What TRT is (and isn’t)
TRT replaces insufficient endogenous testosterone to a physiologic range when clinically indicated. It’s not a shortcut for bodybuilding nor a fix for every symptom. We also screen for contributors like sleep apnea, medications, stress, and weight.
Symptoms & who might benefit
Common symptoms: low libido, fatigue, decreased morning erections, depressed mood, brain fog, reduced strength/recovery. Diagnosis requires both compatible symptoms and consistently low morning testosterone on accurate testing.
Testing: Total T, Free T, SHBG
Confirm with two separate morning Total Testosterone values; assess Free Testosterone in context of Sex Hormone–Binding Globulin (SHBG). Additional labs may include LH/FSH, prolactin, CBC/CMP, lipids, hematocrit, and PSA when appropriate.
Safety monitoring: hematocrit/PSA
- Early follow-up (6–12 weeks): symptoms, hematocrit, blood pressure; adjust plan.
- Ongoing (every 6–12 months): hematocrit, PSA when age/risk-appropriate, lipids, CMP, symptom review.
Therapy and route are individualized and adjusted over time.
Routes & practical expectations
Routes include transdermal and injectable options; selection depends on preference, response, and safety. Expect libido/energy changes within weeks; body-composition shifts accrue over months with training and adequate protein.
Training, protein & sleep basics
- Strength: 2–4 sessions/week, progressive overload, focus on compound lifts.
- Protein: ~25–40 g per meal, total personalized by your clinician/coach.
- Sleep: consistent wake time, morning light, wind-down routine; consider CBT-I strategies when needed.
When to talk to a clinician
If persistent fatigue, sexual dysfunction, or multiple symptoms affect your life, discuss options with a clinician. Emergency symptoms (e.g., chest pain, severe shortness of breath) → seek urgent care/911.
FAQs
Libido/energy can change within weeks; composition and performance adapt over months with training and sleep.
Routine Aromatase Inhibitor (AI) use is not our default; we adjust dose/route first. Decisions are individualized.
If near-term family planning matters, discuss alternatives such as enclomiphene or human chorionic gonadotropin (hCG)–supported regimens with your clinician.