Testosterone Replacement Therapy (TRT)
Duration
30 min - 1 hour
Treatment Type
Subcutaneous Injection • Topical Gel
Results
6 - 8 weeks
It is estimated that up to 25% of men have inadequate levels of testosterone after 35 years of age. Testosterone levels experience a natural decline of 1% to 2% per year after one's mid-20s to 30s, marking a subtle yet significant shift as age progresses. A man’s hormones play a vital role in his overall well-being, vitality, and longevity. Testosterone, in particular, actively contributes to muscle mass, bone density, and notably, libido (sexual drive).
If you find yourself encountering undesired physical changes or struggling to achieve your fitness goals, you may be contending with the effects of "low T." This condition is not just a matter of personal concern; it's intricately linked to an elevated risk of type-2 diabetes, cardiovascular disease, and metabolic syndrome. The consequences reach beyond the immediate, potentially impacting the trajectory of your longevity.
Why Testosterone Decreases With Age
Why Testosterone Decreases With Age
If you are male, your testosterone production might decrease by as much as 1% to 2% yearly. Beginning in your late 20s or 30s, your hypothalamus will tend to reduce the output of gonadotropin-releasing hormone (GnRH). This in turn causes the pituitary gland to create less luteinizing hormone (LH). These chemical changes contribute to lower T production overall.
Symptoms of Low Testosterone
Symptoms of Low Testosterone
Often, the gradual decrease in testosterone doesn't cause noticeable symptoms right away. Also, you may not recognize a connection between the changes you live with. A drop in testosterone may look like:
- A reduction in muscle mass and strength
- Generalized weakness
- Unexplained weight gain
- Low libido (Poor sex drive)
- Reduced spontaneous erections
- Impotence / Erectile dysfunction (ED)
- Reduced sperm count and volume (cause of infertility)
- Insomnia
- Fatigue not alleviated by sleep
- Depression
- Anxiety
- Brain fog (lack of focus and memory recall)
- Brittle bones
- Gynecomastia (enlarged breasts)
Tailored TRT Treatment Options
Tailored TRT Treatment Options
Your first step is to schedule a confidential consultation with our men’s health specialist. You’ll meet with our practitioner in our modern private office (or via telehealth if preferred) to discuss your concerns and learn more about the potential treatment options available to you. All of the services we offer are completely customized according to unique body chemistry, goals, and other individual characteristics. You will be assessed by multiple screening tools to evaluate your risk of erectile dysfunction, low testosterone and mental health. You’ll be provided with an initial bloodwork requisition to assess quantitative values of testosterone and other important hormones. Before and during your TRT, your doctor will evaluate red blood cells, lipid levels, and other biomarkers and organ function tests that are relevant to a healthy, optimal balance. You will also have a detailed cardiac evaluation including an ECG (electrocardiogram) There are some cases where testosterone therapy will not likely be advised, including in very young males or men with measurably adequate or high T levels.
Benefits
Enhance sexual performance
TRT can enhance sexual function in men by boosting libido and alleviating erectile dysfunction. These improvements can be attributed to testosterone’s capacity to enhance penile dilation and stimulate sexual desire.
Enhanced Athletic Performance
TRT can enhance muscle mass and strength, leading to improvement in athletic performance and physical function in men with testosterone deficiency. These enhancements are believed to be a product of stimulated satellite cells and the promotion of protein synthesis, among other factors.
Improved well-being
Testosterone has demonstrated a positive effect on mood and overall well-being. TRT has been utilized to address depression and anxiety in men, additionally, TRT can enhance energy levels and improve overall quality of life by regulating neurotransmitter levels, among other factors.
Treatment Process
Filling in our health assessment forms is the first step (for out-of-town clients this can be offered virtually if requested). Once complete, we’ll send you a Low T blood work panel. Getting your blood done as soon as possible is vital since we can’t initiate any treatment until the blood work is complete.
Frequently Asked Questions
Can TRT increase muscle mass?
TRT can increase muscle mass and strength, leading to improvement in athletic performance and physical function in men with testosterone deficiency. The mechanisms by which TRT increases muscle mass and strength are thought to involve stimulating satellite cells and promoting protein synthesis, among other factors.
Does TRT Improve sexual function?
TRT can improve sexual function by increasing libido and reducing erectile dysfunction in men. This may be due to testosterone's ability to improve penile vascular dilation and by stimulating sexual desire.
Does TRT improve bone health?
Testosterone plays an important role in maintaining bone density and preventing osteoporosis. TRT can help to prevent bone loss and reduce the risk of fractures in older men. This may be due to testosterone's ability to stimulate bone formation and inhibit the destruction of bone mass and density.
What does the blood work look at?
Our blood panel covers 16+ blood markers, including:
- HbA1cMeasures blood sugar levels.
- Creatinine LevelsMeasures how well your kidneys are working.
- AltMade in the liver; high levels in your blood could indicate an issue.
- Alkaline Phosphatase (ALP)Can point to liver damage.
- Lipid AssessmentMeasures the levels of cholesterol and triglycerides in your blood.
- Complete Blood Count (CBC)Gives us an overall picture of your general health.
- Prostate-specific AntigenScreens for certain prostate cancers.
- Free and Total TestosteroneRegulates libido, bone mass, fat distribution, muscle mass, and strength.
- EstradiolHelps regulate your sex drive, sperm production, and testicular function.
- ProlactinIncreases the level of Luteinizing Hormone (LH), which in turn increases Testosterone.
- Luteinizing Hormone (LH)Directly linked to Testosterone production in the testicles.
- FSHHelps control the production of sperm Ferritin measures Iron in your blood; a deficit can point to anemia.
- B12Helps the development of blood, nerve, and brain cells, low levels can point to a deficiency TSH measures the amount of thyroid-stimulating hormone in your blood.
What are my treatment options?
We will personalize your treatment options depending on your results:
Cypionate
This is our 'go-to' choice in most men. Can be injected subcutaneously. Also has the least side effects like acne and breast enlargement or weight gain. It’s a long-acting testosterone ester that metabolizes in approx. 7-8 days. It is bio-identical and works best to treat chronic low testosterone. Typically injected twice per week.
Strength: 100mg/ml
Usage: Inject 1-3 times weekly intramuscularly or subcutaneously
Results: 6 - 8 weeks
Enanthate
It’s a short-acting testosterone ester that metabolizes in approximately 4-5 days. It is bio-identical and works best to treat chronic low testosterone.
Strength: 200 mg/mg
Usage: Inject multiple times per week
Results: 6 - 8 weeks
Androgel
Gel-based Testosterone replacement therapy for patients who decline injections
Strength: 2mg or 5 mg
Usage: Gel applied topically daily to shoulders, chest, and back
Results: 6 - 8 weeks
hCG Monotherapy
Acts as a luteinizing hormone and stimulates the testes to produce more sperm and testosterone, this is an effective treatment for moderately low testosterone. hCG is also sometimes used as an alternative to testosterone products in men with testosterone deficiency who are concerned about the potential risk of decreasing their fertility. Testosterone along with hCG may help improve symptoms of testosterone deficiency while preventing some of testosterone’s side effects such as shrinking the gonads, altering sexual function and causing infertility.
Strength: 10,000 iu
Usage: Inject 1-2x a week intramuscularly
Results: 6 - 8 weeks
What happens at the quarterly follow-ups?
We'll conduct repeat blood work every 3 months during your treatment to evaluate your response to the testosterone treatment and monitor your organ function. There'll also be a virtual follow-up consultation after each set of results. We use these quarterly checks to track your ongoing progress and make any necessary tweaks to your treatment.
This system ensures continued, relevant care, tailored specifically to keep you performing at your best.
If I sign up is my treatment guaranteed?
All care decisions are made based on your test results. So, if your blood work doesn't indicate Low T, we won't treat you for it. If you meet all the clinical criteria for Low T, yet your blood results are normal, we will discuss and offer you bioidentical hormone testing through your saliva.
Please note that bioidentical hormone testing is not covered through MSP and will be an additional private charge.
Are the consultations covered through MSP (Medical Services Plan)?
We utilize a comprehensive investigation process, including blood tests and bio-identical testing done with your saliva, please be aware that these are not covered by MSP.
What time of the day should the bloodwork be completed?
Blood work should be completed in the morning, before 11 am. Initial blood tests will be fasted (this means only drinking water after 10 PM the night before the test).
What happens if the blood tests show other medical problems?
We will inform you of all the results of the blood tests. If there are abnormalities we will advise you to seek appropriate care at your primary care provider accordingly. However, we will not be taking over the primary management of your medical care and will only manage your testosterone deficiency.
Do I need a referral for Testosterone Replacement Treatment (TRT)?
You do not need a referral for the assessment and treatment. If you have a Family Doctor we encourage you to involve him in your medical care and discuss with him the fact that you are seeing us for your concerns. Your privacy is our greatest concern. Therefore we will not disclose or discuss your treatment with anyone, including your family physician if you so desire.
