Education
Am I a Candidate for TRT? Who Qualifies for Testosterone Therapy
Reviewed by Dr. Slava Fuzayloff, DO — Testosterone Clinic NYC · Last updated: July 2026
Education
Reviewed by Dr. Slava Fuzayloff, DO — Testosterone Clinic NYC · Last updated: July 2026
You're a candidate for TRT if a blood test shows low testosterone — usually below 300 ng/dL — and you have symptoms that match, like low sex drive, fatigue, or trouble building muscle. You need both. A low number alone, or symptoms alone, isn't enough to qualify.
The rest of this page breaks down who qualifies, who doesn't, and what to do if your number is borderline but you still feel off. If you're in NYC, Dr. Fuzayloff evaluates every new patient in person.
You qualify for TRT when two things are true at the same time: your testosterone is low on a blood test, and you have symptoms caused by that low level.
Doctors call this the two-part rule, and every major medical guideline (the Endocrine Society and the American Urological Association) uses it.
Here's what each part means:
Low on a blood test. Total testosterone below the normal range, confirmed on two morning tests. One low result isn't enough — levels swing day to day.
Symptoms that match. The physical, sexual, and mood symptoms of low testosterone — real enough to affect your life, not just a number on a chart.
If both are true and nothing else explains the symptoms, you're likely a candidate.
Not sure where you land? This table shows the difference at a glance.
| You're likely a candidate if… | You're likely NOT a candidate if… |
|---|---|
| Testosterone below ~300 ng/dL on two morning tests | Testosterone in the normal range |
| Clear symptoms (low libido, fatigue, muscle loss) | No symptoms, even with a low-ish number |
| Symptoms aren't explained by another cause | Symptoms come from a reversible cause (poor sleep, weight, thyroid) |
| No condition that makes TRT unsafe | A condition that TRT could worsen (see below) |
| You're not currently trying to father a child | You want to conceive soon |
You're probably not a candidate if your testosterone is normal, if you have no symptoms, or if your low level is caused by something reversible that should be fixed first.
TRT isn't a general energy boost — it only helps men who are genuinely deficient.
Three common cases where TRT isn't the answer:
Normal testosterone. If your level is in range, TRT won't help and can cause harm. Normal-but-tired usually points to sleep, stress, or another issue.
No symptoms. A slightly low number with no symptoms rarely needs treatment.
A reversible cause. Untreated sleep apnea, excess weight, thyroid problems, or certain medications can all lower testosterone. Fixing the root cause often restores your level without TRT.
A few health conditions make testosterone therapy unsafe, so a doctor rules them out first. The main ones are prostate or breast cancer, untreated severe sleep apnea, a high red blood cell count, and a history of blood clots or certain heart conditions.
These aren't reasons to feel discouraged — they're reasons to get evaluated in person.
Conditions that require caution or rule out TRT:
Prostate or breast cancer. Testosterone can stimulate these cancers.
Untreated severe sleep apnea. TRT can make it worse.
High red blood cell count (high hematocrit). Testosterone thickens the blood further, raising clot risk.
A history of blood clots or certain heart conditions. These need review before starting.
One more group: men who want to father a child soon. Standard TRT can lower sperm count. That doesn't mean you're out of options — it means a different approach may fit better. If fertility matters to you, see our page on TRT with HCG, which treats low testosterone while protecting fertility.
This is the hardest case, and it's where a real in-person evaluation matters most. A number in the low-normal range paired with clear symptoms can still qualify you — but only a physician who weighs your free testosterone, SHBG, and symptoms together, not just your total number, can say for sure.
Lab "normal" ranges are wide, and the floor is set low. A man at the bottom of normal can feel every symptom of low testosterone — which is why the number alone isn't a diagnosis.
A thorough evaluation looks at more than total testosterone:
Free testosterone — the portion your body can actually use, which can be low even when total looks okay.
SHBG — a protein that binds testosterone and skews what your total really means.
Your symptoms — weighed honestly, not dismissed because a number is "in range."
Faceless online clinics often miss this. That's the gap an in-person doctor fills.
Not sure if your borderline number counts? That's exactly what an evaluation is for. Book an in-person visit with Dr. Fuzayloff — $175, same-day appointments available. He personally reviews your labs and symptoms and tells you straight whether TRT will help.
Book online or call (212) 696-5900.
The only way to know for sure is an in-person evaluation paired with a morning blood test, repeated a second time to confirm the result. A physician then reads your testosterone level and your symptoms side by side to decide.
You can't diagnose low testosterone from symptoms alone or from a single lab result.
Here's what the process looks like:
In-person exam.
A physician reviews your symptoms and health history.
Morning blood draw.
Testosterone is tested early, when it's highest, and confirmed on a second test.
Results reviewed together.
Your labs and symptoms are read side by side to decide.
Wondering which symptoms actually point to low testosterone? See our full guide to low testosterone signs and symptoms.
You don't have to guess from a number or a symptom checklist. An in-person evaluation settles it.
Book an evaluation with Dr. Fuzayloff — $175, same-day appointments available. Board-certified, 25+ years, every new patient seen in person at our Midtown office.
↑ Back to top
