Your Guide to Testosterone Replacement Therapy

Your Guide to Testosterone Replacement Therapy

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Contents Overview What is Testosterone? What is a Normal Testosterone Level? When Does Testosterone Begin to Decline? Understanding the Issue An Everyman Issue Symptoms of Low Testosterone Why Seek Treatment? If Low T is a Normal Rite of Passage, Why Bother? What about the Stigma? 4 4 5 5 6 6 7 8 8 9 The Treatment Process How do I Know for Sure that Testosterone is the Problem? How is Testosterone Administered Social Considerations What Will People Say? Aftercare What about Side-Effects? Importance of Follow Up The Good News Benefits of Treatment But What about the Controversy Cost Considerations Is Treatment Expensive? 10 10 10 11 11 11 11 12 13 13, 14 15 15 15 15

Overview What is Testosterone? The word testosterone may just conjure the image of a football team or body builder. The truth is though, testosterone is found in both men and women. While it is true that males possess 10-20 times more testosterone than females, the hormone plays an important role in the wellbeing of both sexes. At Low T Health Center we cater to men and your specific set of testosterone needs. Testosterone is like the Pony Express of hormones, sending messages from one part of the body to another. Produced primarily by the testes, testosterone is controlled in the brain by the hypothalamus and the pituitary gland. Low testosterone - or Low T - can negatively impact some of the most important functions of the male body. LOW T MEDICAL HEALH WEIGHT CENTER LOSS 4

We recommend that men as young as 30 begin monitoring. What is a Normal Testosterone Level? T levels between 350 ng/dl and 1,000 ng/dl are considered normal. At this range your body allows the brain and testes to work in tandem, keeping everything fairly level. The brain sends periodic signals that stimulate the production of testosterone. As you age, the signals become less frequent, causing testosterone levels to drop. When does Testosterone Begin to Decline? It is difficult for many men to believe that the production of testosterone naturally begins to decline in their 30s. After all, at 30-something a man is just establishing a career, starting a family, and beginning to dream of new mountains to climb. By the time he is 40, a man is losing testosterone by 1.6 percent each year. No matter how hard he works to hold on to his youthful body testosterone levels decline, slowing ushering in a host of issues. Because testosterone loss is a normal part of growing older, we recommend that men as young as 30 begin monitoring. 5

Understanding the Issue An Everyman Situation The American Diabetes Association estimates that as many as 13 million men in the US have Low T. Of those, less than 10 percent are currently being treated. Among men with low testosterone, 70 percent report trouble maintaining an erection while 63 percent report low sex drive. That translates into millions of men who are suffering needlessly, living a less satisfying life than necessary. At its extreme, a lack of testosterone renders a man infertile. Relatively few men experience a total lack of testosterone, although any man fortunate enough to live long enough will experience a loss of the powerful hormone. Next time you are in a sports arena or restaurant, look around. You can bet that every man around you is either in the middle of, or about to begin, testosterone loss. Maybe women have the right idea. For centuries, women have turned to other women with questions regarding hormone changes. That has not historically been the case for men, although the tide may be turning. Perhaps it is time that men invest time and energy into finding a way to feel great again, even if it means putting yourself out there to do so. 6

Symptoms of Low Testosterone Early signs of testosterone loss can be subtle. The onset tends to occur just as a man is at his busiest, making it easy to chalk symptoms up to other issues. Among the indicators of low testosterone are: Decrease in sex drive Erectile dysfunction Decrease in bone mass Increase in abdominal fat Decrease in strength Diminished muscle size Changes in mood A reduction in intellectual powers Trouble concentrating Depression Fatigue Anger Loss of body hair Changes to skin Reduced energy Sleep problems Increased breast size or tenderness Reduced penis or testicle size 7

Why Seek Treatment? If Low T is a Normal Rite of Passage, Why Bother? There is good news, and then there is better news. A decline in testosterone is normal. In fact, all men will experience it. There is no shame, no embarrassment. One man may suffer from a particular set of symptoms while another suffers from others. It is a natural part of the human experience. It is also natural to ask, Why mess with Mother Nature? If Low T is going to happen anyway, who am I to stop it? Those are profoundly personal questions. We understand that there are men who are satisfied with the changes brought about by Low T and are not anxious to do anything about them. However, our patients tend not to feel that way. Medical science is clear as to how Low T impacts the male body and has discovered concise ways to bring testosterone levels to a more acceptable level. Our patients want to take advantage of scientific advances in order to feel more like themselves. Only you can answer how willing you are to allow Low T to impact your everyday life. The men who visit us frequently say that they long for the energy they enjoyed as a younger man or want to get rid of that spare tire that has slowly crept onto their body. Visiting our office is only the first step. 8

Start doing all the things you ve wanted to do. What about the Stigma? There was a time when men were unwilling to talk about their symptoms, even with their doctors. They assumed that any changes they experienced were normal and inevitable. Today, no one expects a man to live with loss. If a man is depressed, he seeks help. When fatigue takes over, he discovers the reason why. When belly fat gives him cause for concern, he seeks out a solution. When he can no longer perform in the bedroom, he gets to the bottom of the issue. Humans are living longer than ever, begging the question: Who wants to live for decades with troubling health issues that can easily be addressed? 9

The Treatment Process How Do I Know for Sure that Testosterone is the Problem? Just as a woman begins to sense when the symptoms of menopause have kicked in, men know when their everyday functions become more of a challenge. In fact, Low T is sometimes referred to as male menopause. The first step to talk to us. Diagnosis includes a physical exam, complete medical history workup, and laboratory tests. We will run blood tests to measure testosterone levels and let you know where you fall on the spectrum. If those blood tests indicate Low T, we can tell you precisely how low they are and explain your options. We will also want to make sure that your Low T is not due to any medications you take or other conditions that can be treated. As great as proper testosterone levels are, no responsible clinician would prescribe them in an attempt to stop the aging process, give you bigger muscles, increase athletic performance, or to increase sex drive. The hormone is prescribed only for those with naturally declining testosterone levels, and then only through a carefully monitored dosage. How is Testosterone Administered? Testosterone is never a one-size-fits-all solution. Not only will each patient need a different dosage to feel their best, but your doctor will also determine which method of administration will work best for your individual situation. Most commonly, we administer testosterone through injections, however we are now certified through BioTE Medical so we can offer Hormone Pellets that only need to be inserted every 6 months. We find people who are very busy love this route as there's no need to remember daily creams or weekly injections. 10

Social Considerations What Will People Say? Unless you decide to share the news, there is no reason for anyone to know that you are receiving testosterone replacement therapy. People are likely to notice that you have lost that spare tire, gained muscle mass, or seem more like the old you. Why not let them believe that you have changed your diet, exercise habits, and are otherwise taking better care of yourself. Strictly speaking, it s true. Aftercare What about Side-Effects? The truth is, few good things in life are risk free. While side-effects of testosterone replacement therapy are relatively rare and almost always minor they can still occur. Let your doctor know if you experience any of the following: Mild fluid retention Breast enlargement Oily skin Acne Worsening of sleep apnea Decreased size of testicles Increased aggression Mood swings Change in urination habits Any sign of a blood clot 11

want to stay ahead...we value your health and of any problems that may arise. Importance of Follow Up Your regular follow up appointments will achieve several goals. Not only will we insure that you are tolerating testosterone replacement well, but you will also have the opportunity to tell us how you are feeling. We will also conduct laboratory tests to check for issues such as: Changes in cholesterol and lipid levels Increase in PSA Decrease in sperm count, particularly in younger men Increase in red blood cell count Problems such as these are not generally an issue, but we value your health and want to stay ahead of any problems that may arise. If a problem is discovered, we will adjust your dosage in order to minimize complications. 12

The Good News Benefits of Treatment It is a savvy patient who weighs risks against reward. Our patients regularly tell us how much they feel like themselves again, and how sorry they are that they waited so long to seek help. Among the reported benefits are: Help fighting depression. Studies have shown that men who suffer from depression frequently have low testosterone levels. The question becomes one of which problem occurred first. Scientists wonder whether Low T causes depression or whether depression somehow accelerates Low T. In either case, our patients tell us is that their moods improve after doctor-ordered testosterone treatment. As with any other testosterone issue, proper dosage is key. TRT can make those workouts worth your time. If, like many aging men, you are frustrated by how difficult it has become to build muscle mass and get those abs back into beach-worthy shape, testosterone may help. It acts by increasing muscle protein synthesis, giving your muscles the kick start they need to respond to regular exercise. Our patients tell us that seeing results is a powerful motivator. The more positive changes they see to their bodies, the more inspired they are to work out. Patients regularly talk to us about their desire to decrease body fat. What they often don t realize before we tell them is that testosterone plays a role in controlling insulin and glucose, and also helps the body metabolize fat. The Catch-22 of body fat is that as testosterone decreases, fat increases. As fat increases, scientists believe that it causes testosterone to decrease further, converting it into estrogen. This theory helps explain why obese men frequently have a higher level of estrogen and less-than-normal levels of testosterone in their blood streams. While body fat may not be the primary reason men first visit us, the loss of body fat is one of the first things they brag about when they return! 13

TRT may help strengthen your heart. Okay, that statement may be a little misleading, but hear us out. The scientific community is split in regard to how testosterone impacts heart health. What is clear to all involved is that other benefits greater muscle mass, less body fat, and increased energy can be beneficial to cardiovascular wellbeing. Testosterone can protect against osteoporosis. Osteoporosis is generally associated with women, however, weak bones can impact men as well. Testosterone makes bones stronger by stimulating bone mineralization and decreasing bone resorption. Why not begin now to protect your bone health as you age? Surely, you want to be out there on the golf course or handball court in retirement. Testosterone improves erections and increases sex drive. This is likely the least surprising of all testosterone benefits. Because testosterone is a sex hormone, most men notice problems in the bedroom first. It is also one of the first areas of improvement reported by many of our patients. TRT may decrease the incidence of Alzheimer s Disease. A study by the University of Hong Kong followed 153 Chinese men aged 55 and older. Of the 153, 47 showed mild cognitive impairment at the beginning of the study. With one year, 10 of those 47 men had moved into the early stages of Alzheimer s. These same men showed low levels of testosterone. Dutch researchers found a link between T levels and overall cognitive function, leading to the theory that testosterone may play a role in preventing brain decay. 14

But What about the Controversy? It is the misuse of TRT that makes headlines. Bodybuilders and professional athletes hoping to achieve quick results have been known to purchase the drug on the black market. This was never how testosterone replacement was intended to be used. TRT is designed to replace testosterone that has naturally declined and to bring men back to a healthy level. Any substance can cause damage when it is misused, giving you one more reason to work with a seasoned medical professional. Cost Considerations Is Treatment Expensive? We currently accept cash payment, but will be happy to work with you to find out if your insurance company reimburses testosterone replacement therapy (many do). Even if your insurance company does not reimburse you for testosterone replacement, you should weigh the potential mental, emotional, and physical benefits against the reasonable costs associated with treatment. With treatment plans ranging from $149.99 - $259.99 per month, our program can be worked into most budgets. 15

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