Lifestyle changes, not testosterone, can improve low energy

Q: I often feel quite tired. My doctor says this fatigue may be caused by my low-normal testosterone level. I'd rather not go on testosterone therapy. What are some other ways to enhance my energy?

A: Research studies have not demonstrated a clear value in giving testosterone therapy to men who may be experiencing symptoms of low-normal or slightly low blood levels of testosterone.

In fact, some studies have even indicated that such treatments may raise the risk of heart trouble. So I can certainly understand if you'd rather avoid testosterone therapy to relieve your fatigue.

The good news is that lifestyle changes can go a long way toward improving your energy and overall health. I'll describe some of them here.

Eat for energy

Caffeine and sugar can give you a temporary lift. But when you eat a diet packed with vegetables, fruits, nuts, whole grains, healthy fats and lean protein, you not only consume the finest energy-boosting foods, but you also promote good health.

That's an energy booster in itself. And don't forget water. If your body is short on fluids, one of the first signs is a feeling of fatigue.

Exercise regularly

Exercise is a proven way to increase your vim and vigor.

Aim for 150 minutes of moderate aerobic activity per week or 75 minutes of vigorous activity, or a mix of the two.

You'll also want to engage in two to three strength-training sessions per week. Allow at least 48 hours between these muscle-building workouts to give your body time to recover.

Get better sleep

Nothing saps your energy faster than a poor night's rest. Most ordinary sleep difficulties can be solved with simple behavioral changes.

For example, use your bed only for sleeping or sex. Watch TV or read in a different room. And go to bed and get up at the same time every day, including weekends.

To get better sleep, avoid coffee or other caffeinated beverages or foods after noon; their effects in disrupting sleep can last for 12 to 16 hours.

Also avoid more than one alcoholic drink after dinner. While alcohol can be an effective "nightcap," helping you nod off more easily, later in the evening it acts as a stimulant, keeping you from getting enough deep sleep.

Finally, if you know or think you may suffer from sleep apnea or another sleep disorder, a doctor who specializes in sleep can improve your own - and with it, your energy.

Control stress

The most common cause of persistent fatigue is stress and the emotional response to it.

You can't eliminate stress from your life, but you can learn relaxation techniques that work as an antidote to it.

Deep breathing, meditation, progressive muscle relaxation and visualization can evoke a state of rest and release. These relaxation exercises lower blood pressure and slow heartbeat and respiration.

Paying attention to these lifestyle changes can do a lot more for your energy than drinking "energy drinks," which are artificial and temporary.

You want the real thing.

• Dr. Komaroff is a physician and professor at Harvard Medical School. For questions, go to AskDoctorK.com.