Helping you find your increased libido and energy level, along with improved bone density, strength and lean muscle mass.
Common symptoms of low testosterone levels include: low libido, lack of motivation to exercise or accomplish tasks in general, fatigue, and trouble either losing weight or gaining muscle mass in spite of their best efforts. Many guys with low T levels feel they just aren’t the same as they used to be. This could also include irritability, lack of focus, depression & erectile dysfunction. Though results certainly vary, most men will notice a significant increase in libido and overall energy/motivation within about 1 month of starting testosterone replacement therapy. It is not uncommon for men to say that they feel overall better, even years younger. They often have better erectile function and better results in the gym, especially when combined with a good diet & exercise regimen. Guys who are overweight who combine TRT with GLP-1 agonists are seeing significant weight loss while keeping or building muscle mass.
Your most accurate (free and total) testosterone levels would be determined by drawing your blood work first thing in the morning, ideally around 7-10 a.m. (A second set of labs may be needed for confirmation, particularly if you are applying for insurance coverage for certain options such as topical gels or the Xyosted autoinjector. Your levels can be affected by various factors such as stress, sleep, and physical activity. A common lab panel for first-timers would include your total T, free T, SHBG, FSH, LH, prolactin, A1c and vitamin D. We can set you up for a lab draw at any lab closest to you (ie, Quest, Lab Corps, CPL, etc.). We also offer a discounted lab panel for those without insurance if drawn in-office. Testosterone levels may begin to decline at around age 35, often in men with poor sleep, increased belly fat, increased stress, prediabetes, and other signs/symptoms of generally poor metabolic health. Although diet & exercise can and sometimes does help, most men are unable to significantly raise their levels on their own. This is likely because it takes a significant commitment to lose the amount of weight needed and address or change one’s lifestyle. If your levels are low, we would still want you to adopt a healthy lifestyle while also looking at the various pharmacologic ways to increase your levels and find the best fit that is safe, effective and affordable.
At DurraniMD, we specialize in all forms of testosterone replacement therapy (TRT). If you would like to boost your own native T levels and/or preserve your fertility potential, I would recommend Clomid or enclomiphene citrate. Back up options would be Natesto nasal T gel and/or HCG monotherapy. If you already have children or if you are not looking to preserve fertility, you may select from any option ranging from testosterone gels, shots, autoinjectors, oral meds, and/or pellet therapy. Each of these have their own pros and cons. My staff and I would be happy to help you find the best fit. Again, whichever option chosen should be safe, effective, easy, and affordable.
Overall, testosterone therapy is safe and easy to monitor. Contraindications to treatment are rare but include: active prostate cancer, elevated hematocrit (over 50%), uncontrolled heart failure, untreated obstructive sleep apnea, and a desire for fertility (see other alternatives described above). Research shows that TRT can be given safely to men who have already been treated for prostate cancer with no sign of recurrence and to men in their 60’s and 70’s and beyond who are otherwise healthy. The most common trouble-shooting issues while on TRT include checking Hct and estradiol levels and advising on whether to recommend a therapeutic phlebotomy and/or estrogen-blocker, respectively. Finally, men who wish to preserve testicular size and/or function may also choose to begin HCG injections alongside TRT. This is not as common, but certainly an option for those where it is indicated or preferred.
