Jessica Zimmer PA-C Rise Mens Health telehealth providers TRT and Fitness: A Definitive Guide for Guys over 40

TRT and Fitness: A Definitive Guide for Guys over 40

As men reach their 40s it’s important to focus on quality vs quantity as it relates to fitness. Keeping up with fitness and Testosterone Replacement Therapy has shown to improve results in men on treatment. Men should evolve their work outs to the changing times and avoid working out like they once did in their 20s.

It is true that adopting a better diet and healthier lifestyle will promote testosterone production and help your body stay above borderline levels where low testosterone symptoms start to occur. If your testosterone levels are clinically low or your symptoms are moderate to severe, diet and exercise alone will likely not reverse hypogonadism (low T) so Testosterone Replacement Therapy (TRT) may be recommended after speaking with one of our providers.

As we cover in our diet tips for low T article, there is no magic pill for long term success to dropping weight and maintaining a thinner waist line especially as men age. There are definitely tools along with TRT to help kick start the weight loss, like phentermine, but maintenance after dropping weight will lead to a much happier life. Visiting the gym or working out at home a few times a week can promote a healthier lifestyle and get you closer to your fitness goals. To help men out, we’ve put together an extensive guide on all forms of working out. Luckily, we also do not like the cookie cutter approach to fitness over 40. This guide includes some beginner to advanced pointers to keep fitness fun. Enjoy.

The 3 Bs of the Basic Workout Template for TRT Fitness After 40

If you’re 40 or 50 or 60 years old, men should incorporate the three “B’s” into their daily routine. The three B’s are bend, build, and breathe. Factoring each “B” into your TRT fitness plan will help the body recover and actually benefit from normal levels of testosterone. As it relates to fitness, normalizing testosterone levels is important because the body uses the hormone for efficient muscle recovery and healthy muscle growth – without proper muscle tissue repair and growth, muscles begin to weaken to the point of atrophy, which can impact blood flow and the immune system due to an underperforming metabolism.

  • Bend fitness: Stretching, flexibility and mobility work. As the lower back and knees are typically the first joints to become worn down with age, range of motion work is important. Taking the time to stretch before any activity is highly suggested. Soreness is generally caused by lactic acid build up in the muscles during the repair process so stretching can alleviate this uncomfortable feeling.
  • Build fitness: Strength training. Including any type of “push and pull” strength work whether it is resistance training or bodyweight work from higher rep muscle building to low rep strength building. Build includes compound and isolation lifts as well.
  • Breathe fitness: Aerobic and Cardio work. Elevating one’s heart rate several times a week is crucial for the heart and lungs to operate effectively.

All three “B’s” are equally important to maintain and feel your best without any problematic injuries. These B’s are also important because you can’t “spot” reduce your belly or love handles. These parts of the body are the last to go in most cases. Building healthy muscle in larger parts of the body like chest, legs, and back will burn away the layers of fat throughout the body. Leanness begins to show after inflammation is removed from the body for at least 2-3 weeks.

A majority of content on the internet available is focused on the younger crowd and isn’t as useful to older athletes. Older men that love to work out have to deal with muscle fatigue that sets in faster as muscles stress easier – it’s just part of aging. Many men over 40 mentally act believe they can do what they once did in their 20 or 30, but there is a rude awakening when the body doesn’t react to what the mind is telling it to do.

Recovery time:

Recovery times are longer and if you’re a dad, fitness probably has not been the center of your focus for many years while raising your family. Focusing on quality lifts vs quantities of poor reps will drastically improve the rate at which men can get back into shape.


As men approach their 50s and 60s, fitness and diet can make them look younger. As we cover in our how to use creatine to improve results on TRT, cell health and regeneration becomes more important over 40 based on the fact that the natural cycle of healing and anti-aging begins to stop. Aside from balancing hormone levels through testosterone replacement, food and exercise becomes really important to help keep cell production intact. Things like poor diet and alcohol can accelerate aging making men look older. A few beers and cocktails won’t hurt you, but practicing moderation and taking extended breaks from the sauce is recommended.

Dad strength:

A common comment we hear from patients is the notion that men still remember when they could push lots of weight although they have not touched a heavy weight for an extended period of time. This so-called Dad Strength can cause some glaring problems when men sacrifice form to relive the glory days of pushing 315 lbs on bench. The potential risks can lead to torn biceps, sprained elbows, or knee damage. Perfect form with 185 lbs on the bar is more effective than 255-315 lbs when you sacrifice form for pride for fitness.

Fatigue and Stamina:

Stamina is another wall that many men hit between 40-60 years old. It’s important to split time between the build and breathe “B’s” to allow the body ample time to recover ready and refreshed to reengage after a heavier lifting day. Getting the heart pumping by running, walking, etc is almost more important than lifting weights as it promotes the right levels of blood flow through the arteries.

One common side effect of TRT is elevated hemoglobin and hematocrit meaning extra red blood cells are produced and flowing through the body. Providers typical ask that men donate blood or prescribe a therapeutic phlebotomy to reduce this blood thickness. Men have reported significant improvements in cardio after donating blood and properly managing their H&H blood levels. This is why regular complete blood count (CBC) labs are important. Common symptoms to watch for are red face, breathing unusually hard, and dragging legs. Providers want to get hematocrit between 44-52% and hemoglobin between 13.5-17.5%  g/dL. It’s not uncommon to retain more water while on testosterone replacement therapy so it’s important to watch out for and talk about these things with you providers.

Get Creative:

While running is a boring option for most or simply not an option due to injury for many, there are several fun alternative versions of cardio that will help get the blood pumping. HIIT (high intensity interval training) or Tabata skill exercises replace jogging for long distances. An example of HIIT can be 1 minute of work with 15 sec rest for 10 reps. These 10-15 minutes sessions are customizable to avoid body parts that have nagging injuries. Men who run for many years generally report bad knees cause by the wear and tear of compounding impact.

Replacing a jog with an upper body HIIT sessions will burn the same number of calories and produce the same level of sweaty mess.

If you experience back problems or have herniated discs, many men opt for swimming, cycling or indoor rowing. All three of extremely popular and great cardio alternatives. Strenuous lifts are doable among men with back problems, but we encourage everyone to wear a weight belt and to only attempt lifting 60-70% of their bodyweight.

The basic framework for the three B’s – Bend, Build, Breathe:

Stretch for 5-10 minutes before every session.

Split your total fitness training sessions evenly between strength and cardio. 15/15, 20/20, 30/30 minutes.

Progress up to several hard sessions per week. Compounding hard sessions for many weeks can be problematic due to the slower rate of recovery in men. For off season athletes or average joes who simply love recreational sports, we suggest one or two hard session of strength and fitness each week with the remaining intensity to remain between 50-70% effort output.

Exercise Intensity

For competitors and athletes that are endurance training for runs or triathlons or races, this is a sliding intensity scale – the term progressive over load is common approach while conditioning for competition. A less aggressive definition refers to progressive resistance training where overtime men add 10-15% of resistance (via weighted plates) week-to-week with the goal to build strength boosting overall fitness and athletic performance.

Increasing the intensity of a work out will improve VO2 max and muscle longevity in preparation for competition. Progressive over load only works for men over 40 if the three B framework is set to avoid sprains and injuries due to over training.


It’s time to stop trying to out exercise poor diet choices. We talk about the 80/20% or 90/10% diet rule a lot in our total health program where 80% = greens and proteins while 20% = brewski and pizza and wings.

Similar to the risk factors associated to over training, poor nutrition forces the liver, kidney, and muscles to fight off toxins and fats rather than improving the body’s ability to recover hindering healthy tone muscles. Using the 10-20% of your diet for the 30 rack of brews and wings will make the gym feel less like a chore and more enjoyable. Breaking out the 10-20% to hours in a day the good:bad food ratio actually fits well into a weekend.

Workout Schedule

Sticking to a week and session format is a good way to create a routine. If we consider for a minute that it takes 26 days to create a habit, it makes sense that routine is habit’s best friend. If time is not on your side because of family, work, or commute it’s fairly easy to get the same level of results from 30 minutes of exercise if you do not have an hour to spare. Formatting the total session will save you time and remove the guess work out of the equation. Start with thirds where

1/3 of your time is bending with flexibility and mobility;

2/3 of your time is building with strength and resistance;

3/3 of your time is breathing with cardio, HIIT or aerobic movements.

With age comes stiff muscles so taking a little extra time to loosen up stiffness can prevent getting hurt.

Compound and isolation exercise are probably words thrown around by gym goers, personal trainers, and certified bro scientists. If you are looking at building strength and dense healthy muscle, which one is the best for you?

These two buzzwords are simply common variations of resistance training.

Best really means what are your goals as it relates to fitness or weight loss. We consider best to be a route and method that works best for you and honestly makes you happy. Working out makes your body produces endorphins and endorphins are the cheapest (and healthiest) chemical obsessions known to man.

Endorphins are released from the pituitary gland during work out acting like a nature morphine for the body to counteract cortisol. When the body is put under the “stress” of exercise these opioid receptors active to alleviate discomfort. While there is no direct impact on testosterone, endorphins can aid in relieving stress and negative mood like depression.

What are Push and Pull movements?

Boiling these movements down to their basic form, we are either pushing heavy things forward or pulling weighted things back to build strength and fitness.

In generally speaking, push movements center around chest, legs and shoulders while pull movements focus on back, biceps and triceps.

The average joe should mix isolation and compound lifts throughout the week mixing to avoid straining and overtraining larger muscle groups like the back, chest, and quads. It’s useful to train muscles involving push movements one day and pull movements on another day to help give certain chest or back or legs some time to rest and recover.

If you focus solely on compound lifts, you might neglect your lower back weakening these sensitive muscles to the point of damage. By adding back extensions, the smaller muscles in the lower back have a chance to “catch up” with the trapezius and latissimus dorsi (mid to upper back) muscles.

If you focus solely on compound lifts like bench press, you might neglect building strength in biceps, triceps, and wrists. Overtraining bench press could also lead to elbow fatigue due to poor form.

If you focus solely on isolation lifts like bicep curls, connecting fibers to larger muscle groups can begin to strain and wear out.

If you neglect leg work outs, less active muscles like hamstrings can become brittle leading to pulls or tears. Atrophy is a common ailment for people that skip leg day. Prolonged sedentary leg muscles can lead to painful spider (Varicose) veins in the legs due to poor blood circulation in your legs. While walking and cardio can help weighted leg work outs like leg press, squats, hamstring curls, calve raises are encouraged to help keep the blood pumping in your legs.

Mixing together push and pull compound or isolation movements will not only keep things exciting in the gym or at home, these movements help avoid overstressing important large muscle groups, increase physical fitness and burn fat, improves muscle health in neglected areas and reduces the tax on the central nervous system.

Are isolation or compound lifts better?

Isolating muscle group is great for strengthening weaker often ignored muscles. Compound lifts allow all muscles to fire off, but without proper form overcompensating stronger muscles to finish a life is a common mistake. Isolating all of the workload on one muscle group removes the chance for secondary muscles from taking over, which is a frequent reaction during compound lifts as fatigue sets in. As mentioned above, chest workouts trigger a lot of muscles from the deltoids around the chest and up through the arms. Triceps and biceps and forearms take the brunt of the weight so it is important to add these isolation auxiliary exercises to supplement your larger compounding lifts. These lighter lifts will allow your body to conform to proper form.

  • Isolation exercises work one muscle at a time.
  • Compound exercises work multiple muscle groups at the same time.
  • Isolation can be movements like bicep curl, tricep pushdown and leg extension/curl.
  • Compound exercises are movements like squat, bench press and deadlift.

While not always, bodybuilding focuses more on isolation movements while compound lifts are geared more towards powerlifting and Olympic.

What are the disadvantages of isolation or compound lifts?

While isolating muscle groups may help strengthen specific muscle groups, balance between auxiliary and primary lifts is critical. Working one muscle group at a time requires less weight and more repetitions verses if multiple muscle groups were being recruited like in compound lifts. Multiple muscle groups can handle more weight but less repetitions, which can impact general cardio strength.

The gold standard for repetitions is 12 for men over 40. It’s important to complete 12 full and controlled motion of an exercise. Control means counting to “three Mississippi” during the repetition as you complete the full motion.

The main disadvantage to isolation and compound lifts are how they apply to day to day active. While strength and healthy muscles are indeed important, the lack of functional movement is the only down side; however, looking back to breathe in the three B’s, cardio and HIIT will balance out the functional necessity of the work out plan.

Compound movements recruit multiple muscle groups and are slightly more functional exercises resulting in faster and more mobility range of motion. By only using squat, bench, and deadlift when fatigue sets in, one muscle group begins to tire out other secondary muscles will try to compensate.

Overthinking exercise can lead to stress and hinder motivation in men, so it is a good idea to listen to your body and blend compound, isolation with both free and machine weights.

While there is a time and place for philosophies like Crossfit and spartan runs, basic fundamentals should be at the center of all fitness plans.

A good personal trainer will always have a preference and guidelines for beginners but every man enjoys a good DIY project, like Tim the tool man Taylor, why not make it your health?

There are two primary tools for compound and isolation movements: free weights and machine weights.

Both use resistance to help work the muscles. Free weights come in the form of dumbbells, plates for straight bar or kettlebell weights. Machines cover all muscles groups from chest press to leg press.

Regardless if its compound or isolation resistance movements, studies prove that these exercises increase the concentrations of circulating testosterone, growth hormone, and cortisol in the blood stream. Interestingly, while resistance training can increase the circulation of these anabolic (testosterone) and catabolic (cortisol) hormones, not all resistance exercises provide the same response.

In a study published in 2014, researchers saw a greater hormonal response and fat burn (metabolism demand) from free weights due to the fact that more muscles groups were involved to push up or pull down the weight. The group of men told researchers they felt the same results from both machine and free weight exercises although the bloodwork shared a different picture. While these exercises promote an increase in hormone release and circulation, if you are clinically low of testosterone your hypothalamus pituitary axis may be off axis due to hypogonadism (low T).

It’s important to note that lifting weights may not reverse your low testosterone levels alone in men over 40 – most men with low testosterone can benefit from testosterone replacement therapy as our goal is to normalize T levels back to where they should be and optimize the bodies response to normal testosterone levels. Replacing T levels back to normal will not only help with muscle recovery and leanness, but working out while on TRT can make it more enjoyable as energy and alertness stabilize. Reference

How important is form while working out?

Controlling the weight is more important than the rate at which the weight moves.

This is why using the “three Mississippi” count during repetitions is necessary. Using proper form will help you prevent injuries and improve results.

Looking around the gym, you might see men doing bicep curls stopping at 90 degrees or squatting to 45 degrees which fires half of the muscles and hinders the full range of movement. In the 3 phases of movement this would fall under the concentric (max tension) phase.

bicep contraction

Full range of motion starts at no movement (isometric) moving to tension (concentric) to release or relaxing the muscle (eccentric).

Without full range of movement, men will miss out on real functional strength. Keeping fast-twitch muscle working at age 40 and beyond will allow men to play outside with kids or compete in recreational sports without twisting an ankle.

Fast-twitch muscle fibers support quick, powerful movements such as sprinting or weightlifting. Like testosterone levels, these fibers begin to diminish with age. Think back to last thanksgiving and the family football match. Did that hot route against your nephew feel Amri Cooper or are you in need of a handicap sticker? Reference, Reference

Posture is where perfect form starts.

If you roll your shoulders back, flex your lower ack, keep your feet shoulder width apart, and relax your knees, this is what’s called the natural athletic position. This is why mirrors surround most gyms. Looking at the movement in the mirror allows people to remain in symmetry and ensure proper muscle movements as they begin to get tired in the middle of a sessions.  A work out buddy can help you keep posture, symmetry, and form in check.

Back strength becomes increasingly important after age 40 because there are more muscles in the back than in the pectoral region. This is where push and pull need to be in sync because the more you pull you should equally push weight to balance out your strength.

Here are the basic work outs for all large muscle groups.

The Lat pull down machine is back work out in the pull category.

Pull ups with a bar is the simpler alternative if you can lift your body weight, but the advantage to the lat pull down machine is the adjustable weight tree allowing you lighten up the load making the lift doable.

To start, adjust the thigh pad so its snug but allowing some room for your heels to raise off the floor. Grab the bar with a wide grip equal width apart, looking forward with your torso upright slightly lean back and flex your lower back. Retract your shoulder blades and pull the bar down in front of you to your upper chest. Squeeze your upper back at the bottom until the bar reaches your chin then release and relax the bar back to the top.

Next up is the shoulder press with dumbbells in the push category.

Starting with 10-15% of your body weight, safely swing the dumbbells to position them by your shoulders with your palms facing forwards with your elbows slightly below 90 degrees.

Locking your lower back, extend through your elbows to press the weights above your head and pause when the dumbbells meet at the top. Flex and squeeze at the top then release and relax the dumbbells down and back to 90 degrees.

Moving on to the pectoral flies, let’s work on your chest with another work out in the push category.

Starting with 20% of your body weight, lay back on the flat bench and fully extend the dumbbells then relax the arms by 20% to create a bend in the elbow. Keeping the same bend, flex and squeeze at the top then release and relax the dumbbells down to your sides at shoulder level. Finish the motion by bringing your arms slowly back to the starting closed position.

Back to the pull movement, bent over lateral raise helps activate those hard to reach back muscles.

Keep your chest big and out, roll your shoulder back and knees slightly bent, bend over at the hips until your torso is just about parallel to the floor. Locking in your lower back, allow the dumbbells to hang directly beneath with your palms facing each other. Similar to pectoral flies, create a 20% bend in the elbow. Keeping the same bend, flex outward like Scott Stapp singing “Arms Wide Open” and squeeze at shoulder level then release and relax the dumbbells down beneath you.

Chest press is the bread and butter work out for the push category. Push-ups are a mighty fine alternative if you can hold up your body weight. Hershel Walker claims to do 750-1500 push-ups each morning so if you do not have time for the gym, Mr. Walker can be your motivation. 

Similar to pectoral flies, lay back on the flat bench and fully extend the dumbbells but this time relax at the top without an elbow bend. Flex and squeeze at the top then release and on the way down begin to slowly turn your wrists in creating a 45-degree angle between your arm and side. Once the dumbbell reaches chest level finish the motion by bringing your arms slowly back to the starting closed position where you can see your knuckles. Think of this movement like a boxer throwing a jab. The twisting arm motion is important to protect your shoulders from flaring out causing injury.

The reverse motion of the pushing chest press is the bent over bar row, which falls under the pull category.

Similar to the lateral raises, keep your chest big and out, roll your shoulder back and knees slightly bent with your feet shoulder width apart. Bend over at the hips until your torso is just about parallel to the floor. Locking in your lower back, allow the dumbbells to hang directly beneath with you where you can see both of your knuckles. Following the same range of motion as the chest press, pull the weight up in a twisting motion like you are throwing a boxing jab on reward. Similar to chest press, this lift allows you to handle heavier weight. Starting with 10% of your body weight and work your way up to 20-30%.

Moving down to the legs, weighted lunges is a great alternative to squats as it puts less pressure on the lower back.

Without perfect form, squats can do major damage to the lower back. A study out of the University of Arkansas found “that there was no greater muscle activation when performing any of the squat depths to that of the body weight lunge. It was revealed that the body weight lunge did indeed produce more activation in the majority of all muscles analyzed when compared to the three squat depths.”

Lunges fall into the push category.

Starting without weights, move into the neutral athletic position with nice posture. Place your hands on your hip with your feet side-by-side begin to step forward with one leg at least 2-3 feet in front of you. Keeping your core flexed, slowly lower the back knee until both knees are bent at about a 90-degree angle making sure that the front knee is in line with your foot. Finish the motion by stepping back to the starting position.

Once you are comfortable with the motion, grab 15% of your body weight and get stepping. Add 20% of your body weight and do step-back lunges, which are a little easier and less exhausting.

Deadlifts are a great pull compound lift but men over 40 should avoid this lift.

While it is the staple for pure strength, without flawless (and I mean flawless) form, 80% of recreational lifts do the lift wrong. Without a strong core and conditioned upper thighs, men tend to allow the weight to pull down the shoulders, releasing the lower back leading to extreme tension. The release then takes the quads out of the equation and the lift turns into Romanian straight back deadlift, which is really an auxiliary lift that is not meant for heavy weight.

Rounding out the core lifts are hamstring curls falling into the pull category.

Often ignored, the hamstrings are critical for a healthy range of motion in walking, running and jumping. Balancing strength between your quads and hamstrings will reduce the risk of pulling muscles and strengthens the knee. Whether you are using a laying and sitting hamstring curl machine, it’s important to keep your toes pointed up or slightly tilted out to create a normal range of motion avoiding too much pressure on the knee flex.

  • Lifting smarter over 40 is important. Conventional squats and deadlifts create unwanted spinal compression, which in time can lead to spinal degeneration.
  • Hip belt squats do not cause spinal compression unlike barbell squats but these machines are rare in commercial gyms.

Breathing is important.

Wow, we had no idea. Tell me more.

A healthy balance of building and breathing with lifts and cardio keeps the blood pumping and heart strong. If you are not a fan of treadmills or jogging, there are new trendy alternatives to consider.

In recent years HIIT and Tabata studios have popped up across the world. While popular now, this method was validated its benefits back in 1996. Professor Izumi Tabata says that the goal if his research was to show that,

“…Tabata is one of the best training in terms of improving both aerobic and anaerobic energy releasing systems because Tabata training imposes maximally stimuli on both systems.”

It was known at the time that interval fitness training was successful but there were not published articles proving its benefits. Thus, Professor Tabata set out to find the impact this style of fitness training has on the body. He worked with the Japanese speed skating team to generate the results of his research. The training involves 6-7 intervals of 20 seconds-all-out intensity exercise followed by 10 seconds of rest during 3 weekly sessions over a 6-week period. The results showed an elevation of the aerobic energy of endurance by 10% and elevated the maximum oxygen deficit by almost 30%. Reference

While routine is great to remain consistent, the body is a smart machine so keep the body guessing will improve results and burn unwanted weight faster.

Cardio in any form is a good change of pace.

There are variations of repetitions like pyramiding, drop sets, and burn outs that are usually used in lifting but can also be applied to cardio. Pyramiding changes the duration of intensity where 6 sets will have start 5 seconds of HIIT, then 10 seconds, 20 seconds, etc.

The rest periods start long then shorter as the HIIT intervals increase. Drop sets are essentially a descending scale of intensity where sprinting leads to jogging then to walking. Burn outs highly recommended if you are just getting started. After lifting or cardio, do something new for 5 minutes. Continuously do a circuit of 5 work outs or simple go “all out” during one work out.

Older athletes should use functional movements during cardio and breathing sessions.

Translating the fitness exercise to mimic the sport or recreational activity will improve times, pace, swing speed, throwing accuracy, and duration of fun (if you a skier, snowboarder or water sports enthusiasts).

Fitness over 40 should be applicable meaning as men age, it gets harder to do the hobbies they love. And as men reach retirement years, it’s important to tailor indoor work out routines to favorite outdoor activities. When testosterone levels are low, this makes fun increasingly more difficult due to fatigue and the mounting frustration as irritability creeps in.

Outdoors to most equals freedom and relaxation from a good day’s work. The treadmill is considered the greatest tool for men in versatile climates.

Running and hiking:

While running or hiking on dirt trails is much different than a rubber surface, the machine can help mimic the hilly terrain and desired distance if you are attempting a through-hike. If you are a member of a fancier gym, find the curve trainer treadmills as they take a lot of pressure off of the knee. Curve trainers are perfect for quick, Tabata work outs and allows you to focus on heart rate work.

It takes consistency and dedication to get over the feeling of your heart pounding through your chest, so start with 10-15 minutes run/walk intervals, as explained in the Tabata section above, then add 5 minutes to that series until you feel comfortable at 30 minutes.

Stationary bike and mountain biking:

Spin classes with stationary bikes have become increasingly popular in recent years and for good reason. Conditioning is the single most important goal to write down before attempting to cycle or mountain bike at altitude. While stationary bike may become dull, the reward is being able to go all day in the mountains freely at your own pace without tiring or injuring yourself after 2 trails. The energy and intensity of a spin class makes the stationary bike sessions more tolerable.

Snorkeling and swimming:

Swimming in lap pools offers up a chance to prepare for snorkeling or scuba diving. Snorkeling in open water is a bit more demanding because it requires proper finning technique. Using the lap pool to perfect the flutter kick and get used to breathing through a snorkel will make your underwater adventure so much more enjoyable.

Paddleboarding and yoga:

Stand-up paddleboarding (SUP) is a fun way to explore lakes or rivers across the world. It’s an excellent way to apply the “bend” of the three B’s as well. Like many yoga poses, SUP works the core muscles. Balancing on water challenges the abdominal muscles, tests your flexibility and stamina. A prepared strong core will allow you to enjoy the view rather than focusing on the frustration of falling off the paddleboard.

Kayaking and Rowing:

Fitness training for outdoor activities is not the only reason to consider the gym. If you enjoy indoor rowing, recreational kayaking is a great alternative to feed the sense of adventure and create an applicable hobby. Kayaking is a great “get away” from the day-to-day allowing you to get away from the distractions of life and relax with some fun.

A dose of the outdoors will rejuvenate any man after months or years of hard work. We ignore all of our patients to find an outdoor hobby to help clear the mind from stresses. Chronic stress decreases testosterone levels so combining clinical testosterone replacement therapy, indoor and outdoor exercise is important.

Stair stepper and hiking:

Hiking has the lowest barrier of entry into the outdoors and carries all of the benefits listed above. The stair stepper is a good place to cross-train as well. Starting at a steady pace, 1-2 seconds between steps, use the time condition your legs to move up a trail for 20-30 minutes. Make sure to support yourself with the handles if you climb this distance as fatigue sets in 10 minutes in.

A balanced diet and goal setting:

As we touch on in the beginning of this article, a balanced diet of greens and proteins becomes increasingly more important for fitness over 40.  Aging men require more protein intake to help sustain optimal nutritional requirements.

The body needs the right number of calories to repair, recover, and grow. A reasonable diet is 1600-1900 calories depending on your work out and what you do for work. Shift workers and laborers need more calories than men that sit at a desk all day. It depends on how much energy is required to feel alert.

Weight loss is not easy, but it is simple. Reducing calorie intake to create a caloric deficit consistently will lead to healthy weight loss.

Men typically overestimate their willpower and underestimated the difficulty of change. It’s a good idea to aim for smaller and simpler steps with goals that are realistic.

“If you are going to achieve excellence in big things, you develop the habit in little matters. Excellence is not an exception, it is a prevailing attitude.”- Colin Powell

Change starts and continues with some wins to build up confidence and foster up the competitive juices. Sometimes calorie targets or 10k finishes don’t work so focus on smaller goals to start. Full energy on smaller objectives is important for fitness goals.

Older athletes need smarter fuel to tackle endurance fitness challenges. The old marathon diet of pasta before races is old science and may lead to injury. As we discuss in our free total health program, stick with a high protein, green and clean diet and simply increase calorie intake the night before a race or intense training session.

Is flexibility important for men over 40?

While all three B’s are important for men over 40, the most neglected B is typically bend. Warming up before a build or breathe set is much different than dynamic stretching or stretching to cool down after an intense session.

While there are many variations of flexibility exercises, two of the most entertaining and efficient methods are dynamic stretching and yoga.

Hot Yoga:

Yoga for men can do wonders for stiff backs and nagging shoulder issues. Today we are going to focus on hot yoga, which is basically a continuous coordinated stretch inside a sauna. The five top reasons to try yoga for fitness are pretty compelling.

First, yoga increases range of motion by opening up tight muscles to allow for a more complete lift. A well-designed yoga session emphasizes movements that open up the most common problem areas like hunched shoulders and tight hips. Try a few different yoga studios before attempting yoga by yourself so a certified instructor can reposition your poor form as you’re crying in the back. A guided yoga tour will improve breathing as each movement is literally focused around breathing in and out flowing from downward dog to warrior pose. Focusing on the flow and breathe translates well to cardio and lifting helping men become more aware of their breathing. Moving into the challenging aspect of yoga is centered around the stabilization as the instructor shifts flow to lateral, twisting, and spinal-arch moves forcing muscles to work at keeping cores center of gravity without falling over. Hot yoga is a great change of pace for off-days from lifting weights and cardio because it promotes active-rest. Active rest allows your body work recover and also keeps men on track to avoid boredom snacking or stir-crazy overeating. Finally, yoga was created for people to remove themselves from the chaotic world to recharge the mind. Men suffering from stress and anxiety may find some peace and quiet in a yoga room as the instructor softly speaks behind sounds track of a killer flute solo echoing through windy hills.

Dynamic Stretching:

Dynamic stretching is a great pre-work out tool before lifting weights. The idea behind this method centers around active movements fitness where joints and muscles go through a full range of motion forcing blood to pump into working muscles before fully working them. Spending five minutes pulling your knees to your chest, touching your toes, bending left to right with a wide stance, pulling your feet to your butt, balancing on one foot and bending over are all movements that activity primary and secondary muscles groups. Slowing stretching is beneficial post work out but not as affective before a work out because it does not elevate the heart rate.

What are the best supplements for men over 40?

While there is no substitute for a healthy balanced diet, supplements can help men over 40 fill the gaps of critical nutrition but also enhance and improve how the body responds to testosterone replacement or low testosterone treatment.

A daily diet without work out boils down to calories ingested and calories used by the body as fuel to stay fully operational. When you add the necessity of working out, supplements refill what was used by the body to perform the exercise aka fitness fuel. Supplements help with recover and overall wellness. Supplements are also convenient as they help you fuel up gaps in day-to-day nutrition missed during a normal daily diet.

A common misconception is that testosterone replacement is a supplement and that taking certain vitamins or testosterone boosters can refill the low testosterone. While diet and supplements may elevate free T and SHBG levels temporarily, total T never normalize and men continue to feel lethargic. The steroid culture in bodybuilding and bio science has tarnished the true benefits of TRT.

TRT treatment is not for juice heads but sometimes the term blends together. When our providers prescribe testosterone replacement, this means that the testicles and their Leydig cells are not converting cholesterol into testosterone so there is very little testosterone circulating throughout the body. When bodybuilders take testosterone, they are typically supplementing to abnormally high and risky levels to promote excessive muscle growth.

Without a prescription and blood work, a majority are doing so illegally without the guidance of a board-certified doctor with a valid state issued DEA licenses for a controlled substance. Men over 40 that want to normalize and truly optimize their levels should consult with a specialist that does not use cookie cutter protocols. Our providers use personalized plans to help our patients feel their best.

Optimizing levels will make you feel your best. T levels can actually be too high, which can lead to elevated estrogen levels. It’s important to find balances with a providers who drives down to the root-cause of the issue.

Using TRT for muscle growth is less about getting these massive gains and more about fostering regular, healthy muscle growth to help you maintain an active lifestyle as you get older.

No matter what type of fitness training you do, your body certainly needs protein to aid recovery, enabling repair and growth of the muscles. The harder and more frequent you train, the more protein you need.


Protein intake is important as men grow older. Whether its whey, casein, or plant based all varieties contain high quantity of essential branch chain amino acids, and lower in lactose resulting in less tummy problems.

Protein shakes throughout the day can suppress appetite and really as no down side if you consume too much of it. The body is smart enough to flush out the rest. Whey isolate has little to no sugar and plant-based mixes with pea protein helps men that are lactose intolerant or sensitive to dairy. Casein is a great late-night option because its main function in dairy essentially thickness the liquid proteins in milk. Casein is slow to digest allowing the body to absorb all of the amino acids.


Men can get enough creatine by eating meats on a regular basis. But creatine supplements also help build and sustain muscle. As we cover in our creatine for TRT article, this complex amino chain is produced in the liver and is transported through blood to feed and supply the muscles with energy. Healthy cell energy and creation helps maintain youthfulness and a great anti-aging supplement.


BCAAs are a great alternative to sports drinks like Gatorade or Powerade. As we talk about in our article about BCAAs and Low T, this supplement can help older men fuel and repair muscles. If we had to rank level of supplemental importance, BCAAs is lower on the list. We do recommend it as an alternative to sugary drinks, but the body typically to convert foods into necessary BCAAs.

Pre-work out:

Pre-work outs are commonly frowned upon and rarely used by men over 40 but they are effective. Most pre-work outs have creatine, BCAAs, and the same level of caffeine as coffee to help improve muscle performance and increase motivation. Many men drink coffee before a work-out, which is a great for short term energy, but most pre-work outs also include supplemental amounts of Beta Alanine, an amino acid to help most muscle performance and L-Carnitine Tartrate is a fast absorbing amino acid that helps convert fatty acids into fuel.


Lipo-B shots are popular among our patients as another option to take before a work out. Lipotropic are three amino acids that help the liver process fats faster thus creating more alertness and energy. The “B” in lipo-B is B12, which is a critical part of energy. When sluggishness is replaced with energy vitamins like B12 and key amino acids, you will see an increase in your metabolism. Lipotropic injections help preserve lean muscle mass which may enhance your metabolism so you continue burning calories after exercise.

The loss of motivation and lethargic feeling that comes with low testosterone is simply another hurdle to jump.

What is the best way to get back into shape?

Navigating fitness is already complex and confusing with what seems to be thousands of “top ways” to start. It’s important to set reasonable goals and work with your provider to come out on top with your low T treatment. Fitness, weight lifting, and the gym should be tools to help alleviate back pain and knee pain. Tailoring your gym experience around hobbies you enjoy will improve the functional fitness aspect of each session.

If you have no time for the gym, at-home work outs like p90x or basic yard work can be a fine place to break a sweat.

Routine can be a good thing, especially for fitness goals. If the knees cannot handle running or HIIT, swimming, cycling, and long-distance indoor rowing can get you where you want to be physically and help men keep the beer gut off.

Stay far away from deadlifts or squats if you have spinal issues or a weak lower back. While compound lifts have been shown to increase testosterone response, single leg work outs are just as effective in activating multiple muscle groups.

Many older men may find it hard to make normal trips to the gym so whether you’re coming back for another try after many years away or you’re simply coming back after hurting yourself losing all momentum, we hope this guide will help you get back on track.

Medically peer reviewed, Written by Our Editorial Team.

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If you do have low testosterone it can be easily treated and monitored via telehealth with the same level of care as you would receive in our traditional clinic setting in Roanoke, Texas. Give us a call if you have any questions!

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1 Comment

  1. Connor Macivor on October 4, 2020 at 11:31 am

    Excellent article. Trying to find the answers online can be a grueling task. I’m glad I found your multi-level explanation.

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