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Does Low Testosterone Increase Your Risk of Severe Covid?

Does Low Testosterone Increase Your Risk of Severe Covid?

By Mike Kocsis | 7 minutes read | Last updated: May 7, 2024
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  • Medically Reviewed by Dr. George Touliatos

    Evidence Based Research

    Recent studies show that Covid affects men more severely than women. A 2020 study found that the rate of men dying due to Covid is 2.4 times more than the rate of women dying due to the same illness.

    Initially, it was believed that one of the reasons behind it might be the hormonal differences in men and women. Some researchers hypothesised that men have higher testosterone levels than women, which might be the reason why they are developing more severe symptoms of Covid.

    However, more recent studies showed entirely different results. According to them, high testosterone levels in men are not the culprit, but they might be the saviour in the case of Covid. The latest data shows that men with low testosterone are more likely to require intensive care or die due to Covid than men with normal testosterone levels.

    If a man with low testosterone levels is admitted to a hospital and his symptoms are mild initially, his chances of dying or developing severe Covid symptoms are significantly higher than a man with normal testosterone concentration.

    In this article, we will analyse the results of one of the latest studies to understand the connection between low T and the risk of severe Covid. We will also talk about the ways you can use to protect yourself from developing severe Covid due to low T.

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    What does the research say?

    In a study published in May 2021, researchers looked at 152 Covid patients of Barnes-Jewish Hospital who became victims of this illness during the first wave. Of these patients, 90 were men, while 62 were women.

    143 of 152 patients were admitted to the hospital. Researchers measured their hormone levels on days 1, 3, 7, 14 and 28 of their stay in the hospital.

    66 men among 90 had severe Covid symptoms, while the remaining 24 had mild symptoms. When their testosterone levels were measured and compared, researchers found that testosterone levels on days 1 and 3 were 65% to 85% lower in men with severe Covid compared to men with mild Covid.

    Testosterone concentration below 250 nanograms per deciliter is called low testosterone in men. The average testosterone concentration in men with severe Covid was 53 nanograms per deciliter on day 1. Testosterone levels reduced to 19 nanograms per deciliter by day 3. On the other hand, the average testosterone concentration in men with mild Covid was 151 nanograms per deciliter on day 1. It dropped below 100 nanograms per deciliter by day 3.

    Men who had the lowest testosterone levels were at higher risk of going to the ICU or dying. 37 patients died during the study; 25 of them were men.

    Researchers found that men who had lower testosterone levels but mild symptoms initially were likely to admit to the ICU within 2 to 3 days. It showed that testosterone levels could predict which patient would become more ill within the next few days.

    Researchers measured levels of other hormones as well, but they did not find any other hormone to be linked with Covid severity.

    The scientists did not find any relationship between Covid severity and hormone levels in women.


    So what’s the outcome?

    The result of this study shows that there might be an association between testosterone levels and Covid severity in men. Many other studies also support this outcome. However, it is hard to figure out the exact connection between these two conditions or tell if severe Covid is really the cause of low testosterone.

    Researchers said that more investigation needs to be done in this field to draw such a conclusion.


    How can you stay on the safer side?

    From the study mentioned above, we can see that most men with severe Covid had low serum testosterone concentration. It is yet not clear whether low T caused Covid or Covid led to low T. However, testosterone levels can be used to predict the mortality rate in Covid patients.

    If you already have low T, correcting it can help you stay safe.

    You can reverse the effect of low T by increasing your testosterone levels. Different methods are used to boost testosterone levels. You choose a method based on the cause of your low testosterone. Men can have low T either due to a poor lifestyle or an underlying issue such as a disease.

    Smoking, excessive drinking, stress, and lack of physical activities are some lifestyle choices that lead to low T. Adopting healthy habits and changing your lifestyle can help you boost your testosterone levels naturally. Here are a few natural ways people use to stimulate their testosterone production.

    • Maintaining a healthy body weight
    • Managing stress
    • Having healthy balanced meals
    • Sleeping 8 hours a day
    • Becoming more active
    • Avoiding alcohol abuse

    These methods may work for you if your low T is due to poor lifestyle habits.


    But what if natural ways don’t work?

    Natural ways are generally not very effective in increasing testosterone levels if the cause of low T is a disease, infection, or genetic disorder.

    If a man has a compromised pituitary or hypothalamus, his testes may not receive signals from the brain to produce testosterone. Testes may not produce testosterone even after receiving signals from the brain if they are injured or infected.

    In that case, testosterone replacement therapy (TRT) comes to help.


    How can testosterone replacement therapy (TRT) help?

    In men with low T, the body is unable to produce endogenous testosterone, so it needs to be replaced with exogenous testosterone. This is what TRT does.

    Men on TRT are prescribed different doses of synthetic testosterone based on their current testosterone level. They will likely get a high dose if their testosterone is very low. In contrast, if their testosterone levels are slightly low, they will get a low dose.

    Men can receive testosterone doses in different forms like injections, gels, skin patches, and pellets. Testosterone injections and gels are considered two of the most effective means of delivering testosterone.

    TRT is a life-long treatment option, meaning you will have to take testosterone throughout your life to keep your testosterone levels stable. Once you stop taking testosterone, your serum testosterone concentration will drop again.

    While TRT is more popular among older men, it is now gaining popularity among the younger generation due to its effectiveness. The cases of low T are increasing with time, either due to unhealthy habits or internal issues. You should talk to your doctor if you are experiencing low T symptoms and find a timely solution to this problem.


    What are the risks of TRT?

    Just like any other prescription medication, continuous use of testosterone can also produce side effects. Thankfully, risks associated with TRT are relatively benign, and if you work with a qualified doctor, you can prevent them to some extent.

    Some of the most common risks of TRT are:

    • Oily skin
    • Acne
    • Testicular atrophy (shrinkage of testes)
    • Infertility

    In some cases, TRT increases the risk of prostate cancer. That is why you must properly discuss your health history with your doctor. If you have had a similar issue, your doctor may not prescribe you TRT.

    Some men on TRT may want to have children. They can reduce TRT’s testicular atrophy side effect by combining this treatment with hCG injections. hCG is another human hormone that is found in small amounts in men. It stimulates testes to secrete more testosterone and convert germ cells into sperms.

    All in all, it improves fertility and addresses symptoms of low T. But, HCG may not be suitable for all TRT candidates. You should discuss its effectiveness with your doctor before combining it with TRT.



    How to increase testosterone after Covid?

    If you have recently recovered from Covid and your testosterone levels have declined due to the illness, you should use the natural methods mentioned above to bring your testosterone levels back to normal. You can also try testosterone-boosting foods such as fatty fish, pomegranate, extra virgin olive oil, and leafy green vegetables to rise testosterone levels.

    Does the Covid vaccine reduce testosterone?

    Based on the current evidence, the Covid vaccine does not affect testosterone, erectile function, sexual function, or fertility in any way. Its most common side effects are chills, fevers, headaches, and pain at the site of injection.

    Summing it up

    Many studies indicate that men with severe Covid have lower testosterone concentration than men with less severe Covid. We don’t know yet whether Covid causes low T or low T increases the risk of Covid, but it is better to stay on the safer side and keep your testosterone levels within the normal range.

    Men with low T can have TRT to restore their sex hormone levels and reduce the effect of low T on the body. Talk to your doctor to set realistic goals related to TRT and get your testosterone levels back to normal.


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    References/Further Reading/Bibliography/ Scientific studies

    Lanser, L., Burkert, F.R., Thommes, L., Egger, A., Hoermann, G., Kaser, S., Pinggera, G.M., Anliker, M., Griesmacher, A., Weiss, G. and Bellmann-Weiler, R., 2021. Testosterone deficiency is a risk factor for severe COVID-19. Frontiers in Endocrinology12, p.694083.

    Lo, S.P., Hsieh, T.C., Pastuszak, A.W., Hotaling, J.M. and Patel, D.P., 2022. Effects of SARS CoV-2, COVID-19, and its vaccines on male sexual health and reproduction: where do we stand?. International Journal of Impotence Research34(2), pp.138-144.

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    Evidence Based Research

    This article has been researched and written based on scientific evidence and fact sheets that have then been crossed checked by our team of doctors and subject matter experts.

    References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.

    Our team of healthcare experts and GMC registered doctors are licensed to UK GMC standards. We strive to provide you with the latest evidence based, researched articles that are unbiased, honest and provide you with accurate insights, statistics and helpful information on the discussed topic to ensure you gain a better understanding of the subject. You can read more about our Editorial Process by clicking here.

    We value your feedback on our articles, if you have a well-researched paper you would like to share with us please contact us.

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    About the Author: Mike Kocsis

    Mike KocsisMike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.

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