More than a lab result
Too often, treatment decisions are based solely on lab numbers. Some providers aim to raise testosterone to the high end of the normal range, assuming this will fix symptoms. However, evidence shows that pushing testosterone to the upper limit doesn’t necessarily make men feel better. Two men with the same total testosterone level can have very different experiences depending on their free testosterone and SHBG.
Patient story: Rob’s lesson
Rob, 52, was prescribed testosterone injections to push his levels from mid‑normal to high‑normal. His total testosterone climbed, but his fatigue persisted. When he sought a second opinion, a practitioner checked his free testosterone, SHBG and thyroid. His free testosterone remained low due to high SHBG. Adjusting his treatment to lower SHBG and support thyroid health finally relieved his symptoms.
Conventional vs functional focus
Conventional approach: Raise the number. Guidelines often define low testosterone as below 300 ng/dL, so the goal is to surpass this threshold. Functional approach: Treat the person. Practitioners evaluate symptoms alongside free testosterone, SHBG and other hormones. They consider lifestyle factors and often use lower doses of therapy combined with stress management, diet changes and sleep optimization. Collaborating with clinics that specialize in testosterone replacement therapy allows them to tailor treatment to how the patient feels rather than just numbers.
Takeaway
Don’t be satisfied with a target number. Treatment should relieve your symptoms and improve your quality of life. Ask your provider to look beyond lab values and adjust therapy based on your unique biology.
