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As men get older, their testosterone levels may decline about 1 percent per year after age 30.
Symptoms of androgen deficiency include fatigue, decreased sex drive, loss of morning erection, erectile dysfunction, feeling sadness or depression, loss of muscle and bone strength, loss of facial or body hair, growing breasts (gynocomastia), irritability, mood swings, and rounded belly.
Many men find themselves limited by a number. You may have been told your testosterone is not low, but you know you still have a laundry list of symptoms. That’s when you truly get to see the benefit of seeking care at a local, provider-owned and operated clinic.
The “normal” range of testosterone for men is considered to be between 300-1100 ng/dL (can vary by lab). However, this range actually has little-to-no evidence behind it. It also doesn’t take into consideration the man’s age or body size. A 33-year-old man should have a higher testosterone level than a 63-year-old man. A guy who is 6’2”, 250 lbs needs more testosterone than a man who is 5’8”, 163 lbs.
Most men feel better when their level is at the higher end of the range. If your natural total testosterone level is above 550 ng/dL, you likely do not need testosterone replacement therapy. That said, every man is different, and it’s worthwhile to look into TRT if you have symptoms of hypogonadism.
The reality is, men’s average testosterone levels were much higher 1-2 generations ago, as men were healthier then.
A 2007 study showed that American men’s testosterone levels had been declining by about 1% per year since 1987, even when adjusted for age. Assuming this trend has continued, that means a 45-year-old man today would have a testosterone level 20% lower than that of a 45-year-old man 20 years ago.
A Danish study from 2010 had similar findings, showing that men who were born in the 1960s had testosterone levels 14% lower, on average, than men born in the 1920s.
Testosterone Replacement Therapy is not indicated for men who are suspected or diagnosed with prostate cancer, breast cancer, severe sleep apnea, and severe urinary symptoms due to benign prostate enlargement (benign prostatic hyperplasia (BPH)).
Although it does not cause prostate cancer, testosterone hormone replacement can worsen existing cases.
There are no studies that have shown TRT to shorten the lifespan, in fact, many have shown that it benefits a man’s health. Low testosterone actually increases a man's risk of cardiovascular disease, stroke, obesity, diabetes, and osteoporosis. The few studies that have shown a correlation between TRT and increased risk of cardiovascular disease were poorly designed. In one of those studies, for example, all of the participants were in their 70's and already had health problems. Multiple medical societies called for the retraction of these studies. That being said, there are always potential risks with any medical treatment. Your provider will review the risks, benefits, and your medical history with a complete exam to be sure that replacement therapy is right for you.
The most significant side-effect of TRT is a condition called erythrocytosis (or polycythemia), which is an abnormally high level of red blood cells (RBCs). Left untreated, this condition could potentially lead to a blood clot. That’s why we closely monitor your blood counts when you are on testosterone. If your RBCs go too high, you’ll need to donate blood to normalize your level.
Other possible side effects include acne, fluid retention, hair loss, and testicular shrinkage.
This is true, some men choose to treat this and some men don't. It is a personal deision. A medication called clomiphene (Clomid) can help prevent testicular shrinkage, as well as maintain fertility. Clomid is taken orally twice a week and has a low incidence of side-effects.
Without Clomid, most men who are on testosterone therapy experience testicular shrinkage to some degree. This happens because when you are giving your body testosterone from outside, your testicles won’t be producing as much on their own. They are less active, so they get smaller. Most men on TRT consider this a small price to pay for their increased libido and better erections, as well as other benefits, that they get while on testosterone therapy.
If you stop testosterone (or take Clomid), your testicles will return to their normal size.
Taking testosterone on its own will reduce the body’s production of sperm, which leads to infertility. If fertility is desired, you can take Clomid to maintain sperm production. And yes, if you stop testosterone (or take Clomid), your fertility will return.
It varies, but can start around 100 mg per week. It is patient specific.
Yes, you can! Maintaining a healthy lifestyle, including a healthy diet, regular exercise (especially weightlifting), maintaining a healthy weight, and getting quality sleep will all help to increase testosterone levels. It’s also important to avoid unnecessary exposure to toxins.
Testosterone replacement therapy can help you to begin and maintain these healthy habits by making it easier to lose weight, increasing energy and motivation, and helping you sleep better.
No. If you stop testosterone, your body will start producing it on its own again, but your levels may not be as high as they were while on TRT.
STEP 1: FREE 15-MINUTE PHONE CONSULT
Book a phone consult and a short and simple questionnaire will be sent to your email address. During this consult, we will help set up your initial lab appointment.
2. INITIAL LAB WORK REQUEST
The next step to being evaluated involves having your lab work completed. You can book your "initial lab work request" via the webdsite, or by completing the invoice you're sent after your initial phone consultation.
Again, these lab orders are gold-standard blood tests that will encompasses all of the necessary blood investigations required to make a preliminary diagnosis of testosterone deficiency and determine if you are a candidate for hormone replacement therapy. In addition to a full hormone panel, this lab work will also look at other general health parameters to help identify any potential reversible causes of low testosterone and give you a more complete picture of your overall health. This advanced testing goes one step further by looking for vitamin and mineral deficiencies, which can also have a negative impact on your testosterone levels and the way you feel.
Please follow the special instructions below for all labs. If you are taking a Biotin supplement, it must be stopped before your lab draw, as it can skew results. Please mention this to our staff when they speak with you so you can be properly advised.
STEP 2: FACE-TO-FACE Evaluation
You will schedule your in-person evaluation for a late afternoon or weekend time that will occur after your lab draw, typically no sooner than 2 days as we must wait for labs to result first. Once your labs have resulted and your face-to-face evaluation has been completed, a personalized treatment plan can be developed for you.
Though not cost-friendly, there is a topical option (as well as other options) for replacement therapy if you are not a fan of injections. There are special instructions for this option. Most men receive their testosterone replacement through injection form and studies show that route to be optimal, as your levels will remain more stable this way.
Pellet therapy is not currently offered at Powerhouse Men's Clinic.
STEP 3: FOLLOW-UP LABWORK & TELEHEALTH VISITS
You will have a telehealth visit with follow-up labs at least every 12 weeks after the initiation of treatment. Follow-up lab work is an additional $75 cost for each draw.
If qualified and you wish to start testosterone replacement right away via injection, a prescription will be sent to your local pharmacy for the first 4-6 weeks. You will then receive your medication in the mail to your home. To avoid breaks in therapy that can affect your testosterone levels, all TRT patients are on a recurring 12 week subscription-based service that will allow you to receive your medication in the mail every month on routine.
The initial lab work includes a comprehensive assessment of your hormone levels and overall wellness. A full set of initial labs will be ordered regardless of whether you are currently on hormone therapy prescribed by another provider or not.
Initial Comprehensive Labs: $175.00 + tax
In-Person Consultation Fee: $145.00 + tax
Subscription program: Begins at $125.00 + tax monthly subscription with a
12-week recurring commitment: includes all follow-up appointments, injection supplies, and any associated shipping costs. It beings 4 weeks after your face-to-face visit.
Follow-up Lab Fee: A separate fee of $75.00 + tax every 12 weeks.
Payment is due when your appointment is booked for lab work.
Payment for FACE-TO-FACE evaluation is due 48 hours before appointment date and the card on file will be charged automatically at that time.
Cancellations for the Face-to-Face Evaluation will be subject to a full charge if not cancelled 48 hours before the appointment. This is necessary because a time commitment is made to you and is held exclusively for you. If you are late for an appointment, you may lose some of the allotted time for that appointment but know we will do our best to work with you.
Once labs orders are paid for through the booking tool, or medication is ordered, the cost is non-refundable and non-negotiable.
Note: If you are not a candidate for replacement therapy after your initial labs are drawn, there are often other options revealed in your comprehensive lab work that can reveal insight in managing your symptoms. We will discuss all possibilities for your specific symptoms at your consultation.
You will also receive access to all of your lab results, which can be helpful to follow your trends in the future.
The action of hormone replacement can take up to four months for the full effect, but most patients notice improvements within the first four to six weeks of their first dose. Most patients will notice the psychological benefits first: better mood, less irritability, more positive outlook. After that patients notice improvements in sleep, increased sexual libido and performance. The longer patients have optimal testosterone levels, the more their body composition changes. Of course, different patients notice different benefits more than others.
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