Optimize It

Most males experience decreased testosterone levels as they age. But other factors that correlate with low T levels include:

• Having a BMI above 27
• Smoking (or having ever been a smoker)
• Having cardiovascular disease or high blood pressure
• Having poorly managed type 2 diabetes
• Having obstructive sleep apnea (OSA)
• Having HIV or cancer
• Being sedentary or exercising fewer than 75 minutes per week

Testosterone is a type of hormone called an androgen. The brain has androgen receptors, and testosterone can cross the blood-brain barrier to stimulate them and affect cognitive function. So when testosterone levels are low, you may feel the effect in your body and brain.

Symptoms of low testosterone include:

• Depression or low self-confidence
• Difficulty concentrating
• Disturbed sleep or sleep length
• Declining muscle and bone mass, and increased body fat
• Fatigue, especially after meals
• Difficulty sustaining exercise or sports routines
• Lower sex drive, few erections, or difficulty staying erect

With Optimize It, patients get blood work done at their local Quest Diagnostics on 2 separate occasions, a few days apart. These must be done before 11am—and at the same time on both days. Testosterone levels are highest in the morning, so this timing helps providers get the clearest picture of where natural T levels are consistently.

These tests also include essential factors such as electrolyte levels, lipids, optional vitamins that can affect hormone health and more. Then, patients meet with a provider via video to discuss the results of their lab work, symptoms and possible treatment options.

Some vitamins and minerals affect testosterone production. With Optimize It, patients have the option to have some of these tested along with their required biomarkers.

During video consultations, providers may use blood work results or other observations to suggest supplements or dietary changes that may support T production. And all patients who complete lab work with Optimize It receive support materials (like emails and articles) that include guidance on how to prioritize micronutrient-dense foods for hormone health.

Common mild side effects of testosterone replacement therapy may include nausea, vomiting, headache, changes in skin color, increased or decreased sexual interest, oily skin or acne and hair loss.

These symptoms are usually mild and may diminish over time. But request a callback from a provider if they get worse or do not go away

Yes. Specifically, TRT can reduce sperm count. Adequate sperm count relies on a process where several hormones trigger each other to create or stop production. When testosterone levels rise above a certain point, hormone receptors in the brain signal the other hormones to halt production. Because TRT boosts testosterone levels quickly, studies suggest that treatment depletes sperm count within 2-3 months.

For many males, sperm count returns within 3-12 months after TRT is stopped—especially if other treatments are involved. But there's no guarantee this will happen. Some studies show that about 10% of patients do not regain their sperm count until somewhere in year two, and others never regain their fertility.

That's why organizations like the American Urological Association recommend not starting TRT if you are intending to start or grow your family in the near future. And if preserving future fertility is of any concern, make sure to discuss your options and some preventative steps with your primary care provider before starting TRT.

Yes, the most extensive controlled testosterone trials to date show that TRT causes a slight increase in blood pressure. But these same studies did not correlate TRT with increased cardiovascular risk.

Still, if you have a cardiovascular condition or a family history of heart disease, we recommend discussing questions or concerns with your provider.

Testosterone replacement therapy is a complex treatment that requires routine monitoring of specific biomarker levels in order to keep patients safe. Then, we offer patients the added option of monitoring vitamins and minerals that directly affect testosterone production. Finally, to qualify for treatment, we need two blood work results confirming low testosterone levels (since those levels can change daily). The first testosterone level test happens within a full biomarker panel, then testosterone alone is redrawn a few days later. For patients who start treatment, testosterone levels are checked every 3 months, and the full panel is rechecked yearly.

Because of this complexity, it's actually easier and more affordable for most patients to pay for their blood work with their health insurance coverage. For uninsured patients, we offer a discounted price for each set of required labs.