You’re tired. Your motivation isn’t what it used to be. Your workouts feel harder to recover from. Maybe your sex drive has dropped, you’re gaining weight more easily, or you simply don’t feel like yourself.
So, you get your testosterone checked.
The result comes back
“normal.”
But you still don’t feel good. So, what’s going on?
This is something I see frequently in men who come to see me. They have symptoms that sound like low testosterone, but they’ve been told their testosterone is normal and that everything looks fine.
The problem is that testosterone is only one piece of the puzzle.
When I evaluate a man’s hormones, I don't only want to know his total testosterone. I want to understand the bigger hormonal picture.
Total testosterone tells us how much testosterone is circulating in the blood, but I may also look at free testosterone, SHBG, estradiol, ultra sensitive estradiol and the hormones responsible for signaling testosterone production.
More importantly, I want to know
why you're having symptoms in the first place.
What If It Isn't Your Testosterone?
Fatigue, low libido, brain fog, decreased motivation, weight gain, and poor exercise recovery can happen with low testosterone, but testosterone isn't the only thing that can cause them.
I also think about sleep quality and sleep apnea, thyroid function, blood sugar regulation, metabolic health, nutrition, medications, stress, exercise, and recovery.
Sometimes testosterone is part of the problem.
Sometimes it isn't.
And sometimes several things are happening at the same time.
That's why I don't believe in treating a testosterone number without understanding the man attached to it.
“Normal” Doesn't Mean I Stop Looking
Reference ranges are useful, but they're not the end of the conversation.
If your testosterone is within the laboratory range but you still don't feel like yourself, my next question isn't automatically:
“How can we raise your testosterone?”
My question is:
“Why do you feel this way?”
That's where the real investigation begins.
I may need to look deeper into your hormones, sleep, metabolic health, cardiovascular health, thyroid function, nutrition, exercise, medications, stress, or other areas based on your history and symptoms.
The goal isn't to chase a testosterone number. The goal is to understand what your body is telling us.
Looking at the Whole Picture
Men's health is rarely about one hormone.
Energy, libido, body composition, cardiovascular health, sleep, metabolism, mood, and performance are all connected. When something starts to change, I want to understand
why before deciding what we should do about it.
If you've been told your testosterone is “normal” but you still don't feel like yourself, there may be more to the story.
that's exactly what I want to help you figure out.
Your testosterone level is one piece of the puzzle. Let's look at the whole picture.
-Dr. C
