Testosterone Replacement Therapy (TRT) Follow-Up Care

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Why should you continue to follow-up with your physician throughout your course of testosterone replacement therapy?

 

1.  To check your total testosterone blood levels: When your doctor puts you on an initial testosterone replacement dosage, his or her goal is to get your total level to mid-to-high normal testosterone levels usually between 500 and 700 ng/mL. The initial dose does not always get you into this range, so it may need to be adjusted.

Of course, the goal of testosterone replacement therapy is to reduce the symptoms of low testosterone without causing any significant side effects associated with testosterone therapy. Different men require different testosterone dosages to accomplish this goal. Thus, it is necessary to follow up with a doctor to monitor your testosterone levels, evaluate the effectiveness of therapy, and report any new side effects.

 

2.  To check your prostate health & red blood cell count:  In addition to checking your testosterone levels and making sure they are in the normal range, your doctor will also monitor your prostate health and red blood cell count.

 

  • Digital rectal exam (DRE):  This procedure physically checks the prostate for cancerous growths. Although current medical thinking is that testosterone replacement therapy does not cause or exacerbate prostate cancer, your physician will likely monitor your prostate health until definitive research exists.
  • Prostate Specific Antigen (PSA) Level: Rising PSA levels can indicate the presence of prostate cancer or benign prostatic hypertrophy. Your doctor will most likely check your PSA levels regularly to make sure they do not increase during testosterone replacement therapy.
  • Hematocrit Level (Red Blood Cell Count): Testosterone therapy may also increase your red blood cell count.1,2 Testosterone stimulates erythropoiesis (production of red blood cells). In most cases the increase in hematocrit (the measure of red blood cells) is small (approximately 2 – 5%) and within a safe range. However, for some users, testosterone produces erythrocytosis which occurs when hematocrit levels rise above safe levels over 50%.2 An elevated red blood cell count increases your risk of blood clots that may lead to heart attack and/or stroke among other problems.