What testosterone level is low enough to need treatment?

Short answer

• For adult men, most doctors consider total testosterone low when it’s below about 300 ng/dL (≈10.4 nmol/L). The Endocrine Society guideline uses a slightly lower cutoff (≈264 ng/dL or 9.2 nmol/L) and emphasizes that treatment should be based on consistent low values PLUS compatible symptoms.

Key points to understand

• Diagnosis = symptoms + consistently low lab results. Typical symptoms: low libido, erectile problems, low energy, loss of muscle mass/strength, weight gain, depressed mood, anemia, decreased bone density.
• Timing and repetition matter: measure total testosterone in the morning (usually before 10 AM) on at least two separate days when you are not acutely ill and not taking drugs that affect levels.
• If total testosterone is borderline (roughly 250–350 ng/dL), clinicians often repeat testing and/or measure free or bioavailable testosterone because assays and reference ranges vary.
• Reference ranges vary by lab and assay. Always compare your result to the laboratory’s listed normal range and discuss it with your clinician.

When treatment is considered

• Most clinicians consider testosterone therapy when:
  1. symptoms consistent with testosterone deficiency are present, and
  2. morning total testosterone is consistently low (commonly <300 ng/dL, or per the lab/guideline cutoff used by your clinician).
• The decision also weighs age, comorbidities, fertility desires (testosterone therapy suppresses sperm production), and potential risks (hematocrit rise, prostate issues, sleep apnea, possible CV concerns).

Testing and follow-up labs clinicians commonly order

• Baseline: total testosterone (morning), sometimes free testosterone, LH/FSH to distinguish primary vs secondary hypogonadism, CBC, PSA (if age-appropriate), lipid panel, and possibly morning cortisol or prolactin if indicated.
• If therapy is started: monitor hematocrit (to avoid polycythemia), symptom response, testosterone levels, and PSA at intervals per your clinician.

Next steps I recommend

• Bring your lab results and symptoms to your primary care doctor, an endocrinologist, or a urologist for evaluation. If you prefer labs first, common national labs are Labcorp and Quest Diagnostics (both widely available and used by clinicians).
• If you want telemedicine options that can arrange testing and follow-up, services such as Hims or Roman provide convenient access for men’s health screening — but be sure the provider you see reviews labs and medical history thoroughly rather than automatically prescribing.

Reliable references

• Endocrine Society clinical practice guideline on testosterone therapy
• American Urological Association statements on testosterone

If you want, tell me: your age, most recent testosterone value (with units and time of draw), symptoms you’re having, and any medications — I can help interpret that result and suggest specific next steps.