The six months of services include: 1) A thorough medical history, 2) Ordering and review/discussion of all labs, and 3) All HRT prescriptions.
Frequently ordered labs include:
What is Menopause: A change in menstrual patterns and the appearance of hot flashes are usually the first signs. Typically it is diagnosed when there is an absence of menstruation for 12 months. Although blood tests are not required, we will run blood or urine tests to determine levels of the hormones estradiol, follicle-stimulating hormone (FSH), testosterone and luteinizing hormone (LH).
Total and Free Testosterone levels
The clinical diagnosis of Low-T is defined as a testosterone value less than 300ng/dL along with symptoms. If a client has "normal" testosterone values but is symptomatic you may still qualify for hormone augmentation.
Free Testosterone is the active portion of the total testosterone that is able to exert an effect on the body.
A lipid panel is a blood test that measures your cholesterol and triglycerides (fats in the blood). TRT can alter lipid levels.
Hemoglobin and Hematocrit
Hemoglobin and Hematocrit are measurements of the amount and volume of red blood cells. TRT can stimulate the bone marrow causing the hemoglobin and hematocrit to rise. Monitoring the hemoglobin and hematocrit is important to control and reduce this side effect.
Luteinizing Hormone (LH)
LH is a hormone that stimulates the primary production of testosterone from the testicles. Measurement of LH provides insight into whether a man’s low testosterone is due from testicular failure or from pituitary dysfunction.
Sex hormone Binding Globulin (SHBG)
Sex hormone binding globulin (SHBG) binds to testosterone in the body. When testosterone is bound to SHBG it is not in an active form. Therefore, it cannot exert its effect on the body through the androgen receptor. Men with elevated SHBG levels can have normal testosterone levels, but since it cannot be utilized by the body, those men will present with symptoms of Low-T. Measuring SHBG helps a us better understand total testosterone and tailor therapy to improve TRT response.
Complete Metabolic Panel (CMP)
A complete metabolic panel (CMP) is the blood measurement of the liver function and basic electrolytes. A CMP is done to see if there are underlying medical conditions.
Estradiol (E2), the predominant form of estrogen, plays a critical role in male sexual function. Estradiol in men is essential for modulating libido, erectile function, and spermatogenesis. High estrogen levels can slow down sperm production and make it harder to create healthy sperm. There are medications that can be employed to decrease the amount of E2. It is very important to manage E2 levels while on TRT.
We will review these labs and your symptoms to create a Hormone Replacement Therapy (HRT) that is perfectly tailored to your body. We can use pharmaceuticals and or neutraceuticals (natural supplements) to obtain the goal of hormone optimization. Once we have established your optimal HRT protocol, typically takes six months, we will maintain that dose and regimen.