Men experience a natural decline in testosterone as they age, but in addition to that, testosterone levels are lower and lower in the last several decades, for a variety of reasons ranging from increased obesity rates to stress and poor sleep to hormone-like substances in our environment, like certain plastics and other chemicals, called endocrine disruptors.

There are definite lifestyle modifications that can be done to improve low testosterone, but at some point, most men do require testosterone therapy to maintain optimal hormone levels. In traditional medicine, total testosterone must be below a very low threshold, usually around 264-300 ng/dL, on two occasions, before therapy would be considered, even in the face of symptoms suggestive of low testosterone.

Modern evidence, however, suggests that most men, especially if they have symptoms of low testosterone, feel better and improve many metrics of health when total testosterone is in the upper half or top 25% of the normal range. Testosterone therapy may help to increase muscle mass, maintain or increase libido and sexual function, improve energy levels and motivation, support cardiovascular health, maintain bone density, enhance cognitive function, reduce abdominal fat, and promote overall metabolic health. The goal of testosterone optimization therapy is not just to avoid deficiency symptoms, but to help men feel and function at their best throughout their lifespan.

Testosterone is just one component of overall health - everything in the body is interconnected. For instance, if low testosterone stems from visceral obesity, you likely face other metabolic challenges, such as fatty liver disease, insulin resistance, or lipid disorders. While testosterone therapy offers significant benefits, it requires careful management. Some men experience increases in LDL particle count or blood pressure that could elevate cardiovascular risk, and these side effects must be managed when they occur. It can also raise resting heart rate and reduce heart rate variability - changes our Concierge Members can track with their included Oura ring, often before lab work reveals concerns, allowing for faster, on-the-fly dose adjustments.

Be aware that TRT can cause infertility, and can cause your body to stop making its own testosterone. There are alternatives, like HCG, which can be used instead of, or in conjunction with, testosterone. In some cases, starting testosterone is an obvious choice, but in other cases, it is a nuanced and personal decision, not to be taken lightly. Given these complexities and the need for close monitoring, we only provide testosterone replacement therapy within our Concierge Medicine program, where it is included as part of a personalized, comprehensive health optimization plan for appropriate candidates.

To find out if TRT or HCG would be right for you, contact us to schedule your Longevity Health Assessment at Abendroth Modern Medicine. In it, we evaluate hormone levels alongside dozens of other biomarkers, body composition, bone density, liver health, strength, cardiovascular fitness, and more, alongside a thorough history and physical examination. If testosterone optimization would be beneficial based on your assessment, we'll discuss it in your report and during your consultation, and we can implement treatment as soon as you join our Concierge Medicine program.