What testosterone level is low enough to need treatment?

Short answer

• For adult men, guidelines commonly use a total testosterone cutoff of about 300 ng/dL (≈10.4 nmol/L). Treatment is usually considered when a man has consistent symptoms of testosterone deficiency and at least two early‑morning total testosterone measurements <300 ng/dL.
• If results are borderline (e.g., ~250–350 ng/dL) or SHBG is abnormal, doctors may also check free testosterone and pituitary hormones and make an individualized decision.

What you should know

• Timing/repeat testing: testosterone peaks in the morning. Labs should be drawn before 10 a.m. and the low result should be confirmed by a second test on a different day.
• Symptoms that matter: low libido, erectile dysfunction, fewer morning erections, fatigue, loss of muscle mass/strength, increased body fat, decreased bone density, depressed mood or difficulty concentrating. Treatment is generally only recommended when low labs are paired with symptoms.
• Other testing: measure luteinizing hormone (LH) and follicle‑stimulating hormone (FSH) to determine primary vs secondary hypogonadism; check SHBG (sex hormone binding globulin) and consider calculated free testosterone if SHBG is high/low. Prolactin and basic metabolic testing are sometimes indicated.
• Risks/contraindications: testosterone therapy has risks (polycythemia/↑hematocrit, possible effects on prostate disease, skin issues, infertility, and cardiovascular concerns in some men). Active prostate or breast cancer are contraindications. Monitoring (hematocrit, PSA, symptom check) is required if therapy is started.
• Older men: age‑related declines are common. Guidelines generally do not recommend treating solely for age without clear symptoms and confirmed low levels.

Practical next steps

1. See your primary care doctor or an endocrinologist/urologist. Bring at least two morning testosterone lab results if already obtained.
2. If you haven’t tested: get a morning total testosterone test (and LH/FSH, SHBG if available). Repeat a low test on a different day before deciding on treatment.
3. If you’re seeking testing: reliable clinical labs include Quest Diagnostics or LabCorp (widely used, consistent reference ranges). For convenient at‑home screening, services such as Everlywell or LetsGetChecked offer morning testosterone kits — useful for screening but confirm low results with a clinical lab and clinician before treatment.
4. For trustworthy patient guidance and guideline references: see Endocrine Society clinical practice guideline and educational resources from Mayo Clinic or Cleveland Clinic.

If you want, tell me your age, symptoms, and any recent testosterone numbers (with the time of day they were taken) and I can help interpret them and suggest which follow‑up tests to ask your doctor for.