Most people don't have a clue. That includes doctors.

- the reference range has been adapted times and times again

- testosterone levels have been falling since industrial times

- for some strange and contrived reasons a lot of people think that the levels of a healthy 18-year old are "unhealthy" as soon as you pass 40. But you should ask yourself what makes it "unhealthy". And why a low level should be "healthy"

Instead of judging the 20 year olds who want to be at the upper range you should have a look at the side effects which come with the lower range. And then have a look at the general population and check for these side effects.

Reference ranges are always adapted to specific populations.

Testosterone levels have not necessarily been falling since industrial times - records farther back than 50-70 years are extremely error prone and sporadic since methods of testing have changed dramatically.

Doctors are not saying that a 40 year old having the same testosterone level as an 18 year are "unhealthy" en masse. It is simply normal for the hormone to decrease as one ages. There is no "strange and contrived reason". It's just how the human body works and isn't a problem unless it goes too low and causes dysfunction of some kind.

The reason for lower testosterone is probably very boring and not some insidious thing like you're implying: people are more obese because they eat more calories, and this is strongly linked to lower testosterone levels.

in this case, reference ranges are adapted so people don't qualify for therapy. The side effects of the low levels don't change just because you change the reference range

>Testosterone levels have not necessarily been falling since industrial times - records farther back than 50-70 years are extremely error prone and sporadic since methods of testing have changed dramatically.

My exhaustive reasearch has shown the opposite. Interestinglingly, even older guys now have higher testosterone levels than younger guys. So you can even see it in the living specimen.

>Doctors are not saying that a 40 year old having the same testosterone level as an 18 year are "unhealthy" en masse. It is simply normal for the hormone to decrease as one ages. There is no "strange and contrived reason". It's just how the human body works and isn't a problem unless it goes too low and causes dysfunction of some kind.

1. doctors say that, en masse.

2. There is some evidence that the lower testosterone levels are caused by injuries and dysfunctions. At least some studies point to that. An analogy: Age doesn't cause bad teeth. Caries and injuries cause bad teeth. If these don't happen, teeth stay healthy. Saying it's normal that your teeth fall out is lazy.

>The reason for lower testosterone is probably very boring and not some insidious thing like you're implying: people are more obese because they eat more calories, and this is strongly linked to lower testosterone levels.

You are partially right. Testosterone is regulated through estrogene. Having high estrogene limits your testosterone production. Obesity and less sport is sufficient.

But a lot of non-obese and healthy people who work out also have low testosterone levels

In defense of the people getting it: that's kind of the tricky part.

My understanding of medical science is that we have a big wide range of what "normal" testosterone levels are in males, and it's expected to drop to some extent as you age, but the range is so big as to be almost meaningless.

I'm not sure what the long-term answer is, but we could benefit a lot from long-term studies on T levels throughout the male lifetime to get a better idea of what the optimal level is for at least the "average" male.

This feels like one of the areas of study that is politically problematic, and therefore avoided.

Anything under 300 along with symptoms (of which I have several hence the blood test in the first place) means further investigation so I am now waiting for the results of a whole host of blood tests that I did last Tuesday that the Endocrinologist ordered. 9 vials! Never had so much blood taken in one go.

I am 39 and never really gave any thought to my testosterone levels if I am honest. But I have been suffering from a whole host of weird issues the past ~3 years. However I am not sure if TRT is something I want to do if it comes back that they are indeed low and it wasn't just a one-off in the first test.

At least it isn't something I want to try first, I will see what other things I can do naturally such as diet changes before I head down the TRT injections, gels, etc. route.

For what it's worth I am in France not the US and I've never known anyone on TRT. Honestly I had never even heard of it outside of sports with people that [ab]use such things.

Usually, low testosterone is more a symptom. Better fix the underlying issue. Get somebody with expertise to look at your tests (i.e. not a government-paid doctor).

Look also into thyroid etc

Thankfully here I get all my results directly in accessible formats (so like a normal video for my MRI results) so I can easily research myself or go for a second opinion without the hassle of having to get my results like back in the UK.

Having said that the Endocrinologist I saw was highly recommended by a close Doctor friend so I have confidence in them.

After doing tons of reading, I decided TRT is something I want. I went to a very questionable "doctor" who will prescribe effectively anything you ask for—(Just Google 'Mens Health Clinic <your area>'). Below, I've listed some of the more compelling videos and articles I went through [0]

The main reason I wanted to try TRT is that I've suffered from severe depression for a long-time; literally, suicide was a daily thought. I tried all the other things people say to do; I ate right, and I religiously tracked my diet. I got sleep-tracking apps and devices and fixed my sleep to get 8+ hours of sleep. After all that didn't help, I went to my normal family doctor, who prescribed escitalopram which "fixed" my depression by making me unable to feel anything, which was a terrible way to live. So I stopped taking that.

I started TRT back in July of 2022.

After being on TRT for about five months, the depression just disappeared. I've had other benefits, too, such as significantly improved musical tone (though this isn't why I started TRT, but it's a nice side-effect).

[0] https://www.youtube.com/watch?v=QBhfP3MBYLU [0] https://www.youtube.com/watch?v=3j232kdcnSQ [0] https://pubmed.ncbi.nlm.nih.gov/32081788/ [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897047/ [0] https://www.eu-focus.europeanurology.com/article/S2405-4569(...

Your initial experience is weirdly similar to mine. My doctor has given me a few different antidepressants over the past 2 and a bit years (Escitalopram, Amitriptyline, Sertraline to name three) but they just made me worse in that I put on weight (which now will not fucking leave!), awful sleep, my penis became useless, and I was just angry 95% of the time. I was a truly awful person to be around and I felt so sorry for my wife and son having to put up with me. So I told him they're not working and we need to look at other ways of treating this depression and anxiety.

He sent me for a testosterone check I think as a bit of a way to just shut me up as I kept asking him what else can we do. He was surprised when it came back at 257ng/dL but as it was above the 249 bottom end he was like "it's a bit low but in the normal range". Thankfully I have a friend that is a doctor and they put me in touch with an Endocrinologist who agreed under 300 at least deserves some further blood work and check I don't have a pituitary gland issue which can cause a lot of my symptoms.

My symptoms are:

* extreme fatigue (to the point of falling asleep in my office chair)

* easily exhausted when exercising

* much longer recovery times from exercising, when I used to have maybe a day or two of muscle aches from pushing myself a bit more to build muscle it would now take me 3 to 4 weeks to recover.

* My concentration is garbage

* Cannot lose the weight around my abdomen. I managed to lose around 13KG back in 2020 yet put it back on thanks to the SSRIs mentioned above and doing the same things I did the first time just does not shift the weight

* Depression but it feels different to my previous experiences with depression not to mention it seems treatment resistant this time whereas before I found Sertraline was at least somewhat effective.

* Heart palpitations that are extremely uncomfortable

* Terrible sleep. It often takes me 2 hours to finally get to sleep and my sleep quality as measured by my FitBit is awful compared to a few years ago (first time the sleep tracking came in helpful)

* Very irritable and easily frustrated

I don't know how that compares to your list of symptoms but they have absolutely wrecked me the past few years. I am just hoping to god there is something of value found in my blood results so I can start working on improving things.

As I said I don't know if I will jump on TRT as it does worry me a little bit. There is no such thing as side effect free HRT after all but my wife has said I should keep an open mind and listen to my Endocrinologist who has said she would recommend it if my blood work comes back with levels in line with ~250ng/dL. I will see what the results are though, if I'm under 250 I think I will have to seriously considering just trying it for a few months. If I am around 300 I think I would rather try some natural ways and retest in 2-3 months and see if it has helped at all. If not then I will give TRT a try.

Brother, it sounds like your life is made of horrendous side effects. I am just a random internet commenter, not a doctor, but I am a fellow man. And if there were ever a time to ignore your fear and roll the dice, it's now.

I am naturally a bit of a worrier about "big" medication regimes like TRT and I over research and over think everything which is obviously not a great thing when it comes to medicine as everything has side effects.

I am slowly starting to adjust my mindset with regards to trying TRT but I need to see what my results are to help me make a decision.

I was like you before I started TRT, super hesitant, and worried I would just be poisoning myself. A good friend of mine kept pushing me to try, and I can't say I have any regrets.

For me personally, I wouldn't want to come off TRT, I feel so much better consistently. IMHO, there are no downsides, at least none yet that I've experienced.

Not trying to second guess your health situation, but I don't see anything about exercise on here. You don't have to go crazy with it (unless you want to), but istm everyone should do some exercise. Walking at leisurely pace helps but I don't really count that as exercise - by that I mean something that gets your heart pumping or significantly tires you out, eg a long walk at a really fast pace or with a loaded rucksack. Obviously this will be different for people who struggle with obesity or have joint issues, but you don't mention any physical handicaps so I'm assuming you have full mobility.

Whoa, it's not HRT, it's TRT. Completely different. HRT is for people with gender dysphoria, whereas TRT is for normal, well-adjusted, no-dysphoric men to maintain healthy testosterone levels (or as high as they can convince their PCP, or more likely, a telemedicine mill, to prescribe), regardless of how healthy they eat, how much alcohol they drink, and how consistent they are with exercise and sleep.

Totally not the same thing.

"whereas TRT is for normal, well-adjusted, no-dysphoric men to maintain healthy testosterone levels". Not sure why you are so persistent on alluding to gender. These discussions have nothing to do with gender dsyphoria.

From my general observations, insecurity is rife in bodybuilding but generally nonexistent in powerlifting and strongman. Powerlifters/strongmen will use steroids for sport performance reasons and they’re generally in the sport because they just like lifting heavy shit. They’re not really comparing themselves to others, just trying to beat their previous PR and they’re generally not doing it to attract women. To an untrained eye they can often times look like a fat dude.

In contrast, a lot of bodybuilders are in the sport because they’re insecure and/or want to attract women. I would say the majority of lads training in the gym are really doing it for these two reasons. This is only made worse when they scan the gym and compare the weight they can lift with that of a power lifter who’s often times no where near as big yet capable of lifting more. As a result, you’re far, far more likely to see bodybuilders getting in scraps than powerlifters and strongmen, half because of the testosterone and half because of the insecurity. Sometimes they’ll find the confidence they’re seeking if they get big enough or start getting women but often times not. A lot of them would be better off doing a a martial art or boxing, probably the former as there’s more of a culture of “you only use this in self defence if you absolutely have to” whereas the majority of local street fighters almost always seem to have a boxing background and something to prove.

No one in a gym is made insecure by someone who is clinically obese, irrespective of how much they can lift. It's even more ridiculous when you realize how many of these people are obese, and on steroids.

If the medical community had been more open about the negligible risks of moderate doses, we could have had a real conversation about it and gotten people reasonable supplementation. Instead, the medical community stayed lockstep in calling it unhealthy/illegal and people learned about it from youtube and bb.com forums.

Absolutely, like shutting off your body's natural T production (!)