Why low testosterone is easy to overlook

Feeling tired, flat or less sharp than you used to is something most men put down to work, age or a hard few months. Often that's exactly what it is. But sometimes hormones are part of the picture, and because the signs are so ordinary, low testosterone is one of the easiest things to overlook.

Why the signs are easy to dismiss

The symptoms men most often describe are ones everybody has from time to time:

• Low energy, or needing caffeine to get through the afternoon
• Brain fog, poor concentration or a shorter fuse
• A lower sex drive, or changes in erections
• A flatter mood or less motivation
• Slower recovery from training, or losing strength
• Poorer sleep, or weight building up around the middle

None of these is specific to testosterone, and they tend to creep in slowly. Most men adapt rather than question them: another coffee, an earlier night, a sense that this is just what your forties feel like. That's why the question of hormones often isn't asked at all.

What else can cause the same symptoms

Plenty. Poor sleep, long-term stress, alcohol, carrying extra weight, low mood or depression, thyroid problems, low iron and some medicines can all produce the same tiredness and fog. Several often overlap.

So a symptom checklist on its own can't tell you whether testosterone is involved. It can only tell you that something is worth looking at properly.

How a doctor works out whether testosterone belongs in the conversation

1. Your symptoms and history

It starts with a conversation: what has changed, for how long, how you're sleeping, your stress, alcohol and training, any medicines you take, and your plans, including whether you may want children in the future.

2. A properly timed blood test

A testosterone test usually measures total testosterone, and often free testosterone and SHBG, the protein that binds it. Levels are highest in the morning, so samples are usually taken early in the day, and a low result is normally confirmed with a second test before anything is decided. The Enovar Baseline Test measures these markers.

3. Reading the results alongside you

Results are never read in isolation. A level inside the reference range doesn't always settle the question, and a single low reading doesn't either. A doctor looks at your results together with your symptoms and history, and may suggest other checks, such as thyroid function or iron, to rule other causes in or out.

4. Agreeing the next steps

Depending on what the picture shows, the next step might be changes to sleep, weight or training, further tests, a referral to your GP or a specialist, or, where a doctor judges it clinically appropriate, treatment. Not everyone is offered treatment, and any options come with a clear explanation of the benefits and risks.

When it's worth getting checked

If symptoms have lasted more than a few months, are affecting your work, relationships or training, or several of them have arrived together, it's worth finding out what's behind them rather than waiting it out. Changes in erections are worth checking too, as they can sometimes be an early sign of heart or circulation problems.

If you feel very low, or have thoughts of harming yourself, don't wait: speak to your GP, call NHS 111, or contact the Samaritans on 116 123.

A simple place to start

The Prime Check is ten quick questions about how you've been feeling lately. It isn't a diagnosis, but it shows whether the changes you're noticing are worth a closer look. From there you can order a blood test, or book a free call if you'd rather talk it through first.

Read more about testosterone health, or see what testing and an assessment cost.