Testosterone Therapy
At InShapeMD, based in Tom Green County, TX, our mission is to help you look and feel your best through testosterone replacement therapy. Conveniently located in San Angelo, TX, we proudly serve the surrounding areas.
As men age, it’s common to experience a decline in testosterone levels, leading to a range of symptoms that can be disheartening. However, with the support of our experienced team and our low T program, we can help you regain your vitality and feel like your younger self again.
Your safety is our top priority! We perform comprehensive lab tests to ensure your treatment is effective and customized to your specific needs. We closely monitor your hemoglobin, hematocrit, and various other markers. All lab testing is covered in your monthly program at no extra charge.
Check your testosterone levels for just $99, with results available the next day.
How to Administer Enclomiphene
Enclomiphene is typically administered in the form of oral tablets but can be compounded as Troches as well. It is taken daily at the same time each day to maintain consistent levels in your body.
Enclomiphene vs. Injectable TRT: Choosing the Right Testosterone Therapy
Enclomiphene is an innovative medication used in testosterone therapy for men, particularly those experiencing low testosterone levels, often referred to as hypogonadism. Unlike traditional testosterone replacement therapies, enclomiphene works by stimulating the body’s own production of testosterone.
How Enclomiphene Works
Enclomiphene is a selective estrogen receptor modulator (SERM) that targets the hypothalamus and pituitary gland. By blocking estrogen receptors, it encourages the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn stimulates the testes to produce more testosterone. This approach helps to restore testosterone levels naturally, rather than simply supplementing them.
Benefits of Enclomiphene
1. Natural Testosterone Production: Enclomiphene supports the body’s ability to produce its own testosterone, which can lead to more balanced hormone levels.
2. Fertility Preservation: Unlike traditional testosterone therapy, which can suppress sperm production, enclomiphene may help maintain fertility in men seeking to conceive.
3. Improved Symptoms: Many men report enhancements in energy levels, mood, libido, and overall quality of life when using enclomiphene as part of their testosterone therapy.
4. Reduces Risk of Testicular Atrophy: Traditional testosterone replacement therapies can lead to testicular atrophy, as they often suppress the body’s natural testosterone production. In contrast, enclomiphene stimulates the body’s own production of testosterone, which helps maintain testicular size and function.
Testosterone Therapy
Testosterone Replacement Therapy
Injectable testosterone replacement therapy (TRT) is a widely used treatment for men experiencing low testosterone levels, known as hypogonadism. This therapy involves administering testosterone directly into the muscle, allowing for a quick and effective restoration of hormone levels. Additionally, we offer oral testosterone options in the form of pills or troches, sourced from FDA-approved compounding pharmacies, to provide flexible treatment alternatives.
Benefits of Injectable TRT Replacement Therapy
1. Rapid Increase in Testosterone Levels: Injectable TRT can quickly elevate testosterone levels in the bloodstream, often within a few days. This rapid onset of action can lead to swift symptom relief.
2. Effective for Severe Deficiency: TRT is often more effective than other forms of therapy, producing noticeable improvements in energy, mood, libido, and overall quality of life.
3. Established Treatment: Injectable testosterone has a long history of use and extensive clinical research supporting its effectiveness and safety, making it a well-understood treatment option.
4. Controlled Dosing: Weekly injections from multi-dose vial allows for precise adjustments to achieve optimal hormone levels.
5. Absorption: Bypasses the liver, leading to fewer potential side effects associated with oral administration.
How to Administer TRT
Testosterone cypionate injections are typically administered intramuscular on a weekly basis. If you prefer not to use the injectable form, alternatives such as oral testosterone are available in pill or troche form. The oral form is taken daily.
Important Considerations with Injectable Testosterone Therapy
Increased levels of Hemoglobin and Hematocrit
One of the more serious risks associated with injectable Testosterone Cypionate is the potential increase in red blood cell production, a condition known as polycythemia. This can raise the risk of blood clots, stroke, or heart attack, making it essential to regularly monitor hemoglobin and hematocrit levels. In some cases, frequent blood donations may be necessary to manage this condition effectively.
Testicular atrophy with TRT
Human chorionic gonadotropin (hCG) is a valuable addition to testosterone therapy for men undergoing treatment for low testosterone levels. While testosterone therapy effectively raises testosterone levels, it can sometimes lead to testicular atrophy and decreased sperm production due to reduced stimulation of the testes.
By adding hCG to testosterone therapy, it helps maintain testicular function and size by mimicking luteinizing hormone (LH), which stimulates the testes to produce testosterone and sperm. This combination can prevent or mitigate the side effects associated with testosterone therapy, such as testicular shrinkage, and support overall reproductive health. Additionally, hCG can help preserve fertility, making it a beneficial option for men looking to maintain their reproductive capabilities while receiving testosterone treatment.
Benefits of Oral TRT Replacement Therapy
Oral TRT: While oral forms can effectively raise testosterone levels, they may not achieve the same peak levels or stability as injectable forms. This is due to factors like first-pass metabolism through the liver, which can affect how much testosterone is bioavailable in the bloodstream.
Injectable TRT is often considered the more effective option for achieving stable testosterone levels, while oral TRT may be preferred for its ease of use. Ultimately, the best choice should be made in consultation with a healthcare provider, who can consider individual health needs and preferences.
- Convenience: Easier to take and may be preferred by those who dislike injections.
- Dosing: Usually requires daily administration, which can be less convenient for some.
- Liver Metabolism: Oral forms are metabolized through the liver, which can lead to more potential side effects, such as liver strain or changes in lipid levels.
Frequently Asked Questions
What is included?
Enrollment in the program requires extensive blood work and a consultation with a Nurse Practitioner, with pricing details provided during the consultation. Upon approval, the monthly fee is $200. This covers any dosage of medication, shipping, supplies, consultations with the Nurse Practitioner, administration of weekly injections, and all required blood work. There are no membership fees.
Enclomiphene Therapy (troches, sublingual, or oral tablets)
Enclomiphene vs HCG
HCG mimics luteinizing hormone (LH) and stimulates the testes to product testosterone and support spermatogenesis. This makes hCG more suitable for injectable TRT users, as it reduces testicular atrophy. HCG’s primary role in TRT therapy is to stimulate the gonads. However, hCG only mimics LH and does not restore FSH signaling, which is also essential for fertility. Enclomiphene increases both LH and FSH, essential for optimal fertility and less side effects. Enclomiphene is more cost effective than hCG.
Clomid vs Enclomiphene
The difference most people notice with pure enclomiphene is a better overall experience with higher testosterone levels and far fewer side effects. Clomid (clomiphene) contains two isomers: enclomiphene and zuclomiphene. Enclomiphene is the isomer responsible for boosting your testosterone levels, by blocking estrogen signals at the pituitary gland. Zuclomiphene is an estrogen agonist with a long half-life, which builds up to high levels on clomiphene therapy and causes a multitude of adverse effects. Zuclomiphene also actively works against enclomiphene, diminishing the benefits of treatment and limiting the testosterone levels achieved. This is why taking enclomiphene is a much better option than Clomid.
https://pubmed.ncbi.nlm.nih.gov/37546076/
Is Enclomiphene an injection?
It is an oral medication, containing enclomiphene. Unlike TRT, which replaces your testosterone synthetically, enclomiphene increases your natural testosterone production. As a Selective Estrogen Receptor Modulator (SERM), enclomiphene blocks estrogen, tricking the brain into producing the hormones luteinizing hormone (LH) and Follicle Stimulating Hormone (FSH). This increases the testes production of testosterone and sperm, respectively, giving your testosterone a 1.5-2.5x boost without the testicular shutdown, shrinkage, infertility, and dependence of traditional TRT.
Does it boost natural production?
Yes, enclomiphene can boost natural testosterone production in men. It works as a selective estrogen receptor modulator (SERM), primarily by blocking estrogen receptors in the hypothalamus. This action reduces negative feedback on the hypothalamus, leading to an increase in the secretion of gonadotropin-releasing hormone (GnRH). In turn, this stimulates the pituitary gland to produce more luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which promote testosterone production in the testes.
Does it increase hematocrit levels?
Enclomiphene has minimal effects on hematocrit compared to traditional forms of TRT. The effect is not as pronounced as that seen with testosterone replacement therapy (TRT).
Does it cause shrinkage?
Enclomiphene is designed to stimulate the body’s own production of testosterone and is generally considered to be less likely to cause testicular shrinkage compared to exogenous testosterone replacement therapy (TRT). When men undergo TRT with external testosterone, their bodies may reduce or halt natural testosterone production, leading to testicular atrophy (shrinkage). Enclomiphene works by blocking estrogen at the hypothalamus, which can increase luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels, promoting the natural production of testosterone and supporting testicular function.
Does it decrease sperm count and infertility?
Enclomiphene is generally intended to stimulate the body’s own production of testosterone and may help improve sperm production rather than decrease it. By increasing the levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), enclomiphene can promote testicular function and enhance spermatogenesis, which is the process of sperm production.
What about estrogen and how do you balance that?
It isn’t possible to increase testosterone without also increasing estradiol, unless your approach incorporates some form of aromatase inhibition. In other words, both TRT and enclomiphene will increase estradiol proportionately as testosterone rises. You will feel the full force of those elevated E2 levels on TRT, whereas enclomiphene is blocking some estrogen receptors in tissues and mitigating the effects of higher E2. We do have estrogen blockers available and prescribe them in those rare cases where it’s needed.
Does it affect the liver?
No adverse effects of enclomiphene on the liver were noted in clinical trials. Raising testosterone levels is actually one of the best ways to prevent or reverse fatty liver.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099110/
What happens if you stop taking it?
While enclomiphene is not typically associated with withdrawal symptoms, some individuals may experience changes in mood or energy levels as their body adjusts to the absence of the medication. Upon discontinuation, your body may revert to its baseline hormonal status, leading to a decrease in testosterone levels over time. This decline can affect various bodily functions, including mood, energy levels, and libido.
Can I just stop the enclomiphene without side effects?
You can just stop without tapering, and your elevated testosterone levels will drop back down to your natural baseline.
Are my levels low enough to qualify?
Levels below 300 ng/dL are often considered low enough to warrant investigation and potential treatment. If your testosterone levels are above this range, they are typically not considered low enough to qualify for testosterone replacement therapy (TRT). However, symptoms and overall health are also important factors to consider. We are guided by more than just a number.
How long does it take to restore normal levels after transitioning to Enclomiphene
It can take up to 3 months to restore your natural testosterone levels
Can I use my Flex spending account (HSA/FSA)?
Yes we accept both. We do not accept any type of insurance
Can I switch from clomiphene to enclomiphene without a waiting period?
Yes you can switch right away
Do I need blood work
Yes, blood work is required. We labs at the beginning of your program to establish baseline levels, followed by additional tests 30 days after each dose increase to monitor your progress. After that, we perform blood tests bi-annually to ensure that your hormone levels remain balanced and to assess your overall health. If necessary, we may schedule more frequent testing based on your individual needs or any specific concerns that may arise during your treatment. Rest assured, all lab tests are included as part of your program, so you can focus on your health without worrying about additional costs.
What are the negative side effects?
Clinical studies have assessed the safety and efficacy of enclomiphene in treating male hypogonadism. Common side effects reported include mood changes, hot flashes, and visual disturbances.
I am no longer producing much Testosterone due to my age, will this help?
Enclomiphene stimulates an increase in your natural production of testosterone, which depends on functional testes. 85% of hypogonadal men have secondary hypogonadism, where the testicles are functional, and these men will respond well to enclomiphene. On the other hand, 15% have primary hypogonadism which will require testosterone replacement.
Peer-reviewed research
Here is a good summary of peer-reviewed research using enclomiphene to treat hypogonadism:
https://pmc.ncbi.nlm.nih.gov/articles/PMC5009465/
Hair Loss
Anything that increases testosterone may accelerate male pattern baldness if you are genetically susceptible to it. However, enclomiphene does not increase DHT to supraphysiologic levels like some forms of TRT, and may be less likely to cause hair loss for this reason. If hair loss becomes a concern, we are able to prescribe dutasteride and other hair protective medications.
Increase in blood pressure
No effects on blood pressure were noted in clinical trials. Enclomiphene has minimal effect on hematocrit compared to other forms of TRT and that may be relevant here
https://academic.oup.com/…/13/Supplement_1/S60/7003618
Libido
It’s possible not to experience a libido benefit with a poorly managed enclomiphene protocol (this happens very often with traditional TRT as well). We can adjust dosage and frequency to maximize libido benefits and prevent adverse effects. Most patients are satisfied with their libido after treatment.
Does it cause Gynecomastia?
SERMs like enclomiphene selectively block estrogen receptors at the breast tissue so gynecomastia is not a concern. It isn’t possible to increase testosterone without also increasing estradiol, unless your approach incorporates some form of aromatase inhibition. In other words, both TRT and enclomiphene will increase estradiol proportionately as testosterone rises. You will feel the full force of those elevated E2 levels on TRT, whereas enclomiphene is blocking some estrogen receptors in tissues and mitigating the effects of higher E2. Estrogen blockers are rarely required with enclomiphene. We do have them available and prescribe them in those rare cases where it’s needed.
What is the difference between Enclomiphene and Enclomiphene Citrate?
Enclomiphene” refers to the active drug compound itself, while “enclomiphene citrate” is the salt form of that compound, essentially the drug combined with a citrate ion, which is often used to make the medication easier to administer orally.
Is it safe for Diabetics
Yes, in fact, increasing testosterone is one of the best ways to improve health in diabetics.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037582/
Blood Thinners
We do not prescribe testosterone-boosting therapies to men on prescription blood thinners.
FDA compounds
The parent compound clomiphene, which contains enclomiphene as its active ingredient, was first FDA approved in 1967. Pure enclomiphene is approved for bulk compounding as of December 12, 2023 under Section 503A of the FD&C Act by pharmacies that fall under FDA regulation and jurisdiction. All of our pharmacy partners are FDA regulated compounding pharmacies.
Data on long term use?
There is some published studies on clomiphene which enclomiphene is much safer.
https://pubmed.ncbi.nlm.nih.gov/31216250/
TRT Therapy (injectable, troches, or oral tablets)
Does it shut down your normal testosterone production?
When external testosterone is introduced into the body through TRT, the hypothalamus and pituitary gland detect the increased levels of testosterone. In response, the pituitary gland reduces the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH and FSH are essential for stimulating the testes to produce their own testosterone. With lower levels of these hormones, the testes may produce significantly less of your own testosterone.
Does it cause testicular shutdown
Yes, TRT therapy can lead to testicular shutdown, also known as testicular atrophy. This occurs because external testosterone supplementation can suppress the body’s natural production of hormones, particularly luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
Does it cause shrinkage?
When TRT is administered externally, the body senses the increased levels and reduces the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones are essential for stimulating the testes to produce their own testosterone and sperm. With lower levels of LH and FSH, the testes may produce less testosterone and sperm, leading to a reduction in size and function over time. Some treatments, like enclomiphene, aim to stimulate the body’s own testosterone production without causing significant testicular atrophy, making them an option for those concerned about this side effect. We can add HCG to your TRT program to counter act testicular atrophy.
Decreased sperm count and infertility
TRT typically increases testosterone levels in the body. However, this external source of testosterone can suppress the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland. Both LH and FSH are essential for stimulating the testes to produce testosterone and sperm. With reduced levels of LH and FSH, the testes may produce less sperm, leading to lower sperm counts. This reduction can result in oligospermia (low sperm count) or even azoospermia (absence of sperm in the semen) and loss of fertility.
Excess red blood cells
Yes, testosterone replacement therapy (TRT) can lead to an increase in red blood cell production. Testosterone stimulates erythropoiesis, the process of red blood cell formation, which can result in elevated hemoglobin and hematocrit levels. However, this increase can sometimes lead to concerns about polycythemia, a condition characterized by an excessive number of red blood cells. It’s important for individuals undergoing TRT to have regular blood tests to monitor these levels and ensure they remain within a safe range.
Frequent blood donations
Yes, individuals undergoing testosterone replacement therapy (TRT) may be advised to donate blood more frequently if they experience elevated red blood cell counts (a condition known as polycythemia). Elevated red blood cell levels can increase the risk of cardiovascular issues or stroke, so regular blood donations can help manage these levels and maintain a safer hematocrit and hemoglobin range. It’s important for those on TRT to have regular blood tests to monitor their blood counts. and to consult with their healthcare provider about the appropriate management strategy, which may include blood donation.
Worsen sleep apnea
Testosterone replacement therapy (TRT) can potentially worsen sleep apnea in some individuals. While testosterone can have beneficial effects on sleep and mood, it may also lead to an increase in the severity of obstructive sleep apnea (OSA) in certain patients. This is particularly a concern in men who already have existing sleep apnea, as testosterone can lead to increased muscle tone in the throat, which may exacerbate airway obstruction during sleep. If you have a history of sleep apnea or are experiencing symptoms such as loud snoring, gasping for air during sleep, or excessive daytime sleepiness, it’s essential to discuss this with our clinic before starting TRT. We may recommend a sleep study or other evaluations to assess your risk and determine the most appropriate course of action.
Mood dysregulation & Anxiety
Testosterone replacement therapy (TRT) can have varying effects on mood and anxiety. For some individuals, TRT may improve mood, increase energy levels, and reduce symptoms of depression and anxiety. However, in others, it can lead to mood dysregulation, irritability, or increased anxiety. Higher doses of testosterone can sometimes lead to more pronounced mood swings or aggressive behavior. Each person’s body reacts differently to hormonal changes. Some may experience improvements, while others may have negative effects. Pre-existing mental health issues can also play a role in how an individual responds to TRT.
Excess estrogen
Yes, testosterone replacement therapy (TRT) can lead to an increase in estrogen levels in some individuals. This occurs because testosterone can be converted into estrogen through a process called aromatization. To manage this, we monitor estrogen levels and, if necessary, prescribe aromatase inhibitors to help reduce estrogen production. Regular monitoring and communication with our clinic is essential to ensure that hormone levels remain balanced during TRT.
Frequency of lab testing
We conduct blood panels at the beginning of your program to establish baseline levels, followed by additional tests 30 days after each dose increase to monitor your progress. After that, we perform blood panels bi-annually to ensure that your hormone levels remain balanced and to assess your overall health. If necessary, we may schedule more frequent testing based on your individual needs or any specific concerns that may arise during your treatment. Rest assured, all lab tests are included as part of your program, so you can focus on your health without worrying about additional costs.
Can I use my Flex spending account (HSA/FSA)?
Yes we accept both. We do not accept any type of insurance
Testosterone Application Method Used at InShapeMD
After careful analysis of all the available application methods, InShapeMD San Angelo utilizes the injection method. For a listing of the Pros and Cons of the different methods, click here. Weekly injections provide a sustained release of testosterone into the bloodstream, and helps avoid extreme fluctuations in testosterone levels between treatments. Another advantage is that the weekly process provides convenient, consistent communication and monitoring with the staff. So if, for example, dosage adjustments are needed, they can be implemented swiftly and seamlessly into the treatment schedule, ensuring that you achieve optimal testosterone concentrations.
Restore Your Vitality with Testosterone Replacement Therapy (TRT) in Texas
Are you experiencing a decline in energy, decreased muscle mass, or a dip in libido? These could be signs of low testosterone. If you live in Texas and suspect you might have low testosterone, InShapeMD can help.
We offer comprehensive hormone therapy, including testosterone replacement therapy (TRT), to help men regain their vitality and overall well-being.
Testosterone is a vital hormone responsible for regulating male sexual function, muscle mass, and energy levels. As men age, testosterone production naturally declines. This can trigger a variety of symptoms that affect both your physical and emotional health.
InShapeMD’s TRT program in San Angelo, TX, provides a safe and effective way to restore healthy testosterone levels.
Our personalized approach involves:
- Initial Consultation:A healthcare professional will discuss your symptoms, medical history, and lifestyle to determine if TRT is right for you.
- Lab Testing:We’ll perform a comprehensive blood test to measure your testosterone levels.
- Customized Treatment Plan:Based on your test results and individual needs, we’ll develop a personalized testosterone replacement therapy plan that may include injections, gels, or patches.
- Ongoing Monitoring:We’ll closely monitor your progress and adjust your treatment plan as needed to ensure optimal results.
Contact InShapeMD today to schedule a hormone therapy consultation today.
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