How can I get my testosterone levels checked and treated if they are low and affecting my mentality?

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Last updated: November 25, 2025 • View editorial policy

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Getting Your Testosterone Levels Checked and Treated

If you're experiencing mental symptoms you believe are related to low testosterone, you should get a morning blood test for total testosterone on two separate occasions, with levels below 300 ng/dL confirming low testosterone—but treatment is only appropriate if you have both low levels AND specific symptoms like decreased sexual desire, erectile dysfunction, reduced energy, or mood changes. 1

When to Get Tested

You should pursue testosterone testing if you're experiencing any of these symptoms: 2

  • Sexual symptoms: Decreased sex drive, erectile dysfunction, reduced sexual activity
  • Physical symptoms: Reduced energy, decreased endurance, fatigue, diminished physical performance, reduced muscle mass
  • Mental/cognitive symptoms: Depression, reduced motivation, poor concentration, impaired memory, irritability, mood changes

How to Get Tested Properly

The testing protocol requires specific timing and methodology: 2, 1

  • Get your blood drawn in the early morning (8-10 AM) when testosterone levels are highest
  • The test must be repeated on a second separate morning to confirm results
  • Use the same laboratory with the same testing method for both measurements 2
  • The diagnostic threshold is total testosterone consistently below 300 ng/dL 2, 1

Important caveat: Do not get tested during acute illness, as this can falsely lower results 1

Additional Testing Your Doctor May Order

If your testosterone is low, your physician should measure: 2, 1

  • Luteinizing hormone (LH) to determine if the problem originates in your testicles or pituitary gland
  • Prolactin levels if your LH is low or low-normal (to screen for pituitary tumors)
  • Follicle-stimulating hormone (FSH) to further evaluate pituitary function

If your total testosterone is close to the lower limit (near 300 ng/dL), measuring free testosterone through equilibrium dialysis or calculated from total testosterone, sex hormone binding globulin, and albumin may be helpful 2

Physical Examination Components

Your doctor should examine: 2

  • Body mass index (BMI) and waist circumference
  • Body hair patterns in androgen-dependent areas
  • Testicular size, consistency, and presence of masses
  • Presence of gynecomastia (breast tissue enlargement)
  • Prostate examination

Treatment Considerations

Treatment is only appropriate when BOTH conditions are met: confirmed low testosterone levels AND symptoms. 2, 1

Lifestyle Modifications First

If you're overweight or obese, weight loss through diet and exercise can improve testosterone levels naturally and should be attempted before medication 1

Testosterone Replacement Options

If lifestyle changes are insufficient and you meet diagnostic criteria, testosterone replacement options include: 1

  • Topical gels applied to shoulders and upper arms
  • Injectable testosterone
  • Implantable pellets

Critical Safety Warnings

You must understand these cardiovascular risks: Testosterone replacement in older men has been associated with increased coronary artery plaque volume and some studies show increased cardiovascular events 2

Monitoring requirements after starting treatment: 1

  • Testosterone levels checked at 2-3 months
  • Prostate-specific antigen (PSA) monitoring
  • Hemoglobin and hematocrit levels
  • Liver function tests

What NOT to Do

Avoid online questionnaires as diagnostic tools—they are not validated for screening or diagnosis and should never replace actual laboratory testosterone measurement 2, 1

The Mental Health Connection

Research shows that 56% of men with borderline testosterone levels (200-350 ng/dL) have depression or depressive symptoms—significantly higher than the 6-23% rate in the general population 3. However, testosterone supplementation has not consistently shown benefit for mood-related endpoints in controlled trials 4. This means your mental symptoms may be related to low testosterone, but they could also represent primary depression requiring separate evaluation and treatment.

Bottom line: Your mental symptoms warrant both testosterone testing AND a separate evaluation for depression, as these conditions frequently coexist but may require different treatment approaches 3

References

1
Guideline

Diagnosis and Treatment of Hypogonadism

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

2
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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