Diagnosing Low T: What You Should Know

Men who had little or no trouble staying lean and strong in their younger years, who were full of energy, find themselves at a loss when they experience chronic fatigue, muscle deterioration, loss of libido, and the diminishing of other “masculine” traits later in life.

It couldn’t be Low T, could it?

Yes, it very well could be, even if you’ve never experienced hormone deficiencies or other major health concerns before.

Researcher uses a microscope to examine a blood sample, which is part of a proper Low T diagnosis.

Scientific findings show that our testosterone levels in our early years are poor predictors of testosterone production as we advance in age, which can lead to false assumptions on the part of patients and medical professionals alike.

The fact is that correctly diagnosing Low T is a process, not just a checklist of signs and symptoms.

Diagnosing Low T

Physicians are too often guilty of using the definition of low testosterone or hypogonadism (the medical term for Low T) found in younger men when diagnosing or treating older men. Hypogonadism is divided into two groups, the first of which includes highly specific physical symptoms of disease, such as:

  • Delayed sexual development
  • Inhibited sexual function
  • Thinning facial and body hair
  • Shrunken or underdeveloped testes
  • Poor bone density

The second group includes more general symptoms, including:

  • Fatigue or reduced energy
  • Poor motivation
  • Depressed mood
  • Impaired concentration
  • Weakened muscle strength
  • Reduced lean muscle mass
  • Weight gain

To better understand how Low T has been diagnosed by medical professionals in recent years, researchers led by Dr. Adam Millar, an assistant professor at the University of Toronto and a physician at Mount Sinai Hospital, Ontario, conducted a systematic review of 40 research projects on low testosterone in aging men. In total, those studies included 37,565 patients with an average age of over 40 years.

Researchers found significant discrepancies in the protocols for low testosterone diagnosis, including:

  • Inconsistent utilization of signs and symptoms as diagnostic tools
  • Uncertainty around the threshold testosterone level for diagnosing Low T in older men
  • Varied beliefs surrounding the prevalence of low testosterone in the male population

Another member of the research team, Dr. Allan Detsky, a professor at the University of Toronto and a physician at Mount Sinai Hospital, summarized their findings:

“Our extensive review of all clinical studies published to date shows that in men over the age of 40, the symptoms and physical signs that are classically found in young men who suffer from pathological hypogonadism, caused by disease in the testes or pituitary gland, correlate poorly with their testosterone levels. These results suggest that it is difficult to extrapolate the way we diagnose pathologic hypogonadism in younger men to older men who have age-related declines in testosterone levels.”

(Read the research abstract here.)

In other words, diagnosing Low T in older men is a finicky business, much more complicated than the diagnosis of disease-related hypogonadism more commonly found in younger men.

Again, diagnosing low testosterone is more than just a checklist of symptoms.

With varying opinions and standards applied in an inconsistent manner across the medical profession, it’s difficult to know who and what to trust.

But, there’s a solution to that dilemma, too.

Diagnosing Low T: What You Can Expect at Testosterone Centers of Texas

Myths abound in just about every medical and health arena. Some are based in truth, and others are entirely false, but the numbers combined with careful examination of your symptoms don’t lie. That’s why we utilize blood testing when diagnosing low testosterone.

We’ll carefully evaluate your symptoms to determine whether or not they’re characteristic of clinical hypogonadism.

If the signs and symptoms point in the direction of Low T or another hormone imbalance, we take the next step. A blood test is the only way you can determine definitively if low testosterone is the problem, or if something else is behind your symptoms.

The researchers above have reinforced the point:

The ease with which symptoms can be misinterpreted makes arriving at a diagnosis difficult. Providers should investigate many possibilities before diagnosing Low T as the cause of your symptoms, and then it’s necessary to confirm that conclusion with blood testing.

Metrics established by the Endocrine Society are used to determine if your testosterone levels warrant a diagnosis of Low T, supported by the presence of symptoms. To be more specific, if your total level of testosterone is below 300 ng/dl, or if your free testosterone is below 9.0 ng/dl, you may be suffering from low testosterone.

It is vitally important to assess both total and free testosterone for both diagnosis and the development of a treatment protocol.

Consult Your Healthcare Provider

If you’re concerned that your fatigue, lack of sexual interest, or difficulty in maintaining your physical fitness are related to low testosterone, request a thorough evaluation from your medical professional, or visit us at Testosterone Centers of Texas.

If the examination and lab results indicate Low T is the source of your difficulties, we’ll prepare a treatment plan that could restore your hormone levels and decrease the health risks associated with the debilitating cycle of low testosterone.

Our all-inclusive TRT (Testosterone Replacement Therapy) guide provides the facts and answers the most common questions about the treatment of low testosterone.

Read the Guide


  • Hidden


(Augie) Juan Augustine Galindo Jr. MPAS, PA-C

(Augie) Juan Augustine Galindo Jr. MPAS, PA-C started his career in healthcare as a fireman/paramedic in West Texas where he served on the Midland Fire Department from 1998-2004.   He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.   After graduating from the Texas Tech Health Sciences Center Physician Assistant Program, he moved to DFW where he currently lives with his wife and three children.

Leave a Comment