Why do you test twice?
Testosterone varies from day to day and through the day. One low result isn't enough to confirm low testosterone. We draw two morning samples on separate days before making a diagnosis.
• Tired, foggy, not yourself / Men's health
Low testosterone in men
Fatigue, low libido, losing muscle, gaining fat around the middle, low mood, poor sleep. These are the symptoms that bring most men in.
Each of them overlaps with several other conditions. So we confirm low testosterone before we treat it.
What this can be
More than one possible cause.
Low testosterone is one possibility. These others can produce the same symptoms, and some can lower testosterone themselves.
Sleep apnea and poor sleep
Broken sleep lowers testosterone and drains energy.
Excess body fat
Fat tissue converts testosterone to estrogen.
Thyroid dysfunction
Can cause fatigue, weight gain and low mood.
Depression
Shares fatigue, low libido and poor sleep with low testosterone.
Medication effects
Opioids, steroids and some other drugs can suppress testosterone.
Pituitary problems
Including high prolactin, which can lower testosterone.
Alcohol
Regular heavy drinking can lower testosterone.
What we measure
The specific tests we run.
These are the tests we run before any treatment decision.
Total and free testosterone, twice
Drawn in the morning on two separate occasions to confirm a low level.
LH and FSH
Pituitary signals that show whether the problem starts in the testes or the brain.
SHBG
The protein that binds testosterone, needed to interpret free testosterone.
Prolactin
High levels can point to a pituitary cause.
Estradiol
Baseline estrogen, which can rise on therapy.
PSA
Prostate-specific antigen, checked before starting therapy.
Hematocrit and CBC
Baseline red cell levels, because testosterone can raise them.
Metabolic panel, lipids and A1c
Kidney and liver function, cholesterol and three-month average blood sugar.
Thyroid
TSH with free T4, to rule out thyroid causes of the same symptoms.
Monitoring on therapy
We keep checking.
If you start testosterone therapy, we check hematocrit and PSA on a regular schedule. Testosterone can raise red blood cell levels, which thickens the blood, and PSA is part of prostate monitoring.
We also discuss fertility before starting. Testosterone therapy can reduce sperm production. If you want children now or later, that changes the conversation.
What happens next
Options, depending on what we find.
If two morning tests confirm low testosterone and other causes are addressed, we discuss whether therapy makes sense for you and which form suits you.
If your levels are normal, we don't prescribe testosterone. We look at sleep, weight, thyroid, mood and medications instead.
What it costs
Published pricing.
Initial evaluation
$250
Self-pay
Follow-up visit
$150
Self-pay
We accept PPO plans from Aetna, AmeriHealth, Horizon and UnitedHealthcare, plus Medicare. HMO plans are not accepted. Lab and treatment costs depend on what is ordered.
See full pricing →Frequently asked
Common questions.
Why does the test have to be in the morning?
Testosterone is highest in the morning. A sample taken later in the day can read low even when your levels are normal.
Will testosterone therapy affect my fertility?
It can. Testosterone therapy can lower sperm production, sometimes significantly. If you want children now or in the future, we discuss this before starting, along with alternatives.
What do you monitor once I'm on therapy?
We check hematocrit, because testosterone can thicken the blood, and PSA, as part of prostate monitoring. We also recheck testosterone and estradiol to keep dosing in range.
What if my testosterone is normal?
Then testosterone isn't the answer, and we tell you so. We look at the other possible causes, such as sleep, thyroid, iron, mood and medications.
Do you prescribe testosterone on the first visit?
No. We confirm low testosterone with repeat morning labs and rule out other causes first.
• 6 N Mississippi Ave, Atlantic City
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