40, Testosterone level of 199

Hi, my name is Dave and I'm 40 years old with a testosterone level of 199 based on a test last week. My doctor won't prescribe me testosterone treatment because I currently have obvious lifestyle issues that are working against my testosterone -- overweight, smoker, and drinker. He says I need to fix those things, which I obviously can't argue, but I'm wondering if testosterone treatment is something that can still help me.

My big problem with his idea that if I lose weight, stop smoking and stop drinking that everything will be 100% okay is that 10 years ago, I had lost 150 lbs when I was 30 years old and I had all the same symptoms I have now -- always tired, feeling depressed for no apparent reason, no sex drive, occasional erectile dysfunction. And this was before I started drinking alcohol (started heavily @ 32) and before I ever had my first cig (started @ 34). At the time, I never had my testosterone checked and never heard of low-T as being anything.

What makes it worse is that everything seems so much tougher now. When I go the gym and eat healthy in the same way I did when I lost 150 lbs back when I was 30, everything happens at such a slower rate. Instead of losing 3-5 lbs in a week where I did everything "perfect", I now will lose 1/2 lb. I'm more than willing to put in the work, but I feel unequipped to win this battle...

You're doctor is right about letting go of the bad habits. No one can argue that, you've said so yourself. As for still being overweight, some physicians have a fear of testosterone due to the idea of cardiovascular damage, which can already be a threat to an overweight individual. However, in recent years, low testosterone has been linked to high cholesterol and even increasing the risk of heart disease.

My advice, if your levels are low and you're healthy enough for treatment, it make no sense to forgo it. You'll only continue to suffer. Yes, if you stopped drinking and really started living a truly healthy lifestyle, your levels might improve somewhat natural. However, it's highly unlikely they'll improve dramatically and very unlikely they'll ever optimize without treatment.