GLP‑1 Medications Show New Benefits
New research presented at ENDO 2025, the Endocrine Society’s leading international conference on hormone science, reveals that GLP‑1 medications like semaglutide, dulaglutide, and tirzepatide may raise testosterone levels in men with obesity and type 2 diabetes. These medications have already transformed the treatment of obesity and blood sugar regulation. Now, they appear to support hormone health as well.
Testosterone Levels Improved Through Fat Loss
Researchers followed 110 men using GLP‑1 therapy over 18 months. At the beginning of the study, only 53% had testosterone levels in the normal range. By the end, that number climbed to 77%. These men were not given testosterone. Instead, they lost weight—especially visceral fat.
This distinction matters. The medications didn’t stimulate testosterone production directly. Rather, by reducing abdominal fat, they removed the hormonal interference caused by that fat. As a result, the body restored balance on its own.
Visceral Fat Disrupts Hormones
Visceral fat, which builds around the internal organs, interferes with the body’s hormone regulation. It drives inflammation, increases insulin resistance, and activates aromatase—an enzyme that converts testosterone into estrogen. Over time, this cascade leads to lower testosterone and a range of symptoms including low energy, reduced libido, and muscle loss.
However, when visceral fat decreases, these negative effects weaken. The hormone environment improves, and testosterone levels often return to normal without medication. GLP‑1 drugs target this process at the source.
Why Hormone Therapy Isn’t the First Step
Although testosterone therapy helps some men, it also carries risks. Side effects can include mood swings, fluid retention, fertility issues, and cardiovascular complications. That’s why we prioritize fat loss before introducing hormone replacement.
By addressing the metabolic root cause—excess visceral fat—we create conditions where testosterone can rebound naturally. GLP‑1 therapy offers this benefit in a medically controlled, research-backed way.
What This Means for Your Treatment Plan
At Austin Thyroid & Endocrinology, we manage many patients with overlapping issues: obesity, low testosterone, insulin resistance, and thyroid dysfunction. These conditions influence one another. Addressing weight often improves hormonal balance, glucose control, and energy levels together.
If you’ve started GLP‑1 therapy and feel better, this may be part of the reason. If symptoms remain—especially those linked to low testosterone—we may recommend lab testing to confirm your status and reassess your care plan.
What Now?
Dr. Scumpia says:
“We now have strong evidence that reducing visceral fat improves testosterone without jumping to hormone therapy. For men with belly fat, fatigue, and metabolic disease, this changes the sequence of care. Lose the fat first. Then reassess the hormones. It’s safer, smarter, and supported by data.”
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