Testosterone Therapy for Men

Optimizing testosterone levels impacts multiple aspects of men’s health. With Testosterone (T) deficiencies men can experience weight gain, low energy, low libido, depression, loss of motivation, decrease in muscle mass and decrease in stamina. Optimal T levels enhance cardiovascular health, improve brain function, and lead to better body composition.

T deficiency is a common cause of the “grumpy old man syndrome”. When we combine T therapy with our healthy aging diet, supplement and exercise programs, we can greatly enhance the quality of life and overall health for men.

T therapy is safe, effective, and one of the most rewarding components of my anti-aging medical practice.


It is pivotal to aim for appropriate T levels in the bloodstream. Commonly in medicine we are content with hormone levels within an extremely broad reference range. Men with overt T deficiency symptoms are often told that their low T blood tests are “normal”, even though they are on the low-end of the reference range. When we restore T levels to a more youthful range men feel a tremendous impact on their health and well-being.


To assess T levels men should have the following hormone levels checked: Total Testosterone, Free Testosterone, Estradiol.

Total T is bound to a carrier protein that circulates in the bloodstream. Most labs have reference ranges of Total T between 300-1000 ng/ml. We strive to maintain Total T levels in the 700-900 ng/ml range.

Free T is not bound to a carrier protein, it is “free” of the binding protein, allowing the T to get into the cells to generate activity. Most labs have reference ranges of Free T between 3.00- 25 ng/dl. We strive to maintain Free T levels of 20- 25 ng/dl.

Estradiol is the main estrogen in our body. Most labs have reference ranges for estradiol between 10-50 pg/ml. We strive to maintain estradiol levels in men of less than 30 – 40 pg/ml.


Men make estrogen in their bodies by the conversion of testosterone into estrogen, primarily within our fat cells, by the enzyme aromatase. Although men need some estrogen, we don’t want elevated estrogen levels as they negate many of the benefits of T. With T therapy it is important to keep estrogen levels low while we simultaneously raise our T levels into optimal ranges. A high T to E ratio is best to maximize the benefits received from hormone therapy programs. We frequently prescribe estrogen blockers such as anastrazole to lower estrogen in men. There are also several natural supplements to lower estrogen in men such as zinc, DIM (Diindolylmethane), omega-3 fats (EPA/DHA), and chrysin.


HCG (Human Chorionic Gonadotropin) is a hormone that mimics Luteinizing Hormone (LH) in the body. LH stimulates the Leydig cells in the testicles to produce more T. We frequently utilize HCG alone or in conjunction with T therapy in men. HCG is administered by an injection under the skin with a small needle, several times per week. It is virtually painless. It is an effective way to prompt the natural production of T in the body.


T administered in a topical cream or gel is a commonly selected option for men. A prescription from a compounding pharmacy works best as we have limitless dose options to customize for each patient. Topical T is usually applied once daily. Compounding pharmacies have easy to use application devices available.


T by injection is usually dosed once per week. T Injections are intramuscular (IM) given in the buttocks or thigh region. Injections are extremely cost-effective and a popular option for many men. Men have the option of receiving injections in their physician’s office or can receive instruction to inject at home.


T pellets are placed by a physician under the skin (subcutaneous) in the hip region. The pellets are time-released and provide continuous T therapy for 4 to 6 months. This is great option for men who travel extensively, or simply want the convenience of pellets inserted a few times per year. Pellets provide a consistent blood level of T that increases when you are active with exercise.


With several options available, men can easily find the type of T therapy that suits their specific needs and lifestyle to optimize health and aging. When hormone levels are balanced men obtain renewed vigor for life and enhanced well-being.

Author: frankcomstock

I am a physician with an anti-aging medical practice in Tucson called Lifestyle Spectrum. I am the author of ANTIAGING 101: Course Manual

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