Wait! Stop! Don’t Start T Therapy!

….. at least, not until you’ve done some preliminary work first.

Men with low T generally tend to fall into two camps; those who ignore it completely and don’t do anything about it and those who jump into it feet first without doing any research beforehand. It’s the second group I’m talking to now.

So, you find out that your T levels are low, you go to one of those doc-in-a-box low T clinics, they confirm your low T, write out a script for T cypionate injections and heck, they even offer to give you your first injection right then and there. It’s all good, right? Well, maybe not.

Starting T injections is pretty much a life long commitment. Typically, what happens is that after a few months of exogenous (external) testosterone, your body will stop producing its own testosterone. At that point, you are dependent on the exogenous source from that point forward. (There have been some incidences where men can re-start their own production by utilizing HcG or Clomid, but it is by no means a sure thing.)

Depending on why your T levels are low, it may be possible to increase them without resorting to T therapy. So, the #1 priority before you take the first shot or the first med is to figure out as much as possible about what’s causing your low T.

There are a number of things that can contribute to low T, many of which can be detected with a simple blood test. Sometimes, fixing the issue can completely solve the low T or at least alleviate it somewhat.

    • Diabetes
    • Iron overload (ferritin levels)
    • Elevated estrogen
    • Elevated Prolactin levels
    • Hypothyroid
    • Vitamin D or Zinc deficiency

Other things that contribute to low T are lifestyle conditions. Addressing them may not cause your low T issues to resolve completely, but can improve the situation significantly.

    • Sleep apnea
    • Obesity
    • Heavy alcohol use


About 10-20% of all men have a condition called:

Varicoceles can lower testosterone production, probably by raising the temperature in the testes. This condition can be detected either by physical exam, ultrasound or a specific type of x-ray. Often, once it’s corrected, testosterone levels rebound on their own.

So, don’t be too quick to jump into T therapy. The very first thing you want to do is to determine the cause, specifically whether it’s primary (originating in the testes) or secondary (originating in the hypothalamus-pituitary axis).

The best way to determine this is to check for your LH (luteinizing hormone) and FSH (follicle stimulating hormone) levels with a blood test. If your testosterone is low, your LH and FSH levels should be high, telling your testes to produce more testosterone. If the testosterone level is low, but the LH or FSH levels are either low or normal, then that’s a good indicator that your problem is originating in your hypothalamus-pituitary axis. That determines your starting point.

If you are a guy experiencing low T, I’d be really interested in hearing whether your doctor tried to determine the cause before wanting to treat the low T. What blood work did he/she recommend? Drop me a comment.