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.

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Low Testosterone is Common

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    Age-related Low T

    Testosterone 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.

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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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    Energy

    Low 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.

Testosterone replacement

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.

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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.

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Testosterone Replacement Options

testosterone

Testosterone

Bioidentical testosterone can be given in several forms – injectable, topical, or implanted pellet. The gold standard treatment is injectable testosterone.

Clomiphene pills

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.

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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.
Testosterone
Enclomiphene & Clomiphene
Most effective
Testosterone injections are the most effective form of TRT, although oral medications can be very effective in younger men.
FDA approved treatment
Testosterone replacement in men with testosterone <300 ng/dL and symptoms of low testosterone.
Fertility
Testosterone therapy decreases fertility. When testosterone is stopped, fertility typically returns within 6 months to 2 years. Enclomiphene and clomiphene preserve fertility.
Testicular shrinkage
Testosterone replacement suppresses testicular production of testosterone, which can cause testicular shrinkage.
Off-label use
Testosterone replacement in men with testosterone >300 ng/dL, and use of oral medications to increase testosterone are considered off label uses of these medications.

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, 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 energy.

No. There is no evidence that testosterone replacement therapy increases the risk for either prostate cancer or cardiovascular disease.

Yes! Bioidentical hormones are the same as what your body normally makes, and therefore function exactly the same as your normal hormones. Pharmaceutical companies make altered version of hormones (so they can patent them), but they don’t work in the same way as your body’s normal hormones. Mother Nature has provided us with the ideal hormones, and pharmaceutical companies have not been able to improve upon them with their synthetic hormones.

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.

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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.

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