Testosterone replacement therapy—TRT—is everywhere right now, but here’s the deal: if you don’t actually need testosterone, it’s not therapy. If you genuinely have low testosterone, though, TRT can be incredible.
It can help restore energy, improve sex drive, support muscle mass, reduce body fat, and generally help you feel like yourself again. I’m a huge advocate for TRT when somebody legitimately needs it. But I’ve never taken it myself. Through lifestyle changes, I was able to raise my testosterone from the 500s to 833 at 50 years old.
The problem is that a lot of guys are walking around feeling tired, weak, unmotivated, and generally crappy—and they assume it’s just part of getting older. You work hard, you’ve got responsibilities, maybe you’ve got kids, and eventually you get used to not feeling great. But you shouldn’t automatically accept that as your new normal. If several of the signs below sound familiar, it may be time to get blood work and find out what’s actually going on.
Signs to get blood work done
1. You’re losing muscle despite training.
If you’re consistently working out but getting smaller, weaker, or having a harder time maintaining muscle, something may be going on hormonally. Testosterone naturally declines as we age, and losing muscle despite doing the right things can be a warning sign.
2. You’re gaining more fat around your midsection.
Your diet hasn’t dramatically changed. You’re still exercising. Yet suddenly you’re softer, your love handles are getting bigger, maybe you’re developing some man boobs, and the dad bod is starting to show up. Changes in body composition—especially when your habits haven’t changed significantly—can be another clue.
3. Your strength and energy are declining.
If you’re weaker in the gym, more fatigued, and struggling with energy despite exercising, eating well, and sleeping properly, get your testosterone checked. Obviously, bad sleep, poor nutrition, excessive drinking, and unhealthy habits can make you feel terrible too, so you need to address those first.
4. Your beard or body hair is getting thinner.
Maybe your beard isn’t as thick as it used to be, or you’re noticing less body or pubic hair. Testosterone plays a role in facial and body hair, so noticeable thinning can be another physical sign that your levels are dropping. This is different from male-pattern hair loss on your head, which has more to do with your follicles’ sensitivity to DHT.
5. Your testicles seem smaller, or your ejaculate volume has decreased.
These can also signal a hormonal shift. Interestingly, testicular shrinkage can also occur after starting TRT because your body reduces its own testosterone production when testosterone is being supplied externally. That’s one reason TRT isn’t something to jump into casually.
6. Your erections or sex drive have changed.
If your erections aren’t as firm or frequent as they once were, or your interest in sex has noticeably dropped, don’t automatically blame your age. Testosterone could be part of the equation, and it’s worth investigating rather than simply accepting it.
There are other signs too. Maybe your sleep has changed, you’re constantly tired, you lack motivation, you’re less excited about life, or you simply don’t feel like yourself anymore. Look at yourself objectively. Has your muscle mass decreased? Has your body fat increased? Are you weaker, more lethargic, and less motivated than you were a few years ago? One symptom doesn’t necessarily mean low testosterone, but when three, four, or more of these things start happening together, that’s when I think you need to pay attention.
Things to understand FIRST
Before jumping on TRT, fix what you can control first. Get your sleep dialed in. Clean up your diet. Exercise consistently and lift weights. Make sure you’re getting the micronutrients you need, manage your stress, and eliminate unhealthy habits. Give those changes three to six months and then get tested again. You may be surprised by how much you can improve naturally.
The other thing you need to understand is that TRT isn’t like taking creatine or a multivitamin. You’re altering your hormones, and some of those changes may not be easily reversible. Once you start TRT, there’s a good chance it becomes a long-term treatment. That doesn’t make TRT bad—it simply means you need to approach it intelligently and with legitimate medical supervision.
Ultimately, the only way to know what’s actually happening with your testosterone is to get blood work. I use Merrick Health because I’ve worked with them for years and trust their approach. They can evaluate your blood work, help develop an appropriate protocol, and provide professional medical oversight rather than treating testosterone, peptides, GLP-1s, or other medications like some trendy internet supplement.
I’m a firm believer that we can fix a lot of things naturally. But sometimes we can’t—and that’s where modern medicine can be an incredible tool. You don’t have to accept feeling terrible simply because you’re getting older. Optimize the things you can control, get your blood work done, understand your numbers, and then make an educated decision with qualified medical guidance.
