In short
- Two things, not one. A diagnosis needs symptoms and a genuinely low morning testosterone. A number alone is not enough.
- Some symptoms count more than others. Low libido, fewer morning erections, loss of body hair and small testes are specific. Fatigue and low mood are not.
- Speed matters. Symptoms are worse when levels fall over weeks than when they drift over years.
- Primary or secondary. LH and FSH separate a testicular cause from a pituitary one, and that changes the investigation.
- It is over diagnosed. Testosterone is frequently prescribed to men who never met the criteria.
Condition Overview
Testosterone deficiency means your body produces too little testosterone and you have symptoms because of it. Both parts matter, since a number alone does not make a diagnosis.
Men usually present with reduced libido, erectile difficulty, persistent fatigue, low mood or irritability, poor concentration, disturbed sleep, loss of muscle and strength despite training, and increasing fat around the abdomen. Levels decline gradually with age, but they also fall with obesity, poor sleep, sleep apnoea, chronic stress, alcohol, some medicines and pituitary or testicular disease.
A private consultation is appropriate because proper assessment needs correctly timed repeat blood tests, a wider panel and a physician who will interpret all of it together. This is part of men’s health and TRT care with Dr. Felix.
When to See a Doctor
- Your libido has clearly dropped over months and has not recovered with rest or a break from work.
- You feel persistently tired, flat or low in mood despite reasonable sleep and no obvious explanation.
- You are losing muscle and strength, or gaining abdominal fat, while training and eating as you always have.
- You have erectile difficulty, morning erections have become rare, or your concentration and motivation have noticeably declined.
- You have headaches, visual changes or breast tissue growth or discharge, which can point to a pituitary problem and need prompt assessment.
- You have very small or recently shrinking testicles, testicular pain or a lump, which requires examination without delay.
- You have started testosterone or anabolic steroids without medical supervision, particularly with headaches, high blood pressure or thickened blood.
How Dr. Felix Assesses This
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1
Symptom history
Dr. Felix maps out what changed and when: libido, erections, energy, mood, sleep, concentration, training response and body composition. Work pattern, travel, alcohol, stress, medication and your plans regarding children are covered, since all of them affect both diagnosis and treatment.
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2
Examination and other causes
Examination includes blood pressure, weight, waist, body composition and a targeted physical assessment. Thyroid disease, iron deficiency, sleep apnoea, depression, diabetes and medication effects are actively looked for, because each can produce the same symptoms as low testosterone.
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3
Correctly timed blood tests
Blood is taken in the morning, when testosterone is highest, and repeated on a separate morning if the first total testosterone is low. Supporting tests such as LH, FSH, prolactin, SHBG, thyroid function, blood count, lipids and metabolic markers are checked alongside.
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4
Diagnosis and plan
Dr. Felix explains what the combined picture shows and recommends a plan. That may be testosterone therapy with monitoring, treatment of a different condition, further investigation of a pituitary cause, or supervised work on sleep and weight with planned retesting.
Treatment Options
TRT Consultation
What this appointment is for Testosterone deficiency needs two things at once: symptoms consistent with it, and a genuinely low…
View Treatment
Testosterone Replacement Therapy
Who this is actually for Adult men with symptoms and signs of androgen deficiency together with a subnormal morning testosterone…
View Treatment
Testosterone Optimization Program
What this programme is It is the layer that comes after diagnosis and initiation. For men whose deficiency is established…
View Treatment
Why Early Treatment Can Matter
Low testosterone rarely stands on its own. It travels with weight gain, poor sleep, high blood pressure and unfavourable blood sugar and lipid patterns, and each of those makes the others worse. Assessing it early means those linked problems are found while they are still simple to influence.
Getting the diagnosis right early also protects you from years of unnecessary treatment. If your symptoms come from thyroid disease, iron deficiency or untreated sleep apnoea, testosterone will not fix them, and treating the actual cause usually works better. Either way, you stop guessing. A TRT consultation is straightforward, and the plan that follows is based on your own results.
Why Early Treatment Can Matter
Low testosterone rarely stands on its own. It travels with weight gain, poor sleep, high blood pressure and unfavourable blood sugar and lipid patterns, and each of those makes the others worse. Assessing it early means those linked problems are found while they are still simple to influence.
Getting the diagnosis right early also protects you from years of unnecessary treatment. If your symptoms come from thyroid disease, iron deficiency or untreated sleep apnoea, testosterone will not fix them, and treating the actual cause usually works better. Either way, you stop guessing. A TRT consultation is straightforward, and the plan that follows is based on your own results.
Symptoms addressed sooner
Energy, libido and mood improve once the correct cause is actually treated.
Linked problems found early
Weight gain, sleep apnoea, blood pressure and metabolic changes often accompany low testosterone.
One clear assessment
A history, an examination and correctly timed bloods settle the question properly.
Cost & Consultation Investment
The assessment is priced as consultation time with Dr. Felix, covering your history, examination, interpretation of the blood work and the written plan you leave with. Laboratory tests are billed by the laboratory and any prescribed medicine is separate. If treatment or ongoing hormonal care follows, it is arranged as a programme or membership rather than visit by visit. Current details are on the pricing page.
Frequently Asked Questions
Most laboratories use a lower limit around 300 ng/dL, though this varies by assay. In healthy non obese men aged 19 to 39 the range was 264 to 916 ng/dL, and the lower limit falls with age to around 219 ng/dL in non obese men over 60. The result is read against the range of the laboratory that produced it.
No. A low or borderline morning value is repeated on a separate day before any diagnosis, because levels fluctuate and a single sample is not a sufficient basis for long term hormone therapy.
Low libido, fewer morning erections, loss of body hair, small testes, breast tissue and low bone density are the more specific ones. Fatigue, low mood, reduced strength and increased body fat are common but non specific.
Primary means the testes are the problem, shown by low testosterone with high LH or FSH. Secondary means the pituitary or hypothalamus, shown by low testosterone with normal or low LH and FSH. The second prompts further investigation and sometimes imaging.
Very possibly. Obesity lowers sex hormone binding globulin, which lowers the total testosterone reading without necessarily lowering the free level. The effect is proportional to the degree of obesity and corrects with weight loss.
It frequently is, and untreated apnoea also lowers testosterone directly. Snoring, waking unrefreshed and daytime sleepiness are asked about specifically, because treating apnoea often resolves the whole picture.
It declines gradually in many men, and free testosterone falls more than total. Men in their eighties have around a half to a third of the levels of men in their twenties. Whether that decline needs treating is a separate and more nuanced question.
That depends on how the diagnosis was made. Where the original evaluation does not support it, the recommendation is to stop and re-evaluate about two months later, because continuing can mask a treatable cause.
Only where a binding protein problem is suspected, most often because of obesity or older age, and only by equilibrium dialysis at a specialist laboratory. The analog assay offered by most commercial laboratories is misleading and should not be ordered.
Yes. Long term opioids and high dose steroids suppress testosterone directly, and several other drugs contribute. Your full medication list is reviewed at the first appointment.
Acute and subacute illness cause a temporary functional drop that has nothing to do with your baseline. Testing then produces a low result and a wrong diagnosis.
It depends on which tests are needed and how many repeat samples, so a single figure would be misleading. You get the full cost in the consultation before anything is arranged.
Evidence
Where this information comes from
Every figure on this page is taken from the sources below. All of them are free to read, so you can check them yourself.
This page is general medical information and does not replace a personal consultation. Trial results are averages across large groups, not a prediction for any one person.