How to Talk to Your Doctor About TRT (Without Getting Dismissed)

A straight-talking guide for men who are tired of being told, “It’s all in your head.”

Let’s be real—there’s nothing more frustrating than finally getting the courage to talk to your doctor about low testosterone symptoms… only to get brushed off with a half-smile and a “Your labs look fine.”

But what if you're not fine? You’re exhausted for no reason, gaining fat even though you’re eating clean, and your drive—in and out of the bedroom—has hit a wall. If that sounds like you, you're not alone. And you're definitely not crazy.

This guide is for men who are ready to advocate for themselves, get real answers, and take control of their health. Here's how to have that conversation with your doctor—without getting shut down.

First: Know the Symptoms of Low T (So You Can Explain What You're Feeling)

Before you walk in the door, make sure you can clearly describe why you think testosterone might be the issue. “I feel off” won’t get you very far.

Here’s a quick checklist of common symptoms to bring up:

• Low energy / constant fatigue
• Decreased muscle mass or strength despite regular workouts
• Increased belly fat
• Low libido / erectile dysfunction
• Brain fog or difficulty focusing
• Depressed mood or irritability
• Poor sleep
• Decreased motivation or drive

Tip: Keep a journal for a week or two before your appointment. Jot down how you’re feeling physically and emotionally each day. The more specific you can be, the harder it is for a doctor to wave you off.

Script: How to Start the Conversation With Your Doctor

Most primary care physicians (PCPs) aren’t trained to dive deep into male hormones—so it helps to lead the conversation with clarity and confidence.

Here’s a simple but effective way to kick things off:

You:
“I’ve been dealing with persistent fatigue, low libido, and some mood swings that aren’t typical for me. I’ve also noticed a drop in strength and motivation. I’ve done some research, and I’d like to check if low testosterone could be a factor. Can we run a full panel to take a look?”

If they respond with something dismissive like “You’re too young for that” or “Your T levels look normal for your age,” you can calmly reply with:

You:
“I understand that my levels might fall within the ‘normal’ range, but I don’t feel normal. I’d like to understand my hormone profile better. Can we start with a focused set of labs so I can make an informed decision about my health?”

Remember, you’re asking to investigate—not diagnose yourself. You’re allowed to ask for more information about your own body.

What Labs to Ask For (And Why They Matter)

When you ask your doctor about testosterone, don’t let them run just a total testosterone test and call it a day. That only gives you part of the picture—and often leaves important clues in the dark.

At AlphaMD, we keep it focused and clinically relevant. Here’s what we look at:

Initial Diagnosis

To determine if you’re dealing with low testosterone, these labs are the most important:

• Total Testosterone – Measures the total amount of testosterone in your bloodstream.
• Free Testosterone – Measures the active testosterone available to your cells. You can have “normal” total T but still feel symptoms if your free T is low.
• Luteinizing Hormone (LH) – Helps determine why testosterone might be low. Is it a signal issue from the brain (secondary hypogonadism) or a problem with the testes (primary hypogonadism)?

These three markers are usually enough to make an accurate diagnosis without unnecessary confusion or extra cost.

Ongoing Monitoring During TRT

Once you're on treatment, monitoring your response—and safety—is essential. Here's what we typically track:

• Total Testosterone
• Free Testosterone
• Estradiol (Sensitive E2) – Estrogen is important in men too. Imbalances can cause symptoms like water retention, mood swings, or low libido.
• Hematocrit – TRT can increase red blood cell production. Excess levels can thicken the blood and need to be monitored.
• PSA (Prostate-Specific Antigen) – Checked once at baseline, especially for men over 40 or with a family history of prostate issues.

These tests give us the information we need to fine-tune your protocol and keep you feeling your best—safely and effectively.

What About All the Other Labs?

You might see long lists online recommending 10 or 15 different hormone or metabolic tests. While some of those can be useful in certain situations, they’re not always necessary for an accurate diagnosis or effective treatment.

At AlphaMD, we personalize lab orders based on each patient’s needs, symptoms, and medical history. That means during your initial consultation, your provider will determine if additional testing makes sense for you—not just apply a one-size-fits-all checklist.

Our goal is to be thorough without overcomplicating the process or driving up your costs unnecessarily.

What If Your Doctor Won’t Run the Labs or Dismisses TRT Altogether?

Unfortunately, some PCPs are still stuck in the past when it comes to testosterone therapy. If you hit a wall, don’t take it personally—and don’t give up.

Here are a few options:

1. Request a Second Opinion

You’re allowed to get a second opinion, and you don’t need anyone’s permission to do so.

2. Find a TRT-Literate Provider

Look for a clinician who specializes in men’s health or hormone optimization. These providers understand how to interpret hormone panels in context—not just by outdated lab ranges. You can:

• Search online for “men’s health clinic” or “testosterone replacement therapy clinic” in your area
• Look for board-certified hormone optimization or functional medicine doctors
• Try telemedicine clinics (like AlphaMD) that specialize in personalized TRT care

3. Vet Your Provider

Before booking, check reviews, look at credentials, and ask this key question:

“Do you treat based on symptoms and labs together, or only based on lab ranges?”

If they answer “just lab ranges,” it may be a red flag.

Don’t Be Afraid to Be Your Own Advocate

You’re not asking for a miracle drug. You’re asking for a fair evaluation of a real medical condition that impacts millions of men—and that’s treatable with the right support.

Yes, it takes effort to be heard. But your health is worth fighting for.

Still Getting Stonewalled? We’ve Got Your Back

At AlphaMD, we specialize in men’s hormone health, including personalized TRT care that looks at the whole picture. Our clinicians listen. Our lab approach is focused and flexible. And our treatment plans are built around your individual needs—not just a number on a chart.

Feeling dismissed doesn’t mean you’re wrong. It means you need the right advocate in your corner. Whether it’s with your current doctor or a new one, don’t stop asking questions—and don’t settle for feeling “just okay.”

Want help reviewing your labs or starting a real conversation about TRT?
AlphaMD is here when you’re ready.