How to Tell If You Have Low Testosterone

how to tell if you have ow testosterone

How to Tell If You Have Low Testosterone

With the advent of the internet, people are becoming increasingly conscious about their health. And one topic in particular that has become popular among men is testosterone.

In the past, the word “testosterone” was stigmatized. This was because the media ran a long campaign demonizing testosterone, claiming it was the devil incarnate.

However, many now recognize the importance of testosterone to male health. Testosterone improves mood, immune system function, blood sugar regulation and brain function to name a few.

Therefore, it’s safe to say that when you have low testosterone, you won’t be at your best. But how can you tell if you have low testosterone?

In this article, I cover the main signs and symptoms of low testosterone, plus what you can do about it if you do have them.

Brain Fog

One hallmark symptom of low testosterone is brain fog – also known as mental fatigue. It appears brain fog isn’t necessarily a condition in itself, but rather a symptom of an underlying condition.

In this case, low testosterone.

Brain fog means you struggle to focus and concentrate for sustained periods of time. You may also have memory problems, and an inability to think clearly.

When I suffered from low testosterone in my 20s, I was persistently dogged by brain fog. I was working in investment banking at the time, and I needed to be at my desk every day by 8AM – sometimes earlier.

I recall that when I arrived at my desk it took me several hours to concentrate fully. Regardless of how much I slept, I struggled to feel alert alert first thing in the morning.

I had to chug down more than one cup of coffee to feel anywhere near “normal.”

It’s hard to describe exactly how brain fog feels. All I can say is that my brain felt like a kind spaghetti soup. Thoughts and ideas were in there, but it was like I couldn’t pick them out.

If my mind was a vault, then I was locked out with no access codes.

brain fog low testosterone

Suffice to say that my creative energy was sapped.

Around this time I also began to write. And as with any endeavor, in the beginning you are always going to suck.

That being said, whenever I sat down to write, I struggled to organize my thoughts in a coherent way. As a result, it often took days on end just to write a single blog post.

After this experience, I’m convinced “writer’s block” has more to do with physiological imbalances, rather than mental hurdles.

Fatigue and Low Energy

Feeling low energy and fatigued are also signs of low testosterone. And when you feel this way, sometimes all you want to is lie on the couch.

Even basic things like reading a book or going for a walk can be a major effort. Therefore, the prospect of doing something like going to a restaurant or the gym can feel overwhelming.

This fatigue can affect your life in a number of ways.

First, it can affect your performance at work – because you no longer have the energy to see things through. As a result, you may find yourself going from one thing to the next; unable to finish projects.

low testosterone low energy

Second, it can have a negative impact on your relationship with your partner. Simply because you don’t feel like doing anything! No self-respecting woman wants to be with a miserable, listless man.

Finally, it robs you of the enjoyment of life. When you have no energy, you quickly realize how many things in life require it.

But aside from this, low energy makes you feel like shit and a passenger in your own life.

Fatigue and Low Energy

Emotional imbalance is another symptom of low testosterone. Obviously, as men we have our own emotions and feelings to deal with as do women. However, we tend to express them in a different manner. Or as is often the case, don’t express them at all.

Is this down to societal conditioning or simply part of being a man? I would say a bit of both. That being said, men are meant to be able to keep their emotions in check. Indeed, there is a fine line between mastering your emotions and suppressing them.

But that’s a topic for another day…

Until you’ve been on both sides of the fence, you don’t realize how dramatically low testosterone can affect your emotional state.

Low testosterone can make you feel extremely emotionally imbalanced. And it can lead to mood swings and depression.

When I went through the misery of low T, I was snappy and irritable. My moods were sombre and I struggled to see the positive side of things.

depressed man

Trying to remain positive was akin to climbing a mountain every day.

Nonetheless, it’s not just lack of testosterone itself that leads to emotional imbalance.

Estrogen, another sex hormone, is as important as testosterone when it comes to emotional balance. Men produce estrogen through the conversion of testosterone via the aromatase enzyme – a process known as aromatization.

Therefore, often in men low testosterone levels will lead to low estrogen. And this can exasperate the emotional imbalance many men feel with low testosterone.

Research underlines the importance of estrogen, suggesting it mediates the mood-enhancing effects of testosterone. One interesting study looked at the anxiolytic (anti-anxiety) and antidepressant-like effects of exogenous testosterone and estrogen on castrated male rats.

The authors of the study found when testosterone was administered alone and estrogen was inhibited, this also blocked protective effects of testosterone. But when estrogen isn’t blocked, it promotes the mood-enhancing and well-being effects of testosterone.

Indecision and Hesitancy

Studies show that low testosterone levels are associated with reduced cognitive abilities. Cognitive abilities include judgement, decision-making, evaluation and memory.

And multiple research papers show men with low serum testosterone levels perform below normal on verbal fluency, spatial awareness and memory. I discuss this topic at length in my book Optimized Under 35.

In many men, low testosterone leads to indecision and hesitancy. But you don’t need a scientific study to verify this one.

The average man today struggles to make a firm decision on virtually anything. Instead of drawing a line in the sand, he is wishy washy.

He prefers to sit on the fence, afraid to polarize opinion or to “offend” people. So he takes the easy way out and opts to make no decision.

Most men struggle to decide what to have for lunch. So getting them to make life-changing decisions is impossible.

I see this first hand with men who ask me for advice on improving their testosterone levels. They may even contact me about my coaching.

At which point, we’ll have a discussion about their lifestyle and nutrition habits. Often, I recommend that if they want to raise their testosterone and get their life back, then they’ll need to make big changes to their lives.

Many will go away to “think about it,” knowing all they won’t do anything about it. And unwittingly, due to their low testosterone, they live in a state of perpetual hesitancy.

As a result, they struggle to make decisions that really matter. A year later I’ll speak to them again, and discover they’re still in the same place.

In the end, these men rarely, if ever, address it, because of their indecision.

Now, this is not to say low testosterone renders you unable to make a decision. Because often guys with low T do make positive changes to lies.

This may mean undergoing testosterone replacement therapy, or reducing stress and improving sleep to boost their testosterone levels.

In my experience, if you are prone to indecision and hesitancy to begin with, low testosterone will only exacerbate it.


Anxiety is a further symptom of low testosterone. From what I’ve seen, most men with low testosterone suffer with anxiety to some extent.

Prior to testosterone replacement therapy, I used to suffer badly with anxiety. I would obsess endlessly over the most trivial things – sometimes for days and weeks on end.

My stomach would be in knots and I would struggle to sleep because I was so anxious.

Now, the anxiety may occasionally subside, but it would always be there lurking in the background.


It even got the point where I had full-blown panic attacks. My breathing became shallow, my airwaves constricted, I felt dizzy and my chest tightened.

On more than one occasion I went to the hospital. It seems silly in hindsight, but at the time I was genuinely worried.

They did x-rays and all sorts, but they would NEVER find anything wrong with me.

This would reassure me for a while, only to through the same process a few weeks later.

Ultimately, I went to see a therapist about my anxiety, which helped a lot. It helped get the panic attacks under control, but the anxiety never really went away.

In addition, I had regular heart palpitations. It was a strange sensation; and to be honest, it freaked me out. So much so that I went to a doctor to get an electrocardiogram (ECG) test done to check my heart was OK.

It was fine, of course, but these regular heart palpitations were really debilitating. I’m positive the palpitations were due to low testosterone.

And after I underwent testosterone replacement therapy, the palpitations disappeared altogether – along with the anxiety itself!

Low Libido

Having a low libido or poor sex drive is also a sign of low testosterone.

Once more, I can verify from first hand experience that low testosterone really does affect your sex drive.

You can go weeks without feeling any sort of sexual desire. It makes you feel like a shadow of yourself; especially if you had a strong sex drive in the past.

And on the rare occasion you do have a libido, the sex is not enjoyable. It’s almost to the point where sex feels like a chore, because it drains what little energy you do have.

I’ve consulted with hundreds of men with low testosterone, and many went through the same experience I did with low libido.

Studies show a correlation between testosterone levels and sexual desire. One study looked at the relationship between libido and testosterone levels in aging men. In total, 1632 men aged 40-70 years participated, with follow-ups at 9 and 15 years after the study.

The researchers found there was a significant association between testosterone levels and libido. Subjects that reported low libido had an “increased, but modest” possibility that they would also suffer from low T.

Erectile Problems

Aside from the fact low testosterone results in low libido, it can also lead to erectile dysfunction. Testosterone isn’t responsible for creating erections, but it has a direct effect on nitric oxide synthesis in the brain – a necessary precursor to erections.

Now, you may be able to get erections when you have low testosterone. However, it’s unlikely the erections will be firm. This can make for disappointing sexual encounters and unsatisfying intimacy with your partner.

One study looked at how testosterone levels alter erectile function in 47 castrated male rats. The authors of the study concluded that erectile function is dependent on testosterone levels, and mediated via nitric oxide.

As a side note, from research there appears to be a correlation between erectile dysfunction and cardiovascular risk. In other words, if you struggle to get a boner, that could be an early indicator of heart disease.

The Massachusetts Male Aging Study was a random sample observational study that included 1290 men aged 40-70 years old. The researchers took blood samples, psychological indexes, medication details and other information about participants’ health. Overall, they found diabetes and heart disease to be strong indicators for erectile dysfunction.

I don’t think erectile dysfunction is always an indicator of heart disease among low testosterone men, especially young men. However, it could indicate that not only do you have hormonal imbalance, but you also have poor circulation.

Therefore, in addition to investigating the possibility of low testosterone, it’s worth taking steps to improve your lifestyle. That means eating a better diet and doing more exercise to promote blood circulation.

Increased Body Fat and Low Muscle Mass
Another common symptom in men with low testosterone is an increased body fat and low muscle mass.

It’s like a double whammy.

Before I was diagnosed with low testosterone, I trained like a demon in the gym. I really wanted to get stronger, so I spent a lot of time squatting and deadlifting.

And at one point I was even squatting three times a week! Yet, for all my hard work and effort, I saw meager results.

Now, I didn’t have low muscle mass per se. But I simply couldn’t gain any muscle mass no matter what!

But I couldn’t figure out why. I concluded that I had maxed out my “genetic potential” at the ripe old age of 28. I

I also had a layer of belly fat that I couldn’t get rid. This was in spite of how much I dieted or how much cardio I did.

You only have to look at my picture below to get an idea. The picture on the left was me just before I started testosterone replacement therapy. I was nervous AS HELL (and it shows on my face)!

The picture on the right is me six months later. My body composition has changed dramatically; I have more muscle mass and less body fat.

But here’s the thing. I didn’t drastically change the way I trained, dieted, or how I lived my life. The difference? Optimal testosterone levels.

If you have low testosterone, a hardcore workout can leave you beat for DAYS. Whereas once you optimize your testosterone levels, it’s amazing how quickly you can recover from a brutal workout.

before and after trt

Furthermore, ever notice how elderly people tend to have low muscle mass (also known as sarcopenia)?

Not only do they fail to do any kind of resistance training to retain muscle mass, but they also have low testosterone levels. That means any muscle mass they do have gradually disappears.

And guess what? Low muscle mass and high levels of body fat are strongly associated with all cause mortality.

The Only Way to Tell If You Have Low Testosterone

So aside from the symptoms we discussed above, how can you tell if you have low testosterone?

In truth, the only way to tell if you have low testosterone is to take a blood test.

The main benefit of taking a blood test is that it never lies. By comparison, saliva test kits are not as accurate as blood test, and may provide false readings from food or drink.

Your blood work is a snapshot at any given time into the state of your health. However, hormones can fluctuate depending on stress levels, the time of day, how much you slept and other factors.

Therefore, at any given time you may get a varied reading on your blood test. That’s why it’s worth getting regular blood tests to get a benchmark of your health.

As a minimum, I recommend you take a blood test with the following markers:

  • Serum or total testosterone – this is the total amount of testosterone in your blood. In most labs, the reference range is typically between 250-1000 ng/dL (8.7-34.7 nmol/L).
  • Free testosterone – this is the bioavailable testosterone in your blood that is available for your body to use. This is typically between 2-4%.
  • SHBG – Sex hormone binding globulin or SHBG is a carrier protein responsible for controlling levels of sex hormones in the blood – hence the name. It's important to measure because it can directly affect your free testosterone levels.
  • Estradiol – Estradiol is a form of estrogen and is the main estrogen found in the male body. As mentioned earlier, estrogen is key to male health, so it’s a good idea to understand where your level is at.

If you’re in the UK, I recommend you take the Male Hormone Check. The test includes all of the above markers and is very reasonably priced.

In addition, as a patient you get a cool online dashboard with a breakdown of your test and what it all means. Use the discount code OPTIMIZE10 at checkout to get a 10% discount!

The Results

If your serum or total testosterone is below the reference range above, then you are classed as hypogonadal. However, in recent times doctors have become fixated on treating patients based on lab tests only.

This means that even if you have the symptoms of low testosterone

But your blood results are within the reference range, you don’t qualify for treatment.

Your doctor should treat you based on a combination of symptoms AND blood work. Indeed, emerging evidence suggests that men can have the symptoms of low testosterone between 500-600 ng/dL.

Whereas, if you have a testosterone level of 250 ng/dL; you’re basically on death’s door. At least in terms of the way you feel.

Final Thoughts

This article covers the main signs and symptoms of low testosterone. But you don’t necessarily need to have all of them to class as low T.

Personally, I had most of them. However, I’ve met men who only have some of these symptoms.

For example, their performance in the gym might be good, but their performance in the bedroom is dire.

Ultimately, low testosterone goes by symptoms FIRST – not by a lab test. Any numbers on a piece of paper come to secondary to how you feel.

If you identify with many of the symptoms described in this article – fear not. The realization that you have low testosterone may come as a surprise.

It certainly did for me at the age of 28 years old. In truth, it made me feel hollow inside.

But it was also a blessing in disguise.

I had been living with the symptoms of low testosterone and didn’t even realize it. It forced me to take action and change the course of my life.

There are a few ways to restore your testosterone levels to normal. One option is to undergo testosterone replacement therapy as I did.

Although I feel nowadays many men are quick to jump on TRT – a lifelong medication – without understanding the consequences.

TRT is incredible and changed my life – but it’s not for everyone.

The vast majority of men can boost their testosterone levels by taking steps to improve their nutrition, exercise routine, and overall lifestyle.

If you’re sick of struggling with the symptoms of low testosterone and want to get your life back, get in touch with me about my 1on1 coaching. We’ll come up with a customized strategy for you to regain your health – without the need for medication.