By Dr. Jamin Brahmbhatt, CNN
(CNN) — “Hey doc, can you order me labs? I want to get my T checked.”
As a urologist, I’ve gotten some version of that message more often in the past few months than in the rest of my career. Testosterone talk has moved from locker rooms to podcasts and now to headlines. US Defense Secretary Pete Hegseth announced on Wednesday the launch of screening for low testosterone among service members who are 30 or over.
Guys who never used to think about their health are suddenly asking real questions about their hormones — and guys who never knew the test existed could soon be getting it by default.
The interest is a good thing. What we do with a single number is the harder question.
If you’re curious about your testosterone, go ahead and have a urologist check it. And if there is a real pattern that suggests “low T” — months of low drive, fatigue, mood changes, muscle loss and weakness — then definitely make an appointment.
You and your doctor should consider two things before anyone talks replacement therapy: Rule out the bigger lifestyle factors first: sleep, alcohol, weight, stress, sleep apnea and the medications you’re already on. And if you might want kids someday, have that conversation before the first dose.
Because a number on a lab report is a starting line, not a finish line. The men who get real value out of knowing their T levels aren’t the ones chasing a higher number. The patients willing to ask what the number may tell them are on the right track.
What testosterone actually is
Triggered by signals from the brain, the testicles produce testosterone — the primary hormone driving male growth and development. These hormone levels fluctuate constantly, running highest in the morning and lower by the afternoon. Just how much testosterone the body releases changes based on sleep, weight, workouts and even stress. This key sex hormone also naturally drops about 1% a year once a man hits his 30s or 40s.
Most labs call normal somewhere between 300 and 1,000 nanograms per deciliter. That’s a wide range, and where “low” begins depends on which guideline your doctor follows and which lab ran the test.
And a diagnosis of low testosterone is never the result of one blood draw. Your doctor will check your T levels, alongside other labs (such as the hormone estradiol and the sex hormone-binding protein globulin), at least twice. This process helps rule out the other factors that can drive a number up or down.
The conversation almost nobody’s having
If a man truly is low, treatment usually means taking testosterone through a gel, a patch or an injection. Sometimes a doctor prescribes implanted pellets. If a patient is running too high, usually from supplements or too big a dose, the fix is to cut back and let the body recalibrate.
For a man who’s truly low and symptomatic, the upside is real: energy, drive, mood, muscle, bone. The goal is a normal level, not a high one.
Raising the number isn’t free. Testosterone therapy shuts down your body’s own production, and with it, sperm. Fertility can fall within weeks and doesn’t always come back. And most of the men I would treat are young enough to want kids. That conversation must happen before the first dose, not afterward.
Pushing levels too high carries its own risks: thicker blood and a higher clot risk, higher blood pressure, worse sleep apnea, and over time,