I LOVE MEN!!  Yes, you read that right.  I love my male patients and I want to help them feel as healthy and vital as possible. One of the important ways for men to optimize vitality is to replace their hormones to youthful levels.  With so much conflicting information out there are you confused about whether or not Testosterone Replacement Therapy is safe?  Well you are not alone.  Since the FDA recently issued a Black Box warning label for all testosterone prescriptions, patients are even more confused about the safety of testosterone replacement.  Despite there being over 60 years of studies showing positive benefit from bio-identical (not anabolic, synthetic) testosterone, there are 2 studies that seem to be causing the confusion.  They were not randomized, controlled clinical trials and both studies have since been determined by a panel of experts to be seriously flawed and limited. This is a classic case of a few bad apples spoiling it for the whole bunch.  For a detailed explanation of these poor studies you can check out:


Another reason why people get confused about the safety of testosterone replacement is because people tend to lump together synthetic and natural testosterone therapy. Synthetic testosterone, abused by body builders, is nothing like the natural testosterone our body makes.  Synthetic testosterone does cause concerning side effects such as increased cholesterol and heart attack risk.  But there is a huge difference between bio-identical testosterone (an exact molecular match to what your body makes) and synthetic (doesn't exist anywhere in nature) testosterone.  Extensive data clearly shows that bio-identical testosterone does NOT increase the incidence of heart attack and stroke - it is actually heart protective!  Ironically, it is low testosterone levels in men that is linked to increased incidence of heart disease and mortality (Malkin et al 2010).

Another large clinical study published in 2015 showed that men treated with testosterone had a 24% reduction in heart attacks, a 36% reduction in strokes, and an unbelievable 56% decreased risk of dying from any cause including all cancers! (European Heart Journal 2015)

OK, fine, but what about testosterone replacement causing Prostate Cancer?  Nope. Not true either.

A collaborative review of 18 studies looked at blood levels of testosterone and estrogen in healthy men compared to men with prostate cancer.  The results showed NO significant association between the risk of prostate cancer and higher hormone levels (Journal National Cancer Institute - Feb 2008).

So then where did the idea that testosterone causes prostate cancer come from? The idea was based on ONE single report from 1941!!  Geesh! Old myths never die. The confusion over testosterone and prostate cancer is explained by the “Saturation Model” that you can read about in the book “Testosterone for Life” by Dr. Morgentaler or in this Life Extension article:  


Harvard professor, Abraham Morgentaler, M.D. did a comprehensive review of the research on testosterone and cancer going all the way back to the 1940’s. Morgentaler’s conclusion is “There is not now, nor has there ever been, a scientific basis for the belief that testosterone causes prostate cancer to grow.”  Researchers are currently giving estrogen and testosterone therapy to active prostate cancer patients since it improves their overall quality of life and survival rate.

What about high estrogen in men causing prostate cancer?  Strike three.  In several studies, the risk of prostate cancer was 30% lower with a doubling of the concentration of estrogen (British Journal of Cancer, June 1999).  It turns out the estrogen is actually apoptotic (kills) prostate cancer cells. The bottom line is that prostate cancer is most common when testosterone levels are low, and lower levels are also associated with increased severity of cancer.

Should men take an estrogen blocker? No! A higher estrogen level in men is heart protective. In fact, most of testosterone’s heart protective benefits come from the conversion of testosterone into estrogen in the body.  Estrogen also helps to prevent Alzheimer’s Disease and boost memory.  In a study reported in the journal Neurology 2005, only the men treated with testosterone that did not have their estrogen levels blocked demonstrated significant verbal memory improvement.  No evidence-based literature shows that raising estrogen is harmful, but numerous studies indicate it is very beneficial for men. Blocking estrogen also results in increased fat mass and decreased sexual function (New England Journal of Medicine 2013)

What about BPH (benign prostatic hypertrophy) and testosterone therapy? Nope, wrong again!  A New England Journal of Medicine meta-analysis 2004 (a review of many studies) determined that there is no evidence that testosterone causes or worsens an enlarged prostate. In fact, it can be beneficial for BPH and symptoms of urinary dysfunction.

Are there any Side Effects with testosterone therapy? As my mentor, Dr. Gino Tutera of Sottopelle®, taught me, “if prescribed appropriately, No.  Men either feel good, great, or awesome!”  Of course there are pros and cons with each type of therapy but I review these in detail with you during your appointment. Something to consider is the potential for transference (contamination) with a topical cream to others such as your kids or wife, so some men may prefer injections or pellets.  Decreased sperm count usually results from all forms of testosterone  which could be a concern in younger men wanting to reproduce.  However, the majority of men seeking hormone replacement are beyond the age when the desire for more children is a concern.  There are alternative treatments available for those who still wish to increase their families.                                                     

Despite old myths, bio-identical testosterone does not cause hair loss, hair growth, acne, aggression, gynecomastia (man boobs), cancer, BPH, sleep apnea, heart attacks or stroke. These side-effects are only associated with high-dose synthetic, anabolic testosterone abuse.

There are many proven benefits to optimizing testosterone back to youthful levels.  What is the optimal level? I aim to get your hormone levels into the upper 1/3 of a normal reference range, NOT just in the normal reference range since the labs ranges are too big! For example, a lab reference range for total testosterone is 250-1000 ng/dl. Your GP may tell you that you are “normal” with a testosterone level of 275. Do you want to feel average or optimal?! The easiest self-test for low testosterone is the absence of morning erections.  Since testosterone levels are naturally highest in the morning, it follows that "normal" levels should produce morning erections.

Benefits of optimized hormone levels include increased strength and stamina, more lean muscle mass and less abdominal fat,  protection against dementia and Alzheimer’s disease, increased bone density,  protection against diabetes and insulin resistance, lower cholesterol,  enhanced mood and well-being, better energy and motivation, improved libido, less erectile dysfunction, better skin tone and collagen, improved healing, protection against heart attack and stroke, lowering of high blood pressure, improvement of arthritis, boost in immune function, strengthened tendons, ligaments, and joints, and improved wound healing..

Testosterone is a controlled substance and requires a prescription from a doctor.  As a Functional Medicine doctor specializing in hormone replacement therapy for the past 15 years, I am well-versed in the complex maze of HRT. I offer a variety of bio-identical hormone prescriptions to meet each patient’s unique needs such as testosterone pellet implants, topical creams or gels, and testosterone injections. The type and dose of hormone is customized for each patient based upon age, lab results, and symptoms.  Schedule an appointment so you can feel GOOD again!

In appreciation of my male patients, I am offering a 20% discount (for new patients only) on the following therapies thru the end of November 2016:

Pellet Hormone Implants have been available for over 60 years, and they're being increasingly recognized for the superior results they achieve. These small (size of a grain of rice) testosterone implants are inserted into the fat tissue in your upper buttock area every 3-6 months. The procedure is virtually pain-free and only takes about 15 minutes. The pellets slowly release testosterone at a constant rate which provides consistent and optimal blood levels.  

"I was diagnosed with low testosterone about 7 years ago and have been using pellets now for the past 3-4 years.  Over the years prior to pellets I tried creams and injections, the creams were very time consuming and messy and did not keep me at a consistent level. The injections for me caused extreme highs and lows and some mood swings and again having to go in for injection was not convenient.  The pellets have been the best thing for me, I go in every 3-4 months for a short painless appointment. Now after being on them for so long I have my timing down for scheduling so I have the pellets inserted on a regular schedule and I have no highs and lows and stay very consistent.  It is the best choice I have made for balancing out my life.                                                                                                     -- Kurt, Seattle

At 57, I had lost all my libido and sexual drive.  This added to my deep depression and lack of energy until I found out about the hormone pellets.  At first, I was skeptical but I decided to try it.  After about one week on the pellets, I was a new man!  My libido and sexual drive was back.  I had more energy and the depression disappeared! I feel like I am reborn!                                                                  -- Kam, Seattle

P-shot (Priapus-shot) uses Platelet Rich Plasma (PRP) to rejuvenate penile tissue and to enhance male erections. The result: better and more frequent orgasms. With a simple blood draw, PRP uses your own stem cells to regenerate tissue and build new blood vessels that promote increased circulation and sensation. This safe, natural process stimulates accelerated repair of muscles and tissue. You grow new tissue with no adverse reaction, as your body does not treat PRP as an invasive substance. Men can expect bigger, firmer and longer-lasting erections and the results can last from 12 to 18 months.

“It is working! I am having much stronger and longer lasting erections. There was some mild discomfort during the procedure but it is totally worth it. I am very happy with the results.”

--JS, Seattle Male Priapus Shot Patient

“I am very pleased with the results of the P-Shot! I can say with confidence that I have larger, firmer, and more sustainable erections.”

--CN, Seattle Priapus Shot Patient

CoolSculpting: CoolSculpting™ is an advanced technology from Zeltiq that uses a controlled cooling process to completely and safely freeze fat cells without harming the surrounding tissues.  Once fat cells are frozen, they will be naturally absorbed by your body and eliminated.  We can precisely target your problems areas such as the love handles, belly area, or chin fat, and the result is permanent.  Permanent fat reduction without surgery! 


 CoolSculpting Treatment for Gynecomastia (Man Boobs):  At Last!  What a fantastic solution for this common but vexing problem in men.  Guys have long been shy about discussing and seeking treatment for this condition that, sadly, is too often considered embarrassing, even before their doctors.  And treatment has been rare and for the most part limited to plastic surgery so consequently most guys just live with it -- and no wonder!  Few surgeons have been skilled enough to guarantee consistent, aesthetically pleasing results.  Surgery is difficult and painful with a long recovery and there is often very evident scarring.  Sometimes, surgical removal of the underlying adipose tissue has left freakish sunken appearance. And it's EXPENSIVE and rarely covered by insurance.

Thank goodness that's soon to be yesterday's bad news; at least in my practice.  Results with CoolSculpting have been uniformly excellent.  So give us a call -- we are booking procedures now.  Just check out the result:

before after testosterone