Testosterone: Understanding the numbers
The most common mistake men make when chasing low testosterone is treating a lab number instead of trying to understand the man behind it. It usually goes like this: a man feels tired, notices his libido has dropped, watches a few videos online, and the next thing he knows, he’s buying a testosterone booster or thinking about injections someone at the gym swears by. But has anyone asked him about his sleep, stress, weight, alcohol intake, medications, medical history or whether he wants children?
Testosterone deficiency is a real medical condition. Feeling tired doesn’t establish the diagnosis, though, and neither does a single low reading. You need compatible symptoms and consistently low levels, confirmed through proper testing.
Testosterone levels shift through the day and from one day to the next. That’s why they’re generally checked with an early-morning blood test, and a low result should usually be confirmed with a second morning test. Depending on the results, a doctor may look at free testosterone, SHBG, LH and FSH, and sometimes prolactin or other markers. Thyroid function, blood sugar, vitamin B12 and vitamin D may also be considered, depending on symptoms.
The fertility risk men should know about
If you’re considering testosterone therapy, please understand this: testosterone taken from outside the body can suppress the hormonal signals that tell your testes to make testosterone and sperm. That can significantly affect fertility. So, if children are part of your plans, have that conversation with a qualified doctor before starting treatment. Understand whether you truly and clinically need it. TRT does have a legitimate role for men with confirmed deficiency. My problem is when it’s used as a shortcut around the fundamentals, or taken without understanding the cause, benefits, risks and long-term implications.
Andropause: The midlife shift men don’t talk about
Andropause, sometimes loosely referred to as “male menopause”, describes age-associated hormonal changes in men, particularly a gradual decline in testosterone. Unlike menopause in women, it is not a universal or clearly defined hormonal transition. Ageing alone does not necessarily mean a man will develop testosterone deficiency.
Some signs men may notice include less interest in sex, fewer spontaneous or morning erections, persistent tiredness, low motivation, loss of muscle or strength, increasing belly fat, irritability, mood changes, brain fog, restless sleep and slower recovery. None of these symptoms, by themselves, prove that testosterone is low. They could just as easily be linked to sleep problems, long-term stress or metabolic health.
Part of the reason these changes go ignored is that they happen gradually, so men begin to see them as a normal part of getting older. There’s also the discomfort around talking about libido, erections or emotional struggles. I’ve had men reach out to me privately about what they’re going through because they find it difficult to bring up openly. But experiencing emotional changes doesn’t make you weak.
What genuinely helps (put in a box)
- Prioritise sleep — 7-9 hours for most adults; get checked for a sleep disorder if you snore heavily or wake repeatedly.
- Tackle belly fat — steady, realistic weight loss, not crash diets.
- Build muscle, and hold on to it — strength training with proper recovery, not training too hard on too little food.
- Manage chronic stress — breathwork, time outside, support, counselling and proper rest.
- Eat enough, and eat well — enough protein, healthy fats and nutrient-rich foods; very restrictive diets can throw off hormone function.
- Fix actual deficiencies — vitamin D and zinc matter, but only supplement with a confirmed need.
- Cut back on the habits that hold you back — smoking, heavy drinking, poor sleep, long hours of sitting.
What’s mostly noise?
Most over-the-counter testosterone boosters, where evidence is thin, and quality varies. The idea that soy lowers testosterone, which clinical studies don’t support. And chasing the highest possible number when the real goal is treating a genuine deficiency, not maximising a figure. If your symptoms persist and your testosterone keeps coming back low, stop experimenting with supplements and see a qualified doctor. Foundational medicine isn’t about rejecting medication or chasing natural fixes. It’s about understanding the whole person and using the right intervention for the right reason.
What Cancer Patients Taught Him About Prevention
The lesson healthy men should take seriously
Don’t wait for a diagnosis before you start taking care of yourself. When you sit with people going through cancer treatment, your idea of health shifts. The things they care about most are usually simple: a night of comfortable sleep, a meal they can actually enjoy, time with their family, and enough energy to get through an ordinary day.
Where lifestyle helps, and where it doesn’t
Does lifestyle matter? Absolutely. But I want to be honest about what it can and can’t do. Eating well, staying active, resting enough and having emotional support can help people hold on to their strength and maintain their quality of life. What lifestyle cannot do is replace cancer treatment. Lifestyle and foundational medicine always work alongside treatment, never instead of it.
A reminder to take your health seriously
If your symptoms persist and your testosterone keeps coming back low even after working on lifestyle factors, stop experimenting with supplements and see a qualified doctor. I’ve always believed in starting with the foundation, investigating what needs investigating, and using medical treatment when it’s appropriate. Foundational medicine isn’t about rejecting medication or chasing natural fixes. It’s about understanding the whole person and using the right intervention for the right reason.
