Hormone Optimization

Hormone Optimization at The Men’s Clinic

If you’re looking for a clinic to prescribe you testosterone after a quick blood test, we are not the place. We do not offer testosterone therapy as a standalone service, and we do not operate like the typical “men’s T clinic.” Hormone optimization is just one part of our comprehensive Wellness Management Program, which also includes concierge-level care, metabolic and performance assessments, and long-term health planning.

We are here for men who want to do the real work—those who are interested in understanding the deeper causes behind their symptoms, correcting lifestyle and metabolic imbalances, and only considering hormone therapy if it’s truly appropriate.

Why “Low Testosterone” Isn’t Always the Problem

Many men associate fatigue, low libido, muscle loss, or mood changes with “low T,” and assume testosterone therapy is the obvious next step. But those symptoms are non-specific and can result from poor sleep, stress, nutrient deficiencies, overtraining, insulin resistance, and other causes.

In a 2015 study published in JAMA Internal Medicine, over 20% of men who received testosterone therapy had not even had their testosterone levels tested prior to starting treatment (Baillargeon et al., 2015). Even more concerning, another analysis showed that up to 40% of patients on testosterone did not meet criteria for hypogonadism, and many were not appropriately monitored after starting therapy (Layton et al., Journal of Clinical Endocrinology & Metabolism, 2015).

This type of treatment model, “symptom, shot, repeat”, is not only poor medicine; it also misses the root cause.

What Most Doctors and Endocrinologists Miss

The reality is that most primary care physicians receive little to no training in male hormone optimization. Endocrinologists, while highly trained, operate under very conservative guidelines that require repeated, consistently low testosterone levels, often below 264 ng/dL, before even considering therapy. These thresholds are based on population norms and disease frameworks, not on performance, function, or quality of life.

According to the Endocrine Society’s 2018 clinical guidelines, testosterone therapy should only be initiated in men with clearly low testosterone and significant symptoms. This means that many men with borderline or “normal” levels, but significant dysfunction, are told nothing is wrong.

That guidance isn’t entirely wrong: testosterone isn’t a miracle drug, and it shouldn’t be treated as one. But neither should we ignore its value when applied carefully, especially in men who have already optimized other variables.

Our Clinical Philosophy: A Balanced, Research-Based Approach

At The Men’s Clinic, our protocol includes a thorough evaluation of:

• Total and free testosterone (measured in the morning, repeated when necessary)
• Sex hormone-binding globulin (SHBG), estradiol, LH/FSH, DHEA-S, and prolactin
• Micronutrient and metabolic status
• Sleep quality, training patterns, stress physiology, and inflammatory markers
• Symptom history and individual androgen sensitivity

We recognize that some men feel and function well with testosterone levels that are below population norms, while others have symptoms even within the “normal range.” This may relate to variability in androgen receptor density and sensitivity, a topic explored in genetic and endocrinology literature (Zitzmann, Asian Journal of Andrology, 2008).

We do not use one-size-fits-all algorithms. We take context into account.

Lifestyle First: Testosterone Isn’t the Starting Point

Before ever considering testosterone therapy, we work with our patients to optimize what we know influences hormone balance:

• Sleep: Even short-term sleep deprivation significantly reduces testosterone levels. One study found that 5 hours of sleep per night for one week reduced testosterone by 10–15% in healthy young men (JAMA, 2011 – Leproult & Van Cauter).
• Training: Both resistance and aerobic exercise increase endogenous testosterone and improve receptor signaling.
• Body fat: Visceral adiposity is associated with reduced testosterone via aromatization and inflammation.
• Nutrition and micronutrients: Deficiencies in zinc, magnesium, vitamin D, and omega-3s all correlate with lower testosterone levels.
• Stress: Chronic cortisol elevation can suppress the hypothalamic-pituitary-gonadal (HPG) axis.

Once these domains are optimized, many men improve without hormone therapy. In fact, several observational studies suggest that the majority of men on testosterone today may not need it if foundational issues were fully addressed (Corona et al., Nature Reviews Urology, 2014)

Our Hormone Optimization Protocol

We do not offer this as a standalone product. It is a component of our broader Wellness Management Plan.

The protocol includes:

• Lab analysis of key hormonal, inflammatory, metabolic, and nutritional markers
• In-depth clinical review and risk/benefit assessment
• Ongoing monitoring, follow-up labs, and dosing adjustments (if therapy is started)
• Clear education about potential side effects, including infertility, polycythemia, acne, mood volatility, and prostate changes
• Coordination with the rest of your health plan—including training, sleep, diet, and recovery strategies

Therapy, if appropriate, may improve body composition, bone density, insulin sensitivity, and overall well-being, but only when it’s the right intervention, at the right time, in the right patient.

Bottom Line: We’re Not a Shortcut Clinic

We don’t offer quick-start testosterone. We don’t treat numbers in isolation. And we don’t chase symptoms without understanding the full picture.

If you’re looking for meaningful, long-term health improvement—including the possibility of hormone optimization within a complete clinical framework—then we’re here for you.

But if you’re only interested in checking your testosterone and getting a prescription, this is not the clinic for you.

Hormone Optimization FAQs