STEP 3. Do you have classic low testosterone symptoms?
The answer to the above question is, in my opinion, just as important as your actual total testosterone lab reading. What are the signs and symptoms of low (or high) Male Testosterone Levels? For example, just what does low testosterone affect in us guys? The most accurate answer is "everything"! Low testosterone effects almost every major system in the male body and has very serious long term health consequences, all of which I outline below.
Before I explain more, I have noticed that over half of all you reading this will have already had a testosterone lab reading taken and are wondering if your number is okay. (Read this link on testosterone levels for more detailed information.) I mention this because some of you have had a doctor tell you that a very low number is okay. The standard range that the labs and doctors will give you for total testosterone is 241-847 ng/dl. But trust me - if you are in the 241-399 range, you will almost for sure be experiencing various symptoms of low testosterone.
There are some guys who do okay in the 400's, but even in the 400's most males will be struggling a little. Again, it is possible for a male to have, for example, total testosterone of 450 ng/dl and feel just as good as a guy that has total testosterone of 700 ng/dl, but this is unlikely. The same goes for high testosterone as well.
There are several things to keep in mind when analyzing the number:
1) Your symptoms of low or high testosterone are just as important as the number itself. Please, please read the symptoms below for signs of low testosterone and signs of high testosterone. Science has just recently found out how all-important testosterone is for us males.
2) Don't trust one lab reading. Testosterone readings can vary, but keep this in mind: low testosterone levels can potentially be deadly long term. You must take your testosterone levels dead serious. (NOTE: Please read my link on How to Increase Your Testosterone Naturally for more information.)
3) Your estradiol, the most abundant form of Estrogen, reading is just as important as your testosterone reading. The normal range is usually 13-54 pg/ml, but what is also really critical is the ratio of testosterone to estradiol. Young males have ratios of 30, 40, 50, etc. You could have a healthy total testosterone reading of 500, but if your estradiol is 50, you are probably going to be struggling. Read this link on Estrogen to understand why.
4) Free Testosterone is just as critical as total testosterone. Free testosterone is generally expressed as a percentage of your total testosterone and the standard range is 1.5%-2.5%. Yes, that means only about 2% of your testosterone is really "free" to do all the things us males need testosterone to do. You want this above 2.0% for sure. You should therefore read my page on How to Control and Manage Free Testosterone.
The symptoms of low testosterone usually creep up upon you slowly and quietly. Because of this, many guys ignore their low testosterone symptoms for months or even years: they literally get used to feeling lousy and functioning poorly. But that can be a deadly mistake as I'll show below.
The symptoms of low testosterone can also fool a guy because they are so ubiquitous. By that I mean that testosterone affects EVERYTHING in the male. It affects our brain, our libido, our muscles, our blood - the list goes on and on. Of course, the number one thing in most guys' mind is how it affects their sex life. Low testosterone affects both libido and erectile strength to varying degrees and that obviously isn't too good for the ol' sex life.
However, common symptoms also include depression, mental fogginess/fuzziness, difficulty concentrating, anxiety, loss of muscle, increased weight gain, decreased facial hair and a general feeling of not caring about anything. When you are low on testosterone, you often just don't care about anything - you just "exist". Pleasure and desire can be greatly decreased affecting your career and your relationships.
Fortunately, verification of low testosterone levels is then rather simple: you go to the doctor and he does some blood work and three days later you get the results. The Official Level for low testosterone level is an abysmal 260 ng/dL and often doctors won't diagnose you as low testosterone (hypogonadal) unless you are at or below this incredibly low figure.
But you need to realize that 260 is VERY low testosterone and is an outdated and arbitrary statistical figure. In all reality, if you're below about 350, you will probably begin to experience long term health issues and many of the symptoms that I list below. I am mentioning this, because I get letters from guys all the time saying that their doctors say it is okay for them to have testosterone levels in the 200's or low 300's. If that is your situation, I encourage you to discuss the deadly long term health consequences of low testosterone that I list below for you.
If you get down to the 200's, there's a good chance that you won't care about much of anything in your life, especially sex. This was verified in a study  from China where guys with low testosterone (average=268) were compared with guys with normal (average=553) levels. Read the typical symptoms for the poor guys on the low side: "89 percent of the subjects suffering from low testosterone reported a lack of energy; 79 percent reported erectile dysfunction; 70 percent reported a loss of pubic hair; and 66 percent reported a decrease in sexual endurance.. From this data, the researchers concluded that low levels of testosterone are directly related to both advanced age and diminished sex drive."
Sadly enough, a lot of guys won't do anything about low testosterone until they begin to experience signs and symptoms of impotence and erectile dysfunction. Penile and pelvic floor muscles are packed with androgen receptors, i.e. your penis needs testosterone or the these muscles literally atrophy. And connective and nerve tissue can atrophy as well. That means you cannot trap the blood necessary for an erection leading to poor performance and the ensuing performance anxiety that follows.
This is true for both young and old by the way. One study found that low testosterone is a factor in 20 percent of young men under 30 with erectile problems. I find it to be an extremely common issue in the letters that I get from the younger guys. 
Kegel Exercises can help you get these muscles back in shape, but you still need the testosterone for your brain and long term health. (You also need lots of Nitric Oxide and good blood flow. See the Erection Repair Guide and the Erection Supplementation Guide for details.)
By the way, one recent Boston University School of Medicine study discovered that testosterone actually guards and protects the penile nerve fibers.  In other words, at least in rats, low testosterone levels means nerve deterioration. No wonder low testosterone is so related to erectile dysfunction!
So if the doc tells you a reading of 350 is fine, I have seen men do the reverse of what I tell you on this site: for a few days prior to your blood test they try to decrease their testosterone: eat horribly all the while you're overtraining on little sleep. That ought to whack a good 30% off your score! But a better solution is to just get a new doctor. You want to work with someone who is not living in 80's as far as medical knowledge and practice.
Why do I say that? Because the symptoms of low testosterone are just plain dangerous. Low testosterone is associated with heart disease, depression , Metabolic Syndrome , diabetes , cognitive disorders and even osteoporosis. It is no exaggeration to say that low testosterone can be the Kiss of Death for all you male homo sapiens out there. A 2007 study found that low testosterone was associated with increased risk of death from heart disease, cancer and all causes.  So please, please do NOT accept your doctor's opinion that testosterone in the 200's or 300's is okay. okay. Yes, some men do very well with their testosterone at low levels, but a big percentage will struggle. See my page on Testosterone and Mortality Rates for additional information.
One of the reasons that low testosterone is so deadly is that it somehow effects almost all of the major cardiovascular markers. One recent large scale epidemiological study found that low testosterone men, < 250, were 1) fatter, 2) had lower HDL, 3) higher triglycerides, 4) higher blood pressure and 5) higher blood glucose.  That is a deadly combination! The low testosterone men were tracked over 18 years and it was found that they had a 40% higher death rate from all causes!
Low testosterone will also often put your relationships and career at jeopardy as well, because testosterone so strongly effects the male brain. For example, supplemental testosterone can aid certain types of memory in men, including a) working memory, which allows you to manipulate information over brief periods of time, b) verbal memory, which helps you recall lists of words, and c) spatial memory, which helps you navigate a route, also benefit.  (By the way, I cover many ways that science has found to re-build your brain on this site. See this link on the Brain for more information about how to build your cognition and memory no matter what your age.
I should also mention that low testosterone is associated with an increased risk of Alzheimer's Disease (AD) as well! How's that for an ugly symptom? The well-known Baltimore Longitudinal Study showed this strong correlation to dementia. Researchers are still trying to figure out why, but studies of rat brain cells found that the hormone limits the production of beta-amyloid peptides. These sticky protein fragments, thought to be a prime contributor to Alzheimer's, build up into small, round deposits and clog the brains of people with the disease.
The hormone also may help ward off AD by directly preventing brain cell death. In studies, researchers manipulated human brain cells, sending them on a course to die. Adding doses of testosterone, however, limited the [brain] cell death."
No wonder that low testosterone leads to depression, feeling like you're "in a fog" and difficulties concentrating! Your libido will probably sag and you may find that you really don't care about much of anything. Multiple studies show though libido increases in a dose dependent manner with testosterone. In other words, the more testosterone, the higher the libido. Low testosterone can even easily lead to anxiety and depression as well. Remember: these are not just symptoms - low testosterone effects your brain chemistry at its core.
On top of all that low testosterone men tend to be slightly sleep deprived because research has shown that low testosterone leads to poor quality sleep.  This is probably due to the extra adiposity (body fat) that comes from decreased muscle mass (or perhaps the alterated brain function mentioned above). It helps to have decent testosterone to burn that fat off your midsection!
I should also mention, though, that one recent study found that many males with low testosterone, defined as < 300, were asymptomatic. In fact, that study found that almost 50% of males in the 50+ age range had no significant symptoms with low testosterone.  In other words, there is a significant percentage of you and your friends out there, generally in the 40+ age range, that are walking around with low testosterone and are actually not even exhibiting symptoms. However, it is still wise to pull your testosterone, because you could be a) low in estradiol or b) prediabetic, two conditions in part controlled by testosterone levels. We have had men on the forum, for example, who were experiencing bone loss and ended up with osteopenia without even realizing it.
The bottom line is that you need your testosterone. It's the heart and soul of the male physiology and psychology. Only you and your doctor can decide your ideal target levels, but the important thing is to have a plan for monitoring. "But I thought it was dangerous to boost your testosterone you may ask?" Well, there are certain issues to be aware of, and I cover those in my page on The Potential Risks of Testosterone.
Again, the opposite can be argued forcefully as well, i.e. what is really dangerous is to NOT boost your testosterone. Low testosterone symptoms are not just symptoms: low testosterone levels can literally kill you (and before that probably make you miserable and impotent). So, please, get to the doctor and get tested if you have any doubt. (And don't be afraid to get tested again: testosterone readings can sometimes be off.)
Low testosterone symptoms are not just symptoms: They are often signs of impending or manifested chronic disease. In other words, low testosterone levels can potentially be debilitating or even deadly (and before that probably make you miserable and impotent). So, please, get to the doctor and get tested if you have any doubt.
Testosterone is a natural substance that INCREDIBLY important to your male body and mind. If your levels are low, testosterone supplementation is not abuse: it's simply getting your hormone levels back in line. Remember: your goal is not to be Barry Bonds with sky high testosterone levels so you can compete with other ten million dollar elite athletes. You are simply trying to get your tissue levels back reasonably close to the days of your youth.
So what do you do if you find you are low testosterone? Well, it depends on your reading. If you're just a little low, say in the 400's, you can try to raise your testosterone naturally. I cover many ways on this site to boost testosterone, including Sex, High Testosterone Diet, Sleep and your Mind. I also write about some of the common things that attack your testosterone such as Testosterone Lowerers, being Overweight, Overtraining and even Pesticides/Endocrine Disruptors. You can put all these together and sometimes boost your testosterone 30% or more.
However, if you are in the low 300's or 200's consistently, then I recommend that you read my HRT (Testosterone Therapy) link. You need to double or triple your testosterone levels and you're probably not going to do that through lifestyle changes. But do what you have to do. Don't leave yourself exposed to a lifetime of heart disease, depression, anxiety, diabetes, metabolic syndrome and other symptoms associated with low testosterone!
More to come later...
1) Changgeng Yi Xue Za Zhi,Jun 2000,23(6):348-53
2) Intl J Impotence Research, 2007
4) J Endocrin Invest, Jun 2007,30(6):451-8; Journal Andrology, 2009, 30:10-22
5) Diabetes Care,Feb 2007,30(2):234-238
6) Saving Your Brain, Jeff Victoroff, p. 135
7) J of Clin Endocrin & Metab,2008,93(1):68-75
88) Arch Gen Psychiatry, 2008, 65:283-289
9) J of Clin Endocrin & Metab, 2008, 93(7):2602-2609
10) J Sexual Med, 2008, 5(Suppl I):4-41