Testosterone Replacement Therapy TRT: What to Know

Testosterone therapy: Potential benefits and risks as you age

If a man’s testosterone is below the normal range, it’s best to repeat it once more to be sure before starting testosterone therapy — often staying on it indefinitely. Men get started on testosterone replacement and they feel better, but then it’s hard to come off of it. Men can often feel a big difference when they stop therapy because their body’s testosterone production has not yet recovered. Just being tired isn’t enough to seek testosterone replacement therapy. General fatigue and malaise has so many other causes, and when most men get a blood test, the result is a normal testosterone level. The blood tests measure total serum testosterone, complete blood count (hematocrit), and prostate-specific antigens (PSA). People can expect to have these blood tests at the start of the treatment, then three to six months later.

Research recommends that clinicians need to exercise caution when prescribing TRT to people who have severe obstructive sleep apnoea. Males aged 40 years older, preadolescent people, and those with migraine or epilepsy may require special considerations. For all these reasons, your healthcare provider will carefully consider if TRT is safe for you based on your unique characteristics.

That is because unlike other clinics, we give patients the choice to provide us with labs or, they can run labs through us. SQ testosterone pellets were initially developed and FDA approved in 1972 and were reformulated in the USA in 2008. The product is provided in a metered pump that supplies 5.5 mg of testosterone per actuation. The recommended dose is two pumps (one to each nostril) applied three times daily. An intranasal testosterone gel applied topically into the nose was approved by the FDA in 2014.

The pharmacokinetics of short-acting testosterone therapy depends on the dose, interval, and method of delivery (SQ versus IM). The half-life for IM testosterone was also shorter at 173 hours versus 240 hours for SQ testosterone. Mean testosterone values over a 7-day time period were 1,659, 896, and 422 ng/dL for IM testosterone SQ 100, and SQ 50, respectively. At this time, there is no definitive evidence indicating what the optimal time interval should be between the two separate tests.

Testosterone enanthate injection (Xyosted) comes as a solution (liquid) to be injected subcutaneously (under the skin) once a week by yourself or a caregiver. This decline in hormones can result in a variety of symptoms including low motivation, decreased stamina and energy, depression, hot flashes, loss of muscle mass and mood swings. Irwig is talking about “direct-to-consumer” online health platforms that offer telehealth services and brick-and-mortar “Low-T” clinics that provide testosterone and other medications specifically for men’s health. Instead, they make money offering testosterone prescriptions (and medications for things like hair loss or erectile dysfunction) directly to men, often included in pricey monthly membership fees. And ads for testosterone therapy have expanded from TV to social media and online advertising, points out Irwig. The barrage of ads and easy access to doctors who prescribe testosterone has convinced many men that they need to take the hormone. There’s also variation in how individual men feel at a given testosterone level.

Frustrated that her doctor didn’t offer more help, she went to a local medical clinic at a friend’s urging and started testosterone pellet therapy, a more potent version of the hormone. For Marcella Hill, 44, the symptoms of depression, body aches and low sex drive were affecting her relationship with her husband. Voedisch, who has been in practice for decades, says the phenomenon among women really started to take off just in the last couple of years.

The main difference between injectable testosterone cypionate and enanthate is the carrier oil. This takes longer to prepare, draw into the syringe, and inject. Cypionate uses olive oil as a carrier, which is far less viscous and easier to inject. Otherwise, the two formulations are used almost interchangeably. Your personal risk, however, including the contraindications cited above, can vary and should be discussed further with an andrology specialist. Erectile dysfunction is one such symptom of low testosterone that may also be an indicator of poor carbon dioxide blood test normal range circulation caused by atherosclerosis, or narrowing of the arteries.

If a person has TRT as a treatment for a health condition, their medical insurance should cover this cost. TRT treatment length is indefinite unless the low levels are due to an underlying cause that is treatable. If any individual takes medications they believe lowers testosterone, they should consider discussing this with their doctor. A doctor will recommend a dosage ranging from 225–396 mg, and a person will typically take oral testosterone tablets twice daily. Oral testosterone is a less common type of TRT that is more expensive and less practical.

The treatment is also fine, he says, if patients have severe and consistent low testosterone levels with no active prostate or breast cancer, and no drugs or treatable or reversible medical conditions causing those levels. It’s important to keep in mind that the goal of testosterone replacement therapy is simply to replace testosterone, not to boost it above average levels. Most men with normal levels who take an average dose of testosterone won’t notice much of an effect, Anawalt says. And whether taking additional testosterone when you already have normal levels increases your risk of heart disease, prostate cancer, or anything else is unknown.