Testosterone levels tend to drift down slowly as men get older, often estimated at around 1% per year from middle age. For many men that decline never causes problems. For others, low testosterone can show up as tiredness, a lower sex drive, or losing muscle more easily. Here is how to tell the difference and what to do about it.
What counts as “low”?
Doctors look at two things together: your symptoms and blood test results. Many guidelines use a total testosterone level below roughly 300 ng/dL as a reasonable threshold for low testosterone, but a single number is never the whole story. Labs and guidelines vary slightly, and how you feel matters just as much as the result.
Common signs worth mentioning to your doctor
- Lower interest in sex or erectile difficulties
- Persistent fatigue or low energy
- Loss of muscle mass or strength, or gaining body fat
- Low mood, irritability or poor concentration
These symptoms have many possible causes, including poor sleep, stress, depression, thyroid problems and some medications, which is why testing matters.
How testing works
Testosterone is usually highest in the morning, so blood is typically drawn early in the day. Because levels fluctuate, a low result is normally confirmed with a second test before any diagnosis is made. Your doctor may also check related hormones to find out why your level is low.
Lifestyle changes that support healthy levels
- Sleep: aim for at least seven hours a night. Short sleep is linked with lower testosterone.
- Body weight: losing excess weight, especially around the waist, can raise testosterone in men who are overweight.
- Strength training: regular resistance exercise supports muscle and overall metabolic health.
- Alcohol: heavy drinking can lower testosterone, so moderation helps.
What to know about testosterone therapy (TRT)
Testosterone replacement can help men with confirmed low levels and symptoms, but it is a medical decision with trade-offs. It can reduce sperm production and fertility, and it requires ongoing monitoring of blood counts and other markers. It is not recommended simply to counter normal ageing. Talk through the benefits, risks and alternatives with a qualified doctor.
This article is for general information only and is not medical advice. Speak with a doctor about your own health.