Evidence
TRT vs natural testosterone boosters: what actually works?
The supplement aisle promises a lot. The evidence is much narrower. Here is how over-the-counter boosters compare to prescribed TRT.
Over-the-counter "boosters"
Most products combine tribulus, fenugreek, D-aspartic acid, or ashwagandha. Randomised trials show:
- Tribulus terrestris — no consistent effect on testosterone.
- D-aspartic acid — short-term rise in some studies, no effect after 90 days.
- Ashwagandha — modest improvement in some small trials, mainly in stressed or training men.
- Fenugreek — small effects on libido, unclear effect on actual testosterone.
Correcting deficiencies
If you are deficient in vitamin D, zinc, or magnesium, correcting it can raise testosterone. Supplementing when you are already replete does not.
Prescribed TRT
Testosterone replacement therapy is a prescription-only treatment a doctor may consider for men with diagnosed hypogonadism. Whether it is appropriate, and how well it works, differs between people. It requires:
- Two morning blood tests confirming low testosterone
- A specialist referral (endocrinologist, urologist, or sexual health physician)
- Ongoing monitoring of PSA, haematocrit, lipids, and symptoms
It is not a lifestyle drug — once started, most men stay on it long term.
How to decide
Start with lifestyle (guide here). If symptoms persist, take the ADAM questionnaire and get a hormone blood test. Treatment decisions follow the labs, not marketing claims.
Take the free 2-minute symptom check
The ADAM symptom check shows whether your symptoms may be worth discussing with a doctor. You can also request a callback to get matched with a men's health doctor at a partner clinic, by telehealth or in person, for an assessment.
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*Blood tests may be bulk billed where eligible, subject to doctor assessment and clinical indication.