by Dr. Christopher Senger
A TRT Doctor Tells All
Some TRT clinics use a cookie-cutter approach. You might as well drive up, push your ass through the window, and get a shot. Here's how to find a good one.
You’re Doomed to Live With a Flaccid Penis
Turn on your favorite sports radio station or watch a late night TV program and you’ll be bombarded with ads declaring that “low T” will condemn you to live life with a flaccid penis, almost no get-up-and-go, and a jelly-belly that rivals Santa Claus.
Testosterone replacement therapy (TRT) clinics are popping up like weeds all over the country, each promising men renewed vigor, healthy sex lives, and the ability to boast chiseled physiques that will be the envy of everyone in the gym.
Well, not so fast. Sure, when administered by an experienced, ethical physician, TRT can be of great benefit to many men, including bodybuilders. However, TRT isn’t a one-size-fits-all proposition. Hormone therapy is serious business.
Not Your Dealer
If you come to my clinic looking solely for a competitive edge for the next IFBB bodybuilding championship, I’ll gently suggest that you look elsewhere. Unless of course you have a specific medical condition, such as hypogonadism, that warrants TRT.
If your testosterone levels are low and your overall health issues meet our clinical criteria, we’ll be happy to treat you. And we’ll do the very best we can to make sure that you’re as fit, energetic, and healthy as possible.
There’s no doubt that customized male optimization programs administered at ethical clinics may be of great benefit for many men, including athletes and weightlifters who are experiencing an age-related decline in testosterone.
The Less is More Treatment Approach
One of the guiding principles in my medical practice is that sometimes less is more. This mentality flies in the face of the medical and marketing strategies of many TRT clinics.
These aggressive clinics tend to medically push things to the limit. They’ll automatically prescribe the weekly 200mg/mL maximum to all patients – a high dose that will put most men at supraphysiological levels. Half that amount (100mg/wk) is enough to put many men on the high side of normal.
The TRT mills will also administer the standard aromatase inhibitors (AI) such as Anastrozole, in combination with Human Chorionic Gonadotropin (HCG). The net result? A lot of guys may “feel” better, but many end up with unwanted side effects like cholesterol issues, water retention, and potentially life-threatening hemoglobin issues.
A more balanced approach would be to dial in a program that benefits each individual. For example, you might respond better and feel best on a regimen of 100mg testosterone, 400IU HCG, and 0.5mg Anastrozole weekly. And your next-door neighbor might achieve the maximum benefit from 125mg testosterone, 1000IU HCG, and 2mg Anastrozole.
That’s just the physical side of the equation. It’s not even taking into consideration the emotional, psychological, and even sexual side effects from carelessly managed hormone replacement treatments. These topics are a real concern.
An irresponsible, ill-conceived TRT regimen can lead to a scenario where a man isn’t prepared to suddenly reacquire the hyper sex drive of a teenager. The distractions can be profound and lead to complications in a marriage and even in a profession.
A Careful Balancing Act and Undivided Medical Attention
Clearly, hormones are nothing to be trifled with. They influence so many of our day-to-day, minute-by-minute decisions and actions. It’s why my practice is based on optimizing hormone levels, rather than pumping guys up to supraphysiological levels of androgens.
Don’t get me wrong, there are plenty of ethical practitioners running TRT clinics. And there’s little evidence that a significant number of safety issues exist in the multi-billion dollar TRT industry.
However, there are also plenty of well-intentioned practitioners who fail to treat each patient as a unique individual with specific healthcare needs and concerns. They may take complete medical histories. They may spend more time with their patients one-on-one than primary care physicians. And they may even follow up on the total and free testosterone and monitor PSA, cholesterol, and hemoglobin levels.
Nevertheless, few practitioners bother to discuss the profound biological, emotional, and psychological implications of dramatically altering the body’s hormonal balance.
The Whole Patient Approach
I recognize that I’m preaching to a well-educated choir. Many of you come to T Nation with a PhD-level understanding of hormone replacement therapy. You know that there’s a multitude of healthy approaches to testosterone enhancement through proper nutrition and various weightlifting/bodybuilding regimens. You also realize that TRT is a serious business.
However, I urge you to do rigorous due diligence when considering a TRT clinic. Look for an elite, leading edge practice that offers services that extend far beyond what you’ll receive at a “testosterone mill” or any ordinary “anti-aging” clinic. The key is not to look for the Fountain of Youth. Ponce de Leon never found it, nor will you.
What to Look for in a Male Optimization Clinic
Here’s a brief checklist of qualities you should look for when selecting a men’s health clinic, along with some questions you need to ask the managing physicians:
- Check out the credentials of the physicians who operate the clinic. Does he or she have relevant and current certifications? How much experience does the physician have in treating men’s health problems? How does the doctor stack up against the health grade reviews of competing physicians?
- Learn whether the clinic is on the cutting edge of advanced medicine. For example, does the clinic offer the therapeutic administration of medical peptides?
- Does the clinic offer a range of tests that go beyond free and total testosterone blood levels?
- Conduct a lengthy telephone or in-person interview with the managing physician. Determine whether the doctor treats patients as individuals, rather than cash-paying customers who take a number at the counter to get the same cookie-cutter menu of services.
- Ask the doctor about his or her guiding medical philosophy. Determine whether the clinic’s practitioners are committed to an integrated approach to men’s health optimization.
- Take a careful look at the premises when you visit. Are the examining rooms comfortable and well equipped? Do the physicians treat you like a partner in your own healthcare?
Whether you’re a champion-level bodybuilder, a guy who’s striving to get the most out of life, or simply someone who wants to be the healthiest man he can possibly be, there’s a male optimization clinic that’ll meet your needs. You just have to be selective when you make your choice. Remember, less is often more!
