Wildwood Men's Health 

TESTOSTERONE REPLACEMENT THERAPY (TRT)

Low testosterone levels can occur in men aged from their 20’s and beyond.  It is widely known that most men start to have a decline in their testosterone levels around age 35. This begins the gradual but inexorable decrease in testosterone that will continue throughout one’s life.  Environmental and physical stressors can accelerate this decline to varying degrees, and it explains why a 30 year old male with symptoms of low testosterone can get stuck in the cycle of being told his levels are “normal”, and then continuing to wonder why he has all of the common symptoms caused by low testosterone.  The conventional medical world has not caught up with modern functional medicine and the art of optimal wellness.  

For some men, TRT can be as simple as twice weekly testosterone injections, but often men need more tailored treatment to keep their estrogen and testosterone levels in balance.  Research has shown that estradiol levels (the most common form of estrogen in the blood) can significantly impact libido and erectile function. (1)  

For example, a man might have chronically low testosterone levels, which then results in lower circulating free estradiol levels (most estrogen in men is created by conversion of testosterone to estradiol by the enzyme, aromatase), and this will cause him to not only experience low testosterone symptoms but more of the low estrogen symptoms as well including trouble maintaining erections, night sweats and other issues with temperature regulation, dryness, emotional flatness, muscle and joint stiffness, and post workout recovery taking longer than usual. In another scenario, a man might have a relatively sudden drop in testosterone levels while estrogen remains normal, which might make him experience low energy, low libido, and trouble gaining muscle.  Everyone is different, and proper TRT without side effects requires regular thorough blood work with evaluation and monitoring of your symptoms by an experienced physician.  

At Wildwood Men’s Health, Dr. Pendell utilizes the medication, Gonadorelin, to maintain your body’s own natural intra-testicular testosterone and sperm production, and to prevent testicular atrophy.  Over the last several years most patients were using HCG for this purpose, but it has since become relatively difficult to obtain and cost prohibitive for most compounding pharmacies to produce due to recent FDA changes.  It is still possible to prescribe HCG (Pregnyl) to traditional pharmacies but prices average $360 for a 10-week supply of the medication.  If this is something you're interested in, ask about special GoodRx pricing where we can get the cost down about 50%.  Gonadorelin, however, has proven to be a safe and reasonably effective alternative to HCG, combating the negative feedback cycle of testosterone on the hypothalamus and pituitary gland which can lead to a decrease in testicular production of testosterone.  

The decision to start TRT can be life changing and a serious commitment.  That’s why Dr. Pendell takes the time necessary to listen to your concerns and help you weigh the pros and cons of starting treatment.  He will walk you through all the treatment options and answer all of your health and hormone questions.  

Research: 

https://pubmed.ncbi.nlm.nih.gov/26908066/    Role of Estradiol in Male Sexual Function

Most peptides used in conjunction with TRT are growth hormone stimulating peptides. These peptides are known as growth hormone secretagogues, meaning they stimulate your pituitary gland to secrete its own growth hormone. 

Why is human growth hormone (HGH) so important? It helps to maintain and repair tissue all throughout the body, facilitating healing after an injury and helping to repair muscle tissue after vigorous exercise. It helps build muscle mass, boost metabolism, and improve the quality and appearance of the skin. Essentially, it is our anti-aging hormone and is present in larger amounts when we’re young and naturally declines as we age. 

Potential signs and symptoms that may indicate low or lower than ideal levels of HGH:

• A higher level of body fat, especially around the waist

• Anxiety and depression

• Decline in memory and mental acuity

• Decreased erectile function and libido

• Fatigue

• Feelings of isolation

• Poor quality of sleep

• Decreased muscle mass

• Reduced strength and stamina

• Decreased bone density 

• Changes in the make-up of blood cholesterol

Generally, if you are low T, we recommend that you commence TRT initially, as many symptoms of testosterone deficiency overlap with those of growth hormone deficiency. 

We can perform a simple blood test that can determine if you are a good candidate for growth hormone stimulating peptide therapy.  Peptides are generally safe and low risk medications, and patients can often achieve significant results with peptides alone.  However, sometimes pituitary function is not sufficient enough to produce satisfactory levels of growth hormone, even with stimulation from peptides, and subsequently, human growth hormone (HGH) replacement is needed.