What is testosterone?
Testosterone is the male sexual hormone produced naturally by the body. It aids in the maturity of the male sex organs, and other aspects of typical male growth. It is produced in the testes and regulated by the hypothalamus and the pituitary gland both located in the brain. Along with male sexual development, testosterone also increases hair growth and distribution on the body, increases muscle and bone mass, and promotes higher energy levels, mood and libido.
What are symptoms of low testosterone?
The symptoms vary from person to person but reported side effects include:
- Increase in body fat
- Loss of ambition
- Loss of muscle mass
- Hair loss
- Loss of bone mass
- Poor recovery
- Loss of strength
- Low sex drive
- Fatigue and tiredness
- Difficulty concentrating
- Decrease in mood
- Erectile dysfunction
If you are suffering some of these symptoms it does not necessary mean you have low testosterone. The only way to find out is to have a blood test.
Low testosterone is caused by male hypogonadism.
What is hypogonadism?
Hypogonadism in men is a condition in which production of testosterone, sperm or both is diminished significantly, negatively affecting everyday life for most males.
What is the normal level of testosterone?
In men, testosterone levels normally start to decline after the age of 30. Average testosterone levels for men between the ages of 40 and 49 are 252 to 916 ng/dL. Between the ages of 50 and 59, testosterone levels decrease even more to between 215 to 878 ng/dl. Alpha Clinics will evaluate your bloodwork and symptoms to determine the best treatment for you based on your testosterone levels.
What is Testosterone Replacement Therapy (TRT)?
Testosterone replacement therapy are treatments designed to replace diminished testosterone levels. There are many different treatments available such as: testosterone booster injections, HCG injections, estrogen blockers, testosterone pellets, gels, creams, and pills.
What are the benefits of Testosterone Replacement Therapy?
There are a number of benefits to TRT such as: increased muscle mass, energy, libido, motivation, mood & confidence. Testosterone replacement therapy can also decrease things like depression and irritability.
What method of treatment works best for Testosterone Replacement Therapy?
Injection treatment is currently the best method of delivery for testosterone in the human body. It has 100% effectiveness when done correctly. Other methods such as gels, creams, pills and patches are higher maintenance, less effective. For instance, creams and gels may transfer from one person to another through direct skin-to-skin contact. If a person who does not require TRT and hasn’t been prescribed testosterone comes into contact with it, severe implications could arise.
How to administer TRT?
Testosterone injections are done intra muscularly, places to be injected are either in the shoulder, leg or glute muscle on average once every one to two weeks. Injection is the most common form of TRT. While injections are both convenient and affordable, the real selling point for injections is the effectiveness of injections. When compared to other types of treatments, injections have been shown to be much more effective. This mostly has to do with the way that the testosterone is injected into the bloodstream during an injection, which means that the testosterone from the treatment works faster than when administered by gel or patch. Because it is put right into the bloodstream, you’ll also find that the effects of the testosterone injection are stronger and can overcome a deeper testosterone discrepancy.
Should you choose to inject testosterone then you must choose an injection site. There are many options around the body for you to inject into such as shoulder, buttock, bicep and quad. The site that you choose will help to determine how easy it is to inject yourself with testosterone and will also determine the soreness you experience. For many people, quad muscles are the best option because you are able to clearly see where you are injecting and inject yourself conveniently.
See how to administer testosterone injections.
Testosterone gels are applied to either the arms, shoulders or abdomen where the testosterone enters into the skin. Applying testosterone gels are not as effective as injections.
What can Alpha Clinics do for me?
First we do blood tests in order to properly gauge your testosterone levels. From there we give you a consultation with one of our GMC registered GP's to evaluate your lab results and symptoms. This will help us determine if you qualify for testosterone replacement therapy, and which specific treatment will be most effective.
How much does Testosterone Replacement Therapy cost?
At Alpha Clinics, testosterone replacement therapy injections start as low as £75 per month
What happens if I stop the Testosterone Therapy?
Testosterone treatment can be stopped anytime, but one must understand that you will go back to feeling the way you used to. Once men are optimized on Testosterone Therapy, they usually continue it indefinitely. This is a personal choice for optimizing quality of life, not an absolute requirement.
Is TRT anabolic steroids?
No, the role of TRT is to increase a man’s testosterone level to a natural and healthy range.
Bodybuilders take testosterone (among other performance enhancing drugs) in high doses which boost their levels to an unnaturally high state. This is why bodybuilders get so big. Men on TRT do report muscle growth and strength gains in the gym. This is expected given their bodies have more testosterone pumping around it. But you wouldn’t be able to tell if a man is on TRT unless you saw a before and after photo. Even then you might just assume he’s been working out. This is one of the reasons why TRT is misunderstood. The absurdity is people assume taking a mild dose of a male hormone to increase it to a normal level is the same as going on a cycle of anabolic steroids which is not the case at all.
Will there be fluid retention?
As testosterone aromatizes it will convert into oestrogen, and as oestrogen levels increase water retention follows. With this increase in estrogen, you will be more sensitive to water retention. Two drugs that are used to help combat fluid retention are Anastrozole and Letrozole. Usually Anastrozole is prescribed with TRT treatment and should help minimize bloat and fluid retention.
Can I maintain fertility on TRT?
One way to maintain fertility whilst on TRT is to keep a very high level of testosterone within the testes. This is achieved by ensuring the testes produce testosterone locally. The most common and cost effective method is to add HCG to a TRT protocol and ensure estradiol is managed. HCG mimics the actions of gonadotropins LH and to a lesser degree FSH to maintain fertility. Many of our clients choose balance TRT with HCG and oestrogen control so they can essentially have both the benefits of exogenous Testosterone whilst keeping the signal to the testes present.
Will my testicles decrease in size?
Taking exogenous testosterone causes your body to stop it’s natural production of testosterone. Testosterone is made in the testes. If the testes are no longer working to produce testosterone then they can atrophy and decrease in size. HCG is a drug commonly prescribed for TRT that helps keep the natural production on in your body. As long as you keep your testes active they won’t decrease in size.
Will I develop Acne or oily skin?
There are a couple of factors that can play into getting acne or oily skin. Keep in mind that acne is multifactorial and there are other things at play besides Testosterone. Your immune system and your cortisol are a couple of examples. Lifestyle and food sensitivities are also a common factor that can cause a person to develop acne. Accutane is a common drug that is prescribed to help treat acne. You may not need to resort to taking drugs to combat acne or oily skin. A simple change in diet might help. There are also various OTC acne medications as well as medicated soaps and body wash.
Will I develop blood clots?
Donating blood will decrease blood counts, however it is not necessary in the majority of cases. Testosterone replacement can cause an increase in red blood cells, studies conducted show this is harmless and does not affect platelets, thus you are not at increased risk of blood clots. Blood donation is therefore not necessary for patients undergoing testosterone replacement therapy. Keep in mind, when we are in high altitude places, our red cells increase to increase oxygen carrying capacity. People that live at altitude do not need to be phlebotomized simply because their red cells have increased. The same is true in Testosterone replacement.
Will I develop Gyno (breast enlargement)?
Breast enlargement (Gynecomastia) can occur when oestrogen levels rise in men. To prevent this from happening an Aromatase Inhibitor(AI) is usually prescribe as part of your TRT protocol. The most common AI prescribe is Anastrozole. This is a powerful drug that will help prevent a rise in oestrogen.
What about nipple sensitivity?
If this occurs in a male patient, it typically means they are converting too much testosterone to too much oestrogen due to the aromatase enzyme. All male patients are placed on a natural supplement called DIM which helps with oestrogen metabolism, but this may not be enough in some individuals. We check oestrogen in men after testosterone is optimized to also be sure the level is in a specific range. A medication called Anastrozole will be called in for those individuals who’s oestrogen is too high, or those experiencing nipple sensitivity.
Who shouldn't have TRT?
- People with a history of prostate or breast cancer. Testosterone can theoretically cause prostate cancers to grow. Prostate cancer treatment is sometimes based on androgen deprivation, where testosterone is depleted from the body. Testosterone can also be converted to oestradiol, which can theoretically cause breast cancers to grow.
- People with a prostate node, PSA >4, or PSA >3 and a high risk for prostate cancer. Based on the same concept as above, testosterone can theoretically cause the prostate to grow, and people at high risk of prostate cancer should avoid taking TRT.
- People with severe lower urinary tract symptoms (LUTS). Lower urinary tract symptoms include frequently having urgent needs to urinate, feeling the need to urinate more often, producing less urine than usual, feeling pain or burning when urinating, difficulty starting to urinate, straining during urinating, having difficulty emptying your bladder, pain with ejaculation, discharge from the urethra, and discomfort in the genitals, groin, lower abdomen or lower back. These symptoms are frequently the result of having an enlarged prostate. Again, TRT can cause the prostate to grow, making these symptoms worse.
- People with severe and untreated sleep apnea. Testosterone can worsen obstructive sleep apnea. If your sleep apnea is treated, you can get TRT.
- People with uncontrolled heart failure. Testosterone can cause more fluid to be retained in your body and can worsen heart failure.
- People with a recent heart attack or stroke in the last six months. Testosterone has possible cardiovascular risks, including risks of heart attacks or strokes.