I'm 44 and my testosterone is 380 ng/dL. My doctor says it's normal. What should I do?

A total testosterone of 380 ng/dL at age 44 is within the laboratory reference range (>300 ng/dL) but is below the 25th percentile for men aged 20–39, meaning 75% of young healthy men have higher testosterone, and the clinical decision depends entirely on whether you have symptoms attributable to hypogonadism (libido decline, erectile difficulty, muscle loss, fatigue, depressed mood), because a number without symptoms does not meet hypogonadism diagnostic criteria (Bhasin et al., J Clin Endocrinol Metab, 2010).

If you have symptoms: request SHBG and free testosterone measurement alongside total testosterone. If free testosterone is below the reference range despite total testosterone of 380, you may be functionally hypogonadal. Additionally: pursue 90 days of lifestyle optimization (sleep, visceral fat reduction, cortisol reduction, resistance training, alcohol reduction) and retest. If symptoms persist and testosterone remains below 400 ng/dL, the conversation about TRT or SERM therapy is legitimate regardless of the "normal" label.

Honesty Scale: Solid (1) for the clinical evaluation approach. The 300 ng/dL diagnostic threshold is a guideline cutoff, not a biological optimization target.

What to do: Do not accept "it's normal" without discussing your specific symptoms. Ask your physician to test SHBG and calculate free testosterone. Ask whether lifestyle optimization is indicated before medication. If your physician dismisses the conversation, consider a consultation with an endocrinologist or a urologist who specializes in male hypogonadism.

For the full picture, read The Testosterone/TRT Deep Dive