The term "normal range" is more of the issue often times. That range is so massive compared to other hormones in the body mostly because of the influence of insurances. They typically don't cover TRT since not doing so (like everything else) will save them money. TRT has also not received as much funding for research as other organizations over time, so it is very much a specialized art.

So that said, if someone is near the higher end of that normal range we'd want to make sure to rule out other issues first. However, there is a recognized condition known as relative hypogonadism. "Relative" is specific to each individual patient. So relative to the levels you used to have when you were younger (950 for example), and now you are 450. This is half the level you were at when you were at your prime. If a man came to us with symptoms consistent with hypogonadism, but had levels that were still within the "normal" range, we sometimes would consider a therapeutic trial of TRT to see if they feel better and their symptoms resolve. If they do, then their symptoms are from relative hypogonadism. If they don't feel better, then their symptoms are not from hypogonadism and they can stop the treatment.

There's good examples of this. We've had someone in the ER before thinking they had something like mono, because they've felt terrible for months. Eventually when other tests showed no abnormalities, we tested his hormones. They looked great, and his T was 600, much higher T than your average man his age. However, review of his older labs showed his previous T level was 900 less than a year before. We referred him to get started on TRT to get his levels back up above 900, and he felt great again. It sounds crazy but what might be high for one man could be another's low, and it's just part of what makes us all different.