Unexplained Anemia: Testosterone Replacement Therapy Might Help


Written by Elite HRT on March 18, 2022

Medically reviewed by

Camille Freking, Regulatory Affairs Specialist, MEDICAL ADVISOR

Many processes within your body contribute to the formation of healthy red blood cells. Your body needs red blood cells to deliver oxygen to every part of your body. If your body isn’t producing a sufficient amount of healthy red blood cells, this can lead to health complications.

Testosterone can help the body to create healthy red blood cells. If you have unexplained anemia, especially as an older adult, here’s what you need to know about the role testosterone can play in restoring your health.

What Is Anemia?

Anemia (sometimes spelled anaemia) is a common blood disorder. It occurs when the body has issues manufacturing a sufficient amount of healthy red blood cells to transport oxygen throughout the body. 

Red blood cells are designed to attract and carry oxygen from the lungs and circulate it around your system. On their return trip, they bring back carbon dioxide for your body to eliminate.

While all types of anemia will generally affect the body the same way, anemia can occur due to a wide variety of underlying causes. Nutritional deficiencies, like vitamin B12 deficiency, folate deficiency (vitamin B9/folic acid), or serum iron deficiency can cause anemia. 

More than 60% of causes of anemia are attributed to nutritional factors like deficiencies. The remainder of cases don’t have a clear cut solution. In some cases, low testosterone can be a contributing risk factor for unexplained anemia.

What Are the Symptoms of Anemia?

The symptoms of anemia are often very similar to the symptoms of other medical conditions. All of these symptoms can indicate a serious health concern. If you’re experiencing these symptoms, it’s important to schedule an appointment with your doctor as soon as possible. You can mention anemia as a possible concern.

  • Fatigue, lack of mental clarity, or excessive sleepiness
  • A general feeling of weakness
  • Irregularity in heart rhythm and/or chest pain
  • Shortness of breath or feeling winded
  • Dizziness or lightheadedness
  • Headaches
  • Coldness in the extremities, especially the hands and feet

If you’re experiencing shortness of breath, irregular heartbeats, or chest pain, it’s best to treat the situation like an emergency and seek medical help immediately. 

How Does Anemia Affect the Body?

The most prevalent and disruptive effect of anemia is the way it throttles energy and makes the body tired. People with anemia often struggle to complete simple tasks. Exercise is vital for a healthy body, and many people with anemia are not physically able to exercise as often as they’d like to.

For some people with anemia, walking long distances or completing physical household chores like sweeping can be draining. Fatigue can also lead to issues with mental focus, which makes it hard to concentrate on work or study. 

A lack of adequate oxygenation can impair organ health. Your organs need oxygen to perform their functions and repair themselves. If they aren’t getting enough, they may not perform their functions as intended. These effects can be particularly devastating to the heart. 

How Does Testosterone Affect Anemia?

Testosterone performs a wealth of functions in the bodies of men. Women have a much lesser need for testosterone, but its function is still important. Younger women are more likely to develop anemia than younger men, but elderly patients who carry the Y chromosome are more likely to develop anemia — i.e., older men are more vulnerable than older women.

As older men approach their senior years, their production of testosterone naturally declines. Testosterone plays a role in the production of red blood cells. Low testosterone, with or without another potential contributing factor, can be a cause of anemia

How Can Testosterone Replacement Therapy Help with Anemia?

It’s important to find a successful treatment plan for anemia. There is no universal treatment for anemia, as the treatment has to be designed to ameliorate the cause.

Testosterone replacement therapy can be helpful for men with simultaneously occurring hormonal imbalance and anemia. Testosterone therapy won’t be helpful for men with normal or sufficient testosterone levels who are currently living with anemia.

Testosterone replacement therapy is helpful for all symptoms of low testosterone. Men with low testosterone often experience diminished energy levels, unwanted weight gain, loss of muscle mass, changes in body composition, changes in libido, changes in sexual function and desire, and changes in mood. 

By supplying the body with additional testosterone as prescribed by a doctor, many symptoms will resolve within a month. Concerns relating to sexual function often resolve within six months.

If it’s determined that low testosterone plays a significant role in your anemia, you can expect to see overall improvements in 3 to 4 weeks. Results and progress need to be monitored with frequent blood tests (usually a Complete Blood Count) to ensure that testosterone levels are healthy, as well as red blood cell levels.

Treatment can be further tailored to your unique needs, pending the results of these tests.

Using Testosterone as Part of a Comprehensive Treatment Plan

Even if low testosterone is the sole cause of your anemia, it’s important to be sure you’re supplying your body with everything it needs to manufacture enough healthy blood cells. This means getting enough vitamin B12, which is crucial for the formation of blood cells. 

Many people with anemia find that vitamin B12 injections work very well to prevent negative effects of anemia. Vitamin B12 also plays a key role in the way the body makes and uses energy by providing metabolic support. Anemic individuals often find that they frequently feel fatigued and don’t have enough energy to get through the day. Vitamin B12 can serve as a valuable solution to that issue. 

It’s also important to eat a nutritionally balanced diet. People who eat vegetarian or vegan diets often have difficulty incorporating sufficient amounts of B12 and iron into their meals, as most people meet their full quota of B12 from animal based foods and foods like shellfish are important sources of iron. This is where iron supplementation can really come in handy.

Starting Treatment for Low Testosterone Related Anemia

The first process of starting treatment involves receiving an official diagnosis. You’ll need a medical examination, as well as blood tests to check your red blood cell count and testosterone levels. If they’re both low, this may indicate that the conditions are related. 

Once you have an official diagnosis for low testosterone, you can begin testosterone replacement therapy. There are several delivery methods for testosterone, with injections being among the simplest and most effective. Many men choose to perform their own testosterone injections at home under the guidance and supervision of their doctor, with regular follow-up bloodwork to monitor baseline levels. 

How Elite HRT Can Help

Elite HRT empowers men to take initiative in their healthcare. You can speak with one of our experienced telemedicine doctors from your home. Your doctor will order tests in your area, review the results, and work to establish a treatment plan that suits your needs. We’ll prescribe testosterone and vitamin B12 if necessary. 

Throughout the duration of your care, we’ll check in with you to monitor your progress and order more tests as necessary. We’re always here to answer your questions, listen to your concerns, and help to assess side effects related to your treatment. It’s the easiest and most convenient way to manage your care. Contact us to get started


Vitamin B12 Deficiency Anemia | Johns Hopkins Medicine

Iron deficiency anemia – Symptoms and causes | Mayo Clinic

Association of Testosterone Levels With Anemia in Older Men: A Controlled Clinical Trial | Hematology | JAMA Internal Medicine | JAMA Network