Finding a Good Doctor

Finding the right provider makes the difference between a frustrating experience and one where you actually feel better.

Green Flags

A good provider will:

• Test free testosterone (calculated from Total T + SHBG), not just total
• Use the sensitive estradiol assay for men
• Start with reasonable doses (80-120mg/week) and adjust based on labs AND symptoms
• Support frequent injections (at least twice weekly)
• Not automatically prescribe AIs to everyone
• Discuss fertility before starting

Red Flags

Watch out for:

• "We start everyone at 200mg every two weeks"
• "We always prescribe an AI with testosterone"
• "Total testosterone is all you need to test"
• "You're in the normal range, so you're fine" (without considering symptoms)

Types of Providers

• Urologists: Specialize in male health, often experienced with TRT
• Endocrinologists: Hormone specialists, but often focused on diabetes/thyroid
• TRT Clinics: TRT-focused, but quality varies enormously - some over-prescribe
• General Practitioners: Accessible, but most have limited TRT training

The key is finding an individual who understands modern TRT protocols, regardless of specialty.

Telemedicine

Telemedicine TRT is convenient and accessible, but evaluate carefully:

• Do they require blood work before prescribing?
• Do they adjust protocols individually?
• Can you speak with an actual physician?

US Telehealth Regulations (2025)

The Ryan Haight Act normally requires in-person visits for controlled substances like testosterone. During COVID, the DEA waived this requirement.

Current status: COVID-era flexibilities extended through December 31, 2025. A fourth extension through 2026 appears likely.

If regulations tighten: May require in-person visit within 30 days of first prescription. Have a backup plan if you rely on telehealth.

Insurance vs. Self-Pay

Route	Cost	Notes
Insurance	$20-50/month + copays	Cheaper if covered, but may have protocol restrictions
TRT Clinic	$150-400/month	More flexible, but adds up over time

If you can find a knowledgeable provider who takes insurance, that's usually the most economical option.

When to Switch Providers

Consider switching if they:

• Dismiss your symptoms despite supporting labs
• Refuse to test free testosterone or SHBG
• Insist on outdated practices
• Don't monitor safety markers (hematocrit, PSA)

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Next up: Final Words