Testosterone

Testosterone therapy is a provider guided treatment option that may be used when clinically appropriate for men with confirmed low testosterone. Treatment is individualized based on medical evaluation and lab results.  

 Common concerns can include low energy, reduced libido, mood changes, decreased muscle mass, and difficulty with recovery. The only way to confirm is through lab testing and a medical evaluation by a licensed provider. 

 Yes. Lab testing and a medical evaluation are required before starting treatment to confirm eligibility and help determine the safest, most appropriate plan. 

Depending on your evaluation and labs, options may include testosterone injections or other provider-guided hormone support when clinically appropriate. Your provider will review options that match your goals and health history. 

Eligibility is determined through a medical evaluation by a licensed provider, based on your health history, symptoms, and lab results. Treatment is provided only when clinically appropriate. 

Yes. Salish Shore Wellness serves patients throughout Whatcom County and Skagit County, including Bellingham, Ferndale, Lynden, Mount Vernon, and Burlington. 

 Testosterone Replacement Therapy (TRT) is a medical treatment designed to restore testosterone levels to a normal range in men whose testosterone is low due to aging, medical conditions, or hormonal imbalances. Men experiencing symptoms like fatigue, decreased libido, mood changes, and reduced muscle mass may benefit from TRT. A healthcare professional will evaluate your symptoms and testosterone levels to determine if TRT is the right treatment. 

 TRT can significantly improve quality of life by:

• Increasing energy levels
• Enhancing libido and sexual performance
• Boosting mood and mental clarity
• Improving muscle mass and strength
• Reducing fat accumulation
• Supporting bone health

By restoring testosterone levels, many men see a major improvement in their overall well-being.

 Subcutaneous (SC) injections involve injecting testosterone into the fat tissue just under the skin, while intramuscular (IM) injections go deeper into the muscle. SC injections offer several advantages:

• Less discomfort: SC injections are generally less painful than IM injections.
• More flexible injection sites: SC injections can be done in areas like the abdomen or thigh, making it easier to rotate sites.
• More stable blood levels: SC injections tend to produce a more consistent release of testosterone compared to IM injections.

In many cases, SC injections are preferred for ease and comfort.

Twice-weekly, low-dose injections help maintain more balanced testosterone levels throughout the week, reducing the fluctuations often seen with weekly or bi-weekly high-dose injections. This approach can:

• Minimize "testosterone peaks" and "valleys," which can cause mood swings and energy fluctuations.
• Improve overall effectiveness by maintaining a steady therapeutic level of testosterone.
• Offer more consistent symptom relief, including better libido and mental clarity.

Testosterone cream/gel is a topical form of TRT that’s applied to the skin, typically on areas like the inner elbow (gel) or the inner thigh & scrotum (cream). Key benefits of testosterone cream include:

• Ease of use: No needles are involved, making it a good option for those who prefer to avoid injections.
• Consistent absorption: Dermal application allows for steady absorption through the skin, though requires twice daily application.
• Lower risk of injection-related issues: Since there’s no need for injections, there's less risk of irritation or infection at injection sites.
• Contact Transference: Dermal Testosterone applications can be transferred onto other people and animals.  It is important to avoid transference with women, children, and animals as testosterone can cause health complications.

However, testosterone injections are often preferred by patients who need faster, more precise delivery and higher absorption rates.

 Enclomiphene is a selective estrogen receptor modulator (SERM) that can stimulate the body’s own testosterone production, making it a potential alternative for some men with low testosterone. Rather than directly replacing testosterone, enclomiphene helps increase natural testosterone levels by blocking estrogen receptors in the hypothalamus. This leads to higher levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn stimulate the testes to produce more testosterone.

Enclomiphene may be particularly beneficial for men with low testosterone due to hypogonadotropic causes, and those who are looking to preserve fertility while treating low T.

Testosterone levels between 600-900 ng/dL are considered to be in the optimal range for most men, and are often associated with:

• Increased energy and vitality
• Better muscle development and fat metabolism
• Enhanced mood and cognitive function
   

In contrast, levels between 300-500 ng/dL may still be within the “normal” range according to some lab standards, but men with these levels often experience:

• Lower energy
• Decreased libido
• Poor mood or increased irritability
   

Men with levels closer to 500-700 ng/dL typically report feeling better overall, with significant improvements in daily life compared to those in the 300-500 ng/dL range.

  Testosterone replacement therapy is a gradual process, with results unfolding over time. While some people may notice some changes in mood and libido within a few days, the full cognitive, physiological, and sexual effects of testosterone replacement therapy will vary by individual, with most occurring over the course of several weeks and months. It takes about 6 weeks on average to start seeing significant and systemic improvements in overall health, with peak results at around 12 months.  

Week 1

Small improvements in sleep, more energy in the morning and more alert during the day.

Week 2

Improvements in libido and erections.  Insulin sensitivity improves, more frequent burst of energy.

Week 3

Improvements in mental clarity and function.  Able to better handle stress, anxiety, and social interactions.  Start to notice increase in sex drive.

Week 4

Measurable improvements in insulin sensitivity, lipid profile (cholesterol & triglycerides).  Improvements in blood flow, production of nitric oxide, and inflammation resulting in increased blood flow to the penis.

Weeks 6-8

Decline in stress, cortisol levels, anxiety, and fatigue.

Month 3

Working out and being active take less effort and yield quicker, more visible and dramatic results.

Month 4

Increases in endurance, stamina, exercise potential, and performance, and you may no longer be experiencing sleep deprivation

Month 6

Increase in bone and muscle mass.  Significant improvements in your mood, libido, and body composition. Sex life is better because of changes in erections and ejaculations, your PSA levels are higher.

Month 9-12

Achievement of maximum results