Fadogia agrestis after 40

After forty, many men notice that recovery takes longer, libido weakens, and fat accumulates more easily. It is precisely this audience that is most actively offered 'natural testosterone boosters', in particular fadogia agrestis. The editorial team looked into what actually happens to hormones with age, whether fadogia can affect this, and which risks make sense to consider specifically in mature age.

What happens to testosterone after 40

With age, the testosterone level in men gradually declines. Long-term observation within the Baltimore Longitudinal Study of Aging (Harman et al., 2001) showed that total and especially free testosterone decline with each decade, although individual differences are very large.

At the same time, a decline in testosterone does not equal a disease. In the European Male Ageing Study (EMAS; Wu et al., 2010), late-onset hypogonadism was defined only by a combination of low testosterone and several sexual symptoms. By such strict criteria it occurred in a relatively small proportion of middle-aged and older men.

An important detail: in the same EMAS, obesity and comorbidities made a greater contribution to low testosterone than age as such. That is, after 40 hormones often 'sag' because of lifestyle rather than because of inevitable aging.

This is exactly where the temptation arises: instead of dealing with weight, sleep and chronic illnesses, to buy a jar with the promise to 'return the hormones of a twenty-year-old'. Fadogia agrestis is one of the most popular ingredients of such products.

What is promised and what is known about fadogia

Fadogia is a West African plant whose stem extract, in studies on male rats, raised testosterone levels and improved sexual behavior. These works were carried out by the Nigerian group of Yakubu and colleagues in 2005-2008, and it is precisely on them that all modern marketing relies.

There are no human studies. All the more, there are no studies in men over 40 with age-related hormone decline or in patients with late-onset hypogonadism. Transferring results from young rats to middle-aged people is an assumption, not proof.

In addition, the same authors described adverse changes in testicular tissue with prolonged administration of the extract. For a young organism this is already alarming, and for a man whose testicular function is already gradually declining, potential toxicity to them looks especially inappropriate.

The review by Clemesha and colleagues (2020) showed that claims of 'raising testosterone' in most commercial boosters are not supported by academic data. Fadogia in this context is just another ingredient with loud promises and a weak evidence base.

Age-related risks: liver, kidneys, medications

After 40 the likelihood of having chronic conditions increases: arterial hypertension, disorders of lipid metabolism, prediabetes, non-alcoholic fatty liver disease. Accordingly, the number of medications a person takes daily also increases.

In studies on rats, fadogia affected liver and kidney enzymes, and the authors interpreted some of the changes as signs of a burden on these organs. How much this applies to humans is unknown, but with existing liver or kidney diseases such uncertainty is a serious argument against.

The interactions of fadogia with drugs have not been studied. Particular caution should be exercised by those who take statins, antihypertensive agents, anticoagulants, drugs for the treatment of diabetes or the prostate.

A separate risk is product quality. Independent analyses of supplements have repeatedly found undeclared steroids in products 'for male strength', and in mature age the hidden intake of androgens can have consequences for the heart, prostate and blood.

What to start with instead of a booster

The clinical guideline of the Endocrine Society (Bhasin et al., 2018) recommends diagnosing testosterone deficiency only in the presence of symptoms and a confirmed low hormone level, measured in the morning on an empty stomach at least twice. This is a simple and accessible first step.

A basic set of examinations worth discussing with a doctor:

1. total testosterone in the morning on an empty stomach (twice), if necessary - free testosterone and SHBG;
2. LH and FSH, to understand the level of the disorder;
3. prolactin, TSH, glucose or glycated hemoglobin;
4. lipid panel, liver enzymes, creatinine;
5. PSA - at the doctor's discretion.

If testosterone is within the normal range, a 'booster' has nothing to affect: the symptoms are most likely related to other causes. If it is truly low, the doctor will choose an approach with proven effectiveness and will monitor safety.

Let us also mention sleep. Even a week of restricting sleep to five hours lowered daytime testosterone in young healthy men (Leproult, Van Cauter, 2011). After 40 sleep often becomes shorter and shallower, and this is one of the simplest levers.

What really works for training after 40

Strength training remains the main 'natural anabolic' at any age. It maintains muscle mass, insulin sensitivity and bone density, and a moderate reduction in fat mass often improves hormonal indicators on its own.

Among supplements, the best studied are creatine monohydrate, protein products for reaching the daily protein norm, and vitamin D with a confirmed deficiency. They do not promise to 'return youth', but they have a predictable safety profile.

It is also advisable to adjust the training process: more time for warming up, recovery between hard sessions, control of pain sensations in the joints. Progress after 40 depends on consistency rather than on extreme stimuli.

If you are still considering fadogia, honestly ask yourself: what problem do you want to solve and is there confirmation that this problem exists? Most often the answer leads to tests rather than to a supplement.

Editorial conclusions

The age-related decline in testosterone is a real process, but it is largely amplified by excess weight, illnesses and poor sleep. Fadogia agrestis does not affect these causes.

There are no human studies of fadogia, in particular in men over 40, and animal data contain signals of possible toxicity to the testes, liver and kidneys.

After 40 it is more advisable to start with tests and a consultation with an endocrinologist or andrologist, and training, sleep and weight control remain the most effective 'hormonal therapy' without a prescription.

We also recommend our materials 'Fadogia or tongkat ali: what is the difference', 'Fadogia agrestis and the liver and kidneys: is it safe' and 'Myths about fadogia agrestis'.

References

1. Harman SM, Metter EJ, Tobin JD, et al. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. J Clin Endocrinol Metab. 2001;86(2):724–731.
2. Wu FC, Tajar A, Beynon JM, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010;363(2):123–135.
3. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(5):1715–1744.
4. Leproult R, Van Cauter E. Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA. 2011;305(21):2173–2174.
5. Yakubu MT, Akanji MA, Oladiji AT. Aphrodisiac potentials of the aqueous extract of Fadogia agrestis (Schweinf. Ex Hiern) stem in male albino rats. Asian J Androl. 2005;7(4):399–404.
6. Yakubu MT, Akanji MA, Oladiji AT. Effects of oral administration of aqueous extract of Fadogia agrestis (Schweinf. Ex Hiern) stem on some testicular function indices of male rats. J Ethnopharmacol. 2008.
7. Clemesha CG, Thaker H, Samplaski MK. 'Testosterone boosting' supplements composition and claims are not supported by the academic literature. World J Mens Health. 2020;38(1):115–122.