What is low testosterone?
Low testosterone (male hypogonadism) is clinically diagnosed by morning total testosterone consistently below ~300 ng/dL plus symptoms. About 2–6% of men have it; rises with age and obesity.
True low T causes fatigue, low libido, reduced muscle mass, weight gain, mood changes, and erectile difficulties. TRT effectively treats it — but requires proper diagnosis with lab confirmation and ongoing monitoring.
Do I have low testosterone? Common signs
If most of these describe what you're experiencing, telehealth may be a good next step:
What causes it
Primary (testicular failure): Klinefelter, mumps, injury, chemotherapy. Secondary (pituitary/hypothalamic): obesity, sleep apnea, opioids, steroids, chronic illness. Most common: age-related plus obesity/metabolic syndrome.
Is it contagious?
No.
A morning lab is critical — testosterone fluctuates, and afternoon levels can be normal even with low T. Two morning measurements are gold standard.
Can it be treated online?
Low T evaluation and TRT management are well-suited to telehealth with lab orders. We work with you to get morning labs, interpret correctly, and prescribe if indicated. Severe symptoms with concerning features (visual field changes, headaches suggesting pituitary tumor), young men with primary testicular failure, or fertility concerns benefit from endocrinology referral.
How low testosterone is treated
TRT options: Testosterone cypionate IM injections (most common, biweekly), testosterone gel (daily), testosterone undecanoate (oral or long-acting IM). Goal: total T in mid-normal range with symptom improvement. Monitor: PSA, hematocrit, lipids, mood, and lab levels every 3–6 months early, then yearly.
Self-care while you wait
- Lose excess weight — even modest loss raises T
- Strength train — increases endogenous T
- Sleep 7–9 hours — poor sleep tanks T
- Limit alcohol
- Manage stress
- Treat sleep apnea if present
- Address other hormone issues (thyroid, prolactin)
How long does it last?
TRT is usually long-term once started — endogenous production typically stays suppressed.
Frequently asked questions
Will TRT make me infertile?
Yes — exogenous testosterone suppresses sperm production. If fertility matters, alternative approaches (HCG, clomiphene) preserve it.
Are there serious risks?
Polycythemia (high red blood cell count) is most common — managed with monitoring and occasional phlebotomy. Long-term cardiovascular and prostate cancer risks remain debated; current evidence doesn't show increased risk in appropriately managed patients.
Will it make me bigger?
Modest muscle and strength gains over months. Doesn't transform anyone — just restores normal function.
What about natural testosterone boosters?
Most supplements have weak evidence. Sleep, exercise, weight loss, and managing stress have more impact than any supplement.
How often do I need labs?
Baseline before starting; recheck at 3 and 6 months; then every 6–12 months once stable.
