Testosterone is a vital hormone responsible for many processes in the human body—specifically in men. It regulates everything from red blood cell production and fat distribution to fertility, and it’s also the driving factor behind characteristics like a deep voice and facial hair. Unfortunately, studies show that millions of men suffer from low testosterone, which can result in fatigue, diminished sex drive, and reduced muscle mass.

“Men produce less testosterone as they get older,” says Ali Gilbert, a men’s health specialist who spoke on Reps, the Muscle & Fitness podcast. This decline often begins as early as age 30. “If you’re overweight or obese, which is a big issue in the U.S., it’s even worse because more body fat means more estrogen and lower T.” 

According to a landmark study published in The Journal of Clinical Endocrinology & Metabolism, the normal reference range for healthy testosterone levels falls between 264 and 916 ng/dL (nanograms per deciliter). Gilbert says that a T level below 300 ng/dL may signify hypogonadism, a condition associated with sexual dysfunction, decreased muscle mass and bone strength, lower fertility, and less energy.

If your T levels are scraping the bottom of the barrel, you’re not alone—but you don’t have to sit there and take it. Testosterone replacement therapy (TRT) is an option that’s becoming increasingly popular for millions of Americans. “In essence, you are replacing a hormone that’s not being produced endogenously anymore,” says Gilbert. Before you take the plunge, here’s what you need to know.

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