Testosterone Replacement Therapy (TRT): What Men in Lewisville Should Know About Optimizing Testosterone
At Health Express Clinics in Lewisville, we’re seeing a growing number of men asking about testosterone therapy—and for good reason. Whether it’s fatigue, low libido, difficulty building muscle, or persistent brain fog, low testosterone (or “Low T”) can significantly impact quality of life. Our clinic offers medically supervised testosterone replacement therapy (TRT), including innovative options like Enclomiphene, with safety, precision, and long-term health in mind.
As a board-certified family physician, I’ve treated countless men with symptoms of hypogonadism. When used properly, TRT can restore energy, motivation, muscle strength, and sexual performance—while improving confidence and emotional well-being.
What Is Testosterone and Why Does It Decline?
Testosterone is the primary male sex hormone responsible for:
- Muscle mass and strength
- Bone density
- Mood and cognitive focus
- Libido and erectile function
- Energy levels and red blood cell production
After age 30, testosterone levels decline by about 1% per year, but some men experience clinical hypogonadism earlier due to:
- Chronic stress
- Obesity and metabolic syndrome
- Sleep apnea
- Environmental toxin exposure
- Prior steroid or opioid use
“When evaluating patients with these symptoms, I always consider root causes—not just hormone levels. TRT isn’t about quick fixes, it’s about strategic hormone optimization,” says Dr. Harveer Parmar.
Signs and Symptoms of Low Testosterone
Common Symptoms Include:
- Low libido or erectile dysfunction
- Fatigue and low energy
- Brain fog or poor memory
- Loss of muscle mass or increased belly fat
- Irritability or low mood
- Poor sleep or night sweats
Local Insight:
At our Lewisville location, many patients with demanding work schedules or irregular sleep patterns report fatigue and low motivation—only to discover that their testosterone levels are well below optimal range.
Diagnostic Approach at Health Express Clinics
We follow evidence-based protocols aligned with Endocrine Society Guidelines and the American Academy of Family Physicians.
Step 1: Initial Evaluation
- Symptom review
- Sleep and lifestyle assessment
- Sexual health and mental well-being screening
Step 2: Lab Testing
- Total testosterone (drawn between 7–10 AM)
- Free testosterone
- SHBG, LH, FSH
- CBC, PSA, estradiol, lipid panel, A1c
Step 3: Confirmatory Testing
- Low total T (<300 ng/dL) on two separate mornings + symptoms
- Evaluate for primary vs secondary hypogonadism
“Many patients come in after using online TRT clinics that prescribed therapy without complete labs. We always start with a full metabolic and hormonal workup to ensure safe, individualized treatment,” explains Dr. Parmar.
Testosterone Therapy Options: Injections, Enclomiphene, and More
1. Injectable Testosterone (Cypionate or Enanthate)
- Most common form of TRT
- Weekly or biweekly intramuscular injections
- Easy titration, affordable
- Ideal for moderate to severe hypogonadism
2. Enclomiphene (Clomid derivative)
- Oral SERM that stimulates natural T production
- Preserves fertility and testicular size
- Best for younger men or borderline cases
“For younger men under 40 who want to preserve fertility, I often start with Enclomiphene before considering full TRT. It supports the body’s own testosterone production without suppression,” says Dr. Parmar.
3. Topical Gels (AndroGel, Testim)
- Daily application
- Lower peaks and steadier levels
- Risk of transference to others (e.g., spouse, children)
4. Implant Pellets
- Long-acting (3–6 months)
- Surgical insertion
- Inflexible dosing; higher cost
Top 5 Questions Patients Ask About Testosterone Therapy
1. Are there side effects of TRT?
Yes—especially if improperly dosed. Side effects of TRT can include:
- Acne or oily skin
- Increased red blood cell count (polycythemia)
- Breast tenderness (from elevated estrogen)
- Reduced sperm production
- Testicular shrinkage
We mitigate risks with regular monitoring, aromatase inhibitor support (if needed), and dose adjustments.
2. Is TRT safe long-term?
Yes, when monitored. Large meta-analyses (e.g., JAMA, 2021) found no increased risk of cardiovascular disease in properly screened, treated men. Monitoring includes:
- CBC every 3–6 months
- PSA for men over 50
- Estradiol levels
- Lipids and insulin resistance markers
3. Can I get testosterone therapy online?
Some online TRT clinics offer convenience but often cut corners on labs or follow-up. At Health Express Clinics, we provide in-person and telehealth TRT—but always with thorough screening, labs, and oversight.
4. Will insurance cover TRT?
Often yes—especially if you meet diagnostic criteria. We assist with documentation and prior authorizations for:
- Injections
- Labs
- PSA screening
5. How quickly will I feel better?
- Libido: 3–4 weeks
- Energy and mood: 4–6 weeks
- Muscle mass and body composition: 8–12 weeks
- Maximum benefit: 6–12 months
TRT vs Enclomiphene – Which Is Right for You?
|
Feature |
TRT (Injections) |
Enclomiphene (Oral) |
|
Primary Use |
Replacement therapy |
Stimulation of natural T |
|
Onset |
Rapid (2–4 weeks) |
Moderate (4–6 weeks) |
|
Fertility Friendly |
❌ No |
✅ Yes |
|
Testicular Atrophy Risk |
Moderate |
Low |
|
Monitoring Needed |
High |
Moderate |
|
Ideal For |
Midlife or older men |
Younger men or borderline T |
“At our Lewisville clinic, I often start younger patients on Enclomiphene and reserve injectable TRT for those with primary hypogonadism or severe symptoms,” says Dr. Parmar.
❌ “TRT is only for older men.”
✔️ Many men in their 30s and 40s develop symptomatic low T due to stress, obesity, or environmental factors.
❌ “TRT causes prostate cancer.”
✔️ Long-term studies (e.g., Eur Urol, 2022) show no increased prostate cancer risk in well-monitored TRT users.
❌ “You’ll feel like Superman overnight.”
✔️ While some benefits come quickly, full optimization takes consistent treatment, lifestyle change, and follow-up.
Our Clinical Protocol for Testosterone Optimization
1. Patient Selection
- Based on symptoms, labs, and exclusion of contraindications (e.g., prostate cancer, untreated OSA)
2. Customized Plan
- Dosage, frequency, and delivery method
- Option to stack with HCG, aromatase inhibitors, or Enclomiphene
3. Monitoring
- Labs every 3 months initially
- Mood, libido, body comp, and energy tracking
- Titrate based on free T and symptom relief
When to Avoid or Delay TRT
TRT is not recommended if:
- PSA > 4 ng/mL without urological workup
- Hematocrit > 52%
- Active cardiovascular event in past 6 months
- Untreated severe OSA or uncontrolled hypertension
- Desire to maintain high sperm counts (unless using Enclomiphene)
“TRT can be life-changing—but it’s not for everyone. We always prioritize safety, especially in men with preexisting cardiovascular or hematologic conditions,” adds Dr. Parmar.
Local Trends in Lewisville and DFW Area
- Texas Department of State Health Services (2023) notes rising rates of male fatigue, obesity, and ED in men aged 35–60 in North Texas.
- At Health Express Clinics, we’ve seen a 45% increase in male hormone consultations over the past two years. Many patients are working long hours, traveling, or in high-stress jobs, contributing to metabolic and hormonal dysregulation.
Final Thoughts and Call to Action
Low testosterone is more than just a number—it’s a quality-of-life issue. Whether you’re dealing with fatigue, low motivation, poor performance, or loss of drive, testosterone replacement therapy may help you get back to feeling like yourself again.
At Health Express Clinics in Lewisville, we combine cutting-edge hormone therapies with expert clinical oversight. Whether it’s traditional TRT or newer options like Enclomiphene, our protocols are safe, personalized, and science-driven.
👉 Ready to take the next step?
Book your confidential TRT consultation with Dr. Harveer Parmar today.
📍 Serving Lewisville, Denton, Carrollton, and the Dallas-Fort Worth metroplex.