Testosterone Therapy: Who Actually Needs It (And Who Doesn’t)
Testosterone therapy (or TRT) is the medical use of bioidentical testosterone to restore levels that have dropped below a functional, healthy range.
You’re tired. You’re gaining weight. Your workouts don’t work like they used to. And let’s not even talk about the drop in sex drive.
You’ve probably heard testosterone therapy can fix all of that. But is it right for you?
Let’s break it down—no fluff, no gimmicks, just real answers.
First, What Is Testosterone Therapy?
Testosterone therapy (or TRT) is the medical use of bioidentical testosterone to restore levels that have dropped below a functional, healthy range.
It can be delivered through:
Injections (most common and reliable)
Topical gels or creams
Pellets (less common, longer acting)
Oral tablets (used selectively)
The goal? Bring testosterone back to optimal levels—not just to “average,” but to where your body runs at its best.
This isn’t about shortcuts or chasing numbers. It’s about fixing a real problem at the source.
Common Signs You May Need TRT
You don’t need a crystal ball to see when your testosterone is low. Your body will tell you—loud and clear.
Here are the red flags:
Fatigue that won’t go away
Low or disappearing sex drive
Difficulty getting or maintaining erections
Increased body fat, especially around the belly
Loss of muscle or strength
Mood swings or feeling “flat” emotionally
Brain fog or poor focus
Irritability or low motivation
Fewer morning erections
If you’ve noticed several of these for more than a few months, it’s time to look deeper.
What Causes Low Testosterone?
Aging is part of it. But it’s not the whole story.
Plenty of men in their 40s and 50s still have healthy levels. Plenty of men in their 30s are already low. Here’s what contributes:
Chronic stress – High cortisol lowers testosterone
Poor sleep – Most testosterone is made at night
Belly fat – Converts testosterone into estrogen
Insulin resistance – Common with processed foods and sedentary living
Environmental toxins – Plastics and chemicals that mimic estrogen
Past steroid use – Suppresses natural production long-term
Undiagnosed sleep apnea – Wrecks hormonal recovery
So the question isn’t “Are you old enough?” It’s “Is your body producing enough to function well?”
How We Determine Eligibility
This is where most clinics get it wrong.
Too many hand out testosterone based on symptoms or a single lab number. That’s lazy medicine.
Here’s what we evaluate before recommending therapy:
1. Full Hormone Panel
We check total testosterone and free testosterone (the active form). We also measure:
Estradiol (estrogen)
LH & FSH (brain signals that control T production)
SHBG (protein that binds testosterone)
DHEA (your precursor hormone)
Cortisol
Thyroid function
Why? Because testosterone doesn’t work in isolation. You have to look at the full hormonal ecosystem.
2. Metabolic and Inflammatory Markers
We assess:
Insulin sensitivity
Blood sugar control
Lipid profile
Inflammation markers
Why this matters: TRT is more effective—and safer—when your foundation is solid.
3. Lifestyle, Sleep, and Stress
Testosterone therapy won’t do much if your body is still in survival mode. We look at:
Sleep quality (especially deep sleep)
Daily stress load
Alcohol, caffeine, and toxin exposure
Fitness and nutrition habits
4. Risk Factors and Medical History
We screen for:
Prostate issues
Blood clotting risk
Untreated sleep apnea
Cardiovascular disease history
TRT is safe for most men when done responsibly—but only when we’ve ruled out red flags.
Who’s a Good Candidate for TRT?
You might be eligible if:
You have consistent symptoms of low testosterone
Your labs show low or borderline-low testosterone (especially free T)
You’ve already optimized lifestyle, sleep, and nutrition—and still feel off
You’re committed to regular monitoring and proper dosing
TRT isn’t magic. But when used correctly, it can change lives.
Who Should Not Jump Into TRT?
You’re not a candidate if:
You’re looking for a quick fix without making lifestyle changes
You have untreated sleep apnea
You’re trying to have children in the near future (TRT can lower sperm count)
You haven’t had comprehensive lab testing
You’re chasing “peak performance” without actual deficiency
More testosterone isn’t always better. Balance is the key.
What to Expect If You Start TRT
Done properly, here’s what men often report in the first few months:
More energy and mental clarity
Stronger sex drive and performance
Better workouts and faster recovery
Leaner body composition
Improved mood and confidence
But it’s not a one-and-done fix. TRT is a long-term therapy that requires:
Regular labs (usually every 3–6 months)
Ongoing dose adjustments
Attention to estrogen control and cardiovascular health
This is why you need a qualified clinician—not a pop-up clinic or online ad.
Bottom Line: It’s About More Than Testosterone
You don’t need TRT just because you're 45. And you don’t need to suffer because a GP said, “You’re in the normal range.”
With my program, CODEX, we don’t chase numbers. We chase function.
If your energy is low, your drive is gone, and your health is slipping—something is off. Whether that’s low testosterone or something else, the only way to know is with real testing and personalized care.
Think you might be a candidate for testosterone therapy? Stop guessing. Start measuring.
Schedule a full assessment and let’s find out what’s really going on—before you waste another year feeling like half yourself.
CODEX
The Art of Aging Well
A revolutionary approach, created by award-winning, board-certified physician and surgeon, Dr. Peter Marta, combining the precision of conventional medicine and the nuance of functional medicine. At the heart of Codex is hormone optimization, with a comprehensive system addressing seven core areas vital for men’s wellness. What even many physicians overlook is that hormonal health and gut health are inextricably linked—you can’t have one without the other. Codex addresses these connections, unlocking vitality and balance through a tailored, easy-to-follow, scientific approach.
