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Who qualifies for Testosterone Replacement Therapy (TRT)?
According to The Journal Of Urology by the American Urological Association and the National Institute of Health (NIH), the general target level for testosterone and the cutoff is usually between 300-350ng/dL to 750-1000ng/dL. That being said, the diagnosis and qualification for TRT involves more than just testosterone levels. TRT is usually prescribed to men who have low levels of testosterone, also known as hypogonadism, which is defined as failure of the gonads, or testes in men. Below are some criteria that providers take into account when determining who qualifies for TRT.
Symptoms of Low Testosterone
Symptoms of low testosterone in males can include (but are not limited to) fatigue or decreased energy levels, reduced sex drive (low libido), erectile dysfunction, decreased muscle mass and endurance, increased body fat or male breast tissue, depressed mood, hot flashes, shrinking testicles, male infertility, hair loss, obesity, irritability, concentration difficulties, and memory issues/mental fogginess. If a male is experiencing any of these symptoms along with low testosterone levels, it may indicate a need for TRT.

Blood Tests
Your provider will run baseline labs, which should include total testosterone, free testosterone (testosterone that not bound to proteins), SHBG, estradiol levels, and LH and FSH just to name a few. Generally a testosterone level between 300-350 is usually the cutoff and anything below these levels are considered to be “low”.
Medical History
Your provider will review your medical history to determine if you have any co-morbidities or pre-disposing conditions/factors such as diabetes, obesity, morbid obesity, metabolic syndrome, pituitary or hypothalamus dysfunction, testicular disorders, mental health disorders, a history of cancer in which a patient underwent chemotherapy or radiation, or even a past history of brain injury.
Physical Examination
Your provider should perform a physical examination to look for signs of shrinking testicles, decreased body hair (hair loss), increased body fat or male breast tissue which is also called gynecomastia, truncal/abdominal obesity and decreased muscle mass, amongst other findings as well.
Age
Testosterone levels naturally start to decline by 1%-3% between the ages of 30-40. Although this may be true for older men, it is important for your healthcare provider to take age into account when determining if TRT is needed. Thus saying that not all older men need TRT.
Ruling Out Other Causes
Apart from primary hypogonadism (also known as primary testicular failure), other conditions such as obesity, thyroid disorders, medication effects, depression, anxiety, stress, PTSD, a history of surgery or brain injury etc. can cause low testosterone levels, which need to be addressed and considered before initiating testosterone replacement therapy.
Like any medication, TRT should be carefully monitored by a healthcare provider to ensure it is safe and effective. As stated above, TRT is not for everyone, and it is important for males to discuss their health history, symptoms, and concerns with their provider.
If you have questions about therapies available for you, reach out to Ever Changing Wellness at 813.666.1366 or email us at info@everchangingwell.com
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