Current as of September 22, 2026.
Short answer: Do not start treatment yet. Confirm the number with a second early morning fasting draw on a different day, make sure it was not taken right after a hard training block, and get LH and FSH so somebody finds out why. Treatment is step three, not step one.
The new screening rolled out in September 2026 and a lot of men are getting a flag for the first time. Here is the order of operations that protects both your health and your career.
First, find out what actually got flagged
The screening starts as a questionnaire about symptoms and risk factors, not a blood draw. A flag on the questionnaire is not a diagnosis. It is a reason to draw labs.
If labs were drawn, ask for the actual number and the time of day it was taken.
Second, check when the sample was taken
DoD's own guidance says a specimen does not count if it was drawn within 30 days of training involving extreme physical or mental distress or sleep deprivation, or during an acute illness or within 30 days of one.
That rule exists because the effect is large and well documented. Marines through a seven day SERE course dropped about 44 percent. Soldiers in an eight day field exercise dropped about 28 percent and were back to baseline four days later. Finnish soldiers bottomed out around day 12 of field training and fully recovered after three days of rest and food.
If your draw came the week after a field problem, a selection course, or a deployment work-up, the number may be telling you about your last month rather than about your endocrine system.
Third, confirm it properly
One low number is not a diagnosis anywhere in this system.
DoD wants two separate morning draws, between 0700 and 1000, fasting, both under 300 ng/dL, along with symptoms that match. TRICARE's own prior authorization asks for morning levels below 300 on at least two separate occasions. Every aeromedical waiver guide wants two or three pre-treatment draws.
Same standard everywhere. There is a reason for that, and any clinic willing to skip it is telling you something about itself.
Fourth, find out why
LH and FSH tell you whether the signal is coming from the testes or from the pituitary. That distinction changes the treatment and occasionally finds something that matters a great deal, which is why very low levels or neurologic symptoms should trigger a pituitary MRI.
While you are at it, the obvious suspects deserve a look. Sleep apnea. Being in a long caloric deficit. Poorly controlled blood sugar. Opioids. Chronic short sleep. Several of those are fixable, and fixing them sometimes fixes the number.
Hematocrit gets checked before treatment starts, and PSA depending on your age and risk.
Fifth, then decide about treatment
Treatment is optional under the policy. That is explicit.
And be clear about what it is for. In DHA's words, testosterone therapy treats a confirmed deficiency that is causing symptoms. It is not a performance enhancer. If your levels are normal, it is unlikely to help you and may cause harm.
If your levels are genuinely low and you have symptoms that match, treatment is a reasonable thing to discuss. If they are low-normal and you feel fine, the honest answer is that the evidence does not support treating that.
Before you start, three questions to answer
Do you hold a special duty status? Flight, dive, submarine, and nuclear billets have their own rules and some of them have no waiver path. Starting first and asking later can cost you the qualification. We wrote a separate piece on where those lines fall.
Do you want children? Testosterone suppresses sperm production. Say so at the first appointment, because there are approaches that protect fertility and there is the option of banking sperm beforehand.
Are you deploying? Start at least 90 days out, plan a supply covering the deployment plus 90 days, and expect to need a waiver for the CENTCOM area of responsibility.
What not to do
Do not buy it online without a prescription. It is a Schedule III controlled substance, unprescribed use is wrongful use under Article 112a, and it is the single fastest way to turn a medical question into a legal one.
Do not start at a clinic that prescribes off one afternoon lab. Besides being bad medicine, it can destroy your ability to get a military waiver later, because the pre-treatment evidence every service requires no longer exists once you are on exogenous testosterone. Reconstructing it means stopping and waiting for your own axis to recover, and that can take a long time.
Do not hide it from your command. Reporting significant health information and authorizing civilian providers to share records with the military health system is a condition of continued service.
Questions people actually ask
Does a flag on the screening mean I have low testosterone? No. The screening is a symptom and risk factor questionnaire. Labs come after a positive screen.
Is one low lab enough? No. The standard is two morning fasting draws on separate days, both under 300, with matching symptoms.
I just came out of the field. Should I get retested? Yes. DoD's own guidance invalidates specimens drawn within 30 days of high stress or sleep deprived training.
Do I have to accept treatment? No. The screening is mandatory. Treatment is your choice.
Can I go to a civilian clinic instead? If you are active duty you have to go through your primary care manager for covered care, and there is no point of service option. A civilian clinic is out of pocket. Guard, Reserve, retirees, and veterans have more room.
Where we fit
We are in Destin, Florida, about twenty minutes from Eglin and Hurlburt Field, which means service members and veterans are a large part of who we see. Telemedicine covers 47 states.
The protocol above is not a checklist we wrote for this article. It is how we run every new patient. Two morning fasting draws before anyone writes anything. LH and FSH to find the cause. Hematocrit and PSA where indicated. An hour with a provider who will read the whole panel with you.
And if the answer is that you do not need testosterone, you will hear that from us. It happens more than you would think, and it is worth more than a prescription.
Discounted pricing for military, law enforcement, and first responders. Request a consultation at hewhealth.com or call (850) 820-8850.
Hew Health is a private medical practice. We are not affiliated with, endorsed by, or connected to the Department of Defense or any branch of the U.S. Armed Forces. This article summarizes public policy as of September 22, 2026 and is general information, not medical advice. Testosterone is a Schedule III controlled substance approved for men with low testosterone caused by an associated medical condition. Safety and effectiveness in age-related low testosterone have not been established.
Sources: DHA clinical practice guideline, "Testosterone Deficiency in the Male Service Member," September 17, 2026. TRICARE prior authorization criteria for testosterone products. Berryman et al., Physiological Reports, 2022. Tait et al., PLoS One, 2022. Salonen et al., Military Medicine, 2019. DoDI 6025.19.