Men do not always have an easy time bringing up low energy, low mood, or changes in sexual function. In my Sun City practice, those conversations often start sideways — a wife mentions it, or a man comes in for blood pressure and quietly adds, "I just don't feel like myself." More often than people realize, the story turns out to involve testosterone.
Here is a plainspoken look at what testosterone does, what low T looks like, how we diagnose it properly, and what treatment can — and cannot — do.
What testosterone does
Testosterone is the main male sex hormone, but its job goes well beyond libido. It helps maintain muscle mass and strength, bone density, red blood cell production, mood, motivation, mental sharpness, and metabolic health. Levels naturally decline with age, but not every man becomes symptomatic. Some men feel fine into their 70s and 80s; others run into symptoms in their 40s or 50s.
Signs of low T
The symptoms men describe most often include:
- Fatigue that does not improve with sleep
- Loss of muscle mass or strength, even with regular activity
- Increase in body fat, especially around the midsection
- Low mood, irritability, or loss of drive
- Brain fog and difficulty focusing
- Low libido and changes in erectile function
- Disrupted sleep
None of these symptoms alone confirm low testosterone — they overlap with thyroid disease, depression, sleep apnea, medication side effects, and plain old life stress. That overlap is exactly why guesswork is not the answer.
How low T is properly diagnosed
A real diagnosis takes more than one finger-prick test at a kiosk. The standard, evidence-based approach is:
- A morning blood draw — testosterone is highest in the morning, so we typically check it before about 10 a.m.
- A repeat test to confirm — one number on one day is not enough. We confirm with a second morning draw, often two to four weeks later.
- A broader panel — we check total and free testosterone, plus other markers like LH, FSH, prolactin, SHBG, thyroid, complete blood count, PSA, and metabolic labs as needed.
- A symptom and history review — numbers only matter in the context of how you feel and what else is going on.
If both tests come back low and the symptoms fit, we have a real diagnosis and a real conversation to have.
Treatment options worth knowing about
If treatment is appropriate, there are several delivery methods, each with trade-offs:
- Topical gels or creams — applied daily; steady levels; care needed to avoid transferring to family members.
- Injections — given weekly or every couple of weeks, at home or in the office; reliable and affordable.
- Pellets — small implants placed under the skin every few months; convenient, but not easily adjusted once placed.
- Lifestyle and medical optimization — strength training, sleep, weight management, and treating sleep apnea or insulin resistance can meaningfully raise testosterone, sometimes enough that medication is not needed.
Whichever path we choose, monitoring matters. We recheck labs at regular intervals and adjust the plan based on how you feel and what your numbers show.
Who shouldn't take testosterone
Testosterone therapy is not appropriate for every man. It is generally avoided in men with active prostate or breast cancer, untreated severe sleep apnea, certain blood disorders, uncontrolled heart failure, or men actively trying to father children. A careful history and screening — including a baseline PSA — is part of any responsible evaluation.
When to come in
If you have been quietly chalking up fatigue, low drive, or mood changes to "getting older," it is worth a conversation. A thorough evaluation will either give you answers or rule things out — both are useful.
You can learn more on our Hormone Replacement Therapy page, or call the clinic to schedule a visit.
Ready to talk with Dr. Khurana?
Pinnacle Health is welcoming new patients in Sun City and across the Northwest Valley. We'll listen, review your history, and build a plan that fits your life.