Frequently Asked Questions

Most health insurances companies do not cover testosterone replacement therapy unless very specific criteria are met and there are strict guidelines must be followed. This restricts our ability to provide you with the best treatment plan. In addition, health insurance companies will not pay for the complementary treatments and medications that maximize testosterone replacement therapy.

For patients on testosterone replacement therapy (TRT), we utilize affiliated pharmacies to provide medication. As such, we cannot write prescriptions for any outside pharmacies. Everything is included in our TRT monthly package, including medication and supplies. Only your initial labs cost extra at $125, all follow up labs are included. There are no hidden fees or extra prices for visits, just a simple, low monthly investment you can count on.

Testosterone is a hormone produced in the body and is responsible for male sex characteristics. Testosterone increases sex drive, protects against disease, increases muscle mass and strength, maintains bone health, sharpens the mind, and improves mood to name a few of ts benefits. Testosterone is absolutely vital in maintaining a man's health, vigor, sexual function, and motivation throughout his lifetime.

There are many other potential causes of low testosterone, including the following:

• Injury (trauma, interrupted blood supply to the testes) or infection of the testes (orchitis)
• Chemotherapy for cancer
• Metabolic disorders such as hemochromatosis (too much iron in the body)
• Dysfunction or tumors of the pituitary gland
• Medications, including opioids, hormones used to treat prostate cancer, and steroids (such as prednisone)
• Acute (short-term) or chronic (long-term) illness
• Alcohol abuse
• Cirrhosis of the liver
• Chronic renal (kidney) failure
• HIV/AIDS
• Inflammatory conditions such as sarcoidosis (a condition that causes inflammation of the lungs and other organs)
• Kallman syndrome (abnormal development of the hypothalamus, a gland in the brain that controls many hormones)
• Klinefelter syndrome (a genetic condition in which a male is born with an extra copy of the X chromosome). Also called XXY syndrome
• High levels of the hormone prolactin
• Obesity or extreme weight loss
• Uncontrolled type 2 diabetes 
• Congenital defect (present at birth)
• Obstructive sleep apnea
• Aging
• Estrogen excess (usually from an external or environmental source)
• Previous anabolic steroid abuse
• Severe primary hypothyroidism
• Pubertal delay
• Trauma (head injury)
• Radiation exposure or prior surgery of the brain

Symptoms include diminished sex drive, erectile dysfunction, lack of morning erections, soft erections, excessive fatigue and tiredness, lack of energy and motivation, reduced muscle mass, weight gain, increased body fat (especially around the middle), decreased bone strength and loss of bone density (osteoporosis), depressed mood, anxiety, irritability, mood changes, brain fog, difficulty focusing, poor concentration, lack of motivation, gynecomastia or  increased breast tissue, nipple sensitivity, hot flashes, night sweats, difficulty sleeping, 

Contraindications to testosterone replacement therapy include an elevated level of Prostate-Specific Antigen (PSA), or history or presence of prostate or breast cancer. There is a risk of worsening symptoms of benign prostatic hypertrophy (enlarged prostate), sleep apnea, congestive heart failure, gynecomastia (breast enlargement), decreased sperm count. 

Natural testosterone should not be confused with synthetic derivatives or “anabolic steroids,” which when used by athletes and body builders have caused disastrous effects, such as heart problems and cancer. Use of synthetic androgens, like stanozolol or methyltestosterone, causes profound decreases in HDL (good cholesterol)  and significant increases in LDL (bad cholesterol) and have been associated with serious heart disease. However, natural testosterone lowers total cholesterol and LDL cholesterol levels while having little to no impact on serum HDL cholesterol levels.

TRT is safe when appropriately prescribed and monitored. There is no evidence that testosterone replacement causes cancer, however preexisting prostate cancer may grow faster with TRT. It is very important to check serum PSA (prostatic specific antigen) test prior to beginning therapy, and to monitor PSA levels regularly during treatment.

 Some patients could experience one or more of the following side effects:

1. Infertility

Testosterone therapy down regulates production of a man’s sperm. Ensure you are upfront with your desire for children with your medical provider and be sure to discuss the situation with your spouse/partner if appropriate. There are inexpensive and effective medications we can add in to your treatment plan to preserve fertility

2. Increase in red blood cells

An increase in red blood cells can lead to blood clots, heart attack, or stroke. We closely monitor blood levels throughout the duration of treatment.

3. Prostate effects

If you have already have an enlarged prostate, testosterone may worsen your symptoms, particularly if you are more than 50 years of age. If you have a history of prostate cancer, you cannot receive testosterone therapy without prior clearance from the urologist who is overseeing your care.

4. Skin reactions

Acne, oily skin, increased body hair and flushing have been reported. These side effects are not very common and are often are transient.

5. Sleep apnea

This is a condition that disrupts breathing during sleep, and if already present, may be worsened by the use of testosterone therapy. If you snore or suspect you may have sleep apnea, be sure to talk to your provider about this condition. 

6. Fluid retention

Although uncommon, you must use caution if you have a history of heart failure or kidney disease. 

Please complete our New Patient Forms prior to your appointment. If you did not receive them with your confirmation email, please click here. Our forms take about 15 minutes to complete. We do not have a waiting area so unfortunately you will not be able to complete the forms in office prior to your appointment.  If you don't feel comfortable answering a question, just skip it. 

• We are not part of a massive health care organization, we are your neighbors! We are full-time established Palm Beach County residents. We live where we work and are a vested in the local community, 
• Convenience!  We offer online scheduling, secure email messages, Telehealth visits, HIPPA compliant text messaging with your provider 24/7 using Spruce - No more leaving messages and waiting days for a response.
• Comprehensive! A lot of men’s health clinics only focus on one thing and do not take the whole person into consideration. Men are much more complicated than just their testosterone levels or frequency of erections.  Extensive lab testing is done prior to initiating any treatment. Our lab tests are truly comprehensive. For only $125, we include all of the following labs:

                    ALP

                    ALT

                    AST

                    Albumin

                    BUN

                    Basophil Count

                    Basophils (%)

                    Calcium

                    Carbon Dioxide

                    Chloride

                    Creatinine

                    DHEA-S

                    E2

                    Eosinophil Count

                    Eosinophils (%)

                    FSH

                    Fasting Glucose

                    Ferritin

                    Free Testosterone

                    Globulin

                    HDL

                    Hematocrit

                    Hemoglobin

                    IGF-1

                    Immature Granulocytes (%)

                    Immature Granulocytes Count

                    LDL

                    LH

                    Lymphocyte Count

                    Lymphocytes (%)

                    MCH

                    MCHC

                    MCV

                    MPV

                    Monocyte Count

                    Monocytes (%)

                    Platelets

                    Potassium

                    RBC

                    RDW

                    SHBG

                    Sodium

                    TC/HDL Ratio

                    TSH

                    Testosterone (Total)

                    Total Bilirubin

                    Total Cholesterol

                    Total PSA

                    Total Protein

                    Triglycerides

                    WBC

                    eGFR

                    fT3

                    fT4

                    hs-CRP

Semaglutide is a prescription-only injectable medication that works by mimicking a hormone called glucagon-like peptide-1 (GLP-1). This hormone is secreted in the gut and targets areas of the brain that regulate appetite and satiety (sense of fullness after eating). 

Before using semaglutide, tell your healthcare provider if you have any other medical conditions, including if you: 

• have or have had problems with your pancreas or kidneys.
• have type 2 diabetes and a history of diabetic retinopathy. 
• have or have had depression or suicidal thoughts, or mental health issues. 
• Are pregnant or plan to become pregnant. semaglutide may harm your unborn baby. You should stop using semaglutide 2 months before you plan to become pregnant. • \
• Are breastfeeding or plan to breastfeed. It is not known if WEGOVY™ passes into your breast milk. You should talk with your healthcare provider about the best way to feed your baby while using semaglutide. Tell your healthcare provider about all the medicines you take. 

• Inflammation of the pancreas (pancreatitis). Stop using semaglutide and seek emergency treatment if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. You may feel the pain from your abdomen to your back.
• Gallbladder problems. Semaglutide may cause gallbladder problems including gallstones. Some gallbladder problems need surgery. Tell your healthcare provider if you have any of the following symptoms: • pain in your upper stomach (abdomen) • yellowing of skin or eyes (jaundice) • fever • clay-colored stools. 
• Increased risk of low blood sugar (hypoglycemia) in patients with type 2 diabetes, especially those who also take medicines to treat type 2 diabetes mellitus such as sulfonylureas or insulin. Talk to your healthcare provider about how to recognize and treat low blood sugar.
• Kidney problems (kidney failure). In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration) which may cause kidney problems to get worse. It is important for you to drink fluids to help reduce your chance of dehydration. 
• Serious allergic reactions. Stop using semaglutide and get medical help right away, if you have any symptoms of a serious allergic reaction including: • swelling of your face, lips, tongue or throat • severe rash or itching • very rapid heartbeat • problems breathing or swallowing • fainting or feeling dizzy 
• Change in vision in people with type 2 diabetes. Tell your healthcare provider if you have changes in vision during treatment with semaglutide. Diabetic retinopathy may be worsened by semaglutide.
• Increased heart rate. Semaglutide can increase your heart rate while you are at rest. Tell your healthcare provider if you feel your heart racing or pounding in your chest and it lasts for several minutes. 
• Depression or thoughts of suicide. You should pay attention to any mental changes, especially sudden changes in your mood, behaviors, thoughts, or feelings. Seek emergency treatment right away if you have any mental changes that are new, worse, or worry you. 
• The most common side effects of semaglutide may include: • nausea • stomach (abdomen) pain • dizziness • stomach flu • diarrhea • headache • feeling bloated • heartburn • vomiting • tiredness (fatigue) • belching • constipation • upset stomach • gas.

Talk to your healthcare provider about any side effects that bothers you or does not go away. Please seek emergency treatment for any severe symptoms.