Testosterone therapy

Male testosterone levels peak while men are in their twenties and deficiency starts as early as age thirty. In fact, 25% of men over thirty and almost 40% over forty-five experience testosterone deficiency, or low T. Testosterone is a vital hormone because it affects many aspects of a man’s mental, physical, and sexual health. Moreover, many organs in the body rely on testosterone to function properly. Organs such as the brain, muscles, bones and pancreas are all impacted when testosterone levels are subtherapeutic. Low testosterone, also known as hypogonadism, in a man means that the adrenal glands or testes are not producing enough testosterone to meet the body’s testosterone needs

Low Testosterone

Low testosterone can result in a variety of symptoms that can greatly affect a man’s health and quality of life. Symptoms include diminished sex drive, lowered sperm production, decreased red blood cell production, reduction of bone mass, irregularities with muscle and fat distribution, weight gain, and loss of muscle strength. Too little testosterone can lead to problems like low libido, loss of muscle mass, weight gain, hair loss, and other problems that affect your physical and sexual health. Low testosterone can also prevent your brain from working at its peak. Some studies have shown that low testosterone might contribute to mental health disorders including lack of motivation, mood swings and depression. Reference ranges may vary depending on which lab facility is conducting the sample analysis, however, low testosterone is commonly diagnosed in a man when the testosterone level is fewer than 300 nanograms per deciliter (ng/dL) of blood.

WHAT IS HORMONE REPLACEMENT THERAPY?

Hormone replacement therapy is designed to ameliorate the signs and symptoms of testosterone deficiency when there is evidence that testosterone levels are low. In symptomatic men, testosterone replacement therapy treats the symptoms caused by low testosterone levels and can help men:

• Feel less irritable, moody or depressed

• Improve cognitive function, helping men to feel more focused and sharper

• Lift energy levels, which can give men an increased sense of drive and motivation

• Boost Libido and erectile function

• Enhance sleep quality

• Increase muscle mass and decrease fat storage

There are a variety of ways to supplement testosterone for men. A man’s personal health and lifestyle are key considerations in selecting the type of testosterone replacement therapy that is appropriate. At Kane Health, we offer testosterone replacement therapy using the following delivery systems: Implantable Pellets –Grain sized testosterone containing pellets are placed under the skin every three to six months in a fifteen-minute office visit. Pellets are available in both traditional and bioidentical forms (BHRT)

Intramuscular Injections – Testosterone is injected into the muscles of the buttocks or the thighs every one to four weeks based on deficiency level.

Gels/Creams – Testosterone gels or creams can be applied each day to your shoulders, arms, or abdomen.

Testosterone Patches – Testosterone patches can be applied each day to your back, arms, buttocks, or abdomen but they are a less popular delivery mechanism.

Our approach to low t

The care of testosterone deficient patients should focus on an accurate assessment of total testosterone levels, symptoms, and signs as well as the proper treatment monitoring to ensure therapeutic testosterone levels are reached and the negative symptoms of low testosterone are ameliorated. Because testosterone levels vary with age, weight, general health, as well as a host of other medical conditions such as prolactinoma.

At Kane Health we offer a wide-ranging spectrum of testosterone replacement therapy (TRT) treatments to address the varying declining hormone levels that men face. Our treatment protocols are designed to address each man’s unique cause of deficiency. A comprehensive work up is performed to determine the root cause of the deficiency as well as rule out any contraindications to therapy. From there we offer a broad range of treatment options to correct the specific deficiency without creating other complications that can be associated with overdosing or providing testosterone to those who do not need it. Once it is determined that you are a candidate for TRT, Dr. Threatt will discuss treatment options based on your health condition, goals and lifestyle. A personalized program will be designed and prescribed to help you achieve the best possible results from TRT. Following the TRT program development, patients in Kane Health’s TRT program will undergo regular hormone diagnostic assessments at key intervals. This regular diagnostic assessment allows Dr. Threatt to titrate treatment based on your body’s response to the therapy and ensure that no new health conditions have emerged that no longer make the therapy safe. The results from testosterone replacement therapy takes time and the amount of time varies from man to man. Factors such as underlying health conditions, a patient’s general health and goals can affect how the body responds to treatment. Generally, the benefits of testosterone therapy can be realized in a matter of weeks following the initial treatment.

WHAT can I expect from testosterone replacement therapy?

At Kane Health, each patient undergoes an extensive health diagnostic assessment to determine the cause of the testosterone deficiency, whether it is clinically indicated and that there are no contraindications for therapy. As a urologist who has been managing men’s hormones for over twenty years, Dr. Threatt considers factors such as the possibility of undiagnosed prostate cancer, male breast cancer, worsening benign prostatic hyperplasia (BPH), polycythemia, recent cardiac events and an increased risk of obstructive sleep apnea (OSA) when making the determination if a patient is a safe candidate for TRT. Furthermore, active TRT treatments can affect fertility rates in men and should be addressed with their medical provider while considering treatment. Our extensive hormone diagnostic lab work includes free and total testosterone, estrogen levels, progesterone, PSA, hematocrit and thyroid levels.

Once it is determined that you are a candidate for TRT, Dr. Threatt will discuss treatment options based on your health condition, goals and lifestyle. A personalized program will be designed and prescribed to help you achieve the best possible results from TRT. Following the TRT program development, patients in Kane Health’s TRT program will undergo regular hormone diagnostic assessments at key intervals. This regular diagnostic assessment allows Dr. Threatt to titrate treatment based on your body’s response to the therapy and ensure that no new health conditions have emerged that no longer make the therapy safe. The results from testosterone replacement therapy takes time and the amount of time varies from man to man. Factors such as underlying health conditions, a patient’s general health and goals can affect how the body responds to treatment. Generally, the benefits of testosterone therapy can be realized in a matter of weeks following the initial treatment.

Risks Associated With Testosterone Replacement

Hormone therapy is a very specialized practice in medicine. Testosterone replacement therapy can be safe and effective, so long as patients receive treatment from a medically qualified source who is reputable. The American Urology Association (AUA) has noted that there has been a huge increase in the prescription of testosterone replacement therapy over the last ten years. The decision as to which type of medical practitioner you need to see hinges on which specialist has a true interest as well as advanced training in the management of testosterone replacement. Many urologists and endocrinologists have the training, but not the interest in managing low testosterone or primary vs secondary male hypogonadism.

With the popularity of testosterone replacement, it’s important to be aware of the number of “practitioners of medicine”, i.e. nurses (RNs), physician’s assistants (PAs), chiropractors and other physician specialists who lack the proper training, but are quick to administer testosterone replacement to anyone requesting it. Simply because a physician has an “MD” next to their name does not necessarily make that physician a qualified expert in hormone replacement therapy. The importance in screening for prostate cancer, pituitary adenomas, metabolic syndrome, and other health related reasons are extremely important in the safe workup and management of Testosterone replacement. Beware of practitioners who do not perform a review of your medical history including your current medications and diagnostic labs prior to prescribing testosterone supplements. Ask what is included in the provider’s initial diagnostic blood panel, and if the provider is not checking free and total testosterone, estrogen, progesterone, PSA, hematocrit and thyroid levels as a part of his or her baseline assessment, it should be a cause for concern. In addition, our health condition is not static, taking testosterone supplements will influence a number of organ systems including down regulating your own natural production of testosterone over time. It can over produce estrogen and if not careful accelerate the spread of an undiagnosed prostate cancer. Treating a man who has undiagnosed prostate cancer with testosterone would be like pouring kerosine on a raging fire. Moreover, there are other medical conditions that can mimic low testosterone levels that can make it easy to assume it is medically necessary when it is in fact not. Unfortunately, there are many online, as well as one-to-two-day courses available for medical practitioners on hormone management, but such high level courses over such a short period of time makes it impossible to cover the vast information and practical training needed to responsibly manage male hormones. In order to properly vet the qualifications of a potential provider, below are a few key things to consider.

Board Certification – In general, board-certified urologists and endocrinologists have the most medical training. Urologists are trained in the diagnosis and treatment of a full spectrum of conditions affecting the male urinary, reproductive, and hormonal systems. An endocrinologist specializes in the diagnosis and treatment of diseases and conditions involving hormones. Endocrinologists focus on disorders affecting the network of glands that secrete chemicals (hormones) responsible for regulating many vital bodily functions. An internist with special interest, training and experience can also manage a man’s testosterone replacement, but be sure to inquire about their training and experience.

Prescription Grade Testosterone – Over the counter or online pills and products that claim to restore or increase testosterone levels without a medical consultation and extensive blood test is usually a red flag that the products used are illegitimate or the provider is not a hormone therapy specialist.

Template Approach – In response to the popularity of testosterone replacement therapy, the market has been flooded with low testosterone clinics and mail order products. All too often, these clinics are not operated by qualified medical professionals. As a result, these facilities and providers will default to using a one size fits all approach and some may even use generalized dosing charts provided by pharmaceutical companies which may not take into account any underlying conditions or that can make TRT dangerous for the patient.

Male vs. Female Hormone Management – Hormone medications may be easy to prescribe and simple to administer, but the uniqueness of each individual and the complexity of age, genetic factors, medication, and lifestyle makes optimizing someone suffering from the effects of low testosterone not so straightforward.The differences in the male and female reproductive systems require that physicians approach hormone health in men and women drastically differently. Hormone therapy for women requires the consideration of not only the primary female hormones of estrogen and progesterone, but also a woman’s menstrual cycle, breast cancer, ovarian as well as uterine conditions and menopause. In contrast, managing a man’s hormones requires consideration of unique issues related to that man’s health. Attention must be considered for risks associated with TRT as it relates to prostate cancer, benign prostatic hyperplasia (BPH), polycythemia, obstructive sleep apnea and any recent cardiac events. You want to select a physician who not only has had the proper depth of formal medical knowledge, but also has the expertise, as well as interest, and enjoys managing male health related conditions.

Extensive Diagnostic and Monitoring – A key tell that a medical provider is not expert in hormone management for men can be found in an insufficient diagnostic lab panel. Extensive diagnostic and monitoring is vital for the safe management of hormone therapy. Ask what is included in a provider’s diagnostic blood panel and if the provider you are considering is not monitoring both free and total testosterone, estrogen, progesterone, PSA, hematocrit and thyroid levels, it should be a cause for concern. In addition, because our health condition is not static, not regularly and properly checking all your key hormone levels can be incredibly dangerous. For instance, treating a man who has developed undiagnosed prostate cancer with testosterone would be like pouring kerosine on a raging fire. Moreover, there are other medical conditions that can mimic low testosterone levels that can make it easy to assume it is medically necessary when it is in fact not.

Although there are many benefits of TRT that can greatly improve a man’s health and quality of life, those benefits should not outweigh the indelible dangers of improper management. Be sure to properly vet your prospective provider and ensure they are not only qualified to manage your hormones, but they are following the appropriate diagnostic protocols.

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650-935-4490

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Kane Health

Men's Health, Men’s Sexual Health Physicians, Concierge Medicine, Low Testosterone Specialists & Functional & Integrative Medicines in Redwood City, CA

801 Brewster Street, Suite 240
Redwood City, CA 94063

650-935-4490

650-447-1228 Fax

hello@kane.health