Testosterone
Bioidentical testosterone can be given in several forms – injectable, topical, or implanted pellet. The gold standard treatment is injectable testosterone.
The Science
What does testosterone do?
Testosterone is necessary for the development and maintenance of many body systems, including the reproductive, musculoskeletal, cardiovascular, immunologic, neurologic, and hematopoietic (blood) systems.
When testosterone becomes low, all of these body systems can be affected. Symptoms vary from none to many, and from mild to severe.
If your testosterone is low, and you have symptoms, replacing your lost testosterone with bioidentical testosterone can resolve your symptoms and help you to feel like your younger self again.
Low Testosterone is Common
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Age-related Low TTestosterone peaks in a man’s 20’s and 30’s, and then decreases over the rest of his life. It is common for symptoms to occur when testosterone decreases below 500-600.
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Endocrine Disruptors
Average testosterone levels in men of all ages have been decreasing worldwide over the last 50 years. Why? It is thought to be because of toxic substances in our environment, such as micro plastics and food chemicals.
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Medical Problems
Chronic medical problems, such as obesity, diabetes, and high blood pressure, are associated with low testosterone levels.
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Medications
Several medications can lower testosterone, including cholesterol medications, some hypertension medications, antidepressants, and opioids.
Symptoms of Low Testosterone
Low testosterone can be disruptive to many important aspects of life, including relationships, self-image, activities of daily living, and health related quality of life.
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EnergyLow testosterone can cause low energy, reduced endurance, fatigue, and disrupted sleep.
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Sexual Function
Low testosterone can cause reduced libido and sex drive, erectile dysfunction, and less sensitivity.
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Fitness & Body Composition
Low testosterone can cause loss of muscle mass, strength, and endurance, difficulty with muscle gain, longer recovery after exercise, loss of bone density, weight gain, and lowered metabolism.
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Psychological
Low testosterone can cause a depressed mood, anxiety, low motivation and drive, and low confidence.
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Cognitive
Low testosterone can effect memory, concentration, attention span, drive, ambition, and decisiveness.
Indications for Testosterone Replacement
Treat symptoms of low testosterone.
The determination of whether you are a candidate for TRT requires an assessment by an expert to evaluate your symptoms, and a blood test to measure your testosterone.
The normal testosterone range in men is considered to be 300-1000 ng/dL. The disease of hypogonadism is defined as a testosterone level <300. That doesn’t mean symptoms only occur when testosterone drops to below 300. Often symptoms start, and treatment can be beneficial, when testosterone falls below 500-600.
Our Healthcare System Overlooks Low Testosterone
Our healthcare system is focused on disease, not wellness.
The “normal” range for testosterone is considered to be 300-1000, which is the range that 95% of men fall within, not the range that results in no symptoms and optimal quality of life. In fact, symptoms of low testosterone often start when testosterone decreases to below 500-600.
Our approach is to treat each man according to his symptoms, with the understanding that the optimal level is different for each patient.
Testosterone Replacement Options
Clomiphene
Clomiphene stimulates the body to produce more testosterone on its own, and is a great option for younger men, and men who want to maintain their fertility.
Enclomiphene
Enclomiphene stimulates the body to make more testosterone on its own, and may have less estrogen related side effects than clomiphene.
Comparison of Treatment Modalities
Testosterone compared to enclomiphene and clomiphene.
Have Questions? We’ve Got Answers
In men, testosterone is typically administered as a weekly injection in the muscle of the butt, thigh, or arm. Injections result in excellent testosterone blood levels and symptom resolution, and this is the way more than 90% of men get their testosterone. We will teach you how to do injections at home, or you can come to the office for your injections. Testosterone can also be administered in topical form, but absorption and symptom resolution is more variable.
Yes. To be a candidate for testosterone replacement therapy, you need to have symptoms consistent with low testosterone, and a blood test that shows low testosterone. We also have to make sure your PSA and hematocrit aren’t elevated. We perform these tests for free in the office (testosterone, PSA, hematocrit). If you are a candidate for treatment (most men are), we can start testosterone in the office that day.
You may feel a change within the first week, but it can take 3-6 months to feel the full effects of testosterone replacement. Often the first changes men feel are an increase in libido and improvements in mood.
No. There is no evidence that testosterone replacement therapy increases the risk for either prostate cancer or cardiovascular disease.
We strongly believe so. We believe bioidentical hormones, which are molecularly identical to and function exactly like your body’s natural hormones, are preferable to synthetic hormones, which are altered from the natural hormones your body makes. The problem with synthetic hormones is they function differently, sometimes very differently, than your body’s natural hormones. The reason pharmaceutical companies make synthetic hormones, of course, is so they can obtain patent protection to guard their ability to make profits. They can’t patent substances naturally made in the body, and therefore can’t make money from them.
Side effects can occur if testosterone levels become too high. Possible side effects include elevated hematocrit, acne, oily skin, male pattern hair loss, nipple pain, and aggression. Testosterone also reduces sperm count and fertility, and can cause testicular shrinkage. If men want fertility within 6-12 months, testosterone shouldn’t be started, and enclomiphene or clomiphene should be considered instead.
Our goal is to resolve your symptoms of low testosterone to get you feeling like your younger self again, without causing side effects. Generally this means getting your testosterone level into the top third of the normal range.
Are You Ready to Feel the Difference?
Let’s do it! Feeling younger and healthier starts with a free consult and in-office testosterone test with a board certified hormone and wellness expert.
Real Patients, Real Results
Real Patients, Real ResultsI had no idea my symptoms were from low testosterone.
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Real Patients, Real ResultsI've been on testosterone now for 6 months, and I love it!
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