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What is TRT and is it Right for You?

What is TRT and is it Right for You?

March 20, 2024

What is TRT and is it Right for You? The Pros and Cons of TRT.

Testosterone Replacement Therapy (TRT) is often marketed as the best solution for men facing declining testosterone levels as they age. Advertisements and personal anecdotes promise a range of benefits, including increased muscle mass, higher energy levels, and improved sexual performance.

But before you jump on the TRT bandwagon, it's important to consider all the factors that go into testosterone treatment: potential side effects, doctor's appointments, finances, and more.

While TRT certainly can offer many benefits, it's crucial to approach it with a clear understanding of the potential risks and practical considerations involved. Let's take a straightforward look at TRT, separating the hype from the reality and covering the pros and cons.

Table of Contents


What is TRT?

TRT is an acronym for Testosterone Replacement Therapy. It's a medical treatment administered to those with clinically low levels of testosterone, especially in men, a condition known as hypogonadism or low testosterone.

Testosterone is a hormone that plays a crucial role in regulating sperm production and various masculine traits. It helps in maintaining bone density, fat distribution, muscle strength, and sex drive. TRT can be administered in several forms, including gels, injections, pellet patches, and implanted under the skin.

You should note that TRT is not a one-size-fits-all remedy, and it comes with its own set of potential risks, side effects, and misconceptions. Choosing TRT comes with medical, psychological, and financial considerations that are often glossed over in the mainstream conversations.


Symptoms of Low Testosterone

Man tired at gym

As men age, low testosterone levels can manifest in various ways, impacting their overall well-being. Early recognition of these symptoms is crucial for effective management. Below are common indicators of low testosterone:

  • Erectile dysfunction

  • Reduced sex drive

  • Shrinking testicles

  • Low or zero sperm count

  • Hot flashes

  • Difficulties with concentration and memory

  • Increased body fat

  • Depressed mood

  • Decreased endurance

  • Loss of armpit and pubic hair

  • Decrease in muscle strength and mass

While this list provides a comprehensive overview of low testosterone symptoms, it's important to note that other medical conditions may present similar signs. Therefore, consulting with your doctor and undergoing testing is the most reliable way to determine if you have low testosterone.


Causes of low testosterone

Causes of low testosterone can be categorized into innate factors, where individuals are born with conditions that can lead to testosterone deficiency, and acquired factors, which develop over time due to various reasons. Innate causes include autoimmune diseases. These conditions occur when the immune system mistakenly attacks healthy cells, potentially affecting testosterone production.

In addition to these congenital factors, low testosterone can also arise due to acquired causes, such as:

  • Aging: Testosterone levels naturally decline with age, with many men experiencing reduced production as they get older.

  • Obesity: Excess body fat, particularly visceral fat, is associated with lower testosterone levels.

  • Metabolic Syndrome: This cluster of conditions, including obesity, high blood pressure, and insulin resistance, can contribute to low testosterone levels.

  • Radiation or Chemotherapy: Cancer treatments like radiation therapy and chemotherapy can damage the testicles, leading to reduced testosterone production.

  • Testicular Damage: Injuries to the testicles caused by accidents or cancer can disrupt testosterone production.

  • Pituitary/Thyroid Gland Disorders: Dysfunction of the pituitary or thyroid glands can interfere with hormonal regulation, including testosterone levels.

  • Medication Side Effects: Certain medications, such as antidepressants and narcotics, may impact testosterone production as a side effect.

  • HIV & AIDS: Infections like HIV/AIDS can affect hormone levels, including testosterone.

Understanding both the innate and acquired causes of low testosterone is crucial for accurate diagnosis and effective management. If experiencing symptoms of low testosterone, it's essential to consult a healthcare professional for proper evaluation and treatment.


What are the normal testosterone levels for adult men?

Testosterone levels in adult men typically range from 300 to 1,000 nanograms per deciliter (ng/dL). These ranges can vary slightly depending on factors such as age, overall health, and individual differences.

For most men, testosterone levels tend to peak in early adulthood and gradually decline with age. However, variations within the normal range can occur due to factors such as genetics, lifestyle choices, and underlying medical conditions.


T-level in nanogram per millimeters





4.65- 18.12




4.46- 17.1







4.06- 15.6






3.67- 13.9


The Benefits of Improved Testosterone

Better energy levels

Testosterone plays a crucial role in erythropoiesis, which is simply the production of red blood cells. Low testosterone reduces red blood cell count, resulting in a low energy level. This can manifest as feelings of weakness and feeling the constant need for caffeine to boost energy.

While TRT isn't a cure-all, many individuals report feeling rejuvenated and experiencing reduced fatigue within the first three to four weeks of treatment. This boost in energy can make you feel more youthful and revitalized, although it's essential to recognize that TRT's effects vary from person to person.


Improved mental capacity

Testosterone plays a pivotal role in cognitive functions such as reasoning, concentration, and memory. Reduced testosterone levels can impair cognitive performance, affecting thinking and memory.

TRT has shown promise in enhancing cognition, verbal skills, and mental focus. Research indicates that TRT can clear mental fog and improve memory. Additonally, individuals experiencing depression may find relief within the first six weeks of TRT, leading to a sense of confidence and resilience.


Reduced Body Mass

Excess fat, especially around the midsection, can contribute to low testosterone levels. Improving testosterone levels can help reduce body mass through increased muscle growth, boosted metabolism, enhanced exercise performance, appetite regulation, and indirect effects on overall well-being.

Research suggests that men undergoing TRT may experience improved fat metabolism, leading to the burning of excess fat and the development of lean muscle mass and strength. By combining TRT with muscle-building exercises, men can effectively target and reduce belly and side fat, making the achievement of a flat stomach within reach.


Improved Libido

One common concern among men experiencing low testosterone levels is a decline in sexual performance, including reduced sex drive and erectile dysfunction.

Research indicates that increased testosterone levels often lead to heightened libido and improved sexual function in men.

Studies have shown that men undergoing TRT typically experience a resurgence in their sex drive within the initial three to six weeks of treatment. Furthermore, after six months of testosterone therapy, many report experiencing stronger and longer-lasting erections, contributing to overall satisfaction and intimacy in their relationships.

Increased bone density

As we get older, our body begins to lose more bone than we build. It is worse among men with low testosterone and, if left untreated, could result in osteopenia or osteoporosis in severe conditions. However, with 6 months of testosterone replacement therapy, bone breakdown will decelerate, giving room for new bones to grow and become stronger. Also, benefits of testosterone therapy it will reduce stiffness in your bones and tendons.


Improved heart health

The primary function of the heart is to pump blood to every part of the body, providing the muscles and organs with the oxygen they need for optimal performance. Testosterone helps red blood cell production through the bone marrow. Low T levels are linked to a variety of cardiovascular diseases.



What are The Side Effects of TRT

Despite ongoing debates surrounding the safety and risks of testosterone therapy associated with TRT, research published by Therapeutic Advances in Drug Safety suggests a lack of conclusive evidence regarding any adverse effects of TRT, particularly with prolonged use. However, other studies indicate that men undergoing testosterone replacement may face an increased risk of cardiovascular diseases.

Currently, TRT is generally regarded as a safe therapy, with only a small number of men experiencing immediate serious side effects. Nonetheless, it is crucial to consult with a healthcare professional before initiating this treatment.

Given that testosterone replacement therapy is a form of hormonal replacement therapy, medical experts still acknowledge the potential for side effects. These may include:

●  Acne

●  Enlarged Prostate, which may increase fluid retention

●  Sleep apnea

●  Sensitivity

●  Breast enlargement

●  Swollen Ankles

●  Decreased testicular size resulting from the stoppage of production of testosterone in the testicles.

●  Heart attack

●  Cardiovascular complication

●  Erythrocytosis

●  Bladder irritability


Key Considerations Before Deciding on TRT

Before starting Testosterone Replacement Therapy (TRT), it's crucial to consider the following:

  1. Medical Screening: Undergo thorough medical screening to determine if you have any conditions that may pose risks with TRT, such as breast cancer, prostate cancer, heart disease, stroke, or untreated sleep apnea.

  2. Risk Assessment: Discuss the potential risks associated with TRT with your healthcare provider. Understand the risks specific to your health profile and lifestyle.

  3. Side Effects: Understand the potential side effects of TRT, including changes in mood, fluid retention, acne, and changes in cholesterol levels. Be prepared to manage these effects with your healthcare provider.

  4. Fertility: If you plan to have children in the future, consider how TRT may affect fertility. TRT can decrease sperm production and quality, so discuss fertility preservation options with your doctor if desired.

  5. Regular Monitoring: Commit to regular monitoring and follow-up appointments with your healthcare provider. This ensures that TRT is effective and safe for you and allows for adjustments to dosage or treatment plan as needed.

  6. Treatment Plan: Work closely with your healthcare provider to develop a personalized treatment plan tailored to your needs and health goals.

  7. Lifestyle Changes: Understand that TRT is not a substitute for healthy lifestyle habits. Maintain a balanced diet, regular exercise routine, and manage stress to optimize the benefits of TRT.

  8. Cost and Insurance Coverage: Consider the financial implications of TRT, including the cost of medication, doctor visits, and lab tests. Check your insurance coverage for TRT-related expenses.

By carefully considering these essential factors before starting TRT, you can make informed decisions about your treatment and ensure the best possible outcomes for your health and well-being.


Other Ways to Support Healthy Testosterone

If you're looking to boost your testosterone more naturally, the most effective approach involves adopting a healthy lifestyle that promotes overall health and well-being.

Maintain a healthy weight

When it comes to testosterone levels, maintaining a healthy weight is crucial. Research indicates that obesity or being overweight is associated with lower testosterone levels. In fact, studies have shown that around 30% of obese men have lower testosterone levels compared to those with a healthy weight. This link between weight and testosterone levels decline underscores the importance of managing body weight through a combination of balanced nutrition and regular physical activity.

Exercise regularly

Regular exercise is key to supporting healthy testosterone levels. Leading a sedentary lifestyle can lead to decreased testosterone production. Engaging in physical activities, particularly resistance training such as weightlifting, has been shown to stimulate the body's testosterone production. Studies have consistently demonstrated that exercise is more effective at boosting testosterone levels than solely focusing on weight loss. Incorporating a variety of exercises into your routine, including strength training and cardiovascular workouts, can help optimize testosterone levels and promote overall health.

Get Quality Sleep

According to the University of Chicago, adequate sleep is essential for maintaining optimal testosterone levels. Research suggests that insufficient sleep can lead to a decline in testosterone levels, impacting various aspects of health and well-being. Aim for 7 to 8 hours of quality sleep each night to support hormonal balance and overall vitality. Prioritize good sleep hygiene practices, such as creating a comfortable sleep environment, establishing a consistent sleep schedule, and minimizing exposure to screens before bedtime. If you struggle with sleep issues, consult with a healthcare professional for personalized recommendations and strategies to improve sleep quality.


Several supplements are believed to help increase testosterone levels naturally. However, it's essential to consult with a healthcare provider before starting any new supplement regimen to boost testosterone, especially if you have underlying health conditions or are taking medications. Here are some supplements that may help support testosterone levels:

  1. Vitamin D: Vitamin D deficiency has been linked to low testosterone levels. Supplementing with vitamin D or increasing sun exposure may help improve testosterone levels, particularly in individuals with low levels of vitamin D.

  2. DHEA (Dehydroepiandrosterone): DHEA is a hormone produced by the adrenal glands that can be converted into testosterone. Some studies suggest that DHEA supplements may help increase testosterone levels, particularly in older adults with low DHEA levels.

  3. Zinc: Zinc is an essential mineral that plays a role in testosterone production. Supplementing with zinc may help improve testosterone levels, especially in individuals with zinc deficiency.

  4. Magnesium: Magnesium is another essential mineral that is involved in testosterone production. Some research suggests that supplementing with magnesium may help increase testosterone levels, particularly in individuals with low magnesium levels.

  5. Ashwagandha: Ashwagandha is an adaptogenic herb that has been traditionally used in Ayurvedic medicine to support male reproductive health. Some studies suggest that ashwagandha supplements may help increase testosterone levels and improve sperm quality.

  6. Fenugreek: Fenugreek is an herb that has been traditionally used to boost libido and improve sexual function. Some research suggests that fenugreek supplements may help increase testosterone levels, particularly in resistance-trained men.

It's important to note that while these supplements may help support testosterone levels, they are not a substitute for a healthy lifestyle. Eating a balanced diet, exercising regularly, getting enough sleep, managing stress, and avoiding excessive alcohol consumption and smoking are essential for maintaining optimal testosterone levels and overall health. Additionally, individual responses to supplements may vary, so it's essential to consult with a healthcare provider before starting any new supplement regimen.

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Eat balanced diet

Proper nutrition plays a vital role in supporting testosterone production and overall health. A balanced diet rich in nutrient-dense foods provides the essential vitamins, minerals, and macronutrients needed for optimal hormonal function. Focus on incorporating a variety of fruits, vegetables, lean proteins, whole grains, and healthy fats into your meals. Foods rich in zinc, vitamin D, and omega-3 fatty acids are particularly beneficial for testosterone production. Consider including sources of these nutrients in your diet, such as lean meats, seafood, nuts, seeds, leafy greens, and fortified foods.

Reduce stress

Chronic stress elevates cortisol and elevated cortisol negatively affects testosterone levels in males. To manage stress effectively, recognize when you're feeling overwhelmed and prioritize self-care activities. It's important to understand that rest is crucial for overall well-being, even amidst busy schedules. Allocate time for relaxation and engage in activities you enjoy, such as outdoor sports or hobbies. Creating a balance between work and leisure can significantly reduce stress levels and support healthy testosterone production.



How much does Testosterone Replacement Therapy cost?

TRT may cost  $1,650 to $3,200 yearly. However, this cost is subject to different factors. They include insurance coverage, location, medical fees, type of medication, mode of administration, and dosage.

Is Testosterone Replacement Therapy safe for long-term use?

TRT is safe if you follow the guidelines: consult a doctor, be truthful about medical conditions and history, and there will be no risk of side effects.

Can lifestyle changes improve testosterone levels?

Yes, stress, weight gain, lack of sleep, and an unhealthy diet can lead to lower testosterone levels. However, being healthy can increase testosterone levels without replacement therapy.

How quickly does Testosterone Replacement Therapy work?

Users report noticeable changes in the first 3 to 4 weeks.

Final Thoughts

TRT may be a solution for some people but it's certainly not for everybody, especially if you want to treat normal aging when there's no underlying medical condition. But if you are suffering from chronic health conditions, undergoing prostate cancer treatment, or experiencing gradual decline in your libido, you can may want to consider giving TRT a try. But it's important that the conversations begin with your doctor and that you explore every option.


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