About testosterone replacement therapy

Testosterone is a hormone produced naturally by the body that helps a man maintain energy, mood, bone strength, sex drive, sexual function, muscle mass, and strength. Most of the testosterone in a man's body is produced in the testicles.

NORMAL LEVELS OF TESTOSTERONE

Just like your cholesterol or blood pressure, there are ranges for testosterone levels that are considered normal. The brain and the testicles work together to keep testosterone in this range. When levels of testosterone are below normal, the brain signals the testicles to make more. When testosterone levels reach a normal level, the brain signals the testicles to make less. Normal levels of testosterone change as you age.

DO I HAVE LOW TESTOSTERONE?

Some people are more likely to have low testosterone than others. There are also certain medical conditions that increase the odds of having low testosterone that you may be unaware of that have an effect on your testosterone levels.

These include:

Obesity
Diabetes (Men age 45 and older with diabetes are twice as likely to have low testosterone.)
High blood pressure
High cholesterol
Asthma/Chronic obstructive pulmonary disease (COPD)
HIV

Signs and Symptoms of Low Testosterone

Because low testosterone signs and symptoms may not be clear and apparent, they may seem to be a normal part of aging or assumed to be caused by other health conditions. Signs and symptoms of low testosterone may include:

Fatigue or loss of energy
Low sex drive (reduced desire to be intimate)
Sexual dysfunction (weak erections, failure to get erections)
Depressed mood
Decreased sense of well-being
Increased body fat
Loss of muscle mass
Decreased bone strength

These symptoms may be a sign of low testosterone or other health conditions and should not be ignored. Low testosterone can be diagnosed by a doctor with a simple blood test. It's important to keep your testosterone at a normal level for your age. The right treatment can bring your testosterone levels back to normal and keep them there. And once you get back the testosterone you've been missing, you may experience lasting symptom relief.

WHAT IS LOW TESTOSTERONE?

Low testosterone can be caused by a signaling problem that occurs between the brain and the testicles that causes the production of testosterone to drop below normal. The brain may also signal the testicles to cut testosterone production if it feels the body has too much testosterone. Low testosterone also can occur when your testicles can't make normal levels of testosterone. Low testosterone affects more than 13 million men in the U.S. over the age of 45. Even though it's natural for men to lose testosterone as they age, the medical condition hypogonadism, also known as low testosterone, is not a natural part of aging. Typically, there is no cure for low testosterone. It is a medical condition that may require ongoing treatment.

Benefits of Optimal Testosterone levels:

Increase in muscle mass and loss of fat
Increased sex drive/libido
Improved erectile function (in men)
Improved concentration
Improved mood and sense of well-being
Increased energy and motivation
Increased strength and athletic performance
Quicker recovery time after workouts
Increased bone strength
Improved sleep

There are numerous additional benefits of optimizing your testosterone levels that aren't listed. The purpose behind testosterone replacement is to make your body more functional. Functional medicine helps create an environment where the body can function at it's best. With your testosterone levels optimized you can enjoy these benefits plus much more. The choice of hormone replacement therapy is best made with a thorough discussion between you and one our doctors here at Transformyou. This can be discussed at your free testosterone replacement therapy consultation.

Additional Resources

CAN WOMEN HAVE LOW TESTOSTERONE?

Simply put, yes! We often mistake testosterone as the “male” hormone. While it’s true that men do produce ten times more testosterone than women, it still plays an important role in the health of women. This is especially true during a woman’s reproductive years when there is actually more testosterone produced in a woman than estrogen. Learn more about women's need for testosterone and the effects of low testosterone in women.

Download the Testosterone De-Mystified Ebook

An androgen (hormone) deficiency is often difficult to identify, as many women will think the symptoms result from psychological or lifestyle issues rather than a biological disorder. A low level of androgens can also result in reduced bone density that can predispose to osteoporosis.

Signs and symptoms of low testosterone in women may include:

Fatigue or loss of energy
Low sex drive (reduced desire to be intimate)
Depressed mood
Decreased sense of well-being
Increased body fat
Loss of muscle mass
Decreased bone strength

To confirm that a woman is suffering from androgen deficiency, the levels of testosterone and sex hormone binding globulin (SHBG) need to be evaluated. Research has shown that if a woman's level of "free" testosterone (calculated from the total testosterone level and the SHBG) is low, this produces symptoms of androgen deficiency even if levels of total testosterone alone appear "normal."

Additional Resources:

See how different levels of testosterone affect women.

Testosterone Replacement Therapy Options

Low testosterone can be easily diagnosed with a simple blood test and treated with testosterone replacement therapy (TRT) to bring your testosterone levels back to normal. The testosterone replacement therapy options available are:

Intramuscular Injections
Sublingual troches that are taken daily
Testosterone creams that are applied daily to the shoulders, upper arms, or abdomen

Each of these options provides adequate levels of hormone replacement. Each has side effects and advantages and disadvantages.

Additional Resources

TESTOSTERONE REPLACEMENT THERAPY: STEPS TO GET GOING

Call 480-839-4131 or fill out a consultation request form and schedule a free consultation with one of our licensed physicians.
If you have recent labs showing testosterone levels please bring them with you to the consultation.
If you don't have recent labs, we can order them for you when you are at your consultation. Your health insurance will most likely cover the labs. For those paying cash we can draw your blood in our office and send it off to the lab. The fees associated with labs are the patients' responsibility at the time of the blood draw.
Once we know you need testosterone therapy we can dispense it to you from our office. If you require a higher dose or need a blend of testosterone that we do not stock in-office, it will be ordered from the pharmacy.
Our Doctors will teach you how to self-administer the testosterone injections or cream. Injections are done either once or twice a week. By self-administering the injections there is no need to come to the office for a shot. Stop making weekly visits and paying office visit fees elsewhere. Our Doctors will teach you how to give yourself the shot so you can save time and money! If you are uncomfortable giving yourself a shot, our physicians can do it each week for no extra cost. Testosterone cream is administered every day.
5-6 weeks after treatment has begun it is a good idea to have your testosterone levels rechecked to make sure the levels are improving. This also allows us to make any necessary dosage adjustments.

Treatment programs are always provided at a flat fee, meaning you know the cost of the entire therapy program up front with no hidden costs. FSA and HSA cards are also acceptable forms of payment for growth hormone therapy and are accepted at transformyou.

The Controlled Substances Prescription Monitoring Program (CSPMP) is a program developed to promote the public health and welfare by detecting diversion, abuse and misuse of prescription medications classified as controlled substances under the Arizona Uniform Controlled Substances Act. Every Physician who possesses a DEA registration is required to also possess a CSPMP registration issued by the Arizona Board of Pharmacy. At transformyou, we adhere to Arizona's CSPMP policy before prescribing a controlled substance to any patient.

All patients always work directly with one of our licensed physicians to ensure patient safety and confidentiality.

CURIOUS ABOUT TESTOSTERONE REPLACEMENT?

If you have any questions in addition to the ones below, schedule a free consultation with Dr. Bird where you will be able to go over many of the questions and concerns pertinent to you. Call 480-839-4131 or fill out a consultation request form to schedule your initial consultation regarding testosterone replacement therapy.

Q: Where are you located?

A: We are located outside of the metro Phoenix area in Tempe. We serve patients all over the country as long as there is an initial face to face visit. Patients can be monitored remotely after the first visit.

Q: What types of Testosterone do you use?

A: We use Testosterone Cypionate, Testosterone Propionate, Testosterone Enanthate and Testosterone cream.

Q: Is it true that a man's Estrogen can rise once Testosterone replacement has begun?

A: Yes, as a matter of fact this will happen almost to everyone who begins treatment. Testosterone is converted to Estrogen through an aromatase enzyme. To prevent this from happening during treatment we will use a medication called an aromatase inhibitor so that your Estrogen levels stay low.

Q: Will my body be able to produce its own Testosterone after treatment?

A: In many cases, yes, we use two medications during and after treatment to help you body continue to produce its own Testosterone. If you have a true problem where your body is unable to make its own Testosterone then you may have be on continuous treatment. We can determine where the problems is after one cycle of Testosterone replacement.

Q: What if my blood test shows lower levels of Testosterone but the lab didn't mark it as low?

A: Testosterone has quite a large numerical range of what they call "normal levels." It could be anywhere from 250 up to 1100ng/dl depending on which lab service is used. Even if you are at the low end of normal you can begin treatment. Most men feel their best when their serum levels are between 600-900ng/dl.

Q: What is the difference between serum and free Testosterone?

A: Serum testosterone is basically your total testosterone level as measured in your blood. Free testosterone is the testosterone in your blood that is not bound to sex hormone binding globulin (SHBG). It is this free testosterone that is biologically active meaning it's able to exert it's effect by permeating a cell and activating its receptor.

Q: Is SHBG (sex hormone binding globulin) bad?

A: Reducing SHBG will increase free testosterone and a rise in SHBG will decrease free testosterone. So it could be bad if you had high levels of it. Certain substrates, hormones, nutrients and even food have an effect on increasing or decreasing SHBG. High insulin levels as well as high IGF-1 levels decrease SHBG. Estrogen increases SHBG.