How To Get On TRT
Everything you need to know before starting testosterone replacement therapy — from bloodwork to finding the right provider.
What Bloodwork You Need
Before any clinic will prescribe TRT, you need baseline bloodwork. Here's the complete panel to request.
Baseline measurement of overall testosterone production
The bioavailable portion that actually matters for symptoms
Must use the sensitive assay — standard is inaccurate for men
Sex hormone binding globulin — determines how much T is free vs bound
Monitors hematocrit and hemoglobin which TRT can elevate
Liver and kidney function baseline before starting therapy
Testosterone can affect cholesterol — need baseline values
Prostate-specific antigen — important baseline for men over 35
Elevated prolactin can cause ED and low libido independent of T levels
Thyroid dysfunction mimics low T symptoms
Distinguishes primary (testicular) from secondary (pituitary) hypogonadism
Pro tip: Get bloodwork done fasted, first thing in the morning (before 9 AM). Testosterone is highest in the morning, and most clinics want fasted samples for accurate lipid and glucose readings.
What to Say to a Doctor
Your first appointment can make or break your TRT journey. Here's how to approach the conversation.
Describe your symptoms clearly
Focus on fatigue, low libido, brain fog, poor recovery, mood changes. These are clinical symptoms doctors take seriously.
Bring your bloodwork
If you've already had labs done showing low T, bring printed copies. Having data makes the conversation much more productive.
Ask about their TRT experience
Ask how many TRT patients they currently manage. If it's under 20, consider a specialist. Experience matters enormously.
Know the ranges
Total T reference ranges are typically 264-916 ng/dL. Many men feel terrible at 300 even though it's 'in range.' Functional medicine targets 600-900+.
Don't mention steroids or bodybuilding
Even steroid-friendly clinics prefer you approach it as a health concern first. Lead with symptoms, not your cycle history.
Ask about their protocol flexibility
Good clinics offer injection frequency options (weekly, 2x/week, daily), multiple delivery methods, and don't force a one-size-fits-all approach.
Telehealth vs Local Clinic
Both options have clear advantages. Here's a head-to-head comparison to help you decide.
| Feature | Telehealth | Local Clinic |
|---|---|---|
| Convenience | From your couch, anywhere | Need to drive to appointments |
| Cost | Usually $89-250/mo all-in | Often $150-400/mo + separate lab fees |
| Lab Work | Use local Quest/LabCorp | Done in-office or referral |
| Medication | Shipped to your door | Pick up at pharmacy or in-office |
| Steroid-Friendly | Many specialize in this | Hit or miss, harder to find |
| Supervision | Virtual check-ins | Hands-on, in-person exams |
| Injection Training | Video instruction | In-person demonstration |
| Speed to Start | Often 1-2 weeks | Can take 3-6 weeks with referrals |
Bottom line: Telehealth is faster, often cheaper, and easier to find steroid-friendly providers. Local clinics are better if you prefer hands-on care or need in-office procedures like injections or shockwave therapy.
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