The Low-Down on Low Testosterone

By Scott D. Miller, MD, MBA

Testosterone – often called the “fountain of youth” for men – is a powerful hormone that influences energy, mood, muscle mass, libido and even confidence. But like any fountain, too little can leave you parched, and too much can leave you drowning.

The Silent Strain of Low T

Low testosterone (or “low T”) is a real, underdiagnosed condition that affects millions of men, especially as they age. Common symptoms include fatigue, low libido, weight gain, mood changes and reduced muscle mass. The problem? Many men chalk it up to “just getting older” and never seek help. That’s a missed opportunity– because when truly deficient, testosterone replacement can restore vitality and well-being.

Too Much of a Good Thing

Here’s the flip side: low T is also overtreated. Not every tired man needs testosterone. In fact, many men with normal levels are being prescribed testosterone for vague symptoms like fatigue or mild sexual dysfunction. That’s not medicine—it’s marketing. Testosterone is not a quick fix or a magic bullet. Replacing it unnecessarily can suppress natural production, shrink testicles, raise blood pressure, worsen sleep apnea and increase the risk of blood clots. It’s like pouring water into a fountain that’s already full—you create overflow, not balance.

What You Can Do Today

So how do you know if you’re a candidate? First, talk to your doctor – ideally one who understands men’s health. Get a proper evaluation, including a morning blood test (when testosterone is highest). And understand this: testosterone replacement is a lifelong commitment – it’s not like taking a vitamin fora week. Instead of self-diagnosing or chasing ads that promise “manhood in a bottle,” focus on what you can control: sleep, exercise (especially resistance training), weight loss, stress management and limiting alcohol. These steps alone can naturally boost testosterone. In short: don’t ignore your symptoms, but don’t chase youth at any cost. Talk to your doctor. Ask smart questions. And aim for balance, not bravado.

Look for my article “A Man’s Guide to Better Sleep” in the next issue.

Scott D. Miller, MD, MBA, is the Medical Director of Robotic Surgery at Wellstar North Fulton Hospital. He is a urologist with Wellstar Urology in Roswell and has practiced in Atlanta for over 20 years. Wellstar North Fulton Hospital offers the Know Your Heart Screening that can determine your risk of heart disease, stroke and other serious conditions. Call 770-956-STAR (7827) to learn more or schedule an appointment.