How To Start Testosterone Replacement Therapy.

Testosterone is only legally available in the United States with a prescription from a licensed physician. So, qualifying for testosterone replacement therapy typically involves a comprehensive evaluation from a healthcare provider, like an endocrinologist, urologist or an internal medicine specialist. Surprisingly, not all physicians are well educated in this particular field of healthcare, as it’s really a specialty subsection of endocrinology.  For example, many endocrinologists are heavily focused on treating patients with thyroid disorders or diabetes. Many urologists focus their practice on treating patients with urinary disorders or prostate issues.  It’s extremely important to determine whether or not the physician you are seeking help from is experienced in hormone replacement therapy.

How To Diagnose and Treat Low Testosterone

When doctors are prescribing testosterone to patients, it is to treat either andropause, hypogonadism or testosterone deficiency. To qualify for testosterone replacement therapy, a diagnosis needs to be made by the prescribing physician. If a patient is presenting with the symptoms that are consistent with having low tea, a physician will typically provide a prescription after having a thorough consultation, medical history, and review of bloodwork.
    As our hormone levels will fluctuate daily, depending on factors, like diet, exercise, and even the time of day or year, physicians will usually try to get bloodwork performed earlier in the morning, where testosterone levels are at their highest.

    Some physicians may require multiple tests, and I’ve heard often of patients who attempt to go through their insurance for TRT, that they need to have multiple tests all with values below normal ranges to qualify.  At best this approach does nothing more than treat lab values and ignores the signs or symptoms that many patients often present with.  In theory, a healthy 35-year-old male may have testosterone levels that are in the bottom 10% yet because they may be slightly above the threshold the insurance company uses to determine low testosterone, they may not qualify for TRT through their healthcare, plan. It’s for this reason that so many patients are willing to come out of pocket and pay cash for services that provide them with physicians that are treating them as individuals as opposed to following the arbitrary reimbursement policies of a healthcare insurance provider.

    Typically a blood test would involve Free and total testosterone, as well as estradiol, a PSA, complete blood count and complete metabolic panel.  Sometimes the physician may also include TSH to check for thyroid function, as well as LH, FSH and even SHBG.   Depending on who you ask, and age, the typical testosterone levels can vary from 270 to 1070 ng/deciliter for men. Testosterone is a hormone which plays an extremely important role in several bodily functions, including lean muscle development, bone mineral, density and health, cognition, the production of red blood cells, as well as the production of sperm as well as sexual and reproductive functioning in men.  So, what are some of the criteria to qualify for TRT?

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Low testosterone levels. After a blood test to measure your Free, in total testosterone levels, they may indicate that you are below normal ranges, and you would therefore be considered a possible candidate for TRT.

Showing signs and symptoms of having low testosterone.

There are many signs associated with low tea, such as fatigue, no libido, mood, swings, poor, sleep, quality, losing muscle tone, and mass, weight gain , lack of confidence and more.  Typically the signs and symptoms are an indication of having a hormone imbalance, and one of the first steps someone can take is taking the hydrogen deficiency in aging males questionnaire, otherwise known as the ADAM Test.

Having a health assessment from a physician for TRT.

A patient’s overall health and medical history will need to be discussed and evaluated to make sure that TRT is safe for you. This usually includes checking for medical conditions that may be contraindicative of TRT like prostate cancer or certain heart conditions.  It’s important to have a thorough evaluation from a licensed and experienced doctor before starting hormone replacement therapy.

Discussing the possible risks and benefits with your doctor.

    It’s important that you don’t go to a physician or a clinic that are just trying to get you to sign up and the biggest red flag is if the doctor does not discuss possible risks.  If they only tell you about the benefits, they are doing you a disservice. You need to be able to make an informed decision, and that would include knowing about how to potentially look for and mitigate any side effects associated with testosterone therapy.

Careful monitoring, and testing.
For any patient that qualifies and begins testosterone replacement therapy, it’s important to regularly monitor your blood and hormone levels, as well as your overall health. This way the physician and patient can work together to determine the effectiveness as well as safety of treatment.

    There is many different ways to administer testosterone however, the two most common you’ll find being prescribed for patients on testosterone replacement therapy are the following:

Injectable testosterone

Testosterone is typically an inexpensive and common medication used in TRT. Patients usually are prescribed a shorter acting form of testosterone, such as testosterone cypionate which has a half-life of about one week.  There are other forms of testosterone which may require less frequent administration. However, the studies seem to indicate that they do not have the same level of consistency regarding their testosterone levels as they may begin to decrease after several weeks.  Most patients that are on testosterone will opt for a weekly self-administered injection typically intramuscularly in the gluteal muscles.

Topical creams and gels for TRT

    The transdermal absorption of testosterone through the utilization of gels, and or creams is also fairly common. These need to be applied on a daily basis as the half-life of the medication is only about a day.  If done consistently, it’s a very good way to maintain consistent testosterone levels.  The downside is that the gel/creams need to be applied every day at approximately the same time which may be inconvenient and patients tend to have lower levels compared with the levels we see in patients on injectable testosterone.


    It’s important to consult a qualified, healthcare, professional determine if TRT is appropriate for your specific medical needs. It is not suitable for everyone and could have not just benefits but potential side effects and risks, which is why speaking with a physician who is knowledgeable in this field is paramount.
If you or anyone, you know, may be interested in learning more to see How You Can Get a Prescription for Testosterone or if TRT is appropriate for you. Please feel free to reach out as the medical team at NovaGenix would be happy to answer any questions and even schedule a free initial consultation with our physician.

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