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The Relationship between Low Testosterone and the Immune System

The Relationship between Low Testosterone and the Immune System

By Mike Kocsis | 7 minutes read | Last updated: October 27, 2023
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  • Medically Reviewed by Dr. George Touliatos

    Evidence Based Research

    Testosterone, also referred to as the ‘king of hormones’ for men, plays a crucial role in driving libido, regulating mood, and maintaining bone density. But did you know testosterone’s influence extends far beyond these well-known roles? Recent studies have unveiled an interesting relationship between testosterone levels and the immune system.

    Keep reading the article to find out how your low testosterone levels might negatively affect your immune system.

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    Understanding testosterone

    Testosterone is a male sex hormone produced by the testes in men and by ovaries in females. Its production begins when the hypothalamus releases gonadotropin-releasing hormone (GnRH) to stimulate the pituitary gland to secrete luteinising hormone (LH) and follicle-stimulating hormone (FSH).

    LH and FSH work together to trigger testosterone formation by Leydig cells in the testes. It creates the hypothalamic-pituitary-gonadal (HPG) axis that regulates testosterone production.

    Testosterone is involved in many functions, such as:


    The Decline of Testosterone

    It is interesting to note that testosterone levels fluctuate throughout a man’s life. They are the highest during early adolescence and then gradually decline after 30.

    The decline in testosterone levels is a natural part of ageing, but sometimes other conditions, including liver disease, HIV, autoimmune disorder, etc., can also contribute to this issue. Many factors can contribute to this problem, including:

    • Ageing
    • Nutritional deficiencies
    • Hormonal disorders
    • Stress
    • Sleep disorders
    • Obesity
    • Smoking
    • Excessive alcohol consumption


    In men, healthy testosterone levels range from 300 to 1,000 nanograms per deciliter (ng/dL). Men with low testosterone (low T) have levels below 300 ng/dL.

    Your body needs testosterone to function normally, but it fails to perform various processes when it does not get enough testosterone. As a result, you may experience low T symptoms, including:


    These symptoms vary from person to person. Consult with a healthcare provider if you are tired of these unwanted low T signs and want to improve the quality of your life. They will help you find a suitable solution, such as lifestyle changes or testosterone replacement therapy (TRT).

    While all these low T symptoms are well-known, recent research discoveries suggest that abnormally low or high testosterone may also disturb your immune system.


    Understanding the immune system

    The human immune system consists of several organs, tissues, cells and compounds that work together to defend the body against disease or infection-causing microbes. It consists of innate and adaptive immune systems. The former produces a general response to an invader, while the latter responds to a specific invader.

    It performs the following key roles to create a healthy defence mechanism.

    • Identify foreign substances
    • Eliminate pathogen
    • Develop immunological memory to enable a quicker response upon successive exposure


    The connection between the immune system and low T

    Some studies indicate testosterone plays a crucial role in managing the immune system in different ways. So, men with high or low testosterone levels may be highly susceptible to certain diseases and infections.

    Your low T may be influencing your immune system in the following ways.

    Testosterone and immune cells: Testosterone is known to influence the function and response of immune cells. Studies indicate it may enhance the activity of T cells and natural killer cells. T cells attack viruses when antigens activate them, while natural killer cells perform the same function without requiring activation. Both cells play a crucial role in identifying and eliminating harmful pathogens.

    When your testosterone level is low, immune cell activity may get reduced, impairing the immune system’s ability to defend the body against pathogens.

    Testosterone and inflammation: Low testosterone may also cause chronic inflammation, leading to autoimmune disorders in which the immune system accidentally starts attacking healthy body cells. Autoimmune disorders like rheumatoid arthritis have been linked to low T in men.

    Testosterone receptors on immune cells: Studies show that several immune cells, including macrophages and neutrophils, have testosterone receptors (molecules that bind to testosterone), indicating that this hormone directly influences their function.

    Testosterone can also indirectly influence the immune system through stress regulation, metabolism, and other physiological processes.



    While the existing studies have provided valuable information, we need to acknowledge their limitations. Some studies have considered only specific populations, while others have used small sample sizes, showing that more work needs to be done to gain a broader understanding.

    Researchers have also not yet fully understood the mechanism underlying the connection between the immune system and low T, leaving room for further investigation. They should continue exploring this intriguing connection to have a more comprehensive understanding.


    Factors influencing testosterone levels and the immune system

    Several factors can directly or indirectly disturb your testosterone levels and immunity. Some of these factors are:

    • Diet
    • Adequate sleep
    • Stress management  
    • Physical activity or exercise
    • Exposure to certain pollutants
    • Certain medicines
    • Certain diseases


    You should maintain a healthy lifestyle to support balanced testosterone levels and keep your immune system healthy. Learn stress management techniques to handle day-to-day stressful situations. Get 7 to 9 hours of quality sleep to feel fresh the next day. Make exercise a part of your life as it offers a myriad of wonderful benefits.


    Benefits of healthy testosterone levels

    Maintaining testosterone levels is crucial for your overall health. Here are the key benefits of having optimal testosterone levels.

    Sexual function and health: Testosterone contributes to sexual health in men in several ways. It controls erection, sexual desire, and sperm formation.

    Bone mineral density: It maintains bone strength and density by supporting mineral deposition and preventing bone breakage.

    Muscle development and maintenance: It helps with muscle protein and fibre formation.  

    Mood regulation: Healthy testosterone levels have been associated with reduced symptoms of depression and improved mood.

    Body composition: It promotes a leaner body composition by regulating fat distribution. It prevents the accumulation of fats around organs, which could otherwise lead to serious health problems.

    Energy levels: It supports energy formation, helping improve physical endurance and stamina.


    When your testosterone levels are below normal, all the above-mentioned roles of testosterone get disturbed. Some men learn to cope with these changes, while others look for ways to restore their testosterone levels and feel better again.

    If you suspect low T, it is advised to consult with hormone specialists to find appropriate guidance and treatment options. They will evaluate your current health condition and medical history to identify low T causes. Your treatment plan will be designed based on what is affecting your testosterone levels.

    If increased weight, poor diet, or sleep deprivation is the cause, you will be asked to improve your lifestyle and try natural ways to boost testosterone. But if your testosterone levels are very low and natural methods are ineffective in your ways, your doctor will most likely prescribe testosterone replacement therapy (TRT).  


    The potential solution: Testosterone replacement therapy (TRT)

    TRT is an effective solution for men experiencing low T symptoms. It involves the administration of exogenous testosterone to bring levels back to a healthy range.

    TRT treatment plans are customised based on testosterone levels, health status, specific needs, and health goals of each patient. Once you start having testosterone, your health will be closely monitored to ensure you don’t experience potential side effects of TRT and your testosterone levels stay optimal.

    Like any other medical procedure, TRT may also produce potential side effects, including fluid retention, low sperm count, acne, etc. Talk about them with your doctor and learn how to avoid these side effects.

    TRT is a lifelong procedure. When you stop having testosterone, your levels drop back to what they used to be before starting the treatment. Hence, you should discuss everything related to the treatment, including its possible results, side effects, and cost, with your doctor before you start it.

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    Summing it up

    The relationship between immunity and low T is multifaceted. The exact mechanisms linking these systems are not yet clear, but the latest studies suggest that low T can contribute to immune system dysfunction. Further research in this field is crucial to understanding the exact connection between testosterone levels and immunity.

    Low T causes many other problems in men, including poor bone and muscle health. If you have low T, you should work with a hormone specialist to understand what is causing the problem and how you can resolve it. TRT is one of the most commonly prescribed effective solutions that help men restore their testosterone levels and feel better again.


    References/Bibliography/Scientific studies/Further reading/

    Çayan, S., Uğuz, M., Saylam, B. and Akbay, E., 2020. Effect of serum total testosterone and its relationship with other laboratory parameters on the prognosis of coronavirus disease 2019 (COVID-19) in SARS-CoV-2 infected male patients: a cohort study. The Aging Male23(5), pp.1493-1503.

    Baillargeon, J., Al Snih, S., Raji, M.A., Urban, R.J., Sharma, G., Sheffield-Moore, M., Lopez, D.S., Baillargeon, G. and Kuo, Y.F., 2016. Hypogonadism and the risk of rheumatic autoimmune disease. Clinical rheumatology35, pp.2983-2987.

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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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