Low testosterone: what to watch for and what to do

Low testosterone (low T) can quietly drain energy, reduce libido, shrink muscle, and change mood. If you’ve felt tired, less interested in sex, or noticed body changes, it’s worth checking—these symptoms don’t always mean low T, but they’re common reasons men seek help.

Many guys put off testing because they think it’s just aging. The difference is that low T from treatable causes can often improve with the right plan. Knowing what tests to order and what treatments really do helps you avoid wasted time and risky choices.

How low testosterone is diagnosed

Start with a morning total testosterone blood test—levels are highest early in the day. If a single result is low, doctors usually repeat the test to confirm. Clinicians often use about 300 ng/dL as a threshold, but your symptoms and other labs matter too.

Useful follow-up tests include free testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) to check whether the problem is the testes or the pituitary. A prolactin level can find pituitary issues. Depending on symptoms, doctors may also check SHBG, iron, and basic metabolic labs.

Treatment options and safety

Not every case needs testosterone replacement therapy (TRT). Start with fixes you control: lose extra weight, sleep better, cut heavy drinking, and lift weights. These changes raise testosterone for many men.

If lifestyle steps don’t help and tests confirm low T, TRT can improve energy, libido, and body composition. Common options are gels, injections, patches, and implanted pellets. Each has pros and cons—gels are easy but risk transfer to partners; injections are cost-effective but cause ups and downs in levels.

Alternatives to standard TRT include clomiphene citrate or hCG, which can raise testosterone while preserving fertility. Talk to your doctor about fertility if you want kids—standard TRT can lower sperm counts.

TRT isn’t risk-free. Providers monitor hematocrit (high levels increase clot risk), PSA for prostate screening, and repeat testosterone, plus liver and lipid checks as needed. If hematocrit rises above typical safety cutoffs or PSA changes, treatment may pause or adjust.

Avoid unregulated products and online sellers that skip prescriptions and lab monitoring. That’s how people get unsafe doses and miss side effects.

If you suspect low T, ask your clinician for a morning testosterone test and discuss your symptoms, reproductive plans, and medical history. A focused evaluation clears up whether simple lifestyle steps will work or whether you need a safer, monitored treatment plan.