Testosterone Therapy

How Does Testosterone Therapy Work?

Testosterone replacement therapy provides the body with an external source of the androgen hormone to compensate for what the body does not provide. TRT acts identically to the body’s naturally produced testosterone, entering the androgen receptor cells to stimulate the many testosterone functions.

When testosterone levels are not in balance, it can throw off numerous other hormone levels, including estrogen and dihydrotestosterone (DHT). Those changes can lead to many breakdowns in the body.

Testosterone’s functions impact androgen receptors throughout the body and brain. Lack of testosterone balance can directly impact the receptors as they will no longer receive adequate signaling. Any functions supported by the receptors may experience a decline in their actions.

The primary functions of testosterone in men include:

• Regulating sex drive
• Supporting red blood cell production
• Maintaining lean muscle mass and bone mineral density
• Regulating metabolism and fat distribution
• Supporting sexual performance and fertility

Testosterone therapy restores critical balance to testosterone levels, providing the receptor cells with an increased hormone supply. TRT goes to work right away, impacting performance at the cellular level. Most males begin to notice positive changes within a few weeks, including:

• Increased sexual interest
• Reduced feelings of depression
• Improvements in inflammation
• Increased motivation
• Less fatigue
• Improved spatial working memory

Over the next few months, men report benefits such as:

• Improved skeletal muscle mass
• Decreased fat mass
• Increased bone mineral density
• Improved red blood cell production
• Reduced serum total and LDL cholesterol
• Increased HDL cholesterol
• Decreased serum triglycerides
• Reduced blood pressure
• Improved erectile functions

Who Can Get Testosterone Therapy?

Men with signs or symptoms of low testosterone may qualify for testosterone therapy. Blood analysis, which measures free and total testosterone and other hormone and blood levels, is a leading factor in determining treatment.

However, it is not the only factor, as some men with low testosterone levels feel fine and have no Low T symptoms. Conversely, some men with T levels at the low end of the normal scale may suffer from significant testosterone-related issues.

Hormone doctors use their discretion and knowledge to determine who can benefit from TRT.

Signs of Low T in men

• Loss of lean muscle mass
• Reduced strength
• Low libido
• Reduced sperm count
• Infertility
• Erectile dysfunction
• Poor concentration
• Memory loss
• Depression
• Brittle bones
• Loss of body or facial hair
• Hot flashes
• Irritability
• Increased breast size (gynecomastia)
• Fatigue
• Insomnia

Low testosterone can arise from many issues, including:

• Testicular injury or cancer
• Cancer treatments
• Chronic disease
• Stress
• Age-related testosterone decline
• Low thyroid function
• Obesity
• Problems with the hypothalamus or pituitary gland
• Other medications or treatments
• Infection

Also called hypogonadism, low testosterone falls under two categories: Primary or secondary hypogonadism. The causes may be congenital (at birth) or acquired later in life during childhood or adulthood. Primary hypogonadism deals with issues regarding the testes, whereas secondary hypogonadism concerns the pituitary gland or hypothalamus.

Congenital conditions associated with primary hypogonadism include:

• Undescended testicles
• Absence of testicles
• Klinefelter’s syndrome
• Noonan syndrome
• Leydig cell hypoplasia
• Myotonic dystrophy

Acquired conditions associated with primary hypogonadism include:

• Anabolic steroid use
• Testicular injury, tumor, or removal
• Chemotherapy or radiation to the testicles
• Mumps orchitis

Congenital conditions associated with secondary hypogonadism include:

• Kallmann syndrome
• Prader-Willi syndrome
• Isolated hypogonadotropic hypogonadism

Acquired conditions associated with secondary hypogonadism include:

• Hypopituitarism
• Brain or head injury
• Brain tumor
• Hyperprolactinemia
• Cushing’s syndrome
• Kidney failure
• Hemochromatosis (iron overload)
• Cirrhosis of the liver
• Obesity
• HIV/AIDS
• Poorly managed diabetes
• Sleep apnea
• Obesity
• Alcohol use disorder
• Some medications

Another condition – late-onset hypogonadism – is a secondary type of Low T associated with the natural aging decline of testosterone production. Decreased hypothalamic-pituitary functions and reduced Leydig cell functions interfere with testosterone and sperm production. Being overweight and having diabetes can exacerbate the decline.

A hormone doctor prescribes testosterone replacement therapy to men diagnosed with Low T. The prescription includes a customized treatment plan that addresses the individual deficiency.

Only legal TRT is effective at treating Low T because it provides the precise dosage required to restore appropriate balance to testosterone levels.

How to get legal testosterone therapy

Getting testosterone therapy begins with having a consultation with a hormone specialist to discuss your symptoms and concerns. You will then complete a medical history questionnaire, physical examination, and blood analysis. Blood tests include:

• Comprehensive metabolic panel (CMP)
• Complete blood count (CBC)
• Total testosterone
• Estradiol (estrogen)
• Lipid panel
• Free T4 (direct)
• Thyroid-stimulating hormone (TSH)
• Insulin growth factor 1 (IGF-1)
• Luteinizing hormone (LH)
• Follicle-stimulating hormone (FSH)
• PSA levels

Other blood tests may be ordered, depending on reported health issues and symptoms. It is crucial to speak with a hormone specialist trained in endocrinology who understands the hormone system’s workings.

If the doctor determines that you have low testosterone, you will receive a prescription for TRT based on the dosage your body needs.

Is Testosterone Therapy Expensive?

TRT is an affordable way to improve testosterone levels and functions in the body. The required dosage is prescribed after comprehensive testing and a thorough review of the individual’s health and physical status. Treatment with testosterone injections is hundreds of dollars less per month than with patches, implantable pellets, or gels.

Testosterone injections come in different forms, and general prices for those are as follows:

Depo-Testosterone
$70 for 1 ml of 200 mg/ml
$300 for 10 ml of 200 mg/ml

Testosterone Cypionate
$275 for 10 ml of 200 mg/ml

Testosterone Enanthate
$275 for 10 ml of 200 mg/ml

Additional options include custom-compounded blends of testosterone cypionate and enanthate, with prices dependent on dosing.

Testosterone boosters are not the same as testosterone replacement therapy. Unlike prescription medications used for TRT, over-the-counter boosters do not actually contain testosterone. Hormone doctors do not recommend boosters for men diagnosed with Low T. Testosterone therapy is crucial to restoring balance to testosterone levels.

A report by ConsumerLab found that of 14 supplements that claim to boost testosterone, some may contain hazardous chemicals, herbicides, or heavy metals. There is no way to know what you are getting when you buy unregulated products.

Because supplements such as testosterone boosters are not subject to FDA approval in the same way as medications, these products have inherent risks. The lack of regulation means you could receive items that can further damage your health.

Another concern is when men purchase TRT illegally from websites that do not require a prescription. Websites not following federal dispensing guidelines may not always provide legitimate and safe medications.

Counterfeit testosterone may come with fake labels, inferior quality, or potentially dangerous substances. It is also illegal to purchase TRT without a valid prescription.

Does insurance cover testosterone therapy?

In some cases, testosterone therapy is covered by insurance. Because there are so many types of insurance policies available, it requires contacting your provider to determine the guidelines for your insurance coverage.

We are often asked about other expenses that can be covered by insurance. Most people will find they are entitled to a yearly physical examination at no or minimal cost. That exam can be used to have the doctor complete the required form for the hormone specialist to review.

Regarding blood tests, not all of the required hormone panels are always covered by insurance. We have heard from many clients who have asked their primary care physicians to order these tests, only to receive bills for hundreds, and in some cases, thousands of dollars in fees after the insurance company turned them down. For that reason, we make prearranged low prices for the required blood panels available to our clients.

How Safe Is Testosterone Therapy?

Doctor-prescribed TRT is one of the safest treatments for men with low testosterone levels. Upon careful review of evidence-based literature and studies by the American Urology Association (AUA), it was determined that there is no evidence linking testosterone replacement to an increase in cardiovascular events.

That had previously been one of the leading concerns about the use of TRT. Years of studies have proven that, when under doctor supervision, TRT is safe and effective at treating Low T.

However, it is vital to note that this does not apply to illegally purchased testosterone injections, which can lead to the following health problems:

• Cardiovascular system: high blood pressure, heart attacks, artery damage, stoke, blood blots
• Infection: hepatitis, HIV/AIDS
• Musculoskeletal system: tendon injury
• Hormonal system: testicular atrophy, reduced sperm count, testicular cancer, gynecomastia (breast enlargement), baldness
• Skin: oily skin, acne, injection site abscess, jaundice
• Psychiatric effects: aggression, delusion, mania, risky actions
• Liver: tumors, peliosis hepatitis

While legal TRT is safe, any medical treatment can lead to potential side effects, the most common being injection site reactions such as redness, itching, irritation, or pain. These symptoms are typically short-lived. Acne, oily skin, breast enlargement, and decreased sperm count are other common side effects.

The best way to reduce the risk of side effects is to receive your TRT prescription from an experienced hormone doctor who understands the nuances of balancing hormone levels. Taking testosterone safely means following all guidelines for administering your medication.

If any side effects occur, contact your doctor for guidance. Do not change the dosage or frequency of injection without doctor’s authorization.