There is no weight you have to be at to begin TRT. We see underweight, normal weight, overweight, and obese men who are hypogonadal, and need TRT.

Low testosterone means three things when it comes to weight management: you lose muscle mass (which you need to keep your metabolism high), you gain fat easier, and you have no energy to exercise. Trying to lose weight while also having low T is like trying to swim with your hands tied behind your back. It can be done, but it is so much harder.

Obesity is a risk factor for low testosterone, but paradoxically, low testosterone is a risk factor for obesity. It makes no sense to force patients to try to lose weight to increase their testosterone, when in reality, low testosterone may have caused it in the first place.

The main and only risk with starting TRT while obese is that the aromatase enzyme is found in the adipose tissue. Aromatase is what converts testosterone into estrogen. There is a risk that you may convert an excess amount of testosterone into estrogen when you start TRT, though there are ways to mitigate this, so it is not a reason not to start TRT if you still have weight to lose.

Believe it or not, TRT has been proven to both improve blood pressure and reduce risk of cardiac events. In fact many cardiologists are now prescribing it. It can have some detrimental effect on the HDL cholesterol (good cholesterol), but actually has not been shown to worsen LDL (bad cholesterol).

We have a large number of military patients that use our service primarily because of the difficulties they have had trying to go the traditional route with Tricare or VA insurance. In our experience, Tricare and VA insurance are the least likely to approve TRT. We offer a military discount for this reason.