The guideline will not name a testosterone number on its own
The Endocrine Society asks for symptoms first, then a low fasting morning reading confirmed on a repeat, and measures free testosterone when the total sits near the limit.
What the study found
The diagnosis needs symptoms plus two low morning readings
The Endocrine Society's pathway does not start with a number. It requires symptoms first, then a low fasting morning total testosterone confirmed on a repeat, with free testosterone measured when the total sits near the limit or binding-protein levels are off. It fixes no single cutoff.
The caveat · Written before the big safety trial
A guideline is expert synthesis rather than primary evidence, and by its own grading many of its recommendations rest on low-quality evidence. It was published in 2018, before the large cardiovascular safety trial reported. It is a United States society position, and other specialist societies set different cutoffs.