to measure, not guess. A full panel separates a real deficiency from a lifestyle problem and guides any decision.
Treat TRT as a medical decision Only if clinically low and symptomatic, with a physician
Where testosterone is genuinely low and symptomatic, replacement may help, but it is a clinical decision with trade-offs, notably reduced fertility, and needs ongoing monitoring. We do not sell or dose it.
This protocol works from your actual levels. Testing partner coming soon.
- Comprehensive hormone panel
We may earn a referral fee if you book testing through a future partner link; it will never affect which tests are listed here. This is not medical advice or a diagnosis.
Most low-testosterone complaints trace back to modifiable inputs: poor sleep, low muscle mass, excess visceral fat, heavy alcohol and chronic stress.
View sources
Low testosterone: diagnosis, causes and treatment options (Peter Attia)
The Drive (Peter Attia): testosterone and hormone health
Peter Attia, MD: testosterone, TRT and how to think about it
Not medical advice. This page is for education only and is not a substitute for professional medical care. Consult a qualified clinician before changing your health routine.
Independent curation. YourProtocol is an independent platform. This protocol is based on the publicly available work of Peter Attia and is not created, reviewed, endorsed by, or affiliated with Peter Attia or Physician · Longevity.
Is this for you
- Men who want the cautious, evidence-first view
- Anyone tempted by OTC boosters who wants a reality check
- People deciding whether to pursue bloodwork or TRT
- Those who value measuring over guessing
Cautions
- TRT is a medical decision, not a product. It carries trade-offs including reduced fertility and requires a physician and ongoing monitoring. We do not sell or dose it.
- Over-the-counter testosterone boosters have weak human evidence and inconsistent quality; this protocol deliberately does not rely on them.
- Supplements here are to correct deficiencies, dosed to blood levels, not to push testosterone above normal.
- Get proper bloodwork and individualized advice from a clinician before making changes.
- Educational only, not medical advice.
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