My Testosterone Is “Normal” — So Why Do I Still Feel Like Crap?
If you’ve had your testosterone checked and were told “everything looks normal,” yet you still feel exhausted, unmotivated, foggy, or disconnected from your libido — you’re not alone.
As physicians, we see this scenario constantly. And the reason is simple:
“Normal” testosterone does not always mean healthy — or optimal — for you.
Let’s break down why this happens and what’s often missed in standard evaluations.
The Problem With “Normal” Testosterone Ranges
Most labs define “normal” total testosterone as something like 300–1000 ng/dL. That’s a statistical range — not a guarantee of how you should feel.
Here’s the issue:
That range includes men who feel great and men who feel terrible.
It doesn’t account for age, symptoms, or hormone signaling.
It ignores how much testosterone is actually available to your tissues.
In other words, being “in range” doesn’t mean your body is functioning well.
Total Testosterone Is Only Part of the Picture
Total testosterone measures how much hormone is in your bloodstream — not how much your body can actually use.
Several factors can make “normal” testosterone functionally ineffective:
High SHBG (Sex Hormone–Binding Globulin)
SHBG binds testosterone and makes it unavailable.
You can have:
Normal total testosterone
Low free testosterone
Classic low-T symptoms
This is extremely common in:
High-stress professionals
Endurance athletes
Men over 35
Yet SHBG is rarely checked in primary care.
Weak Brain-to-Testicle Signaling (Low LH & FSH)
Testosterone production is driven by signals from the brain:
LH tells your testes to produce testosterone
FSH supports sperm production and testicular function
Many symptomatic men have:
“Normal” testosterone
Low or borderline LH and FSH
This pattern suggests secondary hypogonadism — meaning the problem isn’t your testes, but the signal telling them to work.
If no one checked LH and FSH, this diagnosis was missed.
Timing and Lab Errors Matter
Testosterone fluctuates significantly throughout the day.
Common mistakes:
Blood drawn in the afternoon
Testing after poor sleep
Labs drawn while dieting aggressively or overtraining
Any of these can produce misleading “normal” results.
Symptoms Matter More Than a Single Number
Hormones exist to support function, not lab ranges.
Men with borderline or low-normal testosterone often report:
Low motivation and drive
Brain fog or poor focus
Reduced libido or erectile issues
Poor recovery from workouts
Depressed or flat mood
If symptoms are present, they deserve to be evaluated — not dismissed.
Why Many Doctors Stop at “It’s Normal”
This isn’t because your doctor doesn’t care.
It’s because:
Insurance models discourage deeper hormone evaluation
Medical training emphasizes disease treatment, not optimization
Prescribing testosterone carries regulatory and liability concerns
As a result, many clinicians rely solely on total testosterone and move on.
What a Proper Testosterone Evaluation Should Include
A meaningful evaluation looks at:
Total testosterone
Free testosterone
SHBG
LH and FSH
Estradiol (E2)
Thyroid function
Sleep, stress, training, and lifestyle factors
Only after seeing the entire picture can we determine whether:
Lifestyle changes are enough
Medications like clomiphene are appropriate
Testosterone replacement therapy is actually indicated
The Bottom Line
If you feel unwell and your testosterone is “normal,” you’re not imagining things.
You may have:
Low usable testosterone
Poor hormonal signaling
A mismatch between your biology and population averages
And none of that shows up on a single lab value.
A Physician-Led Approach Matters
At Testora Health, we take a comprehensive, clinical approach to men’s hormone health — focused on symptoms, physiology, and long-term outcomes.
If you’ve been told everything is “fine” but don’t feel fine, it may be time for a deeper evaluation.
Schedule a physician consultation to review your symptoms and labs in context.
