top of page

TRT -Testosterone Replacement Therapy

Happy man

Testosterone is a sex hormone, found in Men and Women, but is at higher levels in Men. Men usually experience their peak concentrations of testosterone in their early 20's. and it slowly dwindles with age about 1 to 2% per year.  Decline is most noticed after 40 years of age. This is when symptoms start to creep up slowly, though many times men don’t even realize it.

Symptoms of Low Testosterone

  • Lack of Physical Energy

  • Muscle Loss

  • Poor results  at the Gym

  • Decreased Strength

  • Low Stamina

  • General Fatigue

  • Decreased motivation

  • Previous leisure activities are not enjoyable any more

  • Diminished Mental Sharpness

  • Body Aches and Pains

  • Low Libido or Sex Drive

  • Weight Gain

  • Irritability

  • Poor sleep

  • Sleep Apnea

  • Hot Flashes in and Night Sweats

  • Urinary Symptoms

  • Poor performance at work

  • Erectile Disfunction

  • Depression or anxiety

  • Gynecomastia (male breasts)

Risks for low T include chronic physical or situational stress (work, home life, poor nutrition, Illness, obesity, some medications, exposure to chemicals, history of severe infection or injury). Our lifestyles play a big role on how we are exposed, handle and recuperate from such stressors. 

Evaluation for Low T

We always encourage a full History and Physical exam with your primary care provider. We suggest lab work depending on symptoms to assess Total, Free Testosterone, Estradiol, as well as Gonadotropins and Thyroid. In many cases we should look at prostate and inflammatory markers as well as vitamins, minerals and Cortisol levels. Risk profile assessment, like cardiovascular, metabolic, bone health and certain cancers should be considered on an individualized basis.

An evaluation of low T should ALWAYS include an assessment of lifestyle (sleep, diet & nutrition, leisure time, exercise) as well as recognizing on going stressors and developing strategies to mitigate these.

Management of Low T

Testosterone replacement therapy is considered on an individual basis and may play an important role in recovery. There is no one option that will fit every patient. Regular interval surveillance with labs is also a key factor in optimizing outcomes while avoiding side effects. The goal is to achieve normal levels and avoidance of symptoms/risks while optimizing quality of life.  When appropriate, a patient will be offered diet orientation and nutritional supplementation.

TRT Replacement options

Hormone levels, nutritional status and metabolic markers like insulin and glucose interact with each other. These interactions can create changes on how our body performs.  In other words, an abnormal level of a hormone (like testosterone) could change the effect of another hormone on the body (like insulin, Growth Hormone, Thyroid or Cortisol). So management of these deficiencies should be undertaken in a holistic fashion to optimize results. This means that we will normalize hormone levels while keeping an eye for symptoms or lab results that indicate an imbalance elsewhere. This is the key to success with TRT.

All of this may seem overwhelming, but to get started all you need to do is simply sign up and  follow our recommendations. Even though it may involve a daily schedule for the use of above Rx/supplements; there is no other effort involved until you feel better. With the newfound energy and outlook on life, it should be easier to start a weightlifting program (under supervision) and light aerobic exercise. In addition, we may suggest modifying meals to include a high protein diet and a healthy sleep regime. Other recommendations can include stress management with new learned techniques if necessary; as well as an emphasis on spending time with family and friends so to improve quality of life.

In our experience we have found that managing Low T as part of a comprehensive wellness program, improves stamina, energy, sex life and most notably work performance. While following the program, we have consistently seen patients improve their relationship with family and friends.

Improve sex life


if you are wondering how to support your guy during this time, just do all you can to stay communicative and supportive. Think of how you would like him to treat you during menopause and use that as your starting point. Don’t be afraid to take the reins if he is dismissive of his symptoms. He might not be familiar with the existence of andropause or Low T. If he has some of the above symptoms, suggest he get a medical checkup, including the checking of hormone levels. Men often neglect health issues, and yet as we age, nothing is more important than staying vigilant and making positive lifestyle choices that can result in improved quality of life.

bottom of page