At The Craig Bushon Show, we bring facts and context to issues shaping health and society. Testosterone Replacement Therapy (TRT) is marketed heavily as a solution for low energy, reduced focus, and loss of strength. Medical research shows TRT can help men with clinically diagnosed low testosterone, but it is not recommended for men experiencing only the normal, age-related decline in hormone levels.
Testosterone Declines Naturally with Age
Levels decrease by about 1–2% each year starting in the mid-30s. By age 60, roughly 20% of men measure below 320 ng/dL, and by age 80, about half of men fall below that number.
What does ng/dL mean?
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ng/dL stands for nanograms per deciliter—the standard unit used to measure testosterone in blood tests.
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A nanogram (ng) is one-billionth of a gram.
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A deciliter (dL) is one-tenth of a liter, a common measure of blood volume.
So if a man’s testosterone is reported as “300 ng/dL,” it means there are 300 nanograms of testosterone in every deciliter of blood.
Normal adult male testosterone levels are typically 300–1,000 ng/dL. Levels consistently below 300 ng/dL, combined with symptoms, may indicate hypogonadism (clinically low testosterone).
(Source: AAFP)
FDA Position on Age-Related TRT
In 2015, the U.S. Food and Drug Administration required that all testosterone prescriptions carry a warning: TRT’s safety and effectiveness have not been established for low testosterone due only to aging. The FDA has not approved TRT for “anti-aging” purposes.
(Source: FDA / NIH)
What Clinical Guidelines Say
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American College of Physicians (ACP): TRT may be considered in men with age-related low testosterone and sexual dysfunction, but should be stopped after 12 months if no improvement is seen.
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Endocrine Society and AUA: Hypogonadism should be diagnosed with both consistent symptoms and confirmed low hormone levels on repeat testing. TRT should not be prescribed based only on aging or one lab result.
(Sources: AAFP, Endocrine Society)
Reported Benefits and Risks
Research shows small improvements in sexual and erectile function in men with age-related low testosterone, but no significant gains in mood, cognition, or energy.
Risks include:
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Cardiovascular: blood clots, increased blood pressure, possible heart attack or stroke
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Prostate: growth of prostate tissue, potential urinary symptoms
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Reproductive: reduced sperm production, infertility, and testicular shrinkage
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Sleep: worsening of obstructive sleep apnea
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Blood health: increased red blood cell counts (polycythemia)
(Sources: Mayo Clinic, PMC)
Bigorexia and Rising TRT Use Among Young Men
Bigorexia, or muscle dysmorphia, is a condition where men believe they are not muscular enough despite already being strong or fit. It leads to compulsive weight training, rigid diets, and frequent use of supplements, steroids, or testosterone. Studies suggest about 1 in 10 male gym-goers show signs of this disorder.
(Source: Parents)
Influence from social media has encouraged “testosterone-maxxing,” where young men take TRT or anabolic steroids to enhance muscle size, sexual performance, or appearance. Prescription use among young men is rising, and some bypass doctors entirely by obtaining testosterone through gyms, friends, or online clinics.
(Sources: NY Post, Business Insider)
Personal Accounts of TRT Side Effects
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Gary Pivovarov, 52: Reported insomnia, anxiety, acne, high blood pressure, and loss of sexual sensation after starting TRT.
(Source: Wall Street Journal) -
Mark Brown, 35: A trainer in Australia who discovered his sperm count had dropped to zero after a year on TRT. Fertility recovery required months of hormone therapy.
(Source: Herald Sun) -
Sharok, 38: Former adult performer who bought testosterone from a gym source. He later experienced fluid buildup in his lungs, high red blood cell counts, and depression.
(Source: Them)
Foundations of Long-Term Health
Medical research consistently shows lifestyle factors support hormonal balance and health:
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Sleep: 7–9 hours per night; even one week of poor sleep can reduce testosterone by 10–15%.
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Nutrition: Lean proteins, healthy fats, fruits, and vegetables; excess abdominal fat is strongly linked to low testosterone.
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Exercise: Strength training and interval workouts raise natural testosterone and reduce risk of erectile dysfunction.
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Stress management: Lowering cortisol helps maintain hormonal balance.
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Daily discipline: Healthy habits repeated over time support sustainable results.
TRT is a treatment for clinically diagnosed hypogonadism, not a solution for normal aging or body image concerns. Lifestyle changes remain the primary path to long-term strength, energy, and resilience.
Disclaimer: This content is for educational purposes only and reflects information from medical sources and real-life accounts. It is not a substitute for professional medical advice. Always consult a licensed healthcare provider before starting or stopping any therapy, including testosterone replacement.
