Low Testosterone Testing and Treatment on Long Island
Low testosterone tends to arrive quietly. Energy drops a little. Drive drops a little. Workouts stop producing results. Most men adapt around it for years before anyone checks a lab.
Those symptoms have many possible causes, and testosterone is only one of them. StackMD starts with a full evaluation: your history, your symptoms, and morning lab work that includes total and free testosterone, SHBG, estradiol, LH, FSH, and thyroid function. If the results confirm low testosterone, we talk through treatment. If they point somewhere else, we tell you that and address what the labs show.
Men in Nassau County, Suffolk County, and across New York can start with a telehealth visit.
Medically reviewed by Steven Samuel, DO. Last reviewed October 11, 2026.
Visits are by telehealth. No office visit required.
Condition Focus
Low Testosterone
A full hormone panel reviewed alongside your symptoms and history, so any treatment rests on a confirmed diagnosis.
Morning tests to confirm a low level before treatment
Hormone markers reviewed in the initial panel
The process
How It Works
Three steps, and testing comes before any prescription.
Telehealth visit. You meet with a physician to review symptoms, medical history, medications, and goals.
Lab work. You complete a morning blood draw at a lab near you. A low result is repeated on a second morning before any diagnosis is made.
A plan based on the results. If low testosterone is confirmed, we review treatment options, risks, and monitoring. If it is not, we explain what the labs do show and what to do next.
Signs That May Point to Low Testosterone
These symptoms often appear together when testosterone is low.
- Persistent fatigue despite adequate sleep
- Reduced sex drive
- Fewer morning erections
- Difficulty building or keeping muscle
- Increased body fat, especially around the midsection
- Low mood, irritability, or low motivation
- Trouble concentrating
Why testing comes first
None of these symptoms is specific to testosterone. Sleep apnea, thyroid disease, depression, diabetes, and several medications cause the same picture. That is why we test before we treat.
Root causes
What Causes Low Testosterone?
Treatment depends on the cause, and several causes are reversible.
Age
Testosterone declines gradually in most men, by roughly 1 percent per year beginning in the thirties or forties. A lower level with age is common and does not by itself call for treatment.
Chronic Illness and Stress
Serious or long lasting illness can lower testosterone, and sustained physical or psychological stress may contribute. Levels often recover when the underlying problem is treated.
Excess Body Fat and Insulin Resistance
Obesity is one of the most common causes of low testosterone, and it is often reversible. Weight loss alone raises testosterone in many men.
Sleep Apnea and Poor Sleep
Most testosterone is produced during sleep. Untreated sleep apnea lowers levels and should be treated first.
Thyroid Disease
Thyroid problems cause fatigue, weight gain, and low libido that overlap with low testosterone. We check both so the right problem gets treated.
Medications
Opioids, corticosteroids, and some other prescriptions suppress testosterone production. Tell us everything you take, including supplements.
Alcohol and Inactivity
Heavy drinking lowers testosterone. Inactivity contributes mainly through weight gain. Regular exercise and weight loss can raise levels without medication.
Pituitary and Testicular Causes
Pituitary disorders and testicular injury or disease can reduce testosterone directly. LH and FSH results help separate these causes and decide whether further workup is needed.
How StackMD Treats Low Testosterone
Diagnosis comes first
Current guidelines call for symptoms plus a consistently low morning testosterone level on two separate tests. We follow that standard.
When low testosterone is confirmed, options for testosterone replacement therapy include injections and topical testosterone. The right choice depends on your labs, your health history, and your preferences. Where the cause is reversible, such as weight, sleep apnea, or a medication, we address that as part of the plan and sometimes in place of testosterone.
Testosterone therapy lowers sperm production. If you want children in the future, tell us before starting. One alternative is enclomiphene, which raises the body’s own testosterone production and generally preserves sperm production. Enclomiphene is not FDA approved. It is a compounded medication prescribed off label, and we review what that means before you decide.
Risks and who should not take testosterone
Testosterone therapy is not right for everyone. It is generally not prescribed to men with prostate or breast cancer, a high red blood cell count, untreated severe sleep apnea, uncontrolled heart failure, a recent heart attack or stroke, or plans to conceive soon.
Possible side effects include a rise in red blood cell count, reduced fertility, testicular shrinkage, acne, fluid retention, breast tenderness, and increased blood pressure.
Every StackMD patient on testosterone has follow up labs on a set schedule, including testosterone level, hematocrit, and PSA where appropriate. Doses are adjusted or stopped based on those results.
Find out where your levels stand.
A telehealth visit and a morning lab draw will tell you whether testosterone is part of the picture.
Serving Nassau County, Suffolk County, and all of New York by telehealth.
Common questions
Frequently Asked Questions
Answers to what men usually ask before a first visit.
What testosterone level is considered low?
Most guidelines use a total testosterone below about 300 ng/dL on two separate morning tests, together with symptoms. Free testosterone helps when SHBG is high or low. We do not prescribe testosterone based on symptoms alone.
Can I do this by telehealth?
Will testosterone therapy affect my fertility?
How long before I notice a difference?
Is testosterone therapy safe long term?
Can low testosterone cause depression?
How is this different from anabolic steroid use?
How much does it cost?
Do you take insurance?
Related conditions
Low testosterone often overlaps with erectile dysfunction, low libido, fatigue, and weight gain. We evaluate them together.
Erectile Dysfunction
Address blood flow, hormones, and metabolic factors together.
Brain Fog
Assess hormones, sleep, metabolic health, and recovery support.
Weight Gain
Look at insulin, appetite, thyroid, and hormones together.
Start Your Hormone Assessment Today
A telehealth consultation and a lab order are all it takes to start. Serving patients across Nassau County, Suffolk County, and New York State.
Telehealth visits across New York State
Areas Served
StackMD sees patients by telehealth across New York State, including Nassau County, Suffolk County, and the New York metro area. We serve Garden City, Mineola, Great Neck, Manhasset, Roslyn, Westbury, New Hyde Park, Jericho, Syosset, Port Washington, Massapequa, Hicksville, Levittown, and the rest of Long Island by telehealth.
Medical Disclaimer
This page is for general information and is not medical advice. Treatment decisions are made by a licensed physician after an individual evaluation. Results vary.
References: Bhasin S, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018. Mulhall JP, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018. Lincoff AM, et al. Cardiovascular Safety of Testosterone Replacement Therapy. N Engl J Med. 2023.