Top 10 Questions to Ask Before You Join a TRT Clinic

TRT clinics range from careful medical practices to subscription businesses that will sell you testosterone after a five-minute video call. These ten questions separate them fast. Ask them before you pay anything.

  1. Will you draw labs before prescribing, and will you repeat them? A single low reading is not a diagnosis. Testosterone swings by time of day and by illness. The Endocrine Society guideline calls for total testosterone measured on two separate mornings, fasting, before anyone diagnoses anything.
  2. What is on the panel besides testosterone? You want LH, FSH, estradiol, SHBG, a CBC for hematocrit, PSA if you are over 40, and a metabolic panel. A clinic that only checks total testosterone is not looking for the cause.
  3. Who is the prescribing clinician, and can I talk to them? MD, DO, NP, or PA-C is all fine. Never being able to reach one is not.
  4. Are you going to look for why my testosterone is low? Sleep apnea, thyroid disease, a pituitary problem, opioids, and obesity all cause it, and LH and FSH are what separate a testicular problem from a pituitary one. Some are more urgent than the low testosterone itself.
  5. What does monitoring look like at three, six, and twelve months? Hematocrit especially. Testosterone thickens blood, and this is the side effect that actually sends men to the hospital. The guideline says check it at 3 to 6 months, again at 12 months, then annually, and hold therapy if it climbs above 54 percent.
  6. How do you handle fertility? If they do not raise it before you do, that tells you something. The guideline recommends against testosterone therapy outright in men planning fertility in the near term. See TRT and fertility.
  7. What is the total monthly cost, everything included? Medication, supplies, visits, and labs. Ask what a first year costs, not what the headline plan costs.
  8. Where do labs get drawn and what do they cost in cash? Lab fees are where quoted prices and real prices separate.
  9. What happens if I want to stop? A clinic with no answer has not thought about you past the subscription.
  10. Is any of this contingent on buying supplements from you? A clinic whose margin is in the supplement stack is not a clinic.

One more, off the list

Ask how long the first appointment is. Fifteen minutes is a sales call. A real intake for hormone therapy takes closer to forty-five.

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References

  • Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744. PubMed
  • Wu FCW, Tajar A, Beynon JM, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010;363(2):123-135. PubMed
  • Liu PY, Swerdloff RS, Christenson PD, Handelsman DJ, Wang C. Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis. Lancet. 2006;367(9520):1412-1420. PubMed

Educational content only, not medical advice. Talk to your clinician before making changes.