Edward Blake, a 53-year-old forklift driver from Houston, sought out the same doctor for the same reasons. His testosterone measured 450, within the normal range. “I was feeling kind of tired and stuff, but after the third shot, I’m lifting things with no problem,” said Mr. Blake. He said in addition to feeling stronger, his sex drive improved.

Dr. Pastuszak said he primarily prescribes testosterone to men in the F.D.A.’s low category but will sometimes let other men with symptoms try it. “If you have these guys in the mid range and you put them on it, the majority will say they want to stay on it,” he said, adding that most men will say it makes them feel better and boosts their sex drive. But is that the power of suggestion or the power of the hormone?

“The reality is we don’t have the answer,” said Dr. Pastuszak, noting that there’s a big gray area. “I have to take their word that they feel better on it, whether that’s real or whether it’s placebo.”

Complicating matters, testosterone levels fluctuate, peaking around 8 a.m. and diminishing throughout the day. Levels tend to be lowest around 8 in the evening, then climb during the


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