Low Testosterone: Let’s Talk About It

Are you struggling to find the energy to get through the day? Drawing a blank on the last time you and your spouse had sexual intercourse? You may have low testosterone.

After the age of 40, testosterone starts to fall by about 1.6 percent every year. By the age of 60, the low levels of testosterone would lead to a diagnosis of hypogonadism in younger men. 

Low testosterone is more common than you might think. About 4 in 10 men suffer from low testosterone by the time they reach 45 years old.  While late-onset hypogonadism has become a recognized medical condition, many of the symptoms are associated with normal aging.

But they are more than just symptoms of aging. They’re classic signs of low testosterone. And if you haven’t taken the time to get your testosterone levels checked, these symptoms are just the beginning.

See, total testosterone levels are measured in ng/dl. Testosterone levels typically range from 200 on the low-end up to 1000 ng/dl in men. When you get down to around 400 ng/dl, the symptoms start to become more apparent.

The fatigue kicks in. Desire starts to fade. You feel like you’re in a permanent funk.

Then as that number drops more, you start to see more of the signs. Now you’re down to 350 ng/dl and your motivation is non-existent and you have no drive. You have trouble focusing and can’t concentrate at work.

It’s a gradual decline that robs you of, well….YOU.

sad man low testosterone symptoms

As your testosterone levels continue to drop, you start to notice decreased strength and increased belly fat. Your joints start to hurt, you’re irritable, and sex is the last thing on your mind.

It’s a bit of a change from your 20s.

And here’s the kicker — Men aren’t supposed to talk about this type of thing.

Because sex is a taboo topic, right?


Sex is a perfectly natural part of life.  Motivation, drive, and desire are all biologically essential to our survival. And talking to a professional if you’re feeling these symptoms should be encouraged, not avoided.

The Signs of Low Testosterone

Imagine you’re 21 again.

The drive. The stamina. The confidence.

These helped you become the man you are today. But as time passed, your testosterone levels started to drop. But before you beat yourself up, know this…

Low testosterone can negatively affect men of all ages. In fact, 1 in 4 men over 30 has low testosterone — many have no or minimal symptoms. Because of this, it’s easy to dismiss the lack of desire and fatigue as sleep deprivation or “getting older”.

Sure, you might feel better after a cup or two of coffee, but you’re putting a band-aid on a bigger problem.

You go on like this for a couple of years until the number of symptoms start to increase.

Sex drive is almost non-existent. Depression and anxiety kick in. And you’re 20 pounds heavier despite trying to exercise and eat right.

upset wife no desire

Then what?

You try diet pills, antidepressants, and other extreme measures that are the equivalent of putting on a bigger band-aid.

Now you’re in your 50s and 60s and have no desire to do anything.

Your work and personal relationships deteriorate. The weight gain continues and you’re chronically exhausted.

Sound familiar?

The Simple (Yet Never Easy) Fix

Look, as a medical professional, I wouldn’t wish this on anybody. It’s no way to live. It breaks my heart to see so many men experience this gradual decline in their quality of life when the fix is usually a simple one.

Get your testosterone levels checked.

That’s it.

Getting your levels checked will provide the answer you’ve been looking for. And if you do have low testosterone, you can get started on a treatment plan that’ll help you reclaim your life.

low testosterone appointment

Getting Treated With Testosterone Replacement Therapy

Testosterone Replacement Therapy (TRT) is a treatment plan that works to replenish your testosterone levels back to an optimal level and maintain them at a safe level through blood testing.

And while there are several types of testosterone treatments available, we recommend injections. Overall, our patients have seen the best benefits with injections. Plus, you’ll experience less of the potential of potential side effects.

What if I don’t like shots?”

I get it. 

Nobody likes shots. But they are the most effective. And it allows us to provide a safe, closely monitored treatment plan.

doctor low testosterone

Getting Tested

You’ve made the decision to get tested.

That’s great.

Here’s what you can expect next.

You’ll schedule your initial consultation which includes a full diagnostic blood test so we can understand your medical history, symptoms, and goals. 

So…what are we looking for in this blood test?

For your initial blood tests, we want to discover a baseline aka what your normal levels are. This will include looking over several factors including:

  • Total Testosterone
  • Free Testosterone
  • SHBG (Sex Hormone-Binding Globulin)
  • Estradiol (E2)
  • LH (Luteinizing Hormone)
  • FSH (Follicle Stimulating Hormone)
  • Thyroid Panel
  • CBC (Complete Blood Count)
  • Comprehensive Metabolism

After the report comes back, we’ll go over your results as well as your symptoms. And while we like to get a good overview of what’s going on, we do focus on a few things.

The 4 Main Numbers We Look At

  1. Your total testosterone, the testosterone attached to the proteins in your blood may be normal, but the free testosterone, the testosterone that is not bound to proteins and is, therefore, available to your body for use, may be low.
  2. You may have normal testosterone levels but your Estradiol (estrogen) levels are elevated, which means your body is converting free testosterone into estrogen.
  3. Excess weight gain can lead your body to convert testosterone into estrogen, therefore giving you more belly fat and causing the cycle to spiral out of control.
  4. Cortisol levels can have physiological effects that can suppress your testosterone production.

By focusing on these four numbers, we can gain a good overview of what’s causing your symptoms which allows us to prescribe a proper treatment plan. 

“What if my Testosterone Levels are above 300?”

We commonly see patients that have testosterone levels above 300 that present with common low testosterone symptoms. This becomes confusing for a patient because most insurance companies will only assist if levels are below 300.

With that being said, insurance company guidelines are not treatment guidelines. If you have a testosterone level that is 350-400 with low testosterone symptoms, it is perfectly appropriate to start treatment at that level. We have started many patients on treatment who have an initial testosterone level of 350-400 and have significant improvement in their symptoms.

Our goal testosterone range for patients on testosterone replacement therapy is 700-900. This number is not static but fluid. Some patients require a testosterone level a little greater than 900, while some require a testosterone level less than 700. That is why we do monthly blood draws to have a trend of your levels so we can optimize your dosing and improve your treatment.

Every patient is different and requires a different treatment plan.

The Man in the Mirror

Do me a favor?

Take a look in the mirror.

Is it the same man you used to be?

sad man low testosterone

Now, I don’t ask this to upset you. But I want you to look in the mirror and ask yourself the hard questions. 

Do you still feel vigorous and energetic?

Does the sight of your significant other still excite you?

Do you wake up every morning with a purpose and a mission?

If not, you need to get tested. Because left untreated, it could lead to bigger problems such as osteoporosis, mood swings, reduced energy, and testicular shrinkage.

Testosterone is the key male sex hormone that regulates fertility, muscle mass, fat distribution, and red blood cell production. And when levels start to drop, you can feel (and look) like a completely different man.

With Testosterone Replacement Therapy (TRT), you can feel like the man you used to. You’ll feel better and the people in your life will notice.

You’ll have restored confidence and swagger, improved relationships and a stronger family. Your job performance will improve as will your work relationships. Your desire for sex and intimacy rises and you’ll finally have the energy to get through the day.

That extra energy helps with better workouts, quicker recovery, and just better overall health improvement.

Testosterone is essential and plays a bigger role in the body than most realize. And when its numbers drop, you feel it. 

The man in the mirror has changed.

Look, I don’t know if you have low testosterone. I don’t know anything about your job or family.

But I do know you’re doing yourself (and your family) a disservice by not at least getting tested. 

What Are The Next Steps

First and foremost, talk to your spouse. And be HONEST.

Sit down, tell them you want to talk about a personal and sensitive topic, and let them ask questions.

Tell them what you’re feeling. What you’re thinking. And that you’re ready to seek help.

happy low testosterone discussion spouse

Too often this step goes overlooked and spouses end up feeling undesirable when really, it’s just low testosterone levels.

So have the talk.

View it as an opportunity to find new and different ways to add some intimacy and passion to your relationship.

Your spouse will thank you.

Then, schedule the appointment. If you DO have low testosterone, you can get started on an appropriate treatment plan.

Typically patients begin to see results within two to three months with optimal results usually after just six months of therapy. Now six months might seem like a long time. But to give you a better idea of what you can expect in those six months…

In the first 3-6 weeks, you can expect an increase in sexual desire and a decrease in depression and anxiety.

Inflammation should improve within 3-12 weeks and most of the physical changes (fat loss, lean body mass, and muscle strength) show improvement between 12-16 weeks. Then around at the six-month mark, increases in bone mass are detectable.

As time goes on with regular treatments, the effects become more pronounced. 


Happy guy from TRT

Is TRT for everybody?


Should you get tested regardless?

If you’re over 30 or experiencing…

  • Constant Fatigue/lack of energy
  • Lack of motivation and drive
  • Lack of focus and concentration
  • Poor sleep
  • Crabby/irritable
  • Weight gain and belly fat
  • Low sex drive
  • Depression and anxiety
  • Athletic performance decline
  • Joint pain
  • Muscle loss and decreased muscle strength
  • Brain Fog
  • Erectile dysfunction

Then yes, definitely get tested. A simple blood draw can provide the answer to the question you’ve been putting off.

It can bring clarity to a topic that maybe you’ve pushed aside. And most importantly, it can be the first step in getting your life back.

Stop waiting and start living.

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