TRT Management

Follow-up appointments are crucial to ensure your TRT protocol is optimized and safe. Typically, our schedule includes:

• • Initial follow-up: 6-8 weeks after starting treatment
• • Second follow-up: 3 months after starting
• • Regular monitoring: Every 3-6 months once your protocol is stable

These appointments include blood work to monitor your hormone levels and other health markers, as well as discussions about your symptoms and any adjustments needed to your protocol.

Regular monitoring while on TRT typically includes:

• • Hormone Panel: Total testosterone, free testosterone, estradiol, SHBG
• • Complete Blood Count (CBC): Monitors red blood cell production and hematocrit
• • Comprehensive Metabolic Panel (CMP): Assesses liver and kidney function
• • Lipid Panel: Monitors cholesterol and triglycerides
• • Prostate-Specific Antigen (PSA): For men over 40 or with prostate concerns

The frequency of testing depends on your individual response to treatment, protocol adjustments, and how long you've been on TRT. We typically recommend comprehensive testing every 3-6 months for stable patients.

Optimal injection frequency and dosing are personalized based on your lab results, symptoms, and individual response. However, we generally recommend:

• • Frequency: Most patients benefit from twice-weekly injections (every 3-4 days) rather than once-weekly, as this provides more stable hormone levels and reduces side effects
• • Dosing: Typical total weekly doses range from 100-200mg, split into two injections
• • Injection technique: We provide detailed instruction on proper subcutaneous or intramuscular injection methods

Your protocol may be adjusted based on your lab results and symptom response. We encourage patients to track their symptoms between appointments to help optimize their protocol.

While TRT is generally well-tolerated, some patients may experience side effects. Here's how we help manage common concerns:

• • Elevated hematocrit: May require therapeutic phlebotomy, donation of blood, or protocol adjustments
• • Estrogen-related issues: Managed through injection frequency adjustments, dose modifications, or in some cases, prescription of an aromatase inhibitor
• • Testicular atrophy: Can be addressed with hCG for patients concerned about fertility or testicular size
• • Acne or oily skin: Often improves with protocol adjustments and proper skincare
• • Hair thinning: Uncommon but can be addressed with specific interventions if needed

Our approach focuses on prevention through proper protocol design and regular monitoring. We encourage patients to report any side effects promptly so we can address them quickly.

TRT works best when combined with healthy lifestyle practices. We recommend focusing on:

• • Nutrition: Balanced diet with adequate protein, healthy fats, and micronutrients
• • Exercise: Regular resistance training to maximize the anabolic benefits of optimized testosterone
• • Sleep: Prioritizing 7-9 hours of quality sleep, as poor sleep can counteract TRT benefits
• • Stress management: Chronic stress can impact hormone balance and diminish TRT results
• • Alcohol moderation: Excessive alcohol can increase aromatization and negatively impact results

We provide personalized lifestyle recommendations as part of your treatment plan and can connect you with specialists in nutrition, fitness, and stress management if needed.

Traveling with TRT medication requires some planning:

• • Domestic travel: Carry your medication in original, labeled prescription containers
• • International travel: Bring a copy of your prescription and a letter from your doctor
• • TSA considerations: Needles and syringes are allowed in carry-on when accompanied by labeled medication
• • Temperature control: Testosterone is stable at room temperature but avoid extreme heat
• • Timing considerations: Plan your injection schedule around your travel dates

For extended travel, we can help you plan your protocol and provide necessary documentation. Contact us at least two weeks before international travel to ensure you have everything you need.

If you miss a scheduled injection:

• • Less than 48 hours late: Simply inject your normal dose and continue your regular schedule
• • More than 48 hours late: Inject as soon as possible and then adjust your schedule accordingly
• • Multiple missed doses: Contact us for guidance on safely resuming your protocol

Consistency is important for maintaining stable hormone levels, but occasional timing variations won't significantly impact your overall results. We recommend setting reminders to help maintain your schedule.

TRT is typically considered a long-term treatment for most patients. Important considerations include:

• • Primary hypogonadism (testicular failure) generally requires lifelong treatment
• • Secondary hypogonadism (pituitary/hypothalamic issues) may sometimes be reversible
• • Discontinuing TRT without addressing the underlying cause will usually result in a return to low testosterone levels
• • Some patients may eventually transition to alternative approaches depending on their health status and goals

We view TRT as a partnership in your long-term health and will regularly evaluate your treatment plan to ensure it continues to align with your health goals and needs as they evolve.