Should everyone get testosterone replacement therapy?

No. If testosterone levels are normal, then supplementing it can cause harm. It can be associated with azoospermia, blood lipid changes, sleep apnea, polycythemia, and worsening of prostate or breast cancers if they exist. Therapy should be reserved for those patients with a low level and symptoms associated with a testosterone deficiency after an appropriate workup to ensure that it is the right choice for them.