Am I Eligible for TRT Consultation?

Australian laboratories typically use reference ranges of approximately 8-35 nmol/L for total testosterone.
For TRT consideration, levels generally need to be below the laboratory’s lower limit (commonly <12 nmol/L or <10 nmol/L depending on lab) on two separate morning tests. However, the exact threshold varies by laboratory, clinical context, and symptom severity. Free testosterone and SHBG are also considered. Doctor evaluates results in full clinical context.

Men aged 30-39 can be eligible but require stronger clinical justification including documented symptoms
affecting quality of life, confirmed low testosterone on multiple tests, and ideally identification of
underlying cause (pituitary disorder, testicular pathology, genetic condition). Men under 30 typically
require specialist endocrinologist evaluation and diagnosis before TRT services can be considered. Younger
men need more thorough workup to rule out treatable underlying causes.

Low-normal testosterone (e.g., 12-15 nmol/L) with symptoms is a gray area. Some clinicians may consider
treatment if symptoms are significant and other causes ruled out, while others require levels below
laboratory reference range. This requires individualized clinical judgment. Factors considered include:
symptom severity, age, previous higher baseline levels, presence of low free testosterone despite normal
total testosterone, and failed conservative management. Doctor will discuss your specific situation.

TRT suppresses natural testosterone production and significantly reduces sperm production, potentially
causing temporary or permanent infertility. Men planning to have children in the next 1-2 years are
generally not suitable for standard TRT. Alternative protocols using HCG and/or clomiphene may preserve
fertility while addressing symptoms, but these require specialist supervision. If you have fertility
plans, this must be discussed with doctor who may refer to reproductive endocrinologist.

Untreated severe obstructive sleep apnea is a contraindication to TRT as testosterone therapy may worsen
breathing during sleep. However, if you have diagnosed sleep apnea that is successfully treated with CPAP
and you are compliant with treatment, TRT may still be considered with close monitoring. You’ll need to
provide documentation of sleep study results and CPAP compliance data. Mild sleep apnea being treated may
be acceptable. Doctor will assess individual risk.

History of prostate cancer is not an automatic permanent exclusion, but requires very careful consideration.
You would need clearance from your oncologist/urologist, confirmed disease-free status for sufficient time
period (often 2+ years), undetectable PSA, and understanding of theoretical recurrence risk. This is a
complex decision requiring input from both your cancer specialist and TRT doctor. Some men with treated
low-risk prostate cancer may be candidates; others are not. Individual case review required.

Yes. TRT is a treatment for symptomatic testosterone deficiency, not a preventive therapy or performance
enhancement for asymptomatic men. Even if blood work shows low testosterone, if you have no concerning
symptoms affecting your quality of life, TRT is generally not medically indicated. Treatment should address
a clinical problem, not just a laboratory number. The combination of low levels AND symptoms is required
for appropriate treatment consideration.

Yes, in both directions. Men who initially don’t qualify may become eligible as they age, if testosterone
levels decline further, if symptoms develop or worsen, or if medical contraindications resolve. Conversely,
men who are eligible may become ineligible if medical contraindications develop (cancer diagnosis,
cardiovascular events) or if they decide to pursue fertility. Eligibility is assessed at each consultation
based on current medical status.

If you’re not eligible for TRT after medical assessment, doctor will explain why, discuss whether this might
change in future, suggest alternative approaches (lifestyle modifications, treatment of underlying conditions,
addressing other causes of symptoms), and provide referrals if appropriate (endocrinologist, sleep specialist,
mental health professional). The consultation has value even if outcome is that TRT is not appropriate – you
receive professional medical guidance on your health concerns.