Cut From Steel

FIFTY LETTERS IN. YOU ARE STILL READING.

You are this week's hero. I mean the man reading this in a kitchen at six in the morning, with the coffee going cold beside him. Nobody else in the house is awake. You are up because you decided something a while back and you kept deciding it.

I have written fifty of these letters now. You opened them. Some of them landed on a morning when you felt beaten, and you read them anyway. Most men do not last a week with anything.

You were never handed a trophy for it. Nobody clapped the first time you put the bread down and took the eggs instead. Your wife did not notice the week you started walking after dinner. The walking still counted.

I know how the year looked from where you sit. You began well. The thread got lost somewhere in the middle. You picked it up again without telling anybody. That is rare.

Vince Lombardi spent a career on one idea, and you read it at the top of this page. Getting knocked down happens to every man alive. Standing back up does not.

You have a blood test to book this week, and I will come to that in a minute. Before you do, take the fifty for what it is. You stayed. Very few men ever do.

THE BLOOD DRAW THAT TOLD YOU NOTHING

You went in feeling flat. The doctor ordered a testosterone test, and a nurse drew your blood at half past three that afternoon. You had eaten lunch two hours before. The result came back, and you have been building decisions on it ever since.

I will tell you what that number really was. You got one photograph of a moving thing. Mayo Clinic Laboratories notes that early-morning testosterone in young men runs about 50% higher on average than afternoon levels. The same lab warns that levels can swing a lot from one day to the next, so androgen status should rest on more than a single measurement.

You were handed a verdict from a sample that was never built to carry one. In other words, the test was not wrong. The timing was.

A PROPER TEST HAS THREE PARTS

So what does a real testosterone test look like? Three parts, and not one of them costs extra. Let me take them one at a time.

01 / The Morning Window

You want that needle in your arm early. MedlinePlus, from the National Institutes of Health, says the sample is taken in the morning, between 7 and 10. Mayo Clinic puts the usual window at 8 to 10 a.m. Your body runs testosterone high overnight and lets it drift down as the day goes on. A late draw catches the low point and calls it your baseline.

02 / An Empty Stomach

You should go in fasting. The Endocrine Society guideline asks for total testosterone measured on two separate mornings while the patient is fasting, because food and glucose may suppress the reading. Call the lab the day before and ask what you are allowed to drink.

03 / The Second Morning

You need the whole thing done twice. The Endocrine Society notes that about 30% of men whose first result falls in the low range come back normal when the test is repeated. One low number is a question. A second morning is what turns it into something a doctor can work with.

HOW TO BOOK IT THIS WEEK

You can arrange all of this in one phone call. Ask for a total testosterone test, early morning, fasting. Tell them you want the second one booked on a different day the same week. Write both times down before you hang up.

I want you to ask for one more thing. The Endocrine Society advises checking free testosterone when a man has a condition that shifts SHBG, the protein that carries testosterone through the blood, or when his total sits near the bottom of the normal range. Obesity, diabetes, and thyroid problems all sit on that list. Total testosterone tells you what is in the tank. Free testosterone is closer to what your body can actually spend.

You should also know what no lab value can do by itself. The Endocrine Society holds that symptoms alone do not diagnose low testosterone, because low energy and low mood have many possible causes. Symptoms and the number have to agree before anybody talks about treatment. No man should be started on anything off one printout.

You only need to remember one line from all of this. Two mornings, fasting, on separate days. Anything less is a guess.

— Travis

Insider Member's Corner

6 free habits worth more than any single lab number:

You didn't put in 45 years to settle for beige.

01 / Car · Porsche 911

You already know the shape from fifty feet away. Porsche put the 911 into production in September 1964, after Peugeot forced them to drop the original 901 name, and the car has never left the line since. Steve McQueen took delivery of a slate grey 1970 911S on the set of Le Mans, then drove it through the opening minutes of the film before a single race car turns a wheel. A new base Carrera starts around $135,500 in the States. An older air-cooled one asks for less money and more of you, which is the version most men are really picturing.

02 / Style · Persol 714 Sunglasses

You want a pair of sunglasses that folds into a shirt pocket. Persol built the 714 as a folding version of the 649, a frame first drawn in 1957 for Turin tram drivers squinting into the glare. Steve McQueen made the 714 famous in The Thomas Crown Affair in 1968, then kept them on through Bullitt, The Getaway, and Le Mans. They start around $450 direct from Persol today. Buy one pair, keep it twenty years, and stop losing gas-station plastic every June.

03 / Fitness Gear · A Heavy Bag In The Garage

You do not need a gym membership to hit something. The working rule is that a hanging bag should weigh about half of what you do, which puts most men over 45 somewhere in the 80 to 100 pound range. A bag that is too light swings wild and punishes your wrists, so size up rather than down. Hang it off a joist, keep gloves and wraps on a hook beside it, and give it six rounds of three minutes on the days that went sideways. Very little in your house will cost you less per year of use.