In Detail
A proper diagnosis of low testosterone requires both consistent symptoms and confirmed laboratory deficiency. Symptoms alone are not enough — many men with classic complaints have normal levels, and a small subset of men with low numbers have no symptoms. Numbers alone are not enough either.
Testing is done on a morning blood draw, ideally between 7 and 10 a.m., when testosterone peaks. Most guidelines recommend confirming with a second morning draw before initiating therapy. We measure total testosterone, free testosterone or SHBG, estradiol, LH, FSH, prolactin, a complete metabolic panel, CBC, lipid panel, PSA in age-appropriate men, and often a thyroid panel.
Reviewing the full clinical picture — not just one lab value — leads to better decisions about whether therapy is warranted and what form is most appropriate.