Tired All the Time, No Motivation: Is It Low Testosterone?

In short: constant tiredness in men is usually caused by sleep, mood, alcohol, overwork or a common medical problem such as iron deficiency, thyroid disease, diabetes or sleep apnoea. Low testosterone can add to it, but tiredness on its own is a weak sign. It becomes more likely when the tiredness comes with low sex drive and fewer morning erections. Start with the basic checks, and if you work nights, have any testosterone test two to three hours after you wake up.

Feeling "tired all the time" is common; Healthify notes that fatigue affects most adults at some point. For men in their 40s and 50s it often comes bundled with a loss of drive: work feels like a grind, training slips, and things that used to be fun feel like effort. It's reasonable to wonder about testosterone. This guide explains where hormones fit, what to rule out first, and how to get tested properly, including if you work shifts.

Why am I always tired and have no energy?

Healthify, New Zealand's health information service, groups the causes of fatigue into four buckets (Healthify, Fatigue):

• Medical: anaemia, diabetes, thyroid disorders, heart disease, infections and their aftermath (including long COVID), pain, and medicines.
• Lifestyle: alcohol or drug use, poor sleep habits, too much caffeine, too little exercise and a poor diet.
• Work: shift work, long hours, workplace stress and unemployment.
• Emotional: stress, anxiety, grief and depression. Healthify notes that emotional causes of fatigue are common.

Low motivation deserves its own mention. Losing interest in things you used to enjoy, for more than a couple of weeks, is a core symptom of depression, and in men, depression can show up as tiredness, irritability and withdrawal as much as sadness. It's worth naming early because it's common and very treatable. In New Zealand you can call or text 1737, free, any time, to talk with a trained counsellor or peer support worker. If you or someone else is in immediate danger, call 111.

When tiredness needs a doctor soon

Book a GP appointment rather than waiting it out if your fatigue comes with any of these, which Healthify flags as reasons to get checked (Healthify):

• weight loss or gain you can't explain
• ongoing fevers
• black, tarry stools, blood in your stool, or a change in bowel habits
• trouble staying awake during the day
• extreme thirst
• hair loss
• any other symptom that worries you

Falling asleep at the wheel, or being told you snore loudly and stop breathing at night, needs prompt attention too: both can point to sleep apnoea. Healthify advises seeing a doctor as soon as possible if you feel very sleepy during the day while driving (Healthify).

Can low testosterone cause fatigue in men?

Possibly, but tiredness is one of the least specific symptoms of low testosterone. Healthify lists reduced energy and mood among its vaguer symptoms, behind low libido and erectile dysfunction (Healthify). In the European Male Ageing Study of 3,369 men aged 40 to 79, fatigue was linked to lower testosterone levels, but only three sexual symptoms clustered with low testosterone in a way that helps diagnosis: low sexual desire, fewer morning erections and erectile dysfunction (Wu et al., 2010).

Treatment trials point the same way. In the Testosterone Trials, older men with low testosterone who took testosterone gel for a year had better sexual function and slightly better mood than men on placebo, but no improvement in energy (Snyder et al., 2016).

A rough rule of thumb:

Night shifts, sleep and your testosterone result

Testosterone levels rise during sleep, and its daily rhythm is tied to the sleep-wake cycle (Liu, 2019). That's why sleep loss shows up in the bloods:

• Short sleep. In a small laboratory study of 10 healthy young men, a week of five hours in bed a night lowered daytime testosterone by 10–15% compared with three nights of 10 hours in bed (Leproult and Van Cauter, 2011).
• Sleep apnoea. A meta-analysis of 18 studies found men with obstructive sleep apnoea had lower testosterone, independent of age and BMI; by severity, the difference was statistically clear only in severe apnoea (Su et al., 2022).
• Shift work. In a study of 2,571 men attending a US andrology clinic, non-standard shift workers who also had shift work sleep disorder (a circadian disorder with excessive sleepiness linked to their shifts) reported more hypogonadal symptoms and had lower testosterone than shift workers without it (Balasubramanian et al., 2020).

A review of the evidence concluded that shift work doesn't lower average testosterone by itself unless it causes real sleep loss (Liu, 2019).

The practical point is that poor sleep can lower testosterone and also cause tiredness by itself. Fixing the sleep often fixes both.

Testosterone testing if you work nights or shifts

Testosterone is normally tested in the morning because that's when it peaks, and BPAC advises a sample between 7 and 11 am, ideally after an overnight fast. For shift workers, BPAC's advice is different: test two to three hours after waking, whenever that is (BPAC NZ 2024).

Enhanced Men uses the same rule: if you work nights or rotating shifts, have your bloods taken two to three hours after you wake up, rather than at 7 to 11am; check the collection room's hours first. A few practical points:

• Tell the doctor your roster before the blood test is arranged, so the timing is planned around it.
• Ask the doctor which day of your roster to test on.
• Tell the collection staff and the doctor what time you woke up. A result means little without it.
• As with any low result, expect a repeat test about four weeks later before any conclusion.

Which blood tests to ask for in NZ

There's no single "tiredness test". A GP will usually start with history, an examination and a basic blood panel aimed at the common causes. That often includes a full blood count and iron studies (for anaemia and iron deficiency), thyroid function, HbA1c for diabetes, and kidney and liver function, with other tests guided by your symptoms.

Testosterone belongs in the work-up when tiredness comes with sexual symptoms. Done properly, that means two morning total testosterone results about four weeks apart, with SHBG, LH and FSH. Enhanced Men diagnoses low testosterone when a man has symptoms and two morning results, three to four weeks apart, both below 12 nmol/L total testosterone (the European Association of Urology threshold) or 225 pmol/L free testosterone. Above that line is not low testosterone.

What actually helps

For most tired men the fixes are unglamorous and effective:

1. Protect your sleep, keep regular hours where your roster allows, and get loud snoring or daytime sleepiness assessed.
2. Cut back on alcohol, especially in the evening, when it fragments sleep.
3. Move every day and do some strength training. New Zealand's activity guidelines recommend muscle-strengthening on at least two days a week (Health New Zealand).
4. Take stock of mood and workload. Talk to someone if you're struggling.
5. Get the basic bloods done if tiredness has lasted more than a few weeks.
6. Test testosterone properly if you also have low sex drive or fewer morning erections. The free AMS self-check gives you a symptom score to start from, and our guide to low testosterone symptoms covers the wider picture. If low drive is the main problem, see low libido in men over 40; if your shape is changing too, see losing muscle and gaining belly fat in your 40s.

Where to get tested in NZ if you're always tired

Start with the basic checks: iron, thyroid, blood sugar and sleep. Testosterone belongs in the work-up when the tiredness comes with low sex drive or fewer morning erections. The two usual routes are below, and neither needs a referral.

Your GP. Your GP can request the same morning tests, repeat them and start treatment when low testosterone is clearly there. If two morning results fall between 8 and 12 nmol/L, BPAC suggests your GP consider discussing them with an endocrinologist.

A private doctor by video. Enhanced Men, which publishes this guide, is a New Zealand telehealth clinic run by Dr Jack Yeoman, who does every consult himself. He's registered with the Medical Council of New Zealand in general scope (MCNZ 89436). General scope isn't a specialist registration, and it isn't general practice either: he isn't vocationally registered as an endocrinologist, a urologist or a GP, and he refers you on when your case needs a specialist. You see him by video wherever you live in New Zealand, with no GP referral. Your bloods are taken at your local community lab; if you're eligible for publicly funded healthcare, funded tests cost you nothing, and the lab bills you for any test that isn't funded. He diagnoses low testosterone only when you have symptoms and two morning results, three to four weeks apart, both below 12 nmol/L total or 225 pmol/L free testosterone. Above that line is not low testosterone, and he doesn't prescribe for it. Testosterone treatment usually suppresses sperm production. If you may want children, say so before you start.

Whichever route you choose, take copies of any earlier results, with the time each sample was taken, and what your GP made of them.

If you work nights, either route should time the test two to three hours after you wake up.

FAQ

Can low testosterone make you tired all the time? It can contribute, but tiredness alone is a weak sign of low testosterone. Fatigue has many more common causes, including poor sleep, sleep apnoea, depression, iron deficiency, thyroid problems, diabetes and alcohol. Testosterone is worth testing when tiredness comes with low sex drive and fewer morning erections.

Why am I always tired and have no motivation? The most common reasons are not enough good-quality sleep, stress or overwork, depression, alcohol, and medical problems such as anaemia, thyroid disease, diabetes or sleep apnoea. Losing interest in things you used to enjoy for more than a couple of weeks is worth raising with a doctor, as it can be a sign of depression.

Does shift work lower testosterone? Poor sleep lowers testosterone, and shift workers who struggle with their sleep have been found to have lower testosterone and more symptoms than other shift workers. A review of the evidence concluded that shift work itself doesn't lower average testosterone unless it causes real sleep loss.

When should a shift worker have a testosterone test? Two to three hours after waking, rather than at a set morning time. That's BPAC's advice, and the rule Enhanced Men uses. Tell the doctor your roster so the test can be planned around your sleep, and expect a low result to be repeated before any conclusion.

What blood tests should I ask for if I'm always tired? A doctor will usually check a full blood count, iron studies, thyroid function, HbA1c, and kidney and liver function first. If tiredness comes with sexual symptoms, add two morning testosterone tests with SHBG, LH and FSH.

Where can I get my testosterone tested in NZ? Testing makes most sense when the tiredness comes with low sex drive or fewer morning erections. You can have it done through your GP, or by video with a private doctor such as Enhanced Men, Dr Jack Yeoman's telehealth clinic, with no referral. Either way the bloods are taken at a community lab in the morning, or two to three hours after waking if you work nights, and a low result should be repeated before any diagnosis.

References

1. Healthify NZ. Fatigue. https://healthify.nz/health-a-z/f/fatigue
2. Wu FCW, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010;363(2):123–35. https://doi.org/10.1056/NEJMoa0911101
3. Snyder PJ, et al. Effects of testosterone treatment in older men. N Engl J Med. 2016;374(7):611–24. https://doi.org/10.1056/NEJMoa1506119
4. Leproult R, Van Cauter E. Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA. 2011;305(21):2173–4. https://doi.org/10.1001/jama.2011.710
5. Su L, et al. Association between obstructive sleep apnea and male serum testosterone: a systematic review and meta-analysis. Andrology. 2022;10(2):223–31. https://doi.org/10.1111/andr.13111
6. Balasubramanian A, et al. Increased risk of hypogonadal symptoms in shift workers with shift work sleep disorder. Urology. 2020;138:52–9. https://doi.org/10.1016/j.urology.2019.10.040
7. BPAC NZ. Prescribing testosterone in ageing males. 25 November 2024. https://bpac.org.nz/2024/testosterone.aspx
8. Liu PY. A clinical perspective of sleep and andrological health: assessment, treatment considerations, and future research. J Clin Endocrinol Metab. 2019;104(10):4398–417. https://doi.org/10.1210/jc.2019-00683
9. European Association of Urology. EAU Guidelines on Sexual and Reproductive Health, 2026 edition: Male hypogonadism (section 3.3.5). https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/male-hypogonadism
10. Healthify NZ. Obstructive sleep apnoea. https://healthify.nz/health-a-z/o/obstructive-sleep-apnoea
11. Healthify NZ. Testosterone deficiency. Reviewed 13 December 2024. https://healthify.nz/health-a-z/t/testosterone-deficiency
12. Health New Zealand | Te Whatu Ora (HealthEd). Be active every day: physical activity for adults (HE2311). Updated May 2025. https://healthed.govt.nz/resource/be-active-every-day-physical-activity-adults
13. 1737, Need to talk? Free 24/7 call or text support, run by Whakarongorau Aotearoa | New Zealand Telehealth Services. https://1737.org.nz/

This article is general health information, not personalised medical advice. Ongoing tiredness has many causes, some of which need prompt assessment, so see a doctor if it lasts more than a few weeks or comes with any of the warning signs above.